奥氮平治疗精神分裂症患者家属心理状况分析

目的探讨应用奥氮平治疗首发精神分裂症患者家属的心理健康状况及应对方式。方法将110例应用奥氮平治疗的精神分裂症患者家属做为研究组,102例应用氟哌啶醇治疗的精神分裂症患者家属做为对照组,共治疗3个月,治疗前后使用症状自评量表、应对方式问卷评定患者家属的心理健康状况。结果经过三个月治疗后,研究组家属的SCL-90除偏执因子外,其余因子得分均显著低于对照组（P〈0.05）,应对方式问卷中研究组的解决问题、求助两个积极因子显著高于对照组（P〈0.05）,自责、退避两个消极因子得分显著低于对照组（P〈0.05）。结论应用奥氮平的精神分裂症患者家属的心理状况和应对方式优于应用传统抗精神病药治疗的精神分裂症家属。     

认知行为治疗对精神分裂症顽固性幻听的疗效研究

目的 探讨认知行为治疗对精神分裂症顽固性幻听的疗效.方法 60例伴有顽固性幻听的精神分裂症患者随机分为对照组和研究组,各30例.对照组接受常规治疗,研究组在常规治疗基础上联合认知行为治疗,即在8周的时间内给予8次认知行为治疗.采用阳性与阴性症状量表(PAN-SS)、精神病症状评定量表(PSYRATS)和焦虑自评量表(SAS)分别于治疗前、治疗结束时及随访24周评定患者的临床症状.结果 8周治疗结束时,在PANSS的一般精神病理和SAS评分上,研究组显著低于对照组(P＜0.05);随访24周时,在PANSS的幻听、阳性症状、阴性症状、一般精神病理、PSYR-ATS和SAS评分上,研究组显著低于对照组(P＜0.05).对于幻听,研究组有效率显著高于对照组(P＜0.05).结论 认知行为治疗可能有助于改善精神分裂症的幻听症状,但需要进一步研究.     

儿童精神分裂症认知功能研究

目的:探讨儿童精神分裂症患者的认知功能及与临床症状的关系. 方法:60例未经治疗的儿童首发精神分裂症患者(研究组)和30名健康学龄儿童(对照组),采用中国韦氏儿童智力量表(C-wIsc)、临床记忆量表和瑞文标准推理测验进行认知功能评定;研究组以阳性症状量表(SAPS)和阴性症状量表(SANS)进行临床评估. 结果:研究组总智商(FIQ)评分(97.2±15.6)分,言语智商(VIQ)(100.4±12.6)分和操作智商(PIQ)(90.5±15.3)分显著低于对照组的(115.3±13.7)分,(119.2±11.8)分和(110.6±14.8)分(P均=0.000).研究组等值记忆商MQ评分(70.5±15.2)分显著低于对照组(105.9±13.8)分(P均<0.001).研究组瑞文标准推理测验标准分中位数为5分,对照组为3分(X<'2>=6.44,P<0.05).研究组IQ、MQ及瑞文标准推理测验与SAPS阳性症状评分无显著相关,但与某些SANS阴性症状评分显著相关(r=-0.36,-0.42;P<0.05或P<0.01). 结论:儿童精神分裂症患者存在认知功能障碍,表现为智力发展不平衡、记忆障碍以及执行功能障碍;临床记忆及瑞文标准推理测验缺损与阴性症状严重程度有一定的关系,但与阳性症状无关.     

首发精神分裂症患者血清 β2微球蛋白的变化

目的 探讨精神分裂症患者血清β2微球蛋白(β2-MG)的变化及其临床意义.方法 随机选取60例精神分裂症患者为研究组,60名健康人为对照组,在基线测定两组人群血清β2-M G水平,并应用阳性与阴性症状量表(PANSS)评定精神分裂症患者的精神症状.结果 研究组血清β2-MG水平较对照组明显升高,差异有统计学意义(P<0.05);研究组血清β2-MG水平与PANSS总分(r=0.477,P<0.001)、阴性分(r=0.422,P=0.001)和一般精神病理分(r=0.391,P=0.002)呈正相关,与阳性分无相关性(r=0.107,P=0.418).结论 血清β2-M G在精神分裂症的发病过程中可能起到重要作用,其浓度可作为评定精神分裂症患者免疫功能的指标之一.     

