目的 探讨地震应激对胃泌素、生长抑素、血清超氧化物歧化酶（SOD）活性和丙二醛（MDA）水平的影响，为震后灾区人群应激性溃疡的防治提供理论依据。 方法 随机抽取四川省人民医院2008年5月15日－31日间收治的60名5.12汶川地震灾民为研究组，58名健康体检者作为对照组。分别对两组人群进行心理调查，采用酶联免疫吸附法测定血清胃泌素和生长抑素水平，利用生化法检测血清SOD活性和MDA含量，并对上述各指标在两组间的分布进行比较。 结果 研究组症状自评量表得分高于对照组（P＜0.05）；两组血清胃泌素分别为（1.04 ± 0.67）、（0.74 ± 0.58） ng/mL，研究组高于对照组（P＜0.01）；两组MDA水平分别为（7.16 ± 5.58）、（4.83 ± 4.48） nmol/mL，研究组高于对照组（P＜0.05）；而两组生长抑素分别为（0.74 ± 0.94）、（1.92 ± 3.05） ng/mL，研究组低于对照组（P＜0.01）；两组SOD分别为（6.06 ± 2.20）、（7.79 ± 1.58）U/mL，研究组低于对照组（P＜0.01）。 结论 地震可引起生理应激状态，导致机体在免疫、抗氧化能力、胃肠激素等方面出现一系列变化，胃泌素、生长抑素等均参与应激性疾病的形成，这些变化可能导致地震灾区消化性溃疡高发。
ObjectiveTo compare the cerebral protective effect of unilateral and bilateral antegrade selective cerebral perfusion during total aortic arch replacement, particularly with respect to neuropsychological outcome.MethodsFrom June 2003 to March 2004, 16 patients who underwent total aortic arch replacement were randomly allocated to one of two methods of brain protection: unilateral antegrade selective cerebral perfusion (unilateral group, n =8) or bilateral antegrade cerebral perfusion (bilateral group, n =8). Preoperative and postoperative neurological examination, brain computed tomography(CT) scan, and cognitive function tests were performed.ResultsAll patients survived the operations and were discharged from hospital. No new brain infarction occurred. Transient neurologic dysfunction occurred in 1 patient of each group. There were no intergroup differences in the scores of preoperative and post operative cognitive function ( P gt;0.05).ConclusionBoth methods of brain protection for patients undergoing total aortic arch replacement result in favorable and similar effect of brain protection in term of cognitive function provided the circle of Willis is patent and collateral flow is adequate.
OBJECTIVE: To study the psychology and its management during the process of hand allograft. METHODS: One psychologist participated through the whole process of the present hand allograft. 12 potential candidates of hand transplant were interviewed during the selection of patients to evaluate the state of psychiatry and their abilities to manage stressors like cooperation with medical workers and medical interventions, waiting for donors, adaptation to a new hand and post operation depression. The psychological state of 11 patients were believed to be able to receive hand transplant, and they are further prepared psychologically by the psychologist while waiting for a donor. Two lucky candidates were decided by tissue typing and received hand allograft simultaneously. After the operation, the two patients psychotherapy assisted with effective analgesia, supporting from family and environmental improvement. RESULTS: One out of 12 patients was found not suitable for the transplantation because of psychiatric problem. One week postoperation, the 2 patients were anxious, lack of patience, and horrified at seeing the long-expected grafted hand. After 1 week of treatments and adapation the patients managed to settle with the new hand, and accepted the hand as a whole 1 month postoperation. With the recovery of the hand sensation and motion 4 to 5 months postoperation, the patients held the hand as his own. CONCLUSION: Psychologists are required in the hand transplantation team during the pre-transplant selection of patients and post-transplant rehabilitation.
Objective To compare the effects of cognitive-behavior therapy (CBT) and domestic paroxetine in the treatment of minor depression. Methods A therapeutic technique model for the treatment of minor depression was established. Sixty-four patients with minor depression meeting DSM-IV criteria were divided into CBT and paroxetine groups with 32 patients respectively, and were treated for six weeks. The Hamilton Depression Scale (HAMD) was used to evaluate the clinical efficacy and relapse/recrudescence rate of the two groups. Side effects of paroxetine were also recorded. Results At the end of 2 weeks, no significant difference was noted in the reduction of the HAMD score between the two groups. At the end of 6 weeks, there was little difference in thHAMD score reduction between the two groups (F=8.3,P= 0). No significant difference was found in the curative effects between the two groups (u=316.5,P=0.06).In the paroxetine group, cure rate was 20.7%, significant improvement rate was 48.3%; In the CBT group, cure rate was 10.0%, significant improvement rate was 36.7%.The relapse/recrudescence rate after six in the paroxetine group was higher than in cognitive-behavior therapy group at 6 months’ follow-up (u=106.5,P=0.04).Conclusion The clinical efficacy of cognitive-behavior therapy for minor depression seems to be similar to that of paroxetine. The established model of CBT can be used in clinical practice.
Objective To investigate the cognitive functions in people at high risk for schizophrenia.Methods Two hundred and twenty-two people at high risk for schizophrenia and 331 normal controls were assessed with 14 neuropsychological tests. Results The results of some neuropsychological tests in people at high risk for schizophrenia were worse than those in the normal controls. These tests included information, arithmetic, digital symbol, block design, logical memory, visual memory, Stroop test, verbal fluency, tower of Hanoi, WCST and CPT (Plt;0.01). The time for trail making test A in was longer in the group at high risk for schizophrenia than in the control group (Plt;0.05).Conclusion People at high risk for schizophrenia have general cognitive deficits. Attention and executive function may represent the genetic endophenotype for schizophrenia.
