硫丙咪胺对戊四氮致痈幼鼠海马GFAP、c—fos表达和学习认知的影响

目的：观察硫丙咪胺（Thi）对戊四氮（PTZ）致痫幼大鼠海马胶质原纤维酸性蛋白（GFAP）、c-fos表达及学习认知的影响。方法：发育期SD幼鼠40只随机分为对照组、PTZ致瘸组、TM 30mg·kg^-1干预组和Thi15mg·kg^-1干预组（均n=10）。观察各组大鼠瘸样行为，水迷宫实验观察学习认知能力、免疫组化检测海马GFAP和c-fos的变化。结果：对照组无痫样发作，阿z致痫组有重度发作，Thi30mg·kg^-1干预组有轻度发作（P〈0．05）；水迷宫实验中，PTZ致痫组寻找平台潜伏时间延长和通过平台次数减少，Thi30和15mg·kg^-1干预组寻找平台潜伏时间明显缩短，通过平台次数增加明显，差异有统计学意义（P〈0．05）；PTZ致痫组GFAP和c-fos表达明显强于Thi干预组，差异有统计学意义（P〈0．05），其中Tiff30与15mg·kg^-1干预组相比差异也有统计学意义（P〈o．05）；GFAP和c—fos免疫组化表达与大鼠空间学习记忆能力呈正相关。结论：Thi可能通过抑制PTZ致瘸幼大鼠海马GFAP、c—fos表达，减轻癫痫发作程度，提高其学习认知能力。     

氯喹对戊四氮慢性致痫大鼠脑皮质及海马腺苷激酶表达的影响

目的 观察氯喹对戊四氮致痫大鼠皮质和海马区腺苷激酶(ADK)表达的影响,探讨ADK与癫痫发作的关系及氯喹在癫痫发生过程中的作用. 方法 30只健康雄性SD大鼠按照随机数字表法分为对照组、戊四氮(PTZ)致痫组和氯喹干预组,每组10只.观察大鼠行为学表现,记录其脑电改变,采用免疫组化法检测3组大鼠皮质和海马区ADK的表达. 结果 对照组大鼠无癫痫发作,PTZ致痫组大鼠出现Racine评分中Ⅳ～Ⅴ级严重发作,氯喹干预组大鼠出现Ⅰ～Ⅲ级发作,差异有统计学意义(P＜0.05).PTZ致痫组大鼠脑电记录呈频发高幅的痫样波,氯喹干预组大鼠脑电记录显示慢波、小棘波.PTZ致痫组大鼠脑内ADK表达明显增强,以海马区最为显著,与对照组相比差异均有统计学意义(P＜0.05).氯喹干预组大鼠脑内ADK表达降低,但距离正常水平仍有较大差距,与对照组相比差异有统计学意义(P＜0.05). 结论 癫痫脑组织中存在ADK的表达异常,氯喹可以抑制这种表达,有效控制癫痫发作.     

白藜芦醇对戊四氮致痫大鼠脑脊液、血清S100B蛋白的影响

目的研究白藜芦醇（Res）对戊四氮致痫大鼠脑脊液、血清S100B蛋白的影响。方法采用戊四氮（PTZ）腹腔注射建立慢性癫痫模型,造模成功后予以Res（15mg／kg·d）灌胃干预10d;采用酶联免疫吸附法测定脑脊液、血清S100B蛋白含量,海马标本行Nissl染色。结果经28d连续给药,18只大鼠符合Racine点燃标准,Res干预组大鼠痫性发作潜伏期明显延长,且发作时间明显低于癫痫模型组、二甲基亚砜组（P〈0．05）。海马Nissl染色提示Res干预对大鼠海马CAl、CA3区神经元有保护作用（P〈0．05）,而对齿状回保护作用不明显（P〉0．05）。Res干预组大鼠脑脊液、血清S100B蛋白含量低于癫痫模型组、二甲基亚砜组（P〈0．05）。结论Res降低PTZ致痫大鼠脑脊液、血清SIOOB蛋白含量,或许减缓癫痫发作脑损伤发挥神经保护作用。     

天麻素对戊四氮致痈大鼠海马代谢型谷氨酸受体1和蛋白激酶Cα表达的影响

目的：观察天麻素对戊四氮致痢大鼠海马代谢型谷氨酸受体1（mGluR1）和蛋白激酶Cα（PKCα）表达的影响。方法：成年雄性Wistar大鼠102只随机分成：对照组;戊四氮组;丙戊酸钠干预组;小剂量天麻素（100mg·kg^-1）干预组和大剂量天麻素（200mg·kg^-1）干预组。每组再分4个时间点：12h、48h、5d和7d。用免疫组化检测海马mGluR1和PKα的变化。结果：除对照组无痫样发作外,其余各组大鼠全部出现Racine分级Ⅱ～Ⅴ级瘌样的发作。mGluR1和PKCα阳性细胞数量在戌四氮组明显增加、平均A值增加,与对照组比差异有统计学意义（P〈0．05）;与丙戊酸钠组比差异无统计学意义（P〉0．05）;与小剂量和大剂量天麻素干预组比差异有统计学意义（P〈0．05）。结论：天麻素通过对戊四氮致痢大鼠海马mGluR1和PKCα信号传导通路的抑制作用,影响大鼠痫样发作。     

