随着与现代心理学的融合去宗教化的价值定位,冥想特别是源于东方佛教的正念在心理治疗领域掀起了热潮.近年来,由于神经科学等技术的应用,正念冥想的生物学基础逐渐被揭示,显示出其"正能量"的科学基础.目前,以正念冥想为核心的训练和治疗不仅对众多心理障碍有很好的疗效,而且还对慢性躯体性疾病的防治起到很大作用.冥想,还由于其压力管理、情绪调节、催眠促进、疼痛缓解、专注和决策力提高、学习成绩提升、幸福感增强等作用,从医学、心理学扩展到政府、学校、企业、体育军警、司法、养育等领域,普及于大众.

抑郁症是一种危害全球人类生活质量的精神疾病,具有高患病率、高疾病负担、高致残率等特点.目前有多种针对单胺类神经递质的抗抑郁药物可供使用,然而,约1/3的患者在接受基于多种单胺类药物充分治疗后仍然不能治愈,此类抑郁症在临床上被称为难治性抑郁症.难治性抑郁症的具体病理生理机制尚未明确,但随着抑郁症的炎症机制不断被大众认可,难治性抑郁症的神经炎症也备受关注.本文从炎症的角度对难治性抑郁症的发病机制进行综述,为深入研究其诊断和治疗方法提供思路与方向.

应激医学是一门研究特殊环境条件下,人体应激反应的生理、心理特征及其生物学基础的科学,是精神医学教学的桥梁课,理论与实践并重.第二军医大学开设应激医学课程已有十余年,积累了大量教学经验,并在教学方式方法 上不断尝试改革与完善.虚拟现实技术具有沉浸性、交互性、多感知性、构想性和自主性等特征,或将在应激医学教学领域拥有广阔应用前景.本文着重探讨该技术在应激医学教学中应用的可行性,并初步拟定教学设计方案.

目的 探究热门影视教学法在发展心理学教学中的应用价值.方法 2016年12月—2017年12月,选取我校2015级和2016级医学心理学本科生两个班次,人数均20人.2015级班次为实验班,采用热门影视教学法;2016级班次为对照班,采用传统教学法授课;两个班次学时、授课内容一样.观察并比较两组的临床教学效果.结果 实验组理论成绩(87.4±4.4)分、学生满意度均优于对照组,差异均具有统计学意义(P<0.05).结论 利用热门影视案例教学有利于构建有效课堂,激发学生的学习热情和提高学生的学习能力.

Objective To investigate the features of negative automatic thinking among military personnel stationed on the island and also to analyze related influencial factors.Methods Assessment was performed among the military personnel stationed on the island and ashore by using automatic thinking scale,perceived social support scale and social stress scale,then,the relationship between negative automatic thinking and perceived social support and psychological stress was analyzed in the study.Results The detection rates of automatic thinking,perceived social support and psychological stress among the military personnel stationed on the island were all obviously higher than those of the military personnel working ashore.(P ＜ 0.05 or P ＜ 0.01).The total scores of automatic thinking and stress in the military personnel working on the island were all higher than those of the people working ashore (P ＜ 0.05).There were significant differences in total scores of various scales,when comparisons were made between commissioned officers of the 2 groups (P ＜ 0.05).Differences could only be seen in external family support and stress scores among commissioned officers.Total scores of internal family support and perceived social support of commissioned officers were all lower than those of the non-commissioned officers,but the scores of automatic thinking were higher than those of the non-commissioned officers (P ＜ 0.05).Pearson analysis showed that negative automatic thinking was positively correlated with psychological stress (r =0.292,P ＜ 0.05),however the scores of perceived social support were negatively correlated with the scores of various dimensions (r =-0.540 -0.672,P ＜ 0.05).Stepwise regression analysis indicated that perceived social support partially mediated the relationship between psychological stress and negative automatic thinking,and the mediating effect accounted for 30.9％ of the total effect.Conclusion Negative automatic thinking among the military personnel stationed on the island was on the whole not optimistic,and its influential factors included psychological stress and low social support.Psychological stress could affect negative automatic thinking of the military personnel stationed on the island directly or indirectly by mediating effect.Active and effective family and social support,rational psychological counseling and training were beneficial to the alleviation of negative thinking and the improvement of the physical and mental health of the military personnel stationed on the island.

