冠状动脉旁路移植术后抑郁焦虑状态随访和分析

To explore the presence of depression, anxiety and cardiac events after coronary artery bypass grafting (CABG) prospectively and comparably. To analysis influential factors of depression and anxiety ( peri-operation and 1 year after operation ), and the effection on cardiac events in the year after operation. We followed the patients who underwent scheduled consecutive CABG. We interviewed patients to assess depression, anxiety symptoms using self-rating depression scale( SDS) and self-rating anxiety scale（SAS）before operation , before discharge and 1 year after operation. And cardiac events were also identified. All patients were divided into the group with depression and/or anxiety symptoms or the other group without depression and/or anxiety symptoms 3 times according to depression and anxiety symptoms before operation , before discharge and 1 year after operation. 69 patients completed the follow-up.24 patients (34.8%) had depression and/or anxiety symptoms before CABG, 31 patients (44.9%) had depression and/or anxiety symptoms before discharge, and 10 patients (14.5%) had depression and/or anxiety symptoms 1 year after operation. 6 patients(8.7%) had cardiac events, and 5 patients were re-admitted. Arhythmia before and after operation, the quantity of blood vessel grafted, length of stay , depression and anxiety symptoms before operation, cardiac events may lead to depression and anxiety symptoms 1 year after operation. The use of cardiopulmonary bypass grafting (CPB), Arhythmia after operation, the prolonged length of stay are influential factors of cardiac events. Though the incidence of depression and/or anxiety symptoms 1 year after operation is lower than before operation and before discharge, it is high still. Arhythmia before and after operation, the more blood vessels grafted, the prolonged length of stay , depression and anxiety symptoms before operation and cardiac events could be risk factors of depression and anxiety symptoms 1 year after operation. Much attention must be paid to this phenomenon. Heavy patient's condition, complicated surgery are risk factors of cardiac events, and bad emotion before operation and before discharge are independent to cardiac events. Key words： perspective research; depression；anxiety; coronary artery bypass grafting; follow up

中职生的成就动机与行为问题的关系

Achievement motive is human’s social motive. In some sense, one’s all-life achievements are decided by his/her achievement motive. By which we can conclude that achievement motive has close connection with individual emotional experience. People pursuing success experience more positive emotion and less negative one, and have good behavioral adaptability. This study aims at explore the relation between achievement motive and behavior problems in the secondary vocational education schools through questionaries (the achievement motivation scale, UCLA Loneliness Scale，State-Trait Anxiety Inventory，Center for Epidemiologic Studies depression Scale and middle school students'behavior questionnaire). There were 1005 students whose age ranged from 14to21 years completed the questionnaires. The main conclusions of this thesis are as follows: (1) Achievement motive of student in the secondary vocational education schools is significantly lower than that of students in the senior high school. (2) Students in the secondary vocational education schools show more obvious emotion and Externalizing behavior problems than those of the senior high schools. (3) Students’ motivation for pursuing success in the secondary vocational education schools has negative correlation with emotion and Externalizing behavior problem, while the motivation for avoiding failure has positive correlation with the emotion and Externalizing behavior problem. Achievement motivation has negative correlation with emotion and Externalizing behavior problem. (4) Students’ achievement motivation shows obvious gender difference in the secondary vocational education schools. The avoiding failure element shows upward trend with the grades increasing and the difference is obvious. While the students’ achievement motive in the secondary vocational education schools shows significantly downward trend with the grades increasing. Whether holding a post at school has influence on the students’ achievement motivation, and the difference is significant. (5) Students’ Externalizing behavior problem in the secondary vocational education schools shows obvious gender difference. Whether holding a post at school has influence on the students’ Externalizing behavior problem, and depression and loneliness, and the difference is significant. Key words: Students in the Secondary Vocational Education Schools, Achievement Motivation, Behavior Problem, Emotion Problem, Externalizing Behavior Problem (Note: In this study, the behavior problems include not only the externalizing behavior problems, but also emotion problems.)

维持性血液透析患者认知功能特点研究

Objective: To study the episodic memory, semantic memory, cognitive planning ability and inhibition ability in MHD patients. Method: Neuropsychological research methods such as Action memory of verb-object phrase, Trail Making Test (A and B), Verbal Fluency Test, Go-No/Go test and Stroop Color Naming Task were used to investigate Episodic Memory 、Semantic Memory、Executive Function of 40 MHD and 40 NC. Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale(SDS), Social Support Scale, Life Satisfaction Scale, and biochemical examination were applied and their relationships with cognitive function were analized. The mean age and education level of MHD group and NC group have no significant difference. Result: 1.Action memory of verb-object phrase differed significantly between MHD group and NC group. 2.Two tests of Verbal Fluency differed significantly between MHD group and NC group. 3.Trail Making Test A, Trail Making Test B, the baseline condition of Go-No/Go Test and Stroop Color Naming Test differed significantly between MHD group and NC group. 4.There is no significant difference between MHD group and NC group on the correct rate of No/Go Test and the baseline condition. Both groups showed Stroop Effect in Go-No/Go test, but MHD group performed significantly worse. 5.In Stroop Color Naming Task Test, NC group showed Stroop Effect, significant Repeated Distraction Promotion Effect and significant Negative Priming Effect,while MHD group showed only Stroop Effect and no Repeated Distraction Promotion Effect and no Negative Priming Effect. There is significant difference in Stroop Effect between MHD group and NC group. Conclusion: 1.Comparing with NC group, episodic memory, semantic memory, cognitive planning ability, and inhibition ability of MHD group were impaired significantly. 2.The pathological aging of Executive Function in MHD group showed: executive Function should be a unitary system. 3.Cognitive impairment is negatively correlated with serum creatinine, blood pressure and anxiety score in MHD patients; and is related with hemoglobin, hematocrit, social support and life satisfaction. Keyword: maintenance hemodialysis, episodic memory, semantic memory, cognitive planning, inhibition ability.

阿片药物依赖的神经机制---内侧前额叶与药物的心理依赖

Mental dependence, characterized by craving and impulsive seeking behavior, is the matter of intensive study in the field of drug addiction. The mesolimbic dopamine system has been suggested to play an important role in rewarding of drugs and relapse. Although chronic drug use can induce neuroadaptations of the mesolimbic system and changes of drug reinforcement, these mechanisms cannot fully account for the craving and the compulsive drug-using behavior of addicts. Acknowledging the reinforcement effects of drugs, most previous studies have studied the impact of environmental cues and conditioned learning on addiction behavior, often using established classical or operant conditioning model. These studies, however, paid little attention to the role of cognitive control and emotion in addiction. These mental factors that are believed to have an important influence on conditioned learning. The medial prefrontal cortex (mPFC) has close anatomic and functional connections with the mesolimbic dopamine system. A number of the cognitive neurological studies demonstrate that mPFC is involved in motivation, emotional regulation, monitoring of responses and other executive functions. Thus we speculated that the function of abnormality in mPFC following chronic drug use would cause related to the abnormal behavior in addicts including impulse and emotional changes. In the present study of a series of experiments, we used functional magnetic resonance imaging to examine the hemodynamic response of the mPFC and related circuits to various cognitive and emotional stimuli in heroin addicts and to explore the underlying dopamine neuromechnism by microinjection of tool drugs into the mPFC in laboratory animals. In the first experiment, we found that heroin patients, relative to the normal controls, took a much shorter time and committed more errors in completing the more demanding of cognitive regulation in the reverse condition of the task, while the neural activity in anterior cingulate cortex (ACC) was attenuated. In the second experiment, the scores of the heroin patients in self-rating depression scale (SDS) and Self-rating anxiety scale (SAS) were significantly higher than the normal controls and they rated the negative pictures more aversive than the normal controls. Being congruent with the behavioral results, hemodynamic response to negative pictures showed significant difference between the two groups in bilateral ventral mPFC (VMPFC), amygdala, and right thalamus. The VMPFC of patients showed increased activation than normal controls, whereas activation in the amygdala of patients was weaker than that in normal subjects. Our third experiment showed that microinjection of D1 receptor agonist SKF38393 into the mPFC of rats decreased hyperactivity, which was induced by morphine injection, in contrast, D1 receptor antagonist SCH23390 increased the hyperactivity, These findings suggest: (1) The behavior and neural activity in ACC of addicts changed in chronic drug users. Their impulsive behavior might result from the abnormal neural activity in the mPFC especially the ACC. (2) Heroine patients were more depress and anxiety than normal controls. The dysfunction of the mPFC---amygdala circuit of heroine addicts might be related to the abnormal emotion response. (3) Dopamine in the mPFC has an inhibitory effect on morphine induced behavior. The hyperactivity induced by chronic morphine was reduced by dopamine increase with D1 receptor agonist, confirm the first experiment that the neuroadaption of mPFC system induced by chronic morphine administration appears to be the substrate the impulse behavior of drug users.

中学生抑郁和素质、压力、环境因素的关系及其整合模型研究

As a kind of mood, depression is one of the emotions which people experienced usually. Depressive disorder is one of the common mental diseases. There are about 100 million people in the world be disturbed by depression every year. So it is long history that depression is investigated widely in medicine, psychology, and sociology. There are many theorial problems remain to be solved. Viewed from latest vocuments, the development of depression theory is tending to become more complicated. Most of the prior depression theory focused on relation between one factor and depression. Because depressed individuls have various characteristics and factors that cause depression are different, and each factor can explain only part of depression variance, these prior depression theories are defected. As the knowledge about depression accumulated, the view that depression be caused by multifactor is clearer. There is tendency to integrate these cooperational factor into a model while developing a depression theory. In the present study, depression status of 1625 middle school students from junior 1 to senior 3 are measured using Depression Scale of Middle-school Student which is developed by ourselves. From approach of depressive mood, the present study explored depressive diathesis including attributional style, personality, coping style, and self. The relation among depressive diathesis, stress and depression is analysed. The relation between depression and school life adaptation, depression and cohesion, adaptation in family are also analysed from environmental view. At last, relation among environment, stress, depressive diathesis is examined by using covariance structure modelling. Synthesizing the results from the present study, the following conclusions were drawn: (1) There is grade-characteristics in development of depression in middle school students. Depression degree increased with grade. The main reason may be that the stress middle-school students experience increase and self-acceptance decrease with grade; (2) High depressive diathesis is different from low depressive diathesis. the features of high depressive diathesis are that attributing failure to ability or background, low capacity for status, low sociability, low independence, low self-blame, more illusion. The features of low depressive diathesis are that not attributing failure to ability or background, high capacity for status, high sociability, high independence, high self-acceptance, while facing difficulties, using problem-resolving coping strategy, less self-blame, less illusion. Individuals who have high depressive diathesis showed serious depression, and individuals who have low depressive diathesis showed light depression; (3) Depressive diathesis had accumulative effect on depression. More low depressive diathesis, more light is depression. More high depressive diathesis, more serious is depression; (4) Depressive diathesis can predict present depression and future depression. Predicting present depression is more effective than predicting future depression; (5) Individual who has different depressive diathesis experiences different level of stress. Higher the depressive diathesis individual has, higher stress he will experience. Lower the depressive diathesis individual has, lower stress will he experience; (6) There is correlation between life event pressure and depression. Life event pressure can predict a part of variance of depression. Life event pressure has accumulative effect on depression. More life event and higher life event pressure, more serious depression individual will experience; (7) There exits high correlation between depression and school life adaptation which can predict depression; (8) There is high correlative relation between depression and cohesion, adaptation in family which can predict depression; and (9) Environment have more effect on diathesis than on stress. Diathesis has more effect on depression than stress does. The past depression can predict future depression. This study had enlarged the domain of depressive diathesis such as attributional style, personality, coping style, and self, which are analysed wholly. This study had also enriched the connotation of diathesis=stress theory. Above two aspects are theoretical significance of the study. This study provide a framework of mental health educational curriculum in high school and provide the guideline for prevention and cure of depression. It is the practical significance of this study.