罗红霉素对兔急性心肌缺血再灌注损伤的作用

研究罗红霉素对兔急性心肌缺血再灌注损伤的作用及机制。新西兰大白兔随机分三组。分别于缺血前、后及再灌注结束后测定MDA、IL-6、IL-8、IL-10、中性粒细胞凋亡率。缺血及再灌注后Apo、IR组较Sham组MDA升高(P0.01);再灌注结束后Apo组较IR组IL-6、IL-8减少,IL-10、中性粒细胞凋亡增加(P0.01)。罗红霉素能保护兔心肌缺血再灌注损伤,与减少致炎因子,诱导中性粒细胞凋亡有关。     

我国酒精性肝病的医学困惑与应对策略

酒精性肝病是导致我国肝脏损害的第二大原因,已成为最严重的健康问题之一。我国已经迎来了酒精性肝病的高峰时期,并将会持续增长,卫生系统将面临巨大的压力。然而,对于酒精性肝病本身,还存在着诊断、治疗、预防等众多医学困惑;饮酒的危害不仅仅局限在肝脏,还可引起全身多器官的损害;酒害也早已超越了医疗界,是一个严重的社会问题。对于酒精性肝病的防治需要全社会共同参与,并且将是一条极其漫长而艰难的路程。     

The Effectiveness of Attachment Injury Resolution Model (AIRM) on Increasing Trust among the Injured Women with Marital Infidelity: A Case Study Approach

Abstract

Objective: The present study aimed at determining the effectiveness of emotionally-focused couple therapy, based on attachment injury resolution model (AIRM) on increasing trust among the injured women with marital infidelity. Method: The present study was a single case experiment of the multiple baseline design type. The population included all injured women with marital infidelity, referring to Bushehr family therapy clinics, among whom three women were selected and participated in the intervention through purposive sampling method, based on the desired recall, By considering the inclusion and exclusion criteria and answering the trust scale. Data analysis was conducted by visual analysis, clinically meaningful (reliable change index and normative comparison) and percentage improvement formula. Results: The percentage obtained from the overall increase of trust among the injured women during the therapy was 38.76 and follow-up was 48.58. In addition, the reliable change index during the therapy and a follow-up was 2.77 and 3.49 in the first couple, 3.10 and 3.62 in the second couple, 2.66 and 3.67 in the third couple indicating that these values were significant and higher than z?=?1.96 during the therapy and follow-up (p?=?0.05). Conclusion: Based on the research results, the emotionally-focused couple therapy based on attachment injury resolution model can be used as an effective intervention in reducing the injuries by marital infidelity.     

Stressed organizations and organizational stressors: A systemic analysis of workplace injury

The experiences of five injured workers from one workplace which had been identified as having a very poor workers' compensation claims experience were analyzed using a systemic theory framework. It was predicted that the fundamental stress-producing conflict between safety and profit that exists in industry between workers and their employers is exacerbated when a worker is injured; furthermore, the degree of stress experienced by both the injured worker and the employer is related to the impact of the injury on the organization and on the productivity of the workplace. The increased stress in both the injured worker and the employer results in increased rigidity in responding to the change or threat in the organization caused by workplace injury. A systemic approach to rehabilitation was recommended in which the employer as well as the injured worker were viewed as clients who required varying levels of support and intervention in managing workplace injury.     

Postconcussion Symptoms

Research pertaining to the self-report of symptoms after traumatic brain injury was reviewed. Cognitive, emotional, and motivational factors have more relevance than demographic (except for female sex) and personality factors. Specific neuropsychological deficits in attention and memory have been found in the early stages after head injury of even mild severity. This is unlikely to be the only factor affecting symptom persistence. Exaggeration of cognitive dysfunction occurs in some cases, but appears unrelated to symptom overreport. Increased emotional distress typically accompanies symptom persistence. The psychological reaction of preoccupation with symptoms and emotional distress is not unique to concussion, but also occurs after severe head injury and back injury and relates more to the personal interpretation of the effect of the trauma than to objective indicators of brain injury severity.     

Development and preliminary validation of the Paediatric Awareness Questionnaire for children and adolescents with traumatic brain injury

There is a lack of validated measures for assessing self-awareness of deficits after pediatric traumatic brain injury (TBI). The current study aimed to develop and examine the psychometric properties of the Paediatric Awareness Questionnaire (PAQ), and investigate factors related to self-awareness. The PAQ was administered to 32 children aged 8–16 years with mild to severe TBI (72% male, M age = 11.75, SD = 2.9), their parents, and treating clinicians, and to 32 age- and gender-matched typically developing controls and their parents. Children with TBI and their parents also completed the Knowledge of Injury Checklist (KIC), and parents completed the Depression Anxiety and Stress Scale 21. The PAQ was found to have fair to excellent (α = .79–.97) internal consistency for all versions across both groups and good concordance between parent and clinician total scores (ICC = .78). There was also evidence of convergent validity between the PAQ and KIC for both child (r = ?.45, p < .05) and parent ratings (r = ?.66, p < .001). Poorer self-awareness was significantly related to younger age at injury for the TBI group and lower parental education for the total sample. ANCOVA identified that children with TBI demonstrated significantly poorer awareness than controls after controlling for parental education. Children with TBI typically overestimated their functioning compared to their parents, whereas typically developing children tended to rate their functioning lower than their parents. These findings provide preliminary support for the reliability and validity of the PAQ for assessing self-awareness after pediatric TBI.     

