脑源性神经营养因子Val66Met功能基因多态性与环境因素对抗抑郁剂临床疗效的影响

Objective To explore the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism,environmental factor and their interactions on antidepressant treatment.Methods 340 patients of major depressive disorder (MDD) who met the diagnosis criteria of MDD ( DSM-Ⅳ Axis Ⅰ) were recruited.280 patients of them were finished 12 weeks antidepressant treatment.The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS) before and after 12 weeks antidepressant treatment.Childhood Trauma Questionnaire,28-item Short Form (CTQ-SF) and Life Events Scale (LES) were used to evaluate childhood adverse and life stress before onset.Genotyping of BDNF Val66Met polymorphism was detected by Illumina GoldenGate assays.Results Male patients proportion were significantly higher in non-remitters than remitters (P =0.008 ).After adjusting by gender, the frequencies of genotype and allele for the BDNF Val66Met polymorphism were no significant difference between remitters (AA: AG: GG = 28: 79: 40, A:G = 135:159 ) and non-remitters (AA: AG: GG = 29:81:23 ,A: G = 139:127 ) (P ＞0.05 ).There was no significant difference of CTQ scores and LES scores between the two groups (P＞0.05 ).The regression analysis showed that social intercourse problem and age were the risk factor for the severity of depression.The gender, HDRS baseline scores and mental disorder family history were associated with the efficacy of 12 weeks antidepressant.However,there was no significantly relationship between the interaction of BDNF Val66Met polymorphism and environment with the antidepressant treatment.Conclusion The older men with the mental disorder family history, severe depression symptom would be less-response to antidepressant treatment.However, BDNF Val66Met polymorphism, childhood trauma, life events stress and the interaction of BDNF Val66Met polymorphism and environment have no significantly effect on the 12 weeks antidepressant treatment.     

抑郁症患者脑脊液生长抑素及单胺代谢产物的测定

目的 探讨抑郁症可能的生化病理机制,方法 采用放射免疫测定法及高效液相色谱法,分别测定２７例抑郁症患者和２７例对照者脑脊液（ＣＳＦ）生长抑素（ＳＳ）及单胺代谢产物水平。结果抑郁症组ＧＳＦ中ＳＳ水平和３－甲氧－４羟苯乙二醇（ＭＨＰＧ）水平（Ｐ〈０．０５）和５－羟吲哚乙酸水平（Ｐ〈０．０１）,均低于对照组,而抑制症组ＣＳＦ中高香草酸含量与对照组间的差异无显著性（Ｐ〉０．０５）;抑郁症组ＣＳＦ中ＳＳ与Ｍ     

抑郁症患者神经内分泌节律变化的对照研究

目的 探讨抑郁症患者下丘脑-垂体-肾上腺(HPA)轴、下丘脑-垂体-甲状腺(HPT)轴的功能和节律变化与临床症状晨重夕轻之间的关系.方法 采用放射免疫法对49例符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)重性抑郁发作患者及38例对照组,对早7:00、晚7:00血浆皮质醇(CORT)、促肾上腺皮质激素(ACTH)、三碘甲状腺原胺酸(T3)、四碘甲状腺原胺酸(T4)、甲状腺刺激素(TSH)水平进行测定,采用多因素方差分析比较2组各项指标的变化、并与临床症状之间的关系进行分析.结果 病例组早晨血浆CORT、早晨、晚间TSH水平[分别为(365.94±120.78)nmol/L,(6.24±2.47)μIU/ml,(6.68±2.42)±IU/ml]较对照组[(284.91±83.39)nmol/L,(3.82±1.75)±IU/ml,(4.01±1.69)μIU/ml]明显增高,差异有显著性(P<0.05);病例组早晨、晚间血浆T4水平较对照组显著降低(P<0.05);血浆皮质醇水平的早晚变化在病例组与对照组之间差异有显著性(P<0.001);病例组血浆CORT、T3、T4、TSH水平的早晚变化在单相和双相抑郁障碍、伴有和不伴有精神病性症状的临床亚型之间均差异无显著性(均P>0.05).结论 抑郁症患者血浆皮质醇水平存在早晚异常变化,可能是抑郁症的一项特异的生物学标志.     

伴精神病性症状躁狂发作杀人1例

1病例被鉴定人男,39岁,小学文化,案由为故意杀人。案发前3、4d酒后出现心情好、话多、精力充沛、自以为了不起。案发前一日不顾家人的阻止和老乡一起乘车来南京打工。案发当日称要帮受害人磨刀切菜,在磨刀的过程中突然想起受害人姓朱,而自己从前写过"泽民泽民光择民,镕基镕基天不容"的对联,认为朱和朱镕基总理同姓,因为自己说过朱总     

丁螺环酮精神药理机制研究进展

对丁螺环酮抗焦虑、抗抑郁增效作用的药理机制进行综述.     

吡喹酮治疗131例血吸虫病的临床疗效分析

目的：分析吡喹酮治疗血吸虫病的临床疗效，以期为临床工作提供参考价值。方法本县血吸虫病救治定点医院地方病医院收治的131例血吸虫病患者，采用口服吡喹酮治疗，随访8个月，观察并分析患者的临床疗效及不良反应。结果治疗8个月后，所有患者阴转率及感染度下降率均为100%，临床症状、体征均显著改善，疗效确切。29例患者(22.14%)发生了轻度不良反应，乏力13例(44.83%)，头晕9例(31.03%)，恶心3例(10.34%)，皮疹1例(3.45%)。结论吡喹酮在血吸虫病的治疗方面具有极高的临床价值，控制用量可减轻不良反应、降低医疗费用，值得进一步推广应用。     

240例重症手足口病临床特点及治疗分析

手足口病(HFMD)是由肠道病毒引起的急性传染病,多发生于学龄前儿童,尤以3岁以下年龄组发病率最高。其临床经过轻重不一,普通病例主要症状表现为发热,手、足、口腔等部位的     

混合性抑郁症的识别与处理

本文就混合性抑郁症(抑郁性混合状态)的概念、流行病学、临床特征、诊断与识别、以及处理原则和治疗策略进行综述。     

抑郁症昼夜节律变化与免疫功能的关系

目的:探讨抑郁症昼夜节律的特征与细胞因子浓度的关系. 方法:对符合美国精神障碍诊断和统计手册第4版重性抑郁发作诊断标准的49例患者(抑郁症组)和38名健康人(对照组),采用酶联免疫吸附法测定其早7:00和晚7:00血浆白细胞介素-1β(IL-1β)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)及肿瘤坏死因子(TNF)的浓度,比较各指标早、晚浓度及早晚差值在抑郁症组中有晨重夕轻、无晨重夕轻和对照组之间的差异. 结果:抑郁症组中不论有、无晨重夕轻,其早晨IL-1β浓度及TNF浓度均明显低于对照组(P均<0.05或P<0.01));晚间IL-6浓度均较对照组显著增高(P均<0.05),IL-2浓度较对照组显著降低(P均<0.01);IL-6浓度早晚差值均较对照组显著增大(P均<0.05).结论:抑郁症患者在晚间存在广泛的免疫激活,血浆IL-6的昼夜节律较对照组有异常改变.     

脑室注射β－内啡肽抗血清对失血性休克猫心血管功能的影响

给失血性休克猫侧脑室注射特异性β－内啡肽抗血清，除能引起与脑室注射纳洛酮相同的增强心肌收缩力作用外．还具有明显改善心肌舒张功能，进而促使静脉回流和增加心率，它显示了具有比纳洛酮更好的作用。