综合护理对糖尿病足患者心理状态与生活质量的影响

目的：探讨综合护理对糖尿病足患者心理状态与生活质量的影响。方法：选取52例糖尿病足患者,随机分为照组和试验组,各26例,对照组给予常规护理,试验组采用综合护理进行干预。采用Zung焦虑自评量表（SAS）、抑郁自评量表（SDS）评价两纽患者心理状态,并用社会功能缺陷筛选量表（SDSS）和2型糖尿病生活质量量表（DMQI_,s）对两组患者生活质量进行评价。结果：两组患者干预前SAS、SDS、SDSS、DMQLS评分无差异,实施干预后,两组患者均有SAS、SDS、SDSS评分下降、DMQLS评分升高,但试验组患者SAS、SDS、SDSS评分下降及DMQLS评分升高更明显,与对照组比较,差异有统计学意义（P〈0．01）。结论：综合护理有助于改善糖尿病足患者焦虑、抑郁负性情绪,提高生活质量。     

Beta-adrenergic pathway activation enhances aggressiveness and inhibits stemness in head and neck cancer

Chronic stress leads to the activation of the beta-adrenergic pathway. Its activation has been implicated in the progression of different types of cancer but its role on head and neck squamous cell carcinomas (HNSCCs) remains undefined. The aim of this study was to investigate the influence of the beta-adrenergic pathway activation in the progression of HNSCCs and offer a panel of potential treatments for patients with the active beta-adrenergic pathway. Five hundred and twenty TCGA patients with primary HNSCCs were divided in two groups: ADRB2^low / SLC6A2^low and ADRB2^high / SLC6A2^high. Differentially expressed genes (DEGs) were identified through differential expression analysis. The association of clinicopathological and genomic features between the groups was analyzed using a bioinformatic approach. Potential drugs for treatment of HNSCC were identified based on the DEGs. There was association between ADRB2 and SLC6A2 expressions with age, race, tumor site, histologic grade, perineural invasion, and HPV p16 status. It was identified 898 DEGs between the groups. High ADRB2/SLC6A2 expression stimulated HNSCC proliferation, adhesion, invasion, and angiogenesis. On the other hand, genes related to cell stemness were downregulated in patients with activation of the beta- adrenergic pathway. Finally, 56 FDA-approved antineoplastic and immunotherapeutic drugs were identified as potential targets for the personalized treatment.     

Good epidemiologic practice in retinitis pigmentosa: from phenotyping to biobanking

Inherited retinal dystrophies, such as retinitis pigmentosa (RP), include a group of relatively rare hereditary diseases caused by mutations in genes that code for proteins involved in the maintenance and function of the photoreceptor cells (cones and rods). The different forms of RP consist of progressive neurodegenerative disorders which are generally related to various and severe limitations of visual performances. In the course of typical RP (rod-cone dystrophy), the affected individuals first experience night-blindness and/or visual field constriction (secondary to rod dysfunctions), followed by variable alterations of the central vision (due to cone damages). On the other hand, during the atypical form of RP (cone-rod dystrophy), the cone's functionalities are prevalently disrupted in comparison with the rod's ones. The basic diagnosis of RP relies upon the documentation of unremitting loss in photoreceptor activity by electroretinogram and/or visual field testing. The prevalence of all RP typologies is variably reported in about one case for each 3000-5000 individuals, with a total of about two millions of affected persons worldwide. The inherited retinal dystrophies are sometimes the epiphenomenon of a complex framework (syndromic RP), but more often they represent an isolated disorder (about 85-90 % of cases). Although 200 causative RP mutations have been hitherto detected in more than 100 different genes, the molecular defect is identifiable in just about the 50% of the analyzed patients with RP. Not only the RP genotypes are very heterogeneous, but also the patients with the same mutation can be affected by different phenotypic manifestations. RP can be inherited as autosomal dominant, autosomal recessive or X-linked trait, and many sporadic forms are diagnosed in patients with no affected relatives. Dissecting the clinico-genetic complexity of RP has become an attainable objective by means of large-scale research projects, in which the collaboration between ophthalmologists, geneticists, and epidemiologists becomes a crucial aspect. In the present review, the main issues regarding clinical phenotyping and epidemiologic criticisms of RP are focused, especially highlighting the importance of both standardization of the diagnostic protocols and appropriateness of the disease's registration systems.     

