急性酒精中毒175例急诊诊治分析

目的:探讨急性酒精中毒的急诊诊治。方法:对2004年5月至2007年11月期间的175例急性酒精中毒急诊的临床表现、治疗经过进行回顾性分析。结果:临床表现:主要为神志异常、恶心呕吐、上消化道出血。诊断:饮酒过量史结合临床表现。治疗:早期足量纳络酮联合生脉注射液促醒,胃复安止呕,法莫替丁及奥美拉唑治疗上消化道出血。175例全部经急诊处理痊愈出院。结论:急性酒精中毒只要在急诊根据饮酒过量史及临床表现及时诊断,早期足量纳络酮联合生脉注射液促醒和合理对症治疗,预后较好,通过急诊处理即可治愈。     

Orem自护理论对鼻咽癌病人生活质量影响的调查

目的:了解以"Orem自护理论"指导的鼻咽癌自护计划对病人生活质量的影响。方法:对66例鼻咽癌病人随机分为实验组和对照组,应用症状自评量表在治疗护理前一周及治疗结束后一周作出独立的测试并对二组因子差值进行比较。结果:实验组和对照组在躯体化、强迫、人际敏感、抑郁、焦虑、恐怖、精神病性、其他因子等方面差别有高度显著性意义。偏执因子差别有显著性意义。结论:Orem自护理论"指导的鼻咽癌自护计划能改善鼻咽癌病人心理健康状况,从而改善生活质量。     

山东省城乡空巢独居老人抑郁状况及影响因素

目的 了解山东省城乡空巢独居老人抑郁现状及影响因素。方法 采用多阶段分层整群随机抽样方法于2011年11月-2012年1月抽取山东省空巢老人2667人,以其中443名 ≥60岁空巢独居老人为研究对象,应用简版老年抑郁量表(GDS-15)、社会支持量表(SSRS)和自行设计的一般情况调查表进行问卷调查。结果 空巢独居老人抑郁症状检出率为19.9%(88/443);无医疗保险(41.9%)、不经常锻炼(27.9%)、有慢性病(22.7%)、自评经济状况差(37.1%)的空巢独居老人抑郁症状检出率较高,差异有统计学意义(P<0.01);多因素logistic回归分析结果显示,无医疗保险(OR=0.39,95%CI=0.168~0.907)、自评经济状况差(OR=0.28,95%CI=0.165~0.478)、有慢性病(OR=0.48,95%CI=0.244~0.926)、不参加体育锻炼(OR=0.48,95%CI=0.288~0.800)是空巢独居老人抑郁症状发生的危险因素。结论 山东省空巢独居老人的抑郁症患病率较高,自评经济状况、有无慢性病和是否体育锻炼是空巢独居老人是否患抑郁症的重要影响因素。     

Sphenopalatine ganglion volumetry in episodic cluster headache: from symptom laterality to cranial autonomic symptoms

BackgroundSphenopalatine ganglion (SPG) is a peripheral structure that plays an important role in cluster headache (CH). Hence, a reliable method to measure the volume of SPG is crucial for studying the peripheral mechanism of CH. Additionally, the association between the clinical profiles and the morphology of the SPG in CH remains undetermined. This study aims to use the manual measurement of SPG volume to investigate its associations with CH, including headache laterality, cranial autonomic symptoms (CASs), presence of restlessness or agitation, and other clinical profiles.MethodsWe prospectively recruited consecutive CH patients at a tertiary medical center between April 2020 and April 2022. A total of eighty side-locked, in-bout, episodic CH patients and 40 non-headache healthy controls received 1.5 T brain MRI focusing on structural neuroimaging of the SPG. The manual measurement process for SPG was under axial and sagittal FIESTA imaging, with reference T2 weight images (sagittal and axial) for localization. The inter-observer agreement of the SPG volume (both sides of the SPG from CH patients and controls) between the two observers was calculated. In CH patients, clinical profiles and the number of CASs (range 0–5) were recorded to analyze their association with SPG volume.ResultsThe inter-observer agreement between the two raters was excellent for the new SPG volumetry method at 0.88 (95% CI: 0.84–0.90, p < 0.001). The mean [SD] SPG volume was larger in CH patients than in non-headache controls (35.89 [12.94] vs. 26.13 [8.62] μL, p < 0.001). In CH patients, the SPG volume was larger on the pain side than on the non-pain side (38.87 [14.71] vs. 32.91 [12.70] μL, p < 0.001). The number of CASs was positively moderately correlated with the pain-side SPG volume (Pearson r = 0.320, p = 0.004) but not the non-pain side SPG volume (Pearson r = 0.207, p = 0.066).ConclusionsThis proof-of-concept study successfully measured the SPG volume and demonstrated its associations with symptomatology in patients with episodic CH. The direct measurement of SPG provide insights into studies on peripheral mechanism of CH.     

