Prevalence and risk factors of chronic kidney disease in first-degree relatives of chronic kidney disease patients in Southern China

Aim: The aim of this study was to estimate the prevalence and risk factors of chronic kidney disease (CKD) in first‐degree relatives (FDRs) of CKD patients. Methods: A cross‐section study of first‐degree relatives of CKD patients was conducted between November 2007 and March 2009 in southern China. A total of 1187 first‐degree relatives (494 male and 693 female; mean age 41.26 years) of 419 CKD patients (194 male and 225 female; mean age 32.10 years) were reviewed and tested for haematuria, albuminuria and reduced glomerular filtration rate. CKD risk factors, including age, gender, body mass index, hypertension and the causes of index case were also investigated. CKD was diagnosed according to the criteria of the National Kidney Foundation‐Kidney Disease Outcomes Quality Initiative. Results: The prevalence of CKD in first‐degree relatives of CKD patients was 29.7% (95% confidence interval [CI]: 27.1%–32.2%). After adjusting for all the potential confounders, older age, female gender, hypertension, hyperglycaemia, hyperuricaemia, hypertriglyceridemic, low level of high density lipoproteins, increased body mass index and nephrotoxic medications were independently associated with increased risk of CKD. Furthermore, relatives of index cases with chronic glomerulonephritis were at higher risk haematuria (ORs = 2.12, 95% CI: 1.45–3.10) compared with relatives of index cases with other kinds of renal diseases. Conclusion: The first‐degree relatives of CKD patients are at high risk of CKD, especially those relatives of CKD patients with chronic glomerulonephritis. Screening in this high risk population might help to identify early CKD patients and make a proper intervention strategy to prevent the disease from quick progression.     

百草枯中毒患者家属对预后不满的原因分析与对策

目的分析百草枯中毒患者家属对预后不满的原因及护理对策。方法回顾分析106例某科收治百草枯中毒过程中患者家属对预后不满原因。结果护理人员的没有主动服务,工作责任心不强,缺乏与患者家属的有效沟通,医护缺乏沟通和配合,相关疾病理论知识缺乏;医疗费用大,效果差;患者家属医学知识缺乏等患者对预后不满是主要原因。结论通过建立良好的护患沟通;加强培训,提高护理人员的素质修养,开展主动服务活动等措施是对减少患者家属对预后不满的有效措施。     

Lymphocyte subset abnormalities,autoantibodies and their relationship with HLA DR types in children with Type 1 (insulin-dependent) diabetes and their first degree relatives

Summary Type 1 (insulin-dependent) diabetes mellitus is associated with abnormalities of circulating lymphocyte subsets and autoantibodies. To investigate the prevalence of these in non-diabetic siblings and non-diabetic parents of children with Type 1 diabetes, we analysed T-cell subsets of function and activation in 31 families with an index case of Type 1 diabetes and related these to autoantibodies and HLA DR type. Using two and three colour cytofluorimetry, we studied total and activated (HLA-DR+) CD3+, CD4+, CD8+ lymphocytes and on CD4+ lymphocytes the CD45RA/RO “naive” and “memory” cell phenotypes. Diabetic children (mean duration of disease 3.1 years) had a reduced total lymphocyte count (p <0.05), their non-diabetic siblings a reduced CD4+ T-helper cell count (p <0.05), and their parents a reduced percentage and number of CD3+ T cells (p <0.01 and p <0.05) compared with age-matched control subjects. Diabetic children, their siblings and parents all had significantly increased levels of activated CD4+ T-helper cells (p <0.01, p <0.05 and p <0.01). In diabetic children and their siblings there was a significant over-expression of the CD45RO “memory” cell marker and significant under-expression of the CD45RA “naive” cell marker, whilst these were normal in the parents. Islet cell antibody positive diabetic children had significantly higher levels of CD45RO-expressing CD4+ lymphocytes than those who were islet cell antibody negative (p <0.05). Amongst the siblings and parents, possession of HLA-DR4 was associated with lower percentages of CD4+ and higher percentages of CD8+ T cells. These findings extend current knowledge about the role of immunoregulatory CD45RA/ RO cells in Type 1 diabetes. In addition, they demonstrate lymphocyte subset abnormalities in unaffected family members, some of which may be influenced by HLA DR alleles. [Diabetologia (1994) 37: 155–165] Received: 1 March 1993 and in final revised form: 16 August 1993     

精神分裂症与轻性精神障碍患者一级亲属心理韧性、应对方式的对照研究

目的 探讨精神分裂症与轻性精神障碍患者一级亲属心理韧性与应对方式的相关性.方法 对精神分裂症及轻性精神障碍（抑郁症、焦虑症、强迫症、恐惧症、躯体形式障碍及神经衰弱）患者的94名一级亲属分为精神分裂症组（重性组）（n=45）和轻性精神障碍组（轻性组）（n=49）.两组采用心理韧性量表（RSA）、简易应对方式问卷（SCSQ）进行问卷调查,并进行比较分析.结果 轻性组与重性组心理韧性评分,社会能力[（22.67±4.59）分、（20.76±4.09）分,P＜0.05]、家庭凝聚力[（25.41±4.34）分,（22.60±4.90）分,P＜0.01]、社会资源[（25.35±4.27）分,（23.24±4.16）分,P＜0.05]及总分[（129.22±12.89）分,（122.60±14.54）分,P＜0.05]均高于重性组;两组简易应对方式评分,积极应对分轻性组高于重性组[（27.45±5.22）分,（23.36±6.46）分,P＜0.05];消极应对分低于重性组[（9.92±3.08）分,（11.64±4.36）分,P＜0.05],总分也高于重性组[（36.72±5.26）分,（34.41±5.61）分,P＜0.05];两组除轻性组自我的知觉与消极应对无相关外,心理韧性与积极应对呈正相关（r=0.238～ 0.434,P＜0.01或P＜0.05）,与消极应对呈负相关（r=-0.274～0.401,P＜0.01或P＜0.05）.结论 轻性精神障碍患者一级亲属心理韧性高于重性组,面对逆境时多采取积极应对方式,两组心理韧性与应对方式有相关性.     

社交焦虑障碍患者及其一级亲属持续性操作测验的研究

目的 探索社交焦虑障碍（SAD）患者及其一级亲属持续性注意功能的特征.方法 收集58例SAD患者及68名一级亲属和60例正常对照者分别进行持续性操作测验（CPT）.结果 在简单操作（RT）中,SAD患者组各项指标[舍弃数（5.2±6.9）个、漏答数（6.7±13.6）个、反应时间（421.0±112.0） ms及变异系数（47.3±38.1）％]均高于一级亲属组[舍弃数（2.9±3.3）个、漏答数（1.5±2.1）个、反应时间（342.0±47.0）ms及变异系数（28.9±10.1）％]及正常对照组[舍弃数（2.8±2.9）个、漏答数（1.3±0.7）个、反应时间（329.0±53.0）ms及变异系数（27.8±9.7）％],差异均有统计学意义（P＜0.01）,而后两组差异无统计学意义（P＞0.05）.而在复杂操作（XT）中,SAD患者一级亲属组CPT指标介于两者之间,差异有统计学意义（P＜0.05）.结论 SAD一级亲属在简单操作中未表现出注意功能障碍,而在复杂操作中SAD患者及其一级亲属都存在一定程度注意功能缺陷.     

Weakened untuned gain control is associated with schizophrenia while atypical orientation-tuned suppression depends on visual acuity

Perceptual distortions are core features of psychosis. Weakened contrast surround suppression has been proposed as a neural mechanism underlying atypical perceptual experiences. Although previous work has measured suppression by asking participants to report the perceived contrast of a low-contrast target surrounded by a high-contrast surround, it is possible to modulate perceived contrast solely by manipulating the orientation of a matched-contrast center and surround. Removing the bottom-up segmentation cue of contrast difference and isolating orientation-dependent suppression may clarify the neural processes responsible for atypical surround suppression in psychosis. We examined surround suppression across a spectrum of psychotic psychopathology including people with schizophrenia (PSZ; N = 31) and people with bipolar disorder (PBD; N = 29), first-degree biological relatives of these patient groups (PBDrel, PSZrel; N = 28, N = 21, respectively), and healthy controls (N = 29). PSZ exhibited reduced surround suppression across orientations; although group differences were minimal at the condition that produced the strongest suppression. PBD and PSZrel exhibited intermediate suppression, whereas PBDrel performed most similarly to controls. Intriguingly, group differences in orientation-dependent surround suppression magnitude were moderated by visual acuity. A simulation in which visual acuity and/or focal attention interact with untuned gain control reproduces the observed pattern of results, including the lack of group differences when orientation of center and surround are the same. Our findings further elucidate perceptual mechanisms of impaired center-surround processing in psychosis and provide insights into the effects of visual acuity on orientation-dependent suppression in PSZ.     

