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关键词： 血液检验   贫血诊断   鉴别诊断   价值  

摘要： 目的分析血液检验在贫血诊断与鉴别诊断中的价值。方法研究对象为贫血患者120例,根据患者贫血类型进行分组,其中60例地中海贫血患者、60例缺铁性贫血患者,再选取同期健康体检者60名为对照组,收取时间2015年1月-2018年8月,对三组受检者均进行血液检验,对三组受检者血红蛋白、红细胞平均血红蛋白量、红细胞体积分布宽度、红细胞平均体积、红细胞计数进行比较。结果地中海贫血组和对照组各指标比较,红细胞计数较高,而血红蛋白、红细胞平均血红蛋白量、红细胞平均体积、红细胞体积分布宽度低于对照组(P<0.05);缺铁性贫血组和对照组相比,均具有差异;缺铁性贫血组和地中海贫血组患者相比,红细胞体积分布宽度较高,而红细胞计数以及血红蛋白较低,其具有显著差异(P<0.05)。结论血液检验在贫血诊断具有显著的诊断价值,而联合多项指标进行检测能对贫血类型有效鉴别,具有较高的鉴别价值。

关键词： 急性颅脑损伤   CT   MRI   影像学诊断   鉴别诊断  

摘要： 目的:探究急性颅脑损伤CT、MRI诊断与鉴别诊断效果。方法:对2016年6月—2018年6月60例在本院接受治疗的急性颅脑损伤患者的临床资料进行回顾性分析,所有患者均接受CT和MRI诊断,对比诊断效果。结果:CT与MRI对急性颅脑损伤均具有较高的诊断准确率,但是MRI的准确性高于对照组,差异性具有统计学意义:P <0.05。MRI对脑叶挫裂伤诊断准确性较高,而CT对蛛网膜下腔出血诊断率较高,组间差异性对比;P <0.05。结论:CT与MRI对急性颅脑损伤均具有较高的诊断效果,MRI诊断准确性高于CT,建议两者相结合,提高诊断准确性。

关键词： 创伤后应激障碍   情志   中医情志疗法  

摘要： 根据中医情志理论,将中医情志疗法运用在创伤后应激障碍的治疗中,主要采取了顺情从欲、开导解惑、情志相胜、移精变气、暗示诱导、志意以绳等六种方法。通过对中医情志疗法的整理和分析,发现中医情志疗法治疗创伤后应激障碍体现了传统中医的价值,可进一步在实践中加以验证。

关键词： 医院-社区-家庭一体化延续护理   酒精所致精神障碍   复饮效果  

摘要： 目的探究医院—社区—家庭一体化延续护理降低酒精所致精神障碍患者的复饮效果。方法随机抽取本院2016年1月至2017年6月期间收治的82例酒精所致精神障碍患者,分为对照组和观察组。对照组给予常规护理干预,观察组给予医院-社区-家庭一体化延续护理干预,对比分析两组患者的复饮效果和社会支持评分(SSRS评分)。结果观察组复饮率(48.78%)比对照组(75.61%)低,其客观支持(10.64±2.17)、主观支持(14.34±1.31)和对社会支持的利用度(10.05±1.17)则高于对照组[(8.41±2.05)、(12.11±1.72)、(8.64±1.09)],差异有统计学意义(P<0.05)。结论医院-社区-家庭一体化延续护理在酒精所致精神障碍患者中具有良好的应用效果,能够有效降低复饮率,提高戒酒效果和社会支持评分,值得在临床上推广和应用。

关键词： Psychiatry  

摘要： Chronic psychotic disorders (CPDs) occur worldwide and cause significant burden including reduced quality of life and functional impairment. Care for CPD includes psychosocial and pharmacologic interventions (i.e. anti-psychotic drugs) and ongoing health monitoring. This is challenging in resource-limited settings where staff are sparse and/or undertrained. Importantly, mental health human resource needs predict continued deficits compounded by increasing disease burden. A U.S. team recently developed and tested a CPD treatment approach that combines the use of long-acing antipsychotic medication (LAI) with a brief and practical customized adherence enhancement behavioral intervention (CAE-L). This report describes the methodological details of an ongoing, first-ever refinement and preliminary testing of CAE-L in poorly adherent patients with CPD in Tanzania. Additional innovative elements include: 1) a manualized curriculum that targets specific barriers and facilitators to medication adherence in Tanzanians with CPD, and 2) targeting known, high-risk individuals with CPD (those who miss >= 20% of prescribed antipsychotic medication). The study procedures are intended to pave the way for implementing a large-scale intervention trial for CPD in the Tanzanian setting. An important component of this project is capacity building to help form the next generation of care providers. Visit exchanges modeled on a successful NIH-funded Medical Education Partnership Initiative (MEPI) template will also use the U.S. and Tanzanian teams to share expertise, problem-solve, and plan iterative refinements of project deliverables. Taken together, this project has potential to advance the care of people with CPD in Tanzania and has high generalizability to Sub-Saharan Africa and other lower-resource settings.

