脑卒中是脑缺血性或出血性改变造成的脑部功能缺损的临床疾病,卒中后抑郁(post stroke depression,PSD)是卒中后神经精神障碍中最常见的并发症.随着医学的发展,科研工作者对PSD的认识逐渐加深,也认识到其会严重影响脑卒中患者的生活质量,且患有抑郁症的患者较卒中后非抑郁患者死亡风险明显升高.本文针对性探讨了PSD患者的临床表现、诊断标准、危险因素、高死亡风险的可能原因和治疗、预防的方法进行综述,为促进医务工作者的临床工作效率和PSD患者的临床疗效提供理论支持.

河北省精神卫生中心牵头组建河北省精神卫生专科联盟,通过管理输出、专科共建、岗位锻炼、教育培训等合作形式,各成员单位诊疗能力和规范化水平持续提高,功能定位逐步清晰,人才队伍逐步优化.但是,同质化水平不高、连续性服务不畅、信息化建设缓慢、资源流动少、可持续发展面临挑战等问题依然突出.认为专科联盟对提高区域医疗卫生能力和构建适合专科特色的分级诊疗制度有积极的促进作用,但仍需要完善政策保障,提高医疗保障水平,强化法治观念,加快优质医疗资源扩容,完善绩效考评机制等,更好地激励医疗资源下沉,促进区域精神卫生均衡发展.

目的 分析整理河北省心理援助热线来电数据,了解当前热线中焦虑、抑郁来电者的特点.方法 采用一般人口学资料调查表收集352例焦虑、抑郁来电者的资料,在两次来电中采用广泛性焦虑量表(GAD-7)、患者健康问卷(PHQ-9)评定来电者的焦虑、抑郁情绪.结果 男性PHQ-9前测评分小于女性(P<0.05);不同年龄、文化程度、职业、婚姻状况以及具有不同问题的来电者在GAD-7、PHQ-9前测评分上比较,差异均具有统计学意义(P<0.05).Logistic回归分析结果显示,性别、文化程度与职业是来电者主要问题的影响因素(P<0.05).GAD-7、PHQ-9前测评分均高于各自后测评分(P<0.05).PHQ-9前测评分与PHQ-9后测评分以及GAD-7前、后测评分均呈正相关(P<0.01),GAD-7前测评分与PHQ-9后测评分、GAD-7后测评分均呈正相关(P<0.01),PHQ-9后测评分与GAD-7后测评分呈正相关(P<0.01).结论 心理援助热线的咨询及干预在一定程度上缓解了来电者的焦虑、抑郁情绪状态,热线随访服务有助于来电者维持情绪稳定,并向来电者提供了积极、有效且及时的求助方式.

目的 了解因新型冠状病毒肺炎疫情求助来电者的基本资料和焦虑情绪状态,并为之后开展有效心理服务提供建议.方法 以2020年1月25日至3月10日因疫情来电的求助者为研究对象,通过一般人口学统计资料、广泛性焦虑量表对这些来电者进行调查研究,并对结果进行统计分析.结果 疫情期间共收集455例有效来电信息,其中381例来电者有焦虑情绪,74例来电者情绪正常,χ2检验发现来电者的情绪状态在性别、职业、来电目的方面差异有统计学意义(P<0.05).女性来电者焦虑情绪多于男性;第二级人群焦虑情绪高于第三、四级人群;"需要疫情相关知识"人群中焦虑情绪高于"需要缓解情绪或想投诉"及"需要疫情防控相关信息"人群,"需要缓解情绪或想投诉"人群高于"需要疫情防控相关信息"人群.结论 通过心理援助热线的咨询和帮助,可缓解来电者焦虑情绪.建议进一步完善心理援助热线服务体系,建立多部门联动机制,守护大众重大突发公共卫生事件期间心理健康.

