帕利哌酮缓释剂与利培酮对精神分裂症患者血浆催乳素及社会功能的影响

目的比较帕利哌酮缓释剂与利培酮对精神分裂症患者血浆催乳素及社会功能的影响。方法对31例用帕利哌酮缓释剂与35例用利培酮治疗的精神分裂症患者分别于治疗前及治疗后8、16、24周末检测血浆催乳素水平,采用个人和社会功能量表(PSP)评定患者的社会功能,以阳性和阴性症状量表(PANSS)、临床疗效总评量表中的病情严重程度(CGI-SI)及锥体外系副反应评定量表(RSESE)评定疗效和不良反应。结果治疗前两组的PANSS、CGI-SI及RSESE、PSP评分及催乳素水平比较无统计学差异;治疗16、24周末两组RSESE评分(t=2.26,2.34;P<0.05)和PSP评分(t=2.10,5.33;P<0.05)差异有统计学意义。结论帕利哌酮缓释剂与利培酮均能引起血浆催乳素水平的升高,但帕利哌酮缓释剂在改善患者社会功能方面优于利培酮,且锥体外系副反应较轻。     

团体表达性艺术治疗对慢性精神分裂症患者的疗效对照研究

目的:探讨团体表达性艺术治疗对慢性精神分裂症患者的疗效。方法:将60名患者随机分为艺术组和对照组,所有患者在治疗前及治疗后分别施测阳性和阴性症状量表(PANSS),个人社会功能量表(PSP)及罗森伯格自尊量表(SES),对所得的数据进行统计分析。结果:1艺术组与对照组年龄、病程、抗精神病药物利培酮的日服用剂量,以及治疗前PANSS、PSP和SES的评分无统计学差异;2艺术组和对照组治疗后PANSS的评分低于治疗前,PSP及SES的评分高于治疗前,差异有统计学意义(t=9.079,-16.496,-17.674,10.051,5.706,6.639;P0.001);3治疗前后艺术组PANSS、PSP及SES的差值显著高于对照组(t=2.909,13.707,14.007;P0.01),治疗有效率概与对照组相比,差异有统计学意义(χ~2=4.389,P=0.036)。结论:团体表达性艺术治疗能够显著改善慢性精神分裂症患者的精神症状,提高药物治疗的疗效,增强其社会功能及自尊。     

以复元理念为导向的康复服务对精神分裂患者康复效果的影响

目的:探讨以复元理念为导向的阳光心园康复服务对社区精神分裂症患者康复效果的影响。方法:将符合入组要求的100例精神分裂症患者随机分为干预组和对照组各50例,干预组进入阳光心园接受以复元理念为导向的康复训练课程6个月,对照组接受社区医生的常规随访服务。采用阳性与阴性症状量表(PANSS)、个人和社会功能量表(PSP)、生活质量量表(SQLS)进行评估。结果:干预6个月后,干预组PANSS评分较干预前及对照组明显降低(t=2.711,-2.137;P0.05);PSP评分较干预前及对照组明显升高(t=-2.222,2.016;P0.05);干预组SQLS评分较对照组明显降低(t=-2.051,P0.05);干预组患者的PANSS、PSP、SQLS干预前后得分的差值较对照组均有统计学意义(t=-2.711,1.993,2.023;P0.05);对照组干预前后差异无统计学意义。结论:以复元理念为导向的阳光心园康复服务有利于提高患者自知力和生活质量,改善精神症状和社会功能等。     

