医学生自杀意念相关因素分析

目的探索自尊、自我效能、负性生活事件与临床医学专业大学生自杀意念的关系,为大学生自杀干预研究提供依据。方法采用自尊量表（SES）、一般自我效能感量表（GSES）和青少年生活事件量表（ASLEC）、自杀意念自评量表（SIOSS）等对合肥市随机抽取的800名医学生进行调查并进行多元Logistic回归分析。结果本专科医学生自杀意念检出率存在差异,专科生自杀意念检出率为12.33%,本科生为7.49%;自杀意念与抑郁、绝望、负性生活事件呈显著负相关,与自尊、自我效能感呈现显著正相关。结论低自尊、低自我效能感的医学生更易产生自杀意念;自尊、自我效能感可能是医学生自杀意念与负性生活事件之间的调节器。     

社会支持在农村留守青少年情绪调节自我效能感和情绪性问题行为关系中的中介效应

目的探讨社会支持在农村留守青少年情绪调节自我效能感和情绪性问题行为关系中的中介效应。方法采用一般人口学问卷、情绪调节自我效能感量表、社会支持评定量表和情绪性问题行为问卷对220名农村留守青少年进行调查,采用Pearson相关、结构方程分析情绪调节自我效能感、社会支持、情绪性问题行为间关系及社会支持的中介效应。结果情绪调节自我效能感与情绪性问题行为呈负相关（β=-0.25,P < 0.01）,情绪调节自我效能感与社会支持呈正相关（β=0.60,P < 0.01）,社会支持与情绪性问题行为呈负相关（β=-0.45,P < 0.01）。社会支持在情绪调节自我效能感和情绪性行为问题之间发挥完全中介作用,中介效应值为-0.27。结论社会支持是减少农村留守青少年情绪性行为问题的关键。在实施提高留守青少年情绪调节自我效能感的干预措施时,需要加强情感交流,增强支持感知,以帮助他们减少情绪性问题行为。     

心理剧对抑郁症患者情绪自我效能感、自杀意念、心理困扰的影响

目的 分析心理剧对抑郁症患者情绪自我效能、自杀意念、心理困扰的影响。方法 抑郁症患者90例随机分为观察组、对照组,均为45例,对照组予以常规西药及健康教育治疗2个月,观察组另予以心理剧治疗2个月,比较两组情绪状态、情绪自我效能感、自杀意念、心理困扰。结果 治疗2个月后,观察组汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分较对照组低;观察组治疗后情绪调节自我效能感量表(RESE)表达积极情绪效能感、调节生气/易怒情绪效能感评分较对照组高,两组调节沮丧/痛苦情绪效能感评分比较差异无统计学意义;观察组治疗后,自杀意念中绝望、乐观因子评分及总分、掩饰因子评分均低于对照组;治疗后观察组心理困扰程度较对照组轻。结论 心理剧治疗抑郁症可有效地减轻抑郁症患者焦虑与抑郁情绪,提高患者的情绪自我效能感,减轻自杀意念与心理困扰等,值得在临床推广实践。     

宫颈癌患者社会支持对病耻感的影响：心理弹性的中介作用

目的 探讨心理弹性在宫颈癌患者社会支持和病耻感间的中介作用。方法 采用一般资料调查问卷、社会影响量表（SIS）、社会支持评定量表（SSRS）、心理弹性量表（CD-RISC）对258例宫颈癌住院患者进行问卷调查。结果 宫颈癌患者SIS得分（57.75±8.890）分,SSRS得分（35.76±7.499）分,CD-RISC得分（54.65±15.852）分。SIS得分与SSRS得分（r=-0.347）和CD-RISC得分（r=-0.274）均呈负相关（P <0.05）,SSRS得分与CD-RISC得分（r=0.236）呈正相关（P <0.05）。心理弹性在患者社会支持和病耻感间起中介作用,且中介效应占总效应的12.22%。结论 社会支持可通过心理弹性的中介作用对宫颈癌患者病耻感产生间接影响,心理弹性可提高社会支持对宫颈癌患者病耻感的抑制作用。     

