Significance of the hepatic mitochondrial redox state in the development of posttraumatic jaundice

The effect of the hepatic energy status on the development of posttraumatic jaundice (PTJ) was studied to clarify the mechanism of PTJ. Fifty-four patients with severe torso injury who were expected to develop PTJ on admission with an average Injury Severity Score of 27 were selected for this study. They were retrospectively divided into three groups according to their maximum bilirubin concentration by day 10: group H, 12 patients with marked elevation of serum bilirubin (>8 g/dl); group L, 23 with mild bilirubinemia (2–8 g/dl); and group N, 19 with no bilirubinemia (<2 g/dl). Group H patients, in whom trauma-related shock was severe and prolonged, developed severe hyperbilirubinemia, and their arterial ketone body ratio (AKBR), which reflects the hepatic mitochondrial redox state and is closely correlated to its energy production, was significantly lower throughout the first week. In contrast, the AKBR increased to an above normal level, indicating enhanced energy production in groups N and L. The serum direct/total bilirubin was also higher in group H. The abnormal hepatic energy metabolism is considered to have reduced the excretion of conjugated bilirubin from the hepatocytes into the bile canaliculi, which is a process that has to proceed against the bilirubin concentration gradient. The subsequent diffusion of the accumulated water-soluble conjugated bilirubin in hepatocytes into the blood is thus considered to be one of the causes of PTJ.     

Assessment of sexual abuse and trauma: Clinical measures

Examined are several measures currently used in the assessment of child abuse, sexual abuse, and trauma. These measures include structured clinical interviews, self report measures, screening inventory, symptom checklist, and some measures that include decision making properties. Issues and implications for clinical practice are explored.     

维持性血透患者的心理状态研究

研究我国血透患者的心理状况并进行针对性的心理治疗。方法 采用症状自评量表(SCL90-R)、多维度健康状况心理控制源量表(MHLC)、艾森克个性问卷(EPQ)及终末期肾脏病(ESRD)患者专用的生活质量表对北京六个医院透析中心的92名维持性血透患者进行了心理状态的研究,并与美国及加拿大相同的研究进行了比较分析。结果 本组的血透存在着抑郁、焦虑、恐怖等心理障碍,出现心理障碍的比例显著高于美国同类患者(P<0.01),且焦虑的发生率高于美国同类患者(P<0.01)。这些障碍与MHLC中机遇项分(CED)显著相关(P<0.01)。EPQ中神经质项分高者倾向于发生抑郁、焦虑等心理障碍。本组的血透患者客观生活质量较加拿大同类患者低(P<0.01),但在总的生活满意度上没有显著性差异。生活质量与心理及躯体因素均呈显著相关,心理障碍与躯体症状也显著相关(P<0.01)。结论 本组的血透患者心理状态与美国加拿大同类患者相比既有相同之处,又有特殊之处。我们应该兼顾病人的躯体和精神两方面的健康,努力提高他们的生活质量。     

聋幼儿情绪状态对认知发展的影响

为促进聋幼儿各方面的正常发展，使其早日回归主流社会，我们对聋幼儿进行了认知和情绪表现的研究。通过问卷调查、观察和实验研究得知，聋幼儿的认知发展和良好情绪的培养是分不开的，认知内容适中有利于聋幼儿良好情绪的培养，而良好积极的情绪又可促进聋幼儿认知的发展。对此，我们实验并总结了培养聋幼儿积极情绪和促进认知发展的方法。     

Novel ROC-type method for testing the efficiency of multivariate statistical methods in fMRI.

The receiver operating characteristic (ROC) method is a useful and popular tool for testing the efficiency of various diagnostic tests applicable to functional MRI (fMRI) data. Typically, the diagnostic tests are applied on simulated and pseudo-human fMRI data, and the area under the ROC curve is used as a measure of the efficiency of the diagnostic test. The effectiveness of such a method depends on how well the simulated data approximate the real data. For multivariate statistical methods, however, this technique is usually inadequate, as the spatial dependence among voxels is ignored for simulated data. In this work a modified ROC method using real fMRI data with a broader scope is proposed. This method can be applied to most fMRI postprocessing techniques, including multivariate analyses such as canonical correlation analysis (CCA). Also, the relationship of the modified ROC method with the conventional ROC method is discussed in detail.     

