冠心病介入术前患者睡眠质量及相关因素研究

目的:探讨冠心病介入治疗患者术前睡眠质量及其影响因素。方法:采用一般状况调查表、匹兹堡睡眠质量指数(PSQI)量表、焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)对2013年7月至2014年1月在某院心内科接受介入治疗的392例冠心病患者进行问卷调查。结果:发放问卷410份,回收有效问卷392份,有效率为95.6%。392例患者中287例存在睡眠质量问题,总发生率为73.2%,PSQI总分为9.88±3.63。相关因素分析显示年龄、性别、婚姻状况、焦虑、抑郁和社会支持6项是冠心病介入治疗术前患者睡眠质量的预测因素。结论:冠心病介入治疗患者术前睡眠质量较差,并受多种因素影响。     

焦虑、抑郁及社会支持情况对短暂性脑缺血发作患者睡眠的影响

目的:讨论焦虑、抑郁和社会支持情况对短暂性脑缺血患者睡眠的影响情况。方法:将2012年1月至2014年1月于我院治疗的164名短暂性脑缺血患者为研究对象,采用社会支持评定量表SSRS、自评焦虑量表SAS、匹兹堡睡眠指数PSQI及自评抑郁量表SDS评估病人的抑郁、焦虑与社会支持情况对患者的影响,并分析相关性。在对患者进行一个月的治疗过程中,对伴有焦虑及抑郁症状的患者给予盐酸舍曲林片,并考察药物治疗对患者睡眠质量的影响情况。结果:164名患者中出现焦虑的几率为37.4%,出现抑郁的几率为18.9%,二者同时出现的几率为12.8%,存在睡眠障碍的患者约占68.4%,匹兹堡睡眠指数与自评焦虑量指数、自评抑郁量指数与社会支持评定量的主观支持与患者对支持和利用得分均存在相关性(r=0.66、0.53、-0.39,-0.40,P0.05),且差异有统计学意义。对采集的数据进行多因素回归分析,结果显示,焦虑、抑郁、社会主观支持和患者对支持的利用度是影响睡眠的重要因素。通过Logistic回归分析,结果显示患者对支持利用度的增加及自评焦虑量指数、自评抑郁量指数与发作次数的减少有利于改善患者的睡眠障碍(OR=0.221、2.412、1.938、0.321,P0.05)。结论:抑郁、焦虑和社会支持是导致短暂性脑缺血患者存在睡眠障碍的重要因素,对三者情况进行改善可辅助药物治疗,改善患者睡眠质量。     

终末期肾脏病患者睡眠质量的影响因素及其与生活质量、焦虑抑郁的关系研究

目的:探讨终末期肾脏病(ESRD)患者睡眠质量的影响因素及其与生活质量、焦虑抑郁的关系。方法:选取2018年3月~2019年12月期间我院收治的ESRD患者198例为研究对象。患者睡眠质量采用匹兹堡睡眠指数量表(PSQI)评价。采用焦虑自评量表(SAS)与抑郁自评量表(SDS)评估患者焦虑、抑郁状态。采用肾病生活质量评价量表(KDQOL-SF1.2)评价患者生活质量。分析ESRD患者睡眠质量的影响因素,并分析睡眠质量与生活质量、焦虑抑郁的相关性。结果:ESRD患者中约有93例发生睡眠障碍,睡眠障碍发生率为46.97%(93/198),并将其纳入睡眠障碍组,剩余的105例纳入非睡眠障碍组。非睡眠障碍组KDQOL-SF 1.2评分高于睡眠障碍组,SAS评分、SDS评分则低于睡眠障碍组(P<0.05)。单因素分析结果显示,两组年龄、透析龄、血红蛋白、甲状旁腺激素(iPTH)、血肌酐(Scr)、血钙、血磷比较差异显著(P<0.05),两组性别、配偶、经济收入、文化程度、血清白蛋白、尿素氮(BUN)比较差异无统计学意义(P>0.05)。多重线性回归方程结果显示,年龄、透析龄、血红蛋白、iPTH、Scr、血钙、血磷均是ESRD患者睡眠障碍的影响因素(P<0.05)。PSQI评分与SAS评分、SDS评分均呈正相关,与KDQOL-SF 1.2评分呈负相关(P<0.05)。结论:ESRD患者睡眠障碍的发生率高,年龄、透析龄、血红蛋白、iPTH、Scr、血钙、血磷均是ESRD患者睡眠质量的影响因素,同时其睡眠质量与生活质量、焦虑抑郁具有一定的相关性。     

