5—HT6受体基因多态性与阿尔茨海默病的关联分析

目的探讨中国上海地区汉族人群中5-HT6受体基因多态性与阿尔茨海默病(AD)的相互关系.方法应用聚合酶链式反应(PCR)-限制性片段长度多态性(RFLP)方法,在106例AD患者,87例血管性痴呆(VD)患者和140例正常健康人中观察了5-HT6受体基因多态性的分布,并对5-HT6受体基因多态性与阿尔茨海默病之间的关系进行探讨.结果①阿尔茨海默病与5-HT6受体基因的多态性之间无显著意义的关联(P＞0.05);②在将受试人群进行ApoE基因分型后,ApoEε4型与非ApoEε4型人群中AD与5-HT6受体基因各基因型或等位基因均无关联(P＞0.05);③将AD患者进行ApoE基因分型后,非ApoEε4型AD与5-HT6的267C/T基因型正相关(OR=2.46,95%CI5.43-1.11,P＜0.05).结论中国上海地区汉族人群中5-HT6受体基因多态性与非ApoEε4型阿尔茨海默病相关联,表现为C/T型频率的升高.     

低密度脂蛋白受体相关蛋白基因两种多态性与阿尔茨海默病的关系

目的　探讨低密度脂蛋白受体相关蛋白 (LRP)基因两种多态性与阿尔茨海默病(Alzheimerdisease,AD)的相关情况。方法　应用分子生物学技术 ,在 42例患者和 40名正常人中观察LRP基因、ApoE基因多态性的分布 ,进行关联分析。结果　AD与LRP基因上游区域 5′端插入序列多态性无关联 ;AD与LRP基因外显子 3多态中的等位基因C正关联 (RR =2 .36 2 ,P <0 .0 5 ) ,与基因型C/C正关联 (RR =2 .710 ,P <0 .0 5 ) ;AD与ApoE基因ε4等位基因正关联 (RR =3.194,P <0 .0 1) ,与ε4/ 3基因型正关联 (RR =3.148,P <0 .0 5 ) ,但与ε4/ 2基因型无关 ;无ApoEε4等位基因的AD与LRPC/C基因型正关联 (RR =6 .842 ,P <0 .0 5 ) ,有ApoEε4等位基因的AD患者与LRPC/C基因型无关联(RR =1.85 7,P >0 .0 5 )。结论　ApoEε4是AD发病的风险因子 ;LRP基因多态性与AD正关联是由于LRP基因C/C型在患者中过表达所致 ;LRP基因C/C型是无ApoEε4的AD患者发病的风险因子。     

中性内肽酶基因C159T多态性与阿尔茨海默病关联的初步研究

目的 观察中性内肽酶(neprilysin,NEP)C159T多态在广东地区汉族老年人中的分布,探讨其与晚发阿尔茨海默病(AD)的相关性.方法 以91例晚发AD患者和97名正常老年人为对照进行病例-对照研究.用聚合酶链反应-限制性片段长度多态性方法(PCR-RFLP)分析NEP基因C159T多态性和载脂蛋白E(apoE)基因多态性.结果 AD组C159T多态T等位基因频率较对照组降低(23.2%vs 25.3%,χ2=184.96,P<0.05),而两组间基因型频率差异无统计学意义(P>0.05).AD组apoE等位基因ε4与AD成正关联(19.2%vs 8.2%,OR=2.648,χ2=9.66,P<0.05).无论是否携带ApoEε4,C159T各基因型和等位基因分布在两组间差异均无统计学意义(P>0.05).结论 NEP基因C159T多态C等位基因可能与晚发AD关联,未发现APOEε4与该多态性存在协同效应.     

心血管危险因子与迟发性阿尔茨海默病行为和精神症状间的相关性研究

目的研究心血管危险因子载脂蛋白E(ApoE)、载脂蛋白C-Ⅰ(ApoC-Ⅰ)以及低密度脂蛋白受体相关蛋白(LRP)与汉族迟发性阿尔茨海默病(LOAD)发生行为和精神症状(BPSD)之间的相关性。方法应用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)技术或直接通过PCR方法,分析了136例LOAD(伴BPSD者79例,无伴BPSD者57例)及150名健康老年人的ApoE、ApoC-Ⅰ与LRP基因型。结果①与对照组比较,BPSD组ApoEε4等位基因及ε4基因型出现的频率增高(P<0·001),而ApoEε3等位基因出现频率降低(P<0·001),ApoC-ⅠH2等位基因出现的频率增高(P<0·05);无BPSD组亦出现了ApoEε4等位基因及ε4基因型频率的增高(P<0·05)。②在BPSD组和无BPSD组中,前者ApoEε4等位基因及基因型出现的频率高于后者(P<0·05),而其ApoEε3等位基因频率则低于后者(P=0·001);前者ApoC-ⅠH2等位基因出现的频率高于后者(P=0·005),而其ApoC-ⅠH1等位基因频率则低于后者(P=0·005);③LRP各等位基因出现频率在3组间均无显著性差异(P>0·05)。结论ApoEε4及ApoC-ⅠH2等位基因是LOAD出现BPSD的遗传危险因子,ApoEε3及ApoC-ⅠH1等位基因则可能有保护效应;此研究未能证明LRP基因C766T多态性与LOAD出现BPSD有相关关系。     

