77例出院后精神分裂症患者心理调查分析

研究目的调查分析出院后精神分裂症患者的心理状况，了解存在的问题并探讨解决的对策。研究方法对77例出院后精神分裂症病人就22项心理问题进行调查统计，并对比男女患者差异。结果男性易发脾气、借酒消愁、因病影响工作安排的现象较女性突出，而女性的婚姻状况较紧性明显。结论社区防治的病人心理问题较繁杂，因此防治工作应重视患者的心理特点，解决患者的实际问题。     

哺乳期营养对室间隔心肌细胞发育的影响——游离心肌细胞的形态测量

在心肌细胞分化性生长时期,改变新生鼠的哺乳期营养条件对这些鼠的空间隔心肌细胞将会产生暂时性作用和持久性影响。哺乳期高营养的暂时性作用是增加空间隔心肌细胞的大小和数量;而低营养的暂时性作用则是减慢室间隔心肌细胞的生长。哺乳期高营养的持久性作用是限制室间隔心肌细胞的过度肥大;而低营养则促进成熟鼠的室间隔心肌细胞的过度肥大。     

THE EMERGING ROLE FOR LAPAROSCOPIC GASTROSTOMY

A gastrostomy was fashioned laparoscopically in a 15 year old patient with a severe head injury. A preceding attempt at percutaneous endoscopic gastrostomy had failed. The gastrostomy tube was inserted into the stomach under vision and the stomach attached to the anterior abdominal wall by sutures.     

One-year follow-up of the outcome of a randomized controlled trial of a home-based intervention programme for children with autism and developmental delay and their families

Introduction There is debate about the type and intensity of early childhood intervention that is most helpful for children with developmental problems. The aim of the study was to determine whether a home‐based programme provided over 12 months resulted in sustained improvement in development and behaviour 12 months after the intervention ceased. The characteristics of the children and families who benefited most from the intervention were also studied. Method Randomized controlled trial. Participants A total of 59 children, aged 3–5 years, attending two early childhood intervention centres in Melbourne, Australia. Intervention Half of the subjects received an additional home‐based programme consisting of 40 weekly visits. Main outcome measures Bayley Scales of Infant Development and Wechsler Preschool and Primary Scale of Intelligence Revised, Preschool Behaviour Checklist, Bayley Behaviour Rating Scale and Behaviour Screening Questionnaire. All tests administered pre‐intervention, following the intervention and 12 months later. Secondary outcome measures Family stress, support and empowerment. Results Fifty‐four children completed the assessments 12 months after conclusion of the intervention. Compared with the control group, improvement in aspects of cognitive development in the children who received the extra intervention was sustained 1 year later (P= 0.007) while significant behavioural differences post intervention were not. Analyses of the data by the Reliable Change Index indicated improvement of clinical significance occurred in non‐verbal areas. In contrast to the control group who deteriorated, language skills in the intervention group remained stable. Improvements were significantly associated with higher stress in the families. Conclusion Improvements following the provision of a home‐based programme to preschool children with developmental disabilities were sustained 1 year later. Children from highly stressed families appeared to benefit most, reinforcing the importance of involving families in early childhood intervention programmes.     

综合性营养评估法在维持性血液透析患者中的应用分析

目的 对血液透析患者的几项营养指标进行评估。方法 依据SGA评分对142例维持性血液透析患者进行主观综合性营养评估（SGA）、膳食调查、生化参数的测量。结果 平均每日每公斤体重能量和蛋白质摄入（DEI、DPI）、血白蛋白，均有显著性差异（P〈0．001—0．05）。但营养良好组的DPI和DEI异常率高达49．0％、46．0％，重度营养不良组中各指标异常率均在80％以上。血前白蛋白与白蛋白有显著相关（P〈0．01），与DPI、DEI均无相关。结论 SGA是评价血透患者营养状况的简便方法，但还需其它反映营养状况不同侧面的指标的补充，如DEI、DPI、血白蛋白。前白蛋白作为血透患者营养监测的常规指标有待进一步证实。     

