Context: Since December 2019, more than 80,000 patients have been diagnosed with coronavirus disease 2019 (COVID-19) in China. Social support status of COVID-19 patients, especially the impact of social support on their psychological status and quality of life, needs to be addressed with increasing concern. Objectives: In this study, we used social support rating scale (SSRS) to investigate the social support in COVID-19 patients and nurses. Methods: The present study included 186 COVID-19 patients at a Wuhan mobile cabin hospital and 234 nurses at a Wuhan COVID-19 control center. Responses to a mobile phone app-based questionnaire about social support, anxiety, depression, and quality of life were recorded and evaluated. Results: COVID-19 patients scored significantly lower than nurses did on the Social Support Rating Scale (SSRS). Among these patients, 33.9% had anxiety symptoms, while 23.7% had depression symptoms. Overall SSRS, subjective social support scores and objective support scores of patients with anxiety were lower than those of patients without anxiety. This result was also found in depression. In addition, all dimensions of social support were positively correlated with quality of life. Interestingly, in all dimensions of social support, subjective support was found to be an independent predictive factor for anxiety, depression, and quality of life, whereas objective support was a predictive factor for quality of life, but not for anxiety and depression via regression analysis. Conclusion: Medical staffs should pay attention to the subjective feelings of patients and make COVID-19 patients feel respected, supported, and understood from the perspective of subjective support, which may greatly benefit patients, alleviate their anxiety and depression, and improve their quality of life.

目的 观察系统康复教育应用于脊髓损伤患者治疗中的效果.方法 观察对象为2018年2月—2020年2月期间收治的78例脊髓损伤患者,双色球抽签方法实施分组,39例实施传统治疗和护理的患者纳入对照组,39例实施传统治疗、护理联合系统康复教育的患者纳入实验组,对两种治疗方案的实施效果进行对比和分析.结果 相比于对照组,实验组患者治疗方案的开展获得更为突出的效果,主要表现在:相比于对照组,实验组患者治疗总依从性提升显著,康复认知水平提升显著,并发症发生率降低显著,对比差异有统计学意义(P<0.05).结论 系统康复教育应用于脊髓损伤患者治疗中可获得满意疗效,建议推广.

目的 观察轻中度颅脑损伤患者采用康复治疗的效果.方法 选取2019年1—10月收治的60例轻中度颅脑损伤患者为研究对象,随机分为实验组和对照组,各30例,对照组实施常规治疗,实验组实施康复治疗,对比患者治疗不良事件发生率、治疗前后SAS评分、SDS评分及治疗指标.结果 实验组患者治疗不良事件发生率显著低于对照组,差异有统计学意义(P<0.05).两组患者治疗前SAS及SDS评分对比差异无统计学意义(P>0.05);治疗后的SAS及SDS评分对比中,实验组显著好于对照组,差异有统计学意义(P<0.05).实验组患者治疗指标显著好于对照组,差异有统计学意义(P<0.05).结论 轻中度颅脑损伤患者采用康复治疗的效果显著,能够满足患者治疗需求,值得进一步推广使用.

