脑卒中后焦虑患者健康相关生存质量及其相关因素

目的:探讨脑卒中后焦虑(PSA)患者健康相关生存质量(HRQOL)及其相关因素。方法:对317例不同临床类型缺血性脑卒中患者进行临床神经功能缺损程度、脑卒中专门化生存质量量表(SS-QOL)评分,对符合PSA诊断的患者进行Hamilton焦虑量表评分;分析与HRQOL相关的因素。结果:PSA发生率为45.11%(143例);不同卒中类型患者PSA发生率差异无统计学意义,SS-QOL评分由低到高依次为完全前循环梗死型、部分前循环梗死型、后循环梗死型及腔隙性梗死型,各型间差异有统计学意义(P0.05)。除语言因子外,PSA组SS-QOL总分及其他各因子明显低非PSA组(P0.05或0.01);焦虑程度重、女性、60岁、未婚或丧偶、高中以上文化程度、家庭月收入2000元、神经功能缺损程度重和住院期间由护工照顾与HRQOL呈相关性。结论:PSA发生率较高,性别、年龄、婚姻状况、文化程度、家庭月收入、神经功能缺损程度、照顾者及焦虑程度是影响PSA患者HRQOL的因素。     

Prevalence and risk factors for posttraumatic stress disorder: a cross‐sectional study among survivors of the Wenchuan 2008 earthquake in China

Background: The impact of the May 2008 Wenchuan earthquake, measuring a massive 8.0 on the surface wave magnitude scale, on public health in China has been significant and multifaceted. In light of extant data on prevalence and risk factors for posttraumatic stress disorder (PTSD) after other natural diasters, we collected data from the Wenchuan earthquake survivors to estimate the prevalence of PTSD and to characterize a range of PTSD risk factors. Methods: A cross‐sectional multicluster sample survey of 446 respondents (201 from the Qiang ethnic‐minority group, 245 the majority Han Chinese group) was conducted in August 2008 in Beichuan county, Sichuan province, a region that was severely affected by the earthquake. In total, 240 households were represented, with a mean of 2.2 respondents per household. Data were collected from structured interviews and the Harvard Trauma Questionnaire (HTQ) and DSM‐IV criteria were used to diagnose PTSD. Results: The prevalence of PTSD was 45.5% (203/446). Low household income, being from an ethnic minority, living in a shelter or temporary house, death in family, and household damage were factors significantly related to increased odds of PTSD. Conclusions: PTSD is common after a major disaster. Postdisaster mental health recovery programs that include early identification, ongoing monitoring, preventive and intervention programs, and sustained psychosocial support are needed for the highest‐risk population, namely, the bereaved, people without incomes and those with serious household damage. These populations may also benefit from governmental and nongovernmental programs that provide social and economic support, as suggested by earlier studies. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Social Optimization in the Presence of Cognitive Local Optima: Effects of Social Network Topology and Interaction Mode

The combined tendency for positive self‐presentation and mimicry or social learning results in the capability of a population of simulated individuals to optimize their cognitive structures. A population of parallel constraint satisfaction networks was created, with globally and locally optimal activation patterns. Individuals started with random activations and interacted to find optimal vectors. Two social network topologies were tested, as well as two modes of interaction; results indicated that the ability to optimize activation vectors depends on the social network configuration and whether individuals are influenced by their best neighbor or are attracted to a neighborhood centroid. Simulated individuals are able to find suitable patterns of belief or attitude with very little internal information processing, using social interaction.     

鹿城区自愿婚检政策负面影响调查与分析

目的通过对2003年自愿婚检政策实施后,鹿城区婚检出现负面影响的调查与分析,提出干预性对策与措施。方法从本地区20岁至45岁公民中随机抽样1500名作为研究对象,对关于婚检意识问卷进行调查和统计分析;同时对婚检机构现状调查以及2002--2007年婚检率和出生缺陷率数据进行Logistic回归分析。结果婚检机构及操作模式不完善是导致婚检率急剧下降的根本原因,婚检率下降则出生缺陷率上升。结论政府部门应制定优生法律法规,婚检机构操作模式应尽快完善,提高婚检率,降低出生缺陷率,提高人口素质。     

新生儿宫内感染68例临床分析

目的探讨新生儿宫内感染的病因及临床影响,提高对宫内感染的认识。方法对68例新生儿宫内感染病因及临床影响进行回顾性分析。结果68例新生儿宫内感染病因以巨细胞病毒最多见（26.47%）,其他依次为乙肝病毒（19.11%）、人乳头瘤病毒（16.17%）、衣原体（11.76%）、支原体（8.82%）、单纯疱疹病毒（7.35%）、风疹病毒（4.41%）、淋球菌（2.94%）、梅毒（1.47%）、弓形虫（1.47%）。临床表现复杂多样,易引起胎儿宫内发育不良,先天畸形,分娩异常,脑发育异常甚至死亡等危害。结论新生儿宫内感染病因复杂多样,以病毒感染为主,临床影响大,后果严重,应引起产、儿科医师的高度重视并加强防治工作。     

