老年人抑郁症状与情绪调节策略的横断面研究

目的:考察老年人抑郁症状与情绪调节策略的关系及老年人抑郁症状的相关因素,为老年人抑郁症状的干预提供理论指导。方法:选取北京市某社区60~80岁老年人335名,用流调中心用抑郁量表(CES-D,得分≥16分为"有抑郁症状")来评估老年人抑郁症状,用Gross情绪调节问卷(ERQ,包括认知重评和表达抑制两个分量表)来评估老年人认知重评和表达抑制策略的使用情况,用沉思量表(RRS)来测量老年人沉思策略的使用情况,并用logistic回归分析方法对老年人抑郁症状的相关因素进行分析。结果:有抑郁症状的老年人的比例为19.9%(61/306)。CES-D总分与ERQ的认知重评得分呈负相关(r=-0.21,P<0.01),与ERQ的表达抑制得分的相关无统计学意义(r=0.08,P>0.05),与RRS总分呈正相关(r=0.58,P<0.01)。Logistic回归分析表明,男性(OR=0.42,P<0.05)、健康状况好(OR=0.29,P<0.001)、生活方式好(OR=0.09,P<0.01)、经济状况好(OR=0.05~0.23,P<0.01)和ERQ认知重评得分较高(OR=0.93,P<0.05)的老年人,CES-D得分较低;而高龄(OR=1.04,P<0.05)和RRS总分较高(OR=1.19,P<0.01)的老年人,CES-D得分较高。结论:女性、高龄、经济状况差、健康水平低、无子女或子女在外地或国外、越多使用沉思策略和越少使用认知重评策略的老年人,越可能出现抑郁症状。     

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。     

老年人社区支持与认知功能的关系——中国老年健康影响因素跟踪调查项目的数据分析

目的:探讨社区支持与老年人认知功能的关系,为制定相关的干预策略提供依据。方法:使用中国老年健康影响因素跟踪调查项目2014年横截面数据,剔除缺失值后得到样本6154例,男性2839例(46.1%),女性3315例(53.9%)。使用修改后的简易精神状态量表测量老年人的认知情况。社区支持指以社区为基本单位,为老年人提供各种形式的服务和帮助(包含起居照料、精神慰藉、医疗服务等)。分析社区支持组和无社区支持组的认知功能差异,并采用二元logistic回归分析社区支持与老年人认知功能的关系。结果:无社区支持组的认知功能受损比为33.8%(820/2428),社区支持组为30.5%(1137/3726),差异具有统计学意义(χ~2=7.19,P=0.007);二元logistic回归显示,在调整性别、年龄、受教育程度,城乡、婚姻情况、居住安排和经济状况后,社区支持组发生认知功能受损的风险为无社区支持组的0.84倍(OR=0.84,95%CI:0.74~0.95,P=0.006)。结论:社区支持是老年人认知功能的保护因素。     

老年人抑郁症状合并躯体疼痛的相关因素

目的:探讨我国老年人抑郁症状合并躯体疼痛的患病情况及相关因素,为改善伴抑郁症状合并躯体疼痛老年人生活质量提供参考依据。方法:基于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)的数据,选取其中所有有抑郁症状[简版流调中心抑郁量表(CESD-10)得分10分]的老年人(年龄≥60岁)2370例,其中有1335例合并躯体疼痛(DP组,主诉至少存在一个部位的躯体疼痛)、1035例未合并躯体疼痛(NDP组)。采用逐步logistic回归分析探讨抑郁症状合并躯体疼痛的相关因素。结果:2370例有抑郁症状的老年人中,合并躯体疼痛的检出率为56.33%。Logistic回归分析结果显示,女性(OR=1.45,95%CI:1.22~1.72)、农村户口(OR=2.32,95%CI:1.83~2.95)、患慢性疾病(OR=2.35,95%CI:1.84~2.99)、健康自评越差(健康自评一般OR值为2.09,95%CI:1.69~2.60;健康自评差OR值为3.33,95%CI:2.64~4.20)是老年人抑郁症状合并躯体疼痛的危险因素;年龄≥75岁(OR=0.72,95%CI:0.57~0.92)是老年人抑郁症状合并躯体疼痛的保护性因素。结论:抑郁症状合并躯体疼痛是我国老年人常见症状之一。女性、年龄大、农村人口、患有其他慢性疾病和健康自评状况较差是抑郁症状合并躯体疼痛的相关因素。     

老年人社会经济地位与认知功能的关系

目的:研究老年人社会经济地位与认知功能的关系,为预防老年人认知功能障碍提供参考。方法:本研究数据来源于中国健康与养老追踪调查2015年随访数据,选取其中年龄≥60岁、接受了认知功能调查且社会经济地位变量值完整的调查对象4017例。认知功能指标为时间定向、计算与注意、画图以及情景记忆,社会经济地位指标为受教育程度、人均家庭消费年支出和职业,控制变量为社会人口学特征、健康相关行为、健康状况。结果:老年人认知功能总分为(10.9±3.5)分。多重线性回归结果显示,认知功能总分与受教育程度(β=0.11～0.20)、人均家庭消费年支出(β=0.04)、职业(β=0.03～0.07)正向关联。结论:老年人社会经济地位与认知功能呈正相关,低社会经济地位老年人的认知功能较差。     

