Psychological adjustment in children and adults with congenital adrenal hyperplasia

OBJECTIVE: To determine psychological health in individuals with one form of intersexuality, congenital adrenal hyperplasia (CAH), and its relation to characteristics of the disease and treatment. STUDY DESIGN: Participants (ages 3-31 years) included 72 females and 42 males with CAH, and unaffected relatives (44 females and 69 males). Psychological adjustment was assessed with parent-reports on the Child Behavior Checklist (CBCL) and subject self-reports on the Self-Image Questionnaire for Young Adolescents (SIQYA) or the Multidimensional Personality Questionnaire (MPQ). Information about disease characteristics and genital surgery was obtained from medical records. RESULTS: There were no significant differences between females with CAH and unaffected females on any measure. Psychological adjustment was not significantly associated with genital virilization or age at genital surgery. Males with CAH were not significantly different from unaffected males in childhood, but they showed more negative affect at older ages. CONCLUSIONS: Psychological adjustment is not compromised in females with virilized genitalia who are treated early in life and reared as females. Adjustment does not appear to depend on the characteristics of the disease or its treatment, but sample size and restricted range limit generalizability about adjustment-disease associations.     

复方丹参治疗风湿病关节痛的疗效评价

目的探讨复方丹参对风湿病关节痛患者的影响及疗效评价。方法复方丹参治疗风湿病关节痛患者30例,治疗前后分别用McGill疼痛问卷表(MPQ)测试疼痛强度以及血沉(ESR)和C-反应蛋白(CRP)。结果风湿病关节痛患者治疗后疼痛强度评分明显低于治疗前(P<0.05),且与ESR和CRP指标呈正相关。结论复方丹参对风湿病患者关节痛有明显的良好疗效,MPQ在风湿病关节痛疗效评价方面全面、可靠和有效。     

A critical review of dimension-specific measures of health-related quality of life in cross-cultural research

This article reviews six dimension-specific health-related quality of life (HRQL) measures which have been used cross-culturally. The instruments reviewed are: the Beck Depression Inventory (BDI); the McGill Pain Questionnaire (MPQ); the Center for Epidemiologic Studies—Depression (CES-D); the Zung Self-Rating Depression Scale (SDS); the General Health Questionnaire (GHQ); and the Psychological General Well-Being Index (PGWB). These instruments primarily represent the psychological or emotional dimension of HRQL, and are scales that were developed and validated in the USA, Canada or the UK. The review of specific studies for each of the six instruments was not meant to be exhaustive, but rather to give an indication of the ways in which the instruments have been assessed or used in various countries. The focus throughout this article is on the psychometric properties (reliability, validity and responsiveness) of these scales in different cultures, as well as the processes used to translate the instruments from English into another language. Implications of the results of this review for cross-cultural use of dimension-specific HRQL instruments are drawn.     

Skeletal Muscle Fatigue

Abstract

Skeletal muscle fatigue is a complex problem which deserves attention from physiotherapists and other clinical practitioners. This article will discuss the findings of recent literature to explore some of the main mechanisms thought to underlie fatigue in skeletal muscles. These mechanisms may be peripheral in origin, occurring within the muscle fibres themselves, or central, affecting the neural control of muscle contraction. Peripheral mechanisms of fatigue include metabolic factors such as the availability and utilization of metabolic substrates (e.g. glycogen, phosphocreatine and adenosine triphosphate) during muscle activity as well as the influence of muscle pH on both metabolism and muscle contractile properties. Impairment in neuromuscular transmission and excitation–contraction coupling may also cause muscle fatigue. Central fatigue mechanisms include both psychological and physiological factors which may influence motor cortex activity and hence muscle force output. Pathological factors which may cause abnormal muscle fatigue are also discussed.     

Digit ratio (2D:4D) predicts sporting success among female fencers independent from physical,experience, and personality factors

Research particularly focusing on male athletes and popular sports (running and soccer) suggests associations of lower (masculinized) second‐to‐fourth digit ratio (2D:4D), a putative marker of prenatal androgen action, with better sports performance. Studies focusing on women, non‐mainstream sports, or controlling for covariates relevant for sporting success are still sparse. This study examined associations between 2D:4D and performance of both male and female athletes active in fencing (a non‐mainstream sport dominated by male participants), while controlling for covariates. National fencing rankings and 2D:4D of 58 male and 41 female Austrian tournament fencers (mean age 24 years) were correlated. Among female, but not male, fencers, lower 2D:4D was related to better national fencing rankings. 2D:4D still accounted for incremental variance (12%) in fencing success, when the effects of salient performance factors (age, body mass index, years of fencing, training intensity, and the personality variables achievement, control, harm avoidance, and social potency) were controlled for (totaling 35% attributable variance). Athletes active in the most aggressive form (the sabre) had lower 2D:4D than those active in the other forms (épée and foil fencing). Sporting success in adult life might be partly prenatally programmed via long‐lasting extragenital effects of testosterone.     