四氢叶酸还原酶基因C677T突变与阿尔茨海默病有关

目的　调查一些候选基因的多态性与阿尔茨海默病 (Alzheimer disease,AD)发病的关系。方法　利用Roche公司 Roche Molecular System(RMS)提供的同时检测多种基因多态性的方法 ,检测 1 5种与脂代谢、血压和血栓形成相关基因的 2 9个多态性位点的基因型 ,比较 3 7例 AD患者和 84名健康人在这些等位基因频率方面的差别。结果　 AD组载脂蛋白 E(Apo E)常见基因多态性 (ε2、ε3、ε4)和甲烯四氢叶酸还原酶 (MTHFR)基因的 C677T多态性分布与健康对照组相比有显著不同。Apo Eε4和 MTHFR基因的 677T等位基因的频率在AD组显著高于对照组 (P <0 .0 5 )。结论　 MTHFR基因的 677T等位基因可能是除 Apo Eε4外另一个与 AD发病有关的遗传危险因素     

广州市阿尔茨海默病人及正常老人丁酰胆碱酯酶基因K变异对照研究

目的　观察丁酰胆碱酯酶基因 (BCHE)K变异在广州地区汉族老年人中的分布 ,探讨其与晚发阿尔茨海默病 (AD)的关联性。方法　以 10 6例晚发AD患者和 133名健康老年人为对象进行病例 对照研究。采用等位基因特异聚合酶链反应法 (AS PCR)分析BCHE基因K型多态性。结果　晚发AD患者和正常老年人中 ,正常等位基因 1的频率分别为 93 4 0 %和 93 6 1% ,K变异等位基因 2的频率分别为 6 6 0 %和 6 39% ;晚发AD患者和正常老年人之间BCHE基因K多态各等位基因和基因型分布差异无显著性 (P >0 0 5 ) ;样本采用载脂蛋白Eε4基因 (APOEε4 )分层后 ,AD组与对照组BCHE基因K变异频率仍然无显著性差异 (P >0 0 5 )。结论　BEHE K变异在广州地区汉族人群中与晚发AD不存在关联 ,提示该多态性不是晚发AD的风险因子。     

晚发阿尔茨海默病与早老素1基因及载脂蛋白E基因的关联分析

目的对中国汉族人群中早老素1(presenilin 1, PS1)基因8号内含子多态性与晚发阿尔茨海默病(AD)进行关联分析,探讨PS1与载脂蛋白E(ApoE)基因多态性有无相互作用.方法应用聚合酶链式反应和限制性片段长度多态性方法,检测了103例晚发AD患者和98例正常老年人中PS1与ApoE基因多态性,并对AD与PS1和ApoE各等位基因及基因型进行了关联分析.结果①在晚发AD患者中,PS1等位基因1和1/1基因型频率显著升高(Z=2.09,2.80,P＜0.05),而等位基因2的频率显著降低(Z=2.09,P＜0.05).②晚发AD患者与PS1等位基因1呈正相关(RR=1.58,χ2=5.11,P＜0.05),与PS1等位基因2呈负相关(RR=0.63,χ2=5.11,P＜0.05);晚发AD患者与PS 1/1基因型呈正相关(RR=2.43,χ2=7.57,P＜0.01),与1/2及2/2基因型无明显关联.③晚发AD与ApoE ε3/ε4基因型和等位基因ε4呈正相关(RR=2.95,χ2=8.18;RR=3.13,χ2=13.0,P均小于0.01).结论中国南方汉族人群中PS1和ApoE基因多态性与晚发AD之间有密切相关性.     

