河南焦作市武陟县农村人群癫痫流行病学调查

目的：调查了解我国农村地区癫痫的患病率及治疗缺口，为开展防治工作提供依据。方法：河南省焦作市武陟县作为调查点，采用随机整群抽样方法确定调查人群，由经过统一培训的医生入户调查。调查人数为12457人。凡初筛调查时确诊或可疑的癫痫患者，均经神经科医生再次访查确诊。结果：调查确诊59例癫痫患者，患病率为4．7‰。活动性癫痫患病率为3．5‰，年发病率32．1／10万人口。全部患者中有25．4％未治疗，47．5％患者治疗不正规。活动性癫痫的治疗缺口为32．5％。结论：本次调查农村地区癫痫患病率与以往报道接近，约有2／3患者没有得到正确治疗，应尽快制订合理的干预对策。     

上海农村地区癫痫流行病学抽样调查

目的了解上海农村地区癫癎患病率和治疗缺口,为开展癫癎治疗和管理工作提供依据.方法以二阶段整群抽样法抽取金山区吕巷镇的5个村作为调查点,实际调查10 777人.癫癎病例经初筛及神经科医生复查后确诊.结果确诊癫癎为65例,终生患病率6.03‰(95%CI5.58‰～6.48‰).活动性癫癎为41例,患病率为3.80‰(95%CI2.64‰～4.96‰).活动性癫癎的治疗缺口为70.73%(95%CI56.80%～84.66%).癫癎患者平均年龄为(44.66±18.73)岁,首次发病的平均年龄为(26.28±18.71)岁,首发年龄在30岁之前的患者占61.54%.癫癎的发作类型以全身强直-阵挛性发作为主,占58.46%.结论农村地区癫癎患病率高于以往的调查结果,应重视对农村儿童和青年期癫癎的治疗和管理.     

西藏农村地区惊厥性癫(癎)患病率初步调查

目的 初步调查西藏农村地区惊厥性癫(癎)患病率、治疗缺口及患者生活质量.方法 利用统一的调查表,对西藏拉萨市墨竹工卡县工卡镇和扎西岗乡、昌都地区芒康县曲孜卡乡进行整群逐户问卷调查.结果 共调查14 822人,确诊惊厥性癫(癎)患者37例,患病率0.25%,其中活动性癫(癎)患者35例(94.59%),患病率为0.24%.调查前1周内接受西药正规治疗者1例,治疗缺口为97.1%.癫(癎)患者生活质量评定量表-31(QOLIE-31)总评分平均为(42.15±17.63)分,其中各分项得分中发作担忧得分最低[(22.59±20.31)分]、药物影响的评分最高[(85.83±18.59)分].年龄、职业、文化程度、经济状况、起病年龄、发作次数为QOLIE-31低评分的影响因素(P＜0.05).结论 西藏农村地区惊厥性癫(癎)患病率为0.25%,西药治疗缺口大,主要以藏医藏药治疗为主,对西药治疗癫(癎)的了解很少,生活质量评分低.探索藏西医结合防治癫(癎)、提高当地医护人员的癫(癎)防治知识及公众的健康意识迫在眉睫.     

广西农村部分地区癫(癎)及丙戊酸钠疗效的初步调查

目的 了解广西农村部分地区癫(癎)的发病情况、治疗缺口以及丙戊酸钠的疗效.方法 利用统一的调查表对广西田东、田阳、平果、天等县已确定或怀疑癫(癎)的患者进行调查,再经神经科医生复查后确诊,并对适合使用丙戊酸钠的病例进行疗效观察.结果 共诊断癫(癎)患者303例,未经治疗46.2%,西药治疗45.5%,仅中药、偏方治疗6.3%,治疗不详2.0%,其中活动性癫(癎)人数295例,治疗缺口达81.0%.295例患者进入丙戊酸钠治疗的随访研究,显效率为58.6%,总有效率为75.2%.结论 广西农村地区癫(癎)的治疗缺口较全国其他农村地区高,经丙戊酸钠治疗后,约75%患者发作可得到有效控制,但是不正规治疗可影响患者的预后,故应重视癫(癎)患者的正规治疗.     

