文拉法辛辅助治疗精神分裂症阴性症状Meta分析

目的:探讨文拉法辛治疗精神分裂症阴性症状的疗效和不良反应.方法:用Meta分析方法对8项文拉法辛合并抗精神病药治疗精神分裂症阴性症状研究文章进行再分析.结果:文拉法辛合并抗精神病药治疗精神分裂症阴性症状其治疗前后组内比较效应极强(Z=5.79,P＜0.01),与只用抗精神病药治疗比较差异有显著性(Z=3.02,P＜0.01).结论:文拉法辛合并抗精神病药物治疗精神分裂症阴性症状安全、有效.     

阿立哌唑治疗精神分裂症阴性症状Meta分析

目的探讨阿立哌唑与其他抗精神病药治疗精神分裂症阴性症状的疗效差异。方法用Meta分析对24项阿立哌唑与其他抗精神病药治疗精神分裂症阴性症状文章进行再分析,评价其合并效应量大小和综合显著性检验。结果阿立哌唑治疗前后的自身对照,提示阿立哌唑治疗精神分裂症阴性症状疗效明显,效应极强（χ2=15.32,P〈0.01）;与其他抗精神病药比较差异无显著性。结论阿立哌唑治疗精神分裂症阴性症状疗效显著,与其他抗精神病药差异无显著性,但差异效应因药物不同而异。     

维思通与奥氮平对首发性精神分裂症患者个人和社会功能影响的对照研究

目的 探讨维思通与奥氮平用于首发性精神分裂症住院治疗患者的个人和社会功能的恢复.方法 在为期12周的双盲研究中,首发性精神分裂症患者被随机分为维思通组、奥氮平组.靶剂量为药物的最大推荐剂量：维思通为6 mg/d、奥氮平为30 mg/d.主要疗效指标是在12周单药治疗结束时比较维思通组和奥氮平组的个人和社会功能量表（PSP）均分、阳性和阴性症状量表（PANSS）总分变化差异.结果 在12周单药治疗结束时,维思通组的PANSS评分与奥氮平组无显著差异（P＞0.05）,但维思通组的PSP均分改善优于奥氮平组（P＜0.01）.结论 对于首发性精神分裂症患者,与奥氮平相比,维思通能够更显著的改善患者个人和社会功能,早日回归社会.     

抗精神病药物治疗精神分裂症的卫生经济学比较分析

目的　比较维思通和传统抗精神病药物在治疗精神分裂症时的药物经济学指标 ,探讨何种药物更能降低成本 ,提高疗效。方法　采用自制调查表、社会功能缺陷筛选表和生活质量满意度评定量表对服用维思通和传统抗精神症药物的精神分裂症病人各 5 0例进行调查。结果　在 1年内服用维思通的药费 ($394.36± 2 82 .2 5元 )明显高于传统抗精神病药物 ($2 5 1.90± 32 2 .70元 ) ,0 .0 5 >P >0 .0 0 1。其社会功能和主观生活满意度与传统抗精神病药物相当。结论　服用新型抗精神病药物的费用较高。     

传统抗精神病药及氯氮平换用维思通的自身对照研究

目的 探讨传统抗精神病药及氯氮平换用维思通的方法策略、有效性及安全性。方法 对65例符合CCMD－2－R精神分裂症诊断标准、不愿耐受传统抗精神病药物及氯氮平副反应或虽用足够剂量和时间仍存有阳性和阴性精神病症状的病人,采用重叠交叉逐渐增减剂量方法,逐渐换用维思通治疗;用PANSS,TESS,SDSS作为评估工具自身对照,对换药前后的疗效,副反应,社会功能状况进行比较。结果 所有受试者均安全地换用了维思通治疗。维思通能进一步改善PANSS总分,特别是阴性症状因子改善明显;换用维思通还能显著养活嗜睡、EPS、口干,便秘等副反应;用维思通8周后的社会功能缺陷明显改善;患者对维思通治疗的主观满意度提高。讨论了不同精神病药对生物质量的影响。     