目的 探讨脑梗塞患者早期康复治疗的实施及效果.方法 将我院2016年6月-2019年4月脑梗塞患者100例,随机分组,对照组就诊患者采取常规疗法治疗,观察组对本次就诊患者采取常规疗法+早期康复治疗.比较肢体功能、语言表达和日常自理改善时间;治疗前后患者语言功能量表评分、肢体FMA量表分值、生活自理BI指数;肩手综合征发生率.结果 观察组肢体功能、语言表达和日常自理改善时间、语言功能量表评分、肢体FMA量表分值、生活自理BI指数均优于对照组,P<0.05.观察组肩手综合征发生率低于对照组,P<0.05.结论 常规疗法+早期康复治疗脑梗塞效果良好,对本病治疗有一定的参考价值.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:探索单次小剂量氯胺酮对抑郁症患者疗效和血清瘦素及5-羟色胺（5-HT）水平的影响。方法:符合精神障碍诊断与统计手册第5版（DSM-5）中重性抑郁障碍的诊断标准的39例患者,随机分为氯胺酮组（n=19）和对照组（n=20）。氯胺酮组静脉持续推注0. 5 mg/kg氯胺酮溶液50 mL,推注时间40 min,对照组推注等容量生理盐水50 mL。在治疗前及治疗后第1、3、7天进行病情评估、清晨外周静脉血采样,测量血清中瘦素及5-HT的浓度。用汉密顿抑郁量表（HAMD-24）评定抑郁情绪、贝克绝望量表（BHS）评定绝望、自杀意念自评量表（SIOSS）评定自杀意念。结果:治疗前两组HAMD分、BHS分、SIOSS分均无明显差异（P&gt; 0. 05）。氯胺酮组治疗后1、3、7天HAM D量表分较治疗前均明显减少（P &lt;0. 05）,BHS分及SIOSS分治疗后1、3天较治疗前有明显下降,而治疗后7天恢复到治疗前水平（P&gt; 0. 05）。对照组治疗前后各时点的HAMD分、BHS分、SIOSS分统计学意义均无明显差异（P&gt;0. 05）。氯胺酮组治疗后第1天血清瘦素水平明显上升[（1. 16±0. 76）μg/L vs.（1. 75±1. 00）μg/L,P&lt;0. 01],第3天、第7天仍增高（P &lt;0. 05）,对照组治疗前后无统计学意义;两组治疗前后各时间节点5-HT浓度差异均无统计学意义（P&gt; 0. 05）。结论:氯胺酮有快速的抗抑郁疗效,可能与血清瘦素水平上升有关。</span>

目的 观察丙泊酚对麻醉诱导期芬太尼所致咳嗽的影响.方法 拟行全身麻醉患者113例,年龄25～ 60岁,ASA Ⅰ或Ⅱ级,随机分为两组:对照组依次输注生理盐水0.05 ml/kg和4μg/kg芬太尼,丙泊酚组依次输入丙泊酚0.5 mg/kg和4 μg/kg芬太尼.观察并记录两组患者注射芬太尼0、5、10s时的咳嗽情况.结果 对照组芬太尼引起咳嗽29例,丙泊酚组10例,两组在发生率和严重程度上均有显著的统计学意义(P ＜0.0001).本研究还显示丙泊酚能降低吸烟者的咳嗽发生率.结论 芬太尼全身麻醉诱导前1 min给予0.5 mg/kg丙泊酚可有效抑制芬太尼所导致的咳嗽.

Objective To investigate the effects of ketamine on depressive symptoms induced by streptozotocin in rats .Methods Thirty -six male Wistar rats weighing 180-220 g were randomly divid‐ed into 3 groups ( n =12 each):control group (C group) ,streptozotocin group (STZ group) and ket‐amine 10 mg/kg group (KET group) .Rats in STZ group and KET group were intraperitoneal injected with 60 mg/kg streptozotocin .Twenty -eight days later ,rats were administered saline and 10 mg/kg ketamine ,respectively .Thirty minutes later ,forced swimming test (FST ) was carried out for all the rats ,and the immobility time of FST was recorded .Subsequently ,rats were sacrificed and prefrontal cortex was collected for measuring interleukin-1β(IL -1β) and interleukin-6 (IL -6) by using ELISA kit and brain-derived neurotrophic factors (BDNF) by Western blot .Results Compared with C group , rats in STZ group demonstrated significant increase in the immobility time of FST (P< 0 .01)and signif‐icant increased expression of IL -1β and IL -6 and decreased expression of BDNF (P < 0 .05);Com‐pared with STZ group ,rats in KET group showed significant decrease in the immobility time during FST and significant decreased expression of IL -1βand IL -6 and increased expression of BDNF (P< 0 .05) . Conclusions Ketamine has therapeutic effects for treating streptozotocin-induced depressive symptoms , and its underlying mechanism is probably related to the decreased expression of IL -1βand IL -6 and in‐creased expression of BDNF in the prefrontal cortex .

