The prevalence and clinical correlates of apathy and irritability in Alzheimer's disease

We examined the prevalence and correlates of apathy and irritability in a consecutive series of 101 patients with probable Alzheimer's disease (AD). Based on clinical criteria, 46 (46%) patients had apathy, and 13 (13%) patients had irritability. Apathy was significantly associated with more severe impairments in activities of daily living, significantly more severe extrapyramidal signs, and a significantly higher frequency of both major depression and dysthymia. Patients with irritability had significantly more severe impairments in activities of daily living and significantly higher depression and anosognosia scores. On the other hand, neither apathy nor irritability were significantly associated with deficits in specific cognitive domains.     

Olfactory bulbectomy: emotional behavior and defense responses in the rat

Removal of the olfactory bulbs of male hooded rats caused a reduction in defensive reactions to an unconditioned aversive stimulus (mechanical robot). In the presence of the robot, bulbectomized rats showed significantly less freezing and significantly less suppression of feeding behavior than sham-operated controls. At the same time, the bulbectomized rats were significantly more irritable to handling and showed a significant increase in muricide. These effects could not be attributed to loss of olfactory perception alone. Rats made peripherally anosmic through surgical removal of olfactory afferents were virtually indistinguishable from controls. These results provide further evidence for the view that in addition to their sensory functions, the olfactory bulbs of the rat have important tonic influences on emotional behavior. These tonic influences can occur independently of sensory processing and seem to be critical for the normal expression of emotional behavior or defense responses in this animal.     

地佐辛联合氟比洛芬酯静脉自控镇痛对开胸术后烦躁状态的影响分析

摘 要 目的： 探讨在开胸手术中采用地佐辛联合氟比洛芬酯麻醉处理的临床效果,以及对患者术后烦躁状态的影响。方法: 98例行开胸手术的患者随机分为对照组与观察组各49例,对照组在手术结束后采用芬太尼与地佐辛静脉自控镇痛,观察组联合应用地佐辛与氟比洛芬酯静脉自控镇痛。观察两组患者临床麻醉效果、药品不良反应及术后躁动状况,比较两组患者不同时点的VAS评分与Ramsay镇静评分。结果:观察组患者在术后2 h与4 h的VAS评分均显著低于对照组（P<0.05）,拔管时与拔管后5 min的Ramsay镇静评分明显好于对照组（P<0.05）;术后苏醒期躁动率和不良反应发生率明显低于对照组（P<0.01）。结论: 开胸手术患者术后联合应用地佐辛与氟比洛芬酯静脉自控镇痛可充分保证镇痛效果,缓解术后躁动情况,具有良好的临床应用价值。     

Risk for emerging bipolar disorder,variants, and symptoms in children with attention deficit hyperactivity disorder,now grown up

AIM: To determine the prevalence of bipolar disorder (BD) and sub-threshold symptoms in children with attention deficit hyperactivity disorder (ADHD) through 14 years’ follow-up, when participants were between 21-24 years old.METHODS: First, we examined rates of BD type I and II diagnoses in youth participating in the NIMH-funded Multimodal Treatment Study of ADHD (MTA). We used the diagnostic interview schedule for children (DISC), administered to both parents (DISC-P) and youth (DISCY). We compared the MTA study subjects with ADHD (n = 579) to a local normative comparison group (LNCG, n = 289) at 4 different assessment points: 6, 8, 12, and 14 years of follow-ups. To evaluate the bipolar variants, we compared total symptom counts (TSC) of DSM manic and hypomanic symptoms that were generated by DISC in ADHD and LNCG subjects. Then we sub-divided the TSC into pathognomonic manic (PM) and non-specific manic (NSM) symptoms. We compared the PM and NSM in ADHD and LNCG at each assessment point and over time. We also evaluated the irritability as category A2 manic symptom in both groups and over time. Finally, we studied the irritability symptom in correlation with PM and NSM in ADHD and LNCG subjects.RESULTS: DISC-generated BD diagnosis did not differ significantly in rates between ADHD (1.89%) and LNCG 1.38%). Interestingly, no participant met BD diagnosis more than once in the 4 assessment points in 14 years. However, on the symptom level, ADHD subjects reported significantly higher mean TSC scores: ADHD 3.0; LNCG 1.7; P < 0.001. ADHD status was associated with higher mean NSM: ADHD 2.0 vs LNCG 1.1; P < 0.0001. Also, ADHD subjects had higher PM symptoms than LNCG, with PM means over all time points of 1.3 ADHD; 0.9 LNCG; P = 0.0001. Examining both NSM and PM, ADHD status associated with greater NSM than PM. However, Over 14 years, the NSM symptoms declined and changed to PM over time (df 3, 2523; F = 20.1; P < 0.0001). Finally, Irritability (BD DSM criterion-A2) rates were significantly higher in ADHD than LNCG (χ² = 122.2, P < 0.0001), but irritability was associated more strongly with NSM than PM (df 3, 2538; F = 43.2; P < 0.0001).CONCLUSION: Individuals with ADHD do not appear to be at significantly greater risk for developing BD, but do show higher rates of BD symptoms, especially NSM. The greater linkage of irritability to NSM than to PM suggests caution when making BD diagnoses based on irritability alone as one of 2 (A-level) symptoms for BD diagnosis, particularly in view of its frequent presentation with other psychopathologies.     

