首发精神分裂症症状严重度预测利培酮的6周疗效

目的通过对首发精神分裂症患者治疗前症状的严重度预测利培酮治疗6周后的疗效。方法对62例服用利培酮（3．9±0．9mg／d）的首发精神分裂症患者在治疗前和治疗6周末分别采用简明精神病量表（BPRS）评定。结果疗前BPRS总分与6周BPRS减分值相关（r=0．786,P〈0．01）;焦虑忧郁、缺乏活力、思维障碍、激活性和敌对因子的疗前分,分别与6周减分值呈正相关（r=0．928、0．425、0．645、0．939、0．684,P〈0．01）。结论疗前总症状或各症状群越重,利堵酮治疗6周后的相关症状改善越显著。     

抗精神病药物治疗精神分裂症的甲状腺功能改变与疗效的相关性分析

目的　探索抗精神病药治疗之初的甲状腺功能改变与治疗 4周末疗效的相关性。方法　给 2 3例精神分裂症病人服维思通 (3 6± 0 8)mg/d ,16例精神分裂症病人服氯氮平 (32 8± 6 1)mg/d。在服药治疗的第 4周晨检测T3 、T4和TSH ;服用药 0天和 4周末各测评一次BPRS。结果　①在氯氮平组 ,T4与 4周末焦虑因子分改善呈正相关性 (r =0 7117,P <0 0 1)。②在维思通组 ,T4水平与 4周末缺乏活力因子分改善呈正相关性 (r =0 4 15 4 ,P <0 0 5 )。结论　①氯氮平基础剂量 (10 0mg/d)时的T4升高可能预示用氯氮平治疗量到 4周时焦虑症状明显改善。②维思通基础剂量 (1mg/d)时的T4升高可能预示用维思通治疗量到 4周末时缺乏活力明显改善     

丁螺环酮治疗精神分裂症患者病理性或药源性焦虑的临床效果

目的研究丁螺环酮治疗精神分裂症患者病理性或药源性焦虑的临床效果。方法选出2014年12月~2016年12月我院收入治疗的精神分裂症伴病理性或药源性焦虑患者110例开展调查研究,根据临床治疗方案不同分为治疗组与对照组(n=55),对照组单用抗精神病药物治疗,治疗组在对照组基础上加用丁螺环酮治疗,比较两组治疗后情况。结果治疗后治疗组BPRS评分焦虑忧郁、缺乏活力、思维障碍、激活性、敌对猜忌分值低于对照组,PANSS评分低于对照组(P0.05)。在治疗后第6与第8周,治疗组TESS评分显著低于对照组(P0.05)。从第二周开始,治疗组的HAMA评分减分快于对照组(P0.05)。治疗组治疗有效率(94.5%)显著高于对照组(76.4%)(P0.05)。结论丁螺环酮治疗精神分裂症能够迅速缓解患者精神病性症状,缓解焦虑情绪,安全性较高。     

MRI定向下核团毁损术治疗难治性精神分裂症

目的 应用MRI定向下核团毁损术治疗难治性精神分裂症,并对其疗效及并发症进行评估.方法 采用MRI定向下脑内单靶点或组合靶点射频毁损术治疗38例难治性精神分裂症,术后6月依据全国精神外科协作组1990年标准对疗效进行评价.手术前后应用简明精神量表BPRS及各因子分评价手术效果.结果 38例患者术后6月恢复8例,显著进步15例,进步12例,无效3例,加重0例,有效率92.1%;15例次术后出现早期一过性并发症,均在术后2周内恢复.术后简明精神量表BPRS总分及焦虑忧郁、缺乏活力、思维障碍、激活性、敌对猜疑等因子分均明显下降,术前、术后有显著性差异(P<0.05).结论 MRI定位下核团毁损术治疗难治性精神分裂症效果显著,精确,安全.     

