Different Associations of Health Related Quality of Life with Pain,Psychological Distress and Coping Strategies in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disorder

The primary aim of this study was to measure psychological distress, pain severity, health related quality of life (QOL) and pain coping strategies in patients with irritable bowel syndrome (IBS) and ulcerative colitis (UC). A second aim was to determine the influence of somatic and psychological variables on health related QOL. Eighty-eight IBS and 66 UC patients completed the Irritable Bowel Syndrome Quality of Life Questionnaire (IBSQOL), Pain Severity Scale of West Haven Yale Multidimensional Pain Inventory (WHYMPY), Symptom Checklist-90-R (SCL-90-R) and Coping Strategies Questionnaire (CSQ). T-tests and GLM Analysis of Covariance were used for statistical analysis. IBS patients had significantly higher levels of psychological distress, pain severity and maladaptive pain coping strategies (catastrophization), and lower QOL than UC patients. Variance of QOL in IBS was explained for the most part by catastrophization (15%), then by psychological distress (8%), and for the less part by pain severity (5%). In UC, pain severity explained 21%, psychological distress 8%, and catastrophization 3% of the variance of QOL. These results suggest there are differences between IBS and UC patients in the role of physical and psychological factors in QOL and emphasize the importance of cognitive processes in IBS.     

The trajectory of mathematics skills and working memory thresholds in girls with fragile X syndrome

Fragile X syndrome is a common genetic disorder associated with executive function deficits and poor mathematics achievement. In the present study, we examined changes in math performance during the elementary and middle school years in girls with fragile X syndrome, changes in the working memory loads under which children could complete a cognitive switching task, and the association between these two areas of function, in girls with fragile X syndrome relative to their peers. Our findings indicate that the trajectory of math and executive function skills of girls with fragile X differs from that of their peers and that these skills contribute to predicting math achievement and growth in math performance over time. Also, changes in math performance were associated with incremental increases in working memory demands, suggesting that girls with fragile X have a lower threshold for being able to perform under increasing task demands. Still, we found improvement in executive function performance between 10 and 12 years in girls with fragile X rather than a performance plateau as has been reported in other studies. The findings implicate the importance of early intervention in mathematics for girls with fragile X that addresses poor calculation skills, the supporting numerical skills, and deficits in executive functions, including working memory.     

代谢综合征与乳腺癌

研究显示,代谢综合征可增加女性乳腺癌的患病风险,在绝经后妇女中表现更明显。这种作用可能通过胰岛素抵抗影响雌激素和性激素结合球蛋白水平、高胰岛素血症的直接或间接作用以及脂肪因子水平异常等机制实现。因此,对于我国乳腺癌发病率可能随代谢综合征人群不断扩大而上升的趋势应予以足够重视。     

多囊卵巢综合征与代谢综合征

高胰岛素血症和高雄激素血症是多囊卵巢综合征（PCOS）的两大基本特征,共同参与了PCOS的发生与发展,胰岛素抵抗是连接PCOS和MS的纽带。本文阐述了PCOS和MS的相互重叠、PCOS产生胰岛素抵抗的机制、胰岛素抵抗对PCOS的作用。指出早期识别PCOS,有利于及时纠正、阻断其内分泌紊乱,防止MS的发生。提高胰岛素敏感性的治疗措施包括生活方式调整和药物治疗,生活方式的调整主要是控制饮食、运动和改变生活方式,包括戒烟、戒酒;药物治疗主要是使用二甲双胍和噻唑烷二酮类药物,其他药物如右旋肌醇、N-乙酰半胱氨酸、生长抑素类似物、α糖苷酶抑制剂、内腓肽受体抑制剂也具有增强胰岛素敏感性的作用。     

