山西省贫困地区小学高年级学生心理健康状况

目的:深入了解山西省贫困地区小学生心理健康状况,掌握小学高年级学生心理特征,明白实施心理健康教育的必要性。方法:采用心理健康诊断测验(MHT)量表,调查了山西省中部某贫困县城乡结合部小学248名4~6年级学生的心理健康状况。结果:(1)从总体看,严重问题检出率为2.42%,有1项及以上阳性因子数的被试占总体的77.82%;(2)随着受测群体的年级升高,总体心理健康水平在逐渐下降;(3)从男女内容量表得分看,恐怖倾向差异显著(t=-2.065,P0.05);(4)从独生子女与非独生子女的内容量表得分看,冲动倾向差异显著(t=2.792,P0.01);(5)优等生、中等生和后进生在学习焦虑、对人焦虑、孤独倾向、过敏倾向、身体症状、恐怖倾向、冲动倾向上都存在显著性差异(F=4.602~16.142,P0.01);(6)心理健康水平由高到低排序:非独生子女独生子女;城镇学生农村学生;民主型放任型专制型溺爱型。结论:该地心理健康教育基础为零,男生、独生子女、中等生、寄宿生这几类人群心理健康水平较低,家庭、学校、社会需要给予关注。     

大学生身体锻炼与自我效能感、心理健康的关系

目的:考察大学生身体锻炼与自我效能感、心理健康水平三者之间的关系,探讨自我效能感在大学生身体锻炼对心理健康影响中的中介作用。方法:采用随机抽样方法在某大学抽取在校本科生,使用身体锻炼等级量表(PARS-3)、一般自我效能感量表(GSES)和症状自评量表(SCL-90)对346名大学生进行调查,使用描述性统计、t检验、方差分析、相关分析、回归分析和中介效应检验处理数据。结果:大学生的自我效能感和心理健康水平在性别、年级、专业类别、是否独生子女和生源地等人口学因素上均无显著差异,但身体锻炼量存在性别和生源地上的差异:男性的身体锻炼量高于女性(t=3.92,P0.01),城市学生的身体锻炼量高于农村学生(t=2.89,P0.01);大锻炼量群体的自我效能感和心理健康水平都高于小锻炼量群体(t=7.83,8.15;P0.001);身体锻炼量与自我效能感和心理健康水平三者间都存在显著的正相关(r=0.40,0.36,0.38;P0.01);自我效能感在身体锻炼对心理健康的影响中起部分中介作用。结论:身体锻炼可以直接影响心理健康水平,也可以通过自我效能感间接影响心理健康水平。     

3984例男性新兵PDQ-4人格障碍问卷的横断面调查

目的:对新兵集训期间出现人格倾向的情况进行筛查和统计学分析,并研究人格障碍阳性的相关影响因素。方法:采用整群随机抽样的方法,对2013年夏秋季新入伍的士兵进行横断面调查。结果:本文的分析样本为3984例男性新兵。新兵人格障碍总得分(16.83±10.85),总阳性率为12.9%。强迫型人格障碍的阳性率最高(35.1%),而依赖型人格障碍的阳性率最低(3.4%)。民主型的家庭教养方式、自评健康状况好、家庭月收入高是人格障碍阳性的保护因素,而溺爱型和忽略型的家庭教养方式是人格障碍阳性的危险因素。人格障碍总分阴性者,其心理弹性坚韧性、力量和乐观性因子得分及总得分显著高于人格障碍总分阳性者。结论:本研究中部队新兵的人格倾向问题在某种程度上优于其他新兵人群和一些大学生群体。针对不同新兵的特点进行个性化管理和适当的心理干预,以提升其心理健康状况。     

Bifascicular block: a clinical and electrophysiologic study

The effect of surgery, antiarrhythmic drugs, and atrial pacing on the atrioventricular conducting system was studied in 39 patients with bifascicular block.Twenty-nine patients underwent 38 operations, 23 of which were major. A temporary cardiac pacemaker was inserted prior to surgery in 13 cases. The remaining 25 operations were performed without prophylactic pacemakers. In no patient did heart block develop either during surgery or in the first postoperative week.Twelve patients with bifascicular block received digoxin and either quinidine or procainamide in the usual doses. In none was exacerbation of the atrioventricular conduction defect observed.Ten patients had His bundle recordings during atrial pacing performed at gradually increasing rates until second degree heart block developed. Only two patients developed atrioventricular block at pacing rates below normal, one proximal and one distal to the His bundle.     

Dissecting aneurysm (hematoma) limited to coronary artery. A clinicopathologic study of six patients

Clinical and cardiovascular necropsy features are described in six patients (five women) with dissecting aneurysm (hematoma) limited to coronary artery. The coronary dissections occurred spontaneously in two patients, and an intimal or adventitial tear was not identified in either. Four patients had iatrogenic-induced coronary arterial dissections; three had had aortic valve replacement, and the remaining one had a saphenous vein grafted to the dissected coronary artery. Coronary arterial dissection is an infrequently recognized complication of cardiac surgery and a commonly unrecognized cause of coronary arterial luminal narrowing and sudden death. Although believed to be universally fatal, coronary dissection was not fatal in one of our six patients in whom an occlusive chronic (healed) medial dissection and a healed myocardial infarction were observed.     

Effects of tetrodotoxin on electrical and mechanical activity of cardiac Purkinje fibers

Canine Purkinje and ventricular muscle fibers were superfused in vitro and the actions of tetrodotoxin (TTX, 1.56 X 10(-5) - 3.2 X 10(-7) M) on both electrical and mechanical events were studied. Tetrodotoxin reduced the amplitude of the upstroke, markedly shortened the plateau, reduced the maximum diastolic potential and decreased contractile force in Purkinje fibers. Citrate (present in the TTX solution) did not have any effect on electrical and mechanical events. The modifications induced by TTX occurred whether external calcium concentration was normal, high or low. Furthermore, high calcium increased force by a similar extent whether TTX was present or not. TTX has little effect on slow action potentials due to the activation of the slow channel. Action potential duration and force were affected similarly by TTX as a function of concentration, of time of exposure and of rate of discharge. Also, TTX abolished action potentials due to a partially activated fast sodium current and reduced action potential duration and force much less in ventricular muscle than in Purkinje fibers. It is concluded that the effects of TTX are primarily related to a reduction of sodium influx during the action potential and that the fall in force is an indirect consequence of reduced sodium influx.     

A Double-Blind, Placebo-Controlled Pilot Study of Carbamazepine for the Treatment of Alcohol Dependence

Carbamazepine, chemically related to the tricyclic antidepressants, has multiple clinical actions. It is a potent anticonvulsant, mild sedative, and mood stabilizer. It is nonaddictive and has little toxicity when clinical and laboratory monitoring is performed. It has proven efficacy in the treatment of acute alcohol withdrawal. Kindling and protracted withdrawal are the theoretical rationale for the mechanism of its action in the treatment of alcohol dependence. This 12-month double-blind placebo-controlled pilot study of 29 subjects evaluated the efficacy of carbamarepine for the treatment of alcohol dependence. Subjects were randomly assigned to either placebo or carbamazepine. A baseline assessment and bimonthly follow-up for 12 months assessed demographic variables, mood and functioning, treatment compliance, drinking behaviors, biological markers of drinking, and medication toxicity. Despite the small sample size, compliance difficulties after 4 months and a sizable drop-out rate, there were treatment effects favoring carbamazepine. Univariate analyses showed a decrease in drinks per drinking day and maximum number of heavy drinking days in a row at 2 and 4 months of follow-up. Survival analysis revealed a significant delay in time to first episode of heavy drinking, and close to a trend level of significance for time to first drink. There were significant time, but not time by treatment group, effects on multiple measures of mood. These pilot results are encouraging and support carbamazepine as a possible pharmacologic tool in the treatment of alcohol dependence.     

HPLC法外标法快速测定人血清中卡马西平的血药浓度

目的建立高效液相色谱(HPLC)快速测定人血清中卡马西平(CBZ)血药浓度的方法。方法血清样品经甲醇沉淀后,以甲醇-水=58∶42为流动相,流速为1.0mL·min^-1,色谱柱为Agilent 5HC-C 18(250×4.6mn,5μm),柱温为30℃,紫外检测波长为210nm。结果该法专属性较好,血清中杂质不干扰样品峰的测定;CBZ在0.25~50.0mg·L^-1质量浓度范围内线性关系良好,所获回归方程为Y=156.93X+9.7662(R^2=0.9994);批内、批间精密度和准确度均小于15%;血清样品室温及4℃放置24h,样品稳定性均较好。结论HPLC灵敏、快速、准确,操作简便、线性范围宽,可用于CBZ的临床血药浓度监测。     

嗅鞘细胞移植修复大鼠及人类脊髓损伤的Meta分析

目的:综合评价嗅鞘细胞(OECs)移植治疗脊髓损伤(spinal cord injury,SCI)的价值.方法:计算机检索美国国立图书馆(MEDLINE)、PubMed、Ovid-Medline、Ovid-BIOSIS Previews、CNKI、VIP、CBM数据库中关于嗅鞘细胞移植治疗SCI大鼠及患者的随机对照研究.检索时间均为2000年1月至2012年6月.对符合纳入标准的研究以修改后Jadad量表为标准进行质量评价,收集原始数据,采用RevMan5.0软件进行Meta分析.结果:共28篇文章符合标准,Meta分析显示:15篇以大鼠为模型的实验中,OECs组细胞移植6周后,其后肢运动功能(BBB)评分高于对照组,其差异有统计学意义[WMD=1.24,95％CI(1.12,1.35),P＜0.00001];感觉诱发电位(SEP)潜伏期短于对照组,而波幅高于对照组,其差异有统计学意义[潜伏期WMD=-2.33,95％CI(-3.05,-1.60),P＜0.0001;波幅WMD=0.27,95％CI(0.24,0.30),P＜0.00001];运动诱发电位(MEP)波幅高于对照组,差异有统计学意义[MEP振幅WMD=-0.20,95％CI(-0.55,0.15),P＜0.00001];痛觉测量(Plantar test)潜伏期短于对照组,差异有统计学意义[WMD=-1.05,95％CI(-1.38,-0.72),P＜0.00001];受损区脊髓横断面积大于对照组,差异有统计学意义[WMD=0.93,95％CI(0.79,1.07),P＜0.00001]在SCI患者的13篇文献中,OECs移植后患者的运动、轻触觉及痛觉功能评分均高于移植前,差异具有统计学意义[运动WMD=-5.53,95％CI(-7.04,-4.01),P＜0.00001;轻触觉WMD=-1 1.22,95％CI(-12.98,-9.47),P＜0.0001;痛觉WMD=-9.65,95％CI(-11.41,-7.88),P＜0.000011.结论:就目前为止的研究结果分析,OECs移植能促进SCI大鼠及人的脊髓再生及功能改善.