抑郁症患者的家庭分型及其对自杀意念的影响研究

目的 探讨抑郁症患者家庭亲密度与家庭适应性及家庭分型,并分析其对自杀意念的影响。方法 采取随机抽样的方法,选取2013年10月-2014 年4月湖北医药学院附属人民医院住院的抑郁症患者108例,采用一般情况调查表和汉密尔顿抑郁量表（HAMD）、自杀意念自评量表（SIOSS）、家庭亲密度与适应性评定量表（FACESⅡ-CV）对抑郁症患者进行调查,根据SIOSS评分分为有自杀意念组（SIOSS≥12分）65例,无自杀意念组（SIOSS＜12分）43例。比较两组患者一般情况、家庭亲密度、家庭适应性及家庭分型,采用多因素Logistic回归分析抑郁症患者自杀意念的影响因素。结果 有自杀意念组与无自杀意念组患者年龄、性别、民族、婚姻状况、居住条件及工作时长比较,差异均无统计学意义（P＞0.05）;两组患者受教育程度、职业、经济状况比较,差异有统计学意义（P＜0.05）。有自杀意念组患者FACESⅡ-CV家庭亲密度评分（58.1±13.3）分、家庭适应性评分（39.3±9.1）分,均低于无自杀意念组〔（69.6±9.7）分、（46.9±7.3）分,P＜0.05〕。有自杀意念组与无自杀意念组患者家庭分型分布情况比较,差异有统计学意义（χ2=10.204,P=0.006）。抑郁症患者自杀意念与受教育程度呈正相关（r=0.406,P＜0.001）,与经济状况、家庭亲密度、家庭适应性呈负相关（r值分别为-0.268、-0.404和-0.396,P＜0.001）。多因素Logistic回归分析结果显示,受教育程度、经济状况、家庭亲密度与抑郁症患者自杀意念有回归关系（P＜0.05）。结论 有自杀意念的抑郁症患者家庭亲密度与家庭适应性更差,家庭分型多为极端型;受教育程度越高、经济条件越差、家庭亲密度越低的抑郁症患者自杀意念越强。     

军医院校研究生情绪调节自我效能感在心理素质和抑郁间的中介效应

目的 探讨军医院校研究生情绪调节自我效能感在心理素质和抑郁之间的中介作用。方法 采用医学硕士研究生心理素质问卷（PQQMM）、情绪调节自我效能感量表（RESES）、抑郁自评量表（SDS）对485名军医院校研究生进行整群抽样调查,采用SPSS 19.0软件进行数据分析。结果 心理素质总得分和各维度（认知、适应性与个性）得分均与情绪调节自我效能感得分呈正相关（表达积极情绪自我效能感得分r=0.74、0.57、0.41、0.67,P均<0.01;管理消极情绪自我效能感得分r=0.78、0.65、0.37、0.64,P均<0.01）,两者均与抑郁得分呈负相关（心理素质总得分及各维度得分r=-0.78、-0.54、-0.50、-0.62,P均<0.01;表达积极情绪自我效能感得分r=-0.60,P<0.01;管理消极情绪自我效能感得分r=-0.65,P<0.01）。高情绪调节自我效能感个体的心理素质得分高于低情绪调节自我效能感个体（t=14.71,P<0.01）、抑郁得分低于低情绪调节自我效能感个体（t=-9.43,P<0.01）。表达积极情绪自我效能感在心理素质3个维度（认知、个性、适应性）与抑郁之间存在部分中介效应,分别占总效应的22.38%、6.25%、24.75%;管理消极情绪自我效能感在心理素质3个维度与抑郁之间存在部分中介效应,分别占总效应的24.80%、13.50%、24.54%。结论 情绪调节自我效能感在军医院校研究生心理素质与抑郁之间具有部分中介作用。     

