社区精神分裂症患者生活质量与自知力、精神症状的相关性

目的:探讨社区精神分裂症患者生活质量、自知力和精神症状的关系。方法:选取上海市宝山区17个社区160例精神分裂症患者,采用生活质量量表中文版(SQLS)、自知力与治疗态度问卷(ITAQ)、阳性与阴性症状量表(PANSS)进行评估。结果:患者生活质量量表总评分与自知力显著负相关(r=-0.26,P0.01),与精神症状总分显著正相关(r=0.37,P0.01)。逐步多重线性回归分析显示,总住院次数与生活质量总分负向关联(标准化偏回归系数β=-1.32,P0.01),精神症状总分与生活质量总分正向关联(标准化偏回归系数β=0.34,P0.01)。结论:(1)自知力较好的患者生活质量评分较低,精神症状得分高的患者生活质量评分较高;(2)社区精神分裂症患者的总住院次数及精神症状对患者的生活质量影响较大。     

长期住院精神分裂症患者的生活质量评估

目的评估长期住院精神分裂症患者的生活质量并分析影响因素,为提高患者的生活质量提供科学依据。方法入组精神分裂症患者258例,均为男性,采用生活质量综合评定问卷(GQOLI-74)评定生活质量,阳性和阴性症状量表(PANSS)评定患者的精神病状态,分析年龄、文化程度、婚姻、病情、病程、住院时间、躯体疾病、抗精神病药等对患者生活质量的影响。结果①受教育程度较高、无躯体疾病及服用新型抗精神病药者生活质量总分显著较高(t=2.052,3.425,3.004;P0.05或0.01);而年龄越大、未婚/离婚/丧偶者、住院时间较长、副反应明显者生活质量总分显著较低(t=3.394,2.337,2.855,2.184;P0.05或0.01);②PANSS总分、阳性因子分、阴性因子分及一般精神病理因子分越高,而患者生活质量评分越低(r=0.326,0.371,0.318,0.206;P0.05或0.01)。结论长期住院精神分裂症患者的生活质量受着多因素的影响。     

精神分裂症患者阴性症状与语音情绪识别、述情障碍的关系

目的:探讨精神分裂症患者的阴性症状与语音情绪识别、述情障碍的关系。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准的精神分裂症患者135例,年龄和受教育年限相匹配的正常对照73例。使用语音情绪识别任务、多伦多述情障碍量表和阴性症状自评量表进行测评。结果:精神分裂症组对不同情绪(愤怒、厌恶、恐惧、悲伤、惊讶和讽刺)的正确识别率均低于正常对照组(均P <0.05)。患者组述情障碍的难以识别情绪、难以描述情绪因子和总分高于对照组(均P <0.05)。述情障碍量表的总分及3个因子与阴性症状自评量表(SNS)得分呈正相关(r=0.31-0.51,均P <0.05),而悲伤、和惊奇与SNS得分呈负相关(r=-0.18、-0.21,均P <0.05)。逐步回归分析显示,难以描述情绪因子与SNS得分正向关联(β=1.26),悲伤情绪因子得分与SNS得分负向关联(β=-0.59)。结论:本研究提示精神分裂症患者存在语音情绪识别障碍和述情障碍,且阴性症状的严重程度与语音情绪识别和述情障碍的关系密切。     

精神分裂症患者生活质量与应对方式的关系

目的探讨精神分裂症患者生活质量与应对方式的关系。方法选取符合美国精神疾病诊断与统计手册第4版(DSM-IV)中精神分裂症诊断标准的医院门诊和住院患者共175例。采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)和应对方式问卷(CSQ)对患者进行评估。结果生活质量的生理、心理、社会关系、环境4个因子及总分与应对方式中的问题解决呈显著正相关(r=0.41,0.51,0.37,0.34,0.49;P<0.001),与自责呈显著负相关(r=-0.36,-0.44,-0.32,-0.21,-0.38;P<0.01),与回避呈显著负相关(r=-0.16,-0.19,-0.18,-0.16,-0.20;P<0.05);问题解决和自责两种应对方式能够很好地预测精神分裂症患者的生活质量(F=39.68,P=0.00)。结论精神分裂症患者的生活质量与应对方式关系密切,且问题解决和自责两种应对方式可作为生活质量的预测指标。     

住院精神分裂症患者病耻感与抑郁的关系

目的探讨住院精神分裂症患者病耻感与抑郁的关系。方法采用精神病患者病耻感评估量表、卡尔加里精神分裂症抑郁量表对77例住院精神分裂症患者进行问卷调查。结果精神分裂症患者的抑郁发生率为25.97%;不同受教育程度患者的病耻感总分及能力因子得分差异显著(P0.05);与抑郁总分相关性具有显著意义的变量包括:病耻感总分能力因子(r=0.39,0.35;P0.01),治疗因子(r=0.28,P0.05)。与抑郁体验因子相关性具有显著意义的变量包括:病耻感总分社交因子,能力因子(r=0.34,0.30,0.32;P0.01);与自我评价因子相关性具有显著意义的变量包括:病耻感总分社交因子(r=0.34,0.40;P0.01)。结论住院精神分裂症患者抑郁较常见,且病耻感越强,住院精神分裂症患者抑郁症状越明显。     