代谢综合征与遗传

代谢综合征是指一组与糖尿病和心血管疾病发病风险增加相关联的症候群。不同学术组织对于代谢综合征的定义有所不同,但其基本要素主要包括胰岛素抵抗、异常葡萄糖代谢、高血压、致动脉粥样硬化的脂代谢紊乱、肥胖等。家系研究以及双生子研究显示遗传因素在代谢综合征中各个组分中都扮演着不同程度的重要角色。在代谢综合征患者中有一部分是由于单基因突变所导致的特殊类型的代谢综合征,这些患者的共同特点包括脂质萎缩以及严重的胰岛素抵抗等。导致这些特殊类型代谢综合征发生的单基因突变包括AKT2R274H,PPARs家族的PPARγF388L基因突变、PPARγArg397Cys基因突变、PPARγP467L与PPARγV290M基因突变,核纤层蛋白A／C基因的lamin A G602S突变、LMNA R482W突变等。此外,由于对代谢综合征的定义和理解不同,在代谢综合征的遗传学研究中造成了很大困难。     

代谢综合征的争议与共识

代谢综合征（metabolic syndrome,MS）的主要组分包括中心性肥胖、高血压、糖耐量异常、脂代谢紊乱,而胰岛素抵抗被认为是MS的病理生理学基础。目前,对MS的认识还存在诸多争议,主要包括MS的命名、病因机制和病理生理学基础、其各组分及其阈值的确定以及对心血管疾病的预测价值。尽管存在争议,MS概念的提出将有助于对高危人群的心脑血管疾病及糖尿病的防治。     

非ST段抬高急性冠脉综合征药物治疗规范化分析

回顾性分析我院收治的129例非ST段抬高急性冠脉综合征患者的临床资料.对比在非ST段抬高急性冠脉综合征诊治上与最新指南的差距,找出改进措施.结果表明我院的临床实践与最新指南存在较大差距,在强化抗栓,调脂治疗,β受体阻滞剂及血管紧张素转换酶抑制剂类药物使用上均有待提高.今后应采取更加积极的措施,规范用药,以达到更好的预后和转归效果.     

The relationships among verbal short-term memory, phonological awareness, and new word learning: evidence from typical development and Down syndrome

This study examined the correlates of new word learning in a sample of 64 typically developing children between 5 and 8 years of age and a group of 22 teenagers and young adults with Down syndrome. Verbal short-term memory and phonological awareness skills were assessed to determine whether learning new words involved accurately representing phonological information in memory. Results showed a relationship between verbal short-term memory measures and typically developing individuals’ ability to learn the phonological form of novel words but not their ability to learn the physical referent of new words. Similarly, individuals with Down syndrome showed impaired verbal short-term memory and impaired form but not referent learning. Together, these findings specify the circumstances in which an accurate phonological representation within short-term memory is required for new word learning.     

IQ in childhood and the metabolic syndrome in middle age: Extended follow-up of the 1946 British Birth Cohort Study

IQ in early adulthood has been inversely associated with risk of the metabolic syndrome in midlife. We tested this association in the British 1946 birth cohort, which assessed IQ at age eight years and ascertained the metabolic syndrome at age 53 years based on modified (non-fasting blood) ATPIII criteria. Childhood IQ was inversely associated with risk of the metabolic syndrome, but this association was almost entirely mediated by educational attainment and achieved occupational social class. This may be consistent with a pattern where childhood IQ is strongly associated with outcomes that reflect neurological disorder, such as the degenerative dementias, but less so with common chronic physical diseases of ageing.     

Brief cognitive-behavioral internet therapy for irritable bowel syndrome

While cognitive-behavioral therapy for IBS is quite effective, the limited availability of competent therapists and lack of access to treatment remain problematic. This paper reports on a small, randomized, controlled trial of a five week internet based cognitive-behavioral intervention for IBS with limited therapist feedback via e-mail. Fifty-four IBS patients were recruited via the internet and randomly assigned to either immediate treatment or a wait-list control group. Thirty-one subjects completed the post-treatment assessment. 77% of treatment completers also completed a 3-month follow-up assessment. Treatment completers experienced statistically and clinically significant declines in IBS symptoms and improvements in quality of life. Those gains were substantially maintained at follow-up. Treatment efficacy was partially mediated by reductions in the tendency to catastrophize the social and occupational implications of symptoms, suggesting that catastrophizing may be an important target for treatment.