精神分裂症患者亲属SCL-90评定分析

目的了解精神分裂症患者亲属心理状态与正常人的差异.方法对精神分裂症患者亲属采用SCL-90量表进行评定.结果精神分裂症患者亲属存在明显的紧张、焦虑、恐惧、偏执,SCL-90量表总分明显高于常模,女性对事件的反应态度较男性更强烈.结论精神分裂症患者亲属心理健康较差,必须进行心理教育、咨询和治疗,防止或减少精神疾病的发生.     

短期集体心理治疗对焦虑症患者防御方式及临床疗效的影响

目的 探讨短期集体心理治疗对焦虑症患者疗效的影响,及焦虑症的发生与防御方式的关系.方法 研究对象为符合CCMD-3及DSM-IV的焦虑症患者,共43例.进行汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、防御方式问卷、症状自评量表、SCL-90测评.结果 HAMD评分及HAMA减分值主角组焦虑症患者[(7.82±3.66)分,(14.00±4.52)分]和非主角组焦虑症患者[(5.45±3.05)分,(11.09±4.06)分]显著高于对照组[(1.25±1.05)分,(1.75±0.98)分](P＜0.01).主角组焦虑症和非主角组焦虑症患者的HAMD、HAMA减分值差异无显著性(t=1.648,P=0.115;t=1.589,P=0.128), 但其治疗后的HAMD分[(8.05±3.43)分]、HAMA分[(9.91±4.58)分]、SCL-90中的抑郁[(2.11±0.737)分]、焦虑[(2.10±0.96)分]和其他分[(1.88±0.62)分]较治疗前[(14.68±1.67)分,(22.45±2.46)分,(2.63±0.75)分,(2.73±0.94)分,(2.33±0.85)分]显著降低(t=8.896,P=0.000;t=13.230,P=0.000;t=2.364,P=0.026;t=2.091,P=0.046; t=2.177,P=0.039),不成熟防御因子与抑郁、敌对、精神病性显著性相关(r= 0.489,r=0.414,r=0.463).结论 心理治疗对焦虑有明显疗效,但主角组焦虑症和非主角组焦虑症患者的疗效差异无显著性,焦虑症状与防御方式的不成熟有关.     

Dupilumab shows long-term safety and efficacy in patients with moderate to severe atopic dermatitis enrolled in a phase 3 open-label extension study

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基于盆底超声参数构建的列线图模型预测盆底重建术后 进展性压力性尿失禁的价值

目的 基于术前盆底超声参数构建列线图模型,探讨其预测盆底脏器脱垂（POP）患者盆底重建术后发生进展性压力性尿失禁（SUI）的价值。方法 选取2019年5月至2022年4月我院因国际泌尿科学会POP-Q分度≥Ⅱ度行盆底重建术女性患者495例建立预测模型作为模型组,其中术前POP合并SUI 295例;根据术前、术后SUI发生情况分为术后进展组76例（包括新发46例,加重30例）与SUI改善组219例;对模型组样本采取Bootstrap法重复抽样1000次作为内部验证组。应用单因素分析、多因素Logistic回归分析POP患者盆底重建术后发生进展性SUI的独立危险因素,并构建列线图模型。绘制受试者工作特征曲线、校准曲线、临床决策曲线、临床影响曲线对该模型区分度、校准度及临床适用性进行验证。结果 (1)单因素分析显示,SUI改善组与术后进展组孕次、产次、Ba点及指压诱发试验阳性、高血压史、糖尿病史、术前混合性尿失禁史、联合尿道中段无张力悬吊术（TVT-O）占比,以及盆底超声所测残余尿量（PVR）、尿道旋转角（Uret.rot）、尿道内口呈漏斗样改变、肛提肌损伤比较差异均有统计学意义（均P<...     

