Differences in P50 and prepulse inhibition of the startle reflex between male smokers and non-smokers with first episode schizophrenia without medical treatment

Backgorund Nicotine may improve schizophrenia patient＇s cognitive deficit symptoms.This study was to explore the chronic effects of smoking on prepulse inhibition of the startle reflex （PPI） and P50 in the patients with first-episode schizophrenia （FES）.Methods The event-related potentials （ERP） recording and analysis instrument made by Brain Products,Germany,was used to detect PPI and P50 in 49 male FES patients （FES group,n=21 for smokers and n=28 for non-smokers） and 43 normal male controls （control group,n=19 for smokers and n=24 for non-smokers）.Results Compared with normal controls,the FES group had prolonged PPI latency when elicited by single stronger stimulus （P ＜0.05）; the FES group had prolonged PPI latency and increased PPI amplitude （P ＜0.05,0.01） when elicited by weak and strong stimuli.The FES group had lower PPI inhibition rate than normal controls （P ＜0.05）.Compared with normal controls,the FES group had increased P50-S2 amplitude and increased amplitude ratio S2/S1 （both P ＜0.05）.In the control group,the smokers had a tendency of increase in P50-S2 amplitude （P ＞0.05） and shorter P50-S2 latency （P ＜0.05） than the non-smokers.The smokers had higher PPI amplitude than the non-smokers （P ＜0.05）.In the FES group,the smokers had higher P50-S1 amplitude,shorter P50-S2 latency,and higher amplitude ratio S2/S1 than the non-smokers （P ＜0.05,0.01）.The smokers had higher PPI amplitude than the non-smokers （P ＜0.05）.Conclusions There is obvious PPI and P50 deficits in schizophrenic patients.However,these deficits are relatively preserved in the smokers compared with the non-smokers,which suggests that long-term smoking might partially improve the sensory gating in schizophrenic patients.Whether this conclusion can be deduced to female patients requires further follow-ups.     

Clinical efficacy and safety of moxifloxacin versus levofloxacin plus metronidazole for community-acquired pneumonia with aspiration factors

Background Community-acquired pneumonia （CAP） is a common infectious disease throughout the world and the incidence continues to grow as the population ages.Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem.Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.Methods In this prospective,multicenter,open-label,randomized controlled trial,77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole.The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.Results Seven days after the end of therapy a clinical cure was achieved for 76.7％ （23 of 37） of efficacy-evaluable patients in the moxifloxacin group and 51.7％ （15 of 40） of patients in the levofloxacin plus metronidazole group.There was a significant difference between the two groups （x2=4.002,P ＜0.05）.Bacteriological success rates were similar in the moxifloxacin group （93.3％） and levofloxacin plus metronidazole group （96.4％）,there was no significant difference between the two groups （P ＞0.05）.The overall adverse event rate was 10.8％ （4/37） in the moxifloxacin group versus 17.5％ （7/40） in the levofloxacin plus metronidazole group,there was no significant difference between the two groups （P＞0.05）.No serious adverse events were observed.Conclusions Moxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors.And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.     

Total Cavopulmonary Connection： Lateral Tunnel Anastomosis or Extracardiac Conduit？——an Analysis of 114 Consecutive Patients

Objective To compare the postoperative outcomes of patients with the diagnostic univentricular heart undergoing lateral tunnel （LT） operation with extracardiac conduit （EC） operation. Methods- From June 1996 to July 2007, 114 consecutive patients with a single ventricle underwent total cavopulmonary connection （TCPC） in Children＇s Heart Center, lAniversity Hospital Giessen and Marburg GmbH, Germany. A LT was performed in 19 （16.7%） patients, and an EC in 95 （83.3%） patients. The mean age of EC group was 50.8±31.6 （ranging from 22 to 212） months, and that of LT group was 61.5±41.2 （ranging from 30 to 168） months. Early and midterm outcomes of two groups were analyzed.Results One died in LT group （5.3%） and three in EC group （3.2%）. The overall mortality was 3.5%. There was no significant difference in mortality between EC-and-LT groups （P〉0.05）. The postoperative pulmonary arterial pressure, oxygen saturation, and effusion time of two groups had no significant difference （all P〉0.05）. No significant difference in the occurrences of complications （arrhythmias, enteropathy, and thrombosis） was found between two groups after operation （P〉0.05）. Conclusions There seems no difference between LT and EC in the clinical results in the early and middle postoperative stage. Glenn anastomosis followed by an EC seems to have some advantages.     

Prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer

Background The prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer （NSCLC） remains unclear.This study intends to identify the prognostic factors and to optimize treatments for these patients under update conditions.Methods The data of 124 NSCLC patients who underwent R1-resection at the bronchial stump was reviewed.There were 41 patients in the surgery group （S）,21 in the postoperative radiotherapy （PORT） group （S＋R）,30 in the postoperative chemotherapy （POCT） group （S＋C）,and 32 in the PORT plus POCT group （S＋R＋C）.The constitute proportion in different groups was tested using the X2 method,univariate analysis was performed using the Kaplan-Meier and log-rank method,and multivariate analysis was done using the Cox hazard regression with entry factors including age,sex,pathological type and stage,classification of the residual disease,and treatment procedure.The process was performed stepwise backward with a maximum iteration of 20 and an entry possibility of 0.05 as well as an excluded possibility of 0.10 at each step.Results In univariate analysis,survival was more favorable for patients with squamous cell carcinoma,early pathological T or N stage,and chemotherapy or radiotherapy.There was no significant difference in the survival for patients with different types of the residual disease,except for the difference between patients with carcinoma in situ and lymphangiosis carcinomatosa （P=0.030）.The survival for patients receiving chemoradiotherapy was superior to that for those undergoing surgery alone （P=0.016）.In multivariate analysis,the pathological type （HR 2.51,95% CI 1.59 to 3.96,P=0.000）,pathological T （HR 1.29,95% CI 1.04 to 1.60,P=-0.021） or N stage （HR 2.04,95% CI 1.40 to 2.98,P=0.000）,and chemotherapy （HR 0.24,95% CI 0.13 to 0.43,P=0.000） were independent prognostic factors.Conclusion Patients with squamous cell carcinoma,early pathological T or N stage,or receiving chemotherapy had a more favorable pro     

Effect of Laser in situ Keratomileusis on Accommodation

The accommodative function before and after laser in situ keratomileusis （LASIK） was observed, and the effect of LASIK on accommodation was investigated. In a prospective clinical trial, 48 myopic patients （96 eyes） subject to bilateral LASIK in Refractive Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology （China） from March 2006 to June 2006 were selected and studied. Refractions, accommodative range, amplitude of accommodative response and high frequency component （HFC） of accommodative microfluctuations were measured with NEDIK-730A before and one week and 30 days after operation. Dominant and non-dominant eyes were determined by hole-in-card method. It was found that all of the operative eyes showed an uncorrected visual acuity of 0.8 or better one week postoperatively, and 1.0 or better 30 days postoperatively. Compared with those preoperatively, accommodative range and HFC had no significant difference at first week and 30th day after operation in both dominant eyes and non-dominant eyes （P〉0.05）, but there was a significant difference in the amplitude of accommodative response/accommodative stimulus ratio （A/S） after operation （P〈0.01）, and no significant difference was found in accommodation between one week and 30 days postoperation. No ocular dominance＇s change was noted. There was no significant difference in accommodative function between dominant eyes and non-dominant eyes. It was suggested that LASIK produced no significant effect on accommodation.     

Refinement of CARTO-guided substrate modification in patients with ventricular tachycardia after myocardial infarction

