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·4173··论著·基于比率低频振幅的甲状腺功能亢进症患者脑功能研究武肖然1，王晓岳1，耿艺博1，张红星1，2，张海三1*【摘要】 背景 甲状腺功能亢进症（以下简称甲亢）是临床常见的内分泌心身疾病，常伴发负性情绪，严重影响患者预后，且甲亢患者自杀可能性为未患病者的5倍多。
因此探讨甲亢患者脑损害的神经影像学特征有一定的临床价值和社会意义。
目的 通过静息态功能磁共振成像（rs-fMRI）分析甲亢患者脑自发活动异常模式，并探讨甲亢患者脑损害的神经影像学特征。
方法 选取2014年12月至2016年6月在新乡市中心医院门诊拟行131I 治疗的甲亢患者25例纳入甲亢组，同时选取医院和临近社区招募的性别、年龄、受教育程度与甲亢组无显著差异的健康志愿者28例作为对照组。
使用症状自评量表（SCL-90）评估研究对象的心理健康状况。
研究对象均接受rs-fMRI 检查，通过测量全脑比率低频振幅（fALFF）反映局部脑自发活动。
应用Pearson 相关分析探讨平均比率低频振幅（mfALFF）值与临床变量及心理健康状况之间的关系。
结果 甲亢组SCL-90焦虑、敌对评分高于对照组（P<0.05）。
与对照组相比，甲亢组右侧小脑蚓部7区〔蒙特利尔神经研究所（MNI）坐标：3、-75、-27，t=4.381〕、左侧丘脑（MNI 坐标：-6、 -6、0，t=3.545）、右侧丘脑（MNI 坐标：6、-3、3，t=4.356）的mfALFF 值升高，左侧小脑后叶（MNI 坐标： -39、-81、-27，t=-3.402）、左侧眶部额中回（MNI 坐标：-9、57、0，t=-5.253）、左侧额下回（MNI 坐标：-42、33、18，t=-3.747）的mfALFF 值降低。
相关性分析结果显示，右侧小脑蚓部7区的mfALFF 值与SCL-90焦虑（r=-0.419，P=0.037）、敌对（r=-0.402，P=0.046）评分呈负相关。
·学术交流·自身免疫性脑炎症状特点及易误诊为精神相关问题的原因分析蔡占魁，陈方斌，李娜，周菲菲，符丹萍，徐臖杰，阎同军，高志勤，李光耀，肖阳 摘要： 目的：探讨总结自身免疫性脑炎的症状特点并分析易误诊的原因。
方法：回顾性研究联勤保障部队第九 四医院２０１５年６月至２０２１年６月收治的自身免疫性脑炎患者１５例，并结合文献进行分析。
结果：１５例患者中男性９例，女性６例。
１０例为抗Ｎ 甲基 Ｄ 天冬氨酸受体（ＮＭＤＡＲ）脑炎，２例为抗γ 氨基丁酸Ｂ型受体（ＧＡＢＡＢＲ）抗体相关脑炎，２例为抗富亮氨酸胶质瘤失活蛋白１（ＬＧＩ１）抗体相关脑炎，１例为抗代谢型谷氨酸受体５（ｍＧｌｕＲ５）脑炎。
１５例患者中有７例存在前驱感染样症状，５例起病前存在精神刺激因素；１５例中出现精神行为异常１３例，癫痫强直阵挛发作７例，不自主运动６例，认知障碍１２例，意识障碍６例，自主神经功能障碍９例。
１３例精神行为异常患者有１２例症状缺乏典型性。
临床医生对自主神经功能障碍的识别率较低，９例中有７例被考虑为药物或感染所致。
１５例患者中病重６例，病重的主要原因为意识障碍、中枢性通气不足、肺部感染。
１５例患者中有１０例头颅磁共振成像（ＭＲＩ）存在新发异常病灶。
脑脊液检查示压力异常７例、蛋白异常６例、细胞数异常４例。
脑电图３例未做，余１２例中有４例正常，８例呈慢波，病例６同时存在尖波。
结论：自身免疫性脑炎多伴精神症状，不典型的精神症状尤其伴早期应激心理因素者易被误诊为功能性精神障碍，且在治疗过程中，自主神经功能障碍的症状易被考虑为药物所致。
关键词： 自身免疫性脑炎； 症状特点； 精神障碍中图分类号： Ｒ７４９．１ 文献标识码： Ａ 文章编号： １００５ ３２２０（２０２４）０２ ０１１８ ０４Ｓｙｍｐｔｏｍｃｈａｒａｃｔｅｒｉｓｔｉｃｓｏｆａｕｔｏｉｍｍｕｎｅｅｎｃｅｐｈａｌｉｔｉｓａｎｄｔｈｅｃａｕｓｅｓｏｆｍｉｓｄｉａｇｎｏｓｅｓａｓｍｅｎｔａｌ ｒｅｌａｔｅｄｐｒｏｂｌｅｍｓ ＣＡＩＺｈａｎ ｋｕｉ，ＣＨＥＮＦａｎｇ ｂｉｎ，ＬＩＮａ，ＺＨＯＵＦｅｉ ｆｅｉ，ＦＵＤａｎ ｐｉｎｇ，ＸＵＪｕｎ ｊｉｅ，ＹＡＮＴｏｎｇ ｊｕｎ，ＧＡＯＺｈｉ ｑｉｎ，ＬＩＧｕａｎｇ ｙａｏ，ＸＩＡＯＹａｎｇ．Ｔｈｅ９０４ｔｈＨｏｓｐｉｔａｌｏｆｔｈｅＪｏｉｎｔＬｏｇｉｓｔｉｃｓＳｕｐｐｏｒｔＦｏｒｃｅｏｆｔｈｅＣｈｉｎｅｓｅＰｅｏｐｌｅ’ｓＬｉｂｅｒａｔｉｏｎＡｒｍｙ，Ｃｈａｎｇｚｈｏｕ２１３００３，ＣｈｉｎａＡｂｓｔｒａｃｔ： Ｏｂｊｅｃｔｉｖｅ：Ｔｏｄｉｓｃｕｓｓａｎｄｓｕｍｍａｒｉｚｅｔｈｅｓｙｍｐｔｏｍｓａｎｄｃｈａｒａｃｔｅｒｉｓｔｉｃｓｏｆａｕｔｏｉｍｍｕｎｅｅｎｃｅｐｈａｌｉｔｉｓ，ａｎｄｔｏａｎａｌｙｚｅｔｈｅｒｅａｓｏｎｓｏｆｍｉｓｄｉａｇｎｏｓｅｓ． Ｍｅｔｈｏｄ：Ａｒｅｔｒｏｓｐｅｃｔｉｖｅｓｔｕｄｙｗａｓｃｏｎｄｕｃｔｅｄｏｎ１５ｐａｔｉｅｎｔｓｗｉｔｈａｕｔｏｉｍｍｕｎｅｅｎｃｅｐｈａｌｉｔｉｓａｄｍｉｔｔｅｄｔｏｔｈｅ９０４ｔｈＨｏｓｐｉｔａｌｏｆｔｈｅＪｏｉｎｔＬｏｇｉｓｔｉｃｓＳｕｐｐｏｒｔＦｏｒｃｅｆｒｏｍＪｕｎｅ２０１５ｔｏＪｕｎｅ２０２１，ａｎｄｔｈｅｌｉｔｅｒａｔｕｒｅｗａｓａｎａｌｙｚｅｄ． Ｒｅｓｕｌｔｓ：Ａｍｏｎｇｔｈｅ１５ｐａｔｉｅｎｔｓ，９ｗｅｒｅｍａｌｅａｎｄ６ｗｅｒｅｆｅｍａｌｅ．１０ｃａｓｅｓｗｅｒｅａｎｔｉ Ｎ ｍｅｔｈｙｌ Ｄ ａｓｐａｒｔａｔｅｒｅｃｅｐｔｏｒ（ＮＭＤＡＲ）ｅｎｃｅｐｈａｌｉｔｉｓ，２ｃａｓｅｓｗｅｒｅａｎｔｉ γａｍｉｎｏｂｕｔｙｒｉｃａｃｉｄｔｙｐｅＢｒｅｃｅｐｔｏｒ（ＧＡＢＡＢＲ）ａｎｔｉｂｏｄｙ ｒｅｌａｔｅｄｅｎｃｅｐｈａｌｉｔｉｓ，ａｎｄ２ｃａｓｅｓｗｅｒｅａｎｔｉ ＬＧＩ１Ｏｎｅｃａｓｅｗａｓａｎｔｉ ｍｅｔａｂｏｔｒｏｐｉｃｇｌｕｔａｍａｔｅｒｅｃｅｐｔｏｒ５（ｍＧｌｕＲ５）ｅｎｃｅｐｈａｌｉｔｉｓ．Ａｍｏｎｇｔｈｅ１５ｐａｔｉｅｎｔｓ，７ｈａｄｐｒｏｄｒｏｍａｌｉｎｆｅｃｔｉｏｎ ｌｉｋｅｓｙｍｐｔｏｍｓ，５ｈａｄｍｅｎｔａｌｓｔｉｍｕｌｉｂｅｆｏｒｅｏｎｓｅｔ，１３ｈａｄａｂｎｏｒｍａｌｍｅｎｔａｌｂｅｈａｖｉｏｒ，７ｈａｄｔｏｎｉｃｃｌｏｎｉｃｓｅｉｚｕｒｅｓ，６ｈａｄｉｎｖｏｌｕｎｔａｒｙｍｏｖｅｍｅｎｔｓ，ａｎｄ１２ｈａｄｃｏｇｎｉｔｉｖｅｉｍｐａｉｒｍｅｎｔ．Ｔｈｅｒｅｗｅｒｅ６ｃａｓｅｓｏｆｄｉｓｔｕｒｂａｎｃｅｏｆｃｏｎｓｃｉｏｕｓｎｅｓｓａｎｄ９ｃａｓｅｓｏｆａｕｔｏｎｏｍｉｃｄｙｓｆｕｎｃｔｉｏｎ．Ｏｆｔｈｅ１５ｐａｔｉｅｎｔｓ，６ｗｅｒｅｓｅｒｉｏｕｓｌｙｉｌｌ．Ｔｈｅｍａｉｎｒｅａｓｏｎｓｆｏｒｔｈｅｓｅｖｅｒｅｉｌｌｎｅｓｓｗｅｒｅｄｉｓｔｕｒｂａｎｃｅｏｆｃｏｎｓｃｉｏｕｓｎｅｓｓ，ｃｅｎｔｒａｌｈｙｐｏｖｅｎｔｉｌａｔｉｏｎ，ａｎｄｐｕｌｍｏｎａｒｙｉｎｆｅｃｔｉｏｎ．Ａｍｏｎｇｔｈｅ１５ｐａｔｉｅｎｔｓｗｉｔｈｂｒａｉｎｍａｇｎｅｔｉｃｒｅｓｏｎａｎｃｅｉｍａｇｉｎｇ（ＭＲＩ），１０ｈａｄｎｅｗａｂｎｏｒｍａｌｌｅｓｉｏｎｓ，７ｈａｄａｂｎｏｒｍａｌｃｅｒｅｂｒｏｓｐｉｎａｌｆｌｕｉｄｐｒｅｓｓｕｒｅ，６ｈａｄａｂｎｏｒｍａｌｐｒｏｔｅｉｎ，ａｎｄ４ｈａｄａｂｎｏｒｍａｌｃｅｌｌｃｏｕｎｔ．Ｅｌｅｃｔｒｏｅｎｃｅｐｈａｌｏｇｒａｐｈｙｗａｓｎｏｔｄｏｎｅｉｎ３ｃａｓｅｓ．Ｉｎｔｈｅｒｅｍａｉｎｉｎｇ１２ｃａｓｅｓ，４ｃａｓｅｓｗｅｒｅｎｏｒｍａｌ，８ｃａｓｅｓｓｈｏｗｅｄｓｌｏｗｗａｖｅｓ，ａｎｄ６ｃａｓｅｓｈａｄｓｈａｒｐｗａｖｅｓａｔｔｈｅｓａｍｅｔｉｍｅ． Ｃｏｎｃｌｕｓｉｏｎ：Ａｕｔｏｉｍｍｕｎｅｅｎｃｅｐｈａｌｉｔｉｓｉｓｏｆｔｅｎａｃｃｏｍｐａｎｉｅｄｂｙｐｓｙｃｈｉａｔｒｉｃｓｙｍｐｔｏｍｓ，ａｎｄａｔｙｐｉｃａｌｐｓｙｃｈｉａｔｒｉｃｓｙｍｐｔｏｍｓ，ｓｏｍｅｗｉｔｈｅａｒｌｙｓｔｒｅｓｓｐｓｙｃｈｏｌｏｇｉｃａｌｆａｃｔｏｒｓｉｎｐａｒｔｉｃｕｌａｒ，ｗｈｉｃｈａｒｅｔｈｅｒｅａｓｏｎｓｗｈｙｉｔｉｓｅａｓｉｌｙｍｉｓｄｉａｇｎｏｓｅｄａｓｆｕｎｃｔｉｏｎａｌｍｅｎｔａｌｄｉｓｏｒｄｅｒｓ．Ｉｎｔｈｅｃｏｕｒｓｅｏｆｔｒｅａｔｍｅｎｔ，ｔｈｅｍａｎｉｆｅｓｔａｔｉｏｎｓｏｆａｕｔｏｎｏｍｉｃｄｙｓｆｕｎｃｔｉｏｎａｒｅｅａｓｉｌｙｃｏｎｓｉｄｅｒｅｄａｓｄｒｕｇ ｉｎｄｕｃｅｄ．Ｋｅｙｗｏｒｄｓ： ａｕｔｏｉｍｍｕｎｅｅｎｃｅｐｈａｌｉｔｉｓ； ｃｌｉｎｉｃａｌｆｅａｔｕｒｅｓ； ｍｅｎｔａｌｄｉｓｏｒｄｅｒ基金项目：军区医学科技创新课题（１５ＭＳ０１７）；联勤保障部队第９０４医院院管课题（ＭＳ２０２１２９）作者单位：２１３００３ 江苏常州，联勤保障部队第九 四医院常州医疗区通信作者：肖阳，Ｅ Ｍａｉｌ：ｙａｌｚａｋ９０４＠１２６．ｃｏｍＤＯＩ：１０．３９６９／ｊ．ｉｓｓｎ．１００５ ３２２０．２０２４．０２．００８ 自身免疫性脑炎（ａｕｔｏｉｍｍｕｎｅｅｎｃｅｐｈａｌｉｔｉｓ，ＡＥ）是一组不断扩大的由抗体介导的潜在可治的神经系统疾病，是处于２１世纪神经病学和精神病学交叉点的疾病［１］。
PSYCHOSOCIAL ISSUES IN LONG-TERM SPACE FLIGHT: OVERVIEWLawrence A. PalinkasDepartment of Family and Preventative Medicine, University of California, San Diego, La Jolla CAABSTRACTAnecdotal evidence of the individual and interpersonal problems that o ccurred during the Shuttle -Mir Space Program (SMSP) and other long-duration Russian/Soviet missions, and studies of personnel in other isolated and confined extreme (ICE) environments suggest that psychosocial elements of behavior and performance are likely to have a significant impact on the outcome of long-duration missions in space. This impact may range from individual decrements in performance, health and well being, to catastrophic mission failure. This paper reviews our current understanding of the psychosocial issues related to long duration space missions according to three different domains of behavior: the individual domain, the interpersonal domain and the organizational domain. Individual issues include: personality characteristics that predict successful performance, stress due to isolation and confinement and its effect on emotions and cognitive performance, adaptive and maladaptive coping styles and strategies, and requirements for the psychological support of astronauts and their families during the mission. Interpersonal issues include: impact of crew diversity and leadership styles on small group dynamics, adaptive and maladaptive features of ground-crew interactions, and processes of crew cohesion, tension and conflict. Organizational issues include: the influence of organizational culture and mission duration on individual and group performance, and managerial requirements for long duration missions. Improved screening and selection of astronaut candidates, leadership, coping and interpersonal skills training of personnel, and organizational change are key elements in the prevention of performance decrements on long-duration missions.三类社会心理学问题：个体问题，人际关系问题，组织结构问题。
与睡眠有关的英语演讲稿_与睡眠有关的英语演讲素材5篇睡觉，一般是指人类睡眠，是人类不可缺少的一种生理现象。
人的一生中，睡眠占了近1/3的时间，它的质量好坏与人体健康与否有密切关系，由此可见睡眠对每一个人是多么重要。
下面是我整理的与睡眠有关的英语演讲稿，欢迎大家阅读分享借鉴。
更多睡眠相关内容推荐↓↓↓能促进睡眠的故事世界睡眠日手抄报简单有助于睡眠的小故事科学的睡眠时间是怎样的什么是充足的睡眠与睡眠有关的英语演讲稿1With the College Entrance Examinations approaching , the students of Senior Three are focusing much more on studying. Many of them even begin to stay up studying. A heated discussion was held to argue about the advantages and disadvantages of it.Some students have their own reasons for studying late into night. Firstly, the quietness in the night will result in better effectiveness. Besides,the examinations are only 200 days away so its high time they made good use of every minute. What’s more, seeing others studying so hard, they will feel anxious if they don’t take action.Some others, however, hold the opposite view, saying that a sensible senior student must know how to balance his time between study and leisure. As everyone knows, staying up late will naturally affect the next days performance in class.As far as I’m concerned, different people have different habits. If you can hold it, it’s your own business when to study and when to sleep.与睡眠有关的英语演讲稿2Many people want to ask, what is the best time for sleep? Do we need to sleep early or late? My opinion is to sleep early. Here is the reason why we should sleep early. First, it will make you more healthy. Sleep late would cause illness, long time not sleeping early will damage your body. Second, many people had said that if you dont get many time to sleep, and you sleep late would make black rim of the eye. That is not healthy also, and its not beautiful. We should give our body a rest. Sleep is the best way. Well, there are certain time that is best for us to sleep. Sleep early is definitely better than sleep late. Also, we should not keep awake the whole night. You dont feel the damage when you are young, but when you get older, the problem start to appear. Many disease of heart and lung started from not sleep at night. Many youth think it is fun tokeep awake or sleep late. But I dont think so. Keep your body healthy. I strongly suggest to sleep early.与睡眠有关的英语演讲稿3Staying up late will be detrimental to human health, because the adrenal cortex hormone and growth hormone are all secreted during the night when people are sleeping. The former is secreted before dawn, which can promote the metabolism of carbohydrate in human body, and protect the development of muscle; while the latter is produced only after sleep, which can not only promote the growth and development of young people, but also can delay the aging process of the elderly. As a result, staying up late will cause a variety of harms to human body. First, frequent fatigue and decreased immunityThe most serious sequence caused by staying up late is fatigue and lack of energy. Whats more, the immunity of human body will decrease accordingly. And some other symptoms such as cold, gastrointestinal infections, allergies will also appear.Second, headacheThe next day after staying up late, you will suffer from headache when you are at work or at class. You will be unable to concentrate. Whats more, long-term staying up late and insomnia will also bring invisible damage to our memory.Third, dark circles and puffinessNight is the time for human body to have a good rest. Without adequate rest, you will feel extremely tired, which will lead to poor blood circulation around the eyes, causing dark circles or blood streak in the white of the eye.Fourth, dry skin, dark spots and acneThe period between 11:00 pm to 3:00 am in the next day is the beauty time, and it is also the time for the meridians in human body to move to gall bladder and liver. If these two organs do not have adequate rest, it will be reflected on the skin. So some problems such as roughness, yellowish face, dark spots and acne will appear. Whats worse, long-term staying up late will slowly cause some neurological and psychiatric symptoms such as insomnia, forgetfulness, irritability, anxiety and so on. Fifth, affecting fertilityFor the men and women of childbearing age, if they always stay up late, it will not only affect the motility and quantity of male sperm, but also will affect the secretion of female hormone and the quality of ovum, and it is also likely to influence the menstrual cycle.Sixth, increasing the probability of getting some chronic diseases People who staying up all night always have higher secretion of adrenaline than the average person, which will increase the pressure on metabolism, and thus leading to some chronic diseases, such as hypertension and diabetes.Whats more, there are also other harms caused by staying up late, such as poor eyesight or dysfunction of the liver. We should pay special attention to these bad effects, and try not to stay up late at night.与睡眠有关的英语演讲稿4Today more and more students are inclined to stay up at night.They enjoy the night so much that they dont go to bed until deep into the night or even until the next morning.Hower that would do harm to their health.Students who usually stay up can get tired the next day and they often sleep in class.They cant listen to the teachers heart and soul.As time goes on,they will do bad in their study ,and will be poor health.For these reasons,I would like to advise those students who are staying up not to do that again!You should go to bed before 11 in the evening.Will you take my advice?与睡眠有关的英语演讲稿5Do you always work or study until midnight?Do you often hang out or spend much time in pubs at late night?If you answered yes to either of these questions, you are unfortunately one of the large groups of people who always stay up late. Because of the fierce competition in the society, it seems that everyone has endless work to do and twenty-four hours per day is not enough. Therefore, an increasing number of people stay up late in order to finish the mountainous work. Besides, lots of young people enjoy entertainingat late night. However, many of them are still not aware of the bad effects of staying up late. In fact, it does severe harm to us in three aspects, namely physical health, work efficiency and mental stress.In the first place, staying up late badly impacts on our physical health condition. The human adrenal cortex hormone and growth hormone, which are vital substances for human body, only secrete at night. The former secretes before the dawn facilitating the carbohydrate metabolism and protecting the development of muscle function. The latter only secretes after sleeping. It can improve the growth of the young and slow down the aging of the elderly. However, if people often stay up late, the secretion of these two substances will be gravely impacted. Finally, our health condition will be degraded. It can cause a variety of harms to human body. Normally, frequent staying up late will lead to fatigue and degraded immunity. People may easily get sick when the weather gets a little bit colder or hotter. In addition, it can also cause headache. People may feel heavy in the brain and dizzy for a whole day. Besides, the fertility of both male and female will be impacted. For women, it will affect the secretion of female hormones and the quality of ova. It also tends to affect the menstrual cycle. For men, both the quality and quantity of sperm will be impacted. What is more, staying up late can also damage people’s eyesight, skin and memory capacity, and cause black eyes as well.Furthermore, it negatively impacts on the work efficiency. On the one hand, owing to the discomfort of your health as mentioned above, you may feel distracted from the work. On the other hand, because of the decrease of the memory capacity, your work efficiency will be lower, which means that you may not complete the things as you want. Assume that you are a university student and you plan to review for your psychology examination next week after tomorrow’s class. Nevertheless, you stayed up late yesterday for some reason. Therefore, you probably be late for tomorrow’s class or even skip it. Thus, you must find other time to compensate for it. Afterwards, when preparing your examination, you may feel headache and cannot concentrate on it, thus having difficulty memorizing and understanding the psychological terms and principles. Therefore, your schedule for reviewing chapter 2 and chapter3 will be changed. You can only review chapter 2 and may not finish chapter 3. However, in order to finish reviewing on time, you are more than likely to stay up late again. Then, you will be in the vicious cycle and your work efficiency will be lower and lower.What is also noticeable is that staying up late can bring about mental stress. Since your work efficiency is lower, you probably doubt yourself whether you are a capable person or not. You may think you are not so smart as others and even fear yourself that you can hardly get a good grade in your psychology examination, which makes you feel moreanxious and upset. Besides, if you frequently stay up late, you definitely look tired and in low spirits. Therefore, when working on a group project, maybe nobody wants to be in the same group with you, a low-efficient and anxious person. Thus, you will feel separated from others, which possibly makes you more stressed and upset.In conclusion, although we have a lot of work to do and various activities to participate in, staying up late is by no means a good choice for us. It badly impacts on our physical health, lowers our work efficiency and makes us stressed and anxious. Faced with too much work, we should make good arrangements in advance and maintain a healthy lifestyle.与睡眠有关的英语演讲稿。
