偏头痛患者失能因素分析

目的探讨影响偏头痛患者失能相关因素,为优化偏头痛患者管理提供帮助。方法选择本院门诊178例偏头痛患者,完成偏头痛残疾程度评估量表(MIDAS)和头痛影响测验调查问卷(HIT-6),并记录患者年龄、性别、频率(每月头痛发作次数)、头痛程度评分、初发头痛持续时间、体质量指数(BMI)、广泛性焦虑量表(GAD-7)评分、患者健康问卷抑郁量表(PHQ-9)评分、阿森斯失眠量表(AIS)评分及是否药物滥用、是否先兆性头痛。按MIDAS和HIT-6量表将偏头痛患者分为失能和无失能2组,比较2组年龄、性别、频率(每月头痛发作次数)、头痛程度、初发头痛持续时间、BMI、GAD-7、PHQ-9、是否药物滥用、是否先兆性头痛、是否睡眠障碍。再以与是否失能有统计意义的因素为自变量,是否失能为因变量,进行多元线性回归分析。结果单因素分析显示,是否药物滥用、疼痛程度评分、BMI、频率、PHQ-9评分、GAD-7评分、AIS评分与失能有关(P0.05)。多因素分析显示,抑郁、焦虑评分、AIS评分未进入回归方程(P0.05),是否药物滥用、疼痛程度评分、BMI、频率与失能独立相关(P0.05)。结论偏头痛患者滥用止痛药,发作时头痛程度,发作频率,体质量指数,焦虑影响患者失能。     

偏头痛与焦虑/抑郁的相关性

目的探讨偏头痛与焦虑、抑郁的相关性,旨在重视偏头痛伴发症,为优化偏头痛管理提供参考。方法选择攀枝花市中心医院神经科门诊138例偏头痛患者为研究对象,同期选择本院体检中心年龄、性别与患者组相匹配的70名健康志愿者为对照组,采用偏头痛特异性生活质量问卷(MSQ2.1)、广泛性焦虑量表(GAD-7)、患者健康问卷抑郁量表(PHQ-9)进行评定。结果偏头痛患者焦虑、抑郁检出率分别为59.42%、38.41%,对照组焦虑、抑郁检出率分别为32.86%、8.57%,偏头痛患者焦虑、抑郁检出率均高于对照组(P均0.05)。偏头痛患者GAD-7、PHQ-9评分与MSQ2.1评分呈正相关(r=0.397~0.489,P0.05)。结论偏头痛患者是焦虑、抑郁的高危人群,偏头痛患者生活质量与焦虑、抑郁相关。     

以Logistic回归模型构建病人健康问卷与广泛性焦虑量表联合预测因子对妊娠晚期围产期抑郁障碍预测的临床运用

目的:探索妊娠晚期病人健康问卷(PHQ-9)联合广泛性焦虑量表(GAD-7)评分对围产期抑郁障碍(PND)的预测效果，为早期识别提供依据。方法:选取2020年2月至2020年6月于中国福利会国际和平妇幼保健院、静安区妇幼保健所就诊孕妇873名，采用线上问卷调查形式，收集人口学资料、PHQ-9和GAD-7量表评分，并通过Logistic回归模型，构建基于PHQ-9与GAD-7评分的联合预测因子。结果:(1)围产期抑郁障碍组相较非围产期抑郁障碍组，在年龄、性格、孕期并发症、两系三代抑郁史因素中差异有统计学意义(P<0.05)。(2)PHQ-9与GAD-7联合预测因子预测妊娠晚期PND的AUC值高于PHQ-9和GAD-7量表单独预测(0.942 vs 0.929和0.912)。结论:使用Logistic回归模型构建的PHQ-9与GAD-7评分的联合预测因子可以提高妊娠晚期对PND预测的准确性。     

