From chaos and insecurity to understanding and coping: experienced benefits of a group-based education programme for people with chronic fatigue syndrome

The aim of this study was to elicit participants' experiences with a multidisciplinary patient education programme and their views regarding the usefulness of the programme. Focus group interviews were conducted with 10 participants immediately and nine months following participation in the programme and analysed using thematic analysis. Initially, the participants experienced confusion and insecurity regarding coping with the illness. Participation in the programme appeared to promote understanding, acceptance and coping through gaining greater knowledge, learning coping strategies and exchanging experiences, as well as receiving understanding and acceptance. Thus, the programme was experienced to be a beneficial intervention. However, the participants expressed a need for more guidance or follow-up to maintain the practice of coping strategies for better coping with their illness.     

A clinician survey of speech and non-speech characteristics of neurogenic stuttering

This study presents survey data on 58 Dutch-speaking patients with neurogenic stuttering following various neurological injuries. Stroke was the most prevalent cause of stuttering in our patients, followed by traumatic brain injury, neurodegenerative diseases, and other causes. Speech and non-speech characteristics were analyzed separately for these four etiology groups. Results suggested possible group differences, including site of lesion and influence of speech conditions on stuttering. Other characteristics, such as within-word localization of disfluencies and presence of secondary behaviors were comparable across the etiology groups. The implications of our results for the diagnosis of neurogenic stuttering will be discussed.

Educational objectives: After reading this article, the reader will be able to: (1) provide a concise overview of the main literature on neurogenic stuttering; (2) discuss the speech and non-speech characteristics of neurogenic stuttering; (3) provide an overview of current clinical practices for intervention with neurogenic stuttering patients and their perceived outcome.     

慢性应激对大鼠行为和免疫细胞热休克蛋白70表达的影响

目的：研究慢性不确定应激对大鼠急性整体热水浴后外周血和脾脏免疫细胞热休克蛋白70（Heat shock protein 70, HSP70）表达的影响。方法：随机将大鼠分成慢性应激组和控制组（每组14只）。通过4周的慢性不确定性应激诱发实验组大鼠明显的抑郁行为,此期间控制组大鼠正常饲养。随后给予大鼠42度整体热水浴刺激,维持直肠温度41度25min。热刺激后6h,采用流式细胞仪测定大鼠外周血和脾脏免疫细胞HSP70 水平。结果：与控制组大鼠相比,慢性应激大鼠在急性热刺激后HSP70合成明显减少。控制组大鼠的所有被检测的免疫细胞热应激后HSP70合成均明显增加。相反,慢性应激大鼠仅在外周血的单核细胞和粒细胞检测到HSP70合成增加,同时升高的水平明显低于控制组大鼠。结论：慢性应激降低大鼠免疫细胞HSP70的热诱导反应,提示HSP70保护性作用减弱可能参与了慢性应激损害免疫细胞功能的生物学过程     

亚健康的词源学探讨

亚健康问题逐渐引起人们的关注,然其范畴却未明了。对健康、疾病等相关概念从词源学角度进行分析与探究,在明确了健康与疾病的范畴基础上,提出亚健康是非健康非疾病的中间过渡状态,主要是由一类社会、心理等的非生物因素引起的心身失调,从而明确亚健康概念的范畴。     

PCI术后患者的血糖管理

经皮冠状动脉介入治疗(PCI)已成为冠心病治疗及急性心肌梗死(AMI)血运重建的有效手段。取得令人满意的效果,而被临床广泛接受和应用。在冠心病患者中糖代谢异常发生率显著高于一般人群。有研究显示高血糖是引起冠状动脉支架再狭窄的独立危险因素。因此糖尿病患者PCI术后必须进行严格的血糖管理。根据目前研究结果,可能血糖目标定为餐前血糖7.8mmol/L,且随机血糖10.0mmol/L较为合适。     

脑血管病治疗现状及评析

我国正处于人口老龄化、脑血管病患者迅速增加的时期,针对各地千差万别的医疗水平,系统梳理和总结国内外脑血管病有关指南及规范的基础上,强调了脑血管病的预防的重要性,并提出我国数种常见脑血管病的治疗策略选择的意见及建议。     

阿司匹林在心血管疾病中的应用

阿司匹林(Aspirin)除具有解热镇痛作用外,还具有抑制血小板激活和抗血栓形成的良好作用,对防范和减少冠心病急性事件的发生、发展意义重大。目前有关阿司匹林及心血管疾病的研究日渐深入,诱发了众多焦点问题。阿司匹林应用于心血管疾病的发展过程带给我们许多哲学思考。     

牙科焦虑症患者心理干预的疗效分析

为了探讨心理诱导对牙科焦虑症(dental anxiety,DA)患者治疗的影响,采用焦虑自评量表及汉密顿焦虑量表对门诊就诊患者进行焦虑调查,筛选出伴焦虑者82例,随机分为两组,分别进行心理干预治疗和一般治疗,并对数据进行统计分析.结果显示,心理诱导指导组与对照组相比较焦虑水平明显降低.患者无论在完成第一次治疗还是复诊情况均优于对照组(P<0.01).提示心理干预对DA患者治疗有显著效果.     

老龄活体供肾移植的临床应用

为缓解供体器官的严重短缺,老龄活体供肾移植逐渐成为一种可以接受的对策。老龄活体供肾移植有其特殊性并且更易于引发伦理争论。本文简要介绍此问题的研究现状,并就若干社会伦理学问题展开讨论。     

特异性免疫疗法在儿童哮喘治疗中的应用

支气管哮喘是儿童最常见的慢性呼吸道疾病,近年来发病呈逐年上升趋势。在儿童哮喘的治疗方案中,脱敏治疗是唯一从变态反应疾病的病因治疗可改变疾病进程的疗法。注射脱敏是传统的脱敏方法,儿童疗效优于成人,但由于采用注射的方式,使该方法一直应用于5岁以上的儿童。舌下脱敏治疗是90年代开始在国外进行应用的一种脱敏治疗方法,其安全性和有效性在国外已得到多项临床研究的证实,且其安全性在儿童要优于成人,因此舌下脱敏治疗为5岁以下年幼哮喘儿童的特异性免疫治疗提供了新的思路和治疗策略。