芦山地震后5年雅安城市老人的认知功能及相关因素

目的:了解芦山地震5年后雅安城市老年人的认知功能现状及相关因素,为灾难性事件后老年人群心理健康及认知功能干预提供参考。方法:采取多阶段分层整群随机抽样方法,于2019年3月,选取雅安市区≥60岁老年人885名例,使用老年人一般信息调查表收集一般人口学信息、健康相关信息、受灾情况分布,采用MoCA量表(北京版)评估认知功能。结果:芦山地震后5年雅安城市老年人认知功能障碍患病率为14.9%,其中轻度为9.1%,中、重各为2.9%;不同受灾程度地区老年人的认知功能障碍患病率,差异无统计学意义。Logistics回归分析显示,年龄70~<80岁和≥80岁组的老年人更易出现认知功能障碍[OR=2.98(95%CI:1.72~5.15),OR=6.08(95%CI:3.51~10.55),均P<0.001],大专及以上受教育程度的老人不易出现认知功能障碍[OR=0.15(95%CI:0.05~0.44),P<0.001]。结论:高龄为芦山地震后5年雅安城市老人认知功能障碍的危险因素,受教育程度高为保护因素。     

脑损伤急性应激障碍患者轻度认知障碍的影响因素

目的:探讨脑损伤急性应激障碍患者轻度认知障碍的危险因素。方法:对2017年4-10月华北理工大学附属医院住院的脑损伤患者急性应激障碍认知正常患者316例和脑损伤患者急性应激障碍轻度认知障碍患者158例,采用斯坦福急性应激反应问劵(SASRQ)、简易精神状态检查量表(MMSE)和一般人口学资料对患者进行评测。结果:474例脑损伤急性应激障碍患者MMSE得分为(20.76±5.734),多因素Logistic回归分析显示,男性(OR=0.254,95%CI为0.140～0.461),外向(OR=0.219,95%CI为0.117～0.407),月收入大于5000元(OR=0.545,95%CI为0.304～0.974),脑体力相结合(OR=0.063,95%CI为0.006～0.637),无高血压(OR=0.417,95%CI为0.243～0.714),无噩梦(OR=0.355,95%CI为0.202～0.624),不易怒(OR=0.141,95%CI为0.076～0.260)是脑损伤患者发生MCI的保护因素(P0.05);小学及以下文化(OR=5.146,95%CI为2.494～10.619),偏瘫(OR=2.035,95%CI为1.202～3.444)是脑损伤急性应激障碍发生MCI的危险因素(P0.05)。结论:脑损伤急性应激障碍患者存在明显的轻度认知障碍,低文化水平、偏瘫、高血压、噩梦、易怒是脑损伤急性应激障碍患者发生MCI的危险因素。     

双相Ⅰ型障碍和双相Ⅱ型患者人口学和临床特征的比较

目的:比较双相Ⅰ型障碍和双相Ⅱ型障碍患者的人口学特征、临床特征、治疗特征和生理指标。方法:选取符合美国精神障碍诊断与统计手册第5版(DSM-5)双相障碍的患者381例,其中Ⅰ型302例(79.27%),Ⅱ型74例(19.42%),其他特定及相关障碍5例(1.31%)。用自编临床资料访谈表收集人口学资料及临床特征数据。采用多因素logistic回归和多重线性回归分析方法进行因素分析。结果:与双相II型障碍相比,双相I型障碍患者更容易伴有精神病性特征(OR=5.75,95%CI:2.82～11.76),病程更长,接受重复经颅磁刺激治疗较多(OR=3.09,95%CI:1.02～9.35),尿酸、总胆固醇、高密度脂蛋白浓度更高,汉族更常见(OR=11.50,95%CI:1.76～75.30)、受教育程度更低(OR=10.22,95%CI:1.16～89.77),更少有精神病家族史(OR=2.34,95%CI:1.01～5.42)。结论:双相Ⅰ型障碍和双相Ⅱ型障碍的人口学特征、临床特征、治疗情况和生理指标有差异,可为探讨双相障碍的发病机制提供线索。     