Passage 1During the American War of Independence,women were involved in the active fighting in three ways.First,as members of a distinct branch of the Continental Army,referred to as “Women of the Army”,women staffed field hospitals and acted as militar y support in such roles as water carriers. In an emergency,women water carriers, who had plenty of opportunity to observe the firing of cannons, could replace a wounded comrade. The second way that women were involved in active fighting was as regular troop members who wore men’s uniforms and fought side by side with their male counterparts. Theoretically,women were not supposed to be recruited into the Continental Army,but if a woman was a good soldier,no one made an issue of sex at a time when the army was so short of soldiers that boys not yet in their teens were also being recruited in violation of rules.Third,women were occasional fighters affiliated with local militia companies or committees of safety formed to protect the local community.1.What is the main idea expressed in the passage?A.Women played an important role in military hospitals during the RevolutionaryWar.B.The Continental Army was successful in teaching women to fire cannons.C.The services of women on committees of safety were crucial in winning the war.D.Women were active in combat during the Revolutionary War.2.Women sometimes fired cannons in battle becauseA.they had observed the procedure and could therefore substitute for disabled menB.local militia companies had trained them very carefully for emergency fightingC.they had a better safety record than men for using weaponsD.it was against the law for young boys to fire weapons3.What is probably the main reason that women were permitted to fight in the war eventhough their formal participation was discouraged?A.Only women were successful as water carriers.B.They were needed to make battle uniforms.C.Colonial women were particularly health and strong.D.The army desperately needed combat soldiers.4.Women were involved in fighting the war for American independence in all of thefollowing ways EXCEPT asA.members of committees of safetyB.support personnel at medical facilitiesC.recruiters of soldiers for the Continental Armybat troops in the regular army5.This passage would most probably be assigned reading for a course in what subject?A.NursingB.HistoryC.Social Workbor StudiesPappage2Lichens can be spectacular for anyone who cares to look,but few people take thetrouble.Often modestly colored ,and seemingly two-dimensional as they cling to what-ever surface they find ,they grow in the background-as though designed to be ignored.Yet they hold a special fascination for botanists,partly because they present mysteries still to be solved and partly because they do so many things so well.No casual observer of a lichen would ever suspect that it was a composite of interacting life forms.The seemingly uncomplicated lichen is actually composed of a fungus and a colony of alga’s(or blue-green algae,which some scientists now consider to be bacteria).A few species even include all three of these diverse forms of life.A complete lichen is strikingly different from its separated partners in both appearance and biochemistry;many produce unique compounds which cannot be made by the component organisms alone.Lichens grow in almost every natural habitat imaginable.from deserts to tropical rain forests-even on the backs of certain beetles in New Guinea,and inside rocks (along with algae)in the otherwise barren dry valleys of Antarctica.Many species can tolerate extreme heat,cold ,or dryness.Very few,however,can survive heavy air pollution,and many live only where the air is very clean.The