氯氮平对儿童少年精神分裂症患者肝脏功能的影响

目的通过动态检测青少年精神分裂症患者氯氮平治疗后多项生化指标的变化,了解患者用药过程中肝脏功能损害和适应性。方法选取未经治疗的首发青少年精神分裂症患者70例,于治疗前和治疗2周~6周每周末及7周以上时段,检测患者血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、γ-谷氨酰转肽酶(γ-GT)、胆碱酯酶(CHE)、总胆汁酸(TBA)、总胆红素(T-Bil)、直接胆红素(D-Bil)、间接胆红素(I-Bil)、总蛋白(TP)、白蛋白(ALB)、球蛋白(GLO)、前白蛋白(P-ALB),并同时于2、4、6、8周采用简明精神病评定量表(BPRS)和副反应量表(TESS)评定疗效和副反应。结果患者BPRS和TESS量表评分,治疗前后相比较均具有显著性差异(P<0.05),治疗2周与其它周相比差异具有显著性(P<0.05)。ALT、AST、ALP、γ-GT趋势性变化明显,用药2周时上升至高峰,第3周下降至治疗前水平,甚至略低于治疗前,第4周又升高,第5周以后逐渐下降,并维持在略高于治疗前水平;LDH从第2周开始上升,第4周达高峰,然后逐渐下降,第6周后维持在略高于治疗前水平;T-Bil、I-Bil治疗2周~6周显著低于治疗前(P<0.05~P<0.01),7周后恢复到治疗前水平(P>0.05);D-Bil在治疗2周及4周时低于治疗前(P<0.05);P-ALB在治疗3、4、6周及7周以上时显著高于治疗前(P<0.05);CHE、TBA、TP、ALB、GLO治疗前后始终无显著性改变(P>0.05)。治疗第3周与其它周比较,ALT均具有显著性差异(P<0.01),而其它项目差异无显著性(P>0.05)。结论氯氮平治疗青少年精神分裂症疗效确切,引起的肝脏损害具有规律性,且较轻微,随着治疗的深入,人体可以逐渐适应用药状况。     

西酞普兰与马普替林治疗老年抑郁症的对照研究

目的探讨西酞普兰与马普替林治疗老年抑郁症的疗效和不良反应。方法将80例老年抑郁症患者随机分成两组，一组服用西酞普兰，另一组服用马普替林，疗程6周。采用汉密顿抑郁量表（HAMD）及药物副反应量表（TESS）定疗效和不良反应。结果西酞普兰组显效率为80％；马普替林组显效率为72．5％，两组差异无显著性。西酞普兰组不良反应较马普替林组少而轻。结论西酞普兰治疗老年抑郁症的疗效确切，起效快，不良反应轻，依从性好。     

首发精神分裂症患者精神药物使用调查

目的 了解首发精神分裂症患者精神药物使用情况。方法 采用回顾性调查研究方法对我院2001年1-6月住院的206例首发精神分裂症患者精神药物使用情况进行调查。结果 单一用药到出院者114例，因用药后疗效不好致换药者24例，合并用药者68例；单一用药频度排列前4位的是氯氮平，氯丙嗪、舒比利，维思通；联用抗胆碱药物者63例。结论 非典型抗精神病药物氯氮平仍是一线抗精神病药物，我院对首发精神分裂症患者精神药物使用基本合理，但应减少联合用药。     

河南省幼师学生心理健康状况调查分析

目的 了解河南省幼师学生的心理健康状况，为提高幼师的心理素质提供依据。方法 对来自河南南阳一师，洛阳一师，郑州幼师3所学校的580名幼师女生进行症状自评量表（SCL-90）测定。数据经t检验，q检验和卡方检验。结果 幼师在校生中有63.81%学生存在心理健康问题。11.43%学生有明显心理障碍，突出表现为强迫，人际敏感，偏执，敌对，抑郁，不同年级学生心理健康状况存在明显差异。结论 提示幼师学生存在不同程度心理健康问题。学校心理卫生和教育工作者必须予以重视，进行干预。     

疑病性神经症患者个性特征分析

目的 探讨疑病性神经症患者的人格特征,为临床心理干预提供参考依据.方法 采用MMIP量表对46例疑病性神经症患者进行测试,与中国常模比较.结果 疑病性神经症患者的MMPI分值以Hs、D、Hy、Pt最高,呈1-2-3-7型图形(P＜0.05～0.01);另有Pd、Pa和Sc量表也明显高于常模(P＜0.05～0.01).男女之间比较女性Hs、D、Hy、Mf和Pt显著高于男性组(P＜0.05～0.01).结论 疑病性神经症的发生与个性基础有关,MMIP对辅助评价疑病性神经症患者的人格特征有重要意义.     

Sex difference in the association between surrogate markers of insulin resistance and arterial stiffness

AimsTo investigate the predictive capability of insulin resistance surrogate markers for insulin resistance and arterial stiffness based on sex.MethodsWe assessed the association of triglyceride glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), visceral adiposity index (VAI), and lipid accumulation product (LAP) with homeostasis model assessment-insulin resistance (HOMA-IR) and brachial–ankle pulse wave velocity (baPWV) in both sexes.ResultsA total of 1720 men and 1098 women were evaluated. HOMA-IR showed good correlation with the TyG index (men: r = 0.47, women: r = 0.45), TG/HDL-C (men: r = 0.45, women: r = 0.41), VAI (men: r = 0.51, women: r = 0.48), and LAP (men: r = 0.55, women r = 0.49) (all p-values < 0.001). These markers positively correlated with increased baPWV in both sexes. The standardized partial regression coefficients were 0.11 and 0.14 for the TyG index, 0.13 and 0.16 for TG/HDL-C, 0.14 and 0.19 for VAI, and 0.12 and 0.17 for LAP in men and women, respectively (all p-values < 0.01; all p-values for sex interaction < 0.05).ConclusionsAll insulin surrogate markers showed good correlation with HOMA-IR in both sexes. These indices were also associated with increased baPWV and the associations were stronger in women than in men.     

Altered gut microbiota and mucosal immunity in patients with schizophrenia

Evidence shows that gut microbiota may play important roles in schizophrenia pathogenesis via the “gut-brain” axis, but the mechanisms remain unclear. Here, eighty-four patients with schizophrenia and 84 sex- and age-matched healthy controls were enrolled. Shotgun metagenomic sequencing and 16S rRNA sequencing were performed, and the gut microbiota-associated epitopes (MEs) were predicted, which, together with IgA content, were used to determine the gut microbiota composition associated with gut immune status. Patients with schizophrenia had significantly reduced gut microbiota richnesses compared with those of the healthy controls, and the gut microbiota compositions clearly distinguished the patients with schizophrenia from the healthy controls. Based on two-stage metagenomic-wide association studies, nineteen gut microbiota taxonomies were associated with schizophrenia, and the microbial dysbiosis (MD) index was calculated based on the abundance of differential taxonomies. We found that MD index was positively correlated with MEs diversity and gut IgA levels, and negatively correlated with gut microbiota richness. Glutamate synthase (GOGAT) was more active in the guts of patients with schizophrenia than in those of healthy controls, and high GOGAT activity was associated with altered gut microbiota taxonomies associated with gut IgA levels. Our results may imply a role of the microbiome in the etiology of schizophrenia and contribute to the development of microbiome targeted interventions for schizophrenia.