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881.
观察新型α2肾上腺素受体激动剂右美托咪定(Dex)对全麻诱导期NTI及应激反应的影响.择期全麻手术患者40例,ASA Ⅰ级~Ⅱ级,随机分为两组,D组(n=20):患者入室后Dex1μg/kg滴鼻;C组(n=20)作为对照组,滴入相同容积的生理盐水.30min后进行诱导,观察NTI、改良清醒镇静评分(MOAA/S)、平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2),记录给药前(T0),给药后10min(T1),给药后20min(T2),给药后30min(T3),插管前(T4),插管即刻(T5)各项值变化.D组T1~T3与T0比较,NTI值、MOAA/S逐渐降低(P<0.05)且显著低于C组(P<0.05);D组T2、T3与T0比较,HR明显减慢(P<0.05);麻醉诱导期间,C组T5与T4比较,MAP、HR均显著升高(P<0.05),D组T5与T4比较,MAP、HR虽有所升高,但差异无统计学意义(P>0.05).Dex以1μg/kg滴鼻可明显镇静,使NTI值降低,诱导期血流动力学更加稳定,减少插管时应激反应.  相似文献   
882.
2型糖尿病发病机制的氧化应激学说被广泛地接受,可是大量的证据表明,服用抗氧化剂并不能增加胰岛素的敏感性,相反,体育锻炼能够增加氧化应激,却是治疗糖尿病的首选方案。分子机制的研究也表明,细胞内氧化应激不足时,会导致内质网无法合成二硫键,导致胰岛素生成不足。由此沃森推测,糖尿病是由于氧化应激不足所致。同理,氧化应激不足可能也是阿尔茨海默病、肿瘤等疾病的发病机制之一。沃森的呼声让现在普遍认为氧化应激有害理论的人们开始重新审视氧化应激在机体中的有益作用。  相似文献   
883.
本研究对失眠症患者的压力应对特征进行调查与分析。按照CCMD-3诊断标准,试验组失眠患者52例,在社区分层抽样52人作为对照组,用匹茨堡睡眠指数量表、防御方式问卷、应对方式问卷、社会支持评定量表进行测量。试验组不成熟型防御方式明显高于对照组,成熟型防御方式低于对照组;应对方式试验组以消极应对为主;试验组社会支持总体高于对照组,其中客观支持较高而主观支持和社会支持利用度较低。这些因素共同作用形成了失眠症迁延不愈的主要病理心理机制。心理治疗中要运用恰当的心理治疗方法,引导患者用成熟的、积极的应对方式应对各种压力源。  相似文献   
884.
We previously showed that 24 h after learning, mice significantly remembered the first (D1) but not the second (D2) discrimination in a serial spatial task and that an acute stress delivered 5 min before the test phase reversed this memory retrieval pattern.A first experiment evaluated the effects of dorsal hippocampus (HPC) or prefrontal cortex (PFC) lesions, these two brain areas being well-known for their involvement in serial and spatial memory processes. For this purpose, six independent groups of mice were used: non-lesioned (controls), PFC or HPC-lesioned animals, submitted or not to an acute stress (electric footshocks; 0.9 mA). Results show that (i) non-stressed controls as well as PFC-lesioned mice (stressed or not) remembered D1 but not D2; (ii) stressed controls and HPC-lesioned mice (stressed or not) remembered D2 but not D1; (iii) stress significantly increased plasma corticosterone in controls and PFC-lesioned mice, but not in HPC-lesioned mice which already showed a significant plasma corticosterone increase in non-stressed condition.Since data from this first experiment showed that stress inhibited the hippocampal-dependent D1 memory retrieval, a second experiment evaluated the behavioral effect of intrahippocampal corticosterone injection in non-stressed mice. Results show that intrahippocampal corticosterone injection induced a reversal of serial memory retrieval pattern similar to that induced by acute stress.Overall, our study shows that (i) in non-stress condition, the emergence of D1 is HPC-dependent; (ii) in stress condition, the emergence of D2 requires the PFC integrity; moreover, intrahippocampal corticosterone injection mimicked the effects of stress in the CSD task.  相似文献   
885.
We examined the psychometric properties of two scales of the parenting stress index-short form (PSI-SF) in a low-income sample of fathers of toddlers. The factor structure, reliability, and validity of the parental distress and parent–child dysfunctional interaction subscales were assessed for 696 fathers in a multi-site study of Early Head Start. Confirmatory factor analyses (CFA) compared the fit of the developer recommended two-factor scales with five-factor scales theoretically derived and supported with mothers. Our results suggested that two subscales from the PSI-SF were reliable and valid for this sample of racially diverse, low-income fathers of toddlers. However, these subscales capture multiple dimensions of parenting stress and results also supported the use of more narrowly defined aspects of parenting stress that included general distress, distress specifically related to parenting demands, problematic interactions of the father–toddler dyad, perceptions of the child, and parental perceptions of self as a parent. These unidimensional scales may prove useful in research and clinical activities by allowing researchers to elucidate the mechanisms through which stress impacts parenting and permitting clinicians information to develop more targeted interventions for young children and their families.  相似文献   
886.