健康教育路径对甲状腺癌手术患者生活质量的影响

目的:探讨健康教育路径对甲状腺癌手术病人生活质量的影响。方法:将78例行甲状腺癌择期手术患者随机分为实验组和对照组,每组各39例,对照组采用传统健康教育方法,实验组采用健康教育路径进行教育,采用癌症患者生活质量指数评定量表(QLI中文修订版)、焦虑自评量表(SAS)和抑郁自评量表(SDS),分别于入组时、术后1个月、6个月对两组病人进行问卷调查,评估病人生活质量及焦虑、抑郁程度。结果:实验组甲状腺癌手术患者生活质量指数高于对照组,焦虑抑郁评分低于对照组(P0.05),健康知识掌握情况高于对照组(P0.05)。结论:健康教育路径在甲状腺癌手术患者宣教中效果显著,对甲状腺癌手术病人生活质量的提高有明显作用,可在临床护理工作中逐渐推广。     

冠心病患者术前睡眠质量调查及影响因素分析

目的:研究心血管外科冠心病患者术前的睡眠质量、焦虑情况及其影响因素。方法:采用匹兹堡睡眠质量指数(PSQI)量表、医院焦虑抑郁量表(HADS)和自制的影响睡眠质量因素调查表对入选的100例患者进行问卷调查,对问卷结果进行统计学分析。结果:1住院患者术前10天PSQI总分为9.42±4.90,术前1天PSQI总分为12.39±3.93。2患者术前1天焦虑分数明显升高,且焦虑越重,睡眠质量越差。3影响患者术前睡眠质量的影响因素主要有对手术的焦虑感、术前准备操作、医护人员行为、身体不适感、环境噪音等。结论:心脏外科住院患者术前睡眠质量较差,与焦虑心理显著相关,并受到多种因素的影响,应加强对这些因素的控制,提高其睡眠质量,促进手术的顺利进行。     

甲状腺功能减退症患者心理健康状况及影响因素分析

目的:研究甲状腺功能减退症患者的心理健康状况及其影响因素,为预防、改善甲减患者心理健康状况提供参考依据。方法:选取2014年1月-2016年1月来我院治疗的226例甲减患者作为甲减组,另从杨浦区多个社区随机抽取同期254例健康者作为健康组,采用SCL-90症状自评量表、社会支持评定量表(SSRS)及一般情况调查问卷对两组研究对象进行调查,采用Logistic回归分析甲减患者的影响因素。结果:两组性别、年龄及职业之间的差异无统计学意义(P0.05),而文化程度、经济收入的差异具有统计学意义(P0.05);甲减组患者强迫症状、抑郁、焦虑、精神病性评分及总分均高于健康组(P0.05);甲减组患者中焦虑、抑郁、人际关系敏感所占比重较高,分别为30.97%,26.11%,26.11%;与健康组相比,甲减组患者SSRS评分中主观支持、客观支持、支持利用度评分及总分均明显降低(P0.05);多因素Logistic回归分析显示社会支持、文化程度为小学、经济收入30000元/年是甲减患者心理健康的影响因素(P0.05)。结论:甲减患者心理状况较差,存在较严重的焦虑和抑郁情况,在治疗同时应注意健康教育和心理关怀,尤其是对收入低、文化程度低或社会支持程度低的患者,应给予及时的心理治疗,可提高患者的生活质量。     