目的 探讨艾司西酞普兰合并托吡酯对男性酒依赖患者伴有焦虑抑郁的临床疗效、 安全性及对复饮的影响.方法 采用了随机、 对照的临床试验设计,把入组的患者分成艾司西酞普兰合并托吡酯治疗组(协同用药组)和单用艾司西酞普兰治疗组(单一用药组).共治疗了12周,治疗前后分别采用了汉密尔顿抑郁量表(HAMD)、 汉密尔顿焦虑量表(HAMA)、 用药后出现的不良反应量表(TESS)、 可视渴求量表(VAS)等评估患者的临床效果及安全性.结果 2组HAMA、HAMD评分在治疗后4周末、8周末与治疗前比较差异有统计学意义(P<0.05).随着治疗时间的延长2组VAS评分均逐渐下降,协同用药组渴求程度下降更为明显(P<0.05);协同用药组在随访6个月时复饮率低于单一用药组,差异有统计学意义(χ2=11.009,P=0.001<0.05);2组用药后不良反应发生率的差异无统计学意义(P>0.05).结论 对伴焦虑抑郁症状的酒依赖患者, 艾司西酞普兰合并托吡酯治疗焦虑、 抑郁症状的疗效与单用艾司西酞普兰相当, 但减少对酒的渴求优于单用艾司西酞普兰, 且患者有更低的复饮率. 2种治疗方案的不良反应相当.

成立医疗药事管理内审组,采取随机抽样和有意选择相结合的方法确定追踪对象,针对重点病种进行追踪,设计追踪地图,采用提问 、查看资料 、现场考核等方法,对核心条款和关键环节进行审核.通过多次有组织 、有计划的追踪检查,及时发现工作中存在的问题,促使临床医护人员更加关注患者感受,提升了工作质量,提高了患者满意度.

以钼酸铵为钼源硫脲为硫源,十六烷基三甲基溴化铵(CTAB)为模板剂,采用表面活性剂促助法成功制备了环状结构MoS2,并利用X射线衍射仪(XRD)、扫描电镜(SEM)系统比较研究了CTAB添加量、pH值、钼硫比、反应时间对合成环状MoS2微结构及晶体生长的影响,分析了环状结构生长形成的机理.研究结果表明:MoS2形貌主要受CTAB添加量的影响,随着用量的增多MoS2经历了球花状-不规则环状-规则环状-不规则堆积状的递变过程,最佳CTAB添加量为0.5 g.pH值对MoS2的生长发育以及结晶性和微观形貌有显著影响,当pH=3时,所得产物晶体颗粒的圆整度、均一性较好.钼硫比对产物的结晶性和分散性有一定影响,并且影响到环状结构的生长发育,但是过高的钼硫比会造成严重的团聚现象,当钼硫比为1:4时产物的圆整性和分散性较好.反应时间对产物的结晶度有较大影响,随着反应时间的延长结晶度增加,最佳的反应时间为36 h.

目的 对比氨磺必利与利培酮治疗以阴性症状为主精神分裂症疗效及安全性.方法 以河北省精神卫生中心住院的阴性症状为主精神分裂症患者为研究对象,对符合入组标准且不符合排除标准的患者随机分为氨磺必利组及利培酮组,每组35例.分别于入组时、4周末、8周末进行阳性和阴性症状量表(PANSS)、 阴性症状量表(SANS)、临床总体印象量表(CGI-S)、 副反应量表(TESS)评定.结果 氨磺必利组完成32例,利培酮组完成31例.氨磺必利组药物剂量(665.63±167.74)mg,利培酮组药物剂量(4.32±0.98)mg.4周末和8周末时氨磺必利组PAN-SS阴性症状评分及SANS评分均低于利培酮组(P<0.05);两组组内比较,8周末时PANSS、SANS、CGI-S评分均较入组时评分下降,差异有统计学意义(P<0.05);两组均未出现严重不良反应,不良反应比较差异无统计学意义(56.25％vs.67.74％,χ2=0.882,P=0.348),氨磺必利组以便秘、 体重增加、 震颤、 口干等不良反应为主,利培酮组以震颤、 静坐不能、 便秘、 心动过速等不良反应为主.结论 氨磺必利与利培酮均可改善阴性症状为主精神分裂症的症状,但氨磺必利改善阴性症状效果更明显.

In this paper, the nano-hydroxyapatite/chitosan-chondroitin sulfate (Hap/Cs-Chs) composite materials with different mass ratios were prepared by liquid co-precipitation method. On the basis of the microstructure, phase and compressive strength of the composite materials were investigated respectively. The safety of composite materials was evaluated by MMT method. The results showed that Hap/Cs-Chs composite materials exhibited excellent mechanical performance and good biocompatibility. The nano-Hap particles were dispersed uniformly in the organic phase Cs and Chs with relatively weak crystallinity. It is combined with relatively closely between Hap particles and Cs-Chs. The particle size is about 40nm-100 nm with spherical shape. The crystallization, particle size, and dispersion of Hap are influenced directly by the mass ratio of Hap and Cs-Chs. The uniformity, compactness, and thermal stability can reach the optimum when mass ratio is 50/50. EDS analysis indicated that Ca/P ratio is around 1.80±0.03, belonging to the calcium-rich type of Hap. The Hela cell toxicity experiment confirmed that the composite material has good biocompatibility and safety, and the physical and chemical performance can meet the requirements of bone tissue engineering materials.

In this paper,TiO2 nanotube arrays were prepared by anodic oxidation method in HF aqueous solution.The influencing of the parameters for the phase composition and miscrostructure of titania nanotube arrays on the titanium surface were systematicdly studied,such as oxidation voltage,oxidation time,electrolyte concentration,pH value and annealing temperature.The main and secondary factors of the preparation of titanium dioxide nanotube arrays with regularity,uniformity and microstructure were discussed.The results show that:the oxidation voltage and pH value are the determining factors for the formation and regularity of TiO2 nanotube arrays.Smaller pH value is beneficial to the preparation of TiO2 nanotube arrays in a short time,but TiO2 nanotubes tend to fall off the surface of the substrate,which affects the integrity and uniformity of the nanotube arrays.When the oxidation voltage is 15～25 V and the pH value is 4～ 6,the regulation of microstructure of TiO2 nanotube arrays can be realized.The length,diameter and wall thickness of TiO2 nanotube are mainly affected by the oxidation time and electrolyte concentration.If the range is proper,the microstructure can be controlled by tiny changes.The annealing temperature determines the crystal phase transition of TiO2.Different annealing temperature has little effect on the diameter,wall,regularity and uniformity of TiO2 nanotubes.Rapid heatins and high temperature were not beneficial to the formation of anatase TiO2 nanotubes.The transition of crystal phase can be realized at a lower temperature.

Co-MgAl ternary hydrotalcite-like compounds (HTLcs) were prepared by hydrothermal method.The different Co2+ ratios on the phase composition, crystal structure and crystal growth of HTLcs were investigated by the X-ray diffraction (XRD) and scanning election microscopy (SEM).Simultaneously, the growth mechanism was discussed by the ligand field theory.The adsorption performance and mechanism of calcined Co-MgAl-HTLcs and MgAl-LDHs were comparative investigated with methyl orange (MO) as the adsorption object.The results show that there is exchange exists in Mg2+ and Co2+ at layer board.The lamellar structure of hydrotalcites are not affected at different Co2+ ratios, but the each crystal planes growth of Co-MgAl-HTLcs are affected during the crystal formation process.The calcined Co-MgAl-HTLcs of Co∶Mg∶Al=1∶2∶1 can maintain sheet structure after 500 ℃ calcining.But the crystal size and thickness slightly are decrease compared with that before calcined, the homogeneity and regularity of the product became relative poorer than before calcined.The adsorption decolorization performance of Co-MgAl-LDO is slowly increasing with the time increase on MO simulated dye wastewater.It took the longer to reach adsorption equilibrium for 70 min.The decolorization rate is only to 60%, which is the lower than the MgAl-LDO (90%).The adsorption kinetic study shows that the adsorption process of Co-MgAl-LDO on the MO is more consistent with the quasi-second-order kinetics equation, and the adsorption isotherm is in accordance with the Freundlich model.The adsorption process of MgAl-LDO is more consistent with the quasi-first order kinetic equation, its adsorption isotherm conforms to the Langmuir model.

应用FOUCS-PDCA分析无抽搐电休克治疗前医疗护理的各个环节,查找预约失败原因,通过完善和落实治疗前准备工作,建立术前准备标准及安全核查制度,加强患者安全管理,使无抽搐电休克治疗预约成功率显著提高.