Alzheimer病和血管性痴呆患者APOE及LRP基因多态性与认知及精神行为症状相关性研究

目的 探讨Alzheimer病(AD)和血管性痴呆(VD)患者APOE及LRP基因多态性与认知及精神行为症状(BPSD)的相关性.方法 收集AD患者79例、VD患者85例和健康对照者(对照组)156名,采用简易精神状态检查量表(MMSE)评定认知功能;采用简明精神病量表和汉密尔顿抑郁(HAMD)、焦虑量表(HAMA)评定BPSD.采用PCR-RFLP进行APOEε、LRP基因分型.结果 (1)AD组(17.7％)及VD组(20.5％)APOEε4等位基因频率均高于对照组(5.7％,均P＜0.01).(2)AD组和VD组APOEε4携带者MMSE得分均低于同组APOEε4非携带者[AD组(13.84±2.32)分vs.(14.78±2.54)分,P＜0.01;VD组(15.53±1.87)分vs.(18.45±2.23)分,P＜0.01].(3)AD组患者APOEe4携带者BPSD比例明显高于APOEε4非携带者(55.56％ vs.52.83％,P=0.039).结论 APOEε4可能是AD、VD患者认知障碍的共同危险因素.APOEε4可能是AD的BPSD危险因素.     

脑啡肽酶基因多态性与散发性阿尔茨海默病的关系研究

目的探讨脑啡肽酶(neprilysin,NEP)基因单核苷酸多态性与中国北方汉族散发性阿尔茨海默病(sporadic Alzheimer’s disease,SAD)的关系。方法临床确诊的99例中国北方汉族SAD患者及109例正常对照,提取外周血基因组DNA,聚合酶链反应-限制性片段长度多态性结合DNA直接测序法确定NEP基因rs989692位点及rs6776185位点基因型,分析上述两个位点单核苷酸多态性与AD的关系。结果 AD组和正常对照组NEP基因rs989692位点各等位基因频率及基因型分布无显著性差异(P>0.05);AD组NEP基因rs6776185位点A等位基因频率显著高于正常对照组(88.9%vs 81.2%,P=0.029),AA基因型频率显著高于正常对照组(80.8%vs 67.0%,P=0.024);携带A等位基因者,发生AD的风险是不携带A等位基因者的1.85倍(OR=1.85,95%CI 1.07~3.20);经载脂蛋白E基因(apolipoprotein E,Apo E)ε4等位基因及年龄分层比较,携带ε4基因及年龄<75岁组,AD组A等位基因及AA基因型分布频率仍明显高于正常对照组(P<0.05)。结论 NEP基因rs6776185位点A等位基因和AA基因型可能是中国北方汉族人群SAD的危险因素,可使AD发病年龄提前,并与Apo Eε4等位基因可能具有协同作用。     

载脂蛋白E基因-219G/T多态与阿尔茨海默病的相关研究

目的　探讨上海地区汉族人群中载脂蛋白E基因 (ApoE)启动子区 2 1 9G/T多态与阿尔茨海默病(Alzheimer’sdisease,AD)发病风险的关系。方法　采用聚合酶链式反应 (PCR)和限制性片段长度多态 (RELP)方法 ,于 1 0 4例AD患者和 1 1 1例正常人中检测 2 1 9G/T多态各基因型及基因频率的分布。按比值比 (OR)作疾病关联分析。结果　①AD患者与正常对照人群之间不存在 2 1 9G/T多态各等位基因和基因型频率分布的差异 (P值均大于0 0 5) ;②按ApoEε4基因分层后 ,无论是ε4型人群还是非ε4型人群中都不存在AD患者与正常对照人群间的多态分布的差异 (P值均大于 0 0 5) ;③ 2 1 9G/T多态各基因型的分布不影响AD与ApoEε4等位基因的关联。结论　上海地区汉族人群中 ,ApoE基因启动子区 2 1 9G/T多态与AD无关     

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.     

《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。     

Onset of action of antipsychotics in the treatment of mania

Introduction: An important consideration in treating acute mania is the promptness with which a chosen therapy can bring symptom amelioration. This article reviews the available published data from controlled, blinded studies regarding the latency of responses to antipsychotics in patients with acute mania.

Methods: Articles for this review were obtained from a search of the Medline database (1966–1999), using the following keywords and phrases: antipsychotic, atypical, bipolar disorder, mania, neuroleptic, typical. The bibliographic sections of articles gleaned from this search were used to direct further inquiries.

Results: Although information regarding the onset of action of antipsychotics is limited, we discovered data for four typical and three atypical antipsychotics. Drugs with the fastest onsets include haloperidol, risperidone, and olanzapine, with onsets appearing in 2–6 days. Chlorpromazine and thiothixene were at the slowest end of the continuum, with onsets of 2 weeks or longer. Data regarding pimozide are mixed, with some studies showing an onset equivalent to that of the 'fast' compounds and others showing one similar to that of the 'slow' compounds.

Conclusions: Choice of therapy should consider not only efficacy and safety, but also onset speed. Atypical antipsychotics appear to offer safer, faster, and more effective therapies.     

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。     

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.     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

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