艾司西酞普兰联合利培酮治疗精神分裂症阴性症状的疗效

目的:探讨艾司西酞普兰联合利培酮治疗精神分裂症阴性症状的疗效及对社会功能的影响。方法:选择2017年10月至2019年6月在普陀区精神卫生中心门诊或住院的精神分裂症患者为研究对象,将其随机分为研究组和对照组。研究组44例患者采用艾司西酞普兰联合利培酮治疗;对照组35例患者采用单一抗精神病药物利培酮治疗。观察12周,两组分别于治疗前、治疗10天、4周、8周、12周采用阳性与阴性症状量表(PANSS)及阴性症状评估量表(SANS)评定疗效;于治疗12周前后,采用个人和社会功能量表(PSP)评定社会功能。结果:两组PANSS、SANS、PSP评分治疗后均较治疗前明显改善(P0.05)。两组比较,PANSS、SANS评分在治疗前及治疗10天时差异无统计学意义(P0.05);在治疗4周、治疗8周及治疗12周时差异有统计学意义(t=-2.246,-2.209,-2.384,-2.121,-2.603,-3.368;P0.05)。两组比较,PSP评分在治疗前差异无统计学意义(P0.05);在治疗后差异有统计学意义(t=3.158,P0.01)。结论:艾司西酞普兰联合利培酮治疗与利培酮单一治疗对精神分裂症阴性症状及社会功能均有改善,但联合治疗疗效更优。     

家庭教育联合技能训练对社区精神分裂症患者康复的作用及其社会功能影响

目的探讨家庭教育联合技能训练对社区精神分裂症患者康复的作用及其社会功能的影响因素。方法将182例稳定期社区精神分裂症患者随机分为干预组和对照组各91例,其中脱落2例。在抗精神病药物基础上,对干预组进行家庭教育联合技能训练的综合干预,对照组接受常规社区精神卫生服务,对两组患者观察1年。采用阳性和阴性症状量表(PANSS)、Morning Side康复状态量表(MRSS)和个人和社会表现量表(PSP)对患者进行评估。结果在末次观测时点,干预组PANSS、MRSS和PSP评分明显优于对照组,两组间的差异具有非常显著性(t=-3.61,-2.87,3.16P0.01)。多元逐步回归分析表明,是否干预、婚姻状况、病程、PANSS评分和MRSS评分等因素对患者社会功能的恢复具有重要的预测作用。结论对社区精神分裂症患者运用家庭教育联合技能训练的综合干预技术能够有效地控制精神症状,改善其社会功能,促进患者康复。     

慢性精神分裂症患者入住中途过渡宿舍行系统康复治疗效果观察

目的探讨慢性精神分裂症患者入住中途过度宿舍进行系统的康复治疗对恢复期精神病病人功能恢复的影响。方法将90例慢性精神分裂症患者分为研究组和对照组各45例,研究组患者入住中途过度宿舍,进行系统的康复治疗;对照组病人在精神病专科医院接受常规的专科治疗。分别治疗半年,采用阳性和阴性症状量表(PANSS)、日常生活能力量表(ADL)、社会功能缺陷筛选量表(SDSS)评定两组病人的康复效果并进行比较。结果经过为期半年过度宿舍的系统康复治疗,研究组PANSS量表评分(t=2.20,P<0.01),ADL量表评分(t=1.87,P<0.01)和SDSS量表评分均(t=2.13,P<0.01)优于对照组。结论慢性精神分裂症患者入住中途过渡宿舍行系统康复治疗对其功能恢复有明显的促进作用。     

循证护理对精神分裂症患者社会功能康复及生活质量的影响

目的:探讨循证护理对精神分裂症患者社会功能康复及生活质量的影响。方法:收集上海交通大学医学院附属精神卫生中心门诊收治的精神分裂症患者78例,按照随机数字表法分为对照组和试验组各39例。对照组患者予以常规护理模式,试验组在对照组的基础上予以循证护理,比较两组患者阳性以及阴性症状量表(PANSS)、康复状态量表(MRSS)、威斯康星卡片分类检测(WCST)、简明精神病量表(BPRS)、社会功能缺陷筛选量表(SDSS)、家庭负担会谈量表(FIS)、自知力和治疗态度问卷(ITAQ)评分。结果:与干预前相比,干预后3个月两组患者MRSS、一般精神症状以及PANSS阴性、阳性评分降低(t=9.006~47.588,P0.001),ITAQ评分升高(t=-13.768~-4.187,P0.001),FIS、BPRS以及SDSS评分降低(t=5.139~17.920,P0.001),日常生活能力、社会适应能力以及社会技能评分升高(t=-25.766~-9.659,P0.001),与对照组相比,试验组完成分类数、总应答数、持续性应答数、非持续性错误数较高、错误应答数、选择错误率、完成第一个分类所需时间应答数、持续性错误数、概念化水平百分数较低(t=-28.617~23.701,P0.001),MRSS、一般精神症状以及PANSS阳性、阳性评分较低(t=-12.966~-4.931,P0.001),ITAQ评分较高(t=8.221,P0.001),FIS、BPRS以及SDSS评分较低(t=-10.227~-6.424,P0.001),日常生活能力、社会适应能力以及社会技能评分较高(t=10.122~11.741,P0.001)。结论 :精神分裂症患者予以循证护理能够显著促进认知功能康复,患者身心早日康复,改善社会功能。     

