心理治疗趣谈(一)——医僧巧诈移情疗疾

本刊从这期开始开设一个新的不定期栏目,请中医心理学专家写一些与中医心理学有关的小文章,以飨读者。

爱情疗伤

爱情对病人所产生的效应，是异乎寻常的。近日，美国俄亥俄州州立大学的科研人员，通过对7000多名该州居民长达9年的观察和研究，发现缺乏爱情的孤独者，单是因心脏病而致死的，比有爱情生活的夫妻多出2至3倍。

中医心理治疗与中国传统文化

中医心理学是祖国医学的一个分支,也是中国传统文化的重要组成部分。早在二千多年前,中医经典著作《黄帝内经》,就从理论与实践中提出了心理预防,心理诊断、心理治疗医学,并十分精辟阐述着心理学思想占全书约87％以上。更值得注意的是,在中医心理治疗的漫长发展过程中,显然历尽坎坷。

浅谈中医的心理治疗

近几十年来,随着自然科学和社会科学的飞速发展,医学模式由纯生物医学转向生物-心理-社会医学模式,人们越来越清楚地认识到躯体与心理的密切关系,从而确立了医学心理学在医学中的重要地位.

Opisthorchiasis in Thailand: Review and current status

Opisthorchiasis caused by Opisthorchis viverrini （Oviverrini） remains a major public health problem in many parts of Southeast Asia including Thailand, Lao PDR, Vietnam and Cambodia. The infection is associated with a number of hepatobUiary diseases, including cholangitis, obstructive jaundice, hepatomegaly, cholecystitis, cholelithiasis and cholangiocarcinoma. The liver fluke infection was induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region, particularly in rural areas of Thailand. Health education programs to prevent and control opisthorchiasis are still required in high-risk areas.

Effects of mindfulness-based psychological care on mood and sleep of leukemia patients in chemotherapy

Purpose:The aim of this research was to explore the benefits of mindfulness-based psychological care(MBPC)and assess whether the intervention would be beneficial in reducing insomnia and emotional symptoms of leukemia patients receiving chemotherapy.Methods:A randomized control design study was applied in two hematology departments in a hospital in Zhengzhou.Patients in the experimental group received mindfulness-based psychological care(MBPC),and those in the control group received conventional care.Anxiety,depression,and sleeping problems were measured using the Self-Rating Anxiety Scale,Self-Rating Depression Scale,and the Pittsburgh Sleep Quality Index.Results:Statistically significant differences were observed among anxiety,depression,and sleeping problems between the two groups in the post-test(P<0.05).A significant decrease in anxiety and depression and an improvement in sleep were observed between pre-and post-interventions(P<0.05)in the experimental group.Conclusions:MBPC significantly improved sleep quality and mood of the experimental group.It is an effective complementary therapy for leukemia treatment that is inexpensive,noninvasive,and associated with relaxation and pain reduction.

Application of rational emotive behavior therapy in patients with colorectal cancer undergoing adjuvant chemotherapy

Objective:This study aimed to explore the effects of our rational emotive behavior therapy(REBT)program on symptoms,anxiety,depression,and sleep state in patients with colorectal cancer(CRC)undergoing chemotherapy.Methods:From October 2020 to May 2021,fifty-six patients with CRC in a hospital in the Hunan Province were randomly divided into an intervention group(n=28)and a control group(n=28).The patients in the intervention group completed a 6-week REBT program based on routine nursing care,including four courses:1)establish a relationship and formulate health files;2)group communications and study symptom management;3)continuously provide health knowledge and strengthen healthy behavior;and 4)review the treatment and summary.The control group maintained routine nursing care.The simplified Chinese version of the Memorial Symptom Assessment Scale Short Form(MSASeSFeSC),the Hospital Anxiety and Depression Scale(HADS),and the Pittsburgh Sleep Quality Index(PSQI)scale were used to investigate and compare the intervention effects of the two groups at baseline(T1,before the intervention),four weeks(T2),and six weeks(T3)after the intervention.Results:The intervention group was significantly improved in symptoms,anxiety,depression,and sleep state,compared with the control group.At T2,MSASeSFeSC(24.43±4.26 vs.28.07±3.91),symptom distress(17.29±4.04 vs.19.39±3.59),symptom frequency(7.14±1.51 vs.8.68±1.42),HADS(13.68±3.38 vs.15.86±3.79),anxiety(3.89±1.85 vs.5.18±2.18),and depression(9.79±2.06 vs.10.68±2.23),showed that the difference between the two groups was statistically significant(P<0.05).At T3,MSASeSFeSC(23.89±3.54 vs.30.14±3.94),symptom distress(17.61±3.52 vs.21.32±3.57),symptom frequency(6.29±1.49 vs.8.82±1.47),HADS(11.82±2.57 vs.16.29±3.13),anxiety(3.21±1.64 vs.5.61±1.77),and depression(8.61±1.52 vs.10.68±1.81),showed that the difference between the two groups was statistically significant(P<0.05).The sleep state of the intervention group was better than the control group at T3,with decreased score of PSQI[4.00(3.00,8.00)vs.9.00(7.00,12.50),Z=-3.706,P<0.001].Conclusion:The 6-week REBT program can effectively improve the symptom,anxiety,depression,and sleep state of patients with CRC undergoing chemotherapy,which could as a care plan for patients with CRC who are repeatedly admitted to the hospital for chemotherapy.

