神经内科的住院患者心理状况调查研究

随着社会老龄化的到来,神经系统疾病已经成为导致人类死亡和残废的主要原因,神经内科患者以老年人居多,住院费用较高,预后多不理想,经常有反复住院的情况,住院者的心理状态变化较多。本作者采用心理调查问卷的方式并结合《症状自评量表-SCL90》,艾森克人格问卷。进行了回归性曲线的相关性的分析,并符合t检验,具有统计学意义。部分因子与中国常模相比,差异无统计学意义(P>0.05)。由此得出结论:家属的照顾与医生的诊疗方法以及患者自身的个人性格都对治疗产生一定的影响。患者的心理状况主要表现在抑郁、焦虑、敌对、恐怖、偏执等一系列神经-精神症状,发病率相对来说高于普通人群。     

白癜风动物模型的制备

连续应用５％氢醌２０,３０,４０天,使豚鼠皮肤黑色素明显减少,血清中ＭＡＯ和ＣｈＥ活性增加;免疫球蛋白ＩｇＧ,ＩｇＡ和ＩｇＭ增加,尤其是ＩｇＭ在用药４０天后的增加,与正常对照组比,有显著性差异,提示用５％氢酯使动物模拟白癜风作用。     

白癜风的HLA等位基因遗传学研究进展

白癜风的病因尚不明,国内外研究表明其发生与遗传因素相关,其遗传特征不符合孟德尔遗传规律,而是属于多基因遗传的范畴.主要与人类白细胞抗原HLA-Ⅰ类、Ⅱ类及Ⅲ类基因及其产物相关,以往文献报道认为HLA-Ⅱ类基因与白癜风的关系最为密切.HLA基因的多态性决定HLA分子的多样性.充分认识HLA基因水平的多态性,有助于白癜风的基因诊断和治疗.     

白癜风治疗药物概况

本文在查阅大量国内外文献的基础上,对白殿风治疗药物概况和临床应用及安全性进行分析评价,得出结论:白癜风易诊断,难治疗,迄今未发现能够满足每位患者的特效药,但早发现、早治疗、中西药物联合治疗、内外兼治仍是白癜风的治疗原则.白癜风患者也应树立必胜的信念,长期不懈地坚持治疗.     

神经外科危重病患者家属心理状况调查研究

目的:通过对神经外科急危重患者的家属进行心理问卷调査,来了解家属的心理状态,为提供个体化的心理护理提供依据。方法:本研究随机选择近三年入住我院神经外科的急危重患者家属共159人,其中男性89人,女性70人,进行心理状况调查问卷,量表采用精神卫生焦虑自评量表和精神卫生抑郁自评量表,所得数据采用SPSS18.0软件软件进行分析,P0.05为有统计学差异。结果:(1)结果显示,在被调查的89名男性家属与70名女性家属中,女性的焦虑程度较男性严重,而男性的抑郁程度又较女性严重,二者比较均有统计学差异(P0.05)。(2)医疗费用支付类别不同的患者家属间焦虑、抑郁症状有显著性差异,自费患者家属焦虑、抑郁程度均明显高出医保患者家属(P0.05)。(3)以脑力劳动为主的患者家属其焦虑量表评分明显低于以体力劳动为主的患者家属,而在抑郁量表评分中,脑力劳动为主的患者家属抑郁评分则高于以体力劳动为主的患者家属,二者相比均有统计学差异(P0.05)。结论:女性、体力劳动者焦虑症状明显,男性、脑力劳动者抑郁症状突出。自费医疗的患者家属焦虑和抑郁程度均高于医保患者。作为护士应针对患者家属提供不同的有针对性的心理护理,帮助家属应对心理危机状态,维持患者家庭功能,促进患者康复。     

白癜风患者病变表皮与正常表皮的比较蛋白质组学研究

目的 本文通过开展白癜风患者病变表皮与正常表皮的比较蛋白质组学研究,发现和鉴定白癜风患者病变表皮与正常表皮之间的差异表达蛋白,以探讨白癜风患者表皮发生病变的分子机制。方法 首先,建立和优化了表皮样品中蛋白质的最佳酶切条件。其次,采用基于串联质谱标签（TMT）标记的定量蛋白质组学技术策略开展了稳定期白癜风患者病变表皮与正常表皮的比较蛋白质组学研究,并筛选了差异表达蛋白。最后通过生物信息学分析工具及数据库（GO、KEGG、STRING、GSEA）对差异蛋白进行功能富集分析。结果 优化所得到的最佳酶解条件是由Lys-C （酶∶底物,1∶100）和胰酶（酶∶底物,1∶50）组合而成的顺序酶切。比较蛋白质组学研究共鉴定4 496个蛋白质,其中181个蛋白质为白癜风患者病变表皮中的差异表达蛋白。生物信息学分析表明差异表达蛋白主要与代谢、免疫、氧化还原和细胞黏附相关。其中119个上调蛋白主要参与角质化、转录、氧化应激及蛋白酶解等过程。62个下调蛋白主要参与细胞内物质运输、谷胱甘肽代谢和肌动蛋白细丝封端等过程。结论 比较蛋白质组学研究揭示了白癜风患者病变表皮与正常表皮之间主要存在角质化、免疫、脂质代谢...     

