沈阳地区孕妇产前情绪状态的调查研究

目的了解孕妇产前的情绪波动状况,为其心理辅导、实施精神助产提供科学依据。方法应用焦虑自评量表(SAS)和抑郁自评量表(SDS),对我院2006年上半年来院就诊的孕35周以上的产前孕妇随机抽取220名进行测试,收回有效问卷216份。量表均值用t检验与全国普通人口常规检测的标准数据(常模)进行组间比较。结果孕妇总体产前的SAS与全国正常群体模型(全国常模)相比无显著性差异,但SDS总粗分明显低于全国常模(P<0.01),同时出现抑郁症状的产妇其SDS总粗分明显高于全国常模(P<0.01);在焦虑患者中,轻度患者占91.67%,中度者为8.34%,无重度焦虑的患者;在抑郁患者中,轻度和中度患者各占50%,无重度抑郁患者。结论在调查的产妇中,焦虑的出现率未见增加,但出现抑郁症状的产妇明显多于正常人。     

焦虑和抑郁的共患率研究

目的探讨焦虑和抑郁的共患情况及在性别、年龄、受教育程度的差异。方法采用Zung抑郁自评量表(SDS)和焦虑自评量表(SA S)对374例精神科门诊病人进行测验。结果 374人中抑郁和焦虑同时达到轻度以上的有198人(52.9%),单纯抑郁达到轻度以上的有91人(24.3%),单纯焦虑达到轻度以上的有23人(6.1%),抑郁焦虑未达到轻度标准的有62人(16.6%)(Pearsonχ2=46.69 P<0.01);SDS、SA S总均分均高于国内常模(t=28.83,24.62,P<0.001)。在性别上女性SDS总均分高于男性(t=2.73,P<0.01),SA S总均分高于男性(t=2.48,P<0.05)。在受教育程度上两量表总得分受教育程度低的高于受教育程度高的(F=1.79,8.42,P<0.001);各年龄组得分无统计学差异(F=0.414,0.398,P>0.05)。结论在以SDS、SA S为工具检测的病人中约有52.9%的病人同时具有焦虑和抑郁发生。     

深圳特区内医务人员情绪健康状况调查

目的了解深圳特区内医务人员焦虑抑郁情绪状况及其影响因素。方法对深圳特区内公立医院的临床医生、护士、医技人员采用工作生活自编问卷、焦虑自评量表（SAS）和抑郁自评量表（SDS）进行调查,比较分析SAS、SDS标准分,采用Logistic回归分析法分析焦虑抑郁情绪的有关影响因素。结果共计抽取1423名医务人员,SAS、SDS标准分均高于国内正常人群常模（P＜0.01）,护士组SAS、SDS得分高于医生和医技人员组（P＜0.01）;Logistic回归分析结果显示,是否经常遭遇患者方暴力（言语或行为）、躯体健康自评因素对大部分医务人员的焦虑和抑郁情绪的发生有贡献,不同性别职业分组内有各自不同的影响因素。结论深圳特区内医务人员较国内普通人群的焦虑抑郁情绪严重,其中护士的焦虑抑郁情绪负荷重于临床医生和医技人员,临床医生、护士、医技人员的焦虑抑郁情绪的成因各自不同,躯体健康状况和遭遇患者方的暴力性言语和行为是造成深圳特区内医务人员焦虑抑郁情绪的重要因素,深圳特区内医务人员尤其是护士群体的心理健康状况值得重视。     

精神分裂症患者的家庭负担调查

目的评价精神分裂症的家庭负担情况。方法采用家庭负担会谈量表（FBS）、抑郁自评量表（SDS）及焦虑自评量表（SA S）,对449例符合CCM D-3诊断标准的精神分裂症患者,调查其家庭照料及经济负担情况。结果在FBS的6个因子中,家庭经济负担、家庭日常活动、家庭娱乐活动、家庭成员心理健康4个因子的阳性回答率较高（高于64%）,家庭关系、家庭成员躯体健康2个因子的阳性回答率较低（低于38%）。男性分裂症照料者家庭经济负担因子分显著高于女性分裂症照料者（P〈0.05）,男性分裂症照料者家庭娱乐活动因子分非常显著高于女性分裂症照料者（P〈0.01）。农村患者FBS的家庭经济负担因子分非常显著高于城镇患者（P〈0.01）,家庭娱乐活动和家庭成员心理健康因子分显著低于城镇患者（P〈0.05）。患者家属SA S均分为（48.86±12.43）分,明显高于正常人（36.42±0.53）均分,两者有非常显著性差异（t=14.14,P〈0.01）;其中超过界限值50分者有253例（56.3%）。449例患者SDS均分为（50.06±8.92）分,明显高于正常人（40.23±8.78）均分,两者有非常显著性差异（t=13.03,P〈0.01）;其中超过界限值53分者有282例（62.8%）。结论精神分裂症造成严重的家庭和经济负担,患者亲属焦虑、抑郁情绪明显高于正常人群。     

