综合护理干预对肝癌介入化疗患者不良情绪及生活质量的影响

目的探讨肝癌介入化疗患者应用综合护理干预对心理状况、并发症及生活质量的影响。方法选取2015年2月～2018年3月期间本院收治的肝癌介入化疗患者52例为研究对象,根据入院先后顺序分为两组,研究组(n=26)和常规组(n=26),常规组给予普通护理,研究组则在此基础上给予综合护理,比较两种护理方式患者的不良情绪评分、生活质量评分、疼痛以及并发症情况。结果研究组HAMA评分、HAMD评分、NRS疼痛评分以及并发症发生率低于常规组,差异有统计学意义(P0.05);研究组生活质量评分高于常规组,差异有统计学意义(P0.05)。结论肝癌介入化疗患者应用综合护理干预的效果显著优于普通护理,不仅有助于降低并发症发生率,还可以缓解患者痛苦和不良情绪,促进生活质量的提升。     

PDCA循环对泌尿外科接台手术患者焦虑情绪的影响

目的探讨PDCA循环对泌尿外科接台手术患者焦虑情绪的影响情况。方法选择2017年1月～2019年4月行泌尿外科接台手术(早上10:00以后手术)患者240例,按入院先后顺序分为对照组及干预组,每组各120例,对照组患者采用常规护理模式,干预组患者采用PDCA循环,探讨两组Zung自评焦虑量表评分、术前血压变化情况。结果对照组在术后焦虑自评量表得分为(62.72±4.32),平均血压为(145.2±3.6)/(86.2±4.3)mmHg,平均心率(86.3±4.3)次/min;干预组术后焦虑自评量表评分为(56.42±6.35),平均血压为(136.6±4.3)/(76.3±3.2)mmHg,平均心率(80.6±5.2)次/min,两组比较差异有统计学意义(P0.05)。结论 PDCA循环可有效改善患者术前等待的焦虑状态。     

调脾护心方治疗心脾两虚型室性期前收缩患者焦虑状态临床观察

目的 观察调脾护心方配合琥珀酸美托洛尔缓释片治疗心脾两虚证室性期前收缩患者焦虑状态的临床疗效。方法 将80例心脾两虚证室性期前收缩患者随机分成对照组和治疗组,每组40例,两组均给予琥珀酸美托洛尔缓释片,治疗组加服调脾护心方,两组疗程均为4周。结果 两组患者室性期前收缩疗效比较,差异无统计学意义（P＞0.05）;观察组患者中医证候疗效、琥珀酸美托洛尔缓释片减停情况、焦虑疗效均显著优于对照组（P＜0.05）。结论 调脾护心方可改善室性期前收缩患者的焦虑状态和心脾两虚证候,减少琥珀酸美托洛尔缓释片的使用量。     

新疆维吾尔自治区精神障碍流行病学调查及影响因素研究

背景经济社会的发展、生活方式的转变及新型冠状病毒感染疫情的发生都对人群心身健康水平产生影响,进而可能使精神障碍的患病情况发生变化。然而,目前新疆维吾尔自治区的精神障碍流行病学调查资料尚不完善。目的 调查新疆维吾尔自治区北部（简称北疆）≥15岁人群的常见精神障碍患病率及影响因素,并同新疆维吾尔自治区南部（简称南疆）相关资料进行汇总与对比,得出全疆常见精神障碍患病情况,为制定相应的精神卫生规划提供科学依据。方法 于2021年11月至2022年7月,采用多阶段分层随机抽样法在北疆选取居民3 853例为研究对象。以社会人口学调查表、自评量表（12项一般用健康问卷、心境障碍问卷、90项症状清单等）及他评量表（汉密尔顿抑郁量表、贝克-拉范森躁狂量表、简明精神病量表等）作为调查工具,以国际疾病分类第10版（ICD-10）中的精神与行为障碍分类为诊断标准,由两名具有≥5年工作经验的精神科医师对纳入居民进行精神障碍诊断,诊断不一致者由精神科主任或副主任医师进行二次诊断。结果 北疆地区常见精神障碍时点患病率为9.71%(374/3 853),年龄调整率为10.07%;全疆常见精神障碍时点患病率为9.69%...     

焦虑症患者平静及紧张状态局部脑血流灌注改变

目的：探讨焦虑症患者平静及紧张状态局部脑血流（rCBF)灌注特点。方法：对20例未经治疗的焦虑症患者和20例健康志愿者用双日法进行平静及紧张状态下SPECT显像，以瑞文推理测试为模拟应激工具诱发受检者紧张情绪。结果：（1）平静状态患者桥脑、大部分额叶、部分颞叶、丘脑和基底节的rCBF明显低于对照组（P均＜0．05和0．01）。（2）紧张状态患者桥脑、大部分额叶和颞叶、部分枕叶和顶叶、丘脑和基底节的rCBF明显低于对照组（P＜0．05和0．01）。（3）经协方差分析，模拟应激前后大部分脑区rCBF变化与对照组相比差异均有显著性，且与平静状态相比，紧张状态下rCBF灌注普遍降低，与对照组相反。结论：焦虑症患者可能存在额叶、颞叶、丘脑和基底节的功能低下，焦虑反应时rCBF灌注异常下降可能是焦虑症的特征性改变之一。     

神经反馈在卒中后抑郁和焦虑中应用的研究进展

卒中后情绪障碍发生率很高,严重的抑郁、焦虑对于患者的治疗、康复有着不同程度的消 极影响。神经反馈技术是通过对脑电参数的适应性训练,从而改善患者的情绪症状。目前应用神经 反馈干预卒中后抑郁、焦虑的研究相对较少,且对于干预脑区及脑波尚无统一定论。本文将对神经 反馈在卒中后抑郁、焦虑方面的应用加以综述。     

Headache symptoms consistent with migraine and tension-type headaches in children with anxiety disorders

ObjectiveTo examine the incidence of headache symptoms consistent with migraine and tension-type headache (TTH) in children with anxiety disorders.Method.Parents of children with anxiety disorders (n = 27) and children without anxiety disorders (n = 36) completed a headache questionnaire based on the International Classification of Headache Disorders (2nd edition) criteria.ResultsChildren with anxiety disorders had a higher incidence of headache symptoms consistent with migraine and TTH compared to children without anxiety disorders. Girls with anxiety disorders and children with separation anxiety disorder had a higher incidence of headaches compared to girls without anxiety disorders and children with other anxiety disorders respectively. Children with anxiety disorders and headaches had higher self-reported anxiety symptom severity compared to children with anxiety disorders without headaches and children without anxiety disorders.ConclusionFindings highlight an overlap in anxiety and headaches in children and warrant further research on factors that contribute to the etiology and maintenance of these co-occurring problems.     

Men and women differ in inflammatory and neuroendocrine responses to endotoxin but not in the severity of sickness symptoms