北京月坛社区老年高血压患者抑郁情绪调查及危险因素分析

目的 探讨北京月坛社区老年高血压患者抑郁的流行病学特征及危险因素，为健康老化制定个体化干预方案提供依据。方法 2019年6月至2019年10月，采用整体抽样方法，在北京市西城区月坛社区选取60岁及以上老年高血压患者613例，采用患者健康问卷(PHQ-9)抑郁量表行抑郁情绪判定。同时搜集受试者一般人口学信息及慢性病史等健康情况。分别采用单因素及二元Logistic回归模型分析不同性别老年高血压患者抑郁情绪的影响因素及独立危险因素。结果 老年高血压患者抑郁情绪总体阳性检出率为11.58%,9.81%的男性患者存在抑郁状态，12.53%的女性患者存在抑郁状态。男性中患有冠心病、存在睡眠障碍者的抑郁情绪发病比例更高，女性中存在经济压力、患有听力障碍、视力障碍、慢性胃炎、慢性肝胆疾病及存在睡眠障碍者存在抑郁情绪的比例更高(P<0.05)。存在睡眠障碍的男性患者发生抑郁情绪的风险更高，OR值为4.825(95%CI:1.777～13.105);存在经济压力、患有听觉障碍、视力障碍、慢性胃炎及存在睡眠障碍的女性患者发生抑郁情绪的风险更高，OR值分别为：14.362 (95%CI:2.224～9...     

天津市18岁及以上人群自杀未遂流行病学调查

目的:了解天津市18岁及以上人群终生自杀未遂的发生率及特征,并探讨相关的危险因素。方法:采用2011年在天津市进行的精神障碍流行病调查样本,以18岁及以上且过去半年内在本地居住时间≥3个月的人作为调查对象。使用一般健康问卷(GHQ-12)对被试进行筛查,并根据得分进行精神障碍危险等级划分,进行DSM-IV-TR轴I障碍定式临床检查及终生自杀未遂行为的评估,完成分布特征、危险因素等分析,最终共有4438人完成本次调查。结果:76人报告有终生自杀未遂行为,调整后发生率为0. 75%(95%CI:0. 49%～1. 00%)。自杀的方法主要是服用治疗药(31. 9%)和使用工具(24. 3%),自杀未遂者中精神障碍的患病率为68. 7%,其中以情感性精神障碍为主(49. 5%)。多因素logistic回归分析显示存在精神障碍的诊断(OR=5. 38,95%CI=2. 44～11. 83)、主观睡眠质量差(OR=3. 79,95%CI=1. 72～8. 35)、有宗教信仰(OR=4. 51,95%CI=1. 95～10. 45)、主观家庭经济状况差(OR=2. 79,95%CI=1. 35～5. 75)是自杀未遂的危险因素。结论:社区人群中自杀未遂行为较高,多种因素与自杀未遂行为相关。     

大学生抑郁症复发相关的人格特质

目的:探索影响大学生抑郁症复发的人格特质。方法:于2018年4-10月开展基线调查,对8079名大学新生使用复合性国际诊断访谈表(CIDI 3.0)进行调查,采用贝克抑郁量表评估抑郁严重程度、人格特质问卷诊断人格特质、神经质问卷测量神经质得分、人际关系综合诊断量表诊断人际关系行为困扰、功能失调性态度量表评价认知障碍,并在2019年4-10月及2020年4-10月完成两次随访调查。结果:大学新生抑郁症1年随访复发率为9.16%(95%CI:6.38%～12.02%),2年随访复发率为18.59%(95%CI:13.94%～23.26%)。边缘型人格特质(OR=4.60,95%CI:2.28～9.28)是大学生抑郁症复发的独立危险因素,其中男性(OR=6.40,95%CI:1.98～20.71),女性(OR=3.77,95%CI:1.56～9.10)。边缘型人格特质与抑郁症复发之间存在剂量-反应关系,有5～8个边缘型人格特征的大学生比0个特征的大学生抑郁症复发的风险高(OR=3.58,95%CI:1.12～11.43)。结论:具有边缘型人格特质的大学生抑郁症患者更易复发。     