含吐温80中药注射剂对不同动物的过敏反应

目的:观察吐温80及含吐温80的中药注射剂对不同动物的过敏反应,阐明不同动物出现毒性反应的原因.方法:在犬和猴两种不同种属的动物体内,分别静注或静滴0.35%吐温80溶液及含相同百分含量吐温80的中药注射剂,观察动物的血压、心率、心电图及过敏反应.结果:犬静滴吐温80溶液及含吐温80的中药注射剂5ml·kg-1(内含吐温80 17.5mg·kg-1)后,均出现血压下降、心率减慢及皮肤红斑、流涎呕吐、痉挛抽搐等过敏反应;而猴静注或静滴吐温80溶液及含有吐温80的中药注射剂10ml·kg-1(内含吐温80 35mg·kg-1),未出现过敏反应.结论:犬对吐温的过敏反应是动物的种属性特异反应.     

抑郁症和精神分裂症患者激惹症状的对照研究

目的探讨抑郁症与精神分裂症患者激惹症状的特点。方法使用激惹、抑郁和焦虑量表(IDA)对64例抑郁症患者,50例精神分裂症患者及67例健康人进行评定。结果与对照组比较,抑郁症组内向性激惹因子[(5．09±2．88)分]、外向性激惹因子[(4．23±2．80)分]、抑郁因子[(8．78±3．56)分]及焦虑因子[(8．45±2．96)分]分均显著升高,差异有显著性(P＜0．01)。精神分裂症组除抑郁因子分外,其余因子分与对照组差异无显著性(P＞0．05)。与抑郁症组比较,精神分裂症组的内向性激惹因子、抑郁因子及焦虑因子分均显著下降,差异有显著性(P＜0．05或P＜0．01)。结论对抑郁症患者激惹症状的防治是非常有必要的。     

Effects of olfactory bulbectomy on NMDA receptor density in the rat brain:

Olfactory bulbectomy (OBX) transects the glutamatergic efferents from the olfactory bulbs, and the changes of glutamatergic N-methyl-D-aspartate (NMDA) receptor-mediated function are though to be involved in the behavioral deficits seen in OBX rats. In the present study, irritability scores in OBX male Wistar rats were correlated with discrete regional effects on NMDA receptor function measured using a [3H] MK-801 binding assay. Irritability scores, measured before and for 2 weeks after OBX, showed a gradual increase in irritability after OBX. A reduction of the NMDA receptor density was observed in the cerebral cortex and amygdala 16 days after OBX, but not in the striatum, olfactory tubercle, entorhinal cortex, and hippocampus. These results demonstrate that OBX causes changes in the NMDA receptor system in certain brain regions and suggest that these changes may be responsible for the behavioral deficits of OBX rats.     

东莞市入侵红火蚁伤人导致1例过敏性休克

目的了解人群被入侵红火蚁蜇咬后引发过敏性休克的临床症状、治疗情况及红火蚁的发生情况,为其蜇咬人后的治疗提供资料。方法采用访问主治医生及查阅病历、访问患者,调查被蚂蚁叮咬的现场生境等方法进行。结果患者入院诊断为蚂蚁咬伤,过敏性休克,经医院及时对症抢救2h后痊愈;访问患者证实其是被蚂蚁叮咬后引起身体不适入院;调查患者被叮咬生境发现有入侵红火蚁孳生。结论患者被入侵红火蚁蜇咬后引起过敏性休克,应加强入侵红火蚁防控,人被蜇咬后要及时就治。     

激惹、抑郁和焦虑量表(IDA)的信度和效度研究

目的 评价IDA量表的信度和效度。方法 使用IDA、SDS和SAS对291例大学生和64例抑郁症患者进行评定。结果 IDA具有良好的心理测量特性，Cronbach α系数在0.419-0.769,IDA各分量表的劈半相关系数在0.427-0.639,IDA各分量表与SDS、SAS间的相关系数均在0．400－0．776，IDA各分量表得分在非抑郁大学生、抑郁大学生和抑郁症患者之间存在非常显著性差异。结论 IDA量表具有良好的信度和效度，值得推广使用。