脑血管病的康复治疗疗效观察

目的：探讨早期康复治疗在脑血管病康复中的应用及疗效观察早期康复治疗对脑血管病患者功能重建是否有效,是否值得推广。方法：选取本院神经科2009年6月至2010年3月住院40例脑血管病患者,随机分为康复治疗组和对照组（每组20例）,康复治疗组在进行常规治疗的同时,进行早期康复训练,并且在康复治疗前后分别进行Barthel指数（ADL）评分,以量化分析治疗前后的效果。结果：经康复训练后,康复治疗组治疗前与治疗后比较,ADL评分有明显的增高,二者的差异具有显著性（P〈0．01）;康复治疗组与对照组在神经功能恢复方面,有明显的好转,二者的差异具有显著性（P〈0．01）。结论：脑血管病患者早期进行常规治疗,同时行康复训练治疗,有助于神经功能的恢复,提高自理能力及生活质量,此治疗方案对脑血管患者的康复有积极的作用,疗效满意,方法值得在康复相关科室长期应用推广。     

老年肿瘤患者心理问题分析与护理对策研究

目的：了解老年肿瘤住院患者的心理问题,找出老年肿瘤住院患者常见的心理问题以及产生心理问题的原因,探讨改善老年肿瘤住院患者心理问题的有效护理措施,为临床护理提供切实可行的依据。方法：对我院2010年7月-2011年7月老年肿瘤住院患者采取问卷调查及深入访谈相结合的方式进行调查。结果：数据显示,1000例患者中,761例患者存在心理问题,占76.1%;其中,186例患者有严重的心理问题,占24.44%;老年肿瘤患者常见的心理问题为：焦虑与抑郁、多疑、恐惧紧张、绝望与悲哀;产生心理障碍的原因在于患者自身疾病、环境、经济状况等。结论：老年肿瘤患者心理问较为严重,通过实行有针对性的护理措施,有效治疗老年肿瘤患者的心理问题,减轻患者心理压力,促进患者的健康,保护患者安全。     

基于NR2B 基因探讨疏肝与补肾法对吗啡精神依赖 的调节作用及机制

目的:探讨补肾法与舒肝法对大鼠吗啡精神依赖的调节作用及机制。方法:使用盐酸吗啡建立大鼠精神依赖模型(conditioned place preference,CPP),采用Obersiver 5.0行为学软件分析大鼠的CPP效应,并利用Real time PCR方法测定伏核和前额叶皮质内NR2B亚基的mRNA含量。结果:与对照组相比,模型组大鼠在白侧累积停留时间极显著长于对照组(P<0.01),同时伏核与前额叶皮质中NR2B的mRNA水平也显著升高(P<0.01和P<0.05);与模型组相比,补肾组和舒肝组大鼠在白侧的累积停留时间显著下调(P<0.05),疏肝组NR2B的mRNA也显著下降(P<0.05),而补肾组变化不显著。结论:①补肾法与舒肝法对吗啡引起的精神依赖均有调节作用。②舒肝法的作用机制可能在于通过影响伏核和前额叶皮质中NR2B亚基的mRNA表达进一步调节精神依赖的相关神经通路。③补肾法的作用机制与NR2B亚基的mRNA表达关系不密切,其调节的具体机制尚有待研究。     

心理干预对非小细胞肺癌患者免疫功能及心理状态的临床研究

目的:研究心理干预对非小细胞肺癌患者免疫功能及心理状态的影响。方法:70例NSCLC患者随机分为治疗组(n=36)和阳性对照组(n=34),另设正常对照组(n=30),治疗组进行心理干预,阳性对照组和正常对照组不给予干预,30天后,计算患者的EORTC QLQ-C30积分并测定T细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+指标。结果:治疗组患者干预后的生存质量(一般情况、躯体功能、社会功能等)及CD3+、CD4+、CD8+含量较干预前均有差异(P<0.01或P<0.05),治疗组患者干预后的生存质量及CD3+、CD4+、CD8+含量较阳性对照组干预后均有差异(P<0.01或P<0.05)。结论:心理干预对非小细胞肺癌患者的心理状态有积极作用,同时能提高患者的免疫力。     