慢性精神分裂症照料者生命质量的调查

目的:调查慢性精神分裂症患者照料者的生命质量状况。方法:纳入符合ICD-10慢性精神分裂症患者照料者60例和与之匹配的健康对照组60例,采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、生活质量综合评定问卷(GQOLI-74)和领悟社会支持量表(PSSS)分别对两组进行评估。结果:慢性精神分裂症患者照料者的HAMD、HAMA评分高于健康对照组(t=8.218,6.144;P0.001),PSSS总分(t=6.242,P=0.000)和GQOLI-74各维度分(t=2.622,4.983,2.983,4.184,6.137;P0.05)低于对照组,差异有统计学意义。生活质量的心理功能维度与心理健康状况(HAMD,HAMA)呈负相关(r=-0.288,-0.312;P0.01),与家庭支持呈正相关(r=0.457,P0.01),总体生活质量因子分与抑郁情绪呈负相关(r=-0.167,P0.05),GQOLI-74的4个维度与社会支持总分呈正相关(r=0.157,0.281,0.414,0.164;P0.05或0.01)。结论:慢性精神分裂症患者照料者的心理健康状态、社会支持度、生活质量较健康对照组差,应引起重视。     

慢性精神分裂症患者共情缺陷及其相关因素

目的调查慢性精神分裂症患者的共情缺陷及其相关因素。方法采用人际反应指针量表(IRI-C)对116例住院慢性精神分裂症患者和109例社区正常对照组的共情能力进行比较,并应用情绪-社交孤独问卷(ESLI)、德克萨斯社交行为问卷(TSBI)、罗森伯格自尊量表(SES)、阴性症状评定量表(SANS)、住院精神病人社会功能量表(SSPI)等进行评定,分析患者共情能力的相关因素。结果研究组IRI-C总分显著低于对照组(t=3.97,P0.01),且总分离散度大于对照组。患者的受教育程度、阴性症状与患者共情能力有相关性(r=0.115,-0.459;P0.05);IRI-C总分与SES总分、TSBI总分呈正相关(r=0.386,0.541,P0.01),并且TSBI总分进入回归模型,Beta值为0.417,与ESLI总分无相关性,但与社交孤立因子、社交孤独因子相关(r=-0.256,0.327;P0.05),且社交孤立、社交孤独因子全部进入回归模型,Beta值分别为-0.258,0.523。结论慢性精神分裂症患者存在广泛的共情缺陷,并且阴性症状明显、自尊水平低、缺乏自信心、支配性差、社会退缩、社交孤独,共情能力越差。     

不同年龄精神分裂症患者的工作记忆

目的:探讨不同年龄精神分裂症患者的工作记忆差异,以及工作记忆与精神分裂症患者临床症状的关系。方法:采用横断面研究方法,用数字广度和空间广度测验分别对124例健康被试和123例符合美国精神障碍诊断与统计学手册第四版(DSM-Ⅳ)中精神分裂症诊断标准的住院患者进行工作记忆评估,采用阳性和阴性症状量表(PANSS)对患者进行临床症状评定。结果:除数字广度逆序分外,精神分裂症组数字广度和空间广度测验其余各项成绩均低于正常对照组(均P<0.05)。精神分裂症组和正常对照组的数字广度总分、正序分、逆序分均与年龄呈负相关(r=-0.21～-0.37,均P<0.05)。将两组按照年龄分为高年龄组和低年龄组进行协方差分析,数字广度和空间广度测验均表现出显著的组别和年龄效应(均P<0.05),但组别和年龄无交互作用(均P>0.05)。在精神分裂症组中,数字广度总分和数字广度逆序分与PANSS总分负相关(r=-0.22,-0.24,均P<0.05);数字广度总分、正序分、逆序分、空间广度总分、逆序分与阴性症状负相关(r=-0.22～-0.26,均P<0.05)。结论:本研究提示同正常人一样,精神分裂症患者的言语工作记忆随年龄增长逐渐下降,但这种下降并无疾病特异性,患者工作记忆水平的下降与阴性症状存在一定负相关。     

精神分裂症患者述情障碍与自尊水平相关性

目的:探讨精神分裂症患者述情障碍与自尊水平的相关性。方法:对182例精神分裂症患者和238例正常对照者分别以多伦多述情障碍量表(TAS-20)和罗森伯格自尊量表(SES)评测述情障碍与自尊水平,对患者同时用阳性和阴性症状量表(PANSS)评估精神症状,分析精神分裂症患者的述情障碍与自尊水平及精神症状的关系。结果:患者组TAS总分高于对照组(t=3.49),SES得分低于对照组(t=-4.19),差异具有统计学意义(P均0.05);相关分析显示,患者TAS总分与SES总分(r=-0.15,P0.05)呈负相关,TAS总分与PANSS总分(r=0.18,P0.05)呈正相关;SES总分与PANSS总分(r=-0.15,P0.05)呈负相关,差异均具有统计学意义。结论:精神分裂症患者存在明显的述情障碍,其述情障碍与自尊水平明显相关。     

病耻感与精神症状关系初步研究

目的 调查精神分裂症患者的病耻感状况,探讨病耻感与精神症状的关系.方法 取北京安定医院住院治疗的精神分裂症患者95例,北京东城区社区精神分裂症患者152例,采用贬低-歧视感知量表、阳性与阴性症状量表(PANSS)对患者进行评估和测查.结果 研究对象“贬低-歧视感知量表”平均得分为(2.38±0.33)分,显著低于量表中点2.50分(t=-5.507,P＜0.01);患者的贬低-歧视感知量表评分与阳性因子分(r=0.136,P＜0.05)、PANSS总分(r=-0.152,P＜0.05)、BPRS分(r=-0.185,P＜0.01)均呈负相关.结论 ①精神分裂症患者未强烈感知到他人的贬低和歧视态度:②精神分裂症患者的精神症状越明显,感知到的病耻感就越少.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.