2型糖尿病患者抑郁患病率调查与分析

调查2型糖尿病（T2DM）患者抑郁患病率,探讨影响抑郁发生的因素。从青岛市城区常住居民中随机抽取40岁以上者5000人,选取其中已诊T2DM患者440例,运用Zung抑郁自评量表等进行调查、测定临床生化指标,进行分析。T2DM患者抑郁患病率为21．82％,抑郁对血糖控制不利,病程长、收入低、应用胰岛素、有并发症、不运动、血糖控制差为T2DM患者抑郁患病的危险因素。     

老年糖尿病患者人工髋关节置换术的围手术期处理体会

探讨老年糖尿病患者人工髋关节置换术围手术期的治疗方法。对2000年1月~2006年3月54例糖尿病患者行人工髋关节置换术进行术后随访,利用临床关节功能及放射学检查进行分析。54例手术患者血糖控制满意且顺利度过围手术期。按Harris评分标准,术后髋关节功能优良率分别为人工股骨头置换组74%(14/19),人工全髋关节置换组91%(32/35)。未发现感染及假体松动现象等并发症。老年糖尿病患者如果有髋关节置换手术指征,没有严重的并发疾病,在重视围手术期处理的情况下,可以行人工髋关节置换术,且疗效肯定。     

情绪劳动与抑郁及焦虑的关系：情绪耗竭的中介作用

本研究探讨情绪劳动与抑郁、焦虑的关系,着力考察情绪耗竭在二者之间的中介作用。采用情绪劳动量表、情绪耗竭量表和SCL-90对328名零售业员工进行调查。结果表明：表面行为与情绪耗竭、抑郁及焦虑没有显著相关;深度行为对情绪耗竭、抑郁及焦虑有显著的负预测作用;情绪耗竭在情绪劳动与抑郁及焦虑之间起完全中介作用。     

Residual Geriatric Depression Symptoms: A Place for Psychotherapy

Geriatric depression is a relatively commonly occurring mental disorder. A subpopulation of depressed older adults are those who have engaged in or completed pharmacotherapy, yet continue to experience depressive symptoms. We review the prevalence, psychosocial effects, and treatment of residual symptoms of depression in older adults. Data from previous studies conducted by our group are presented to support our contention that residual symptoms of geriatric depression are treatable through psychosocial means.     

外科手术患者的血糖管理

随着糖尿病患患者数的迅速增加,需要接受外科手术治疗的糖尿病患者也越来越多。糖尿病患者的血糖控制与外科手术相互影响,一方面,手术应激可进一步加重糖尿病患者的糖代谢紊乱;另一方面,合并糖尿病使患者发生围手术期并发症甚至死亡的风险大大增加。因此,对糖尿病患者进行完整的术前评估,良好的术前、术中、术后血糖管理是糖尿病患者手术顺利进行、平稳渡过围手术期、改善预后的重要保证。     

自动思维及归因方式对抑郁症作用的多因素分析

目的：探讨抑郁症患者治疗前后自动思维、应付方式变化对抑郁严重程度变化的影响及其相互作用。方法：对97例抑郁症患者分别在其入、出院时进行测评,测评工具包括自评抑郁量表、自动思维问卷和归因方式问卷。此外对100例正常对照亦进行上述测评,其中29例在15—20天后重测。结果：自动思维问卷得分、归因方式问卷得分的logistic回归分析、路径分析表明,自动思维、对正性事件的整体性维度的归因方式对抑郁程度的影响有显著作用,自动思维的变化对SDS的变化的直接影响最大(路径系数为0．572),归因方式中正性事件整体性归因的变化为其次(路径系数为一0．193),而自动思维的变化与归因方式中正性事件整体性归因的变化的相互影响较小(路径系数为-0．188)。结论：自动思维、对正性事件的整体性维度的归因方式对抑郁严重程度有显著影响。     

Exercise and Depression: A Review of Reviews

There has been considerable research interest in the effects of exercise upon depression outcomes. Recently, health agencies in the United Kingdom (UK) and beyond have made several guidance statements on this issue. Therefore, this review seeks to provide a synthesis of evidence regarding the effectiveness of exercise in the management of depression (including postnatal depression) in adults. Studies were identified by searching PubMed, Medline, Cochrane Library (CENTRAL) and PsychINFO using relevant search terms. The article describes how meta-analyses from peer reviewed journals have reported exercise as treatment for depression is more effective than no treatment, as effective as traditional interventions in some instances, possibly a promising approach to postnatal depression and has equivalent adherence rates to medication. However, reviews have also raised concerns about the methodological quality of trials, possible overestimation of treatment effects and lack of data regarding long term benefits. Based on the available evidence it is concluded that while awaiting further high quality trial evidence it would seem appropriate for exercise to be recommended in combination with other treatments.     