<正>2011年初,我们根据卫生部《精神卫生工作指标调查评估方案》[1](以下简称《评估方案》)对保定市《中国精神卫生工作规划(2002-201年)》[2](以下简称《规划》)部分指标的落实情况进行了调查。1对象与方法

衰老是机体在退化时期组织器官生理功能下降及生理功能紊乱的综合表现,是机体固有的、复杂的、不可逆的过程.在研究中发现,机体衰老时不仅外表发生变化,体内亦发生了许多生化和组织学的变化,本文就衰老时机体体内发生的这些变化进行综述,为抗衰老的研究提供临床资料.

Objective To investigate the effect of exercise on learning and memory impairment of senile dementia mice and explore its mechanism. Methods After 4 weeks of exercise with the running wheels, water maze task was used to evaluate the learning and memory function of mice. The activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) were measured with colorimetry. The alterations in hippocampus slices morphology were assessed using microscope. The BI-2000 image system was used to evaluate the microcirculation in mice′s ala auris. The survival time and persistent time of gasping were observed on acute anoxia mice. Results Compared with control group, the escape latency in directional swimming was prolonged, SOD activity was decreased and the content of MDA was increased in mice of model group. Compared with model group, exercise prolonged the escape latency, increased SOD activity and decreased the content of MDA and improved neurodegenerative changes and reduced the death of neuron in hippocampus slices and improved the microcirculation and enhanced the effect of anti-anoxia in mice. Conclusions Exercise can improve the learning and memory impairment in various degree. The mechanism may be related to improving the microcirculation and enhancing the effect of anti-anoxia and decreasing the free radical in mice.

Objective To study the effects of different exercise loadings on free radicals in the brains of mice with memory disorders. Methods Sixty mice were,at random,divided into a control group,a model group,a nimodipine group,a group with a high load of exercise,a group with a moderate load of exercise and a group with a low load of exercise.The three exercise groups trained to run on a wheel.In the 6th week of the experiment,all the groups were injected with sodium nitrite in the abdominal cavity to model mice with memory disorders,except the control group which was injected with the same amount of sodium chloride.From the 5th week,the nimodipine group was treated with 30 mg·kg~(-1) of nimodipine once daily until the end of the experiment.In the 8th week,the superuxide dismutase (SOD) activity and the malonie aldehyde (MDA) content in the brain tissue of mice in each group were measured with a spectrophotometer. Results Compared with the model contrast group,SOD activity in the nimodipine group was significantly elevated. MDA content had a tendency to decrease,but the differences among the groups were not statistically significant.SOD activity and MDA levels in the three exercise groups increased significantly.There was no significant dependence of any of these effects on the exercise load. Conclusions Any loading of exercise can significantly enhance SOD activity in the brains of mice with memory disorders,lower the level of MDA and elevate the ability to clean up free radicals.

Objective:To study the effects of various exercises quantity on microcirculation and anti-hypoxia ability in mice.Method:The mice of exercises group were administered to exercise in running wheels,The BI-2000 image system was used to evaluate the diameter and velocity of microcirculation in mice's auricle after 4 weeks of exercises.Acute anoxia in mice were produced by sodium nitrite hypoxia under normal pressure and decapitation.In these two models the survival time and persistent time of gasping were observed.Result:Comparing with control group,in exercises groups the velocity of microcirculation in mice auricle significantly speeded up(P0.05) ;the diameters of microartery dilated(P0.05) ;after decapitation the gasping time prolonged significantly(P0.05) .In sodium nitrite hypoxia model the survival time in exercises groups and nimodipine group shortened significantly(P0.05) .Conclusion:Exercises can improve the microcirculation and enhance the capacity of anti-anoxia in mice and the effect is related to exercises quantity.

Objectives To investigate infection status of Demodex mites among some college students in Baoding and explore the relationship between Demodex mites infection and sex,age and the bad habit of smoking and drinking.Methods 935 college students in Baoding were selected for the diagnosis of Demodex mite infection using transparent adhesive tape method.The related current situation was recorded.Results The infection rate of Demodex mites of the college students was 13.05%(13.54% in male and12.60% in female).There was no significant difterence in the infection rate between male and female(P>0.05).There was also no significant difference in the infection rate between the freshmen and the senior students(P>0.05).The infection rate of the men who had the habit of smoking and drinking was higher than that of the men who hadn't those habits(P<0.01).Conclusions The infection rate of Demodex mites of the local college students was in the range of the domestic infection rate and was in a lower level;the habit of smoking and drinking might be one of pathogenic factors.