Repetitive response to gemcitabine that led to curative resection in cholangiocarcinoma

This study reports a case of unresectable intrahepatic mass-forming cholangiocarcinoma which showed a dramatic response to gemcitabine that led to curative resection and a long-term survival of more than five years.Six and five cycles of gemcitabine monotherapy were administered separately over a three-year period and a radical excision was performed at 4.5 years after diagnosis.This case indicates the role of gemcitabine as a neoadjuvant chemotherapeutic agent for cholangiocarcinoma and guarantees a randomized controlled prospective study.

Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection

AIM: To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H. pylori) eradication and to identify predictive factors for successful eradication. METHODS: From April 2006 to June 2010, we retrospectively assessed 2428 consecutive patients (1025 men, 1403 women; mean age 55 years, age range 18-92 years) with gastric histology positive for H. pylori infection referred to our unit for 13-C urea breath test(UBT), after first-line therapy with proton pump inhibitor (PPI) b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 d. Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d. + amoxicillin 1 g b.i.d. + tinidazole 500 mg b.i.d. for 14 d). Third choice treatment was empirical with PPI b.i.d. + amoxicillin 1 g b.i.d. + levofloxacin 250 mg b.i.d. for 14 d. RESULTS: Out of 614 patients, still H. pylori-positive after first-line therapy, only 326 and 19 patients respectively rechecked their H. pylori status by UBT after the suggested second and third-line regimens. "Per protocol" eradication rates for first, second and thirdline therapy were 74.7% (95% CI: 72.7%-76.4%), 85.3% (95% CI: 81.1%-89.1%) and 89.5% (95% CI: 74.9%-103%) respectively. The overall percentage of patients with H. pylori eradicated after two treatments was 97.8% (95% CI: 97.1%-98.4%), vs 99.9% (95% CI: 99.8%-100%) after three treatments. The study found that eradication therapy was most effective in patients with ulcer disease (P < 0.05, P = 0.028), especially in those with duodenal ulcer. Smoking habits did not significantly affect the eradication rate. CONCLUSION: First-line therapy with amoxicillin and clarithromycin produces an H. pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.

The expression significance and associativity of ILK and PTEN in gastric cancer tissue

Objective: To research the contribution of ILK and PTEN to the carcinogenesis and development of gastric carcinoma and the relation with anti-oncogene PTEN. Methods: ILK and PTEN proteins, PTEN mRNA of 76 cases of normal gastric mucous and 112 cases of gastric carcinoma were detected by immunohistochemistry method and in situ hybridization. Results: The expression of ILK, PTEN protein in gastric carcinoma group and normal gastric mucosa group, muscular layer invasive group and no muscular layer invasive group, lymphatic metastasis group and non-lymphatic metastasis group were all statistical significance (P < 0.05 or P< 0.01). The expression of PTEN mRNA of gastric carcinoma group was lower than that of normal gastric mucosa group (P < 0.01). The expression of ILK and PTEN protein had negative correlation (r = -0.347, P < 0.01). Conclusion: ILK protein increasing and PTEN protein decreasing have closely relation with the genesis and development of gastric carcinoma, and controlling them may become a new treating target gastric cancer.

Prevalence of pulmonary embolism at autopsy among elderly patients in a Chinese general hospital

Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylaxis, diagnosis, and treatment of PE. Methods All medical records of deaths from the West Branch of the Chinese People＇s Liberation Army （PLA） General Hospital were retrospectively re- viewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers and detailed characteristics of patients who had PEs were noted. Prophylactic measures, along with diagnosis and treatment of PE, were recorded, if performed. Results During the 10-year period, 1057 patients died in the study hospital and 278 necrop- sies were performed （autopsy rate： 26.3%）. Nine patients were found to have PE （3.2%）, and in seven of these patients （2.5%）, the PE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all seven of the fatal PE cases. Right intracardiac thrombosis was detected in five of the nine PE patients （55.6%）. All patients with PE had been hospitalized in medical departments, and only one had undergone surgery during hospitalization. Antemortem prophylaxis was performed in two of the nine PE cases （22.2%）. None of the 9 patients had received a clinical diagnosis of PE before death. Conclusions The incidence of and death rate associated with PE may vary among different races and regions. Continuous monitoring of PE by means of necropsy in certain representative medical institutions is necessary.