护理干预对精神分裂症患者生活质量的影响

目的 探讨护理干预对精神分裂症患者生活质量的影响.方法 对100例精神分裂症患者随机分为研究组与对照组,每组各50例.研究组实施护理干预,对照组仅实施常规护理.分别采用阳性与阴性症状量表(PANSS)、生活质量综合评定问卷(GQOLI-74)评定患者疗效及生活质量.结果 护理干预后研究组PANSS总分及阴、阳性症状评分...     

对门诊颌面外伤清创手术患儿家属进行心理疏导在防范医疗纠纷中的作用

目的探讨对门诊颌面外伤清创手术患儿的家属进行心理疏导在防范医疗纠纷中的作用。方法选择我院2016年9月～2019年10月收治的60例门诊颌面外伤清创手术患儿家长作为对象。根据随机数表法将60例家属分成对照组和研究组,每组30例。对照组进行简单的安慰鼓励,研究组给予心理疏导。对比观察两组家属的满意度及焦虑情绪,并且统计医疗纠纷发生情况。结果 (1)研究组家属满意度93.3%,高于对照组80%(P0.05);(2)护理前,两组家属的焦虑情绪无统计学差异(P0.05),而护理后研究组焦虑评分低于对照组(P0.05);(3)统计医疗纠纷,研究组0例,对照组2例,发生率比较,研究组低于对照组(P0.05)。结论患儿门诊颌面外伤清创手术期间,加强对家属的心理疏导,可防范医疗纠纷。     

护理门诊对精神分裂症患者康复和生活质量的影响

目的 探讨精神分裂症护理门诊对精神分裂症患者康复和生活质量的影响.方法 将250例出院的精神分裂症患者随机分为研究组和对照组,2组均予以利培酮维持治疗.研究组在此基础上予以精神分裂症护理门诊干预.采用阴性症状与阳性症状量表(PANSS)、生活质量综合评定问卷(GQOLI)及总体幸福感量表(GWB)分别于出院时及出院3年末进行评估.结果 1年末,研究组PANSS总分较出院时明显降低(P<0.01),也显著低于对照组(P<0.01).研究组GQOLI评分和GWB评分在1年末均显著高于对照组(P<0.01).结论 精神分裂症护理门诊有助于进一步改善精神分裂症患者的精神症状,提高患者的生活质和幸福感.     

重复经颅磁刺激干预对精神分裂症超高危人群的影响

目的:探讨重复经颅磁刺激(rTMS)干预对精神分裂症超高危人群的影响.方法:采用随机数字表法将60例经精神病风险综合征定式访谈筛选的精神分裂症超高危患者分为研究组(n=30)和对照组(n=30);采用低频rTMS分别对研究组及对照组予以真、伪刺激5次/周,连续4周.分别于治疗前后进行阳性与阴性症状评定量表(PANSS)...     

精神分裂症辅以体育锻炼疗效观察

目的:探讨体育锻炼对精神分裂症的辅助治疗作用.方法:在药物治疗的同时对60例慢性精神分裂症辅以体育锻炼(研究组),疗程6个月.采用阳性与阴性症状量表(PANSS)于治疗前、治疗3、6个月分别各评定1次;于治疗前、治疗6个月后作实验室检查;并与常规药物治疗的52例进行对照(对照组).结果:研究组PANSS总分、阴性量表分和血糖比对照组降低,差异有显著性.结论:体育锻炼对慢性精神分裂症的阴性症状有一定的治疗作用,对糖尿病的预防有益.     

竞争性就业状态下的城市男性精神分裂症患者生活质量调查

目的:了解竞争性就业状态下的城市男性精神分裂症患者生活质量状况.方法:收集符合竞争性就业标准的30例城市男性精神分裂症患者作为研究组,不符合竞争性就业标准的30例城市男性精神分裂症患者作为对照组,用自制一般资料调查表、阳性与阴性症状量表(PANSS)、生活质量综合评定问卷( GQOU)评定两组患者. 结果:两组患者一般...     

