希望疗法对肺癌根治术后患者心理状态及癌因性疲乏的影响

目的探讨希望疗法对肺癌根治术后患者心理状态及癌因性疲乏的影响。方法选择2019年1月～2020年9月我院收治的88例肺癌患者为研究对象,均采用肺癌根治术治疗。按随机数字表法将研究对象随机分为观察组和对照组,每组各44例。对照组患者给予常规心理护理,观察组患者给予希望疗法。比较两组患者护理前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、Piper疲乏修订量表(R-PFS)评分以及癌症患者生命质量核心量表中文版评分。结果观察组护理后SAS评分、SDS评分和R-PFS评分均低于对照组(P0.05);观察组护理后癌症患者生命质量核心量表中文版评分高于对照组(P0.05)。结论希望疗法能够显著降低肺癌根治术后患者的焦虑、抑郁情绪,缓解其癌因性疲乏,提升生活质量,值得临床中推广应用。     

甲磺酸阿帕替尼联合正念减压疗法对晚期卵巢癌患者的癌因性疲乏、自我效能感及肿瘤血管生长因子的影响

目的 探讨甲磺酸阿帕替尼联合正念减压疗法(MBSR)对晚期卵巢癌患者癌因性疲乏、自我效能感及肿瘤血管生长因子的影响。方法 选取我科2018年7月～2020年9月期间收治的115例晚期卵巢癌患者随机分为两组,对照组57例给予多西他赛注射液联合顺铂注射液,观察组58例在对照组治疗的基础上联合甲磺酸阿帕替尼片及MBSR,比较两组患者治疗后的癌因性疲乏、自我效能感、肿瘤血管生长因子及不良反应。结果 两组患者在治疗后,癌因性疲乏程度、自我效能感均较治疗前改善,且观察组改善幅度高于对照组(P0.05);两组患者在治疗后,肿瘤血管生长因子均较治疗前降低,且观察组降低幅度高于对照组(P0.05)。结论 甲磺酸阿帕替尼联合正念减压疗法能够有效抑制晚期卵巢癌患者肿瘤细胞的生长,缓解患者身体和心理的压力,改善患者癌因性疲乏和自我效能感,降低不良反应的发生率。     

临床心理护理程序对食管癌患者的干预效果分析

目的 探讨临床心理护理程序对食管癌患者的干预效果.方法 选取本院2018年9月～2020年9月收治的92例食管癌患者作为研究对象,按随机数字表法将研究对象随机分为观察组和对照组,对照组46例患者给予常规护理,观察组46例患者在对照组基础上给予临床心理护理程序.观察对比两组患者护理前后的汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、Piper疲乏修订量表(RPFS)评分和匹兹堡睡眠障碍指数量表(PSQI)评分,以及护理满意度.结果 观察组患者护理后的HAMA评分、HAMD评分、RPFS评分和PSQI评分均低于对照组(P＜0.05);观察组患者护理满意度(95.65％)高于对照组(71.74％)(P＜0.05).结论 临床心理护理程序可有效缓解食管癌患者的负面情绪,减轻其癌因性疲乏,改善睡眠质量,提高患者的护理满意度,值得临床推广应用.     

帕罗西汀对脑胶质瘤术后患者情绪、应激水平及癌因性疲乏的影响

目的 探究帕罗西汀应用于恶性脑胶质瘤术后患者的效果及对应激水平、焦虑抑郁情绪、癌因性疲乏的影响。方法 选取我科2021年3月～2022年7月期间97例恶性脑胶质瘤术后患者,根据抽签法分组。均给予术后常规放疗联合替莫唑胺治疗,对照组48例联合给予结构式心理治疗,观察组49例在对照组基础上联合帕罗西汀治疗,对比两组患者焦虑与抑郁症状、癌因性疲乏、应激指标水平。结果 治疗后观察组汉密尔顿焦虑量表与汉密尔顿抑郁量表评分、癌因性疲乏各项评分、皮质醇、促腺上腺皮质激素、内皮素-1水平低于对照组,有统计学意义（P<0.05）。结论 帕罗西汀联合结构式心理模式对替莫唑胺治疗的恶性脑胶质瘤术后患者干预,可有效降低癌因性疲乏程度、应激反应以及焦虑抑郁情绪。     

早期积极心理干预对前列腺癌放疗患者癌因性疲乏的影响

目的 探讨早期积极心理干预对前列腺癌放疗患者癌因性疲乏（CRF）的影响。方法 选取本院2020年1月～2023年1月收治的前列腺癌放疗患者200例作为研究对象,采取随机数表法分为观察组与对照组,各100例。对照组采用常规干预,观察组在对照组基础上联合积极心理干预。比较两组干预前后癌症疲乏量表（CFS）,同时评估其欧洲癌症研究与治疗组织生活质量测定量表（EORTC QLQ-C3）。结果 观察组干预后躯体疲乏、情感疲乏、认知疲乏评分显著低于对照组,差异有统计学意义（P<0.05）;观察组干预后社会功能、情绪功能、角色功能、认知功能、躯体功能、总体生活质量评分显著高于对照组,差异有统计学意义（P<0.05）。结论 对前列腺癌放疗患者实施早期积极心理干预不仅能显著改善患者CRF症状,还能显著改善其生活质量。     