针刺联合手法治疗神经根型颈椎病的疗效评估

目的：观察针刺联合中医推拿手法治疗神经根型颈椎病的疗效并探究其机制。方法：选取2021年1月至2022年10月辽宁中医药大学附属第二医院骨科收治的神经根型颈椎病患者120例作为研究对象,按照随机数字表法分为对照组和观察组,每组60例。2组患者均行常规牵引疗法。对照组配合单纯中医推拿手法治疗,观察组在中医推拿手法治疗基础上联合针刺治疗。疗程均为1个月。比较治疗前后2组患者麻木评分、颈部残障指数（NDI）、简化McGill疼痛问卷（MPQ）评分、血清白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）、血清白细胞介素-1β（IL-1β）、血液流变学指标水平变化情况,以及治疗有效率。结果：观察组治疗有效率（91.67%）明显高于对照组（73.33%）,2组比较,差异有统计学意义（P<0.05）;治疗后2组患者MPQ、NDI、麻木3个评分均显著下降（均P<0.05）,与对照组比较,观察组改善明显（P<0.05）;治疗后2组患者血液流变学各项指标表达水平均显著下降（P<0.05）,且观察组改善更为显著（P<0.05）。结论：针刺联合中医推拿手法治疗神经根型颈椎病疗效突出,可改善患者颈部麻木、疼痛等症状,同时改善颈部功能障碍状态,降低血黏度,下调血清IL-6、TNF-α和IL-1β表达水平。     

腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的临床研究

目的 探讨腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的临床疗效。方法 选取我院2017年9月～2019年12月治疗的腹股沟疝患者80例为研究对象,采用随机数字表分组法将其分为对照组和观察组,每组各40例。观察组采用TAPP治疗,对照组采用常规开放式无张力疝修补术。记录并比较两组①手术指标：手术时间、术中出血量;②住院指标：首次排气时间、住院时间;③临床并发症发生情况。采用McGill疼痛问卷简表（SF-MPQ）对患者术后1、2、3 d时疼痛程度的进行评估。结果 观察组患者手术时间为（53.37±7.45）min,长于对照组,观察组患者的术中出血量为（28.55±5.37）mL、首次肛门排气时间为（1.42±0.54）d及住院时间为（5.54±1.36）d,均分别少于对照组（P＜0.05）。观察组术后切口感染、腹腔感染、肠梗阻、血肿及尿潴留等并发症总发生率（10.00%）明显低于对照组（30.00%）（P＜0.05）。术后1、2及3 d时观察组疼痛MPQ评分均比对照组明显低（P＜0.05）。结论 腹腔镜经腹腹膜前疝修补术可减少腹股沟疝患者术中出血量及首次肛门排气时间,缩短住院时间、促进胃肠功能恢复,且术后并发症少。     

Paired comparisons of sensory pain adjectives.

BACKGROUND: Language is an important tool in the communication of pain. The most widely known verbal pain assessment tool is the McGill Pain Questionnaire (MPQ). The MPQ scoring procedure implies equal weights for different pain describing adjectives with the same rank value. AIM: In the present study the relative intensity of the most severe sensory pain adjectives of the MPQ was examined by means of Thurstone's method of paired comparison. METHOD: A questionnaire was constructed to run a balanced pairwise comparison experiment with pain describing adjectives obtained from the Dutch version of the MPQ. The questionnaire was filled out by psychology freshmen (N=528). RESULTS: Subjects were highly consistent in their choices regarding the paired comparisons but showed substantial individual differences with respect to agreement about the relative intensity of the adjectives. However, some adjectives were clearly rated as more painful than others, these were lancinating, bursting and tearing. Adjectives seen as relatively least painful were clasping, shooting and freezing. CONCLUSIONS: The results suggest that the MPQ scoring procedure is not entirely consistent with the relative ranking obtained in the present study. The authors do not consider the extent of this deviation to be a violation of one of the MPQ's underlying assumptions.     

脊髓损伤的中枢性疼痛诊断、评价和康复治疗

脊髓损伤的中枢性疼痛,是一种严重影响患者生存质量的顽固性疼痛。关于这种痛的发生,R.Melzack和G.Bedbrook提出的中枢兴奋性升高学说,近年来已为一系列实验所逐步证实。戴红等提出它可能主要经由非特异性投射系统上传,造成患者大脑觉醒水平提高所致,并存在一定的受体机制。根据14年的临床观察,归纳出其诊断标准和鉴别诊断标准,其评测应采用莫克吉尔疼痛答卷和视觉模拟评分法进行,治疗宜采用综合疗法。