阿立哌唑治疗精神分裂症对照研究的Meta分析

目的 探讨阿立哌唑与其他抗精神病药治疗精神分裂症的疗效和不良反应的差异.方法 用Meta分析对12项阿立哌唑与其他抗精神病药治疗精神分裂症对照研究的文章进行再分析,评价其合并效应量大小和综合显著性检验.结果 阿立哌唑治疗前后的自身对照,合并效应量d=2.64,95%CI为(2.33,2.96),综合显著性检验x2=16.55,P＜0.05,提示阿立哌唑治疗精神分裂症前后症状学变化有非常显著性差异,效应极强.阿立哌唑与对照药物在第2周末和治疗结束后的组间比较,分别为y合并=-0.08,95%CI为(-0.20,0.05),x2=1.15,P＞0.05;y合并=-0.07,95%CI为(-0.19,0.06),x2=1.00,P＞0.05.提示两组疗效相当,差异无统计学意义.阿立哌唑的恶心呕吐和失眠比对照组多,头昏头痛、便秘及视力模糊比对照组少,但两者之间均无统计学意义,其他不良反应均显著少于对照组(x2=8.88～19.89,P＜0.01).结论 阿立哌唑与对照组的疗效相当,不良反应明显不同.     

维思通治疗精神分裂症的疗效观察

目的　与氯氮平相对照 ,观察维思通治疗精神分裂症的疗效及不良反应特点。方法　 75例门诊精神分裂症患者 ,随机分为维思通治疗组 (4 0 )例和氯氮平治疗组 (35例 )。疗程为 12周。治疗期间用阳性和阴性症状量表 (PANSS)评定疗效 ,用副反应量表 (TESS)评定二组药物的不良反应。结果　维思通的疗效与氯氮平比较差异无显著性 (P >0 .0 5 ) ,副反应评定 ,维思通组锥体外系副反应发生率高于氯氮平组 (P<0 .0 5 ) ;氯氮平组便秘、流涎、肥胖、心动过速、心电图异常、嗜睡、乏力发生率明显高于维思通组 (P <0 .0 1)。结论　维思通治疗精神分裂症的疗效与氯氮平相当 ,但副反应小 ,安全性优于氯氮平 ,可作为治疗精神分裂症的一线用药     

维思通与舒必利治疗精神分裂症对照分析

探讨维思通治疗精神分裂症的疗效,副反应及作用机理,以维思通治疗精神分裂症38例、舒必利治疗42例进行对照分析,采用PANSS、TESS、ESRS量表评定疗效和副反应,用t检验、X~2检验进行分析。结果显示维思通与舒必利治疗精神分裂症均有确切疗效,在改善阳性症状方面维思通优于舒必利,在改善阴性症状方面二者无差异,维思通副反应较少,安全度较高。     

维思通与氯氮平治疗以阴性症状为主的精神分裂症的疗效对照研究

目的探索维思通对以阴性症状为主的精神分裂症的疗效与副反应。方法对８０例以阴性症状为主的精神分裂症住院患者，用维思通与氯氮平随机对照，采用ＳＡＮＳ、ＢＰＲＳ和临床疗效总评进行评定。结果维思通的疗效优于氯氮平，而副反应发生率也较低。结论维思通是治疗以阴性症状为主的精神分裂症较理想的药物     

维思通致迟发性肌张力障碍一例报道

维思通是一种新型非典型抗精神病药物,它具有独特的5-羟色胺、多巴胺D_2受体平衡拮抗作用,锥体外系反应发生率低,对精神分裂症特别是以阴性症状为主的精神分裂症效果好等特点。许多国家已把维思通做为第一线抗精神病药物。国内尚未见到有关维思通致迟发性肌张力障碍的报道。现将笔者遇到1例报道如下。 李某,男,55岁,教师。因孤僻,多疑27年,又     

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 -