Advancing infection control in dental care settings: Factors associated with dentists' implementation of guidelines from the Centers for Disease Control and Prevention

Background and OverviewThe authors set out to identify factors associated with implementation by U.S. dentists of four practices first recommended in the Centers for Disease Control and Prevention's Guidelines for Infection Control in Dental Health-Care Settings—2003.MethodsIn 2008, the authors surveyed a stratified random sample of 6,825 U.S. dentists. The response rate was 49 percent. The authors gathered data regarding dentists' demographic and practice characteristics, attitudes toward infection control, sources of instruction regarding the guidelines and knowledge about the need to use sterile water for surgical procedures. Then they assessed the impact of those factors on the implementation of four recommendations: having an infection control coordinator, maintaining dental unit water quality, documenting percutaneous injuries and using safer medical devices, such as safer syringes and scalpels. The authors conducted bivariate analyses and proportional odds modeling.ResultsResponding dentists in 34 percent of practices had implemented none or one of the four recommendations, 40 percent had implemented two of the recommendations and 26 percent had implemented three or four of the recommendations. The likelihood of implementation was higher among dentists who acknowledged the importance of infection control, had practiced dentistry for less than 30 years, had received more continuing dental education credits in infection control, correctly identified more surgical procedures that require the use of sterile water, worked in larger practices and had at least three sources of instruction regarding the guidelines. Dentists with practices in the South Atlantic, Middle Atlantic or East South Central U.S. Census divisions were less likely to have complied.ConclusionsImplementation of the four recommendations varied among U.S. dentists. Strategies targeted at raising awareness of the importance of infection control, increasing continuing education requirements and developing multiple modes of instruction may increase implementation of current and future Centers for Disease Control and Prevention guidelines.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, Atlanta.The authors thank Jon Ruesch, who when this study was conducted was the director, Survey Center, American Dental Association, Chicago, for his effort in the collection of the data for this research project. Mr. Ruesch is now retired.     

薯蓣皂苷元无定形固体分散体制备及体内外评价

目的 制备薯蓣皂苷元无定形固体分散体（diosgenin amorphous solid dispersion,Dio-ASD），提高Dio溶出度和生物利用度。方法 应用分子模拟技术分析Dio与载体之间相互作用并通过抑晶实验验证，构建Dio与载体混溶性曲线相图，理论预测二者混溶性；以Soluplus为载体，应用共沉淀法制备Dio-ASD；通过溶出度测定、差示扫描量热分析（differential scanning calorimetry,DSC）、X-射线粉末衍射（X-ray powder diffraction,XRPD）、扫描电镜分析（scanning electron microscopy,SEM）、傅里叶红外光谱（Fourier transform infrared spectroscopy,FT-IR）对Dio-ASD进行体外评价；采用UPLC-MS/MS方法测定大鼠体内Dio血药浓度，计算药动学参数，对Dio-ASD进行体内评价。结果 分子模拟结果显示Soluplus与Dio之间能形成疏水键和氢键相互作用，结合能强于其他载体，且Soluplus对Dio的抑晶作用最强。构建了...     

A hydrodynamic study of pleural drainage systems: some practical consequences

BACKGROUND: A pleural drainage system must be capable of efficiently evacuating the air or fluids from the pleural cavity so that adequate lung reexpansion can take place. The air flow and negative pressure of the system will depend on the particular design of each model. This experimental study analyzes the specifications and performance of the pleural drainage systems currently on the market. METHODS: Thirteen models of pleural drainage systems connected to wall suction were examined. The models were classified into the following three groups: dry systems; wet systems; and single-chamber systems. We determined the ambient air flow and the negative pressure generated according to the suction level. The components of each model are also described. RESULTS: Under normal conditions, dry (except for the Sentinel Seal; Sherwood Medical; Tullamore, Ireland), wet, and single-chamber systems reach similar air flow rates (17 to 30, 24 to 27, and 22 to 28 L/min, respectively). With higher wall suction levels, wet systems increase the air flow (26 to 49 L/min) but the negative pressure becomes unstable because of the water loss phenomenon, dry systems increase the air flow (29 to 50 L/min) without modifying the regulator pressure, and single-chamber systems also raise the air flow (45 to 51 L/min) but increase the negative pressure. When there is an air leak, dry systems (except for the Sentinel Seal) lose less negative pressure than the other systems. CONCLUSIONS: The functioning of these systems can be optimized only by applying a suitable wall suction level adjusted to each case. Although the three types of systems are capable of evacuating adequate air flow rates, the negative pressure and the capacity to maintain it in the presence of an air leak are different in each system. Being fitted with valves and not water compartments makes the dry systems the safest and the ideal for use when the patient has to be moved.     

胡椒碱胶囊自乳化释药系统的处方筛选及体外质量评价

摘 要 目的： 研究胡椒碱自乳化释药系统的处方及其体外特性。方法: 通过溶解度、处方配伍试验以及伪三元相图的绘制来筛选处方,并考察空白处方、含药处方对自乳化效率的影响以及自乳化后乳滴的粒度分布,考察了胡椒碱自乳化胶囊的溶出速率和稳定性。结果: 胡椒碱自乳化胶囊的最终处方为油酸乙酯、Tween 80、Transcutol P,三者之比为30∶55∶15（w∶w∶w）,药物为辅料总量的2.5%,粒径约为90 nm,胡椒碱自乳化胶囊60 min溶出度是自制的胶囊剂6倍;低温和常温稳定性考察药物含量无明显变化。结论:所制备的胡椒碱自乳化胶囊自乳化效率高、能力强、性质稳定,体外溶出率高。     

大剂量90Sr敷贴治疗瘢痕疙瘩疗效分析

目的 探讨分次大剂量法90Sr敷贴治疗瘢痕疙瘩的方法 学及临床应用价值.方法 将224例患有瘢痕疙瘩的患者随机分成两组:124例患者采用分次大剂量照射法治疗,100例患者采用常规分次小剂量照射法进行治疗,并将后者作为对照组.结果 大剂量组和常规小剂茸组在.临床治愈率、有效率和副作用发生率均有显著差异(均P＜0.05),大剂量组患者治愈率明显提高,副作用发生率也增高.结论 分次大剂量90Sr敷贴法治疗瘢痕疙瘩具有较高的临床应用价值.     

Cystic fibrosis patients have poor sleep quality despite normal sleep latency and efficiency

STUDY OBJECTIVES: Cystic fibrosis (CF) patients may be predisposed to poor sleep quality due to upper and lower airway abnormalities and impaired gas exchange. Previous sleep investigations of CF patients using single-night polysomnography have reported conflicting results. We hypothesized that sampling sleep for a prolonged period in a patient's normal environment may give a more representative assessment of sleep quality than a single-night polysomnogram, and that impaired sleep quality would correlate with pulmonary disease severity and self-assessed sleep quality. DESIGN: Using wrist actigraphy, we measured sleep quality in clinically stable CF patients and age-matched control subjects. In addition, each CF patient and control subject completed the following three questionnaires: the Epworth sleepiness scale; the Pittsburgh sleep quality index (PSQI); and the Medical Outcomes Study 36-item short form. RESULTS: Twenty CF patients and control subjects were enrolled in the study, and were well-matched for age, sex, and body mass index. The mean (+/- SD) FEV(1) for CF patients was 61.0 +/- 20.1% predicted. CF patients and control subjects had similar sleep duration, sleep latency, and sleep efficiency. However, CF patients had higher PSQI scores (6.45 vs 4.55, respectively; p = .04), a higher fragmentation index (FI) [31.72 vs 18.02, respectively; p < 0.001], and less immobile time (88.87 vs 91.89, respectively; p = 0.02). There was a significant correlation of FI with FEV(1) and PSQI scores. CONCLUSIONS: Stable CF patients have disrupted sleep, and sleep disruption may in part be related to the severity of pulmonary disease. In addition, the PSQI may be useful in detecting CF patients with poor sleep quality.