进食障碍疗效的影响因素分析

目的:了解进食障碍住院患者疗效的影响因素. 方法:收集36例进食障碍患者住院治疗的临床资料并进行分析. 结果:根据疗效分组显示,疗效好的患者闭经时间短、住院时间长、体质量(体重)增加明显、鼻饲治疗者多(P均<0.05),而在病程、起病年龄、入院前体质量减轻情况,有否导泻,引吐,入院时汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分、住院意向、住院病房模式等方面差异均无显著性(P均>0.05). 结论:进食障碍的患者需要及早、长程的综合治疗,对于治疗依从性差的患者,鼻饲治疗颇为有效.有自行导泻引吐症状可能是促使患者住院治疗的重要因素.     

Parental efficacy,parental monitoring efficacy,and monitoring among Asian-Indian parents of adolescents living in Chennai,India

The purpose of this study was to investigate the relationship between parental efficacy and a new concept entitled parental monitoring efficacy, and to examine the association between parental monitoring efficacy and monitoring. We conducted two studies on two samples of Asian-Indian parents and adolescents living in Chennai, India. In the first study of 241 parents of adolescents in grades, 9–12, we constructed a new measure of parental efficacy that included two factors. The first factor, responding competently to negative adolescent behavior was more strongly predictive of parental monitoring efficacy than the second factor, instilling positive behavior. In the second study of 215 parents and adolescents in grades 10 and 12, parental monitoring efficacy predicted monitoring, especially adolescent disclosure and parental control. The importance of parental control as a monitoring technique among traditional Indian parents was discussed.     

奎硫平治疗精神分裂症疗效有关因素分析

目的：分析影响奎硫平治疗精神分裂症疗效的有关因素。方法：对50例住院经奎硫平治疗〉8周的精神分裂症患者作回顾性分析。结果：经过单因素回归分析发现年龄大、病程长、有家族史、病情反复发作及以阴性症状为主等因素均影响奎硫平的疗效，最后得到包括有家族史、反复发作和阴性症状为主的主效应方程，回顾性评判正确率达到86％。结论：患者的年龄偏大、病程长、病情反复发作和以阴性症状为主等因素均会影响奎硫平的疗效。     

Secretin as a Treatment for Autism: A Review of the Evidence

Secretin is used in the United States for diagnosis of pancreatic gastrointestinal (GI) dysfunction and disease. Repeated therapeutic use has not been approved. Widespread interest in secretin as a treatment for autism followed media reports of behavioral improvements in an autistic child who received the hormone during a GI diagnostic procedure. International demand for secretin soared in the absence of experimental evidence of its efficacy for autism. This review presents a brief history of secretin's rise to popularity and summarizes research on secretin as a treatment for autism. Seventeen studies are reviewed comparing the effects of secretin forms, dosage levels, and dosing intervals on outcome measures with approximately 600 children. Twelve of 13 placebo-controlled studies failed to demonstrate the differential efficacy of secretin. Implications for advocating treatment in the absence of empirical evidence are discussed.     

利培酮对慢性精神分裂症泌乳素的影响

目的探讨非典型抗精神病药利培酮对泌乳素的影响及其与临床疗效的关系。方法采用固定剂量利培酮（６ｍｇ／ｄ）治疗慢性、男性精神分裂症３０例,疗程１２周;在治疗前后评定ＰＡＮＳＳ量表,并用放射免疫法测查血浆中泌乳素（ＰＲＬ）浓度。以１６例健康人为对照。结果治疗后,患者ＰＡＮＳＳ总分及其分量表均显著降低;治疗前患者ＰＲＬ较对照组显著降低,治疗后显著性增高。治疗前后泌乳素差值与ＰＡＮＳＳ阳性症状分量表减分值、减分率显著相关。结论利培酮对精神分裂症血泌乳素水平有明显影响,而且泌乳素水平与临床疗效相关。     

齐拉西酮不同给药方法治疗精神分裂症患者对照研究

目的:探讨齐拉西酮不同给药方法治疗精神分裂症的疗效及患者的耐受性。方法:50例精神分裂症患者随机分成两组各25例,A组为缓慢加药组,B组为快速加药组,进行为期6周的研究。采用阳性和阴性症状量表(PANSS)、临床疗效总评量表(CGI)、不良反应评定量表(UKU)以及相关实验室检查评价齐拉西酮的疗效和安全性。结果:治疗结束后,两组患者PANSS评分较治疗前差异有统计学意义(时间效应F=85.978,P0.01);两组间PANSS评分差异无统计学意义(组间效应F=0.550,P0.05);两种不同给药方法与PANSS评分时间无交互作用(F=0.906,P0.05)。治疗前后体质量、血糖、血脂变化差异无统计学意义。A组不良反应发生率88%显著高于B组62.5%(P0.05)。结论:齐拉西酮治疗精神分裂症缓慢加药与快速加药的疗效相当,但快速加药不良反应较少。     

Oral topiramate as an add-on treatment for refractory status epilepticus

Stojanova V, Rossetti AO. Oral topiramate as an add‐on treatment for refractory status epilepticus.
Acta Neurol Scand: 2012: 125: e7–e11.
© 2011 John Wiley & Sons A/S. Objectives – Oral anti‐epileptic drugs (AED) represent possible add‐on options in refractory status epilepticus (SE). We report our experience in using topiramate (TPM) to treat SE unresponsive to sequential trials of multiple agents. Materials and Methods – Over 57 months, we identified 11 SE patients treated with TPM in our hospital, all of them suffered from SE refractory to at least two treatments, and six had generalized SE. Nine patients were managed in the ICU and required intubation. Results – We found a definite electro‐clinical response in 2/11 patients, already evident after 12–96 h after TPM introduction, and a possible response in 2/11 patients (concomitantly with other AEDs); 7/11 did not respond. Partial‐complex SE appeared to better respond than generalized‐convulsive SE. One patient developed a severe nephrolithiasis. Conclusions – As compared to previous small series describing only patients responding to TPM, this unselected observation underscores the difficulty of treating refractory SE, regardless of the agent.     

急性脑梗死溶栓治疗近、远期疗效及影响因素分析

目的 分析急性脑梗死溶栓治疗后近期(24 h)、远期(3月后)的疗效以及相关影响因素.方法 对南方医科大学附属南海医院神经科自2006年1月至2011年12月收治的53例急性脑梗死患者应用尿激酶溶栓治疗,以美国国立卫生院卒中量表评分(NIHSS)及改良的Rankin量表评分(mRS)作为评价指标,评估溶栓治疗后24 h、3月后的疗效,以及对其相关影响因素进行Logistic 回归分析.结果 溶栓治疗后24h病情好转者有28例(52.8％),多因素Logistic回归分析表明影响24 h疗效的因素为性别(P=0.007)、发病至溶栓治疗的间隔时间(P=0.017)及溶栓前纤维蛋白原水平(P=0.001).溶栓治疗后3月后病情好转者有40例(75.4％),多因素Logistic回归分析表明影响3月后疗效的因素为溶栓前的NIHSS评分(P=0.002)及24h的溶栓效果(P=0.002).结论 影响急性脑梗死溶栓治疗远、近期疗效的因素不同,在临床工作中应分别注意对待.     

托吡酯治疗癫癎的长期疗效观察

目的观察托吡酯治疗不同类型癫癎的长期疗效及安全性.方法采用开放性试验的方法,给予115例不同类型癫癎患者托吡酯单药或添加治疗,6个月后进行疗效评定,1年和2年时计算控制率和托吡酯保留率,记录不良反应.结果 (1) 6个月时总有效率单药治疗组为83.9%,添加治疗组为66.1%,对各型癫癎均有一定疗效,各组间发作控制率和总有效率比较差异无显著性;(2)稳定期儿童组有效剂量为(105.72±48.28) mg/d,成人组为(176.36±62.81) mg/d;(3)控制率1年为40.0%,2年为28.7%;保留率1年为67.8%,2年为46.1%;(4)34例(29.6%)出现不良反应,为轻、中度的中枢神经系统症状以及厌食和体质量减轻.结论托吡酯是较好的广谱抗癫癎药物,长期应用仍有较好的疗效和安全性.     

奎硫平治疗少儿精神分裂症的疗效

目的探讨奎硫平治疗少年精神分裂症的疗效。适宜剂量和副反应。方法47例首发的少儿精神分裂症给以奎硫平治疗观察8周,分别在治疗前后1、2、4、6、8周给以PANSS量表和TESS量表评定。结果奎硫平治疗少儿精神分裂症的显效率82．98％,起效时间为1周,有效剂量为100-200mg／d。结论奎硫平对少年儿童精神分裂症的治疗,无论是阴性症状,阳性症状,都有肯定的疗效,且起效时间快,副反应少而轻微,有更高的安全性和更好的治疗依从性。     

思瑞康治疗女性首发精神分裂症患者的疗效及安全性观察

目的 探讨思瑞康对女性首发精神分裂症患者的疗效及安全性.方法 对48例女性首发精神分裂症患者进行为期16周的思瑞康开放性治疗试验.治疗前及治疗后第4、8及16周末采用阳性和阴性症状量表（PANSS）及临床疗效总评疾病严重度量表（CGI-SI）评价疾病的严重程度;不良反应量表（TESS）评估药物不良反应;Sampson氏锥体外系不良反应量表（SAS）评价不良反应症状;利用自编的月经调查问卷每4周调查1次月经情况;治疗前、治疗结束时分别测定体重及血清催乳素（（PRL）水平.结果 ①治疗16周后PANSS总分值较治疗前明显下降,差异有极显著性（P＜0.001）,阳性和阴性症状量表分值较治疗前均明显下降（P＜0.05）;②各治疗时段PANSS总分、阳性因子分、阴性因子分均较前一次明显下降（P＜0.05）;③疗后CGI-SI分值与疗前相比明显下降,差异有极显著性（P＜0.001）;④36例患者PANSS减分率≥75%;⑤SAS评分疗前、疗后无显著性差异;⑥治疗后体重中度增加,与治疗前相比差异有显著性（P＜0.01）;⑦患者疗前、疗后血清PRL水平差异无显著性（P=0.307）;⑧月经周期、月经量及行经时间与用药前比较均无明显改变;⑨整个治疗期间未发生严重的不良反应.结论 思瑞康剂量达500～800mg/d时,能有效控制精神症状,对阳性、阴性症状均有效;发生锥体外系不良反应的危险性较小;对月经影响不明显,是较为理想的新型抗精神病药物.     

Personality: Predictor of Neurostimulation Outcomes in Patients With Chest Pain and Normal Coronary Arteries

Objectives. To study the impact of personality traits on the effect of neurostimulation in patients with chest pain and normal coronary arteries. Materials and Methods. Using the Dutch personality questionnaire, we retrospectively studied the personality traits in 33 patients treated with neurostimulation, either transcutaneous electrical nerve stimulation or spinal cord stimulation after 5 years. Neurostimulation was successful in 21 patients. Baseline characteristics and medication also were assessed for possible interactions with personality traits and neurostimulation outcome. Results. Patients with beneficial neurostimulation scored lower on the “social inadequacy” scale than patients with neurostimulation failure (p = 0.032). In univariate analyses, low scores at the “social inadequacy” scale and the use of calcium antagonists were associated with beneficial outcome of neurostimulation. In multivariate analysis low scores at the “social inadequacy” scale remained an independent predictor for beneficial neurostimulation outcome, when adjusted for other variables. Conclusion. Personality traits are a determining factor in the evaluation of neurostimulation for patients with chest pain and normal coronary arteries.     

Cannabinoids for epilepsy: What do we know and where do we go?

Over the past decade there has been an increasing interest in using cannabinoids to treat a range of epilepsy syndromes following reports of some remarkable responses in individual patients. The situation is complicated by the fact that these agents do not appear to work via their attachment to endogenous cannabinoid receptors. Their pharmacokinetics are complex, and bioavailability is variable, resulting in difficulty in developing a suitable formulation for oral delivery. Drug interactions also represent another complication in their everyday use. Nevertheless, recent randomized, placebo‐controlled trials with cannabidiol support its efficacy in Dravet and Lennox‐Gastaut syndromes. Further placebo‐controlled studies are underway in adults with focal epilepsy using cannabidivarin. The many unanswered questions in the use of cannabinoids to treat epileptic seizures are briefly summarized in the conclusion.     

企业员工应对效能及相关因素探讨

目的 探讨企业员工应对效能、自我隐瞒以及与抑郁的关系,为促进企业员工保持良好的心理健康提供依据.方法 采用应对效能量表、自我隐瞒问卷和抑郁自评量表对616名企业员工进行调查.结果 （1）应对效能方面,不同性别、职称的企业员工评分差异有统计学意义,女性自信程度分量表得分高于男性（t=1.979,P＜0.05）.高级职称员工的应对效能总分和胜任力评分高于初级职称员工（t分别为4.486,3.130;P＜0.05）.男性员工在应对效能总分、胜任力和自信程度上低于全国常模,女性员工在胜任力上高于全国常模,而在认知水平上低于全国常模,差异均有统计学意义（P＜0.05）.（2）自我隐瞒方面,男性员工评分高于女性（t=5.024,P＜0.01）;高中以上文化程度的企业员工评分低于初中以下文化程度（t=4.758,P＜0.01）;初级职称和中级职称的员工评分高于高级职称的员工（F=3.052,P＜0.05）;在年薪方面,＞5万元的员工评分高于＜3万元的员工（F=3.358,P＜0.05）.（3）抑郁检出率为29.4％,情绪正常组的员工在应对效能总分及各分量表分数均高于轻度抑郁组和中度及以上抑郁组（F分别为34.11,15.47,21.37,30.19;P＜0.01）.（4）企业员工自我隐瞒总分与应对效能总分、认知水平和自信程度呈负相关（P＜0.05）.自我隐瞒、职称对应对效能有预测作用,分别可以解释其变异量的2.7％和3.9％.结论 企业员工心理健康不容忽视,提升应对效能可有效提高员工的心理健康.     

Teachers as Facilitators of Student Participation in School Mental Health Promotion

A research project examined longitudinal and cross-sectional relationships between teacher facilitation of student participation and student motivational beliefs in health promotion planning and action. Participants were 1,864 students from the ten pilot schools of the Norwegian Network of Health Promoting Schools. Multi-level regression models revealed that teacher facilitation was associated with a range of positive outcomes, including higher perceived participatory skills, collective efficacy, outcome expectancy and school satisfaction. Longitudinal analysis revealed that a change in teacher facilitation was associated with change in participatory skills, collective efficacy and outcome expectancy, but not school satisfaction. The results highlight the important motivational role of teachers in school mental health promotion.     

盐酸司来吉兰治疗早期帕金森病的疗效观察

目的 观察司来吉兰治疗早期帕金森病（PD）的疗效和安全性。方法 采用随机空白对照法,将60例已用安坦、金刚烷胺、维生素E联合治疗的早期PD患者分为司来吉兰治疗组和空白对照组,前者在原用药物剂量不变的基础上添加盐酸司来吉兰片5mg/d,疗程8周。采用改良Webster评分评价药物疗效并观察不良反应。结果 司来吉兰组治疗后4周及8周时改良Webster评分较治疗前明显改善（均P〈0．01）,且明显低于空白对照组（均P〈0．05）;司来吉兰组总有效率为76．7％,明显优于空白对照组（P〈0．01）;未见明显不良反应。结论 司来吉兰是一种安全有效的早期PD治疗用药。     

