目的将躯体症状、情感症状及负性事件三者结合,编制一份适合在综合医院实施的躯体形式障碍筛查量表并进一步验证其信度、效度。方法通过查阅文献、参考中国精神疾病分类中躯体形式障碍的诊断标准(第3版)(Chinese Classification of Ment...目的将躯体症状、情感症状及负性事件三者结合,编制一份适合在综合医院实施的躯体形式障碍筛查量表并进一步验证其信度、效度。方法通过查阅文献、参考中国精神疾病分类中躯体形式障碍的诊断标准(第3版)(Chinese Classification of Mental Disorders,third edition,CCMD-3)、国际疾病分类(International Classification of Diseases,ICD)-10躯体形式障碍诊断标准,结合临床经验构建躯体形式障碍三维度量表模型,包括躯体症状、负性情感、负性事件3项条目,并进行预调查条目分析和验证预问卷模型,形成躯体形式障碍筛查量表(简称Neuro-11)。对2014年6月-2016年6月就诊于深圳市人民医院神经内科的461例患者进行基本资料、躯体形式障碍筛查量表、广泛性焦虑量表(theseven-item generalized anxiety disorder scale,GAD-7)、9项患者健康问卷(patient health questionnaire-9,PHQ-9)的调查及测评,精神科医师根据ICD-10躯体形式障碍诊断标准进行电话访谈诊断,诊断结果为躯体形式障碍诊断的金标准。分析各人口学特点的得分情况,通过ROC曲线分析该量表的临界值,分析量表的内部信度及效标效度,分析量表3个维度之间的关系。结果 Neuro-11包含3个维度及11个条目,3个维度分别为躯体症状、负性情感及负性事件。当量表得分≥10分时,可认为患者有躯体形式障碍倾向,所对应的敏感度为0.88,特异度为0.72。Neuro-11的内部一致性Cronbach α系数为0.73,分半信度系数为0.68;并且随着Neuro-11的得分升高,GAD-7、PHQ-9的得分也升高。结论综合医院躯体形式障碍筛查量表的三维理论合理,对躯体形式障碍的诊断价值良好,具有良好的信度、效度,并且可作为躯体形式障碍严重程度的衡量工具。展开更多
BACKGROUND:Adeno-associated virus(AAV)gene therapy has been proven to be reliable and safe for the treatment of osteoarthritis in recent years.However,given the complexity of osteoarthritis pathogenesis,single gene ma...BACKGROUND:Adeno-associated virus(AAV)gene therapy has been proven to be reliable and safe for the treatment of osteoarthritis in recent years.However,given the complexity of osteoarthritis pathogenesis,single gene manipulation for the treatment of osteoarthritis may not produce satisfactory results.Previous studies have shown that nuclear factorκB could promote the inflammatory pathway in osteoarthritic chondrocytes,and bone morphogenetic protein 4(BMP4)could promote cartilage regeneration.OBJECTIVE:To test whether combined application of AAV-p65shRNA and AAV-BMP4 will yield the synergistic effect on chondrocytes regeneration and osteoarthritis treatment.METHODS:Viral particles containing AAV-p65-shRNA and AAV-BMP4 were prepared.Their efficacy in inhibiting inflammation in chondrocytes and promoting chondrogenesis was assessed in vitro and in vivo by transfecting AAV-p65-shRNA or AAV-BMP4 into cells.The experiments were divided into five groups:PBS group;osteoarthritis group;AAV-BMP4 group;AAV-p65shRNA group;and BMP4-p65shRNA 1:1 group.Samples were collected at 4,12,and 24 weeks postoperatively.Tissue staining,including safranin O and Alcian blue,was applied after collecting articular tissue.Then,the optimal ratio between the two types of transfected viral particles was further investigated to improve the chondrogenic potential of mixed cells in vivo.RESULTS AND CONCLUSION:The combined application of AAV-p65shRNA and AAV-BMP4 together showed a synergistic effect on cartilage regeneration and osteoarthritis treatment.Mixed cells transfected with AAV-p65shRNA and AAV-BMP4 at a 1:1 ratio produced the most extracellular matrix synthesis(P<0.05).In vivo results also revealed that the combination of the two viruses had the highest regenerative potential for osteoarthritic cartilage(P<0.05).In the present study,we also discovered that the combined therapy had the maximum effect when the two viruses were administered in equal proportions.Decreasing either p65shRNA or BMP4 transfected cells resulted in less collagen II synthesis.This implies that inhibiting inflammation by p65shRNA and promoting regeneration by BMP4 are equally important for osteoarthritis treatment.These findings provide a new strategy for the treatment of early osteoarthritis by simultaneously inhibiting cartilage inflammation and promoting cartilage repair.展开更多
文摘BACKGROUND:Adeno-associated virus(AAV)gene therapy has been proven to be reliable and safe for the treatment of osteoarthritis in recent years.However,given the complexity of osteoarthritis pathogenesis,single gene manipulation for the treatment of osteoarthritis may not produce satisfactory results.Previous studies have shown that nuclear factorκB could promote the inflammatory pathway in osteoarthritic chondrocytes,and bone morphogenetic protein 4(BMP4)could promote cartilage regeneration.OBJECTIVE:To test whether combined application of AAV-p65shRNA and AAV-BMP4 will yield the synergistic effect on chondrocytes regeneration and osteoarthritis treatment.METHODS:Viral particles containing AAV-p65-shRNA and AAV-BMP4 were prepared.Their efficacy in inhibiting inflammation in chondrocytes and promoting chondrogenesis was assessed in vitro and in vivo by transfecting AAV-p65-shRNA or AAV-BMP4 into cells.The experiments were divided into five groups:PBS group;osteoarthritis group;AAV-BMP4 group;AAV-p65shRNA group;and BMP4-p65shRNA 1:1 group.Samples were collected at 4,12,and 24 weeks postoperatively.Tissue staining,including safranin O and Alcian blue,was applied after collecting articular tissue.Then,the optimal ratio between the two types of transfected viral particles was further investigated to improve the chondrogenic potential of mixed cells in vivo.RESULTS AND CONCLUSION:The combined application of AAV-p65shRNA and AAV-BMP4 together showed a synergistic effect on cartilage regeneration and osteoarthritis treatment.Mixed cells transfected with AAV-p65shRNA and AAV-BMP4 at a 1:1 ratio produced the most extracellular matrix synthesis(P<0.05).In vivo results also revealed that the combination of the two viruses had the highest regenerative potential for osteoarthritic cartilage(P<0.05).In the present study,we also discovered that the combined therapy had the maximum effect when the two viruses were administered in equal proportions.Decreasing either p65shRNA or BMP4 transfected cells resulted in less collagen II synthesis.This implies that inhibiting inflammation by p65shRNA and promoting regeneration by BMP4 are equally important for osteoarthritis treatment.These findings provide a new strategy for the treatment of early osteoarthritis by simultaneously inhibiting cartilage inflammation and promoting cartilage repair.