摘要： Highlights from the article: To understand the obstacle to consult a psychiatrist in general hospital in the perspective of non-psychiatrist physicians. Anxiety and depression were the most symptoms (64.4%, 62.2% respectively) that the physicians saw in their medical diseases patients that needed a psychiatric consultation.

关键词： Untreated individuals   Stigma   Self-identification   Need   Help-seeking  

摘要： It is unclear to what extent failure to recognize symptoms as potential sign of a mental illness is impeding service use, and how stigmatizing attitudes interfere with this process. In a prospective study, we followed a community sample of 188 currently untreated persons with mental illness (predominantly depression) over 6 months. We examined how lack of knowledge, prejudice and discrimination impacted on self-identification as having a mental illness, perceived need, intention to seek help, and help-seeking, both with respect to primary care (visiting a general practitioner, GP) and specialist care (seeing a mental health professional, MHP). 67% sought professional help within 6months. Fully saturated path models accounting for baseline depressive symptoms, previous treatment experience, age and gender showed that self-identification predicted need (beta 0.32, p<0.001), and need predicted intention (GP: beta 0.45, p<0.001;MHP: beta 0.38, p<0.001). Intention predicted service use with a MHP after 6months (beta 0.31, p<0.01;GP: beta 0.17, p=0.093). More knowledge was associated with more self-identification (beta 0.21, p<0.01), while support for discrimination was associated with lower self-identification (beta -0.14, p<0.05). Blaming persons with mental illness for their problem was associated with lower perceived need (beta -0.16, p<0.05). Our models explained 37% of the variance of seeking help with a MHP, and 33% of help-seeking with a GP. Recognizing one's own mental illness and perceiving a need for help are impaired by lack of knowledge, prejudice, and discrimination. Self-identification is a relevant first step when seeking help for mental disorders.

摘要： Sleep spindles are NREM sleep EEG oscillations, which are initiated within the thalamus and are regulated by thalamo-cortical circuits. Previous work from our and other research groups has shown marked spindle deficits in patients with schizophrenia (SCZ). However, the presence of spindle impairments at illness onset, including which parameters are most affected, their topographic characteristics, and their relationships with clinical symptoms have yet to be characterized. In this study we performed sleep high density (hd)-EEG recordings in twenty-seven first-episode psychosis (FEP) patients and twenty-three healthy controls (HC). Several spindle parameters-amplitude, duration, and density-were calculated and compared across groups. FEP patients showed reduced spindle duration and density, but not in spindle amplitude relative to HC. These spindles reductions were localized in a frontal area and predicted the severity of FEP patients' negative symptoms. Altogether, these findings indicate that spindle deficits are present at the beginning of psychosis, contribute to clinical symptomatology, and point to frontal thalamo-cortical dysfunctions, thus providing a potential treatment target for early interventions in SCZ and related psychotic disorders.

关键词： 血液检查   贫血诊断   鉴别诊断  

摘要： 分析讨论在贫血诊断和鉴别诊断中应用血液检查的具体效果。 方法:选取本院2018年1月-2019年1月缺铁性贫血患者100例,将其作为观察组;选取同期健康人群100例,将其作为对照组。比较两组患者检验结果。 结果:观察组红细胞平均血红蛋白量、血红蛋白量、红细胞平均体积均低于对照组,血清铁转蛋白受体高于对照组,P<0.05。 结论:在贫血患者的诊断和鉴别当中使用血液检验效果明显,临床应用价值较高,具有推广应用价值。

关键词： 小剂量抗精神病药   心理疗法   躯体化障碍  

摘要： 研究小剂量抗精神病药联合心理疗法治疗躯体化障碍的效果。方法:选取2018年6月-2019年2月我院收治的64例躯体化障碍患者作为研究对象,按照治疗方法分两组观察组和对照组,观察组32例,对照组32例,对照组采用小剂量抗精神病药治疗,观察组采用小剂量抗精神病药联合心理疗法治疗,对比两组的心理焦虑量表评分和治疗效果。结果:观察组与对照组比较,观察组的心理焦虑评分较低,治疗效果好,治疗有效率高,对比差异有统计学意义,P<0.05。结论:小剂量抗精神病药联合心理疗法治疗躯体化障碍的效果好,不仅可以提升治疗效果,还可以改善患者的心理状况,临床实用价值高,值得推广。