Ⅱ型糖尿病患者的心理状况调查分析

目的 了解2型糖尿病患者的心理状况。方法 采用症状自评量表（SCL-90）、抑郁自评量表（SDS）和焦虑自评量表（SAS）对67倒2型糖尿病患者进行调查，并与62例体检正常者进行对照。结果 2型糖尿病患者在SCL-90总分、阳性项目分、躯体化、焦虑、抑郁、恐怖以及SAS、SDS得分与对照组相比，差异有显著性（P〈0．05～0．01）。结论：2型糖尿病患者存在明显的心理障碍，主要表现为躯体化、焦虑、恐怖、紧张、抑郁，因此对2型糖尿病患者在药物治疗的同时，还应进行积极的心理干预。     

武警某部住院战士心理健康状况

目的了解住院战士心理健康状况,为下一步心理工作提供建议。方法采用症状自评量表(SCL—90)、艾森克人格问卷成人式(EPQ)、焦虑自评量表(SAS)及抑郁自评量表(SDS)对某院228名住院战士进行测查。结果①住院战士SCL-90总分、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性得分均低于军人常模(t=9.18,9.17,13.45,11.18,5.57,6.54,9.35,2.37,12.29;P<0.05),躯体化因子得分高于国内成人常模(t=5.08,P<0.05),差异有显著统计学意义;②住院战士EPQ的P、N分低于军人常模(t=7.61,10.42;P<0.01或0.05),E、L分值高于军人常模(t=7.44,2.05;P<0.05);③住院战士SDS高于中国成人常模(t=5.26,P<0.01),SAS高于中国成人常模(t=3.83,P<0.05)。结论住院战士比较多见的是抑郁情绪,焦虑情绪及心理问题躯体化也可见到。     

癫痫患者认知功能与心理健康状态的关系

目的探讨癫痫患者认知功能与心理健康状态的关系。方法对50例癫痫患者（试验组）及40例体检健康者（对照组）行蒙特利尔认知评估量表（M oCA）、抑郁自评量表（SDS）及焦虑自评量表（SA S）评定。结果试验组与对照组认知功能障碍、焦虑及抑郁检出例数分别为：42/50（84.00%）vs 3/40（7.50%）（χ2=52.020,P〈0.05）、12/50（24.00%）vs 1/40（2.50%）（χ2=8.312,P〈0.05）和28/50（56.00%）vs 7/40（17.50%）（2χ=13.860,P〈0.05）。两组患者的M oCA总分、M oCA 7个子项目、SA S标准分、SDS标准分和SDS 4个子项目比较P均〈0.05,差异有统计学意义。相关性分析显示认知功能评分与心理健康状态评分呈负相关。结论癫痫患者存在认知功能障碍和焦虑抑郁障碍,癫痫患者认知功能评分与心理健康状态评分有关。     

精神分裂症患者家属的心理状况调查及对策

目的 了解精神分裂症患者家属的心理状况。方法 采用症状自评量表（SCL-90）、焦虑自评量表（SAS）扣抑郁自评量表（SDS），对98名精神分裂症患者家属进行调查，并与全国常模进行比较。结果 精神分裂症患者家属存在严重的，躯体化、焦虑抑郁情绪及偏执等心理问题。结论 精神分裂症患者家属存在严重的心理问题，因此，应对家属提供心理帮助，以提高他们的生活质量，有利于病人的康复。     

330名大学新生考期焦虑、抑郁状况及相关因素研究

目的了解大学新生考期焦虑、抑郁情绪状况，以利于更好的组织教学和管理。方法采用Zung焦虑、抑郁自评量表对理工科、综合性两所不同高校330名大学新生进行施测。结果大学新生焦虑、抑郁均值都高于全国常模，且具有显著性差异（P〈0.01）；大学新生女生焦虑、抑郁均值均高于男生，且具有极其显著性差异（P〈0．001），理工科大学和综合性大学学生焦虑、抑郁均值比较，无显著性差异（P〉0．05）；高分组女生比例高于男生，除了中重度焦虑外，轻度焦虑、轻度抑郁和中重度抑郁均有显著性差异（P〈0．05）；高分组学校间理工科大学比例高于综合性大学，但焦虑、抑郁不同程度均无显著性差异（P〉0．05）。结论大学新生焦虑、抑郁情绪状况不良，高于全国常模水平；女生焦虑、抑郁均值和高分组比例均高于男生；理工科大学和综合性大学间焦虑、抑郁均值和高分组比例无显著性差异。     