disappearance of lichens from an area gives warning of a threatened environment.1.Which of the following would be the best title for the passage?A.The Versatility and Complexity of the Lowly LichenB.The Hidden Characteristics of Algae ColoniesC.The Disappearance of the Lichen SpeciesA.the Habitats of Spectacular Fungi2.The author states that lichens grow “as though designed to be ignored”because they areA.not totally understood by botanistsB.troublesome to collect for the purposes of studyC.uncomplicated in their internal structureD.not easily noticed by observers3.According to the author,most people are unaware that the lichen is aA.l eafy plantB.c lass of simple bacteriaC.two-dimensional life formbination of organisms4.All of the following are mentioned as being a part of the lichen EXCEPTA.a fungusB.algaeC.a beetleE.b acteria5.The third paragraph of the passage mainly discussesA.what lichens look likeB.where lichens can be foundC.how lichens are classifiedD.how lichens reproduce6.The author implies that lichens might be used toA.find water sourcesB.destroy unwanted plant lifeC.test for air purityD.provide food in remote areasPassage3Three years of research at an abandoned coal mine in Argonne,Illinois,have resulted in findings that scientists believe can help reclaim thousands of mine disposal sites that scar the coal-rich regions of the United States. In a pilot reclamation project,they tested the growth possibilities of eight species of plants in the old mine’s huge pile of acidic and toxic wastes.The researchers applied ground limestone,put a thin layer of topsoil on it ,and sowed the plant seeds on the refuse,consisting of waste coal,rock, clay,and mining debris.Initially,the plots were dominated by invading annual weeds ,but in the second and third growing seasons desirable grasses and other plants became well-es-tablished.The scientists’s findings are believed to be the first step toward restoring some 22,500 acres of coal refuse sites in Illinois and thousands of acres in other states.1.What is the main topic of the passage?A.A bandoned coal minesB.R eclamation of a mine disposal siteC.New species of plantsD.Regions where coal has caused scars2.According to the passage,what have scientists been testing ?A.H ow to locate abandoned minesB.T he disposal of toxic wastesC.The growth potential of certain plantsD.How to convert refuse into useable energy3.How many kinds of plants did the scientists test?A.OneB.TwoC.ThreeE.E ight4.According to the passage,what did researchers do to prepare the area?A.They ground up the rocks.B.They added some topsoil.C.They added fertilizer.E.T hey refused to do anything.5.What happened during the first year of the study?A.The grasses became well established.B.Weeds took over the area.C.The soil became too acidic.D.Plants were unable to grow.6.It can be inferred from the passage that in the United States, abandoned coal mines existB.Primarily in Illinois.C.In limited numbers.D.In several states.E.Near operational mines7.It can be inferred from the passage that widespread applications of the scientists’findings should lead toA less coal being minedB new varieties of grassesC more refuses sites.D less barren landPassage4Psychiatric tests show that a well-balanced person gets much angrier when provoked than an abnormal person does.At the New York State Psychiatric Instituted. James Page and Professor of Psychology Carney Landis of Columbia University studied the reaction of 200 normal and 210 abnormals.They tested their reactions to maddening situations of every type and variety,such as veing laughed at and ridiculed,veing repeatedly disconnected on the telephone,accidentally hitting their thumb with a hammer, being worked on by a backseat driver,being told to “shut up”and mind their own business,discovering someone cheating in a friendly card game,etc.In almost every instance the anger reaction of the normal group was much more intense than that of the abnormal one.