广州市城乡55岁及以上人群痴呆患病率调查

目的调查广州市城乡≥55岁人口痴呆的患病率。方法采用分层整群抽样方法,将广州市12个区市分为老城区、新城区、郊区,根据各层≥55岁的人口数占广州市相应年龄段人口总数的比例确定各层应查人数,实查5276人。调查采用筛查和确诊两阶段法,按美国精神障碍诊断和统计手册第4版的标准诊断痴呆。结果①查出痴呆患者183人,粗患病率为3.47%,其中阿尔茨海默病(AD)、血管性痴呆(VD)和其他痴呆的粗患病率分别为2.43%、0.85%和0.19%。年龄标化后的痴呆、AD和VD患病率分别为1.94%、1.28%和0.55%。②女性痴呆粗患病率高于男性(4.35%vs2.21%,P<0.001),二者的年龄标化患病率分别为1.12%、2.72%。痴呆患病率随年龄增长而上升。③农村人口的痴呆患病率(4.32%)高于城镇人口(3.27%),差异有统计学意义(P<0.01)。④文盲者的痴呆患病率(6.17%)较小学(2.68%)和初中及其以上(1.41%)文化程度者高(P<0.001)。结论AD是广州地区老人中主要的痴呆类型,VD次之。老年期痴呆患病率随年龄的增长而升高。文化程度低者痴呆患病率较高。     

成都地区老年期痴呆患病率调查

目的 调查成都地区城乡老年期痴呆和阿尔茨海默病(AD)的患病率.方法 采用分层随机整群抽样方法 ,将成都市19个区市县(总人口972万)分为城区、郊区、近郊和远郊,根据各层人口占总人口比例确定各层应查≥55岁的老人数(5 555人),实查5 353人.调查采用筛查和确诊两阶段法,按美国精神障碍诊断与统计手册第3版修订本的标准诊断痴呆.结果 (1)查出痴呆患者143例,患病率为2.67%.其中AD为2.05%,血管性痴呆(VD)为0.37%,其他痴呆为0.24%.(2)女性患病率(3.14%)高于男性(2.16%;P<0.05).(3)痴呆患者的平均年龄[男(80±9)岁,女(82±7)岁]高于正常老年人[男女均为(67±8)岁;P<0.001],且痴呆患病率随年龄增长而上升.(4)农业人口的患病率(2.79%)高于非农业人口(2.40%),但差异无显著性.(5)文盲老人的患病率(4.45%)较小学(1.48%)和初中及其以上(0.17%)文化程度者高(P<0.001).结论 AD是成都地区老人中主要的痴呆类型,VD次之.文盲老人的痴呆患病率高,老年期痴呆患病率随年龄的增长而升高.     

上海城区老年性痴呆患病率调查

目的调查上海城区老年人群中痴呆的患病率。方法采用横断面调查,对≥60岁的社区居民3 141名进行了全套神经系统体检、神经心理测试和问卷调查,根据国际统一的诊断标准,DSM-Ⅳ标准诊断痴呆,NINCDS-ADRDA和NINDS-AIREN标准诊断阿尔茨海默病(AD)和血管性痴呆(VaD)并计算人群痴呆的患病率,以及各亚型构成比和患病率。结果诊断痴呆156例,痴呆患病率为5.0%;女性痴呆的患病率为5.8%,显著高于男性(4.0%,P=0.012)。痴呆患病率随年龄的增长有显著升高趋势,随文化程度的提高有显著下降趋势(P<0.001)。AD、VaD、其他类型痴呆和未分型痴呆的比例分别为72.4%、16.0%、5.1%和6.5%;女性AD患病率为4.7%,显著高于男性(2.3%,P<0.001)。AD和VaD的患病率均随年龄的增长而升高(P<0.001)。结论上海城区老年人群中痴呆患病率为5.0%,其中以AD(72.4%)为痴呆的主要类型。     