Circadian Phase Preference in College Students: Relationships With Psychological Functioning and Academics

The current study offers a comprehensive assessment of psychosocial functioning and academic performance in relation to circadian phase preference in a US sample of undergraduate college students (N?=?838), aged 17–26 (M?=?19.78, SD?=?1.89). Women had greater morning preference than men, and seniors had greater morning preference than freshmen. Circadian phase preference, fatigue, perceived stress, depression, anxiety, and substance use were assessed cross-sectionally and grade point average (GPA) was assessed prospectively. Evening phase preference was related to higher levels of fatigue, alcohol and caffeine use, and worse academic performance than morning or intermediate phase preferences. (Author correspondence: djtaylor@unt.edu)     

心理应激对牙周炎组织氧化还原反应影响的动物实验研究

目的:明确心理应激对大鼠牙周炎组织局部病损以及抗氧化酶活性和丙二醛(MDA)含量变化的影响。方法:40只健康Sprague-Dawley大鼠随机分为对照组(C)、实验性牙周炎组(EP)、实验性牙周炎+心理应激组(EP+PS)以及实验性牙周炎+心理应激+药物组(EP+PS+DR),每组10只。分别采用丝线结扎法和慢性不可预知性应激法建立大鼠实验性牙周炎模型和心理应激模型。EP组动物仅用丝线结扎右上颌第二磨牙颈部,EP+PS组动物同时接受丝线结扎和心理应激刺激,EP+PS+DR组动物除上述处置外,按5 mg/kg/日剂量腹腔注射氟西汀,而C组大鼠无任何干预措施。4周后对所有动物进行糖水偏爱度测试、行为学观察和血清学检测,并计算牙槽骨丧失和附着丧失情况,同时测量牙龈组织中抗氧化酶活性以及MDA含量。结果:慢性不可预知性应激导致大鼠旷场实验中央区移动距离减少(P<0.05)、中央区停留时间增加(P<0.05)、糖水偏爱度降低(P<0.05)、血清皮质酮与促肾上腺皮质激素浓度升高(P<0.05);并且应激大鼠的牙槽骨丧失和附着丧失明显大于单纯牙周炎组(P<0.05);同时,心理应激状态下大鼠牙龈组织的氧化还原代谢异常,表现为超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)和过氧化氢酶(CAT)活性明显低于单纯牙周炎组(P<0.05),而MDA含量明显高于单纯牙周炎组(P<0.05)。氟西汀在拮抗心理应激的同时,可以明显改善动物牙周炎组织局部降低的抗氧化酶活性以及升高的脂质过氧化产物含量(P<0.05)。结论:心理应激可以导致牙周炎组织的氧化损伤加重,有效拮抗心理应激有助于减轻牙周炎性组织病损。     

自适应式与固定式生物反馈训练对出口梗阻型便秘患者肛直肠功能和心理状态的影响

目的:探讨自适应式与固定式生物反馈训练对出口梗阻型便秘(OOC)患者肛直肠功能和心理状态的影响。方法:选取2017年4月～2019年12月期间晋城大医院收治的OOC患者98例,根据随机数字表法将患者分为对照组(n=49,固定式生物反馈训练)和研究组(n=49,自适应式生物反馈训练),比较两组患者疗效、肛直肠功能、排便次数、排便困难评分和心理状态。结果:研究组治疗8周后的临床总有效率93.88%(46/49),高于对照组的77.55%(38/49)(P0.05)。两组治疗8周后排便次数增加,排便困难评分降低(P0.05),研究组治疗8周后排便次数多于对照组,排便困难评分低于对照组(P0.05)。两组治疗8周后直肠肛门抑制反射阈、肛管静息压均较治疗前下降,模拟排便时直肠肛管压力梯度较治疗前升高(P0.05)。两组治疗8周后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均较治疗前下降,且研究组低于对照组(P0.05)。结论:与固定式生物反馈训练相比,自适应式生物反馈训练可获得与之效果相当的肛直肠功能改善程度,并可进一步减轻患者症状及改善心理状态,疗效显著。