“This,”they reported, “is in accord with other psychiatric findings. For one of theoutstanding symptoms of mental unbalance is an emotional apathy.”So if you blow your top when you bang you shin against a piece of furniture,or when your sweetheart goes out with another guy-don’t worry about it.It’s just a sign that you’re normal.1.this passage deals mainly with theA.sinilarity to previous psychiatric studies of New York State Psychological Institute’sfindings concerning anger reactions.B.Absence of apathy in normal.C.nature of incidents tending to provoke anger in normal versus abnormal.D.level of intensity in anger reactions registered by normal versus abnormals.2. The main idea of this passage is thatA.anger is a universal phenomenon among humans.B.Psychiatric tests proved that a person who gets angry is well-balanced.C.Normal persons are apt to get angry much more easily than abnormal persons.D.Normal persons react more intensely to anger provoking situations than doabnormal individuals.3.The author recommends that ,if you tend to become angry,you shouldA.treat it as a normal reaction.B.Not worry about what has made you angry.C.Try to control your anger.D.Become concerned.4.The word”apathy”meansA.need for affection.B.Confusion.ck of feeling.D.Anger.5.The last two sentences of the passages containA.an important DETAIL supporting the GENERALIZATION.B.An unrelated comment about the SUBJECT MATTER..C.An opinion of Drs.Page and Landis.D. A suggestion from the author about what you should do about theGENERALIZATION.Passage 5What does a scientist do when he or she”explains” something? Scientific explanation comes in two forms; generalization and reduction. Most psychologists deal with generalization.They explain particular instances of behavior as examples of general laws.For instance most psychologists would explain a pathologically strong fear of dogs as an example of classical conditioning.Presumably,the person was frightened earlier in life by a dog. An unpleasant stimulus was paired with the sight of the animal (perhaps the person was knocked down by an exuberant dog) and the subsequent sight of dogs evokes the earlier response-fear.Most physiologists deal with reduction. Phenomena are explained in terms of simpler phenomena. For example, the movement of a muscle is explained in terms of changes in the membrane of muscle cells, entry of particular chemicals, and interactions between protein molecules within these cells. A molecular biologist would “explain” these eventsin terms of forces that bind various molecules together and cause various parts of these molecules to be attracted to one another.The task of physiological psychology is to “explain” behavior in physiological terms. Like other scientists, physiological psychologists believe that all natural phenomena-including human behavior-are subject to the laws of physics. Thus, the laws of behavior can be reduced to descriptions of physiological processes.How does one study the physiology of behavior? Physiological psychologists cannot simply be reductionists.It is not enough to observe behaviors and correlate them with physiological events that occur at the same time. Identical behaviors, under different conditions, may occur for different reasons, and thus be initiated by different physiological mechanisms: This means that we must understand” psychologically” why a particular behavior occurs before we can understand what physiological events made it occur.1.What does the passage mainly discuss?A.The difference between” scientific” and “unscientific” explanationsB.The difference between human and animal behaviorC.How fear would be explained by the psychologist, physiologist, and