百乐眠联合氟哌噻吨美利曲辛治疗冠心病合并焦虑症状患者的疗效

目的：探讨百乐眠联合氟哌噻吨美利曲辛（商品名：黛力新）对冠心病合并焦虑症状患者的疗效。方法将冠心病合并焦虑症状患者随机分为两组,对照组只给予常规冠心病治疗药物＋黛力新治疗,试验组给予常规冠心病治疗药物＋百乐眠＋黛力新治疗,治疗时间为4周。观察比较两组患者的有效率和汉密尔顿焦虑量表（HAMA）评分。结果治疗2周和4周时,两组患者与治疗前比较, HAMA评分均明显降低,且试验组评分更低,差异均有统计学意义（P＜0．01）。治疗4周后,试验组总有效率为92.9％,明显高于对照组的80．5％,差异有统计学意义（χ2＝18．28,P ＜0．01）。结论百乐眠联合黛力新能够有效改善冠心病患者的焦虑症状。     

百乐眠胶囊治疗脑卒中急性期失眠患者的临床疗效

目的：观察百乐眠胶囊治疗脑卒中急性期失眠的临床疗效。方法将144例缺血性脑卒中伴失眠患者按照服药情况分为观察组和对照组,两组患者均按照脑卒中临床路径规范治疗,观察组给予百乐眠胶囊治疗（4粒,2次／d）,对照组给予阿普唑仑治疗（0．4 mg／d）,治疗期间观察药物不良反应及患者症状改善情况,治疗前及治疗3周后分别通过匹兹堡睡眠质量指数（PSQI）量表进行睡眠质量评价,通过改良Rankin量表对患者的生活能力进行评价。结果治疗3周后两组患者睡眠质量、生活自理能力均明显改善,差异有统计学意义（ P＜0．05）,且观察组的日间功能障碍评分和改良Rankin量表评分较对照组改善更佳,两组比较差异有统计学意义（P ＜0．05）。结论百乐眠胶囊对脑卒中急性期失眠患者的疗效显著,尤其是在日间功能障碍改善方面。     

九味镇心颗粒与丁螺环酮治疗广泛性焦虑症的对照研究

目的探讨九味镇心颗粒治疗广泛性焦虑症的疗效及安全性。方法将78例广泛性焦虑症患者随机分为九味镇心颗粒组（研究组）和丁螺环酮组（对照组）,治疗6周,采用汉密尔顿焦虑量表（HAMA）与治疗中需处理的不良反应症状量表（TESS）评定临床疗效和不良反应。结果治疗6周后,研究组显效率为81．25％,对照组为77．14％,两组显效率比较差异无统计学意义（P〉0．05）。治疗后第2周末HAMA评分研究组低于对照组（P〈0．05）。研究组治疗后第4、6周末HAMA评分低于治疗前（P〈0．05）,对照组治疗后第4、6周末HAMA评分低于治疗前（P〈0．05）。两组在不良反应方面差异无统计学意义（P〉0．05）。结论九味镇心颗粒治疗广泛性焦虑症与丁螺环酮疗效相当,是安全有效的,且较丁螺环酮显效快。     

帕罗西汀联合生物反馈仪治疗躯体形式障碍对照研究

目的观察帕罗西汀联合生物反馈仅治疗躯体形式障碍的临床疗效。方法69例躯体形式障碍患者随机分为研究组（帕罗西汀联合生物反馈仪治疗）和对照组（单用帕罗西汀治疗）;于治疗前及治疗后第2、4、6周末用症状自评量表（SCL-90）和汉密尔顿焦虑量表（HAMA）分评定疗效;Asberg氏抗抑郁药副反应量表（SERS）评定不良反应。结果治疗后两组SCL-90躯体化、抑郁、焦虑因子分、HAMA总分较治疗前明显减少,两组间差异比较有统计学显著性意义（P〈0．01）;第2周末、第4周末,研究组SCL-90中躯体化、抑郁、焦虑因子分明显低于对照组,差异有统计学意义（P〈0．05）;第2周末开始研究组HAMA总分明显低于对照组,差异有统计学意义（P〈0．05）;两组各时期SERS评分比较差异无统计学意义（P〉0．05）。结论帕罗西汀联合生物反馈仪治疗躯体形式障碍。起效更快,疗效更为显著,不增加不良反应。     