Impacts of Asthma in Patients With Bronchiectasis: Findings From the KMBARC Registry

PurposeAlthough the coexistence of asthma and bronchiectasis is common, the impacts of asthma on bronchiectastic patients (BE) have not been well evaluated because this issue using bronchiectasis cohorts has been investigated in only a few studies.MethodsIn the present study, 598 patients who were prospectively enrolled in the Korean bronchiectasis registry were evaluated. The clinical characteristics between BE with asthma and those without asthma were compared.ResultsAsthma was found in 22.4% of BE. BE with asthma had a higher body mass index (BMI) (P = 0.020), more dyspnea (P < 0.001), larger sputum volume (P = 0.015), and lower forced expiratory volume in 1 second (FEV1) (P < 0.001) than those without asthma. BE with asthma had a higher rate of previous pneumonia (P = 0.017) or measles (P = 0.037) than those without asthma. Regarding treatment, BE with asthma used inhaled corticosteroids, long-acting muscarinic antagonists, and leukotriene receptor antagonists more frequently than those without asthma. Although intergroup differences were not observed in disease severity of bronchiectasis (P = 0.230 for Bronchiectasis Severity Index and P = 0.089 for FACED), the Bronchiectasis Health Questionnaire (BHQ) scores indicating the quality of life, were significantly lower in BE with asthma than in those without asthma (61.6 vs. 64.8, P < 0.001). In a multivariable model adjusting for age, sex, body mass index, forced expiratory volume in 1 second %predicted, sputum volume, modified Medical Research Council dyspnea scale ≥ 2, and the number of involved lobes, asthma was associated with lower BHQ scores (β-coefficient = −2.579, P = 0.014).ConclusionsBE with asthma have more respiratory symptoms, worse lung function, and poorer quality of life than those without asthma. A better understanding of the impacts of asthma in BE will guide appropriate management in this population.     

南京中学生健康危险行为与抑郁症状关系

目的 了解江苏省南京市中学生健康危险行为和抑郁症状分布情况,并探讨两者之间的关联。方法 采用青少年心理健康状况调查表,于2010年9-10月随机抽取南京市5所学校2 118名中学生进行问卷调查。结果 调查的2 118名中学生中,具有1、2、3项及以上健康危险行为的中学生分别为21.6%、6.0%、4.4%;抑郁症状检出率为46.0%,其中轻度、中度、重度抑郁症状检出率分别为29.4%、13.4%、3.3%;高中生、有健康危险行为的学生抑郁症状检出率均高于初中生、无健康危险行为的学生,差异均有统计学意义(P<0.05);多因素logistic回归分析显示,随着健康危险行为项数的增加,抑郁症状检出率呈上升趋势(χ_趋势²=58.9,P<0.05),调整人群归因危险度百分比(PARc%)为14.8%。结论 健康危险行为是罹患抑郁症状的危险因素,应引起学校、家庭和社会的重视。     

抑郁障碍患者主观与客观认知功能的差异性研究

背景 抑郁障碍患者的主观认知功能与客观认知功能存在差异。目前,关于主客观认知功能差异影响因素的研究有限。目的 探索抑郁障碍患者主观和客观认知功能的差异及其影响因素,为进一步理解抑郁障碍患者认知功能受损情况提供参考。方法 纳入2022年1月13日—2023年12月11日在成都市第四人民医院门诊就诊或住院治疗的、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）抑郁障碍诊断标准的77例患者为研究对象。采用蒙哥马利-艾森贝格抑郁量表（MADRS）评定患者抑郁症状严重程度,采用抑郁感知缺陷问卷（PDQ-D）和中国简版神经认知成套测验（C-BCT）分别评定患者的主观认知功能和客观认知功能,采用席汉残疾量表（SDS）评定患者的社会功能,以临床总体印象量表-疾病严重程度量表（CGI-SI）评定患者病情严重程度。采用Pearson相关分析考查年龄、受教育年限、MADRS总评分、SDS总评分、CGI-SI评分与主客观认知功能及其差异的相关性。采用多元线性回归探索主客观认知功能差异的影响因素。结果 是否用药的抑郁障碍患者PDQ-D总评分和主客观认知功能差异（D值）比较差异均有统计学意义（t=-4.2...     