住院精神病患者冲动行为意念的调查研究

目的探讨住院精神病患者冲动行为意念的原因及防范对策。方法对某三甲精神病专科医院2016年8~11月收治住院的男性精神病发生冲动行为意念患者60例实施干预治疗的资料进行调查分析,总结防范护理措施。结果住院精神病患者冲动行为意念形成原因主要与精神症状支配、否认疾病有关,主要表现为不配合治疗及攻击行为比例多,时间多发生在早上与上夜时段,且以保护性约束法占比例较多。结论对精神病患者的冲动行为意念进行积极有效干预,可避免其危害的扩大,降低冲动行为发生的风险,维护良好的住院环境,利于患者重返社会,从而减轻家庭、医院及社会的压力。     

太原市杏花岭区白癜风患者临床流行病学调查及患病影响因素的Logistic回归分析

摘要 目的：调查太原市杏花岭区白癜风患者临床流行病学情况,并分析患病影响因素。方法：于2020年6月至2021年6月采用多阶段分层随机抽样的方法,抽取太原市杏花岭区辖10个街道符合条件的常住居民进行调查,共抽取1440例,实际完成调查研究1428例,应答率为99.17%。采用我院自行设计的问卷调查表收集资料。根据是否患有白癜风将研究对象分为白癜风组（n=31）和无白癜风组（n=1397）。采用单因素和多因素Logistic回归分析太原市杏花岭区白癜风患者患病影响因素。结果：纳入的1428例居民中,共诊断出31例患有白癜风,患病率为2.17%。31例白癜风患者中,男性占比高于女性,占54.84%;年龄21~40岁区间患病率最高,占29.04%;未婚的白癜风患者偏多,占45.17%;文化程度为初高中的白癜风发生率偏高,占41.94%;职业为学生的白癜风发生率偏高,占32.27%。单因素分析显示：太原市杏花岭区白癜风的患病与白癜风家族史、精神因素、暴晒史、饮酒史、吸烟史、经常接触化学物质、饮食规律、蔬果摄入量、饮食合理、皮肤病史有关（P<0.05）。多因素Logistic回归分析显示：饮酒史、白癜风家族史、皮肤病史、经常接触化学物质、暴晒史、精神因素是白癜风发病的潜在独立危险因素,而饮食合理、蔬果摄入量大、饮食规律则是其保护因素（P<0.05）。结论：太原市杏花岭区白癜风发生率较高,饮酒史、白癜风家族史、皮肤病史、经常接触化学物质、暴晒史、精神因素是白癜风发病的潜在独立危险因素,而饮食合理、蔬果摄入量大、饮食规律则是其保护因素。     

白癜风相关基因研究进展

白癜风是一种多基因遗传性疾病,虽然环境是白癜风的发病因素,遗传因素在白癜风发病机制中也起着重要作用。近年来不断有与白癜风相关基因的报道,综述近几年关于白癜风易感基因定位及相关基因的研究,为进一步研究白癜风的病因提供思路。     

Characterization of Vitiligo Antigens

Patients with vitiligo have circulating antibodies directed in part to pigment cell antigens with MWs of approximately 90, 75, and 40-45 kDs. These antigens are denominated VIT 90, VIT 75, and VIT 40, respectively. To further characterize these “vitiligo” antigens, we examined their relation to antigens defined by a panel of 25 monoclonal antibodies (moab) to pigment cell antigens. We found by immunoprecipitation and SDS-PAGE analysis of ¹²⁵I labelled, detergent soluble, human melanocyte macromolecules, that 24 (83%) of 29 patients with vitiligo had antibodies to one or more vitiligo antigens vs. 2 (7%) of 28 control individuals. Seventeen of the 25 moabs did not react with any labelled antigen in the same lysate. Of the remaining eight moabs, only four precipitated an antigen that co-migrated with one of the vitiligo antigens. Moab TA99, HMSA-5, and TMH-1 (all directed to the 75 kD tyrosinase-related protein [TRP1]) co-migrated with VIT 75. Moab W6/32 (directed to class I HLA antigen) co-migrated with VIT 40. Immunodepletion studies with vitiligo antibodies selectively depleted the antigen defined by W6/32 but not the antigen defined by TA99 and HMSA-5, indicating that VIT 75 was not the 75 kD tyrosinase-related protein. The vitiligo antigens were easily labelled by the lactoperoxidase technique but poorly labelled with ³⁵S-methionine, suggesting they are expressed on the cell surface. These studies indicate that VIT 90 and VIT 75 differ from antigens defined by currently available moabs to pigment cell antigens. VIT 40 appears to share a cross-reactive epitope, or be tightly bound to, class I HLA antigen.     