Background Substrate modification guided by CARTO system has been introduced to facilitate linear ablation of ventricular tachycardia （VT） after myocardial infarction （MI）. However, there is no commonly accepted standard approach available for drawing these ablation lines. Therefore, the aim of the present study was to practically refine this time consuming procedure.
Methods Substrate modification was performed in 23 consecutive patients with frequent VTs after MI using the CARTO system. The initial target site （ITS） for ablation was identified by pace mapping （PM） during sinus rhythm and/or entrainment pacing （EM） during VT. According to the initial target site, two approaches were used. The initial target site in approach one has a similar QRS morphology as VT and an interval from the stimulus to the onset of QRS cmplex （S-QRS） of ≥50 ms during PM in sinus rhythm or a difference of the post pacing interval and VT cycle length ≤30 ms during concealed entrainment pacing of VT; The initial target site in approach two has an similar QRS morphology as VT and an S-QRS of 〈50 ms during PM in sinus rhythm.
Results Overall, 50 lines were performed with a length of （35±11） mm. Procedure time averaged （232±56） minutes, fluoroscopy time （10±8） minutes. Sixteen patients were initially involved into approach one. After completion of 3±1 ablation lines, no further VT was inducible in 13 patients. The remaining 3 patients were switched to use the alternative approach. However, in none of them the alternative approaches were successful. Approach two was initially used in 7 patients. After completion of 3±1 ablation lines, no further VT was inducible in only 2 patients. The remaining 5 patients were switched to approach one, which resulted in noninducibility of VT in 4 of them. The initial successful rate was significantly higher in the group of approach one compared to that in the group of approach two （13/16 patients vs 2/7 patients, P=-0.026）.
Conclusions The approach for     

The clinical value of BALP on diagnosis and treatment of osteoporosis in postmenopausal women

Objective： To investigate the changes of bone-specific alkaline phosphatase （BALP） in postmenopausal women, analyze the relationship between BALP and bone mineral density, and study the effects of treatment with risedronate on BALP. Methods ： In this study, 243 women who were all at least 1 year past natural menopause were divided into two groups according to WHO standards. Group Ⅰ was 100 osteopenic patients aged from 43 to 85 （mean age, 61.2 years）. Group Ⅱ was 143 osteoporotic patients aged from 45 to 80（mean age, 62.6 yearsi. Bone mineral density（BMD） was measured by dual-energy X-ray absorptiometry （DEXA） and bone-specific alkaline phosphatase（BALP） was tested among all the patients. All the osteoporotic patients received 1-year Risedronate treatment. BALP was tested again after 3 months treatment of Risedronate for osteoporotic patients and BMD was measured after 1-year treatment. All data were processed by the application of statistical package SAS for windows V.6.12. Results： BALP was greater in the osteoporotic patients as compared with the osteopenic patients （P 〈 0.05）. There was also a significant difference of BALP in the patients before and after treatment of risedronate （P 〈 0.05）. BALP was greater in the patients who were less than 5 years past a natural menopause as compared with those who were more than 5 years past a natural menopause （P 〈 0.05）. There was no significant difference of BALP in the patients who were more than 10 years past a natural menopause. Risedronate decreased serum BALP significantly. Logistic regression analyses showed that 3-month percentage decrease in BALP was profoundly associated with the 1-year percentage increase in BMD（r = 0.696, P 〈 0.01 ）. Conclusion： BALP can predict the response in bone mass during Risedronate treatment in postmenopausal women and identify those noncompliant patients. 3-month percentage change in serum BALP was significantly correlated with the increase of BMD. Serum BALP can play a role in the monitoring of risedronate-treated postmenopausal women with osteoporosis, but it is poor to predict the treatment effects on an individual level.     

COA theme issue of the Chinese Medical Journal: A call for papers

Background Rheumatoid arthritis （RA） is characterized by inflammation of the synovial membrane, leading to invasion of synovial tissue into the adjacent cartilage matrix with degradation of articular cartilage and bone as a consequence. Dickkopf-1 （DKK-1） and osteoprotegerin （OPG） have been demonstrated to be key molecules involved in bone erosion and bone remodeling. The aim of this study was to explore the potential role of DKK-1 and OPG in different stage of RA. Methods The protein levels of DKK-1 and OPG were detected by ELISA. The serum samples were collected from 300 patients with RA and 60 healthy controls. Of which, 150 RA patients were defined as early RA （disease duration 〈1 year）, and other 150 RA patients were defined as Ionglasting RA （disease duration 〉5 years）. At the time of serum sampling, various clinical and laboratory parameters were assessed. The correlations of DKK-1 or OPG and clinical/laboratory parameters were analyzed. Results The serum level of DKK-1 was elevated in patients with longstanding RA compared with healthy controls, while no significant difference was observed between the two groups in the level of OPG. In contrast, in early RA patients, the circulating OPG was elevated, while there was no significant difference between the two groups in expression of DKK-I. The serum DKK-1 was correlated with Sharp score and DAS28 in longstanding RA patients. In early RA, age was the only parameter that was significantly related to serum OPG. Conclusions There was a cross-talk between DKK-1 and OPG, which involved in bone destruction in RA. In different stage of RA, DKK-1 and OPG may play different roles in the pathogenesis of RA.     