From Suffering to Satisfaction in Method Acting

We analyze the success of Konstantin Stanislavski＇s method of emotion memory in Western acting schools. We propose a path that, counter-intuitively, connects the emotional distress related to this method with an attachment to it. A chain of psychological steps explains this dynamic： the delegation of power from the actor to the director, emotional suffering during the training, rise of feelings within the dyad, and eventually rise of satisfaction. Our argument draws especially on interdisciplinary research on athlete-coach relationships in sports psychology while also suggesting wider application to educational psychology and psychotherapy.

Estrus Grouping in Sheep Treated with Melengestrol Acetate （MGA）

In Mexico the predominant sheep production system is the semi-extensive with grazing during the day and stanchion afternoon and night. Sheep herd are usually small, approximately 10 to 75 heads. The objectives of these systems are savings and marketing of lambs. Meat is the main economic product of this kind, the breeding is long, which do not control the delivery dates and ages of the sheep are not uniform, affecting the demand for the local market （for the months of June and December）. Therefore the aim of this work was implement a technology that allows the grouping of the estrus and therefore group deliveries for batches of uniform lambs. This technology was designed to suppress the estrus and heifers growth promoter of feedlots, this technology is melengestrol acetate （MGA） which is a synthetic progesterone oral administration that it is easy to manage in the food or alone, economic that it does not represent any risk for sheep females of abortive type, evaluating the effect of the MGA on rate of estrus and gestation in sheep. Work developed in the municipality of Charo from Michoac^in State, M6xico, 20 hair sheep divided in two groups of 10 female, group one treated with MGA and group tow was the whitens. 100% of the sheep treated with a dose of 0.45 mg MGA/head/day for 17 days orally, presented estrus grouped in 5-10 days; however only 50% of the sheep of the witness group presented estrus. In the experimental group there was a rate of 70% with a gestation difference time of no more than ten days gestation and witness group 50%. The MGA is an efficient alternative for the producer of sheep when administered 0.45 mg MGA/head/day for 17 days because inhibits the estrus and once withdrawn treatment manifests estrus synch with which get a rate of gestation elevated by natural riding.

Importance of Monitoring of Emotional Stress and Physiological Functions of Humans during the Night Sleep

The diagnosis of disease and prescription of therapy are mainly realized through the control of physiological functions in humans during wakefulness. However, little attention is paid to evaluate the functional state of a patient in sleep. The efficiency of prescribed medicines is also determined in wakefulness. The effects of these drugs during sleep are usually out-of-sight of a physician. Human psychoemotional state during wakefulness is closely related to sleep. Various serious disturbances in physiological functions appear during the night sleep. They include cardiovascular disorders （hypertensive crisis, myocardial infarction, arrhythmias, stroke, etc.）, which may cause sudden death. A large body of evidence shows that stress is followed by sleep disorders. They serve as a factor, which contributes to the development of stress. It should be noted that sleep is the major anti-stress factor. The vicious circle is formed, which can be revealed by a complex control of human physiological functions during wakefulness and sleep. We developed a new methodology and constructed an information-and-equipment device for monitoring of vital physiological functions of humans during sleep in a real everyday life. This approach holds much promise for the diagnosis of disease and evaluation of therapeutic efficacy.

Common causes of geriatric medical emergencies in China

To the Editor One of the most significant demographic changes in our cotmtry is the increase in the elderly population. In China Mainland, the population aged 60 and older was 194 million in 2012, accounting for 14.3% of the total population. However, by 2053, it is estimated that the number of elderly will reach 487 million, representing 34.8% of the total population. Elderly patients represent an everncreasing populace in emergency medicine who often present with atypical signs and symptoms as well as eomorbidities that can complicate diagnoses and treatment.Ell The geographic factors and the developmental status of the country can influence the spectrum of common geriatric emergencies. Thus, this study presents a retrospective analysis of common causes of geriatric emergencies involving 9,628 elderly patients from Jan. 2008 to Dec. 2013 in an emergency department in Beijing, China.