【摘要】 目的 探讨轻度认知功能障碍的心理学特点及其危险因素。 方法 由神经专科医生采集2009年9-12月在神经内科门诊就诊患者106例的临床资料，进行简易智能量表（MMSE）、听觉词语测验（AVLT）、画钟测验（CDT）、日常生活功能量表（ADL）、Hamilton 抑郁量表（HDRS）及临床痴呆评定量表（CDR）等神经心理测试。根据检查结果分为MCI组与对照组。 结果 MCI组受教育年限低于对照组（Plt;0.05），高血压病、糖尿病、脑卒中史高于对照组（Plt;0.05）。Logistic多因素回归分析显示受教育年限和高血压病史与MCI密切相关。MCI组MMSE总分、CDT得分、AVLT即刻记忆、延迟记忆及长时延迟再认显著低于对照组，ADL评分及HDRS评分高于对照组（Plt;0.05）。 结论 高血压病是MCI的危险因素，较高的受教育年限是MCI的保护因素。MCI患者在多个神经心理学领域受损。【Abstract】 Objective To investigate the neuropsychological characteristics of mild cognitive impairment (MCI) and its risk factors. Methods The clinical data of 106 patients in our neurologic department from september to December 2009, were collected by neurologists,and tested them by Chinese version of the mini-mental state examination (MMSE) , auditory verbal learning test (AVLT) , clock drawing test (CDT)、activities of daily living (ADL)、Hamilton depression rating scale (HDRS) and clinical dementia rating scale (CDR). All subjects were divided into MCI patients group and the control group. Results Educational level was significantly lower and hypertension, diabetes mellitus and stroke history were significantly more in patients with MCI than the control. The factors associated with MCI in logistic regression analysis were lower educational level and hypertension. The scores of MMSE、CDT and AVLT of MCI were significantly lower than those of the control, and the scores of ADL and HDRS were significantly higher than those of the control (Plt;0.05). Conclusion Hypertension is the risk factor and high educational level is the protective factor for MCI. MCI patients are impaired in multiple neuropsychological domains.
Objective To investigate the scientificity of patient-reported outcomes instrument for asthma ( Asthma-PRO) , which maybe used to evaluate the efficacy of anti-asthma drugs in clinical trials and clinical practice.Methods 366 asthma patients and 100 healthy subjects were face-to-face interviewed by well-trained investigators, and the data of Asthma-PRO instrument were collected. The psychometric performance such as reliability, validity, responsiveness and clinical feasibility in the Asthma-PRO instrument was evaluated. Results The split-half reliabilities of the Asthma-PRO instrument and each dimension were greater than 0.8. In the analysis of internal consistency of each dimension, the cronbach’s alpha coefficient was greater than 0.7. Factor analysis showed that the instrument has good construct validity. The scores of each of the facets and total scores between the asthma patients and the healthy subjects were different. The recovery rate and the efficient rate of the questionnaire were more than 95%, and the time required to complete a questionnaire was within 20 minutes, indicating that the scale had a high clinical feasibility. Conclusion The Asthma-PRO instrument has good reliability, validity, responsiveness and clinical feasibility.
ObjectiveTo compare the anxiety, depressive and personality characteristics between diabetes mellitus patients with or without diabetic retinopathy (DR), and look for psychological treatment and corresponding prevention measures. Methods435 diabetic patients were enrolled in this study from April to November 2014 in our hospital, including 178 DR cases (group A) and 257 cases without retinopathy (group B). All the patients completed a questionnaire, the Self-Rating Anxiety (SAS), the Self-Rating Depression Scale (SDS) and the big five personality scale (NEO-FFI), and were scored by eye doctors. According to the score, SAS can be divided into mild anxiety, moderate anxiety, and severe anxiety. SDS is divided into depression, mild depression, moderate depression and major depression. NEO-FFI was scored from emotional stability, outgoing, openness, easy-going and sense of responsibility. Multiple linear regression analysis was used to analyze the DR risk factors in those scores and education level, high blood pressure, age, alcohol consumption, occupation and other factors. ResultsThere were 110 cases of mild anxiety, 57 cases of moderate anxiety, 11 cases of severe anxiety; 74 cases without depression, 53 cases of mild depression, 31 cases of moderate depression, 20 cases with major depression in group A. There were 181 cases of mild anxiety, 53 cases of moderate anxiety, 23 cases of severe anxiety; 177 cases without depression, 44 cases of mild depression, 25 cases of moderate depression, 11 cases with major depression in group B. Group A patients had higher SAS, SDS scores than group B, the difference was statistically significant (P=0.035). Group B patients had higher NEO-FFI score in outgoing, easygoing, responsibility (P=0.022), lower NEO-FFI score in emotional stability (P=0.014) and same NEO-FFI score in openness(P=0.210)compare to Group A patients. Multiple linear regression analysis results showed that education level, high blood pressure, age, weight, drinking, occupation can affect the degree of changes in the retina (P=0.019). ConclusionsCompared with those without retinopathy, DR patients were more prone to anxiety and depression. They also had low score in personality characteristics of outgoing, easygoing, responsibility.