上唇系带的结节与隆起：转移性结直肠癌的诊断标记物

Objective： To determine whether the nodule and eminence on the frenulum labii superioris, location of Yinjiao （DU28） according to the meridian theory, could be used to prognosticate the recurrence of patients with colorectal cancer. Methods： The data of 101 patients with colorectal cancer in Tianjin Medical University Cancer Institute and Hospital from May 2011 to November 2011 was analyzed. The photos of all patients＇ frenulum labii superioris were taken. Nodule and eminence on frenulum labii superioris were the positive standard. Biopsy and pathological testing for the nodule were carried out on one patient with large nodule on frenulum labii superioris. Results： Patients with positive frenulum labii superioris had a higher risk of recurrence and/or metastasis than patients with negative frenulum labii superioris. There were no significant differences in diagnosis of recurrence and/or metastasis between the status of frenulum labii superioris and the traditional diagnostic criteria （P=0.238）. The Kappa was 0.606 （P〈0.001）. The sensitivity was 76.0% and the specificity was 85.4%. The pathological report demonstrated that the nodule on frenulum labii superioris was mucosal excrescence with normal structure. Conclusion： Nodule and eminence on frenulum labii superioris are potential diagnostic markers for metastatic colorectal cancer.     

难治性抑郁症和首发抑郁症听觉P50与认知功能的相关研究

目的探讨难治性抑郁症（TRD）和首发抑郁症（FED）患者听觉诱发电位P50和认知功能的相关性及其可能的神经生理机制。方法应用美国NicoletBravo脑电生理仪,对33例TRD、37例FED和35名健康对照者（HC）进行P50和认知功能检测,并对两者进行相关分析。结果①TRD患者的S2-P50波幅以及S2/S1,S1-S2和100（1-S2／S1）三种表达式与FED、HC组存在显著性差异（P〈0．05或P〈0．01）;②TRD患者的总智商、操作智商、长时记忆和短时记忆与FED、HC组存在显著性差异（P〈0．05或P〈0．01）;③TRD患者的P50异常指标与其短时记忆中的图片、再生和触觉功能损害显著相关（P〈0．05或P〈0．01）。结论TRD患者比FED患者存在更为显著的感觉门P50异常和认知功能损害,其P50异常与患者的短时记忆损害存在显著的相关性。     

舒必利对难治性抑郁症的增效作用

目的:探讨文拉法辛缓释胶囊联合小剂量舒必利治疗难治性抑郁症的疗效及安全性.方法:73例难治性抑郁症患者随机分为合用组38例,单用组35例,总疗效8周.于治疗前和治疗2、4、6、8周分别用汉密尔顿抑郁量表(HAMD-17)及治疗中出现的症状量表(TESS)评定疗效及不良反应.结果:两组评分较治疗前均显著下降(P＜0.01),但合用组显效率显著较好(P＜0.05).两组不良反应差异无统计学意义(P＞0.05).结论:文拉法辛缓释胶囊联合小剂量舒必利治疗难治性抑郁症疗效明显优于单用文拉法辛缓释胶囊,安全性较好.     