自杀是复杂且致死率高的重要公共健康问题,应激和睡眠障碍均为自杀的重要风险因素,且三者之间具有密切的关联.由于应激和睡眠障碍具有可改变性,了解应激、睡眠和自杀的关系及其生理机制,有助于了解自杀的病理基础,探寻识别和干预自杀的关键靶点,促进对自杀的预防和干预.本文介绍有关应激、自杀、睡眠关联的最新研究结果,分别从HPA轴功能、多胺应激反应系统等神经生理基础,以及基因、表观遗传修饰等遗传学的角度探讨三者关联的生理机制,探索该领域的研究挑战及未来的研究方向.

Our previous study reported that fully reduced high mobility group box 1 (fr-HMGB1) and disulfide HMGB1 (ds-HMGB1) induce depressive-like behavior; however, the underlying mechanisms remain unclear. In the present study, the induction of depression via the kynurenine pathway by different redox states of HMGB1 was investigated in vivo and in vitro. To evaluate the expression of enzymes of the kynurenine pathway, reverse transcription-quantitative PCR and western blot analyses were conducted. Additionally, cytokine levels were measured by ELISAs. Following intracerebroventricular injection of ds- and fr-HMGB1, behavioral tests were performed, revealing the presentation of depressive-like behavior, and essential proteins in the kynurenine pathway were demonstrated to be upregulated at the mRNA level, suggesting that ds- and fr-HMGB1 contributed to the development of this behavior via the kynurenine pathway. ds-HMGB1 directly activated the kynurenine pathway and cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) in the hippocampal tissue. Conversely, fr-HMGB1 upregulated the aforementioned factors only following treatment with H2O2. These findings indicated that ds-HMGB1 induced depression in a manner associated with the kynurenine pathway, whereas oxidation of fr-HMGB1 evoked activation of the kynurenine pathway, resulting in depressive behavior.

[Abstract] Depression is a common clinical mental disease and has posed a serious threat to human health. Recent studies have found that immune-effecting microglia is closely related to the occurrence of depression. Microglia induces depression through a variety of inflammatory and non-inflammatory mechanisms. It is of great significance to study the role of microglia in the occurrence of depression, which can help to explore new targets of depression treatment and novel antidepressants. [Key words] depression; microglia; inflammation; neuronal plasticity; tryptophan metabolic pathway [Acad J Sec Mil Med Univ, 2018, 39(7): 780-783]

随着科技进步的发展,传统的闭卷考试形式已不能满足培养创新人才,注重学习过程考察和学员能力评价的要求.笔者利用记忆心理学中的测试效应理论对我校医学心理学本科考试做了实验性初探,发现通过此次考试改革,学员对知识点的掌握理解能力、自主学习能力、实践应用能力均有所提高.

抑郁症是一种常见精神疾病,极大影响人类健康.传统抗抑郁药治疗起效慢、缓解率低.氯胺酮作为一种全身麻醉剂广泛应用于临床,近年来发现其具有快速、高效的抗抑郁作用.其抗抑郁作用可能与NMDA受体、AMPA受体、BDNF、mTOR、GSK-3、突触可塑性等密切相关,但具体机制仍不清楚.深入研究氯胺酮快速抗抑郁的作用机制对新型快速抗抑郁药物的研究具有重要意义.

Objective:To observe the effect of Hydrocortisone-conjugated glycine (HG) on allergic reaction induced by Compound 48/80 (C48/80) in rats.To establish an effective research tool for later in-depth study of glucocorticoid nongenomic mechanism.Methods:60 Male SD rats randomly divided into 4 groups:acute allergic group (intraperitoneal injection C48/80+vehicle control,n=15),cortisol (GC)intervention group (intraperitoneal injection C48/80+GC,n=15),HG intervention group(intmperitoneal injection C48/80+HG,n=15) and a normal control group(peritoneal injection with the same amount of normal sodium,n=15).Module and intervention groups injected intraperitoneally with C48/80 were injected with vehicle control (Equal amount of anhydrous ethanol,diluted solvent for GC and HG),GC or HG respectively 5 mins later.Rectal temperature and mean arterial pressure were monitored every 5 mins.After intraperitoneal injection of C48/80 30 mins rats were sacrificed,took the throat tissue and lung tissue of rats,paraformaldehyde fixed and sliced to observe with morphology.At the same time rat serums were collected,serum histamine content was determined by ELISA Kit.Results:Compared with the control group,the rectal temperature and mean arterial pressure of the rats in the model group showed a decreasing trend,C48/80 stimulation can induce edema,alveolar damage and inflammatory cell infiltration in rat throat and lung tissue,the histamine level in serum of rats was significantly higher than that of control group (P＜0.05);Compared with the model group,the above mentioned allergic reactions could be reduced by the intervention groups(P＜0.05),but the HG intervention group promotes rat rectal temperature reduce recovery,a faster onset time,higher efficiency compared with the GC intervention group (P＜0.05);HG intervention group significantly reduced the throat and lung edema,alveolar damage and inflammatory cell infiltration induced by C48/80 stimulation;HG intervention group significantly attenuated the average arterial pressure decrease in rats than the GC intervention group (P＜0.05);HG intervention group can significantly inhibit the increase of serum histamine level caused by C48/80 stimulation (P＜0.05),however,there was no significant difference between the HG and the GC intervention group on the total level of histamine inhibition in 30min.Conclusions:HG can inhibit acute allergic reaction induced by C48/80 in rats rapidly;Can inhibit the release of histamine in mast cells significantly;HG may inhibit the degranulation of mast cells and inhibit the release of histamine in inflammatory mediators through nongenomic mechanism,thereby inhibiting immune inflammatory response and exert anti-allergic and anti-inflammatory effects,thus provides an effective research tool for studying the nongenomic mechanism of glucocorticoids.

