217例老年精神病人的躯体共病性研究

目的：探讨老年精神科病人躯体疾病共病情况及其意义。方法：调查217例老年精神科病人的精神科诊断及合弄躯体疾病情况。结果：88．9％的病人合并有躯体疾病，每一个病人合并的躯体疾病的病种数平均为2．18种。合并的躯体疾病多见的是脑血管病、高血压、心脏病、感染、糖尿病、慢性阻塞性肺疾病（COPD）等。结论：老年精神科病人的躯体共病现象具有普遍性，其躯体疾病分布具有普通老年科病人的特点。躯体共病影响精神疾病的疗效预后及老年精神科的临床工作模式。     

贫困山区育龄妇女健康状况调查分析

育龄妇女的健康状况。可以反映一个地区的社会经济发展水平，也可反映当地医疗保健服务的水平以及群众利用服务的能力。通过对贫困山区岳西县555名育龄妇女的健康状况及影响因素进行分析，发现常见病、多发病仍威胁贫困山区育龄妇女的健康，同时家庭经济状况直接影响农村育龄妇女对卫生服务的利用。     

已婚育龄妇女避孕措施变化趋势分析

目的:了解已婚育龄妇女避孕措施的变化趋势,为指导计划生育服务工作提供科学依据。方法:收集1983~2005年苏州市已婚育龄妇女避孕方法的资料,并用统计软件对其变化趋势进行了分析。结果:已婚育龄妇女节育率在88.38%~92.94%范围波动,长效避孕措施现用率从75.19%下降至71.27%,而短效避孕措施从12.86%上升至17.11%。宫内节育器的现用率从50.09%上升到66.50%;避孕套从1.94%上升到14.21%;其他避孕方法的现用率均呈下降趋势,其中女性绝育现用率从24.42%下降到4.50%。结论:节育率维持在较高水平;长效避孕措施现用率下降而短效避孕措施现用率上升;避孕方法使用趋于多样化,需要提供满足个性化需求的指导和服务。     

儿童感觉统合失调及其影响因素的调查分析

目的 研究儿童感觉统合失调与学习障碍及环境因素的关系。方法 采用感觉统合评定量表和学习障碍(PRS)筛查量表，分别对755名学龄儿童进行检测、分析。结果 感觉统合严重失调率为13．25％；感觉统合正常与失调儿童的学习障碍有统计学差异(P＜0．005)；其中在LD儿童中感觉统合失调率占63．51％；感觉统合失调与母孕期的情绪、是否足月顺产、出生后的喂养方式、居住环境、孩子1岁内有无高热、家长对孩子的态度及期待等因素有关(P＜0．05)。结论 儿童感觉统合失调与环境因素、学习障碍有一定的关系。     

服用抗精神病药物的老年人与成年人心电图比较

目的：观察老年与成年精神病人服用抗精神病药物后的心电图（ＥＣＧ）改变。方法：８４例老年精神病病人（男性３５，女性４９例，年龄６３±ｓ３ａ）与１００例成年精神病病人（男性５０例，女性５０例，年龄４０±１０ａ），服用抗精神病药物前及服２ｍｏ以上的首次ＥＣＧ资料进行比较。抗精神病药包括吩噻嗪类、丁酰苯类及三环类抗抑郁剂和抗躁狂药等。结果：８４例老年病人中ＥＣＧ异常６３例（７５％），１００例成年人中ＥＣＧ异常４６例（４６％）（Ｐ＜０．０５）。结论：由于老年人服抗精神病药后易发生ＥＣＧ异常，因此开始剂量宜低，增量要小，严密监测心脏功能。     

Evaluation of Mini Mental State Examination and Brief Psychiatric Rating Scale on aged schizophrenic patients

Abstract  Mini Mental State Examination (MMSE), Brief Psychiatric Rating Scale (BPRS) and subscales of the BPRS were performed on 73 elderly inpatients (mean age: 67.9 years; standard deviation: 7.2; range: 60–89) diagnosed with DSM-III-R chronic schizophrenia. Forty of the subjects were men and 33 were women. A significant negative correlation was observed between MMSE and the age, factor negative, factor depressive, and total score of BPRS. We believe, however, that it is relatively sufficient to screen for demented illness of schizophrenics using MMSE when considering the age and the psychiatric symptoms (especially negative or depressive symptoms). Forty-eight (66%) of the 73 patients were categorized as 'demented' by MMSE. These results suggest that the aged inpatients with schizophrenia in a hospital showed certain kinds of cognitive deficits (including senile dementia) more frequently than the general population.     