基于红外光谱法的云南重楼及其近缘种的亲缘关系研究

目的傅里叶变换红外光谱(fourier transform infrared spectroscopy,FTIR)结合化学计量学方法分析云南重楼Paris polyphylla var.yunnanensis及其近缘种的亲缘关系,为重楼属药用植物资源的开发利用提供理论依据。方法采集云南重楼、白花重楼Paris polyphylla var.alba、毛重楼Paris mairei、南重楼Paris vietnamensis、五指莲Paris axialis var.axialis共50份样品的红外光谱信息,对光谱数据进行自动基线校正、自动平滑、纵坐标归一化、多元散射校正、二阶求导等预处理,采用主成分分析(principal component analysis,PCA)、偏最小二乘判别分析(partial least squares discriminant analysis,PLS-DA)及系统聚类分析(hierarchical cluster analysis,HCA)分析光谱数据。结果原始红外光谱中,1 653、1 156、1 082、1 021、925、851、759、572、524 cm~(-1)等为重楼属植物的共有峰,主要归属为黄酮、淀粉和糖苷类成分的吸收峰;毛重楼和五指莲分别在1 535和1 369 cm~(-1)附近有特征吸收峰,可与另外3种重楼属植物相区分。以全波段光谱数据进行PLS-DA和PCA,PLS-DA对重楼属植物分类效果优于PCA,能够准确区分5种野生重楼属植物。系统聚类分析(HCA)及向量夹角余弦相关性分析能够反映5个重楼属植物的亲缘关系,云南重楼与白花重楼和南重楼的亲缘关系较近,与毛重楼和五指莲的关系较远。结论 FTIR结合化学计量学方法,能够快速区分不同种类重楼属植物,明确云南重楼及其近缘种之间的亲缘关系,为重楼属植物亲缘关系研究提供一种快速、有效的方法,同时为重楼种质资源开发和利用提供理论基础。     

精神分裂症患者与其一级亲属的社会认知功能比较研究

目的：对比分析精神分裂症患者与其一级亲属在社会认知功能方面存在的差异。方法随机选取100名精神分裂患者和该100名患者一级亲属,调查他们的一般资料,并进行威斯康星卡片分类测验、持续操作测验和韦氏成人记忆量表修订版的测评。通过 t 检验和卡方检验比较患者组和亲属组认知功能的差异。结果无论是亲属组还是患者组,均有超过一半的人存在工作记忆-执行功能缺陷,但两组存在工作记忆-执行功能缺陷的概率差异有统计学意义,患者组存在工作记忆-执行功能缺陷的比例高于亲属组(χ2=4.582,P =0.032);而两组人群的注意障碍(χ2=1.496,P =0.221)和记忆障碍的差异无统计学意义(χ2=3.380,P =0.066)。结论与精神分裂症患者相比,其一级亲属存在工作-执行功能缺陷的比例较低,但存在同样风险的注意障碍和记忆障碍。     

精神障碍患者家属抑郁状况及影响因素

目的 了解住院精神障碍患者家属的抑郁状况并分析相关影响因素,为制定干预措施提供参考依据。方法 于2013年10月-2014年7月,在沈阳市精神卫生中心随机抽取住院的精神障碍患者家属600人,使用抑郁自评量表（SDS）进行问卷调查,并对数据进行logistic回归分析。结果 600名精神障碍患者家属中,SDS标准分为（61.22±11.26）分;抑郁倾向457人,阳性率76.17%;不同性别、年龄的精神障碍患者家属抑郁倾向阳性率比较差异有统计学意义（P<0.05）;多因素分析显示,女性（OR=4.018,95%CI=1.998~8.081）,年龄30~49岁（OR=3.177,95%CI=1.371~7.361）、≥50岁（OR=4.766,95%CI=1.768~12.846）,患病重性精神疾病（OR=15.488,95%CI=7.725~31.052）为抑郁倾向的危险因素;以与患者关系为父母（或长辈）为参照,与患者关系为配偶（OR=0.031,95%CI=0.002~0.559）、子女（OR=0.013,95%CI=0.001~0.240）及兄弟姐妹（OR=0.005,95%CI=0.000~0.088）,家庭人均月收入水平1 500~2 999元（OR=0.117,95%CI=0.035~0.387）、≥3 000元（OR=0.120,95%CI=0.037~0.384）,医疗费用的支付方式为公费（OR=0.099,95%CI=0.040~0.244）均为精神障碍患者家属抑郁倾向的保护因素。结论 住院精神障碍患者家属的抑郁倾向阳性率较高,应引起社会的广泛关注,对其进行积极有效的心理干预非常必要。