精神分裂症患者配偶心理健康状况调查与心理干预

目的探讨精神分裂症患者配偶的心理状况及心理干预效果。方法对100例精神分裂症患者配偶采用症状自评量表（SCL—90）、焦虑自评量表（SAS）和抑郁自评量表（SDS）进行测评,并根据测评结果,针对存在的心理问题给予干预。结果精神分裂症患者配偶SCL—90（除强迫、偏执外t=2.08~7.59,P〈0.05或0.01）;SAS、SDS评分也明显高于国内常模（t=6.51和5.89,P〈0.01）,存在明显的焦虑、抑郁情绪,经心理干预后评分也随之下降。结论精神分裂症患者配偶存在不同程度的心理问题,心理干预能够提高他们的心理承受能力,减轻心理应激反应。     

平均红细胞体积和平均红细胞血红蛋白含量筛查妊娠合并轻型地中海贫血的价值

目的探讨平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)检测在筛查妊娠合并轻型地中海贫血(地贫)中的价值。方法 1514例孕妇在首次产前检查时,同时检查外周血MCV、血红蛋白浓度(Hb)、MCH及血红蛋白电泳等指标,依据首次产前检查时血常规及血红蛋白电泳结果分3组:Ⅰ组127例:Hb<100g/L伴血红蛋白电泳异常;Ⅱ组69例:Hb<100g/L而血红蛋白电泳正常;对照组1318例:Hb>100g/L及血红蛋白电泳正常;以基因诊断作为地贫诊断金标准。结果Ⅰ组MCV及MCH最低,明显低于Ⅱ组和对照组(P<0.01),而Ⅱ组与对照组无显著性差异(P>0.05)。MCV及MCH检测筛查地贫与基因诊断结果比较:灵敏度(Se)98.06%、特异度(Sp)72.04%、假阳性率0.28、假阴性率0.02、准确度90.31%、阳性预测值79.53%、阴性预测值90.30%、阳性似然比3.50、阴性似然比0.028。结论轻型地贫者有MCV、MCH降低的特征,临床上检测MCV、MCH筛查妊娠合并轻型地贫,其灵敏度高,且特异度也较高,假阳性率和假阴性率低。方法简便、实用、经济。可作为基层医院轻型地贫的筛查指标。     

Vertical transmission of HIV in Ghanaian women diagnosed in cord blood and post-natal samples

HIV RNA detection in the newborn is the main diagnostic tool for vertical transmission. Most infections are thought to occur peri- or post-natally, hence preventive antiviral therapy administered days before and during delivery. This study used cord blood for molecular diagnosis, examined viral load and HIV-1 subtypes as determinants of transmission, and compared molecular variability of maternal, cord blood, and post-natal quasispecies. Ninety-seven seropositive mother-cord blood paired plasmas from Ghana were tested for HIV RNA. Viral load was quantified and a subgroup of 45 random women samples was typed and subtyped. HIV-1 from infected pairs was cloned, sequenced, and analyzed phylogenetically. The prevalence of HIV infection in pregnant women was 3.3%. 13/97 cord blood samples (13.5%) contained HIV RNA. No correlation between either viral load at labor (range 10(3)-10(7)) or HIV-1 subtype and in utero transmission was found. In both transmitting and non-transmitting mothers, 56% of HIV-1 strains were CRF02_AG. In three pairs, maternal and cord blood quasispecies were closely related, suggesting late pregnancy or perinatal transmission, while in four pairs, genetic distances suggested transmission earlier during gestation. Maternal viral load and genotype did not correlate with HIV-1 pre-natal transmission. HIV infection during gestation appears relatively frequent.     