Attentional bias toward emotional stimuli in accidentally injured Chinese patients with different posttraumatic growth levels

Extensive evidence has been obtained that supports an association between an attentional bias (AB) toward negative stimuli and vulnerability to stress-related psychopathology, little is known regarding the characteristics of individual AB in different posttraumatic growth (PTG) levels. The current study used a modified dot-probe task to investigate if individual differences in AB towards either positive or negative emotional stimuli, are related to self-reported PTG. A sample of 202 patients completed the experiment. Patients with low levels of PTG did not exhibit AB toward negative or positive stimuli, patients with medium levels of PTG had difficulty disengaging attention from negative stimuli, patients with high levels of PTG had difficulty disengaging attention from positive stimuli. And the AB towards positive stimuli was only predictive for PTG. An implication of this finding is that there are different characteristics of implicit cognitive processing in patients with different levels of PTG, suggesting the necessity of psychological intervention on the accidentally injured patients.     

Does multitasking mediate the relationships between episodic memory,attention, executive functions and apathetic manifestations in traumatic brain injury?

Apathy is frequently described in patients with traumatic brain injury (TBI); its negative consequences particularly affect functional independence. Among apathetic manifestations, lack of initiative and lack of interest have mainly been associated with cognitive impairments. However, few studies have been conducted to precisely identify the underlying cognitive processes. Our aims were (1) to determine the best predictor of apathy from among several cognitive processes, including episodic memory and attention/executive mechanisms and multitasking, and (2) to examine to what extent multitasking could mediate the relationships between specific cognitive processes and lack of initiative/interest. Seventy participants (34 patients with TBI matched with 36 control participants) were given a questionnaire to assess anxio‐depressive symptoms, four tasks to assess specific cognitive processes, and one task to assess real‐life multitasking. Participants’ relatives completed an apathy questionnaire. Multitasking, as assessed by the number of goals not achieved, was the only significant predictor of apathetic manifestations. In addition, the mediation analyses revealed that multitasking performance mediated the relationships between verbal episodic memory and lack of initiative/interest, whereas executive and attentional functions were only indirectly related to lack of initiative/interest due to their significant impacts on multitasking. These results shed new light on the aetiology of apathetic manifestations in patients with TBI, indicating how specific cognitive deficits are expressed in real‐life multitasking, and consequently, how they may lead to the development and/or maintenance of apathetic manifestations.     

Brain drawings following traumatic brain injury (TBI) and links to illness perceptions and health outcomes – Findings from a population-based study

Objective: Individuals’ illness perceptions predict health behaviours and influence functional outcomes. This study examined associations between a novel assessment of illness perceptions, in the form of adult’s brain drawings after traumatic brain injury (TBI) and questionnaire measures of illness perceptions, quality of life and post-concussive symptoms.

Design: Population-based, prospective longitudinal study examining 245 adults with predominantly mild TBI with high risk of complications.

Main outcome measures: Participants were asked to draw pictures of what they thought their brain looked like before injury and at baseline and one month post-injury. Drawing characteristics (height, width and percentage damage at one month) were examined in relation to each outcome of interest at six months.

Results: Greater damage at one month was associated with more negative illness perceptions (rs = .23), poorer mental health (rs = ?.21), and more total post-concussive symptoms (rs = .27 to r = .35) at six months. The extent of damage depicted reduced over time (p < .001). No associations were found between the amount of damage drawn and injury severity, nor the height or width of drawings and injury severity or illness perceptions.

Conclusion: Drawings post-TBI offer a simple, cost- and time-effective way to begin discussions and improve understanding of peoples’ illness perceptions.     

Public health consequences of road traffic injuries – Estimation of seriously injured persons based on risk for permanent medical impairment

Despite the fact, that Sweden has one of the safest traffic environments in the world, a large number of people are still injured in road traffic accidents in Sweden. The core concept of the Vision Zero that was adopted by the Swedish parliament in 1997 is to decrease the number of deaths and serious injuries caused by traffic. The vision has been followed-up in terms of decreased mortality, but there was not a consensus on how the concept “seriously injured” should be measured at that time. The aim of this paper is to describe how to develop a measure to estimate the number of seriously injured people in Sweden. The results show that it is possible to estimate the health impact of road traffic accidents based on the definition of medical impairment. According to the results, 8389 people were seriously injured (permanently medical impaired more then 1%) in the road transport area in Sweden in 2013. If the number of people who had slipped or fallen down without any vehicle being involved is excluded, the number of seriously injured was around 4700. The result of the study has been included in the road safety goal for Sweden with the aim to have 25% less seriously injured people in 2020 than the average for the years 2006–2008. The results also showed that 91% of the seriously injured were transported by car, bike or by foot. The relatively high proportion of pedestrian fall accidents happening within the transport system irrespective of whether a vehicle was moving or not raises the question whether these types of accidents should be included in the reporting of formal road traffic accidents.