中国老年人认知功能减退的性别和城乡差异

目的:了解中国老年人认知功能减退的性别和城乡差异,为改善老年人的认知功能提供参考依据。方法:采用中国老年健康影响因素跟踪调查项目,收集2005、2008、2011、2014年各4393、4122、2398、1760名65～104岁老年人追踪数据,采用简易认知量表修订版(MMSE-R)评估认知功能。应用增长曲线模型拟合出老年人的认知轨迹,分析老年人认知轨迹的性别和城乡差异。结果:男性、城市、经济状况好、参加社会活动、不患相关慢性病老年人的MMSE-R得分高于女性、乡村和镇、经济状况差、不参加社会活动、患相关慢性病的老年人(均P0.05)。增长曲线模型结果显示,老年人的认知功能随年龄增长呈现非线性下降趋势。结论:中国老年人的认知功能随年龄的增长加速下降,不同性别、城乡老年人的认知轨迹存在明显差异。     

北京市海淀区老年人认知功能状况及其影响因素

目的:探讨北京市海淀区65岁以上老年人认知功能现况及其影响因素。方法:随机抽取北京市海淀区29个社区的老年人采用简易精神状况检查量表(MMSE)、日常生活能力量表(ADL)及一般情况调查表进行调查。结果:1按照认知功能缺损的划分标准,8.8%的老年人存在认知功能障碍;2不同性别间认知功能缺损率无显著差异,不同年龄、文化程度之间认知功能缺损率差异显著(P均0.001);3MMSE总分与ADL总分呈显著性负相关(r=-0.475,P0.01);4多元线性回归分析表明年龄、自理能力、教育程度对老年人认知功能的影响起决定作用的占33.4%。结论:与全国其它省市近几年研究结果相比,北京市海淀区老年人认知功能缺损状态相对较轻,主要受到年龄、文化程度及日常生活能力的影响。     

河北省城市社区老年人睡眠障碍的现况调查

目的:了解城市社区老年人的睡眠障碍的流行病学特点,初步分析相关因素.方法:本研究为现况调查.选取河北省4市区3176例60岁以上社区老年被试者,采集一般人口学资料,采用匹兹堡睡眠质量指数量表(PQSI)、日常生活能力量表(ADL)评定睡眠状况及日常生活能力.结果:参与调查的3176例老人中有938例(29.5％) PQSI≥7分,其中男性286例,女性652例,男∶女=1∶2.3.ADL＞26分者232例(7.3％),其中PQSI≥7分者132例(56.9％).多因素logistic回归分析显示,ADL评分较高(OR=1.58)、需要生活照料(OR=1.49)、高龄(≥70岁)(OR=1.37)、女性(OR=1.69)、无业(OR=1.66)、脑力劳动(OR=1.92)、单身或丧偶(OR=1.33)、伴有躯体疾病(OR=2.18)者PQSI得分较高.居住地点固定(OR =0.81)、参加体育锻炼(OR=0.76)、参加读报纸/杂志/书籍(OR=0.82)、参加娱乐活动(OR=0.80)者PQSI得分较低.结论:城市社区老年人的睡眠障碍发生率较高,睡眠障碍的发生可能与较高年龄、女性、无职业及缺乏运动的生活方式有关.     

云南省西盟佤族自治县精神障碍现况调查

目的:了解西盟佤族自治县精神障碍流行病学特征,探讨影响精神障碍患病率的心理社会危险因素。方法:采用多阶段抽样方法,抽取在西盟佤族自治县居住6个月以上年满18岁的各族居民2381人作为调查对象。以一般健康问卷(GHQ)作为筛查工具,以ICD-10症状清单作为诊断工具进行入户访谈。结果:任何一种精神障碍的终生患病率为19.86%(419/2110),使用精神活性物质(烟、酒)所致的精神和行为障碍为12.99%(274/2110),神经症、应激相关的及躯体形式障碍为6.30%(133/2110),非器质性睡眠障碍为2.94%(62/2110),心境障碍为2.32%(49/2110),精神分裂症为1.00%(21/2110)。多因素非条件logistic分析结果显示,与神经症、应激相关的及躯体形式障碍有关的影响因素包括男性(OR=0.43)、年龄较大(35~49岁,OR=1.78;50~64岁,OR=2.59;≥65岁,OR=3.51)、未婚及其他婚姻状况(OR=0.31)、非佤族及拉祜族民族(OR=0.29);与使用精神活性物质(烟、酒)所致的精神和行为障碍有关的影响因素包括男性(OR=2.41)、年龄较大(35~49岁,OR=2.29;50~64岁,OR=3.20;≥65岁,OR=4.58)、农民及个体户外的其他职业(OR=0.41)及其他民族(OR=0.32);与心境障碍有关的影响因素包括男性(OR=0.35)及年龄较大(≥65岁,OR=3.05)。结论:西盟佤族自治县各类精神障碍的终生患病率、烟酒所致精神和行为障碍、焦虑障碍患病率较高,应加强少数民族地区精神障碍防控工作。     

社区老年人社会支持对其认知功能的影响

目的:探讨社会支持对社区老年人认知功能的影响.方法:采用社会支持评定量表(SSRS)、简易精神状态评定量表(MMSE)对成都地区286名60岁及以上的社区老年人的社会支持及认知功能进行调查.结果:老年人认知功能总平均为(23.91±4.38)分.不同性别与受教育程度的老年人在认知功能上均差异具有统计学意义(P＜0.05).老年人社会支持总分平均为(38.41±8.94)分.高中低3组社会支持水平的老年人在认知功能上的定向力、记忆力、注意力和计算能力、回忆、语言能力比较(F=23.97,7.73,9.69,3.14,13.65;P＜0.05)差异均有统计学意义:社会支持水平越高,老年人的认知功能也越好.进一步的回归分析结果显示,在控制年龄的基础上,主观支持1仍然能显著预测老年人的认知功能(β=0.28,t=3.87,P＜0.001).结论:社会支持是老年人认知功能的重要保护性因素,加强社会主持有助于改善老年人认知功能.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.