Augmentation strategies in geriatric depression

Approximately 30–40% of elderly patients with major depression have inadequate response to an initial therapeutic trial of antidepressant medication. In these cases augmentation of the antidepressant has been recommended as one way of improving the rate of response. This article reviews the literature on augmentation strategies in treatment-resistant geriatric depression. Successful augmentation with lithium, triiodothyronine, stimulants, carbamazepine, valproate and a tricyclic–serotonin reuptake inhibitor combination have been described. However, there have been no controlled trials and, with the exception of two open prospective studies of lithium potentiation, the literature consists entirely of case reports and retrospective case series. As a result, it is difficult to draw conclusions about the efficacy of these strategies in late life, especially since treatment failures seldom get reported. Side-effects may limit the usefulness of some augmentation regimens in old age—up to 25% of patients treated with lithium or carbamazepine discontinued these medications because of adverse events. There is a need for controlled studies to better determine the clinical utility of augmentation strategies in physically well depressed elderly, as well as those with depression complicating medical illness, dementia and other neurological disorders.     

老龄大鼠内侧隔核TrkB mRNA的表达及人参皂甙的保护作用

目的:探讨人参皂甙对老龄大鼠内侧隔核TrkB mRNA表达的影响,为老年记忆减退性疾病的发病机制及人参皂甙的临床应用提供分子生物学基础。方法:选用Wistar大鼠,分成青年组、老龄组、给药组,采用原位杂交组织化学方法检测大鼠内侧隔核TrkB mRNA含量的变化情况。结果:老龄组内侧隔核TrkB mRNA阳性反应物的平均灰度值与青年组相比呈非常显著增高,而给药组的平均灰度值比老龄组呈显著降低。结论:老龄时内侧隔核TrkB mRNA表达低于青年组,而给药组较老龄组明显增加。说明人参皂甙具有增强TrkB mRNA表达,防止中枢神经系统神经元退行性改变的作用。     

老年腹股沟疝患者疝环充填式无张力修补术86例

目的总结弛环充填式无张力修补术治疗老年腹股沟疝患者的经验。方法回顾分析2002年3月-2005年7月采用德国Braun公司生产的Braun mesh和plug治疗的86例老年腹股沟疝患者的临床资料。结果平均手术时间35min，术后8-10h下床活动，2周恢复日常生活，伤口均一期愈合，术后尿潴留15例，异物感3例，随访3—40个月无一例复发。结论疝环充填式无张力修补术操作方便，创伤小，恢复快，复发率低，是老年患者理想有效的疝修补术。     

老年大鼠下丘脑视上核和弓状核的超微结构变化

观察老年大鼠下丘脑视上核腹侧大细胞神经元和弓状核神经元的超微结构,结果显示:老年大鼠视上核腹侧血管加压素(VP)神经元的胞体较成年鼠大,胞质结构比较致密,内含许多核糖体颗粒,粗面内质网分散成小泡状,神经分泌颗粒增多,溶酶体、线粒体、高尔基氏复合体数量都较多.而弓状核内的暗细胞和亮细胞的核糖体减少,高尔基氏复合体和线粒体都变化,还有少数神经元固缩,细胞质内胞器明显减少,呈现变性现象.结果提示:老年期下丘脑视上核VP神经元机能增强;而弓状核内两种细胞都显示机能减弱的征象.老年时下丘脑各核团神经元的这种不协调性变化,可能是动物衰老的一种重要表现.