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     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

广西农村壮族妇女精神分裂症患者生活质量状况调查

目的研究农村壮族妇女精神分裂症患者的生活质量及影响因素。方法前瞻性的队列研究。采用随机分层抽样法分为农村壮族妇女精神分裂症组、农村汉族妇女精神分裂症组、农村正常妇女对照组,应用“世界卫生组织生存质量测定报告”(WHOQOL-100)及PANSS量表调查其生活质量和疾病的严重程度。结果农村壮族妇女精神分裂症患者生活质量明显低于农村汉族妇女精神分裂症患者,影响其生活质量的相关因素是生活环境及精神支柱/个人信仰。结论经济贫困、环境条件、缺乏有效的医疗服务和社会保障是农村壮族妇女精神分裂症患者生活质量低的关键。因此,建立农村壮族社区精神卫生服务网络势在必行。     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

The origins of innervation of the esophagus of the dog

This study defined the origins of extrinsic efferent and afferent innervation of the normal canine esophagus. When all the layers of the wall of the 3 esophageal regions (cervical, thoracic and abdominal) were injected with horseradish peroxidase (HRP), labeled nerve cells were found in the nucleus ambiguus (NA) and parasympathetic nucleus of X (PX) of the brainstem. Most labeled cells in the NA were located in the compact column (retrofacial nucleus) while labeled cells in the PX were located in separate rostral and caudal areas. There was no somatotopic organization in either the NA or PX. Labeled sympathetic postganglionic neurons were found in the cranial cervical, middle cervical, cervicothoracic, thoracic sympathetic trunk and celiacomesenteric ganglia. The HRP injection of the esophageal wall labeled sensory cell bodies in the glossopharyngeal, proximal and distal vagal, and C2-T6 spinal ganglia. There was no discernible pattern of distribution of labeled cells in the autonomic or sensory ganglia. When the HRP injections were confined to the mucosa-submucosa layers of the thoracic esophagus, a small number of labeled cells were identified in the NA; however, no labeled cells were found in the NA when injections were confined to the mucosa-submucosa of either the cervical or abdominal esophageal regions. With these confined injections, the labeled nerve cells appeared in the rostral part of the PX. Thus, it appeared that the internal tunics of the esophagus (i.e., the mucosa and submucosa) were innervated by neurons in the rostral PX while the muscular tunic was innervated by neurons in the caudal PX and the rostral NA. After mucosa-submucosa injections, labeled sympathetic neurons appeared in the same ganglia that were identified after whole wall injections and these had a similar random distribution. These injections also labeled neurons in the glossopharyngeal, proximal vagal, and distal vagal ganglia, but unlike the whole wall injections there was no labeling in the spinal ganglia. This suggested that the labeled cells of the spinal ganglia seen after whole wall injections conveyed impulses from the tunica muscularis and serosa.     

Impact of our understanding of the genetic aetiology of epilepsy

A genetic contribution to aetiology is estimated to be present in up to 40% of patients with epilepsy. It is useful to categorise genetic epilepsies according to the mechanisms of inheritance into Mendelian disorders, non-mendelian or ‘complex’ disorders, and chromosomal disorders. Over 200 Mendelian diseases include epilepsy as part of the phenotype, and the genes for a number of these have been identified recently. These include autosomal recessive progressive myoclonic epilepsies such as Unverricht-Lundborg disease, Lafora disease and the neuronal ceroid lipofuscinoses, and three autosomal dominant idiopathic epilepsies. The last named have been shown to arise from mutations in ion channel genes. Autosomal dominant nocturnal frontal lobe epilepsy is caused by mutations in CHRNA4, benign familial neonatal convulsions by mutations in KCNQ2 and KCNQ3, and generalised epilepsy with febrile seizures plus by mutations in SCN1B. ‘Complex’, familial epilepsies are more difficult to analyse, but evidence has been obtained for loci predisposing to juvenile myoclonic epilepsy on chromosome 6p and 15q. Lastly, the genes underlying several spike-wave epilepsies in mice have been cloned, and three of these encode sub-units of voltage-gated calcium channels. Received: 29 September 1999/Accepted: 7 December 1999