山东省癫癎流行病学调查研究

目的 了解中国山东省的癫癎）病流行现况及其危险因素.方法 以调查问卷为基础,运用国际统一癫癎诊断标准,采用多级分层随机整群抽样方法,逐户进行调查.结果 调查人数251 492名,癫癎患者335例,癫（痫）患病率为1.33‰;男性患病率为1.35‰o,女性患病率为1.31‰;城市患病率为1.20‰,农村患病率为1.39‰,均差异无统计学意义.癫癎发病率为18.69/10万.发作类型以全面性发作为主为60.90％;部分性发作为34.33％;发作不能分类为4.78％.首次发病平均年龄为（15.37±15.77）岁.特发性癫癎为60.90％,症状性癫（痫）为39.10％.大部分患者未进行正规治疗,治疗缺口为54.33％.结论 山东省癫癎患病率、发病率处于全国较低水平,治疗缺口与国内文献报道一致.癫癎发作类型以全面性发作为主;癫癎发病以特发性癫（痫）为主,症状性癫癎病因中以脑炎为主.     

我国癫(癎)的诊断与治疗现状

20世纪90年代以来我国的癫(癎)研究有了较大的进展.流行病学调查结果显示,我国癫(癎)的患病率为0.70%,活动性癫(癎)患病率为0.46%,治疗缺口为6.48%.这些数字对规划癫(癎)研究的发展方向具有重要意义.如果按照0.70%估算,我国约有癫(癎)患者900万,其中约500万未曾接受治疗或未经过正规的治疗,这使医疗行政部门及医疗保障面临巨大的压力和挑战.     

河南焦作市武陟县农村人群癫痫流行病学调查

目的 :调查了解我国农村地区癫痫的患病率及治疗缺口 ,为开展防治工作提供依据。方法 :河南省焦作市武陟县作为调查点 ,采用随机整群抽样方法确定调查人群 ,由经过统一培训的医生入户调查。调查人数为 12 45 7人。凡初筛调查时确诊或可疑的癫痫患者 ,均经神经科医生再次访查确诊。结果 :调查确诊 5 9例癫痫患者 ,患病率为 4 7‰。活动性癫痫患病率为 3 5‰ ,年发病率32 1/ 10万人口。全部患者中有 2 5 4%未治疗 ,47 5 %患者治疗不正规。活动性癫痫的治疗缺口为 32 5 %。结论 :本次调查农村地区癫痫患病率与以往报道接近 ,约有 2 / 3患者没有得到正确治疗 ,应尽快制订合理的干预对策     

扬州市头桥农村地区的癫癎流行病学调查

目的了解扬州市头桥农村地区的癫癎流行病学特征及状况.方法采用随机整群抽样方法,对扬州市头桥农村地区8个自然村人群进行入户见面表格癫癎普查.结果实际被调查的11 118人中,共查出各类型癫癎患者87例,患病率为7.83‰,年发病率为53.4/10万.76例(85.05%)未发现明确病因,仅3例(3.45%)有家族史.首次发病年龄<20岁者33例(37.93%);≥20岁者54例(62.07%);平均病程17.51年;发作类型以全面强直阵挛性发作为主(78.16%),年发作次数在10～29次;87例患者中从未进行抗癫癎治疗50例(57.47%).结论该地区癫癎患病率、发病率均高于国内其他农村地区;发作类型仍以全面强直阵挛性发作为主.癫癎治疗管理水平较低.     

WHO/IEM/ILAE全球抗癫痫运动-宁夏农村癫痫的流行病学调查

目的：调查宁夏农村癫痫病人的患病率、发病率和治疗缺口。方法：利用统一的调查表，采用随机整群抽样的方法．对宁夏吴忠市利通区杨马湖乡逐家逐户进行癫痫流行病学问卷调查。结果：共调查11630人，确诊癫痫病人99人，癫痫病患病率8．51‰，发病率25．8／100000人。从未接受治疗的病人数45人，占45．5％，不正规治疗的病人数22人，占22．2％，正规治疗的病人数32人，占32．3％，1周内接受过西药治疗的人数19人，占19.2％。结论：宁夏农村地区癫痫病患病率较高，治疗缺口较大。     

我国癫(癎)的诊断与治疗现状

20世纪90年代以来我国的癫痫研究有了较大的进展。流行病学调查结果显示，我国癫痫的患病率为0．70％，活动性癫痫患病率为0．46％，治疗缺口为6．48％。这些数字对规划癫痫研究的发展方向具有重要意义。如果按照0．70％估算，我国约有癫痫患者900万，其中约500万未曾接受治疗或未经过正规的治疗，这使医疗行政部门及医疗保障面临巨大的压力和挑战。     

Neuroimaging in epilepsy in tropics

Epilepsy is a major public health problem in many tropical countries. Also, some of the tropical diseases are major contributors to the higher prevalence of epilepsy in these countries. The etiologic factors responsible for epilepsy in these countries are quite different from those in the developed world. This article discusses the etiologic factors and neuroimaging of epilepsy in light of the conditions in these tropical countries.     

癫痫与抑郁关系的研究进展

抑郁是癫痫患者中常见的精神障碍,严重地影响了患者的生活质量。传统的观点认为癫痫患者因为存在着诸多社会学问题易出现抑郁倾向,癫痫和抑郁是单向的联系,但大量的研究已经证明癫痫和抑郁之间存在双向的联系,一种异常状态的存在可能易转化为另一种异常状态的发展。癫痫和抑郁存在着共同的发病机制。本文主要就癫痫和抑郁的双向联系以及抗抑郁药物在癫痫患者中的应用进行阐述。     

Sudanophilic lipid accumulation in astrocytes in periventricular leukomalacia in monkeys

Summary Sudanophilic lipid accumulation is a characteristic feature of periventricular leukomalacia (PVL) of infants. At least two types of lipid-containing cells have been identified, one being the macrophage, the other the pre-myelin glial cell. A third type of lipid-containing cell has been seen in two monkeys with spontaneous PVL. Electron microscopically this cell appears to be an astrocyte. This probably represents a reaction of the astrocyte to hypoxia and may be the equivalent of the hypertrophic astrocytes found in human infants.Supported in part by NIH grant HDO 8633 and the Regional Primate Research Center Grant RR-00166     

Increase in cathepsin D activity in rat brain in aging

Cathepsin D-like activity in homogenates of five brain areas of 3-month-old and 24-month-old Fischer 344 rats was measured. With hemoglobin as substrate at pH 3.2, more than 90% of the activity was inhibited by pepstatin. In each area studied, activity was more than twice as high in the old rat brain: 140-160% higher in the cortex, cerebellum, pons-medulla, and striatum and 90-100% higher in the hippocampus and spinal cord. The greatly increased metabolic capacity in the absence of an increase in protein turnover may have a role in age-related pathological degeneration in the brain.     

Increase in noradrenaline-synthesizing enzyme activity in medulla oblongata in Parkinson's disease

Summary Dopamine beta hydroxylase (DBH), the noradrenaline-synthesizing enzyme, and phenylethanolamine-N-methyltransferase (PNMT), the adrenaline-synthesizing enzyme, were assayed in 18 areas of brain stem in eight cases of parkinsonian syndromes and of four age- and postmortem delay-matched controls. Dissection was performed by the punch technique and enzyme activities assayed by radiometric methods. No significant change was found for PNMT activity. DBH activity was significantly increased in the A2-C2 area of the medulla oblongata (including the nucleus tractus solitarius) in the cases of Parkinson's disease.The A2-C2 area is known to be implicated in the control of blood pressure in rats. These findings are discussed in relation to orthostatic hypotension and the influence ofl-dopa therapy.Supported by grants from INSERM ATP 657897, ATP 8179113, CRL 79-1-356-6, DGRST (80 E 0882), FRMF, and Sandoz-France France     

Issues in evaluation of cognition in the elderly in developing countries

Background:

Developing regions of the world host the majority of elderly subjects who are at risk for dementia. Reliable epidemiological data from these countries is invaluable in tackling this global problem. Scarcity of such data in literature is largely attributable to problems that are unique to developing communities worldwide.

Objective:

To classify and describe the problems that interfere with the collection of reliable epidemiological data on cognitive impairment in the elderly in developing communities, and to suggest practical solutions for some of them.

Methods:

Inferring from the experiences of a large, ongoing, population-based study on the cognitive impairments in the elderly in South India and from the review of literature.

Conclusion:

A fatalistic attitude regarding aging in the communities, significant heterogeneity in educational abilities and activities of daily living, high illiteracy among rural subjects, and lack of an organized health care system and updated demographic figures are some of the major factors that contribute to technical, namely, methodology-related problems and practical, namely, subject-related problems in such epidemiological studies.     

Characteristics of nociceptors in the periodontium--an in vitro study in rats

Recent studies have indicated that nociceptors can be classified into various types according to their physiological properties. These studies have clarified that the frequency distribution of various nociceptor types is different among body sites and animal species. In the present study, we investigated the physiological properties of rat's periodontal nociceptors in an in vitro jaw-nerve preparation. Responses were recorded from functional single filaments in the inferior alveolar nerve. To determine the nociceptor type, calibrated von Frey filaments, heat, and bradykinin (BK) stimuli were used. We found five subtypes of nociceptors in the periodontal ligaments of the lower incisor: Adelta-high threshold mechanonociceptors (Adelta-HTM, n=28), Adelta-mechanoheat nociceptors (Adelta-MH, n=6), Adelta-polymodal nociceptors (Adelta-POLY, n=26), C-high threshold mechanonociceptors (C-HTM, n=3) and C-polymodal nociceptors (C-POLY, n=4). Most nociceptors were Adelta-innervated, while only a small number of C-innervated nociceptors were found. The present results suggest that periodontal nociceptors transmit mainly fast pain, and may thus play a role in rapid detection of injure-related stimuli during mastication.     

Suicide in the elderly in Austria

In most countries men and women have the highest suicide rates in age groups over 60 years. We investigated suicide rates for the elderly in Austria, a country with one of the highest suicide rates in the world, for the period 1980–1991, using data from the Federal Statistical Division. Suicide rates remained stable over the last decade at a very high level. The mean rate for men was 85.2, for women 28.6/100 000. In men and women rates rise with age. The mean rate of men rises from 51.2 (60–64 years) to 117.3/100 000 (over 85 years); in women there is an increase from 21.4 (60–64 years) to 32.8/100 000 (over 85 years). We did not confirm findings in other countries, where suicide rates have increased in recent years.     

Ethnic disparities in problem behaviour in adolescence contribute to ethnic disparities in social class in adulthood

BACKGROUND: It is important for prevention of social class disparities to know how ethnic disparities in social class arise among migrant children. We contribute to this understanding by examining the role of problem behaviour in adolescence. METHODS: Prospective observational study with 753 Dutch native and 217 Turkish migrant adolescents (11-18 year) followed for 10 years. Internalising and externalising problems were assessed in adolescence and employment status and occupational level were assessed in adulthood. The difference in odds ratios (OR) before and after adjustment for internalising and externalising problems was an indication of the predictive value of disparities in internalising and externalising problems for the development of social class disparities. RESULTS: A total of 135 (62%) of the Turkish and 602 (80%) of the Dutch adults were employed. Internalising and externalising problems were not associated with employment status. Of the employed, 65 (48%) Turkish and 179 (30%) Dutch adults worked in low-level occupations (p < 0.0001). Internalising and externalising problems were associated with both ethnicity and occupation. The OR for low-level occupation for Turkish adults was 1.78 (1.19-2.65), indicating ethnic disparities. Adjustment for internalising problems lowered the OR with 36% to 1.50 (0.97-2.31), and adjustment for externalising problems lowered it with 8% to 1.72 (1.15-2.57). Findings were similar for men and women and did not vary by age. CONCLUSIONS: Ethnic disparities in occupational level in adulthood could partly be attributed to disparities in mental health between Turkish migrants and Dutch natives in adolescence. Prevention of ethnic disparities in mental health at young age may therefore also contribute to the prevention of occupational differences in adulthood.     

Defects in Bioenergetic Coupling in Schizophrenia

Synaptic neurotransmission relies on maintenance of the synapse and meeting the energy demands of neurons. Defects in excitatory and inhibitory synapses have been implicated in schizophrenia, likely contributing to positive and negative symptoms as well as impaired cognition. Recently, accumulating evidence has suggested that bioenergetic systems, important in both synaptic function and cognition, are abnormal in psychiatric illnesses such as schizophrenia. Animal models of synaptic dysfunction demonstrated endophenotypes of schizophrenia as well as bioenergetic abnormalities. We report findings on the bioenergetic interplay of astrocytes and neurons and discuss how dysregulation of these pathways may contribute to the pathogenesis of schizophrenia, highlighting metabolic systems as important therapeutic targets.