昆明市15岁及以上居民自杀相关问题现况调查

目的:了解昆明市居民自杀问题的检出率及其相关因素。方法:按照分层容量比例概率随机抽样法,以昆明市≥15岁5033人为调查对象。在复合性国际诊断交谈检查2.1版(Composite InternationalDiagnostic Interview-version2.1,CIDI-2.1)回答后进行自杀相关问题调查,并分析人口学相关危险因素。结果:调查5033人中有自杀意念者占5.89%(95%CI,5.24%～6.54%),计划自杀1.71%(95%CI,1.35%～2.06%),曾有过自杀行为者0.76%(95%CI,0.52%～1.00%)。女性自杀意念、自杀计划及行为的发生率均高于男性(7.50%vs.4.15%,2.65%vs.0.84%,1.32%vs.0.24%;均P0.001)。城镇居民更易出现自杀意念(6.27%vs.3.42%;P0.001);离婚、分居、丧偶、受教育程度低者更易出现自杀计划(P0.05)。各年龄段、汉族和少数民族自杀问题检出率差异无统计学意义。患有焦虑障碍、物质使用障碍、情感障碍、躯体形式障碍者多易出现自杀相关行为。结论:昆明市居民中自杀问题突出,患有几类精神障碍是发生自杀问题的危险因素,应针对自杀行为进行有效干预。     

医学院校大学生心理症状两年随访研究

目的:了解医学院校大学生2年新出现心理症状的检出率及影响因素。方法:选取某医科院校大一全体新生2910人,用大学生人格问卷(UPI)对其中心理症状阴性的大学生(n=2376)进行大三后测,采用自编人口学问卷、抑郁自评量表(SDS)、自杀行为问卷(SBQ-R)、家庭功能量表(APGAR)、心理复原力量表(ERS)、痛苦表露指数(DDI)评估心理症状的相关因素。结果:大三心理症状阳性率为15.3%。Logistic回归结果显示,女性(OR=1.60,95%CI:1.22～2.10)、精神疾病家族史(OR=1.83,95%CI:1.11～3.02)、熟人自杀史(OR=1.52,95%CI:1.01～2.28)心理咨询史(OR=2.63,95%CI:1.50～4.62)及SBQ-R得分越高(OR=1.15,95%CI:1.05～1.25)是医学院校大学生心理症状阴性转阳性的危险因素,而DDI得分越高是其保护因素(OR=0.98,95%CI:0.96～0.99)。结论:医学院校大学生入学2年后超过15%的人新出现心理症状,对有精神疾病家族史、熟人自杀史、心理咨询史、高自杀风险及低自我表露程度的学生(尤其是女生)予以重点关注。     

内蒙古自治区失眠患病率汉蒙民族差异的现况调查

目的:探索内蒙古自治区成人失眠的患病率及危险因素，并比较汉族和蒙古族的民族差异。方法:采用分层多阶段不等概率抽样，于2019年7月-12月抽取内蒙古自治区41个区县旗246个村居的14 164名在当地居住6个月及以上的18岁及以上居民，采用复合性国际诊断交谈表-3.0版、国际疾病分类第10版中F51.0非器质性失眠症的诊断标准完成。采用Pearson χ~2检验比较汉族和蒙古族的患病率和一般人口学特征，采用logistic回归分析失眠可能的危险因素。结果:共12 315人完成调查，其中汉族9849人和蒙古族2089人，失眠患病率分别为5.0%和4.6%,差异无统计学意义(P>0.05)。55～64岁(OR=1.75,95%CI:1.14～2.67)、酒精使用障碍(OR=2.73,95%CI:1.27～5.88)、抑郁症(OR=3.77,95%CI:2.36～6.04)、焦虑障碍(OR=2.70,95%CI:1.75～4.19)、慢性疼痛(OR=3.07,95%CI:2.07～4.54)、心脏病(OR=1.84,95%CI:1.43～2.36)、糖尿病或高血糖(OR=1.92,95...     

青海省18岁及以上人群精神障碍流行病学调查

目的:了解青海省成年人群精神障碍的患病率及分布特点。方法:采用多阶段分层整群抽样方法抽取青海省≥18岁人群12001人,用扩展的一般健康问卷(GHQ-12)筛查,将调查对象分为精神障碍高、中、低危险组,然后用美国精神障碍诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的三组人群进行诊断检查。将计算出的患病率调整并推广至青海省370万成年人口。结果:11178人完成了调查。调整后精神障碍总的现患率(最近1个月)为18.04%,95%可信区间(95%CI)为15.99%～20.28%;患病率前三位的分别是酒精使用障碍(12.24%)、广泛性焦虑障碍(1.40%)和心境恶劣障碍(1.13%)。男性精神障碍总的现患率及酒精使用障碍的现患率均明显高于女性[(27.92%vs.7.47%,23.39%vs.0.30%;OR(95%CI)=4.80(3.81～6.05),OR(95%CI)=100.22(35.07～286.38)];农村与城市居民精神障碍总的患病率差异无统计学意义(18.33%vs.17.08%,OR=1.09,95%CI:0.76～1.56)。在有精神障碍的人群中,功能损害程度为中等到严重者占15.48%,但仅2.59%有精神障碍者曾经因心理问题在医疗机构就诊,仅0.94%曾在精神科就诊。结论:青海省酒精使用障碍是特别需要关注的公共卫生问题。     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Intestinal helminthiasis in school children in Haiti in 2002

A survey on intestinal helminths in school children was conducted in Haiti in 2002. This first nationwide study involving the entire country was stratified by department according to urban and rural zones using the cluster method. Focusing on elementary school children (n=5792; age range 3 to 20 years), it involved 26 urban and 49 rural schools randomly selected. Stools were preserved in formalin and examined by the Ritchie technique. Thirty-four per cent of stools (1981/5792) tested positive for intestinal helminths with the following parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis (0.2%). The helminth prevalence was higher in rural (38.4%) compared to urban areas (30%). There was no significant difference in prevalence by sex and age. The importance of geohelminths changed from one department to another with the highest prevalence found in the Southern department of Grande Anse (73.7%) and the lowest prevalence in the Center department (20.6%). Five out of the country's nine departments had a similar prevalence varying from 25.5% to 28.2%. Intestinal helminthic polyparasitism was observed in a percentage of infested school children comprise between 3.4% and 28.6% according in relation to the geographical area. A program to fight against geohelminths in school children should be initiated as a public health priority. Albendazole is the drug of choice. Frequency of drug distribution should be based on the prevalence of geohelminths in each department.     

Experience in adult population in dengue outbreak in Delhi

A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.     

Changes in the hypothalamic nuclei in in experimental allergy

Summary In rabbits subjected to prolonged sensitization and in which the Arthus phenomenon was induced there was a marked reaction of the hypothalamic nuclei. Staining by Gomori's method indicated a cellular swelling, loss of granules, and protoplasmic vacuolization in the supraoptic nucleus. There was a considerable increase in the size of the cross-sectional area of the cells. The same effects were much less well shown in the paraventricular nucleus. These results show that marked signs of increased neurosecretion developed in the animals at the height of the Arthus phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten Éksperimental'noi biologii i Meditsiny, Vol. 55, No. 4, pp. 110–113, April, 1963.     

Cerebellar noradrenergic systems in aging: studies in situ and in in oculo grafts

Age-related changes in noradrenergic function in the rat cerebellum were examined using electrophysiological and electrochemical techniques. Sprague-Dawley and Fischer 344 rats showed subsensitivity to norepinephrine (NE) locally applied onto cerebellar Purkinje neurons. The modulatory actions of NE on Purkinje cell-evoked activity was also examined. In young rats NE preferentially inhibits spontaneous activity more than evoked excitations when compared to control. These modulatory actions of NE are not seen in senescent Fischer 344 rats. The intrinsic vs. extrinsic influences determining the loss of efficacy to NE were examined using three groups of rats with in oculo cerebellar grafts. The first group had young grafts grown in young hosts and these grafts showed a potent response to perfused NE. The second group, old grafts in old hosts, showed a diminished responsiveness to NE with respect to the first group. The third group consisted of young grafts in old hosts. These grafts demonstrated a responsiveness to NE that was indistinguishable from those in the first group. The integrity of the presynaptic NE fibers was examined in the grafts using electrochemical techniques. No difference in the release of NE was observed in the old grafts. Taken together, these results suggest a loss of postsynaptic NE function that is intrinsically determined. The change in NE modulation could influence information processing within the aged cerebellar cortex. This deficit could underlie behavioral changes seen in senescence.