不同药物治疗方案对难治性抑郁症患者社会功能的影响

目的 研究不同药物治疗方案对难治性抑郁症(TRD)患者社会功能的影响.方法 对375例TRD患者随机分为帕罗西汀组、文拉法辛组、米氮平组、帕罗西汀+利培酮组、帕罗西汀+丙戊酸钠组、帕罗西汀+丁螺环酮组、帕罗西汀+曲唑酮组及帕罗西汀+甲状腺素组共8组进行双盲对照治疗8周,分别于基线、8周末评定社会功能缺陷筛选量表(SDSS),于基线、4周末及8周末评定健康调查问卷(SF-36)及17项汉密顿抑郁量表(HAMD-17).结果 8组SDSS8周末评分与基线比较均差异有显著性(P＜0.01);SF-36社会功能因子分4周末、8周末与基线比较均差异有显著性(均P＜0.01),SF-36社会功能因子分(除外帕罗西汀组、文拉法辛组)8周末与4周末比较、8周末减分与4周末减分比较均差异有显著性(P＜0.05或P＜0.01).8组SDSS8周末减分[帕罗西汀+利培酮组(7.05±6.39)分、米氮平组(6.53±4.75)分、帕罗西汀+甲状腺素组(5.14±4.94)分、帕罗西汀组(5.13±4.94)分、帕罗西汀+曲唑酮组(5.00±4.94)分、帕罗西汀+丙戊酸钠组(4.60±4.09)分、文拉法辛组(4.57±4.18)分、帕罗西汀+丁螺环酮组(4.24±4.95)分]比较差异有显著性(Z=2.076,P=0.038).两两比较帕罗西汀+利培酮组分别与文拉法辛组、帕罗西汀+丙戊酸钠组及帕罗西汀+丁螺环酮组比较均差异有显著性(P＜0.05),米氮平组与帕罗西汀+丁螺环酮组比较差异有显著性(P＜0.05).多元逐步回归分析显示:SDSS8周末减分与HAMD-17基线分、HAMD-17 8周末减分及本次病期相关.结论 8种药物治疗方案均能显著改善TRD患者的社会功能,但改善程度、改善时序不一;影响社会功能恢复的因素主要是抑郁症状严重程度、药物疗效及本次病期.     

色氨酸羟化酶2基因多态性与重症抑郁发作和治疗反应的关系分析

目的分析中国汉族人群中色氨酸羟化酶2（TPH-2）基因单核苷酸多态性（SNP）rs4570625和rs7305115位点与重症抑郁发作（MDD）和抗抑郁药物治疗反应的关系。方法设立病例组（汉族MDD患者,n=346）和对照组（汉族正常人,n=347）;根据对治疗的反应,病例组患者再分为难治性抑郁症组（TRD组,n=72）和非TRD组（NTRD组,n=274）。通过Taqm an探针SNP基因分型技术对TPH-2基因的rs4570625和rs7305115位点进行基因分型,分析等位基因和基因型频率在各组间的分布差异。结果病例组TPH-2基因rs4570625位点的基因型及等位基因分布的频率与对照组比较,差异有统计学意义（P〈0.05）。按性别分层后,男性TRD组与男性NTRD组SNPs rs4570625和rs7305115位点的基因型和等位基因分布频率比较,差异有统计学意义（P〈0.05）。结论 TPH-2基因rs4570625位点可能与抑郁症的发病有关;男性患者rs4570625和rs7305115位点的多态可能可用于预测对治疗的反应。     

文拉法辛治疗抑郁症伴焦虑症状的疗效及影响因素

目的探讨文拉法辛治疗抑郁症伴焦虑症状患者的疗效及影响因素。方法采用汉密尔顿抑郁量表-17项(HAMD-17)和汉密尔顿焦虑量表(HAMA)筛选60例抑郁症伴焦虑症状患者,并随机进行国产文拉法辛缓释片治疗(博乐欣组,n=31)或进口文拉法辛胶囊治疗(怡诺思组,n=29),治疗8周,观察两组患者的疗效以及不同焦虑程度患者的疗效,分析抑郁和焦虑症状首次缓解时间的影响因素。结果治疗3周后,博乐欣组和怡诺思组抑郁和焦虑症状得分均显著降低(P<0.05);治疗8周后,两组治疗有效率分别为77.4%和65.5%。不同焦虑程度患者HAMD-17基线分差异有统计学意义(P<0.01),治疗3周后HAMD-17得分差异无统计学意义(P>0.05),各时段治疗有效率差异无统计学意义(P>0.05)。抑郁症状首次缓解时间与首次发作存在诱因和HAMD-17基线分呈显著负相关(P<0.05),与HAMA基线分呈显著正相关(P<0.05);而焦虑症状首次缓解时间与年龄呈显著正相关(P<0.05),与首次发作存在诱因呈显著负相关(P<0.01)。结论文拉法辛对抑郁症伴焦虑症状患者具有较好疗效。     