若干新技术在糖尿病治疗中的应用

糖尿病是严重威胁人类健康的常见病,其治疗手段在不断进展和完善。近年来某些新科学技术在糖尿病治疗中发挥着重要作用,动态血糖监测和胰岛素泵的应用使糖尿病的治疗更加理想。     

妊娠晚期亚临床甲状腺功能减退症对母婴合并症的影响

本研究旨在观察妊娠晚期亚临床甲状腺功能减退症对母婴合并症的影响。最终选择2010年1月～2010年11月期间共325例妊娠晚期孕妇分为病例组（A组,n＝65）和正常对照组（B组,n＝260）,观察两组之间母婴合并症的变化。结果显示,两组之间在年龄、住院日、血压、体质量指数（BM I）、心率、分娩时孕周、血糖以及血脂方面差异均无统计学意义（P＞0．05）。但与B组相比较,A组发生母亲合并症及胎儿合并症的发生率明显增加,差异有统计学意义（P＜0．05）。此研究提示妊娠晚期亚临床甲状腺功能减退症增加母婴合并症的风险。     

对妊娠晚期畸形胎儿实施致死性引产的可行性分析

在妊娠晚期发现胎儿畸形,许多胎儿父母要求引产。一些患儿父母因为在医院引产出活体畸形婴儿而与医院产生纠纷。本文考虑采用医疗方法在引产前或引产中使胎儿心跳停止,确保引产出的胎儿为死婴（即致死性引产）以减少纠纷,利于社会。本文试图从医疗、伦理、法律的角度,探讨在胎儿父母要求下,对妊娠晚期畸形胎儿实施致死性引产的可行性。     

A Year's Experiences with a Postpartum Depression Group

The author defines postpartum mood and adjustment disorders, risk factors, symptoms, treatment, and resources. The purpose, goals, themes, and co-leadership issues of a postpartum depression psychoeducational group, offered year-round in an urban community center, are discussed. A vignette from the group is presented to sample its process and content.     

强化控制2型糖尿病患者血糖、血压＼血脂可降低尿白蛋白／肌酐比率

探讨2型糖尿病（T2DM）患者尿白蛋白／肌酐比率（UACR）的主要影响因素。89例T2DM患者实施血糖、血脂、血压强化控制,随诊1年并检测相关指标变化,统计学分析显示强化治疗后UACR降低,糖化血红蛋白和收缩压的变化值是影响UACR变化的主要因素。强化控制血糖、血脂、血压,尤其是严格控制糖化血红蛋白及收缩压,能减低糖尿病肾病发生的风险。     

Patterns of Adolescent Depression to Age 20: The Role of Maternal Depression and Youth Interpersonal Dysfunction

Considerable research has focused on youth depression, but further information is needed to characterize different patterns of onset and recurrence during adolescence. Four outcome groups by age 20 were defined (early onset-recurrent, early-onset-desisting, later-onset, never depressed) and compared on three variables predictive of youth depression: gender, maternal depression, and interpersonal functioning. Further, it was hypothesized that the association between maternal depression and youth depression between 15 and 20 is mediated by early-onset depression and interpersonal dysfunction by age 15. Eight hundred sixteen community youth selected for depression risk by history (or absence) of maternal depression were interviewed at age 15, and 699 were included in the 5-year follow-up. Controlling for gender, early onset and interpersonal dysfunction mediated the link between maternal depression and late adolescent major depression. Different patterns for males and females were observed. For males maternal depression’s effect was mediated by early onset but not interpersonal difficulties, while for females maternal depression’s effect was mediated by interpersonal difficulties but not early onset. Maternal depression did not predict first onset of major depression after age 15. The results suggest the need for targeting the impact of maternal depression’s gender-specific effects on early youth outcomes, and also highlight the different patterns of major depression in youth and their likely implications for future course of depression.