molecularbiologist.D.How scientists differ in their approaches to explaining natural phenomena2.In the first paragraph the word “deal” could best be replaced by which of thefollowing?A.barterB.bargainC.are playingD.are concerned3.Which of the following is most clearly analogous to the example in the passageof the person who fears dogs?A. A child chokes on a fishbone and as an adolescent is reluctant to eat fish.B. A person feels lonely and after a while buys a dog for companionship.C. A child studies science in school and later grows up to become a teacher.D. A person hears that a snowstorm is predicted and that evening is afraid to drivehome.4.According to the passage, which of the following is important in explaining amuscle movement?A.The flow of blood to the musclesB.Classical conditioningC.Protein interactionsD.The entry of unpleasant stimuli through the cell membrane5.The author implies that which of the following is the type of scientific explanationmost likely used by a molecular biologist?A.ExperimentationB.ReductionC.InteractionD.Generalization。
论著DOI：10.16662/ki.1674-0742.2022.36.021舒肝解郁胶囊与艾司西酞普兰联合治疗抑郁症伴焦虑症的效果分析黄长灿，朱晶珠，柴皓福建省宁德市康复医院，福建宁德352100［摘要］目的探讨在常规艾司西酞普兰的基础上联合舒肝解郁胶囊治疗抑郁症伴焦虑症取得的临床效果。
方法便利选取2021年1—12月期间于福建省宁德市康复医院就诊的抑郁症伴焦虑症患者84例作为研究对象，以随机数字表划分为两组，即对照组（42例）与研究组（42例）。
对照组应用艾司西酞普兰治疗，研究组在此基础上联合舒肝解郁胶囊治疗。
针对两组临床疗效，治疗前与治疗8周时精神症状评分与神经递质水平，以及不良反应进行比较。
结果研究组总有效率为95.24%较对照组的78.57%高，差异有统计学意义（χ2= 5.126，P<0.05）。
治疗前各项精神症状评分比较，差异无统计学意义（P>0.05）；研究组治疗8周时汉密尔顿抑郁量表（HAMD）及汉密尔顿焦虑量表（HAMA）分值低于对照组，差异有统计学意义（P<0.05）。
治疗前去甲肾上腺素（NE）、多巴胺（DA）、5-羟色胺（5-HT）比较，差异无统计学意义（P>0.05）；治疗8周时研究组NE、DA、5-HT较对照组高，差异有统计学意义（P<0.05）。
研究组不良反应发生率16.67%与对照组11.90%比较，差异无统计学意义（χ2=0.389，P>0.05）。
结论在常规艾司西酞普兰的基础上联合舒肝解郁胶囊治疗抑郁症伴焦虑症效果可靠，可以有效改善患者抑郁与焦虑症状，以及神经递质水平，具有推广价值。
［关键词］舒肝解郁胶囊；艾司西酞普兰；抑郁症；焦虑症［中图分类号］R5 ［文献标识码］A ［文章编号］1674-0742（2022）12(c)-0021-05Analysis of the Effectiveness of Combining Depression with Anxiety Disor⁃der treated by Shugan Jieyu Capsule and EscitalopramHUANG Changcan, ZHU Jingzhu, CHAI HaoNingde Rehabilitation Hospital, Ningde, Fujian Province, 352100 China[Abstract] Objective To explore the clinical effects achieved in the treatment of depression with anxiety disorder based on the combination of regular escitalopram with Shugan Jieyu capsule. Methods From January to December 2021, 84 patients with depression with anxiety disorder who attended Ningde Rehabilitation Hospital during this pe‐riod were conveniently selected as research subjects and divided into two groups by random number table, namely, the control group (forty-two cases) and the study group (forty-two cases). The control group was treated with escitalopram, and the study group was treated with Shugan Jieyu capsule on this basis. The clinical efficacy, psychiatric symptom scores and neurotransmitter levels before treatment and at 8 weeks of treatment, and adverse effects were compared be‐tween the two groups.Results The total effective rate of the study group was 95.24%, which was higher than 78.57% in the control group, the difference was statistically significant (χ2=5.126, P<0.05). There was no statistically significant difference in the scores of various psychiatric symptoms before treatment (P>0.05); at 8 weeks of treatment, the Hamil‐ton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores in the study group were lower than those in the control group the difference was statistically significant (P<0.05). There was no statistically significant difference in the levels of norepinephrine (NE), dopamine (DA), and 5-hydroxytryptamine (5-HT) before treatment (P>0.05); After 8 weeks of treatment, the results of NE, DA, and 5-HT in the study group were higher than those in the control group, the difference was statistically significant (P<0.05). There was no statistically significant difference in the incidence of[作者简介] 黄长灿（1980-），男，本科，主治医师，研究方向为精神科。