Predictive,pre-natal and diagnostic genetic testing for Huntington's disease: the experience in Canada from 1987 to 2000

Predictive and pre-natal testing for Huntington's Disease (HD) has been available since 1987. Initially this was offered by linkage analysis, which was surpassed by the advent of the direct mutation test for HD in 1993. Direct mutation analysis provided an accurate test that not only enhanced predictive and pre-natal testing, but also permitted the diagnostic testing of symptomatic individuals. The objective of this study was to investigate the uptake, utilization, and outcome of predictive, pre-natal and diagnostic testing in Canada from 1987 to April 1, 2000. A retrospective design was used; all Canadian medical genetics centres and their affiliated laboratories offering genetic testing for HD were invited to participate. A total of 15 of 22 centres (68.2%), currently offering or ever having offered genetic testing for HD, responded, providing data on test results, demographics, and clinical history. A total of 1061 predictive tests, 15 pre-natal tests, and 626 diagnostic tests were performed. The uptake for predictive testing was approximately 18% of the estimated at-risk Canadian population, ranging from 12.5% in the Maritimes to 20.7% in British Columbia. There appears to have been a decline in the rate of testing in recent years. Of the predictive tests, 45.0% of individuals were found to have an increased risk, and a preponderance of females (60.2%) sought testing. A greater proportion of those at < or = 25% risk sought predictive testing once direct CAG mutation analysis had become available (10.9% after mutation analysis vs 4.7% before mutation analysis, p = 0.0077). Very few pre-natal tests were requested. Of the 15 pre-natal tests, 12 had an increased risk, resulting in termination of pregnancy in all but one. Diagnostic testing identified 68.5% of individuals to be positive by mutation analysis, while 31.5% of those with HD-like symptoms were not found to have the HD mutation. The positive diagnostic tests included 24.5% of individuals with no known prior family history of HD.     

Predictive and pre-natal testing for Huntington Disease in Australia: results and challenges encountered during a 10-year period (1994-2003)

This study summarizes 10-years' experience of predictive and pre-natal testing and pre-implantation genetic diagnosis (PGD) for Huntington disease (HD) in Australia. Results are presented from 2036 direct mutation predictive tests conducted between January 1994 and December 2003. Thirty-eight per cent of results (776/2036) were positive, 56% (1140/2036) were negative, and 6% (120/2036)) were in the mutable normal (27-35 CAG repeats) or in the reduced penetrance (36-39 CAG repeats) ranges. Ninety-four per cent (1908/2036) and 6% (128/2036) of those tested had prior genetic risks of 50% and 25%, respectively. Twenty-seven per cent (34/128) of those at 25% risk had their genetic status changed to positive, thus revealing the positive status of their at-risk parent. During this period, 63 pre-natal tests were also conducted, and 13 children were born following PGD for HD. Social workers specializing in predictive testing counselling over this 10-year period across Australia identified and summarized particularly challenging counselling issues. These included the interpretation of mutable normal and reduced penetrance range test results, potential conflicts of interest between family members regarding testing decisions, unanticipated consequences of both predictive and pre-natal testing decisions, the importance of following protocols for predictive testing to facilitate long-term adjustment to results, and the potential for genetic discrimination. The identified issues highlight the importance of the protocols for predictive testing and indicate that extension of the international guidelines published in 1994 may be timely.     

Pre-natal exposure to perfluoroalkyl substances may be associated with altered vaccine antibody levels and immune-related health outcomes in early childhood

Abstract

Perfluoroalkyl substances (PFAS) are suggested to have immunosuppressive effects; exposure in utero and in the first years of life is of special concern as fetuses and small children are highly vulnerable to toxicant exposure. The objective of this study was to investigate the effect of pre-natal exposure to PFAS on responses to pediatric vaccines and immune-related health outcomes in children up to 3 years of age. In the prospective birth-cohort BraMat, a sub-cohort of the Norwegian Mother and Child Cohort Study (MoBa), pregnant women from Oslo and Akershus, Norway, were recruited during 2007–2008. Three annual questionnaire-based follow-ups were performed. Blood samples were collected from the mothers at the time of delivery and from the children at the age of 3 years. As a measure of pre-natal exposure to PFAS, the concentrations of perfluorooctanoate (PFOA), perfluorononanoate (PFNA), perfluorohexane sulfonate (PFHxS), and perfluorooctane sulfonate (PFOS) were determined in maternal blood from 99 BraMat participants. Main outcome measures were anti-vaccine antibody levels, common infectious diseases and allergy- and asthma-related health outcomes in the children up to the age of 3 years. There was an inverse association between the level of anti-rubella antibodies in the children’s serum at age 3 years and the concentrations of the four PFAS. Furthermore, there was a positive association between the maternal concentrations of PFOA and PFNA and the number of episodes of common cold for the children, and between PFOA and PFHxS and the number of episodes of gastroenteritis. No associations were found between maternal PFAS concentrations and the allergy- and asthma-related health outcomes investigated. The results indicate that pre-natal exposure to PFAS may be associated with immunosuppression in early childhood.     

Demand for antenatal care in South Africa

On May,24 1994, the then South African president, Mr. Nelson Mandela, declared that all health care for children under the age of 6 years, and pregnant women would be free. Unfortunately, there has been no significant decrease in maternal, perinatal and infant mortality. Thus, there is a need of research into the factors that influence the demand for antenatal services. The objectives of this paper are to (a) establish the determinants of individual pregnant women's choice to seek antenatal care; and (b) deal with potential endogeneity bias in the relationship between the decision to seek pre-natal care and perceived health status. The joint determination of consumption of antenatal care and pregnant woman's health status requires estimation of a simultaneous system. To help mitigate the simultaneity bias and avoid the inconsistency inherent in the application of Ordinary least Squares (OLS) method to simultaneous equations systems, we used Two-Stage Probit Maximum Likelihood Estimator Method. In the antenatal structural-form equation, the coefficients for TOILET, AGE, OCCUPATION, EMPLOYMENT, SMOKER, METHODS and QUALITY were statistically significant at P 相似文献   

Expression of Epstein-Barr virus membrane antigen gp350/220 in E. coli and in insect cells.

The Epstein-Barr virus open reading frame BLLF1 encodes the major envelope glycoproteins gp350 and gp220. Fragments of the gp350/220 gene were expressed in Escherichia coli in order to define regions of the polypeptide chain reacting with human sera. The C-terminal half of the protein was sufficient for recognition by all VCA-positive sera tested. A membrane anchor truncated version of gp350/220 was expressed in insect cells using the baculovirus system. Proteins of different sizes were specifically detected in the cells while a glycosylated 220-kDa protein was secreted. The insect cells were tested for their suitability as tools for performing monospecific immunofluorescence.     

Sex chromosome rearrangements leading to partial aneuploidies and mosaicisms: use of QF-PCR for detection and quantification of the involved cell lines

Chromosome rearrangements can lead to aneuploidies of specific chromosome regions and could be present in the entire individual or limited to some tissues (mosaicism) depending on the developmental stage of the embryo when the rearrangement occurs. We report 6 cases with sex chromosome rearrangements identified by conventional cytogenetics and tested by quantitative fluorescent polymerase chain reaction (QF-PCR). QF-PCR has been largely employed for rapid detection of common aneuploidies in pre-natal and post-natal diagnosis and consists in DNA amplification by polymerase chain reaction (PCR) using fluorescent labelled primers and the analysis of chromosome specific small tandem repeats (STR). We tested 5 sex chromosome specific STR markers in multiplex PCR amplifications together with other chromosome specific STR markers as control amplifications. The PCR products were analysed by capillary electrophoresis. The results from QF-PCR analysis were obtained within one day and confirmed our cytogenetic observations. This study shows that QF-PCR analysis can detect sex chromosome imbalance and also suspect mosaicism or chromosome rearrangement.     

Inbreeding and fertility in a South Indian population

Among 1913 women in Karnataka State, South India, 37.74% had married a relative (a consanguineous union), 60.79% were non-consanguineously married, and 1.46% did not know whether they had married a relative. Mean number of living offspring for consanguineously married women who had completed their reproduction was 3.89, and for the non-consanguineous 4.07. There is no significant difference in the mean level of fertility for the two groups measured in this way. Pre-natal mortality is lower (but not significantly) among consanguineously married women who have completed their reproduction than among the non-consanguineous group, but post-natal mortality is significantly higher among the conceptuses of the consanguineously married women. Although consanguineously married women conceive more frequently, that is, are more fecund than the non-consanguineous women (mean number of conceptions being 6.61 and 6.28, respectively), the difference is not significant. The differential survival of the offspring results in the consanguineous group having slightly lower net fertility, although the difference is not statistically significant. The lower sterility rates of the consanguineously married women (3.21% of all consanguineously married women show primary sterility compared to 3.47% of the non-consanguineous) may be due to greater compatibility of uniting gametes in the consanguineous marriages. The data reveal that women married to a relative and having completed their reproduction show higher fecundity, lower pre-natal mortality, higher post-natal mortality, lower sterility rates, and thus no significant difference in net fertility to those who had not married a relative.