Interactional synchrony and negative symptoms: An outcome study of body-oriented psychotherapy for schizophrenia

Objective: We sought to assess the efficacy of a manualized body-oriented psychotherapy (BPT) intervention for schizophrenia, by focusing on improvement of negative symptoms and on changes in interactional synchrony. We also explored aspects of a phenomenological theory of schizophrenia, which states that negative symptoms should be understood within an encompassing disturbance of subjectivity and intersubjectivity. Method: Sixteen persons with schizophrenia participated in 10 weeks of BPT. General psychiatric symptomatology and negative symptoms were assessed before and after therapy. Interactional synchrony was assessed via cross-correlations of movements between patient and interviewer in interviews conducted before and after therapy. Results: Psychiatric symptomatology and negative symptoms significantly improved with a medium effect size. We also demonstrated a significant increase in interactional synchrony with a strong effect size. Post hoc analyses showed a significant increase only with open-ended interviews conducted by the same interviewer. Furthermore, we explored the correlation between negative symptoms and interactional synchrony, finding a large inverse relationship. Conclusions: BPT for schizophrenia may effectively reduce patients’ negative symptoms and psychiatric symptomatology. Moreover, it may yield some recovery of pre-reflective social relations. Further evidence of the specific relation between negative symptoms and interactional synchrony would support a phenomenologically informed holistic view of schizophrenia.     

重症颅脑损伤并医院肺内感染的临床分析

目的　控制重症颅脑损伤合并医院肺内感染的发生； 方法　采取回顾性调查的方式对院内６ 年来神经外重症颅脑损伤发生肺内感染因素进行分析；结果　发现感染因素主要与创伤重、昏迷、侵袭性操作、应用大量激素和抗生素使用不合理有关；结论　控制感染应从保持呼吸道通畅入手，严格无菌操作，严格消毒灭菌，加强病房管理， 宏观调控抗生素的应用     

严重腹部损伤病人早期血钾变化分析

目的了解严重腹部损伤病人早期血钾变化情况；方法对64例严重腹部损伤病人（ISS评分≥16）在入院2-72h内进行血清钾测定；结果49例存在不同程度的低血钾，最低仅2.15mmol/L； 结论低血钾在严重损伤病人是广泛存在的，严重可影响病人呼吸、循环功能的复苏，应引起临床医生的高度重视。     

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目的前瞻性随机对照观察结肠次全切除联合改良Duhamel术与结肠次全切除术治疗重度功能性便秘(severe functional constipation,SFC)的疗效及并发症。方法分析南京军区南京总医院2004年6月至2006年7月间31例经过严格非手术治疗后效果欠佳的SFC临床资料,随机分为结肠切除组(n=10)和联合切除组(n=21),经过对结肠镜、结肠传输试验和排粪造影等检查结果的分析,分别行结肠次全切除和结肠次全切除联合改良Duhamel术治疗。均随访1年以上,对比两组术后近期疗效。结果两组术前临床资料差异无显著性意义,均手术成功。联合切除组随访1年后胃肠生活质量指标评分[(107.6±8.2)对(92.1±9.6)分]、便秘症状指标改善度[(73.6±8.2)%对(60.3±8.5)%]和便秘复发率(9.5%对60.0%)等方面明显好于结肠切除组。两组术后肛门排气时间、术后平均住院日、术后早期并发症和大便失禁等方面差异无显著性意义。结论结肠次全切除联合改良Duhamel术治疗SFC较结肠次全切除术对于胃肠生活质量改善更明显,是较为合理、疗效较好的手术方案。     

重症急性胰腺炎心脏损伤的发病机制

重症急性胰腺炎早期炎症介质使微循环血管通透性增加,组织间隙积液,胰腺组织水肿、坏死,腹腔内大量体液积蓄,二者导致有效循环血量急剧下降,回心血量下降.随着有效循环血量进行性下降,冠脉血流不足,心肌细胞缺血,心肌受到不同程度的损伤,心脏负担相对过重,心肌纤维被动拉长易位,导致心肌细胞膜的损伤.炎症介质连锁反应和放大效应使机体大量释放细胞因子如TNF-α、细胞介素、氧自由基等活性物质,导致心肌细胞的完整性受损,心肌细胞凋亡,心脏功能障碍甚至衰竭.此外,腹腔间隔综合征、胰腺炎相关性腹水、电解质紊乱等也是参与其发生的重要因素.     

茵陈承气汤对大鼠急性出血坏死性胰腺炎腺泡细胞凋亡及调控基因的影响

目的 :研究茵陈承气汤对大鼠急性出血坏死性胰腺炎腺泡细胞凋亡及调控基因Bax表达水平的影响。 方法 :胰胆管内注射去氧胆酸钠制备大鼠急性出血坏死性胰腺炎模型 ,随机分为对照组 ,模型组 ,中药 (茵陈承气汤 )治疗组 ,观察各组大鼠胰腺组织病理学、血清淀粉酶、IL - 6、IL - 8的变化 ,应用TUNEL法分析急性胰腺炎时胰腺腺泡细胞凋亡情况 ,WesternBlotting检测凋亡调控基因 -Bax的表达情况。 结果 :中药组大鼠血清淀粉酶 ,IL - 6、IL - 8水平较模型组低 ,病情明显改善 ,两组差异有显著性 (P <0 0 5 ) ;模型组凋亡指数为 2 34± 1 15 ,中药组为 11 5 2± 3 41,P <0 0 1;模型组Bax的表达水平为 96 8± 2 76 ,中药组为 1331± 112 ,P <0 0 1。 结论 :茵陈承气汤可能通过上调促凋亡基因Bax的表达水平 ,诱导已受损的腺泡细胞发生凋亡 ,减轻腺泡细胞坏死 ,减少胰酶及炎性介质的释放 ,从而有利于防止急性胰腺炎的病理损害恶化     