腹腔镜前列腺癌根治术联合心理干预对局限性前列腺癌患者预后影响

目的探讨腹腔镜前列腺癌根治术联合心理干预对局限性前列腺癌患者预后的影响。方法选取2017年1月～2019年1月期间我院收治的局限性前列腺癌患者60例作为本次研究的对象,按随机数字表法将研究对象随机分为观察组和对照组,每组各30例。对照组患者给予腹腔镜前列腺癌根治术治疗,观察组在对照组的基础上联合心理干预。观察比较两组患者干预前后的SAD、SDS、IPSS,手术情况、住院时间及干预后SF-36评分和护理满意度。结果 (1)干预前,两组患者的SAS、SDS、IPSS评分差异无统计学意义(P0.05),与干预前相比,两组患者干预后的SAS、SDS、IPSS评分明显降低,且观察组患者评分明显低于对照组(P0.05);(2)与对照组相比,观察组的患者干预后的生活质量明显改善(P0.05);(3)干预后,观察组患者对护理满意度明显高于对照组(P0.05);(4)两组患者住院时间及手术情况差异无统计学意义(P0.05)。结论腹腔镜前列腺癌根治术联合心理干预治疗局限性前列腺癌患者,能够改善其负面情绪,提高生活质量,使患者预后良好。     

心理护理对腹腔镜下胆囊切除术患者的焦虑抑郁及治疗依从性的影响

目的探讨心理护理干预对腹腔镜下胆囊切除手术患者的焦虑抑郁情绪及治疗依从性的影响。方法将我院2018年3月～2019年3月收治的腹腔镜下胆囊切除手术患者100例,随机分组,分别给与常规围手术期护理(对照组,n=50)和围手术期重视心理护理干预的实施(观察组n=50),观察两组患者的胃肠功能恢复指标、疼痛程度、焦虑抑郁情绪、自我效能感、治疗依从性的差异。结果观察组患者术后肠鸣音恢复时间、肛门首次排气时间、排便时间经观察均慢于于对照组(P0.05);两组术后6h疼痛评分无差异(P0.05),术后24h、48h、72h疼痛评分均有降低,且观察组降低程度较对照组更为显著(P0.05);两组干预前,焦虑、抑郁心理状态评分经评测无差异(P0.05);干预后评测分值较前均有程度不等下降,但观察组下降程度较对照组更为显著(P0.05);两组干预前,自我效能感评分无差异(P0.05),干预后评分较前均有升高,但观察组升高程度较对照组更为显著(P0.05);观察组干预后治疗依从性各维度即遵守院内制度、积极乐观、合理饮食、适宜锻炼比例均高于对照组(P0.05);观察组术后并发症率低于对照组(P0.05)。结论在围手术期对腹腔镜下胆囊切除手术患者积极开展心理护理干预,可促进胃肠功能恢复,缓解疼痛,改善焦虑抑郁状态,提高自我效能感及治疗依从。     

心理支持对胃癌化疗患者负性情绪和依从性及生活质量的影响

目的观察心理支持对胃癌化疗患者的焦虑抑郁情绪,治疗依从性及生活质量的影响。方法选取2015年1月~2016年12月期间我院收治的87例胃癌化疗的患者作为研究对象,将所有患者随机分为两组。对照组43例接受常规护理,观察组44例患者在常规护理的基础上接受心理支持。比较两组患者干预过程中的焦虑抑郁情绪,依从性及生活质量评分(QOL)的变化。结果观察组干预后焦虑抑郁情绪改善程度显著优于对照组,且治疗依从性显著高于对照组,差异具有统计学意义(P0.05)。干预后观察组患者的生活质量评分显著高于对照组(P0.05)。结论在常规护理的基础上,合并心理支持能够有效改善胃癌化疗患者的焦虑抑郁情绪,提高其治疗依从性及生活质量。     

帕罗西汀对围术期面肌痉挛患者的情绪、疾病不确定感及睡眠的影响

目的 观察帕罗西汀对面肌痉挛患者在行显微血管减压术前、术后的情绪、疾病不确定感和睡眠质量各项评分的影响。方法 选取2017年3月至2019年7月期间我院收治的114例择期行显微血管减压术的面肌痉挛患者作为研究对象,分为对照组和观察组各57例,两组患者均给予微血管减压术治疗和围术期管理,观察组57例从术前一周开始增加帕罗西汀治疗,术后三周后对比两组患者术前、术后的情绪,及疾病不确定感评分及睡眠质量各分项评分。结果 治疗后两组患者的SAS评分、SDS评分明显低于治疗前(P0.05),且观察组患者的SAS评分、SDS评分低于对照组(P0.05);治疗后两组患者的疾病复杂性、不确定性、疾病不确定感均优于治疗前(P0.05),且观察组优于对照组(P0.05);治疗后两组患者睡眠质量各项指标均优于治疗前(P0.05),且观察组睡眠质量各项指标优于对照组(P0.05)。结论 帕罗西汀可明显改善围术期的面肌痉挛患者情绪,减轻患者的不确定感,提高睡眠质量。     

医护患一体化心理护理对食管癌同步放化疗患者的影响

目的 分析医护患一体化心理护理在食管癌同步放化疗患者中的应用效果及对患者不良情绪的影响。方法 本次研究对象来源于本院2018年6月～2020年6月收治的96例接受同步放化疗治疗的食管癌患者,根据抽签法分组（每组n=48）,对比组接受常规护理,观察组接受医护患一体化心理护理,对比两组汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HMAD）评分、Piper疲乏修订量表（RPFS）评分、患者满意度、住院时间、治疗费用。结果 观察组护理后HAMA评分、HMAD评分、RPFS评分均低于对比组,观察组患者满意度（95.83%）高于对比组（70.83%）,观察组住院时间比对比组短,观察组治疗费用比对比组低（P<0.05）。结论 食管癌患者同步放化疗期间实施医护患一体化心理护理,可有效改善患者心理状态,减轻癌因性疲乏感,促进机体康复,降低治疗成本,提高患者满意度。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -