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关键词： 慢性酒精中毒   精神障碍   腹部超声检查   结果分析  

摘要： 目的研究慢性酒精中毒所导致的精神障碍患者腹部超声检查的结果并对结果进行分析。方法对2016年3月-2019年3月期间在该院进行住院治疗的127例因慢性酒精中毒而引起的精神障碍的患者的腹部超声图像资料进行回顾性分析。结果在127例患者中,共计有120例患者检查结果呈现阳性。阳性率为94.49%,其中慢性酒精性肝病61例,酒精性脂肪肝49例,酒精性肝硬化10例,正常例数7例;合并肝囊肿10例,肝血管瘤2例,肝内胆管结石3例,胆囊炎,胆囊结石8例,胆囊息肉6例,慢性胰腺炎3例,脾肿大12例,肾囊肿7例,肾结石18例。结论应用超声诊断的方式对因慢性酒精中毒而引发的精神障碍患者进行检查,检查其是否存在机体内脏器合并损害等情况具有明显的作用,具有操作简单、无创伤性、快捷、方便等特点,最重要的是其诊断率较高,因而值得临床广泛应用。

关键词： 脑性瘫痪   镜像视觉反馈疗法   运动想象疗法   精神发育迟滞   康复训练  

摘要： 目的观察镜像视觉反馈疗法结合运动想象疗法在脑性瘫痪(CP)合并精神发育迟滞(MR)患儿康复训练中的应用效果。方法选取2014年6月—2017年6月南京医科大学附属儿童医院收治的CP合并MR患儿100例,依据随机数字表法分为观察组和常规组,每组50例。常规组给予常规康复疗法治疗,观察组在常规组基础上给予镜像视觉反馈疗法结合运动想象疗法治疗,比较两组粗大运动功能、精神发育、功能独立性情况。结果观察组和常规组治疗后3个月、6个月粗大运动功能量表(GMFM)、儿心量表、儿童功能独立性评定量表(WeeFIM)评分明显高于治疗前,观察组治疗后3个月、6个月GMFM、儿心量表、WeeFIM得分明显高于常规组,差异均有统计学意义(P<0.05)。结论镜像视觉反馈疗法结合运动想象疗法可有效促进CP合并MR患儿粗大运动功能、精神发育的康复,有利于提高患儿的功能独立性。

关键词： 创伤后应激障碍   多发伤   高危因素   早期护理干预   PCL-C评分  

摘要： 目的:分析多发伤患者创伤后应激障碍的高危因素以及探讨早期护理干预的效果.方法:回顾性收集时间为2016年10月-2018年10月我院收治的多发伤患者79例,对所有患者应激障碍的高危因素进行分析,并对所有患者进行早期护理干预,分析护理干预的效果.结果:多发伤创伤后的应激障碍与年龄、性格、既往病史以及烟酒依赖、皮质醇水平有关,并且对患者进行护理后PCL-C评分明显改善.结论:多发伤创伤后的应激障碍与年龄、性格、既往病史以及烟酒依赖、皮质醇水平有关,早期护理干预可以明显改善PCL-C评分水平.

关键词： 原发性颅内淋巴瘤   核磁共振成像   鉴别与诊断   诊断价值  

摘要： 研究原发性颅内淋巴瘤的核磁共振成像的特点,以提高诊断水平。方法:选取20例经病理证实的原发性颅内淋巴瘤患者,分析其核磁共振成像特点。结果:20例患者中,单发14例,多发6例,共30个病灶,其中额叶10个,颞叶5个,顶叶6个,枕叶4个,基底节3个,小脑2个;其中5例病及胼胝体。核磁共振成像特点:T1WI序列为等或稍低信号,T2WI、T2WI/FLAIR序列为等或稍高信号,周围水肿较轻;扫描增强后,呈现为团块状或斑片状,明显表现出均匀强化。20例患者均为B细胞性非霍奇金淋巴瘤。结论:原发性颅内淋巴瘤的核磁共振成像有着独特的特征表现,瘤体的数量以及位置可以有效呈现出来,有着比较高的诊断价值。

关键词： 高危妊娠   创伤后应激障碍   应对方式   疾病不确定感   影响因素   路径分析   中介作用  

摘要： [目的]探讨高危妊娠女性创伤后应激障碍现状,以及疾病不确定感、应对方式与创伤后应激障碍之间的关系及作用路径,建立三者的关系模型。[方法]采用一般资料调查表、创伤后应激障碍清单平民版、Mishel疾病不确定感量表和特质应对问卷对南京市某三级甲等综合医院待产的306例高危妊娠女性进行调查。[结果]高危妊娠女性的创伤后应激障碍阳性率为16.3%,低学历、非独生女、无固定工作、存在疾病史或创伤史、双胎妊娠及睡眠质量不满意的高危妊娠女性得分较高(P<0.05)。疾病不确定感可以直接或通过不同的应对方式间接影响创伤后应激障碍水平,应对方式在疾病不确定感与创伤后应激障碍症状之间能够起到完全或部分中介作用。[结论]建议加强对高危妊娠女性心理需求的理解和支持,借助产科护理门诊提供高危妊娠人群的集中管理,给予与疾病相关的充足且具有实际指导意义的信息,以降低疾病不确定感,帮助调节孕期不良情绪反应,通过强化积极正向的应对方式缓解应激症状。

关键词： 一片狼藉   舆论场   创伤后应激障碍   口号式   雪崩   韩国   雪花  

摘要： 看似很有道理的口号式金句,其实只能传递情绪,并不是最终的答案.“雪崩的时候,没有一片雪花是无辜的!”“我什么都没做,怎么就雪花了,怎么就不无辜了?”“韩国雪崩了,能怪到中国雪花的头上吗……”韩国女星崔雪莉自杀去世后,没想到中文舆论场中最激烈的话题之一,竟然是围绕一句在中国网友心中已经耳熟能详的“名言”.争到一片狼藉后,大家都累了,只想达成一个共识:“可别再雪崩雪花的了,我都雪花PTSD(创伤后应激障碍)了”.

关键词： ketamine   psychosis   cerebellum   celastrol   oxidative stress   NADPH oxidases  

摘要： Administration of subanesthetic doses of ketamine during brain maturation represents a tool to mimic an early insult to the central nervous system (CNS). The cerebellum is a key player in psychosis pathogenesis, to which oxidative stress also contributes. Here, we investigated the impact of early celastrol administration on behavioral dysfunctions in adult mice that had received ketamine (30 mg/kg i.p.) at postnatal days (PNDs) 7, 9, and 11. Cerebellar levels of 8-hydroxydeoxyguanosine (8-OHdG), NADPH oxidase (NOX) 1 and NOX2, as well as of the calcium-binding protein parvalbumin (PV), were also assessed. Furthermore, celastrol effects on ketamine-induced alterations of proinflammatory (TNF-alpha, IL-6 and IL-1 beta) and anti-inflammatory (IL-10) cytokines in this brain region were evaluated. Early celastrol administration prevented ketamine-induced discrimination index decrease at adulthood. The same was found for locomotor activity elevations and increased close following and allogrooming, whereas no beneficial effects on sniffing impairment were detected. Ketamine increased 8-OHdG in the cerebellum of adult mice, which was also prevented by early celastrol injection. Cerebellar NOX1 levels were enhanced at adulthood following postnatal ketamine exposure. Celastrol per se induced NOX1 decrease in the cerebellum. This effect was more significant in animals that were early administered with ketamine. NOX2 levels did not change. Ketamine administration did not affect PV amount in the cerebellum. TNF-alpha levels were enhanced in ketamine-treated animals;however, this was not prevented by early celastrol administration. While no changes were observed for IL-6 and IL-1 beta levels, ketamine determined a reduction of cerebellar IL-10 expression, which was prevented by early celastrol treatment. Our results suggest that NOX inhibition during brain maturation prevents the development of psychotic-like behavioral dysfunctions, as well as the increased cerebellar oxidative

关键词： 地震   创伤后应激障碍   心理问题  

摘要： 通过对受灾地区不同人群地震创伤后应激障碍进行调查研究,为日后开展对创伤后应激障碍心理健康教育等相关工作提供相关数据和经验,对推动灾难医学的发展有重要意义。方法:采用简单随机抽样的方法,随机抽取什邡市当地居民并采用问卷填写的方式进行调查。结果:数据分析结果显示5.07%对PTSD非常了解,16.11%了解PTSD,大部分人(78.82%)一般了解或不了解PTSD。:其中女性(17.2%)相对男性(13.9%)更为严重。根据卡方检验可知,年龄、学历、婚姻状况对PTSD的影响具有统计学意义(P<0.05)结论:汶川地震对受灾群众的心里造成严重的不良影响,在进行社会救助时还要注重其心灵创伤,促进受灾群众更好的全面康复。

关键词： 汶川地震   创伤后应激障碍   什邡市居民  

摘要： 了解汶川地震11年后什邡市居民PTSD及其相关影响因素。方法:采用简单随机抽样的方法,在什邡市城区,洛水镇街道随机抽取453名居民进行调查。结果:女性PTSD与男性PTSD无显著差别。PTSD症状出现频率较高的有:想起灾害恐惧害怕(46.4%),看到或听到与灾害有关的事情担心灾害再度发生(44.4%),脑子里无法摆脱灾害发生时的情景(39.0%)。与PTSD发生的相关因素有年龄(p=0.01)、婚姻状况(P=0.002)、学历(P=0.00)。结论:地震对当地居民身心有较大影响。年龄、婚姻、学历是其重要影响因素。PDST的发生有可预测性,可根据调查采取相应措施。

关键词： Physical activity   Severe mental illness   Schizophrenia   Lifestyle   Implementation  

摘要： Background Despite an increase in studies showing the efficacy of lifestyle interventions in improving the poor health outcomes for people with severe mental illness (SMI), routine implementation remains ad hoc. Recently, a multidisciplinary lifestyle enhancing treatment for inpatients with SMI (MULTI) was implemented as part of routine care at a long-term inpatient facility in the Netherlands, resulting in significant health improvements after 18 months. The current study aimed to identify barriers and facilitators of its implementation. Methods Determinants associated with the implementation of MULTI, related to the innovation, the users (patients, the healthcare professionals (HCPs)), and the organisational context, were assessed at the three wards that delivered MULTI. The evidence-based Measurement Instrument for Determinants of Innovations was used to assess determinants (29 items), each measured through a 5-point Likert scale and additional open-ended questions. We considered determinants to which >= 20% of the HCPs or patients responded negatively ("totally disagree/disagree", score < 3) as barriers and to which >= 80% of HCPs or patients responded positively ("agree/totally agree", score > 3) as facilitators. We included responses to open-ended questions if the topic was mentioned by >= 2 HCPs or patients. In total 50 HCPs (online questionnaire) and 46 patients (semi-structured interview) were invited to participate in the study. Results Participating HCPs (n = 42) mentioned organisational factors as the strongest barriers (e.g. organisational changes and financial resources). Patients (n = 33) mentioned the complexity of participating in MULTI as the main barrier, which could partly be due to organisational factors (e.g. lack of time for nurses to improve tailoring). The implementation was facilitated by positive attitudes of HCPs and patients towards MULTI, including their own role in it. Open responses of HCPs and patients showed strong commitment, colla