舒肝颗粒治疗焦虑障碍的疗效

目的观察舒肝颗粒对焦虑障碍的疗效。方法采用开放性病例对照研究,将177例焦虑障碍患者分为舒肝组、联合组和西药组,分别治疗观察6周,于治疗前、治疗后2、4、6周分别采用HAMA、CGI及TESS量表评价3组患者的I临床疗效及不良反应情况。结果选择入舒肝组的患者平均年龄偏大,女性占79％,治疗前HAMA总分较低,平均病程偏短,接受舒肝颗粒治疗后6周HAMA总分均显著下降（P〈0．05）;联合组与西药组均于治疗4周后HAMA总分显著下降（P〈0．05或P〈0．01）,两组HAMA降分值比较差异无统计学意义（P〉0．05）;3组患者疗效指数（E1）评分比较,差异有统计学意义（P〈0．05）,第2周西药组低于于舒肝组和联合组,第4周舒肝组患者E1评分低于其他两组,差异均有统计学意义（P均〈0．05）;3组治疗的安全性比较发现,舒肝组各类不良事件的发生率明显低于其他两组,差异有统计学意义（P〈0．05）;临床观察发现治疗早期舒肝组、联合组的苯二氮革类药使用率明显低于西药组（P〈0．05）。结论舒肝颗粒对轻中度焦虑患者有一定的治疗作用,虽然其临床起效缓慢,但其不良反应发生率低,与抗焦虑或抗抑郁药联合使用可减少苯二氮革类药的滥用。     

艾司西酞普兰联合正念认知疗法对广泛性焦虑障碍患者临床症状和生活质量的效果

目的观察艾司西酞普兰联合正念认知疗法(MBCT)对广泛性焦虑障碍患者临床症状和生活质量的效果,为广泛性焦虑障碍的治疗提供参考。方法选择72例就诊于天津市安定医院、符合《国际疾病分类(第10版)》(ICD-10)广泛性焦虑障碍诊断标准的患者,采用随机数字表法分为研究组和对照组各36例,研究组给予艾司西酞普兰联合MBCT,对照组单用艾司西酞普兰治疗,于治疗前和治疗8周后采用汉密尔顿焦虑量表(HAMA)、焦虑自评量表(SAS)和健康调查简表(SF-36)进行评定。结果治疗8周后,两组HAMA和SAS评分均较治疗前低,差异均有统计学意义(P均0. 01),研究组HAMA和SAS评分均低于对照组,差异有统计学意义(P均0. 01);治疗后研究组SF-36各因子评分及总评分均较治疗前高,差异均有统计学意义(P均0. 01),对照组SF-36除社会功能、心理健康因子外,其他各因子评分及总评分均较治疗前高,差异有统计学意义(P均0. 01),治疗后研究组SF-36各因子评分及总评分均高于对照组,差异均有统计学意义(P 0. 05或0. 01)。结论与单用艾司西酞普兰相比,艾司西酞普兰联合MBCT可能更有助于改善广泛性焦虑障碍患者的临床症状和生活质量。     

度洛西汀、米氮平、帕罗西汀与阿米替林治疗伴躯体症状抑郁症的对照研究

目的探讨度洛西汀、米氮平、帕罗西汀与阿米替林治疗伴躯体症状抑郁症的疗效和安全性。方法将符合国际疾病分类第10版（ICD一10）诊断标准的伴躯体症状的抑郁症患者117例,随机分为4组,分别给予度洛西汀、米氮平、帕罗西汀与阿米替林治疗,疗程8周。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）和副反应量表（TESS）评定疗效及不良反应。结果4组药物均能迅速起效,第2周末HAMD、HAMA评分较治疗前差异有统计学意义（P〈0．05）,治疗8周后,4组闯疗效无统计学意义（P〉0．05）,4组HAMD、HAMA评分较治疗前有统计学意义（P〈0．01）,4个治疗组不良反应有统计学意义（P．〈0．01）。结论治疗伴躯体症状的抑郁症,四药总体疗效相似,均起效较快,度洛西汀、米氮平和帕罗西汀不良反应相对少,依从性好。提示四种药物均为治疗伴躯体症状的抑郁症一线药物,度洛西汀、米氮平和帕罗西汀值得临床推广。     

积极式个案管理模式对精神分裂症患者生活质量影响的研究

目的探讨积极式个案管理模式对精神分裂症患者生活质量的影响。方法选取800例精神分裂症患者随机分为两组,分别接受积极式个案管理治疗（研究组,入组400例,完成380侧）和普通康复治疗（对照组,入组400例,完成350例）,应用阳性与阴性症状量表（PANSS）、Camberwell需求评价量表（CAN）、生活质量量表（QOLS）、家庭负担量表（FBI）和WHO-精神残疾评价量表简化版（DAS—S）分别于入组前、入组后1年、2年末对患者的精神症状、生活质量变化等进行评定。结果（1）治疗后,PANSS总分和阴性症状评分,两组比较差异有统计学意义（P〈0．05）;（2）CAN帮助栏目分量表中基本生活、家庭和社会职能及社会救助因子分研究组较前均有下降,两组比较差异有统计学意义（P〈0．05）,cAN帮助来源分量表中社会帮助因子分研究组较前升高,两组比较差异有统计学意义（P〈0．01）;（3）生活质量量表中日常生活、家庭生活及安全感因子分,研究组均有提高,对照组无变化,两组比较差异有统计学意义（P〈0．05）;（4）家庭负担量表评分,家庭经济和心理健康因子分,研究组明显下降,对照组无变化,两组比较差异有统计学意义（P〈0．05）;（5）精神残疾评价量表评分,研究组DAS—S评分有下降,两组比较差异有统计学意义（P〈0．05）。结论积极式个案管理模式能提高精神分裂症患者社会功能及生活质量。     

心理护理对慢性精神分裂症患者强迫症状的效果研究

目的探讨心理护理对慢性精神分裂症患者强迫症状的干预效果。方法将85例伴有强迫症状的慢性精神分裂症患者随机分为研究组（42例）和对照组（43例）,研究组接受共6个月的心理护理,并在基线、干预后3月末、干预后6月末应用耶鲁-布朗强迫量表（Y—BOCS）、汉密尔顿焦虑量表（HAMA）评定疗效。结果干预后6月末,研究组和对照组的Y—BOCS评分以及HAMA评分较干预前均有显著性降低（P〈0．05）。而在干预后3月末、6月末,干预组的Y—BOCS评分和HAMA评分均显著低于对照组,且差异均有显著性意义（P〈0．05）。结论心理护理可有效改善慢性精神分裂症患者的强迫症状。     

重复经颅磁刺激治疗伴躯体疼痛抑郁症患者的疗效观察

目的探讨重复经颅磁刺激（rTMS）治疗伴有躯体疼痛的抑郁症患者的临床疗效和安全性。方法将60例伴有躯体疼痛的抑郁症患者随机分为两组,各30例,均给予度洛西汀口服8周,研究组同时联用rTMS,对照组则予假性rTMS刺激4周,观察8周。于治疗前及治疗后第1,2,3,4,8周应用汉密尔顿抑郁量表（HAMD）、医学结局研究用疼痛量表（MOSPM）和治疗中出现的不良反应量表（TESS）评定两组的治疗效果和安全性。结果治疗结束后两组的MOSPM和HAMD评分均较治疗前显著下降（P〈0．05）;治疗第1,2,3,4周,研究组的MOSPM评分低于对照组,差异有统计学意义（P〈0．05）;治疗第2,3,4周,研究组的HAMD评分低于对照组而显效率高于对照组,差异有统计学意义（P〈0．05）;治疗第8周,两组患者的MOSPM和HAMD评分及显效率差异均无统计学意义（P〉0．05）,治疗期间无严重不良反应发生。结论rTMS能有效治疗伴躯体疼痛的抑郁症,迅速缓解疼痛改善抑郁症状,早期疗效优于单一度洛西汀治疗,且安全性高。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高,而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。     

Effect of high simple dose of cisplatinum and of radiation on the brain of rabbit

Abstract

In former studies of intracarotid and intravenous administration of cisplatinum, separate and combined with brain irradiation, we found no cerebral damage. In this study! gradually increasing high doses (above the therapeutic ones) of cisplatinum were administered intravenously to one series of rabbits arid increasing high amounts of irradiation (above the therapeutic amounts) were given to another series. Although the rabbits that received highest doses of irradiation developed areas of alopecia and skin ulcers on the head! the general clinical and histopathologic examination of the rabbits brains in both series was normal. The purpose of this study was to establish the effects of high doses of intravenous cisplatinum and irradiation on the rabbits brains. [Neural Res 1997; 19: 216–218]