围手术麻醉期患者睡眠质量与心理健康状态的相关性分析

目的:了解围手术麻醉期患者的睡眠质量与心理健康状态的关系。方法:对50例备行手术麻醉患者(试验组)及40名正常人(对照组)行匹兹堡睡眠质量指数问卷(PSQI)评定、抑郁自评量表(SDS)及焦虑自评量(SAS)评定,对上述量表结果进行分析。结果:试验组睡眠紊乱率、焦虑及抑郁发生率分别为:26%、24%及56%,两组PSQI、SAS及SDS评分异常率比较P<0.05,差异有统计学意义。两组患者的PSQI总分、PSQI子项目睡眠效率及睡眠障碍、SDS标准分、SDS 4个子项目精神性情感症状、躯体性障碍、精神运动性障碍、抑郁的心理障碍和SAS标准分比较P<0.05,差异有统计学意义。相关性分析显示睡眠质量评分与心理健康状态评分呈负性相关。结论:围手术麻醉期患者存在焦虑抑郁躯体化情绪心理障碍及睡眠紊乱。围手术麻醉期患者睡眠质量评分与心理健康状态评分有关。     

心理护理对恶性肿瘤患者抑郁焦虑的影响

目的:探讨恶性肿瘤住院患者焦虑抑郁情绪的相关因素及心理护理干预对其的影响。方法:对158例恶性肿瘤住院患者(肿瘤组)及170例良性疾病住院患者(良性组)进行焦虑、抑郁自评(应用焦虑自评量表(SAS)、抑郁自评量表(SDS))及他评(应用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评分调查及统计分析;将肿瘤组患者随机分为常规护理组(对照组)、常规护理 心理护理组(护理组),通过心理护理干预,观察两组SAS、SDS、HAMD、HAMA评分变化。结果恶性肿瘤住院患者焦虑、抑郁程度明显高于良性疾病患者,差异有显著性(P<0.01)。在接受心理护理干预后,患者的焦虑抑郁评分及发生率较干预前明显下降,差异有显著性(P<0.05或0.01)。结论:恶性肿瘤患者焦虑和抑郁情绪程度及发生率高于良性疾病患者;心理护理干预可改善恶性肿瘤住院患者焦虑、抑郁情绪,有利于提高患者的生活质量及康复。     

运动疗法对慢性阻塞性肺疾病患者抑郁状态的效果观察

目的:探讨运动疗法对慢性阻塞性肺疾病(COPD)患者抑郁状态的临床效果。方法:选取52例COPD患者,随机分为试验组和对照组,各26例。对照组给予支气管扩张、健康教育、氧疗,试验组在对照组的基础上实施运动疗法,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、ADL生活质量量表对两组患者治疗前后进行评估。结果:对照组患者SAS、SDS评分治疗前后无明显变化,试验患者SAS、SDS评分均明显低于治疗前(P0.05),两组治疗后组间比较,差异亦有统计学意义(P0.05);试验组生活质量的改善优于对照组(P0.05)。结论:运动疗法能有效的改善COPD患者焦虑、抑郁负性情绪,提高患者的生存质量。     

急性心肌梗死患者心理弹性水平与生活质量、焦虑抑郁和医学应对方式的相关性分析

摘要 目的：分析急性心肌梗死（AMI）患者心理弹性水平与生活质量、焦虑抑郁和医学应对方式的相关性。方法：选取2019年3月~2020年8月期间我院收治的AMI患者142例。分别采用心理弹性量表(CD-RISC)、生活质量自评量表 (WHOQOL-BREF)、Zung焦虑自评量表(SAS)、Zung抑郁自评量表(SDS)、医学应对方式问卷(MCMQ)评估所有患者的心理弹性水平、生活质量、焦虑抑郁情况和医学应对方式,并与国内常模对比。采用Pearson相关性分析心理弹性评分与生活质量评分、焦虑抑郁评分和医学应对方式评分的相关性。结果：AMI患者力量、坚韧性、乐观性各维度评分及CD-RISC总分均较国内常模低（P<0.05）。AMI患者心理、生理、社会关系、环境以及WHOQOL-BREF平均分均低于国内常模（P<0.05）。AMI患者SAS、SDS评分均高于国内常模（P<0.05）。AMI患者回避、屈服评分较国内常模高,面对评分低于国内常模（P<0.05）。Pearson相关性分析结果显示：CD-RISC总分与WHOQOL-BREF平均分、面对评分呈正相关,而与SAS、SDS、回避、屈服评分呈负相关（P<0.05）。结论：AMI患者心理弹性水平与焦虑抑郁、生活质量和医学应对方式相关,治疗时应采取相应措施提高患者应对疾病的能力,通过提高AMI患者的心理弹性,缓解其焦虑、抑郁情绪,进而提高生活质量。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.     