We are facing increasing stress and challenges because of the fierce competition and fast pace of daily work and life.In other words,we are exposed to more frequent and intense social stress.Continual and intense stress is known to be detrimental to human well-being.Stress has been regarded as a major contributing factor of human diseases.There-fore,it′s necessary to review the recent research progress in stress biomarkers that are of different types,such as cortisol,α-amylase,catecholamine,heat shock protein and cytokines.In this review,we will focus on the most well reported stress biomarkers,including cortisol and α-amylase.We hope that this review will enable researchers and practitioners to gain in-sights into stress biomarkers,which will lead to improved healthcare decisions regarding prevention,treatment and rehabili-tation of stress-related diseases.

Hydrocortisone-conjugated glycine (HG) was a synthesized glucocorticoid with bigger molecular structure and could hardly go through the cell membrane. Our previous study indicated that HG inhibited IgE-mediated histamine release from mast cells and rapidly alleviated allergic reaction. However, the potential effect of HG on vascular inflammation has not been fully clarified. In this study, we explored the mechanism of HG on inflammatory response induced by TNF-alpha in human umbilical vein endothelial cells (HUVECs). The expression of ICAM-1, VCAM-1 and NF-kappa B was measured by real-time quantitative PCR and Western blotting. The expression of inflammatory cytokines was measured by ELISA. RU486 (MIFEPRISTONE) was used to block the effect of glucocorticoid receptor. The results showed that both HG and traditional glucocorticoid had strong anti-inflammatory properties. The expression of inflammatory cytokines was significantly inhibited by HG in HUVECs. Furthermore, the expression of VCAM-1 and ICAM-1 was also reduced by HG as demonstrated by RT-PCR. Finally, we found that HG could not inhibit NF-kappa B activation compared to the traditional glucocorticoid, and the effect could not be reversed by glucocorticoid receptor antagonist RU486. In conclusion, HG inhibits TNF-alpha mediated inflammatory response not through NF-kappa B pathway but in a glucocorticoid receptor independent mechanism. These results suggested that HG could be used as a novel anti-inflammatory candidate of traditional glucocorticoid without the adverse side effect dependent of glucocorticoid receptor.

Objective To study the change pattern of cognition of the ship crew at different stages during prolonged sea deployment,so as to provide scientific evidence for the screening of the ship crew,development of the protocols for the prevention,treatment and improvement of cognition impairment that occurred among the ship crew with a view to reduce the rate of accidents during prolonged deployment at sea.Methods A retrospective study was made on the 185 naval ship personnel who were involved in the 3-month prolonged sea deployment.Detection,comparison,and analysis were performed by using the occupational fatigue scale,the on-line test (A,B) and the continuous performance test (CPT).Results During the 3-month prolonged sea deployment,the fatigue level of the ship crew at day 35 was significantly greater than the fatigue level one week before and after the prolonged deployment,and statistical significance could be seen,when comparisons were made between them (P ＜ 0.05).The length of time spent on the on-line test A and B was longer than that one week before and after the prolonged deployment,and statistical significance could also be seen,when comparisons were made between them (P ＜ 0.05).The accumulated scores of the continuous performance test were all lower than those one week before and after the prolonged deployment,and statistical significance was also noticed,when comparisons were made between them (P ＜ 0.05).Conclusions Prolonged sea deployment could affect such cognitive capabilities as information processing,reasoning,attention and alert of the ship crew.