新型冠状病毒肺炎疫情期间居校隔离的高三学生抑郁焦虑情绪与社会支持的相关性

目的 了解新型冠状病毒肺炎疫情期间居校隔离的高三学生焦虑抑郁情绪和社会支持水平,为对其进行有针对性的心理干预提供参考。方法 采用随机抽样方法,选取山东省滨州市三所重点高中的高三学生为研究对象,共724人。采用广泛性焦虑障碍量表（GAD-7）、患者健康问卷抑郁量表（PHQ-9）和领悟社会支持量表（PSSS）评定其焦虑抑郁症状和社会支持水平。采用偏相关分析考察PSSS评分与GAD-7和PHQ-9评分的相关性,采用多元线性回归分析探讨PSSS和PHQ-9评分的关系。结果 检出存在焦虑症状者341人（48.64%）,检出存在抑郁症状者383人（54.64%）。女生PSSS总评分、家庭支持和其他支持维度评分均高于男生,差异均有统计学意义（t=-3.431、-3.048、-4.482,P均<0.01）。不同学科组合的高三学生GAD-7、PSSS总评分以及家庭支持和其他支持维度评分差异均有统计学意义（F=1.992、2.660、2.074、3.138,P<0.05或0.01）。PHQ-9评分与PSSS总评分及各维度评分均呈负相关（r=-0.329、-0.283、-0.284、-0.284...     

高职大专学生睡眠状况及影响因素

背景 睡眠障碍对人群身心健康及社会经济发展均会产生不良影响,高职大专学生承受着学习、就业和家庭经济状况等方面的压力,其睡眠质量可能会受到一定程度的影响。目的 探讨高职大专学生睡眠状况及影响因素,为改善高职大专学生睡眠状况提供参考。方法 于2022年1月-2月,采用分层随机抽样,选取成都市温江区5所高职大专院校的3 300名学生为研究对象。使用失眠严重程度指数量表（ISI）、患者健康问卷抑郁量表（PHQ-9）、广泛性焦虑障碍量表（GAD-7）进行评定。采用Pearson相关分析考查ISI评分与PHQ-9评分和GAD-7评分之间的相关性;采用Logistic回归分析考查失眠症状的影响因素。结果 检出2 497名（81.90%）高职大专学生存在失眠症状。不同性别、家庭经济状况、是否独生子女、学习或就业带来的心理压力、平均每天上网时长、体育锻炼以及是否有焦虑症状或抑郁症状的高职大专学生失眠症状检出率差异均有统计学意义（χ²=21.032、22.172、8.983、75.939、36.781、32.350、54.512、86.561,P<0.01或0.05）。高职大专学生ISI评分与GAD-7评分和PHQ-9评分均呈正相关（r=0.620、0.714,P均<0.01）,GAD-7评分与PHQ-9评分呈正相关（r=0.824,P<0.01）。性别、家庭经济状况、学习或就业带来的心理压力、平均每天上网时长、体育锻炼是否达标以及是否有抑郁症状可预测高职大专学生的失眠症状（P<0.01或0.05）。结论 女性、家庭经济状况一般和很差、学习或就业带来的心理压力中等或较大以及平均每天上网时长2~5 h、5~7 h、>7 h及体育锻炼未达标、存在抑郁症状是高职大专学生出现失眠症状的危险因素。     

微课在新冠肺炎疫情期间内科住院患者心理健康教育中的应用

目的 探讨新冠肺炎疫情期间微课在内科住院患者心理健康教育中的应用效果。方法 选择2020年1月26日-2月10日在绵阳市第三人民医院内科病区住院治疗的患者为研究对象，通过微信公众号和微信群，制作并向患者推送微课视频以实施心理健康教育。在实施前和实施两周后采用广泛性焦虑量表（GAD-7）和患者健康问卷抑郁量表（PHQ-9）评定患者的焦虑和抑郁状态。结果 微课实施前，患者GAD-7和PHQ-9评分分别为（13.03±4.32）分、（14.07±3.13）分；实施后，患者GAD-7和PHQ-9评分分别为（8.58±2.84）分、（12.11±3.27）分。微课实施前后，中度及以上的焦虑和抑郁检出率比较差异均有统计学意义（P均<0.01）。结论 新冠肺炎疫情期间运用微课实施心理健康教育可能有助于缓解内科住院患者的焦虑抑郁情绪。     

经颅直流电刺激联合认知行为治疗对产后抑郁症的作用

目的:探索经颅直流电刺激(tDCS)联合认知行为治疗(CBT)对轻中度产后抑郁症(PPD)的作用。方法:采用随机数字表法将62例PPD患者随机分为对照组(CBT+伪tDCS)和观察组(CBT+tDCS),疗程4周。治疗前、治疗后第2、4周时采用9条目患者健康问卷(PHQ-9)、7条目焦虑问卷(GAD-7)评估患者的抑郁、焦虑情况;采用匹兹堡睡眠质量指数(PSQI)评估患者睡眠状况。结果:治疗前两组PHQ-9、GAD-7及PSQI评分比较差异无统计学意义;治疗后两组PHQ-9、GAD-7及PSQI评分明显降低(P0.05或P0.01);且观察组各项评分明显低于对照组(P均0.05)。结论:CBT能够改善轻中度PPD患者抑郁焦虑情绪及睡眠质量;tDCS联合CBT作用更佳。     

偏头痛慢性转化的临床危险因素分析

目的 比较慢性偏头痛（CM）与发作性偏头痛（EM）的病史特征、临床特点等,探究偏头痛慢性转化的危险因素,为其防治提供依据和策略。方法 共纳入在中南大学湘雅医院神经内科就诊的CM患者72例及EM患者109例进行回顾性分析。采集患者基本信息,先进行单因素分析,筛选有统计学意义的指标进行相关分析和非条件性多因素logistic回归分析。结果 单因素分析发现两组的BMI（P=0.000）、病程（P=0.000）、基线头痛发作频率（P=0.000）、基线头痛持续时间（P=0.037）、匹兹堡睡眠质量指数量表（PSQI,P=0.000）、焦虑自评量表（SAS,P=0.000）及抑郁自评量表（SDS,P=0.001）差异有统计学意义。logistic回归分析显示BMI（OR=1.468,95%CI：1.148~1.876）、病程（OR=1.102,95%CI：1.022~1.188）、基线头痛发作频率（OR=1.461,95%CI：1.247~1.711）、睡眠质量（OR=1.494,95%CI：1.198~1.864）、焦虑状态（OR=1.201,95%CI：1.048~1.376）是偏头痛慢性转化的危险因素。结论 控制体重、减少头痛发作频率、缩短病程、改善心境状态与睡眠质量,有可能延缓偏头痛的慢性进展。     

晚发型偏头痛与青年（早发型）偏头痛临床特点比较

目的：比较晚发型偏头痛和早发型偏头痛临床特点。方法按患者年龄是否≥45岁,将90例偏头痛患者分为晚发型偏头痛组（≥45岁,晚发组）和早发型偏头痛组（＜45岁,早发组）,通过病历资料回顾,从诱发因素、临床分型、头痛性质及部位、头痛程度和持续时间、头痛发作频率和伴随症状等方面比较2组临床特点。结果2组在诱发因素、临床分型、头痛性质（部位）、头痛程度和持续时间、头痛发作频率、伴随症状等临床特点方面差异有统计学意义（ P＜0.05）。结论晚发型偏头痛和早发型偏头痛具有不同的临床特点。在临床治疗方面,要根据不同的临床特点予以针对治疗。     

应用SF-36中文版对偏头痛患者生存质量的调查

目的探讨偏头痛患者生存质量的现状,分析其影响因素。方法采用健康状况量表SF-36中文版对122例偏头痛患者和112例健康者对照并进行现场问卷调查。用两样本t检验比较两组生存质量评分,以多元逐步回归分析筛选偏头痛组生存质量的影响因素。结果偏头痛组在生理功能、生理职能、躯体疼痛、总体健康、精力、社会功能、情感职能、精神健康等8个维度的评分上均显著低于对照组（P〈0.01）;偏头痛患者生理综合评分的影响因素有头痛频率、头痛程度、学历,心理综合评分的影响因素有头痛程度、头痛频率、病程、学历。结论偏头痛患者生存质量偏低,通过控制其影响因素,如头痛频率、程度等可能有助于改善患者的生存质量。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

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     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -