Boundary Ambiguity in Parents With Chronically Ill Children: Integrating Theory and Research

Abstract: This article integrates theory and research related to boundary ambiguity in parents of children with a chronic health condition. We propose that boundary ambiguity is a risk factor for psychological distress in these parents. Clinical applications and a case example highlight how boundary ambiguity can be assessed and managed in clinical settings by professionals working with parents with chronically ill children. Questions are provided for assessing boundary ambiguity in clinical and research settings, and implications for research are discussed.     

Early separation and suicidal behaviour in the parental homes of 40 consecutive suicide attempters

Forty suicide-attempt patients who were consecutively admitted to an intensive-care unit, their significant others and treatment personnel were investigated by semistructured interviews. The patients were divided into neurosis (n = 14), abuse (n = 19) and psychosis (n = 7) groups. Twenty-one of the patients (52%) had lost contact with one or both parents before the age of 18, in 25% of cases owing to death and in 27% because of the parents' divorce or separation. Parents and/or siblings of 19 patients (47%) had shown suicidal behaviour in the form of attempted suicide and/or suicide. Differences between the groups were not significant. Alcohol abuse in the parental home was overrepresented in the abuse group compared with the other groups. The role of identification with the dead and suicidal parent in prompting suicidal actions in adulthood is discussed, as well as that of the impeded evolution of stable external object relations owing to parental losses.     

北京市宣武区中学生生殖健康知识调查分析

【目的】掌握青少年性发育特点,以便开展有针对性的青春期生殖健康教育,提高自我保护能力,使其健康的成长。【方法】重点高中2所、普通高中4所、职业高中3所,分别选择同年级、同号班级22个班的1 800名高中生,由专门调查员进班发问卷,要求学生在15 min内完成。学生填写问卷时,采用校方人员回避,问卷不记名方式,填写后当场封存,确保学生的隐私权。【结果】调查学生中生理知识知晓率达到70.74%,性病、艾滋病方面知识知晓率达53.9%,相关避孕知识知晓率15%,学生中的性活动发生率17.9%,缺乏保护意识的学生占25.4%,接触过淫秽品的学生43.5%,对婚前性行为的看法持开放态度的学生占38%。【结论】学生的性观念开放,综合自我保护能力较低,易受疾病和社会危险因素伤害,对其成长过程造成障碍。     

Smith-Fineman-Myers综合征的候选基因GPC4分析

目的:探讨GPC4基因与中国山东Smith-Fineman-Myers综合征(SFMS)的关系,并分析SFMS患者GPC4基因突变。方法:利用primer3设计扩增GPC4全部编码序列及内含子和外显子接头序列的引物,采用PCR扩增结合PCR产物直接测序方法检测GPC4基因开放性阅读框架区域基因突变。结果:在GPC4基因开放性阅读框架区域内并未检测到导致疾病的基因突变。结论:山东SFMS家系患者不是由于GPC4基因编码区域基因突变所致。     

腹主动脉瘤动脉壁血管平滑肌细胞增殖及凋亡的研究

目的研究腹主动脉瘤 (abdominalaorticaneurysm ,AAA)在发病不同时期动脉壁平滑肌细胞 (smoothmusclecells,SMC)增殖与凋亡的改变。方法建立大鼠AAA模型 ,分别于术后 3d、1、2、3、4周切取腹主动脉 ,应用原位DNA片段末端标记 (TUNEL)和免疫组织化学方法检测腹主动脉壁中SMC凋亡和相关基因bcl 2、bax蛋白以及增殖细胞核抗原 (PCNA)、α 血管平滑肌肌动蛋白(α actin)的表达。结果TUNEL及PCNA表达高峰时段分别为术后 2～ 3周和 1周 ;术后 3d至 1周凋亡细胞少于PCNA阳性SMC ,2～ 4周多于PCNA阳性SMC且SMC数量明显减少 ;bcl 2与bax蛋白表达分别于术后 1、3周达到峰值 (P <0 0 1)。结论动脉壁SMC增殖和凋亡的失衡与AAA发病密切相关 ;bcl 2与bax基因参与了对AAA动脉壁中SMC凋亡的调控。     

连续核移植对异种山羊(Bore)克隆胚胎发育的影响

目的探讨连续核移植与异种山羊克隆胚胎发育之间的关系。方法分别以波尔(Bore)山羊耳部成纤维细胞、山羊-兔异种克隆桑椹胚卵裂球为核供体,以兔卵母细胞为受体,进行连续核移植。结果共构建145枚异种原代重构卵、73枚继Ⅰ代及20枚继II代重构卵,经电融合后,获得重构胚数分别为90、58和14枚,融合率分别为62.1%、79.5%和70%;162枚重构胚在同等条件下进行体外共培养,卵裂率分别为72.2%、75.9%和28.6%,囊胚率分别为10%、13.8%和0%;融合率方面,原代、继I及继II重构卵之间无显著差异(P>0.05);早期发育率无显著差异,但继Ⅰ代重构胚高于原代重构胚,相反,继II代远低于前两者,差异极显著(P<0.01)。结论波尔山羊体细胞核经第1次核移植过程中异种受体卵胞质作用后,比高度分化的体细胞更有利于重构胚的发育,但异种山羊克隆胚卵裂球反复多次暴露在异种卵胞质中,可能不利于细胞核的发育。     

核因子kB在大鼠胃缺血再灌注损伤中的表达及意义

目的研究核因子kB（NF-kB）在大鼠胃缺血再灌注损伤中的表达及意义。方法采用大鼠胃缺血再灌注（gustric ischemia/reperfusion, CI／R）模型（夹闭腹腔动脉30min后再灌注），分别于再灌注0．5、1、3、24h取胃，计算胃黏膜损伤指数。应用免疫组化、Western blot方法检测胃黏膜NF-kB p65。结果大鼠GUR后引起胃黏膜损伤，再灌注1h时损伤最明显，随后降低，24h接近正常。GI／R后胃黏膜NF—kB阳性细胞数和蛋白表达量增多，与胃黏膜损伤变化规律一致。结论NF-kB在大鼠CI／R损伤过程中发挥着重要作用。