抑郁症是一种与炎症反应、神经免疫关系密切的神经精神疾病.微生物,尤其是肠道菌群,则与人类免疫调节机制形成、感染和炎症反应息息相关.研究已证实,肠道菌群在炎症性肠病、哮喘等自身免疫性疾病的发生发展过程中起了相当大的作用.这些探讨非感染性疾病与微生物的关系的研究和理论形成了卫生学假说,亦即“老朋友”假说.目前,很多研究正在运用卫生学假说的观念,探索肠道菌群与抑郁症发生、发展、预防和治疗之间的联系,并取得了一些进展.本文重点就肠道菌群失调是否能够促进抑郁症发生及其可能机制做一综述.

NLRP3炎性小体是一种分子量约为700Kda的大分子多蛋白复合体,能被多种病原相关的分子模式或损伤相关的分子模式活化,对固有免疫系统免疫功能的发挥具有极其重要的作用.但如果其被过度激活则可通过活化的半胱天冬酶-1持续地将pro-IL-1β和pro-IL-18剪切为成熟的IL-1β和IL-18,进而激活下游信号转导通路,产生大量的炎性介质,引起机体发生严重的炎症反应,最终促进多种炎症性疾病的发生与发展,如Muckle-Wells综合征、2型糖尿病、非酒精性脂肪肝、动脉粥样硬化、炎症性肠病和阿尔兹海默病等.因此,对NLRP3炎性小体进行深入的研究不仅有助于阐释固有免疫系统如何有效地发挥其免疫功能,而且作为系列炎症反应的核心,NLRP3炎性小体还可能成为多种炎症性疾病防治的新靶点.我们就NLRP3炎性小体的结构与功能,激活与调控,分布与疾病的近期研究作一综述.

The most important military performance of military medical universities is talent-cultivating.The definition of military medical research depends mainly on the objects of the research,which originate in military demands,not only on funds provided by the military.The emphasis and property of military medical research should be based on basic and applied basic research.

Depression is a very common mental health problem in our modern society. Stress is involved in the provocation of depression. The pathogenesis of depressive disorder is still not well known. The development of neuroendocrine immunology opens a new sight for clarification of mechanism underlying stress-induced depression. Chronic stress activates peripheral and central immune systems accompanied with the release of inflammatory mediators, including cytokines. Activated immune system mediates the process of depression through the interaction with neuron system and neuroendocrine system, including regulating the monoamine neurotransmitter system in synthesis, metabolism and reuptake, inducing the overactivation of hypothalamus-pituitary-adrenal (HPA) axis and its negative feedback regulation, and reducing neurogenesis. This present paper reviews the cytokines mechanisms underlying stress-induced depression.

Glucocorticoids (GC) are the most important regulatory hormones involved in stress response. GCs are also widely used clinically as anti-inflammatory and immunosuppressive drugs. In addition to the well-known classical genomic mechanisms, GCs also take effects by nongenomic mechanisms. The therapeutic benefits of nongenomic GC actions have been exploited in clinical medicine, especially with high-dose pulsed glucocorticoid administration. However, it is certainly not the case that the inherent non-genomic glucocorticoid mechanisms evolved only for their clinical utility. So that there must exist some unrevealed important physiological significance. Based onour series of studies focusing on the active actions of the rapid secreted GC over the last few years and literature review, we propose that the physiological significance of nongenomic mechanisms of GC lies in stress regulation.

目的 探讨远岛环境对不同类型守卫战士反应时的影响.方法 运用华东师范大学科教仪器厂生产的注意分配测量仪(EP707A)对远岛和对照组战士进行对光反应时和对声选择反应时的测量.结果 远岛守卫战士的对光反应时、对声选择反应总时间、每次对声选择反应时与对照组不同类型的战士比差异不具有显著的统计学意义,远岛守卫5年以上的士官对声选择反应正确次数比对照组少,差异具有显著的统计学意义(t=7.11,P＜0.01),远岛守卫士官对声选择反应正确次数进步比对照组少,差异具有显著的统计学意义(z=4.57,4.29,P＜0.05).结论 长期远岛守卫(5年以上)影响战士的判断能力；在远岛环境中守卫2年以上影响战士的快速学习能力,但无论是短期还是长期守卫对战士的感觉能力和以感觉能力为主的混合能力没有产生明显的影响.