Impaired mood and increased anxiety represent core symptoms of sickness behavior that are thought to be mediated by pro-inflammatory cytokines. Moreover, excessive inflammation seems to be implicated in the development of mood/affective disorders. Although women are known to mount stronger pro-inflammatory responses during infections and are at higher risk to develop depressive and anxiety disorders compared to men, experimental studies on sex differences in sickness symptoms are scarce. Thus, the present study aimed at comparing physiological and psychological responses to endotoxin administration between men and women. Twenty-eight healthy volunteers (14 men, 14 women) were intravenously injected with a low dose (0.4 ng/kg) of lipopolysaccharide (LPS) and plasma concentrations of cytokines and neuroendocrine factors as well as negative state emotions were measured before and until six hours after LPS administration. Women exhibited a more profound pro-inflammatory response with significantly higher increases in tumor necrosis factor (TNF)-α and interleukin (IL)-6. In contrast, the LPS-induced increase in anti-inflammatory IL-10 was significantly higher in men. The cytokine alterations were accompanied by changes in neuroendocrine factors known to be involved in inflammation regulation. Endotoxin injection induced a significant increase in noradrenaline, without evidence for sex differences. The LPS-induced increase in cortisol was significantly higher in woman, whereas changes in dehydroepiandrosterone were largely comparable. LPS administration also increased secretion of prolactin, but only in women. Despite these profound sex differences in inflammatory and neuroendocrine responses, men and women did not differ in endotoxin-induced alterations in mood and state anxiety or non-specific sickness symptoms. This suggests that compensatory mechanisms exist that counteract the more pronounced inflammatory response in women, preventing an exaggerated sickness response. Disturbance of these compensatory mechanisms by environmental factors such as stress may promote the development of affective disorders in women.     

Mouse chronic social stress increases blood and brain kynurenine pathway activity and fear behaviour: Both effects are reversed by inhibition of indoleamine 2,3-dioxygenase

Psychosocial stress is a major risk factor for mood and anxiety disorders, in which excessive reactivity to aversive events/stimuli is a major psychopathology. In terms of pathophysiology, immune-inflammation is an important candidate, including high blood and brain levels of metabolites belonging to the kynurenine pathway. Animal models are needed to study causality between psychosocial stress, immune-inflammation and hyper-reactivity to aversive stimuli. The present mouse study investigated effects of psychosocial stress as chronic social defeat (CSD) versus control-handling (CON) on: Pavlovian tone–shock fear conditioning, activation of the kynurenine pathway, and efficacy of a specific inhibitor (IDOInh) of the tryptophan–kynurenine catabolising enzyme indoleamine 2,3-dioxygenase (IDO1), in reversing CSD effects on the kynurenine pathway and fear. CSD led to excessive fear learning and memory, whilst repeated oral escitalopram (antidepressant and anxiolytic) reversed excessive fear memory, indicating predictive validity of the model. CSD led to higher blood levels of TNF-α, IFN-γ, kynurenine (KYN), 3-hydroxykynurenine (3-HK) and kynurenic acid, and higher KYN and 3-HK in amygdala and hippocampus. CSD was without effect on IDO1 gene or protein expression in spleen, ileum and liver, whilst increasing liver TDO2 gene expression. Nonetheless, oral IDOInh reduced blood and brain levels of KYN and 3-HK in CSD mice to CON levels, and we therefore infer that CSD increases IDO1 activity by increasing its post-translational activation. Furthermore, repeated oral IDOInh reversed excessive fear memory in CSD mice to CON levels. IDOInh reversal of CSD-induced hyper-activity in the kynurenine pathway and fear system contributes significantly to the evidence for a causal pathway between psychosocial stress, immune-inflammation and the excessive fearfulness that is a major psychopathology in stress-related neuropsychiatric disorders.     

Risk factors for fatigue in patients with epilepsy

Fatigue is highly prevalent in patients with epilepsy and has a major impact on quality of life, but little data is available on its effects and management in epilepsy. To identify the incidence and risk factors of fatigue in patients with epilepsy, 105 epilepsy patients (45 women and 60 men) were enrolled in our study. Demographic and clinical data were collected and psychological variables including fatigue, sleep quality, excess daytime sleepiness, anxiety, and depression were measured by Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale, respectively. Of 105 patients, 29.5% exhibited fatigue (FSS score ⩾4). We found no correlation between the occurrence of fatigue and any of our demographic or clinical variables. Fatigue is correlated with low sleep quality, anxiety, and depression, but not with excess daytime sleepiness. Thus, we concluded that fatigue is highly prevalent in patients with epilepsy, and that low sleep quality, anxiety, and depression are significantly correlated with fatigue in epileptics, while excess daytime sleepiness not.