Nutritional Status and Related Factors in Patients with Gastric Cancer after Gastrectomy: A Cross-Sectional Study

Patients after gastrectomy for gastric cancer are at risk of malnutrition, and poor nutritional status negatively affects patients’ clinical outcomes. Knowledge of the factors influencing patients’ nutritional status can inform interventions for improving patients’ nutrition. A cross-sectional study was conducted to describe nutritional status and related factors in gastric cancer patients after gastrectomy. A convenience sample of gastric cancer patients with gastrectomy was recruited from general surgery or oncology clinics of a medical center in northern Taiwan. Data were collected with self-reported questionnaires, including the Functional Assessment Cancer Therapy—Gastric Module version 4, the Concerns in Meal Preparation scale, the Center for Epidemiologic Studies Depression Scale, and the Mini Nutrition Assessment. One hundred and one gastric cancer patients participated in the study. There were 81 cases of subtotal gastrectomy and 20 cases of total gastrectomy. Most patients (52.5%) were malnourished or at risk. Linear regression showed that symptom severity (β = −0.43), employment status (β = 0.19), and difficulty in diet preparation (β = −0.21) were significant predictors of nutritional status. Together, these three variables explained 35.8% of the variance in patient nutritional status (F = 20.3, p < 0.001). More than 50% of our participants were malnourished or at risk for malnutrition, indicating a need for continued monitoring and support after discharge from hospitals. Special attention should be given to patients with severe symptoms, unemployment, and difficulties in diet preparation.     

新兵SCL-90测评结果分析与心理疏导对策研究

目的：评估新兵心理健康,分析心理教育与疏导对新兵的心理影响,提高新兵心理素质,为新时期军队建设提供科学依据．方法：把2005年入伍新兵300名随机分为对照组和干预组．新兵入伍1wk内对对照组和干预组分别运用SCL-90症状自评量表实施心理测评;对干预组实施以普及心理科学知识为目的的心理教育、以提高心理知识运用水平为目的的心理训练和以解决心理问题为目的的心理咨询等心理教育与疏导措施,6mo后再分别进行测评．结果：实施心理干预前,对照组和干预组无统计学差异;实施心理干预后,干预组干预前后SCL-90各因子中躯体化、抑郁、焦虑、精神病性4因子分和阳性项目数显著低于干预前;对照组没有统计学差异．结论：干预组在实施心理干预后心理健康状况有明显改善,效果明显,对照组新兵在实施心理干预前后心理健康状况无统计学差异．     

对海洛因依赖者心理健康与应对方式的研究

目的了解海洛因依赖者的心理健康状况及应对方式。方法对入组的60例吸毒者,在脱毒后、出所前、出所随访中作SCL-90和简易应对方式的测查,并与正常对照组比较分析。结果SCL-90和简易应对方式各因子均值比较,心理症状戒毒组比正常对照组高（P〈0.05）,积极应对戒毒组比正常对照组低（P〈0.05）,消极应对戒毒组比正常对照组高（P〈0.05）,消极应对与心理症状显著相关（P〈0.05）。出所前组与正常男性比较,仅其他因子（睡眠饮食障碍）戒毒者高（P〈0.05）。所外随访未复吸组与正常对照男性比较,无显著差异（P〉0.05）。回顾未复吸组在往所戒毒期间与正常对照男性比较,有躯体化、强迫、抑郁、焦虑、敌对、精神、其他7个因子和总均分有显著差异（P〈0.05）,17例复吸者作了同样的比较分析,除积极应对因子外,余因子均有显著差异（P〈0.05）。17例复吸者再入所时,各因子均值高于正常对照组（P〈0.05）。结论吸食海洛因成瘾可造成吸毒者心理健康状况恶化和应对方式不良,心理症状与消极应对方式相关,有诸多心理健康问题和对社会应激事件通常采用消极应对方式的戒毒者,其复吸的可能性要大。