急性重症胰腺炎42例治疗体会

急性重症胰腺炎(SevereAcute Pancreatitics.SAP)是外科常见病、多发病,进展凶猛、病情复杂,并发症多、愈后差。目前国内外对SAP诊断的认识已基本一致。非手术治疗已逐渐为大家所接受,而手术治疗中手术指证、时机及方式的选择上仍有诸多争议。现将我院1999年至2005年12月份收治的重症胰腺炎42例的治疗经验总结报告如下。1资料和方法1.1一般资料男20例,女22例,年龄22岁~82岁,平均急性重症胰腺炎42例治疗体会@杨东亮$莱芜市中医院!山东莱芜271100急性重症胰腺炎;;治疗方法;;效果[1]中华医学会外科学会胰腺学组.急性胰腺炎的诊断及分级标准[J].中华外科杂志,1997,35(12):773.     

左西孟旦联合氢氯噻嗪治疗重症心力衰竭的临床研究

目的 探讨左西孟旦联合氢氯噻嗪治疗重症心力衰竭的临床疗效。方法 选取2020年7月—2023年7月复旦大学附属中山医院青浦分院重症监护室收治的100例重症心力衰竭患者，按随机数字法将所有患者分为对照组和治疗组，每组各50例。对照组患者口服氢氯噻嗪片，50 mg/次，2次/d。治疗组在对照组的治疗基础上静脉滴注左西孟旦注射液，5 mL加入5%葡萄糖注射液500 mL中。两组用药7 d。观察两组的临床疗效和临床症状改善时间，比较两组治疗前后心功能指标、生活质量综合评定问卷调查表（CQOLI-74）评分和血清细胞因子水平的变化情况。结果 治疗后，治疗组总有效率是98.0%，显著高于对照组的82.0%（P＜0.05）。治疗后，治疗组呼吸困难、乏力、气促、下肢水肿好转时间均短于对照组（P＜0.05）。治疗后，两组左室射血分数（LVEF）、心排血量（CO）、GQOLI-74评分均显著高于同组治疗前（P＜0.05）；治疗后，治疗组LVEF、CO、GQOLI-74评分高于对照组（P＜0.05）。治疗后，两组β型脑钠肽（BNP）、可溶性生长刺激表达基因2蛋白（sST2）、同型半胱氨酸（Hcy）、胱抑素C（CysC）水平均较同组治疗前显著降低（P＜0.05）；治疗后，治疗组BNP、sST2、Hcy、CysC水平低于对照组（P＜0.05）。结论 左西孟旦联合氢氯噻嗪治疗重症心力衰竭有较好的临床疗效，能有效改善患者的临床症状，增强心功能指标，降低机体炎性反应，值得临床借鉴应用。     

CSF Baclofen levels after intrathecal administration in severe spasticity

Summary The pharmacokinetic parameters in the CSF of baclofen given to 4 patients as an intrathecal bolus are reported. Considerable inter-individual variability in the parameters was observed. The elimination half-life ranged from 0.9 to 5 h and the clearance from 0.013 to 0.08 l·h^–1.In order to optimize treatment, it is suggested that CSF baclofen levels be matched to changes in Hoffman's monosynaptic reflex (H reflex).     

Flexible,intensive insulin therapy and dietary freedom in adolescents and young adults with Type 1 diabetes: a prospective implementation study

Aims To assess the outcome of a Diabetes Treatment and Teaching Programme (DTTP) on glycated haemoglobin (HbA_1c), severe hypoglycaemia (SH) and severe ketoacidosis (SKA) in adolescents and young adults with Type 1 diabetes. Methods Quality-assurance project with assessment of participants 1 year after participation in a DTTP (5-day inpatient course, groups ≤ 10 patients, fixed curriculum of education/training, introduction of dietary freedom). Before–after analyses of participants aged 12–15, 15–18, 18–21 and 21–24 years. Main outcome measures were HbA_1c, SH and SKA. Results For the 1592 participants, aged 12 to 24 years, mean age at enrolment was 19 ± 3 years, mean duration of diabetes was 7.3 ± 5.4 (range 0.3–24) years, mean baseline HbA_1c declined from 8.8 ± 2.3% to 8.1 ± 2.0%. The incidence of SH was 0.31 vs. 0.11 events/patient/year; the incidence of SKA 0.17 vs. 0.07 events/patient/year. In mixed effects models taking into account effects of centres, age and diabetes duration, the mean difference was −0.64%[P < 0.001, 95% confidence interval (CI) −0.79 to −0.5] for HbA_1c, −0.2 events/patient/year (P < 0.0001, 95% CI −0.28 to −0.12) for SH and −0.1 events/patient/year (P < 0.0001, 95% CI −0.14 to −0.06) for SKA. Conclusions Adolescents and young adults with Type 1 diabetes benefit from participation in a standard DTTP for flexible, intensive insulin therapy and dietary freedom.