The Relative Contribution of Domains of Quality of Life to Overall Quality of Life for Different Chronic Diseases

This study examined the contribution of the quality of life (QoL) domains physical, social and psychological functioning to the explanation of overall QoL. Various disorders may differentially affect QoL domains due to disease-specific factors and, consequently, the relationship between QoL domains and overall QoL may vary between diseases. We therefore studied this relationship for several diseases as well as the differential impact of these diseases on QoL. The present study had a cross-sectional design. We selected patients (aged 57 years and older) with one of the following eight chronic medical conditions: lung disorder, heart condition, hypertension, diabetes mellitus, back problems, rheumatoid arthritis, migraine, or dermatological disorders. The total group of respondents included 1457 patients and 1851 healthy subjects. Regression analyses showed that the domain of psychological functioning contributed to overall QoL for all disorders, whereas physical and social functioning contributed to overall QoL for some disorders. Differences were found between most patient groups and healthy subjects with respect to physical functioning; with respect to social and psychological functioning some groups differed from the healthy group. Explanations for the findings and implications for clinical practice are discussed.     

Sry监测体外扩增造血细胞植入效果的实验研究

目的：探讨Y染色体性别决定基因(Sry)作为评价和追踪造血细胞移植后植入状态检测指标的可行性。方法：根据Sry DNA序列设计引物及制备探针，然后进行PCR检测、斑点杂交和原位杂交．动态追踪经不同条件下体外扩增的纯系雄性小鼠BMMNC回输至雌性小鼠后的植入状态。结果：PCR结果显示在各移植组小鼠的骨髓有核细胞、脾细胞及外周血白细胞中均有Y染色体特异性序列的存在；斑点杂交结果显示在各回输组间并无明显差别，但用脾脏组织作原位杂交的结果则发现基质细胞支持扩增回输组的阳性颗粒数目与输注新鲜细胞组相似，但略少于雄性小鼠；而输注细胞因子扩增细胞实验组小鼠则明显少于雄性动物的阳性对照标本和基质细胞支持扩增回输组。结论：(1)经重复检测表明上述方法的重复性好，结果可信．可作为检测性别不同时造血干细胞移植效果的一种检测手段；(2)证实基质细胞支持下的体外扩增的造血细胞具有较好的植入能力。     

Surgical metabolism

Summary. Trauma, operative interventions, infection and other disturbances of homeostasis lead to a uniform reaction of the body, namely release and activation of hormones and cytokines. Profound alterations of substrate flow result, with mobilization of energy stores and degradation of structural and functional proteins of vital organs like the gut mucosa. Due to these reactions the energy demands of the organs are met and energy-consuming synthesis of substrates is indicated. Clinically, hypermetabolism, hyperglycemia, lipolysis and increased urea production with negative nitrogen balance can be observed. The metabolic reactivity is reached by an increased substrate cycling. To avoid negative consequences such as organ dysfunction, a rational situation-adapted substrate supply is warranted as well as reduction of catabolic stimuli and stimulation of anabolic factors. The metabolic care of the surgical patient is still a basic and important task.      

精神病患者家属的心理分析及护理

作者采用询问交谈的方法对精神病患者家属的心理状态进行了调查分析，大多数精神病患者家属存在着焦虑、急躁、自卑、厌恶、矛盾、无能为力等心理。同时，针对性地提出了以安慰、鼓励、心理启发、支持为主的护理方法和措施。     

1,1,1,2—四氟乙烷—1,1—二氟乙烷二元系恒温汽液相平衡

采用静态蒸汽总压法实验装置，在２９．９４℃、３９．９２℃和４９．９３℃下，测定了１，１，１，２－四氟乙烷－１，１－二氟乙烷二元系汽液相平衡时的物料，总量、系统组成、蒸汽总压和汽相体积。结合物料衡算和Ｔ、Ｐ、ｘ推算ｙ的曲面样条函数法，计算出对应的平衡汽液相组成。用改进的ＰＲ状态方程和一个与温度无关的可调相互作用参数关联了实验数据。