老年期痴呆流行病学研究概况

随着人口出生率的下降及人类平均寿命的延长,世界人口趋于老龄化,老年期痴呆患者也随之增多,已成为危害老年人健康的主要疾病之一。我国卫生部将老年期痴呆列入“九五”老年医学研究的重点项目之一。本文就老年期痴呆流行病学研究进展作一简要综述。 1 患病率 老年期痴呆患病率各地报道差异较大。我国上海在同一地区做过两次大规模的流行病学调查,得     

社区糖尿病患者痴呆患病率调查

目的 调查社区糖尿病患者痴呆患病率,计算年龄别、性别患病率,并与非糖尿病组相比较.方法 对上海市某社区50岁以上常住居民中糖尿病患者及与其年龄、性别相匹配1:1对照的非糖尿病患者进行调查.运用问卷采集人口学及病史资料,MMSE筛查认知功能.对于文盲≤19分、小学≤21分、初中及以上文化程度≤24分者,进一步给予成套神经心理学量表检查,依据DSM-Ⅳ诊断痴呆.结果 糖尿病患者中痴呆患病率[4.75%(23/484),95%CI:3.03%～7.04%]高于非糖尿病患者[2.24%(11/490),95%CI:1.13%～3.98% X~2=4.54,P=0.03].糖尿病组60～69、70～79和80岁以上各年龄段的痴呆患病率分别为1.94%(2/103)、4.43%(9/203)和14.12%(12/85)(趋势X~2=18.04,P<0.01);非糖尿病组相应年龄段痴呆患病率分别为1.43%(2/140)、2.86%(6/210)和5.00%(3/60,趋势X~2=4.58,P:0.03).糖尿病组女性和男性痴呆患病率分别为6.55%(19/290)和2.06%(4/194,X~2=5.18,P=0.02);非糖尿病组女性和男性痴呆患病率分别为3.01%(9/299)和1.05%(2/191).结论 糖尿病患者中痴呆患病率显著高于非糖尿病患者,2组痴呆患病率均随年龄增大而升高,并且女性痴呆患病率高于男性.     

北京市门头沟区老年期痴呆流行病学调查

目的针对北京市门头沟区1756名60岁以上老年人老年期痴呆患病率及不同类型痴呆患病率进行调查。方法2007年5-9月,运用多阶段、分层、整群随机抽样的方法,抽取居住地位于北京市门头沟区、具有北京市户籍且年龄≥60周岁,签知情同意书自愿参与调查的老人1756人,由经过培训的调查员逐户访问,完成调查问卷及简易痴呆筛查量表（MMSE）,对阳性病例460人及5%阴性病例62人由精神科医师按照国际疾病分类第十版（ICD-10）中痴呆的诊断标准做出痴呆的临床诊断。结果门头沟区老年期痴呆7.16%的患病率中,阿尔茨海默病与脑血管性痴呆总患病率比较无明显差别;男性阿尔茨海默病患病率低于女性,而脑血管性痴呆患病率高于女性;城镇阿尔茨海默病患病率及脑血管性痴呆患病率均高于农村;年龄越大越容易患老年期痴呆,文化程度越低越容易患老年期痴呆。结论高龄、低教育水平是老年期痴呆的高发人群,全科医师或社区护士可有计划的进行调查,掌握情况,早期预防,及时发现,积极治疗。     

多发梗塞性痴呆的临床与CT

<正> 多发性梗塞性痴呆(Multi-infarct dementia MID)是老年人除Alzheimer氏病之外的另一类器质性痴呆。近年来,随着脑血管病发病率的增加及平均人口寿命的延长,脑血管性痴呆的患病率亦随之增长。     