艾地苯醌结合美多芭对帕金森患者的疗效、步态及精神状态的影响

目的 探讨艾地苯醌结合美多芭对帕金森病患者的疗效、步态及精神状态的影响。方法 以2018年10月-2019年9月在本院就诊的71例PD患者为研究对象,按随机数表法分成对照组(n=35)和实验组(n=36); 对照组患者接受美多芭药物治疗,起始剂量为0.125 g/次,3次/d,口服,每6～7 d根据患者耐受情况增加1次剂量,最高≤0.75 g/d,连续治疗12周; 实验组在对照组的基础上服用艾地苯醌,剂量30 mg/次,3次/d,口服,连续治疗12周; 评价2组患者临床疗效、帕金森病综合评分量表(Unified parkinson's disease rating scale,UPDRS)评分、认知[简明智能量表(Mini-mentalstate examination,MMSE)及蒙特利尔认知量表(Montreal cognitive assessment,MoCA)]及步态的变化情况。结果 治疗12周后实验组总有效率明显高于对照组(72.2% vs 42.9%,P=0.012); 治疗12周后患者UPDRS各项评分均较治疗前降低,且实验组明显低于对照组(P<0.05); 治疗12周后MMSE及MoCA评分较治疗前明显升高(P<0.05),且实验组明显高于对照组(P=0.032,0.007)。治疗12周后患者步长较治疗前明显增大,且实验组明显高于对照组(P=0.000); 患者步频较治疗前明显降低,且实验组明显低于对照组(P=0.017); 患者步速较治疗前明显降低,且实验组明显低于对照组(P=0.009)。2组不良反应发生率无明显差异(16.7% vs 8.6%,χ²=1.050,P=0.305)。结论 艾地苯醌结合美多芭对帕金森病患者具有较好的临床疗效,可明显改善患者精神认知状态及步态情况。     

加用加巴喷丁治疗难治性癫痫的临床观察

目的观察加用加巴喷丁（ＧＢＰ）对难治性癫痫（ＩＥ）的临床效果与安全性。方法观察ＩＥ２０例，以加用ＧＢＰ前３个月的月均发作频率为基线，与治疗后１６周以上的月均发作频率进行比较，计算反应率，发作改变百分率（ＰＣＨ）和有效率，参照病人或家属病情日记。加用前和治疗中与结束前均定期进行临床和规定实验室检查。结果ＰＣＨ较加用前减少４７８％（Ｐ＜００１），有效率为１２／２０，其临床疗效单纯部分性发作（ＳＰＳ）＞全身强直阵挛性发作（ＧＴＣＳ）＞复杂部分性发作（ＣＰＳ），而对强直性发作（ＴＳ）无效。与其它传统抗痫药无明显交互作用。结论加用ＧＢＰ是治疗ＩＥ有效而安全的选择方法之一。     

氯氮平血药浓度及其有关因素分析

目的：探讨服用氯氮平平时的血药浓度及其与剂量、疗效不良反应之间的关系。方法：回顾分析了763例用氯氮平治疗的住院精神病患者的一般资料、氯氮平用药剂量及其血药浓度、诊断、临床疗效和不良反应等情况。结果：精神分裂症患者与神经症、抑郁症及反应性精神病患者之间用药剂量的差异有显著意义,老年患者的治疗剂量明显低于其他年龄组（P＜0．05）。用＞150－350mg/d的治疗剂量和／或氯氮平血药浓度200－500ng/ml时,疗效相对较好。女性的稳态血药 浓度显著高于男性患者。结论：监测氯氮平治疗血药浓度,有助于调整剂量,减少不良反应和了解药物的相互作用,可为氯氮平治疗精神疾病提供重要参考。     

精神分裂症患者氯氮平使用现况调查

目的:了解精神分裂症患者氯氮平的使用现状。方法:按一定的抽样比例,抽取10个省市46家专科医院或综合医院精神科,于2002年4月22日至24日,采用自制问卷对4779例门诊和住院精神分裂症患者进行氯氮平使用情况调查。结果:39.0%(1863/4779)的患者使用氯氮平治疗,平均剂量为(216±133)mg/d;其中41.2%的患者为联合用药,合并使用抗胆碱能药物者为19.2%。与未使用氯氮平的患者比较,使用氯氮平的患者病程较长、家庭收入较低;男性及住院患者更多使用氯氮平,氯氮平治疗者疗效指数低于非氯氮平治疗者。患者的性别、就诊部门、家庭收入和是否首次住院以及抑郁和攻击症状为是否使用氯氮平治疗的影响因素。结论:精神分裂症患者氯氮平使用率为39.0%,其中41.2%为联合用药。是否使用氯氮平治疗与患者的经济状况和临床特征等因素有关。