1例妊娠合并急性白血病患者带来的分析与思考

通过对1例妊娠合并急性白血病患者的病例资料进行回顾分析,从孕期化疗的特点来探讨其终止妊娠及进一步化疗治疗的时机与方式,以及从该患者治疗和妊娠之间的矛盾来讨论医生在母体和婴儿生存权益的重要性,总结出医护人员的人性化与职责,深入伦理学思考临床医生对类似患者的最佳治疗应该作出的判定与决策,从而有利于构建和谐社会。     

The Relationship of Pregnancy Status to Job Satisfaction: An Exploratory Analysis

Forty-three women who had worked outside of the home prior to becoming pregnant and had returned to the same place of employment after the birth of their children participated in the study. To do so, they responded to a two-part questionnaire asking about their work lives (e.g., level of job satisfaction before, during, and after their pregnancies) and demographic characteristics (e.g., occupation). The results indicated that their job satisfaction was significantly greater before their pregnancies than either during or after their pregnancies. Job satisfaction during pregnancy had a significant, positive correlation with satisfaction with organizational maternity leave policies. Perceived reactions from women's coworkers and supervisors were also examined. Implications for these findings for organizations are discussed. Limitations of the study, and how they might be rectified in future research, are also addressed.     

网络社会排斥对抑郁的影响：一个有调节的中介效应模型

为探讨网络社会排斥对抑郁的影响以及自尊和正念在二者关系中的作用机制,采用网络社会排斥问卷、自尊量表、正念注意觉知量表和流调中心用抑郁量表(CES-D)对644名大学生进行调查,结果发现：（1）网络社会排斥不仅能直接影响抑郁,还能通过自尊的中介作用对抑郁产生影响。（2）正念能够调节网络社会排斥对抑郁的直接效应及自尊的中介效应的前半路径。具体而言,网络社会排斥对抑郁的预测作用以及自尊的中介作用在低正念个体中更加显著。研究结果表明,作为一种消极的人际关系体验,网络社会排斥会增加个体抑郁的风险,而正念能够弱化网络社会排斥的消极影响。     

Counseling Women Who Have Experienced Pregnancy Loss: A Review of the Literature

The authors review pregnancy loss scholarly literature and discuss themes of silence, grief, psychological distress, role of social support, satisfaction with health care, and coping strategies from a counseling standpoint. Counseling needs of women who have experienced pregnancy loss are delineated, and recommendations for future research in this area are made.     

Measurement of Depressive Symptoms in Women With Breast Cancer and Women With Clinical Depression: A Differential Item Functioning Analysis

Differential item functioning (DIF) analyses of the Beck Depression Inventory-II (BDI-II) were conducted on samples of 267 women with breast cancer and 294 women with clinical depression. Patterns of items in which there was significant and nonsignificant DIF were identified using statistical tests and measures of DIF effect size. At the most general level, 15 of 21 BDI-II items were associated with nontrivial DIF suggesting that the item responses of these samples do not reflect the same underlying construct. Factor analyses of the BDI-II using a psychometrically defensible method for item level factor analysis supported the conclusions from the DIF analyses. These findings suggest that researchers and practitioners should apply caution when interpreting self-report depression symptoms in breast cancer patients.     

童年中晚期友谊质量与抑郁的关系:一项纵向研究

以友谊质量问卷和儿童抑郁量表为研究工具,对小学3到4年级847名儿童进行了18个月的追踪研究,采用交叉滞后的研究设计,考察了童年中晚期友谊质量与抑郁的关系。结果表明：（1）同一时间点的友谊质量和抑郁之间呈显著的负相关;（2）早期的友谊质量可以显著预测随后的抑郁,早期的抑郁也可以显著预测随后的友谊质量,且相对于友谊质量对抑郁的积极作用,抑郁对儿童友谊质量的瓦解作用更为突出;（3）童年中晚期友谊质量与抑郁的双向作用关系具有跨性别稳定性。     

抑郁症神经成像研究的临床转化:预防、诊断和治疗的新取向

抑郁症的预防、诊断和治疗是临床所面临的主要问题,其效果的提升有待超越传统方法,寻求新的方法和技术。其中抑郁症的神经成像转化研究为此提供了一个新的突破口,该研究取向旨在将抑郁症的神经成像基础研究的发现转化为临床运用。文章综述了其在抑郁症的预防、诊断和治疗上的潜在运用价值。未来方向需要更好地促进抑郁症神经成像转化研究的双向自由流通、强调将新的方法转化到日常的临床实践和健康决策上去、促进多学科的合作和相关人才的培养,以及进一步探究转化过程中所面临的特定基础和临床主题。