天水市60岁及以上人群痴呆流行病学现况调查

目的了解天水市60岁及以上人群痴呆患病率及相关因素。方法采用多阶段分层整群抽样方法随机抽取甘肃省天水市≥60岁人群2430人为调查对象,用长谷川痴呆量表(HDS)、一般健康问卷(GHQ)进行筛查,将调查对象分为痴呆高、中、低危险3组,再以缺血指数量表(HIS)、临床痴呆评定量表(CDR)、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进行诊断检查。结果 2416人完成调查,痴呆患病率为12.12%[95%CI为9.32%~15.76%];痴呆患病率男性(14.63%)高于女性(9.46%),痴呆患病率农村(12.95%)高于城市(7.43%),但差异无显著差异(P0.05);患病率随年龄的增长而不断上升(P0.01),60~65岁为5.32%,66~70岁为7.95%,71~75岁为17.48%,76~80岁为20.08%,81~85岁为21.22%,86岁以上为30.23%;高龄、家庭收入低、婚姻状况不良、独居、文化程度低等为痴呆患病的危险因素。结论甘肃省天水市痴呆患病率较高,影响因素较多,应采取针对性措施予以干预。     

广州市60岁及以上老人轻度认知障碍的患病率调查

目的调查广州地区城乡年龄≥60岁老人中轻度认知障碍(MCI)的患病率。方法用分层随机整群抽样方法抽样,采用筛查和确诊两阶段法进行调查,实查年龄≥60岁老人4697人,失访率4.9%。MCI诊断需符合Petersen的诊断标准及临床痴呆程度评定量表(CDR)评分等于0.5。结果①检出MCI患者257例,粗患病率为5.47%,经广州市2000年人口年龄构成标化,MCI的患病率为4.94%;②其中男女MCI患者分别为67例和190例,女性粗患病率显著高于男性(6.87%vs 3.47%,P<0.001),年龄标化患病率分别为6.51%和2.90%;③MCI患病率随年龄的增加而增高(P<0.001);④城区MCI粗患病率略低于农村,但差异无统计学意义(5.22%vs 6.66%,P>0.05);⑤有脑血管病史患者MCI的患病率高于无脑血管病史的老人(10.93%vs 5.08%,P<0.001)。⑥血管性非痴呆认知障碍(VMCI)的患病率为0.72%,男女两性的患病率差异无统计学意义(P>0.05)。结论MCI患病率随年龄增长而增高,女性高于男性,有脑血管病史者患病率较高,提示高龄、女性、有脑血管病史是MCI的易感因素。     

金纳多治疗多发性脑梗死性痴呆的疗效观察

血管性痴呆(VD)系指缺血性、出血性脑血管疾病引起的脑损害所致的痴呆,VD在60岁以上老人中患病率为3.96％,占全部痴呆的2/3。VD中以多发性梗死性痴呆(MID)为最多见。MID每年发病率占人口的0.7％～1.6％,是威胁高龄人群生     

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.     

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

Psychiatric Quarterly -     

Summary of legislation of 1941 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -     

Asymmetry of on- and off-pathways of blue-sensitive cones of the retina of macaques

Macaque retinal ganglion cells whose receptive-field center recieves input from blue-sensitive cones show an overt asymmetry of the frequency of ON-center and OFF-center varieties, an asymmetry not present in ganglion cells whose center receives input from the other two cone types. A similar asymmetry of ON/OFF responses is found in the local electrotetinogram (d-wave) mediated by signals from blue-sensitive cones. ‘Blue-ON-center’ ganglion cells have larger receptive-field centers and shorter conduction latencies than other opponent-color varieties, suggesting an appreciable degree of receptor convergence and presumably large cell bodies. Intracellular stainings of these neurons with Procion Yellow show that they correspond to diffuse stratified (Parasol) ganglion cells whose flat-topped dendritic arborization stratifies in the sclerad half of the inner plexiform layer. In view of the known characteristics of macaque bipolar cells and of the ON/OFF asymmetry, it is proposed that these ganglion cells are postsynaptic to cone-specific flat bipolars possibly mediating sign-inverting synaptic contacts. The results also indicate a reversal, for the blue-cone pathway, of the ON/OFF lamination of the inner plexiform layer that has recently been described in other species.     

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.