微生态肠内营养在结直肠癌患者围手术期的应用

目的:探讨微生态肠内营养在结直肠癌患者围手术期应用中的疗效。方法:将90例结直肠癌患者随机分为3组:常规治疗组(RT)、肠内营养组(EN)及添加微生态制剂肠内营养组(EMN)。观察患者术中肠道清洁度以及术后排气时间、吻合口漏、感染情况以及菌群失调情况,并监测手术前后内毒素、CRP、TNF水平变化及淋巴细胞计数改变。结果:术后排气时间EN组及MEN组均早于RT组(P<0.05),而EMN组早于EN组(P<0.05);第1次排便后细菌油镜计数结果示EN组及MEN组均明显低于RT组(P<0.05),而EMN组低于EN组(P<0.05)。术后外周血内毒素及CRP水平EN组及MEN组均低于RT组(P<0.05),而EMN组低于EN组(P<0.05);外周血淋巴细胞计数EMN组较术前有所增加(P<0.05),其他两组无明显变化;TNF水平各组均高于术前水平(P<0.05)。肠腔清洁度、吻合口漏、切口感染率及腹腔感染率差异均无统计学意义(P>0.05)。结论:添加微生态制剂肠内营养能有效防治患者肠道菌群失调,增强机体免疫力,促进肠道功能恢复。     

Risk factors of type 2 diabetes among Korean adults: The 2001 Korean national health and nutrition examination survey

This study aimed to identify risk factors for type 2 diabetes (T2D) in Korea, a rapidly changing country. Data of 5,132 adults aged 20-85 were used from the 2001 Korean Health and Nutrition Examination Survey. Multiple logistic regression was carried out to identify risk factors for T2D. Three models were specified: (i) socioeconomic and demographic factors (model 1: age, gender, education, poverty income ratio, employment), (ii) behavioral risk factors and covariates (model 2: obesity, physical activity, smoking, alcohol drinking, dietary quality, family history of T2D, co-morbidity) and (iii) socioeconomic, demographic, and behavioral factors (model 3). The prevalence of T2D was 7.4%. Less education (OR 1.41, 95% CI 1.08-1.84), age (OR 2.19, 95% CI 1.56-3.08 in 40-59 yrs, OR 4.05, 95% CI 2.76-5.95 in 60 yrs + comparing to 20-39 yrs) and abdominal obesity (OR 2.24, 95% CI 1.79-2.82) were risk factors for T2D even after controlling for other factors simultaneously. There was a significant association of T2D with ever smoking (OR 1.34, 95% CI 1.06-1.67). The relationship of age with T2D was modified by gender in model 1 and the relationship of smoking with T2D was modified by obesity in model 2. Less educated, older, obese or ever smokers were more likely to have T2D. Gender mediated the relationship of age, and obesity mediated the relationship of smoking, with T2D. Intervention programs for T2D in Korea should take the interactions among risk factors into account.     

小学生应对同伴冲突自我监控训练的实验研究

目的探索提高小学生同伴冲突应对能力的方法。方法采用2×2因素实验设计,运用自我监控的问题解决模式对106名三、五年级小学生(实验组)进行同伴冲突应对能力的训练,另101名三、五年级小学生为对照组,采用儿童社交问题解决访谈提纲和小学生社交技能教师评定量表于实验前后对两组学生施测。结果经过自我监控训练后,在解决冲突的有效性上,三年级实验组有显著提高(9.58±1.60/8.12±2.36,t=3.846,P<0.01),在解决冲突的适应性上,三、五年级实验组均有显著提高(10.52±1.87/7.96±2.44,t=6.612,P<0.01;11.02±1.65/7.54±2.44,t=9.561,P<0.01);教师评定的结果表明,训练后三、五年级实验组处理冲突的能力均有显著提高(29.35±1.70/26.62±4.66,t=4.063,P<0.01;31.59±2.73/27.59±4.39,t=6.147,P<0.01)。结论自我监控训练是一种有效提高小学生同伴冲突应对能力的方法。     

腰椎间盘突出症患者腰腿痛的血循环障碍因素与推拿手法的促循环作用机制

推拿手法长期以来被广泛用于腰椎间盘突出症的治疗．但其疗效机制却不甚明了。腰椎间盘突出症最具特征性的临床症状是不同程度的腰腿痛，其发病机制主要是机械压迫、无菌性炎症刺激以及循环与营养障碍等因素导致受累神经根传导功能的障碍，其中血循环与营养障碍是腰腿痛发病的重要环节。手法治疗对患者腰腿痛的缓解与消除作用应与改善患者的血循环和营养障碍有直接或间接的关系。     

哮喘患者团体辅导实践与体会

结合临床实践,重点介绍作为心理干预形式之一的团体辅导在哮喘患者中的应用情况,包括实施方案、过程、所遇问题及处理等方面。笔者旨在验证、推广团体辅导这一有效改善哮喘患者情绪的心理干预方法,为提高哮喘患者生活质量的临床实践活动提供参考。