基于复元理念的个案管理康复服务对社区精神分裂症的作用

目的:探讨基于复元理念的个案管理康复服务对社区精神分裂症患者的疗效及可行性。方法:将符合入组标准的社区精神分裂症患者140例随机分为干预组和对照组各70例,干预组应用基于复元理念的个案管理康复服务,对照组接受常规的精神康复服务。用阳性阴性症状量表(PANSS)评定精神症状严重程度,生活满意度量表(LSIA)评定生活满意度,生活质量量表(SQLS)评定生活质量,个人和社会功能量表(PSP)评定个人和社会功能及人际关系,自尊量表(SES)评定自尊。用复发率和再住院率评价患者的复发情况。结果:两组间比较:干预6个月后,干预组阴性症状分、PSP得分、SES得分、SQLS得分及心理社会分量表得分与对照组比较差异有统计学意义(t=-2.06,2.205,2.082,2.194,-2.221;P0.05),LSIA得分与对照组差异无统计学意义(t=0.751,P0.05)。组内比较:干预组PANSS得分、PSP得分、SES得分在基线与半年后比较差异有统计学意义(t=6.759,P0.01;t=-4.878,P0.01;t=-2.524,P均0.05),干预组SQLS得分、LSIA得分在基线与半年后比较差异无统计学意义(t=-1.540,0.549;P0.05);对照组PANSS得分、PSP得分、SES得分、SQLS得分及LSIA得分在基线与半年后比较差异无统计学意义(t=0.806,-1.855,1.698,-0.248,-1.650;P均0.05)。干预半年后,干预组复发率低于对照组。结论:对社区精神分裂症患者进行基于复元理念的个案管理康复服务具有可行性和有效性,有助于其康复。     

联用文拉法新改善精神分裂症阴性症状的临床研究

目的探讨联用文拉法新治疗精神分裂症阴性症状的临床疗效和安全性。方法将60例以阴性症状为主的精神分裂症患者随机分为实验组和对照组,分别给予利培酮合用万拉法新及单用利培酮治疗,疗程12周,用阳性和阴性症状量表(PANSS)评定其疗效,用副反应量表(TESS)评定其药物的安全性。结果疗后4周实验组PANSS总分、阳性因子分、阴性因子分、一般精神病理分以及对照组PANSS总分、阳性因子分与疗前比较差异有显著性(t=2.02～2.2,P<0.05);疗后8、12周两组PANSS总分和各因子分与疗前比较差异有极显著性(t=3.45～20,P<0.01)。治疗后4、8、12周两组间比较阴性因子分差异有极显著性(t=4.44～11,P<0.01)。两组药物副反应(TESS)比较无显著差异性。结论在利培酮基础上联用文拉法新治疗精神分裂症阴性症状起效快,显示较好的临床疗效,无明显药物副作用。     

帕利哌酮对精神分裂症患者社会功能影响的随访研究

目的比较帕利哌酮与利培酮长期服用对精神分裂症患者社会功能的影响。方法 160例病程小于5年的精神分裂症患者随机分为帕利哌酮组与利培酮组各80例进行为期1年的随访,在治疗前、治疗12月末进行个人和社会功能量表(PSP)评定。结果帕利哌酮组73例完成研究,利培酮组75例完成研究。与治疗前相比,两组1年后PSP评分均有很大提高,帕利哌酮组较利培酮组更明显(t=3.51,P<0.001);帕利哌酮组在社会中有用的活动(χ2=11.88,P<0.01)、个人和社会关系(χ2=9.08,P<0.01)2个维度较利培酮组改善更明显。结论长期服用帕利哌酮能不断提高精神分裂症患者社会功能,帕利哌酮对社会功能的改善优于利培酮。     

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.