Antioxidant Status in the Blood of Patients With Active Vitiligo

We have previously reported that patients with active vitiligo (AVP) have elevated urinary levels of catecholamine metabolites, such as homovanillic and vanilmandelic acids, irrespective of the form of the disease (acrofacial, segmental, generalized). We have suggested that abnormal release of catecholamines from autonomic nerve endings might play an etiological role in the onset and development of vitiligo through an overproduction of toxic (oxy)radicals in the microenvironment of melanocytes in the affected areas. In the present study we have investigated whether this suggested increase in radicals might be associated with an oxidative stress in the blood of AVP. We have analyzed by gas-chromatography mass-spectrometry, by high pressure liquid chromatography, by spectophotometry plasma levels of vitamin E (Vit E), lipoperoxides (LIP), and polyunsaturated fatty acids of phospholipids (PL-FA), erythrocyte reduced glutathione (GSH), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) activities in 62 patients affected with different forms of active vitiligo (acrofacial, segmental, generalized) and in 60 age-matched controls. Our results show that blood levels of Vit E, SOD, GSH, GSH-Px activity, LIP and PL-FA in AVP were not significantly different from those of healthy age matched controls, indicating that melanocyte damage in vitiligo is not linked with a generalized oxidative stress.     

健康信念模式对无症状高尿酸血症病人危险行为的护理干预

目的:研究健康信念模式对无症状高尿酸血症人群的干预效果,为控制高尿酸血症寻求有效途径,从而预防冠心病、脑卒中及Ⅱ型糖尿病的发生.方法:采用随机实验组对照组实验设计,实验组以健康信念模式进行护理干预,一年后检测相关知识及生理指标,并进行统计学分析.结果:干预后实验组相关知识掌握显著优于对照组,血尿酸显著下降(P＜0.01),血脂、体重指数的差异有统计学意义(P＜0.05),血压、血糖的差异无统计学意义(P＞0.05).结论:健康信念可激发无症状高尿酸血症人群的内在动机,减少危险行为,保持最佳的健康状态.     

Further Evidence for Involvement of Both Cell Mediated and Humoral Immunity in Generalized Vitiligo

Immunohistochemical and immunoserological evidence supports the involvement of both cell-mediated and humoral mechanisms in the pathogenesis of melanocyte destruction in vitiligo. Punch biopsies from depigmented vitiliginous skin (VS), normal-looking pigmented skin (PS), and marginal skin (MS) from patients with generalized vitiligo (n = 15) were labeled with K 1.2.58, OKM1 (CD11b), Leu 11b (CD16), Leu 19 (CD56), IFN-γreceptor, IL-2 receptor (CD25), IgG, IgM, C3c, and C3d MoAbs. In addition, in vitro effects of vitiligo sera (n = 13) on human newborn melanocytes (HMel) under different culture conditions were studied. The immunohistochemical findings showed absence of K 1.2.58+ epidermal melanocytes in VS and abnormal morphology in MS. In these areas, a few CD11b + cells in the dermis and epidermis could be detected but no significant numbers of CD16+ or CD56+ cells were seen among the mononuclear cellular infiltrate. IL-2 and IFN-γ receptors were clearly expressed by the cellular infiltrate. No significant deposition of complement or immunoglobulin was seen. The addition of vitiligo sera to HMel cultures induced a significant cellular proliferation. The stimulation of cell proliferation occurred regardless whether the sera were added alone or when preheated (56°C for 1 hr) and then supplemented with a complement source (P < 0.01 at 2%, P < 0.001 at 10%, and P < 0.01 at 20% for sera alone) (P > 0.05 at 2%, P < 0.05 at 10%, and P < 0.01 at 20% for decomplemented sera plus complement). In contrast, incubation of vitiligo sera together with normal lymphocytes with HMel significantly decreased the number of living melanocytes in a dose dependent manner, suggesting an antibody-dependent cellular cytotoxicity (ADCC) reaction (P < 0.01 at 2% and 10%, P < 0.001 at 20%). The presence of lymphocytic infiltrate at marginal skin with evidence for IL-2- and IFN-γ-receptor expression and the decrease in the number of living cells by ADCC-like mechanisms provide further support for an autoimmune pathogenesis in vitiligo.     