色氨酸羟化酶2基因多态性与重症抑郁发作和治疗反应的关系分析

目的 分析中国汉族人群中色氨酸羟化酶2(TPH-2)基因单核苷酸多态性(SNP)rs4570625 和rs7305115位点与重症抑郁发作(MDD)和抗抑郁药物治疗反应的关系.方法 设立病例组(汉族MDD患者,n=346)和对照组(汉族正常人,n=347);根据对治疗的反应,病例组患者再分为难治性抑郁症组(TRD组,n=72)和非TRD组(NTRD组,n=274).通过Taqman探针SNP基因分型技术对TPH-2基因的 rs4570625和rs7305115位点进行基因分型,分析等位基因和基因型频率在各组间的分布差异.结果 病例组TPH-2基因rs4570625位点的基因型及等位基因分布的频率与对照组比较,差异有统计学意义(P<0.05).按性别分层后,男性TRD组与男性NTRD组SNPs rs4570625和rs7305115位点的基因型和等位基因分布频率比较,差异有统计学意义(P<0.05).结论 TPH-2基因rs4570625位点可能与抑郁症的发病有关;男性患者rs4570625和rs7305115位点的多态可能可用于预测对治疗的反应.     

难治性抑郁症文拉法辛与米氮平治疗的药物经济学分析

目的 比较文拉法辛和米氮平治疗难治性抑郁症的成本-效果和成本-效用.方法 研究纳入难治性抑郁症患者105例,按照计算机生成的随机数随机分为文拉法辛组50例和米氮平组55例.计算8周治疗药费成本,以临床治愈率和临床有效率为治疗效果,质量调整生命年为治疗效用.采用描述性分析及非参数检验比较两组的成本-效果和成本-效用.结果 治疗8周每位抑郁症患者治疗成本文拉法辛组1 396.44元,米氮平组1 206.90元,前者比后者成本高189.54元.成本-效果分析显示,两组每成功治愈或治疗有效1％患者的成本接近（临床治愈率成本相差0.06元,临床有效率成本相差1.08元）.成本-效用分析显示两组之间差异无统计学意义（生理机能Z=-0.15,P＞0.05;心理健康Z=-0.54,P＞0.05）.结论 文拉法辛和米氮平治疗难治性抑郁症的成本-效果、成本-效用相似.     

伴和不伴有凶杀行为的精神分裂症患者听觉感觉门控P50的研究

目的 分析伴和不伴有凶杀行为的精神分裂症患者听觉感觉门控P50的变化及其意义.方法 应用256导联高密度脑电仪采用听觉条件(S1)-测试刺激(S2)模式对26例具有凶杀行为的精神分裂症患者(凶杀组)、27例非凶杀行为的精神分裂症患者(非凶杀组)和32名正常对照者(正常组)进行听觉诱发电位P50检测.应用阳性和阴性症状评定量表(PANSS)对患者进行临床精神症状评定.结果 (1)与正常组相比,凶杀组、非凶杀组S1-P50的波幅[Fz脑区分别为(2.4±1.6)μV、(2.5±1.5)μV和(3.4±2.7)μV和潜伏期[Fz脑区分别为(68±19)ms、(67±20)ms和(61±19)ms]差异均无统计学意义(均P＞0.05),s2.P50波幅高[Fz脑区分别为(0.8±0.7)μV、(2.5 ±1.6)μV和(3.3±2.2)μV]和潜伏期延迟[Fz脑区分别为(50 4±26)ms、(75±19)ms和(70±24)ms](均P＜0.01);凶杀组和非凶杀组的s2-P50波幅和潜伏期差异均无统计学意义(均P＞0.05).(2)与正常组相比,凶杀组、非凶杀组的S2/S1比值高[Fz脑区分别为35±26、153±137和125±85],S1-S2差值小[Fz脑区分别为1.69 ±1.55、0.08 ±2.41和0.17±2.30]和100(1-S2/S1)值小[Fz脑区分别为65 ±26、-53 ±137和-25 ±85](P＜0.01).而凶杀组和非凶杀组的S2/S1比值、S1-S2差值和100(1-S2/S1)差异均尤统计学意义(均P＞0.05).(3)凶杀组和非凶杀组的PANSS总分、阳性量表总分、阴性量表总分及一般精神病理量表总分的差异均无统计学意义[凶杀组分别为:(110 ±27)分、(26±10)分、(29±7)分、(55±12)分;非凶杀组分别为:(105 ±27)分、(24 ±8)分、(28±10)分、(53 ±12)分](均P＞0.05),且与反映P50的S/S1、S1-S2差值和100(1-S2/S1)指标的相关性差异均无统计学意义(均P＞0.05).结论 伴和不伴有凶杀行为的精神分裂症患者感觉门控存在异常,能通过听觉P50检测,但P50指标无差异.     