脑内置入壳聚糖及其衍生物后大鼠的行为及脑电图观察

目的观察壳聚糖及其衍生物置入脑内后大鼠的行为和脑电图变化。方法采用立体定向的方法分别将壳聚糖、高粘度壳聚糖、羧甲基壳聚糖及戊二醛化壳聚糖注入大鼠脑内，参照Racine标准，定时观察大鼠的癫痫发作行为及脑电图的变化。结果各组大鼠痫性发作行为的例数作多组等级资料秩和检验分析，差异有显著性意义（P〈0．05），但各组间两两比较时差异无显著性；大鼠异常脑电图以频发尖波最为常见，且各组均有数量不等、程度不同的痫样放电．其中戊二醛化壳聚糖组痫样放电的发生率明显高于对照组（P〈0．05），各实验组中壳聚糖组的痫波频率最低，且与对照组比较差异无显著性（P〉0．05），而戊二醛化壳聚糖组的痫波频率明显高于其它各组（P〈0．05）。结论脑内置入壳聚糖对大鼠的癫痫发作行为及脑电活动无明显影响。     

PCNA和GFAP在脑星形胶质细胞瘤中表达的双重染色研究

目的研究人脑星形胶质细胞瘤中增殖细胞核抗原（PCNA）和胶质纤维酸性蛋白（GFAP）的表达及其与肿瘤分级的关系。方法采用免疫组化双重染色法对41例人脑星形胶质细胞瘤进行PCNA和GFAP两重标记检测。结果脑星形胶质细胞瘤中PCNA与GFAP表达率均为100％，PCNA表达水平与肿瘤分级呈正相关（r=-0．627，P〈0．01），GFAP表达水平与肿瘤分级呈负相关（r=-0．568，P〈0．01）；Ⅰ-Ⅱ级与Ⅲ-Ⅳ级胶质瘤间PCNA和GFAP表达均有显著性差异（P〈0．05）；GFAP表达和PCNA表达水平呈负相关（r=-0．332，P〈0．05）。结论PCNA与GFAP的表达有一定的相关性。PCNA与GFAP的双重表达与脑星形胶质细胞瘤的增殖活性和恶性程度有关。     

TOLL样受体4及细胞因子在致痫大鼠发病机制中的作用

目的探讨海马组织中TOLL样受体4（TLR-4）和白细胞介素1B（IL-1β）、肿瘤坏死因子。（TNF-α）及白细胞介素10（IL-10）在致痼大鼠发病机制中的作用。方法应用戊四氮（PTZ）腹腔注射建立大鼠致痫模型后,观察大鼠致痫过程中的行为学变化,分别于14、21、28和35d留取大鼠海马组织,用酶联免疫吸附测定方法（ELISA）检测海马组织中TLR-4、IL-1β、TNF-α和IL-10的蛋白含量,用实时荧光定量PCR方法检测海马组织中TLR-4mRNA的表达水平。结果随着致痫时间的延长,大鼠癫痫发作程度逐渐加重,但是致痈30d后癫痫发作程度有所减轻。随着癫痫发作的进展,海马组织中TI。R-4、IL-1β、TNF-1β和IL-10的蛋白含量逐渐升高（P〈0．01）,海马组织中TLR-4mRNA表达水平明显增强（P〈0．1）5或P〈0．01）,而在35d有所下降。TLR-4的蛋白含量与IL-1β、TNF-α和IL-10含量呈正相关（P〈0．01）。结论TOI．L样受体4表达增强及炎症因子和抗炎因子的表达失衡在致痫发病过程中发挥着重要作用。     

托吡酯对戊四氮致癫癎大鼠海马AQP4表达水平的影响

目的探讨托吡酯对戊四氮致癫癎大鼠海马AQP4表达水平的影响。方法将30只Wistar大鼠随机分为戊四氮致癫癎组、托吡酯干预组和正常对照组，每组各10只；癫癎模型点燃后在不同时相点灌注取材，通过HE染色观察大鼠海马神经元的变化，并应用免疫组化法检测大鼠海马AQP4表达水平。结果HE染色显示托吡酯干预组神经元变性和坏死较戊四氮致癫癎组明显减轻；免疫组化显示戊四氮致癫癎组在致癫癎后12hAQP4的表达显著增强，致癫癎后24h达高峰，托吡酯干预组在致癫癎后12h～36h各时相点AQP4表达水平均分别低于戊四氮致癫癎组相应时间点（P〈0．05）。结论托吡酯通过下调大鼠海马AQP4的表达可能参与了对大鼠海马神经元的保护过程。     

重复经颅磁刺激预处理对毛果芸香碱致痫作用及海马GAD65表达的影响

目的：观察0．5Hz经颅磁刺激预处理对毛果芸香碱致大鼠癫痫作用的影响及可能机制。方法：将大鼠随机分为0．5Hz重复颅磁刺激（rTMS）组和对照组,分别进行连续2周的相应预处理后腹腔注射毛果芸香碱,观察注药后90min内痫性发作潜伏期和痫性发作行为表现。应用免疫组化学方法观察两组大鼠海马区谷氨酸脱羧酶65（GAD65）的表达。结果：①与对照组相比,rTMS组癫痫发作潜伏期明显延长,发作程度显著减轻（均P〈0．05）;②与对照组相比,rTMS组大鼠海马区表达GAD65神经元的数量明显增多（P〈0．05）。结论：0．5HzrTMS预处理有明显抗癫痫作用,而海马区GAD65阳性表达神经元的增加可能是其抗瘸机制之一。     

16Hz次声作用对大鼠海马TRPV4、GFAP和fos蛋白表达的影响

目的研究16Hz，90dB和130dB次声作用后，大鼠海马瞬时感受电位香草酸家族4（TRPV4）通道蛋白、胶质纤维酸性蛋白（GFAP）和fos蛋白的表达情况。方法16Hz，90dB和130dB次声作用于大鼠，2h／d，作用7d后采用免疫组织化学染色方法，观察大鼠海马中TRPV4蛋白、GFAP和fos蛋白表达的情况。结果16Hz，130dB次声作用7d后，与对照组相比较大鼠海马中显著表达TRPV4阳性神经元，GFAP阳性星形胶质细胞和fos阳性神经元（P〈0．05），三者分布一致，关系密切；90dB组大鼠的上述三种蛋白表达均较130dB组弱（P〈0．05）。结论16Hz，90dB和130dB次声作用可以引起大鼠海马TRPV4阳性细胞表达增多，且能够激活神经元和星形胶质细胞。     

The neuroendocrinology of stress and the pathophysiology and therapy of depression and anxiety

Clinical and preclinical studies have gathered substantial evidence that stress response alterations play a major role in the development of major depression, panic disorder, and post-traumatic stress disorder. The stress response, the hypothalamic pituitary adrenocortical (HPA) system and its modulation by corticotropin-releasing hormones (CRH),corticosteroids,and their receptors, and the roles of natriuretic peptides and neuroactive steroids are described. We review the role of the HPA system in major depression, panic disorder, and post-traumatic stress disorder and its possible relevance for treatment. Impaired glucocorticoid receptor function in major depression is associated with an excessive release of neurohormones such as CRH, to which a number of signs and symptoms characteristic of depression can be ascribed. In panic disorder, a role of central CRH in panic attacks has been suggested. Atrial natriuretic peptide (ANP) is causally involved in sodium lactate-induced panic attacks. Furthermore, preclinical and clinical data on its anxiolytic activity suggest that nonpeptidergic ANP receptor ligands may be potentially useful in the treatment of anxiety disorders. Post-traumatic stress disorder is characterized by a peripheral hyporesponsive HPA system and elevated CRH concentrations in the CSF. This dissociation is probably related to an increased risk of this disorder. We further review recent data that describe an important role of GABA(A)-receptor modulatory,3 alpha-reduced neuroactive steroids in major depression, anxiety, and its treatment. Antidepressants are effective in both depression and anxiety disorders and have major effects on the HPA system,especially on glucocorticoid and mineralocorticoid receptors. Normalization of HPA system abnormalities is a strong predictor of the clinical course, at least in major depression and panic disorder. Currently,CRH-R1 or glucocorticoid receptor antagonists and ANP receptor agonists are being studied and may provide future treatment options more closely related to the pathophysiology of these disorders.     

Polymorphisms of DRD4 and DRD3 and risk of avoidant and obsessive personality traits and disorders

We investigated whether polymorphisms of the dopamine D4 receptor (DRD4) and polymorphisms of the dopamine D3 receptor (DRD3) were associated with personality disorder symptomatology rather than with personality traits such as novelty seeking. DNA was obtained from 145 depressed patients in a clinical trial. These patients were assessed for the presence of personality disorder symptoms and disorders. The 2-repeat allele of the DRD4 exon III polymorphism was associated with increased rates of avoidant and obsessive personality disorder symptomatology. The T,T genotype of the DRD4 -521 C>T polymorphism was also associated with increased rates of avoidant and obsessive personality disorder symptomatology. The Gly9,Gly9 genotype of the DRD3 Ser9Gly polymorphism was associated with increased rates of obsessive personality disorder symptomatology. None of these three polymorphisms were associated with novelty seeking or other temperament traits on the Temperament and Character Inventory. Our results suggest that genetic polymorphisms of DRD4 and DRD3 may well be associated with personality traits, and that conflicting findings to date may arise from the problem of phenotype definition.     

癫痫共病抑郁的机制及临床诊疗

本文目的是探讨癫痫共病抑郁的可能机制及临床诊疗。癫痫是一种常见的、慢性的、致残性的神经疾病,癫痫患者生活质量下降,存在明显的负性情绪,常伴发各种精神疾病。癫痫与抑郁具有共同的神经生物学基础,可能存在共同的发病机制。本文从癫痫共病抑郁的发病机制、临床诊断及治疗方面予以总结归纳。     

沙盘游戏疗法在地中海贫血患儿心理干预中的应用

本文目的是对沙盘游戏疗法在地中海贫血患儿心理干预中的应用进行综述,以期为地中海贫血患儿的心理康复提供参考。地中海贫血是以珠蛋白生成障碍为主要特征的遗传性疾病,由于长期输血治疗,患儿存在较多的心理和行为问题。沙盘游戏疗法作为一种有效、实用的儿童心理治疗方法,对提高地中海贫血患儿的康复效果、改善生存质量有重要的临床意义。     

Cultural Identity and Experiences of Prejudice and Discrimination of Afghan and Iranian Immigrant Youth

In culturally diverse and immigrant receiving societies, immigrant youth can be subject to prejudice and discrimination. Such experiences can impact on immigrant youth’s cultural identity and influence their psychosocial outcomes. This paper presents findings of a study that examined cultural identity and experiences of prejudice and discrimination among Afghan (N = 9) and Iranian (N = 17) immigrant youth in Canada. The study had a prospective, comparative, longitudinal qualitative design. Data was gathered through focus groups, interviews, journals and field logs. Four main themes emerged on participants’ experiences of prejudice and discrimination: (a) societal factors influencing prejudice; (b) personal experiences of discrimination; (c) fear of disclosure and silenced cultural identity; and (d) resiliency and strength of cultural identity. Drawing from Rosenberg’s (Conceiving the self, Basic Books, New York, 1979) self-concept framework and Romero and Roberts (J. Adolesc., 21:641–656, 1998) distinction between prejudice and discrimination, results indicated that youth’s extant and presenting cultural identity were affected. Inclusive policies and practices are needed to promote youth integration in multicultural and immigrant receiving settings.

躯体化障碍和未分化躯体形式障碍患者辅助检查项目和费用调查

目的 了解躯体化障碍和未分化躯体形式障碍患者辅助检查项目和费用及其相关因素.方法 对115例躯体化障碍或未分化躯体形式障碍的患者,采用自编既往就诊检查情况调查表、自编躯体症状自评清单、症状自评量表、汉密尔顿焦虑量表和汉密尔顿抑郁量表进行评估.结果 患者就诊前辅助检查总费用为 72～10 948 元(中位数 1 068 元);检查频度为 1 ～ 53 次(中位数9.0次);检查项目数为 1～13 项(中位数6.0项).重复检查频度为 0～44 次(中位数 3 次),重复项目数为 0 ～ 9 项(中位数 2 项).检查频度及重复频度较高的项目为血常规、B超、CT、尿常规、摄片、生化常规、MRI、心电图、粪常规.检查频度与病程、就诊科室数及HAMD总分均呈正相关(P＜0.05),检查总费用与检查频度呈正相关(P＜0.01). 结论躯体化障碍和未分化躯体形式障碍患者辅助检查种类多,重复检查多,应引起重视.     

Seclusion and restraint and prediction of violence

The authors studied the use of seclusion and restraint on an inpatient unit in a state psychiatric hospital. Of 69 randomly selected inpatients, 51% experienced seclusion or restraint at least once. More psychotic than nonpsychotic patients required seclusion or restraint. However, neither psychosis/nonpsychosis nor voluntary/involuntary admission status predicted the likelihood of violent threats or actions. Patients experiencing seclusion and restraint showed a nonsignificant trend toward longer mean length of stay in the hospital. The frequency of patient behavior leading to seclusion or restraint appeared to be directly related to the stimulation caused by the presence of many staff members and other patients.