从临床调查看开展糖尿病健康教育的重要性

目的:探讨对糖尿病患者进行健康教育的重要性。方法:采用自制的调查表,以问卷的方式对520名糖尿病人进行调查。结果:77．2%的病人是因体检或因其他疾病而意外被发现的,31．5%的病人会坚持定期检查血糖,28．9%的病人检查过餐后血糖, 45．9%和76．6%的病人还在用副作用很大的降糖灵和优降糖,只有29．3%的病人能够正确了解胰岛素,63．4%的病人相信或是相信过虚假的广告宣传。结论:对糖尿病人群进行糖尿病知识的健康教育是很必要的。     

Keratinocytes Suppress TRP‐1 Expression and Reduce Cell Number of Co‐cultured Melanocytes – Implications For Grafting of Patients with Vitiligo

A pilot study for grafting of patients with vitiligo using cultured epithelial autografts containing melanocytes gave disappointing clinical results, with pigmentation achieved in only one out of five patients. Irrespective of the fate of melanocytes grafted back onto the patients, we experienced problems in identifying melanocytes within these well‐integrated keratinocyte sheets. This led us to explore the fate of these cells within these sheets in vitro and to seek to improve their number and function within the sheets. We report that the introduction of a fibroblast feeder layer can improve melanocyte number within melanocyte/keratinocyte co‐cultures initially, but at very high keratinocyte density, there is a marked loss of melanocytes (as detected by staining for S100). Additionally, we found that keratinocytes not only down‐regulate melanocyte number, but also pigmentary function; thus, it was possible to identify melanocytes that were S100 positive but tyrosinase‐related protein‐1 (TRP‐1) negative in confluent well‐integrated keratinocyte sheets. In summary, our data suggest that keratinocytes at high density initially suppress melanocyte pigmentation (as evidenced by a lack of TRP‐1 expression) and then cause a physical loss of melanocytes. The introduction of a fibroblast feeder layer can help maintain melanocyte number while keratinocytes are subconfluent, but fails to oppose the inhibitory influence of the keratinocytes on melanocyte TRP‐1 expression.     

水螅摄食中的特殊行为

取经中性红活染后的杆吻虫喂水螅,仔细观察了水螅的摄食行为.结果表明,水螅垂唇端部能够相互识别出同类;水螅的垂唇与胃区能协力把杆吻虫吞入胃腔,触手经常随食物进入胃腔;吞食时经常出现头部内翻或外翻;个体间及其成体与芽体间常出现争夺食物的现象,当垂唇端部互不相触时,体型较大的个体常常把较小个体或芽体连同食物一起吞食;垂唇内胚层腺细胞对食物有消化作用,对同类无伤害;水螅的神经系统已有初步的整合功能.     

Host-Seeking Behavior of Selected Chrysops Species (Diptera: Tabanidae) Harboring Trypanosomatidae (Kinetoplastida)

The host-seeking behavior of hematophagous arthropods can be altered by symbiotes, thereby biasing sampling techniques and inaccurately reflecting symbiote or vector prevalence. Knowledge of any altered vector behavior is essential in vector control and monitoring. Species of Chrysops are vectors of human and animal pathogens. Six species of Chrysops were collected at two locations in South Carolina to determine if diurnal host-seeking behavior was influenced by trypanosomatid infection. Fifty-five percent of the host-seeking Chrysops were infected with trypanosomatid parasites. Prevalence of infection in host-seeking Chrysops were statistically indistinguishable during both the morning and evening at both sites. The results indicate that the prevalence of parasites among wild host-seeking Chrysops might not be influenced by infection status.     

Approaches to Repigmentation of Vitiligo Skin: New Treatment with Ultrasonic Abrasion,Seed‐Grafting and Psoralen Plus Ultraviolet A Therapy

Vitiligo vulgaris is a common disease throughout the world although its pathogenesis is not yet known. The most frequent treatment used for vitiligo is PUVA (psoralen plus ultraviolet A) and topical steroids but against stable refractory vitiligo, various other surgical techniques have been developed such as autografting, epidermal grafting with suction blisters, epithelial sheet grafting, and transplantation of cultured melanocytes. We have discovered a new method using ultrasonic abrasion, seed‐grafting and PUVA therapy. The ultrasonic surgical aspirator abrades only the epidermis of recipient sites. This easily and safely removes only the epidermis, even on spotty lesions or intricate regions which are difficult to remove using a conventional motor‐driven grinder or liquid nitrogen. Epidermal seed‐grafting can cover more area than sheet‐grafting, and subsequent PUVA treatment can enlarge the area of pigmentation with coalescence of adjacent grafts. In this article, we provide a general overview of the current surgical therapies including our method for treating stable refractory vitiligo.