抑郁症患者合并躯体疾病情况及其与自杀意念的关系研究

目的 了解抑郁症患者合并躯体疾病情况,并探讨其与自杀意念的关系。方法 选取2013年10月-2014年4月在新疆维吾尔自治区人民医院临床心理科住院的抑郁症患者125例,采用一般情况调查表、汉密尔顿抑郁量表（HRSD）和自杀意念自评量表（SIOSS）进行调查。根据SIOSS评分分为有自杀意念组（SIOSS≥12分,n=81）和无自杀意念组（SIOSS＜12分,n=44）。抑郁症患者自杀意念评分与合并躯体疾病数量的相关性分析采用Pearson相关分析;抑郁症患者自杀意念的影响因素分析采用多因素Logistic回归分析。结果 抑郁症患者合并躯体疾病的前3位分别为失眠（87.2%,109/125）、头痛（69.6%,87/125）、腰背痛（66.4%,83/125）;有自杀意念组合并失眠、头痛、腰背痛、焦虑的发生率均高于无自杀意念组,差异有统计学意义（P＜0.05）。抑郁症患者自杀意念评分与合并躯体疾病数量呈正相关（r=0.362,P＜0.05）;多因素Logistic回归分析结果显示,受教育程度、失眠、头痛是抑郁症患者自杀意念的影响因素（P＜0.05）。结论 抑郁症患者合并躯体疾病中失眠与疼痛最常见;合并躯体疾病数量越多,自杀意念越严重;受教育年限长、失眠、疼痛是自杀意念的危险因素。     

艾滋病患者生存质量对心理痛楚的影响：一个有调节的中介模型

目的：探究艾滋病患者生存质量对心理痛楚的影响，以及自我效能的中介作用和社会支持的调节作用。方法：分别采用世界卫生组织艾滋病专用生存质量调查简表、心理痛楚感量表、一般自我效能感量表、社会支持评定量表对172例艾滋病患者进行问卷调查。结果：艾滋病患者的生存质量对其心理痛楚具有显著的负向预测作用（β=-0.356,SE=0.071,P<0.001）；自我效能在生存质量与心理痛楚之间发挥部分中介作用（β=-0.145,SE=0.041,95%CI:-0.231～-0.071），中介效应占总效应的比例为28.94%；高水平的社会支持在生存质量与自我效能之间存在调节作用。结论：艾滋病患者的生存质量与心理痛楚之间存在一个有调节作用的中介模型自我效能，生存质量可通过自我效能对心理痛楚发挥作用，且生存质量对自我效能的影响受到社会支持水平的调节。     

情绪智力对护生人文关怀能力的影响：职业自我效能的中介作用

采用护理专业大学生人文关怀能力量表、护生职业自我效能问卷、情绪智力量表对331名本科护生进行问卷调查。结果表明,本科护生的人文关怀能力（121.60±17.11）分、职业自我效能（90.53±9.14）分和情绪智力（63.36±13.30）分,均呈现中等偏上水平;人文关怀能力、职业自我效能和情绪智力之间存在显著正相关（r=0.367～0.449,P<0.001）;职业自我效能在情绪智力对人文关怀能力的影响中起部分中介作用。在本科护生的教育中,应重视情绪智力和职业自我效能的培养,从而有效提高本科护生的人文关怀能力。     

抑郁症状在海军官兵睡眠与自杀意念间的中介作用

目的 探讨抑郁症状在海军官兵睡眠与自杀意念间的中介作用.方法 采用随机抽样和集体测验方法,使用匹兹堡睡眠质量指数(PSQI)量表、抑郁自评量表(SDS)和自杀意念自评量表(SIOSS)对849名海军官兵进行调查,研究海军官兵睡眠、抑郁症状、自杀意念三者之间的关系及检验抑郁症状在睡眠与自杀意念间的中介效应.结果 发放问卷849份,回收有效问卷812份,有效率为95.6％.相关分析结果显示,睡眠质量、入睡时间、睡眠障碍与抑郁症状之间(r=0.446、0.390、0.394,P均<0.01)及自杀意念之间(r=0.498、0.462、0.420,P均<0.01)均呈正相关;抑郁症状与自杀意念之间呈正相关(r=0.706,P<0.01).模型各路径系数差异有统计学意义(P<0.05),各拟合指标均较好(χ2=5.380,P=0.250).抑郁症状在睡眠与自杀意念间的中介效应为0.28,中介效应占总效应的41.2％(7/17).结论 抑郁症状在海军官兵的睡眠与自杀意念的关系中起部分中介作用.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.