Composition and diversity of bird communities in Swedish farmland–forest mosaic landscapes

CapsuleThe amount of forest (at local and landscape scales) and occurrence of residual habitats at the local scale are shown to be the major factors influencing bird community composition in farmland–forest landscapes in central Sweden.

Aims To investigate the importance of local habitat and landscape structure for breeding birds in farmland–forest landscapes in central Sweden.

Methods Breeding birds were censused at 292 points. A detailed habitat mapping was made within 300 m of the points. Within a 300–600 m radius only two major habitats (forests and arable fields) were identified.

Results Cluster analyses of bird communities identified three site types that also differed in habitat composition: (i) partially forested sites in forested landscapes; (ii) heterogeneous sites with residual habitats in mosaic landscapes; and (iii) field-dominated farmland sites in open landscapes. A total of 19 of 25 farmland bird species (restricted to farmland or using both farmland and forest) had the highest abundance in farmland sites with mosaics of forest and farmland, while only six farmland species had the highest abundance in field-dominated sites. The bird community changed from being dominated by farmland species to being dominated by forest species (common in forest landscapes without farmland) at small proportions (10–20%) of forest at the local scale. A major difference in habitat composition between heterogeneous and field-dominated sites was the occurrence of different residual habitats (e.g. shrubby areas and seminatural grasslands). These habitats seemed to influence bird community composition more than land-use, despite covering <10% of the area. Seminatural grasslands were important for bird community composition and species-richness, but grazing seemed to be less important. Among different land-use types, cereal crops were the least preferred fields. Set-asides with tall vegetation and short rotation coppices were positively associated with species-richness of farmland birds.

Conclusion In general, the composition of the landscape was important for bird community composition, although amount and distribution of forests, occurrence of residual habitats and land-use of fields at the local scale had the strongest influence on bird community composition. The possible implications of these patterns for managing farmland–forest landscapes are discussed.     

Chemical constituents from the fruits of Rhus typhina L. and their chemotaxonomic significance

This work describes the isolation and characterization of twenty-nine compounds from the fruits of Rhus typhina L., including eleven flavonoids (1–11), eleven phenols (12–22), two pentacyclic triterpenes (23–24), two organic acids (25–26), one lumichrome (27), one courmarin (28) and one pyrimidine (29) on the basis of their spectroscopic data. Compounds apigenin (1), daidzein (4), orobol (5), 3′, 5, 5′, 7-tetrahydroxyflavanone (6), naringenin (7), butein (8), (-)-catechin (9), quercetin-3-O-α-L-(3″-O-galloyl)-rhamnoside (11), 2-hydroxybenzoic acid (13), 4-hydroxybenzaldehyde (14), vanillin (15), methyl 3,4-dihydroxybenzoate (16), 3,5-dihydroxybenzamide (18), tyrosol (19), caffeic acid (20), 3-(2,4,6-trihydroxyphenyl)-1-(4-hydroxyphenyl)-propan-1-one (21), phlorizin (22), friedelin (23), oleanolic acid (24), 4,4-dimethyl-heptanedioic acid (25), anthranilic acid (26), lumichrome (27), scoparone (28) and uracil (29) have not been recorded before in this plant. This is the first report on the occurrence of compounds 4–7, 9, 11, 13–14, 16, 18–21, 25–29 from the genus Rhus. Moreover, the chemotaxonomic significance of these isolated compounds was also summarized.