广泛性焦虑与强迫症患者的感觉门抑制比较研究

目的 了解广泛性焦虑(GAD)和强迫症(OCD)患者的听觉P50特点,为感觉门理论提供证据.方法 应用美国Nicolet Bravo脑电生理仪,采用听觉条件刺激(S1)-测试刺激(S2)模式对41例GAD和69例OCD及58名正常对照组作了听觉PSO检测.结果 (1)三组在S1-P50潜伏期以及S2-P50潜伏期上差异无统计学意义(P>0.05).(2)三组在S1-P50波幅(NC:6±3,GAD:3±2,OCD:5±3,P<0.01)、S2-P50波幅(NC:2±1,GAD:4±1,OCD:2±1,P<0.01)、S2/S1、S1-S2、100(1-S2/S1)上三组差异有统计学意义(P<0.01).(3)GAD和OCD S1-P50波幅明显低于正常对照组.OCD S2-P50波幅明显高于正常对照组.(4)P50抑制明显减弱,即S2/S1比值明显增高(NC:39%±22%,GAD:50%±29%,OCD:88%±42%,P<0.01).(5)S1-S2和100(1-S2/S1)均下降(NC:3±2和61±22;OCD:1±1和15±22,GAD:3±3和50±29,P<0.01).(6)OCD组S2/S1高于GAD组.OCD组S1-S2和100(1-S2/S1)低于GAD组(P<0.01).结论 焦虑障碍的感觉门同样也存在异常,表现为抑制不足,能通过听觉PS0进行定量检测.S2/S1、S1-S2和100(1-S2/S1)3种表达式的结合有可能是特定的脑电生物学指标之一.     

注意缺陷多动障碍患儿执行功能和 感觉门控功能分析

目的 探讨注意缺陷多动障碍（ADHD）患儿执行功能和感觉门控功能状况,并分析两者之间的 关系。方法 36 例符合国际疾病分类第10 版（ICD-10）ADHD 诊断标准的患儿分别进行威斯康星卡片分类 （WCST）测试和听觉click 刺激模式ERP-P50 检查,并与38 例性别、年龄与其匹配的对照组进行对比,同 时将患儿WCST 各指标与ERP-P50 各指标之间进行Pearson 相关分析。结果 ADHD 患儿组P50 S1、P50 S2 潜伏期较对照组延长,P50 S1、（S1-S2）波幅、100（1-S2/S1）较对照组降低,S2 波幅、S2/S1 比值较对照组增高, WCST 中完成分类数（Cc）、概念化水平（CI%）较对照组降低,错误应答数（Re）、持续错误数（Rpe）、完 成第1 个分类所需应答数（Rf）较对照组增加,差异有统计学意义（P <0.05）;Pearson 相关分析得出P50 S1、 P50 S2 潜伏期和P50 S1 波幅与WCST 各指标之间无相关性（P >0.05）,P50 S2 波幅、S2/S1 比值与Cc、CI% 呈负相关,与Re、Rpe、Rf 呈正相关（P <0.05）;（S1-S2）波幅、100（1-S2/S1）与Cc、CI% 呈正相关,与 RE、Rpe、Rf 呈负相关（P <0.05）。结论 ADHD 患儿存在执行功能及感觉门控功能的损害,且感觉门控功 能损害与执行功能损害之间存在一定的相关性。