Multiple trajectories of peer and parental influence and their association with the development of adolescent heavy drinking

This study used latent growth mixture modeling to identify discrete developmental patterns of heavy drinking, perceived parental disapproval of substance use, and association with peers who drink from early to late adolescence among a sample of 5591 youth. We also examined associations among these trajectories to determine how the development of heavy drinking relates to the development of perceived parental disapproval of substance use and association with peer drinkers, both separately and jointly. We found that youth who perceived that their parents maintained consistently strong disapproval of substance use throughout adolescence were much more likely to abstain from heavy drinking during this period than were youth who reported that their parents' disapproval for substance use either decreased or was maintained at only a moderate level. Furthermore, we found that across a variety of peer contexts—stable high association with drinking peers, stable low association, and increasing association—youth were at lowest risk for developing problematic patterns of heavy drinking when they perceived that their parents maintained strong disapproval of substance use throughout adolescence.     

Counselor skill influences outcomes of brief motivational interventions

The aim of this study was to estimate the influence of counselor skills during brief motivational interventions (BMIs) on patient alcohol use 12 months later. Ninety-five BMIs delivered by five counselors of similar background and training were recorded and coded using the Motivational Interviewing Skills Code (MISC). Baseline alcohol measures and sociodemographics of patients did not differ across counselors, whereas MISC scores and outcome at 12 months did. Multilevel models showed that counselors with better motivational interviewing (MI) skills achieved better outcomes overall and maintained efficacy across all levels of an important predictor (patient ability to change), whereas counselors with poorer MI skills were effective mostly at high levels of ability to change. Findings indicated that avoidance of MI-inconsistent skills was more important than frequency of using MI-consistent skills and that training and selection of counselors should be based more on the overall MI-consistent gestalt than on particular MI techniques.     

From the brain to bad behaviour and back again: Neurocognitive and psychobiological mechanisms of driving while impaired by alcohol

Issues. Driving while impaired by alcohol (DWI) is responsible for substantial mortality and injury. Significant gaps in our understanding of DWI re‐offending, or recidivism, reduce our ability to practically assess recidivism probability and to match interventions to individual risk profiles. These shortcomings reflect the baffling heterogeneity in the DWI population and the limited focus of much existing DWI recidivism research to psychosocial, psychological and substance use correlates. Approach. This narrative review summarises the evidence for the contribution of neurocognitive and psychobiological mechanisms to DWI behaviour and recidivism. Given the nascent nature of this literature, insight into the putative contribution of these mechanisms to DWI is also drawn from other experimental literatures, particularly those on alcohol use disorders and cognitive and behavioural neuroscience. Key Findings. Alcohol‐related neurotoxicity and dysregulation of hypothalamic–pituitary–adrenal axis and serotonergic systems may underlie certain offender characteristics consistently correlated with heightened DWI risk, persistence and intervention resistance. Their markers are less vulnerable to sources of bias than subjective psychosocial indices and are more far‐reaching than alcohol abuse in explaining DWI behaviour and recidivism. Implications. The investigation of neurocognitive and psychobiological mechanisms in DWI research is a promising avenue for discerning clinically meaningful subgroups within the DWI population. This can lead to research and development in alternative assessment and more targeted intervention technologies. Conclusion. Multidimensional research in DWI and recidivism offers novel avenues for increasing road safety.[Brown TG, Ouimet MC, Nadeau L, Gianoulakis C, Lepage M, Tremblay J, Dongier M. From the brain to bad behaviour and back again: Neurocognitive and psychobiological mechanisms of driving while impaired by alcohol. Drug Alcohol Rev 2009;28:406–418]     

影响精神分裂症疗效的相关因素分析

88例精神分裂症患者痊愈回归农村5～9年,病情稳定率37.50%,复发率62.50%.出院后2年为高复发危险期.疗效巩固相关因素逐步回归分析表明:在α=0.05、0.1水平上,选入家庭于预1个因素;在α=0.2水平上,选入性别、年龄、文化、婚姻、治疗依从、家庭经济、家庭干预、生活事件8个因素,其中家庭干预为核心主导因素.结合上述因素,对疗效巩固的影响进行了讨论.     

The blood-nerve barrier: enzymes, transporters and receptors--a comparison with the blood-brain barrier

The blood–brain barrier (BBB) has been much more extensively investigated than the blood–nerve barrier (BNB). Nevertheless it is clear that there are both similarities and differences in the molecular and morphophysiological characteristics of the two barrier systems. A number of enzymes, transporters and receptors have been investigated at both the BNB and BBB, as well as in the perineurium of peripheral nerves, which is also a metabolically active diffusion barrier. While there have been few systematic comparisons of the distribution of these molecules in both the BNB and BBB, it is apparent from the data available, reviewed in this article, that their distribution also supports the concept of the BNB and BBB having some features in common but also showing distinct identities. These similarities and differences cannot simply be accounted for by the presence of the inductive influences of astrocytes at the BBB and absence at the BNB. Whether the Schwann cell also has the capacity to induce some BNB properties remains to be determined.