城乡社区精神分裂症患者家属的家庭负担对照研究

目的 了解城乡结合精神分裂症患者家庭负担现状及城乡患者之间家庭负担的区别。方法 采用ＦＩＳ和ＤＡＳ量表分别对病例组和对照组患者及其主要照顾者进行调查分析。结果 １．病例组家庭负担明显高于对照组，２．经济负担农村高于城市，而主观负担城市高于农村（Ｐ均〈０．０１）。３．病例组ＦＩＳ与ＤＡＳ密切相关，某些ＦＩＳ单项分与病程相关（Ｐ〈０．０５），结论 精神分裂症患者确实给家庭带来明显的客观和主观负担，客观     

β淀粉样蛋白与生长因子变化与老年性痴呆致病因素的研究

目的：检测血清β淀粉样蛋白（β－ＡＰ）和多肽生长因子含量变化,探讨其在Ａｌｚｈｅｉｍｅｒ病（ＡＤ）和血管性痴呆（ＶＤ）发病机制中的可能作用。方法：采用放射免疫分析法（ＲＩＡ）检测临床诊断为ＡＤ患者８例,ＶＤ患者１５例及６３例缺血性脑血管病（ＩＣＶＤ）患者血清β－ＡＰ、转化生长因子α（ＴＧＦ－α）和类胰岛素样生长因子Ⅱ（ＩＧＦ－Ⅱ）的水平,同时与健康对照组比较。结果：ＡＤ与ＶＤ患者β－ＡＰ、ＴＧＦ－α和ＩＧＦ－Ⅱ水平明显高于ＩＣＶＤ组和健康对照组,均具有显著性差异。ＩＣＶＤ患者血清β－ＡＰ、ＴＧＦ－α和 ＩＧＦ－Ⅱ水平亦明显高于对照组,其中以脑梗塞后遗症（ＳＣＩ）和椎基底动脉供血不足（ＶＢＩ）组增高十分明显,与对照组比较差异显著（Ｐ＜０．０５）。ＡＤ与 ＶＤ患者 ３项测定指标之间具有明显的正相关。结论：①β－ＡＰ可能是ＡＤ和ＶＤ发病的危险因素。②引起ＡＤ和ＶＤ神经元毒性作用进而导致痴呆．这可能与ＴＧＦ－α和ＩＧＦ－Ⅱ增多有关。③β－ＡＰ与ＴＧＦ－α、ＩＧＦ－Ⅱ密切相关,在老年斑形成过程中可能起重要作用。     

复发性脑梗塞与抗心磷脂抗体,血脂关系的研究

目的探讨复发性脑梗塞与抗心磷脂抗体、血脂的关系。方法采用酶联免疫吸附（ＥＬＩＳＡ）等方法检测了３７例复发性脑梗塞（ＲＣＩ）和６８例首发性脑梗塞（ＦＣＩ）患者的血清抗心磷脂抗体（ＡＣＬＡ）及血脂７项指标，并与５０例对照组比较。结果ＲＣＩ组的ＡＣＬＡ阳性率明显高于ＦＣＩ及对照组；ＴＧ、ＴＣ、ＬＤＬ－ｃ及ＡＰＯＢ血清平均水平ＲＣＩ和ＦＣＩ组均明显高于对照组，而血脂水平两组比较差异无统计学意义。结论ＡＣＬＡ与ＲＣＩ的发生有密切关系，血脂代谢对ＲＣＩ和ＦＣＩ的影响无差别。     

Alzheimer病和血管性痴呆患者血清β—AP与多肽生长因子相关性

目的:探讨血清β淀粉样蛋白(β－ＡＰ)和多肽生长因子含量变化及其相关性在Ａｌｚｈｅｉｍｅｒ病(ＡＤ)和血管性痴呆(ＶＤ)发病机制中的作用。方法:采用放免法检测ＡＤ患者３２例,ＶＤ患者３４例及６３例缺血性脑血管病(ＩＣＶＤ)患者血清β－ＡＰ、转化生长因子α(ＴＧＦ－α)和类胰岛素样生长因子Ⅱ(ＩＧＦ－Ⅱ)水平,与对照组比较。结果:ＡＤ与ＶＤ患者血清β－ＡＰ、ＴＧＦ－α、ＩＧＦ－Ⅱ水平明显高于ＩＣＶＤ组和对照组,有显著差异(Ｐ＜０．０１),两组患者血清β－ＡＰ和ＩＧＦ－Ⅱ之间呈明显相关关系。结论:①β－ＡＰ是ＡＤ和ＶＤ发病危险因素;②引起ＡＤ和ＶＤ神经元毒性作用进而导致痴呆与ＴＧＦ－α和ＩＧＦ－Ⅱ增多有关;③β－ＡＰ与ＴＧＦ－α、ＩＧＦ－Ⅱ密切相关,并在老年斑形成过程中起主要作用。     

老年急性脑血管病并多器官功能衰竭患者SIL-2R和T细胞亚群的测定

采用ＥＬＩＳＡ和ＡＰＡＡＰ法对３２例老年急性脑血管病（ＡＣＶＤ）并多器官功能衰竭（ＭＯＦ）患者及４０例老年和３５例非老年ＡＣＶＤ患者血清可溶性白细胞介素２受体（ＳＩＬ２Ｒ）及Ｔ细胞亚群水平进行了测定。并与３０例对照组比较。结果显示，疾病各组除ＣＤ３外ＳＩＬ２Ｒ和ＣＤ８均较对照组明显升高，ＣＤ４／ＣＤ８比值则明显下降，其中以老年ＡＣＶＤ并ＭＯＦ组变化最为显著，与老年和非老年ＡＣＶＤ组比较，亦有显著性差异；ＣＤ４水平老年ＡＣＶＤ并ＭＯＦ组较老年和非老年ＡＣＶＤ组及对照组明显降低，老年和非老年ＡＣＶＤ组与对照组比较无显著性差异；上述指标也与老年ＡＣＶＤ并ＭＯＦ患者的预后密切相关     

脑卒中患者客观生活质量及其影响因素的研究

目的：探索脑卒中幸存者的客观生活质量及其影响因素。方法：采用横断面调查的方法对２０５例脑卒中幸存者及２１６例正常对照以ＦＡＩ、ＡＮＦＤ、ＳＤＳ及ＤＩＳ、ＳＡＳ、ＵＬＳ、ＳＳＲＳ、ＬＳＩＡ、ＬＳＩＢ、ＦＡＣＥＳＩＩ－ＣＶ、ＴＳＢＩＡ及ＴＳＢＩＢ、补充综合问卷等为工具进行客观生活质量及有关影响因素的研究。结果：发现脑卒中幸存者的ＦＡＩ明显低于对照人群,其主要影响因素依次为ＡＮＦＤ、ＳＳＲＳ、ＳＤＳ、Ｄ     

Alzheimer型痴呆的髓鞘素蛋白自身应答性T细胞免疫反应

通过计数分泌细胞因子γ－干扰素（ＩＦＮ－γ）、辅助性Ｔ细胞（Ｔｈ１），检查ＡＤ患者外周血和脑脊液（ＣＳＦ）中Ｔ细胞免疫应答。方法：将单个核细胞（ＭＮＣ）暴露于中枢神经系统（ＣＮＳ）髓鞘素抗原髓鞘碱性蛋白（ＭＢＰ）和含脂质蛋白（ＰＬＰ）中进行体外短时间培养，用酶联免疫斑点试验（Ｅｌｉｓｐｏｔ）检测ＩＦＮ－γ分泌性Ｔｈ１细胞链，同时检测急性脑血管病（ＣＶＤ）和其他神经疾病（ＯＮＤ）患者作为对照。结果显示ＡＤ患者外周血中呈高水平ＭＢＰ应答性Ｔｈ１细胞链，而其ＣＳＦ中尤为明显，外周血中ＰＬＰ应答性Ｔｈ１细胞亦显著高于ＯＮＤ对照组。结论认为ＡＤ患者存在高水平的髓鞘素蛋白自身应答性Ｔ细胞反应，且在与ＣＮＳ紧邻的ＣＳＦ中表现得尤为显著，其在ＡＤ发病机制中的作用还有待进一步深入探讨。     

缺血性服血管病患者脑脊液超氧化物歧化酶和丙二醛的临床价值

检测了急性缺血性脑血管病患者４２例和对照组３０例的脑脊液超氧化物歧化酶，丙二醛含量。病例组ＭｎＳＯＤ和ＭＤＡ含量均显著高于对照组，ＣｕＺｎＳＯＤ含量轻型患者高于中，重型患者，短暂性脑缺血发作患者高于对照组和梗塞组，而且与患者神经功能缺损各分呈显著性负相关。     

缺血性脑血管病纤维蛋白原和血小板状态的观察

目的　探讨血小板和纤维蛋白原（ＦＩＢ）在脑梗死发病中的作用。方法　观察有血栓倾向的疾病、ＴＩＡ、急性脑梗死患者及正常对照组的血小板计数（ＰＬＴ）、血小板平均体积（ＭＰＶ）、血小板聚集率（ＰｔＡｇｔ）和ＦＩＢ浓度。结果　脑梗死急性期的ＰＬＴ 明显低于正常组和其它疾病组,各疾病组的ＭＰＶ 和ＦＩＢ明显高于正常组,ＰｔＡｇｔ各组无明显差异。ＦＩＢ与欧洲卒中评分（ＥＳＳ）成正相关。结论　血小板和ＦＩＢ的变化出现在脑梗死之前,它们促进了血栓的形成,ＦＩＢ的水平可作为评价病情严重程度的指标之一。     

重症肌无力患者外周血乙酰胆碱受体特异性T细胞sIL-2R、IFN-γ、IL-4的表达和转录

目的了解ＭＧ患者的乙酰胆碱受体（ＡＣｈＲ）特异性细胞免疫应答。方法采用酶联免疫吸附试验（ＥＬＩＳＡ）检测３０例ＭＧ患者和２０名健康对照者经ＡＣｈＲ刺激后外周血单核细胞（ＰＢＭＣ），辅助性Ｔ细胞１（Ｔｈ１）相关的干扰素（ＩＦＮ）γ、辅助性Ｔ细胞２（Ｔｈ２）相关的白细胞介素（ＩＬ）４及与细胞免疫活化密切相关的可溶性白细胞介素２受体（ｓＩＬ２Ｒ）的分泌，用逆转录聚合酶链反应（ＲＴＰＣＲ）结合狭缝印迹杂交检测ＩＦＮγ、ＩＬ４的信息核糖核酸（ｍＲＮＡ）转录。结果总ＭＧ患者组ＩＦＮγ显著高于健康对照组，尤以急性ＭＧ患者组（１４例）更明显，且其升高与其ｍＲＮＡ转录水平一致。虽然这两组ＭＧ患者的ｓＩＬ２Ｒ亦明显高于健康对照组，但患者组的ＩＬ４表达及其ｍＲＮＡ转录与健康对照组相比差异无显著意义。结论ＭＧ患者有Ｔｈ１和Ｔｈ２的失衡，ＭＧ患者有ＡＣｈＲ特异性细胞免疫活化，Ｔｈ１的细胞因子ＩＦＮγ可能作为效应因子参与了ＭＧ的发病。     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

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     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Bibliography of officers of department of mental hygiene

Psychiatric Quarterly -