帕金森病患者神经精神症状及其影响因素研究

目的调查帕金森病(PD)患者的神经精神症状的发生、分布情况,并分析各神经精神症状间的相互关系及影响因素。方法应用简明精神病量表(BPRS)调查209例PD患者的20项神经精神症状发生率和分布情况,并分析各神经精神症状间的相关性以及与临床特征包括年龄、受教育时间、病程、认知水平、运动功能、抑郁、焦虑、睡眠、生活质量、左旋多巴等效剂量等的相关性。结果 PD神经精神症状发生率较高的前3位分别为动作迟缓(84.21%)、关心身体健康(66.51%)和焦虑(54.55%),发生率较低的症状为不合作、定向障碍和自知力障碍(均为5.26%)。BPRS的5个分量表即焦虑抑郁、缺乏活力、思维障碍、激活性和敌对猜疑两两之间均具有相关性(均P0.01),其中思维障碍与敌对猜疑(r=0.477)、缺乏活力与思维障碍(r=0.441)、缺乏活力与敌对猜疑(r=0.429)之间呈中度相关。BPRS总分与受教育时间、帕金森病睡眠量表(PDSS)评分和简易精神状态检查量表(MMSE)评分呈负相关,与年龄、统一帕金森病评定量表(UPDRS)第3部分评分、修订Hoehn-Yahr(H-Y)分期、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、帕金森病生活质量问卷(PDQ-39)评分呈正相关(均P0.05),与病程和左旋多巴等效剂量无相关性(均P0.05)。BPRS高分组(35分)PD与BPRS低分组(≤35分)PD患者在年龄、起病年龄、UPDRSⅢ、PDQ-39、HAMA、HAMD和MMSE评分间比较存在统计学差异(均P0.05)。逐步多元线性回归分析结果示HAMA和MMSE评分对BPRS总分影响最大(r2分别为0.196和0.270)。结论 PD患者的神经精神症状发生率高且具多样性。MMSE评分越低,PD患者精神症状越严重。     

氯氮平和利培酮治疗精神分裂症患者比较研究

目的 评价氯氮平和利培酮治疗精神分裂症的疗效和副作用。方法 将40例精神分裂症患者随机分为氯氮平组和利培酮组(氯氮平组20例,利培酮组20例),于治疗前和治疗12周末各作一次韦氏成人智力量表、韦氏记忆量表、威斯康星卡片分类测验、言语流利性测验、连线测验A、简明精神症状评定量表(BPRS)、TESS副反应量表。结果 治疗12周末氯氮平组显著改善BPRS评分,利培酮组显著改善迟滞、思维障碍、敌对猜疑因子分,但氯氮平组较利培酮组敌对猜疑因子分减分率高。两组之间副反应评分有显著性差异,利培酮组明显低于氯氮平组,其余各项无显著性差异。结论 氯氮平较利培酮治疗敌对猜疑效果好,但利培酮较氯氮平副作用小,安全性较高。     

33例在校大学生精神分裂症临床对比分析

调查了33例在校大学生精神分裂症,与同期住院、年龄相近的精神分裂症患者对比发现,大学生以理工科专业为主,低年级占多数。遗传、病前性格与对照组相似。病前生活事件强度明显高于对照组。BPRS量表因子分析,大学生组以焦虑、忧郁、敌对猜疑因子为明显,对照组的缺乏活力因子较突出。两组疗效相似。     

晚发与早发精神分裂症临床症状的比较研究

目的 了解晚发与早发精神分裂症临床症状之间的差异。方法 对不同年龄初发精神分裂症患者进行BPRS、SANS、SAPS、HAMA和HAMD量表评定,然后作临床症状的比较。结果 晚发组在BPRS缺乏活力因子分,SANS总分,HAMD迟缓、绝望感因子分低于早发组,BPRS敌对猜疑因子分高于早发组(P<0.05)。晚发组的以被害妄想、牵连观念、情绪不稳较多见,而被洞悉感、思维形式障碍、情感迟钝、意志缺乏较少。结论 晚发精神分裂症与早发精神分裂症的临床症状有所不同,提示晚发精神分裂症可以作为精神分裂症的一个亚型。     

维思通对女性精神病人血清催乳素及月经周期的影响

目的　探讨维思通对女性精神病人血清催乳素 (PRL)及月经周期的影响 ,同时也观察了这一副反应对病人的情绪影响。方法　对 5 6例服用维思通的首发精神分裂症女性病人进行连续 12周的治疗观察 ,并测定用药前和用药后第 4周、12周的PRL数值 ;以及观察 3次月经周期变化。在疗前及 12周治疗结束后评定BPRS、TESS。结果　第 4周内病人PRL变化不明显 (0 0 5