Fluvoxamine, a common antidepressant agent, is designed to exert its pharmacological effect by inhibiting synaptic serotonin reuptake. However, increasing evidence has demonstrated that σ1 receptors are likely to be involved in the mechanism of action of fluvoxamine. The present study aimed to observe the effects of fluvoxamine on the expression levels of mammalian target of rapamycin (mTOR), Ca2+/calmodulin-dependent protein kinase 2γ (Camk2γ) and glycogen synthase kinase-3β (GSK-3β) in fluvoxamine-treated N2a cells and attempted to elucidate whether σ1 receptors mediate the pharmacological effects of fluvoxamine. The N2a cells were randomly divided into three groups (each n=6): DMEM group (D group), 0.5 μmol/l fluvoxamine group (F group) and 0.2 μmol/l BD1047 (a σ1 receptor antagonist) + 0.5 μmol/l fluvoxamine group (BF group). Western blotting was used to determine the expression levels of mTOR, Camk2γ and GSK-3β in the cultured N2a cells after two days of incubation. The F group exhibited significant increases in the expression levels of mTOR and Camk2γ and a significant reduction in the expression levels of GSK-3β compared with those in the D group (P<0.01). By contrast, the BF group demonstrated significant reductions in the expression levels of mTOR and Camk2γ and a significant increase in the expression levels of GSK-3β, compared with those in the F group (P<0.01). These results suggest that σ1 receptors mediate fluvoxamine-elicited changes in the expression levels of mTOR, Camk2γ and GSK-3β in N2a cells, which indicates that σ1 receptors are likely to be involved in the pharmacological effects of fluvoxamine.

目的 检测抑郁大鼠给予氯胺酮后,前额皮层及海马区组织内IL-1β和IL-6表达的变化.方法 Wistar大鼠雄性20只按照随机方式分为2组,各10只,给予生理盐水的大鼠入对照组(C组),给予10 mg/kg氯胺酮的大鼠为K组.应用行强迫游泳实验15 min的方法建立大鼠抑郁模型.次日,腹腔注射氯胺酮或等体积生理盐水,注射30 min后再次进行强迫游泳实验5 min,记录不动时间.并分别采用Western Blot法和双抗体夹心ABC-ELISA法检测大鼠前额皮层及海马组织中IL-1β和IL 6的表达情况.结果 与对照组比较,应用氯胺酮后大鼠强迫游泳不动时间明显减少(P＜0.01),大鼠前额皮层及海马区的IL-1β和IIL-6表达均明显下调(P＜0.05).结论 氯胺酮对抑郁大鼠的抗抑郁作用可能与前额皮层及海马IL-1和IL-6的表达下调有关.

疼痛是一种不愉快的主观感觉和情绪方面的体验,往往和实际或者潜在的伤害相联系.国际疼痛学会将疼痛定义为:"与组织损伤或潜在的组织损伤相关又或是可以用这类损伤描述的不愉快的主观感受和情感经验."在临床中慢性疼痛患者常伴有焦虑、抑郁等精神疾病症状.塞来昔布为特异性选择性环氧化酶-2(COX-2)抑制剂,其在慢性疼痛的治疗中具有较好的改善作用.笔者在临床中对一位慢性疼痛伴有抑郁症状患者使用塞来昔布,发现其疼痛及抑郁症状均得到显著改善,现报道如下.

Objective To evaluate the effects of sirolimus on scopolamine-induced cognitive dysfunction in rats.Methods Thirty male Wistar rats,aged 3 months,weighing 200-250 g,were equally randomized into 3 groups:normal saline group (NS group),scopolamine group (SC group) and scopolamine + sirolimus group (SS group).Normal saline,scopolamine 0.8 mg/kg and sirolimus 3.5 mg/kg + scopolamine 0.8 mg/kg were injected intraperitoneally in groups NS,SC and SS,respectively,and the injection was continued for 14 consecutive days.The cognitive function was assessed by Morris water maze test on 15th day.After behavior test,the rats were sacrificed and the prefrontal cortex and hippocampus were harvested for determination of amyloid β protein (Aβ) and Tau protein expression.Results Compared with NS group,the escape latency was significantly prolonged,the ratio of time spent in the target quadrant was decreased,Aβ expression in prefrontal cortex and hippocampus was upregulated and Tau protein expression in prefrontal cortex and hippocampus was down-regulated in group SC (P ＜0.05 or 0.01).Compared with SC group,the escape latency was significantly shortened,the ratio of time spent in the target quadrant was increased,Aβ expression in prefrontal cortex and hippocampus was down-regulated and Tau protein expression in prefrontal cortex and hippocampus was up-regulated in group SS (P ＜ 0.05 or 0.01).Conclusion Sirolimus can significantly improve scopolamine-induced cognitive dysfunction in rats and the changes in the expression of Aβ and Tau protein in prefrontal cortex and hippocampus may be involved in the mechanism.