The objective of this study was to assess, via heart rate, the arousal levels of participants in group trauma reexposure therapy for posttraumatic stress disorder, and so to better understand this common mode of treatment, particularly in regards to its presumed curative factor, extinction. Six Vietnam combat-related PTSD inpatients participated twice weekly in group trauma reexposure therapy during which their electrocardiograms were recorded. Heart rate was quantified continuously off-line. Heart rates of participantsnot directly engaged in imaginal reexposure to their personal combat traumas consistently exhibited mild linear declines from the beginnings to the ends of the approximately 2.5 hour sessions. Participants actively engaged in personal combat trauma reexposure exhibited higher whole-session heart rates. Most also exhibited more specific elevation extending over the later portions of therapy sessions during which intensive reexposure usually occurred. Surprisingly, no patients exhibitedfocal increases in heart rate concurrent with periods of most intensive traumatic incident review as judged from videotape. Administering imaginal reexposure in a group context does not preclude substantial physiological (sympathetic) arousal, as is preconditional for extinction. Under conditions in which the actively engaged reexposure patient is reliably identified, group trauma reexposure therapy may not provide an opportunity for “vicarious” flooding in nonengaged participants.  相似文献   
887.
Recent research indicates that awareness of the rhythmic patterns present in spoken language (i.e., prosody) may be an important and relatively overlooked predictor of reading ability. Two studies investigated the prosodic processing abilities of skilled adult readers and adults with developmental dyslexia. Participants with dyslexia showed reduced awareness of lexical and metrical stress and these skills were found to be significantly associated with, and predictive of, phonological decoding ability. In contrast, the same individuals showed normal patterns of stress based priming at magnitudes similar to controls. These results—suggesting reduced phonological awareness in the context of intact phonological representations—are consistent with recent findings reported in the domain of phonemic processing. Implications for the phonological deficit theory of dyslexia are discussed.  相似文献   
888.
Abstract

Discrepancies between physiological activity, behavioural anxiety, and self-reported anxiety were examined when focus of attention was manipulated in a public speech task for four groups of individuals: repressors, low-anxious, high-anxious, and the defensive high-anxious. They were exposed to self-focus (when their behaviour was socially evaluated) and other-focus (when their behaviour was not socially evaluated) conditions. Repressors had consistently the lowest level of self-reported anxiety, but had consistently greater physiological activity in all conditions and greater behavioural anxiety in the self-focus condition. The high-anxious showed the opposite pattern, i.e. their self-reported anxiety was greater than their physiological and behavioural anxiety, and this finding was significant in the self-focus condition. No significant pattern of discrepancy was found for the low-anxious or defensive high-anxious groups. The findings are discussed and interpreted within the framework of recent cognitive models of anxiety.  相似文献   
889.
Trauma‐related exposure therapy is a useful but not universally effective treatment for post‐traumatic stress disorder. Anxiety sensitivity may play an important role in this disorder, as it does in panic disorder. Studies have shown that interoceptive exposure therapy reduces anxiety sensitivity in panic disorder. The present case study was a preliminary investigation of the merits of including interoceptive exposure therapy in the treatment of post‐traumatic stress disorder, in order to improve treatment outcome for a patient who had no history of panic disorder or panic attacks. Interoceptive exposure therapy (4 sessions) was one component of treatment, combined with trauma‐related exposure therapy (4 sessions of imaginal exposure followed by 4 sessions of in vivo exposure). Treatment outcome was assessed with the Clinician‐Administered Post‐traumatic Stress Disorder Scale, a self‐report measure of post‐traumatic stress disorder symptoms, and measures of symptoms and cognitions commonly associated with post‐traumatic stress disorder. Scores on all outcome measures decreased over the course of treatment, with gains maintained at 1‐ and 3‐month follow‐up. Symptoms of anxiety sensitivity and post‐traumatic stress disorder decreased during interoceptive exposure therapy. The results indicate that interoceptive exposure therapy is a promising adjunctive intervention for post‐traumatic stress disorder. Further research is needed into the merits of combining interoceptive exposure therapy and trauma‐related exposure therapy as a means of boosting treatment efficacy.  相似文献   
890.
Exaggerated startle is a common symptom (based on Diagnostic and Statistical Manual of Mental Disorders [fourth edition] Criterion D) for many patients with posttraumatic stress disorder (PTSD). Findings from previous studies suggest that exaggerated startle may be due to trauma exposure or pretrauma vulnerability factors for PTSD development. The present clinical case study reports on a patient with PTSD characterized by a very prominent startle response and preference against standard trauma-related exposure strategies. On the basis of recent findings that interoceptive exposure exercises (e.g. shaking head side to side, hyperventilation) elicit trauma-related memories (Wald & Taylor, 2008), the authors sought to determine whether repeated application of an acoustic startle stimulus would serve to diminish the prominent startle response and facilitate exposure and overall symptom reduction by eliciting trauma-related memories. The protocol was successful in eliciting vivid and distressing trauma-related memories. Over the course of seven exposure trials, the patient demonstrated a decrease in distress elicited during the protocol, improved mood, and reduced general anxiety and trauma-related distress. He also reported significantly decreased startle response to loud noises encountered during activities of daily living. Although preliminary, these finding suggest that the acoustic startle protocol may be a viable (interoceptive) exposure strategy for individuals with PTSD, particularly those with exaggerated startle responses and those who are not amenable to standard trauma-related exposure strategies.  相似文献   
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