文拉法辛缓释片与西酞普兰、阿米替林治疗抑郁症的对照研究

目的比较文拉法辛缓释片与西酞普兰、阿米替林治疗抑郁症的疗效、不良反应。方法将120例抑郁症患者随机分为3组,分别给于文拉法辛缓释片(博乐新)、西酞普兰、阿米替林治疗4周。采用汉米尔顿抑郁量表(HAMD)、不良反应量表(TESS)在治疗前和治疗第1、2、4周末分别评定疗效、不良反应。结果文拉法辛缓释片组在第1周末即显效,HAMD评分与治疗前比较差异有统计学意义,与另2组比较差异亦有统计学意义(P<0.05,P<0.01);其余2组与治疗前比较差异无统计学意义(P>0.05)。文拉法辛缓释片组第2周末与治疗前比较差异有统计学意义(P<0.01),3组间比较差异有统计学意义(P<0.05)。至第4周末3组与治疗前比较差异均有统计学意义(P<0.01),但3组间比较差异无统计学意义(P>0.05)。阿米替林组锥体外系及抗胆碱能不良反应最高,消化系统和精神、神经系统不良反应西酞普兰组最高。结论文拉法辛缓释片治疗抑郁症与阿米替林及西酞普兰比较起效较快,不良反应较少。     

抗抑郁治疗对老年脑卒中后抑郁及康复的影响

目的:观察抗抑郁治疗对老年缺血性脑卒中后抑郁症状及神经功能康复的作用.方法:将老年脑卒中后抑郁患者356例分为文拉法辛组128例、阿米替林组116例及对照组112例,于治疗前后进行汉密尔顿抑郁量表(HAMD)和神经功能缺损量表(CSS)、日常生活能力量表(ADL)评定.结果:文拉法辛组和阿米替林组治疗第2周HAMD评分和第12周CSS评分较治疗前和对照组均明显降低;文拉法辛组和阿米替林组3个月后ADL亦明显改善(P均＜0.05),但阿米替林组不良反应明显高于文拉法辛组.结论:抗抑郁治疗有利于老年脑卒中后抑郁患者神经功能康复,提高生活能力,减少并发症.     

度洛西汀和文拉法辛治疗抑郁症对照研究

目的:探讨度洛西汀和文拉法辛对抑郁症的疗效及安全性。方法:70例抑郁症患者随机分为度洛西汀组和文拉法辛组各35例,分别给予度洛西汀与文拉法辛治疗6周。用汉密尔顿抑郁量表(HAMD,17项)评定疗效,治疗中出现的症状量表(TESS)评定不良反应。结果:度洛西汀组30例及文拉法辛组33例完成了6周的治疗。两组HAMD评分从治疗1周起明显下降(P<0.05),且一直持续到6周。6周末两组有效率分别为73.3%和78.8%;临床治愈率分别为53.3%和57.6%,两组差异无统计学意义(P>0.05)。度洛西汀组不良反应中恶心的患者明显高于文拉法辛组(P<0.05),其余不良反应无显著差异。结论:度洛西汀治疗抑郁症疗效与文拉法辛相似,恶心的不良反应更明显。     

文拉法辛与阿米替林预防偏头痛的对照研究

目的以阿米替林为对照,评价盐酸文拉法辛胶囊预防偏头痛的疗效及安全性。方法79例偏头痛患者随机分成盐酸文拉法辛组（n=40）和阿米替林组（13=39）,盐酸文拉法辛组服用盐酸文拉法辛胶囊75mg／d,阿米替林组服用阿米替林75mg／d,疗程均为3月。治疗前、治疗1个月、2个月和3个月后分剐评价患者的头痛发作次数、严重程度和头痛持续时间,以及治疗后1个月、2个月和3个月的不良反应发生情况。结果经盐酸文拉法辛和阿米替林治疗1月、2月及3月后,患者的头痛发作次数、严重程度及持续时间均显著改善,差异有统计学意义;同时治疗2个月疗效好于1个月,治疗3个月疗效好于2个月;两组患者治疗前后各时点头痛发作次数、严重程度、持续时间比较无统计学差异。但阿米替林不良反应发生率显著高于盐酸文拉法辛,分剐是77．8％和21,差异有统计学意义。结论盐酸文拉法辛预防偏头痛疗效确切,安全性好。     

盐酸文拉法辛和草酸艾司西酞普兰治疗抑郁症的对照研究

目的 比较盐酸文拉法辛和草酸艾司西酞普兰治疗抑郁症患者的疗效和安全性.方法 69例抑郁症患者随机分为盐酸文拉法辛组和草酸艾司西酞普兰组.盐酸文拉法辛治疗剂量150～225 mg/d,草酸艾司西酞普兰治疗剂量10～20 mg/d,采用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)以及副反应评定量表(TESS)评定疗效和不良反应,观察时间为期8周.结果 两组药物在治疗终末期疗效以及不良反应差异没有统计学意义(P＞0.05).在治疗第6周末草酸艾司西酞普兰组HAMD/HAMA总评分低于盐酸文拉法辛组(P＜0.05).结论 盐酸文拉法辛与草酸艾司西酞普兰对抑郁症患者均有较好的疗效,安全性一致,但是后者起效更快.     