相似文献   

舍曲林合并舒必利治疗精神分裂症的临床研究

目的探讨舍曲林合并舒必利治疗精神分裂症的疗效和安全性。方法将86例符合CCMD-3诊断标准的精神分裂症患者随机分为研究组与对照组,研究组给予舍曲林合并舒必利治疗,对照组服用利培酮,疗程8周,用PANSS、CGI、BPRS及TESS评定疗效和安全性。结果疗后8周舍曲林合并舒必利组总有效率为88．37%,维思通组总有效率69．77%,两组比较有显著性差异(P＜0．05)。两组治疗前后PANSS、BPRS评分均有明显下降(P＜0．05),两组间比较研究组两量表总分下降更明显,差异有显著性(P＜0．05),尤其PANSS中一般精神病理量表分、BPRS中缺乏活力因子分、焦虑抑郁因子分差异显著(P＜0．05)。结论舍曲林合并舒必利治疗精神分裂症阴性与阳性症状疗效可靠,不良反应小,大大提高患者的生活质量。     

Characteristics of the sympathetic innervation of the nictitating membrane and of the vasculature of the nose and tongue of the cat

Summary Vasomotor responses from the nasal mucosa and tongue, and contractions of the nictitating membrane, were recorded on stimulation of the cervical sympathetic or internal carotid nerves.Preganglionic sympathetic nerve fibres which elicited a membrane response possessed a lower threshold than those which evoked nasal vasoconstriction, while the latter displayed a lower threshold than fibres which evoked tongue vasoconstriction. The sympathetic vasodilator fibres to the tongue, whose activity was revealed after-receptor blockade, had a similar threshold to the vasoconstrictor fibres.Membrane contraction, nasal vasoconstriction and occasionally tongue vasoconstriction could be evoked by stimulating the internal carotid nerve. The postganglionic fibres innervating the nasal mucosa had a similar threshold to those of the nictitating membrane, which may indicate that there are small myelinated fibres innervating the mucosa.The preganglionic compound nerve action potential had four major components, S₁–S₄. S₁, S₂ and usually S₃ fibres were associated with membrane contraction; S₂, S₃ and sometimes S₁ fibres were associated with nasal vasoconstriction; and S₃, usually S₂ and occasionally S₁ fibres were associated with vasoconstriction in the tongue. It is concluded that each of these three groups of nerve fibres, but not S₄ fibres, may include fibres associated functionally with the three effectors.There was a considerable difference between the relative amplitude of the responses of the three effectors elicited by stimulation of the cervical sympathetic nerve at frequencies between 0.2 and 2 Hz. Vasoconstrictor responses were relatively larger than membrane contractions suggesting differences in the mechanisms of neurotransmission at the neuroeffector junctions.     

Mechanisms of the suppression of the nociceptive reflex of the opening of the mouth during stimulation of the structures of the limbic brain

The comparative effectiveness of the inhibitory influence of tetanic stimulation of hypothalamus, amygdala and limbic cortex on EMG-response of m. digastricus evoked by electrical stimulation of tooth pulp nociceptive afferents was studied in cats anesthetized with a mixture of chloralose and nembutal. It was found that inhibition of the EMG-component of the jaw-opening reflex is most pronounced in case of stimulation of medial and lateral region of the hypothalamus, the inhibitory effect of central and medial nuclei of the amygdala is less pronounced and the effect of the limbic cortex is the weakest. It was shown that the mechanism of the antinociceptive effect of tetanic stimulation of the hypothalamus is not related to the concomitant increase of the blood pressure. After stabilization of the blood pressure the suppressive effect of the hypothalamus remains without changes, that points out to a direct, primary, not baro-afferent mechanism of the inhibition of the activity of nociceptive neurons of the trigeminal sensory nuclei. Noradrenaline, injected intravenously, induced a large increase of the blood pressure accompanied by a pronounced inhibition of the pain reflex. Angiotensin causes the same degree of blood pressure elevation without changes in the amplitude of the EMG-response of the pain reflex. Hypothalamic and noradrenergic mechanisms for control of pain sensitivity are discussed.     

Development of the projection from the nucleus of the brachium of the inferior colliculus to the superior colliculus in the ferret

Neurons in the deeper layers of the superior colliculus (SC) have spatially tuned receptive fields that are arranged to form a map of auditory space. The spatial tuning of these neurons emerges gradually in an experience-dependent manner after the onset of hearing, but the relative contributions of peripheral and central factors in this process of maturation are unknown. We have studied the postnatal development of the projection to the ferret SC from the nucleus of the brachium of the inferior colliculus (nBIC), its main source of auditory input, to determine whether the emergence of auditory map topography can be attributed to anatomical rewiring of this projection. The pattern of retrograde labeling produced by injections of fluorescent microspheres in the SC on postnatal day (P) 0 and just after the age of hearing onset (P29), showed that the nBIC-SC projection is topographically organized in the rostrocaudal axis, along which sound azimuth is represented, from birth. Injections of biotinylated dextran amine-fluorescein into the nBIC at different ages (P30, 60, and 90) labeled axons with numerous terminals and en passant boutons throughout the deeper layers of the SC. This labeling covered the entire mediolateral extent of the SC, but, in keeping with the pattern of retrograde labeling following microsphere injections in the SC, was more restricted rostrocaudally. No systematic changes were observed with age. The stability of the nBIC-SC projection over this period suggests that developmental changes in auditory spatial tuning involve other processes, rather than a gross refinement of the projection from the nBIC.     

Origins of the sympathetic innervation of the cervical end of the uterus in the rat

A retrograde neuronal tracer (Fast Blue) was injected in the cervical end of the uterine horn of virgin rats. The majority of the retrogradely labeled post-ganglionic sympathetic neurons were found in the sympathetic chain (74%). The superior mesenteric ganglia, inferior mesenteric ganglia and suprarenal ganglia accounted for 22, 3 and <1%, respectively. The distribution of neurons in the sympathetic chain labeled from the uterus resembles that described for other pelvic organs.     

Sexual pheromones and the evolution of the reward system of the brain: the chemosensory function of the amygdala

The amygdala of all tetrapod vertebrates receives direct projections from the main and accessory olfactory bulbs, and the strong similarities in the organization of these projections suggest that they have undergone a very conservative evolution. However, current ideas about the function of the amygdala do not pay sufficient attention to its chemosensory role, but only view it as the core of the emotional brain. In this study, we propose that both roles of the amygdala are intimately linked since the amygdala is actually involved in mediating emotional responses to chemical signals. The amygdala is the only structure in the brain receiving pheromonal information directly from the accessory olfactory bulbs and we have shown in mice that males emit sexual pheromones that are innately attractive for females. In fact, sexual pheromones can be used as unconditioned stimuli to induce a conditioned attraction to previously neutral odorants as well as a conditioned place preference. Therefore, sexual pheromones should be regarded as natural reinforcers. Behavioural and pharmacological studies (reviewed here) have shown that the females' innate preference for sexual pheromones is not affected by lesions of the dopaminergic cells of the ventral tegmental area, and that the systemic administration of dopamine antagonists do not alter neither the attraction nor the reinforcing effects of these pheromones. Anatomical studies have shown that the vomeronasal amygdala gives rise to important projections to the olfactory tubercle and the islands of Calleja, suggesting that these amygdalo-striatal pathways might be involved in the reinforcing value of sexual pheromones.     

Topographical organization of the motoneuron pools that innervate the muscles of the pinna of the cat

The topographical organization of the 22 motoneuron pools that innervate the pinna muscles of the cat was examined by injecting the B-subunit of cholera toxin conjugated to horseradish peroxidase into individual muscles. All 22 pools are found in the facial nucleus, organized as rostro-caudally oriented columns, and arranged according to the action of the muscles they innervate. Pools innervating muscles that pull the pinna dorsally are located in the dorsal two thirds of the medio-dorsal subdivision, and those innervating muscles that pull the pinna ventrally are located in the ventral one half of the nucleus. Motoneurons innervating muscles that pull the pinna cranially are located laterally, those that pull the pinna caudally are located medio-ventrally, and those that change the shape of the pinna are located along the entire dorso-ventral extent in the center of the medio-dorsal subdivision. This topographical layout is consistent with the somatotopic organization of the entire facial nucleus as demonstrated in a variety of species. © 1995 Wiley-Liss, Inc.     

Histochemical methods for the further characterisation of the tumourettes of the posterior lobe of the pituitary

Summary The granular cell tumourettes of the posterior lobe of the pituitary possess neuraminic acid containing carbohydrate. After removal of neuraminic acid with neuraminidase and exposure to FITC (Fluorescein isothiocyanate) labelled peanut agglutinin (Arachis hypogaea) (PNA), intracellular receptor structures could be demonstrated. The significance of the findings is discussed.