Treatment of 336 cases of chest trauma

Objective： To summarize the clinical features, diagnosis and treatment of chest trauma. Methods： A retrospective analysis was conducted among 336 cases of chest trauma admitted to our hospital from January 2009 to May 2011. Results： Out of all cases, 325 were cured, accounting for 96.7%; 11 died, accounting for 3.3%. Among the dead cases, one died of hemorrhagic shock, three of acute respiratory distress syndrome, three of multiple organ failure, and four of severe multiple traumas. Conclusions： （1） For patients with severe chest trauma, early emergency treatment is crucial to save life. （2） Open thoracic surgery is needed for acute cardiac tamponade, intrapulmonary vascular injuries, progressive intrathoracic bleeding, lung laceration, tracheal breakage, and diaphragmatic injury. In addition, operative timing and method should be well chosen. （3） Pulmonary contusion is one of common complications in chest trauma, for which the combination of strong anti-infection therapy and mechanical ventilation is an effective treatment strategy.

Trauma care construction under the guidance of county-level trauma centers

Severe trauma has the characteristics of complicated condition, multiple organs involved, limitq auxiliary examinations, and difficulty in treatment. Most of the trauma patients were sent to prima hospitals to receive treatments. But the traditional mode of separate discipline management can easi lead to delayed treatment, missed or wrong diagnosis and high disability, which causes a high mc tality in severe trauma patients. Therefore, if the primary hospitals, especially county-level hospit~ （usually the top general hospital within the administrative region of a county）, can establish a sc entific and comprehensive trauma care system, the success rate of trauma rescue in this region can ] greatly improved. On March 1st, 2013, Tiantai People＇s Hospital of Zhejiang Province, China set up trauma care center, which integrated the pre-hospital and in-hospital trauma treatment procedur~ and has achieved good economic and social benefits. Till March 1st, 2017, 1265 severe trauma patier （injury severity score 〉16） have been treated in this trauma center. The rescue success rate reach~ 95~ and the delayed and]or missed diagnosis rate was less than 5%. Totally 86 severe cases of peK fractures with unstable hemodynamics were treated, and the success rate was 92%. The in-hospil emergency rescue response time is less than 3 min, and the time from definite diagnosis to surge is within 35 min.

Effects of five-element music therapy on elderly people with seasonal affective disorder in a Chinese nursing home

OBJECTIVE: To explore the effects of five-element music therapy on elderly patients with seasonal affective disorder in a Chinese nursing home.METHODS: The patients(n=50) were recruited from a Shijingshan district nursing home in Beijing,China. They were randomly assigned to two groups, a treatment group and a control group,with 25 participants in each group. The patients received music therapy for 1-2 h each week over an8-week period. The music therapy involved four phases: introduction, activities, listening to the Chinese five-element music, and a concluding phase.The participants in the control group did not listen to the five-element music. This study consisted of two parts:(a) a qualitative study that used focus groups to understand the feelings of the patients with seasonal affective disorder;(b) a quantitative study that involved administration of the self-rating depression scale(SDS) and Hamilton depression scale(HAMD) before and after treatment.RESULTS:(a) Qualitative analysis results: strength derived from the five-element group music therapy and emotional adjustment. The five-element group music therapy can reduce patients' psychological distress and let them feel inner peace and enhance their life satisfaction.(b) No significant difference in SDS and HAMD scores was found between the two groups(P>0.05) prior to treatment. After treatment,the mean SDS score of the control group was 49.9±18.8, while the treatment group's score was 40.2±18.1. The HAMD score of the control group was11.2±3.1, and the treatment group's score was 8.8±4.9. Following 8 weeks of music therapy, the SDS and HAMD scores of the treatment group were significantly lower than those for the control group(P<0.05).CONCLUSION: Five-element music therapy alleviated the symptoms of seasonal affective disorder in the elderly patients.

Acupuncture-moxibustion Theories of Ge Hong

Ge Hong （261-341）, courtesy name Zhichuan, also known as Baopuzi or Ge Ximlweng, born in Jurong of Danyang （present-day Jurong ofJimlgsu Pronce）, was a famous Taoist and physician during the Eastern Jin Dynasty. He had a reputation for broad reading, mad was enthusiastic over Huamg Di Nei Jl＇ng （Yellow Emperor＇s Classic of InternM Mediclhe） and A^J J？hg （Classic of Ditticult Issues）, esoteric arts, mid alchemy. He was once ma official of theEastern Jin Dynasty, but later lived as a recluse on Luofu Mount of Guangdong Province. His one hundred scrolls of Yu Hail FaJlg （PrescripKons Hidden 111 Golden Chambe was supplemented later by Tao Hong-jing and Yang Yong-dao, and became Fu GuaJlg Zhou Hou BeiJi Fang （Supplement Handbook of Prescripgons for Emergenc [Zhou Hou Bei Ji Fang （Handbook of Prescripgons for Emergencies） for short] nowadays, in which, convenient, low-price, and effective treatment methods were included.