电针结合文拉法辛对抑郁症患者抑郁症状及睡眠改善作用的对照研究

目的观察电针结合文拉法辛对抑郁症患者抑郁症状及睡眠的改善作用。方法将40例抑郁患者随机分为对照组和研究组,各20例。对照组给予文拉法辛治疗,研究组给予电针结合文拉法辛治疗,共观察2周。采用汉密尔顿抑郁量表（HAMD）评定疗效,多导睡眠检测睡眠状况,并使用不良反应量表（TESS）评定不良反应。结果电针结合文拉法辛组显效率为65％,对照组显效率为60％,两组比较差异无统计学意义（P〉0．05）;电针结合文拉法辛组第1周末与单纯文拉法辛治疗组HAMD评分比较差异有统计学意义（P〈0．05）;电针结合文拉法辛组对睡眠的改善作用优于单纯文拉法辛治疗组（P〈0．05）;电针结合文拉法辛组不良反应发生率为39．2％,对照组为37．1％,两组比较差异无统计学意义（P〉0．05）。结论电针结合文拉法辛与单纯文拉法辛治疗抑郁症疗效相当,不良反应相似,但是起效较单纯使用文拉法辛快,而且对睡眠状况改善更好。     

文拉法辛与舍曲林治疗躯体形式障碍门诊病例对照研究

目的 评价文拉法辛与舍曲林对躯体化障碍和未分化躯体形式障碍的临床疗效和安全性. 方法文拉法辛组26例,剂量范围75～225mg/d;舍曲林组26例,剂量范围50～100mg/d,两组均以汉密尔顿焦虑量表(HAMA)、临床大体印象量表(CGI)、副反应量表(TESS)评定观察12周. 结果 47例完成研究(文拉法辛组22例,舍曲林组25例).研究终点,文拉法辛组和舍曲林组的HAMA-躯体性焦虑因子分均明显下降,文拉法辛组HAMA-躯体性焦虑因子分减分值平均为1.9±2.1,舍曲林组为3.2±2.5,差异无统计学意义(t=-1.961,P＞0.05).文拉法辛组临床总有效率为59.1%,舍曲林组为60.0%,差异无统计学意义(χ2=0.004,P＞0.05).文拉法辛组不良反应发生率为40.0%,舍曲林组为28.0%,差异无统计学意义(χ2=0.869, P＞0.05). 结论文拉法辛与舍曲林治疗躯体化障碍和未分化躯体形式障碍疗效相当,且均较为安全.     

两种剂型文拉法辛治疗抑郁症的药物成本与疗效分析

目的 比较两种剂型文拉法辛治疗抑郁症的药物成本与疗效.方法 将2008年1月～2009年8月期间,在抚顺煤矿脑科医院住院的抑郁症患者64例随机分成两组,文拉法辛速释剂组(博乐欣组)和缓释剂组(缓释片组)各32例.博乐欣组给予文拉法辛速释剂(博乐欣胶囊,25mg/粒),开始剂量为每次1粒,3次/d;7d后增至每次2粒,3.次/d,直至最后1周.缓释片组给予文拉法辛缓释荆(文拉法辛缓释片,75mg/片),开始剂量为每天1片,7d后增至每天2片,直至最后1周.两组连续用药8周;分别于治疗前和治疗8周末进行汉密尔顿抑郁量表(HAMD)和不良反应量表(TESS)评定.采用最小成本分析方法对两组治疗方案进行成本-效益分析.结果 经过治疗8周后,博乐欣组和文拉法辛缓释片组的HAMD减分率分别为(66.52±28.40)%和(71.08±22.60)%,两组差异无显著性.博乐欣组痊愈率66.70%,有效率81.31%;文拉法辛缓释片组痊愈率72.33%,有效率85.54%,两组间差异无显著性.博乐欣组发生不良反应10例(31%),文拉法辛缓释片组有8例(25%),两组间差异无显著性.治疗8周末计算治疗药物成本,服用博乐欣成本为1156.05元,服用文拉法辛缓释片成本为945.00元,两者差为211.05元.文拉法辛缓释片成本/效果比值小于博乐欣.结论 文拉法辛缓释片和速释剂(博乐欣)治疗抑郁症均有肯定的疗效,疗效相近,不良反应发生率低,文拉法辛缓释片的治疗费用更低.     

西酞普兰与文拉法辛治疗抑郁症的对照研究

目的:比较西酞普兰与文拉法辛治疗抑郁症的疗效及安全性.方法:将50例抑郁症患者随机分入两组分别用西酞普兰和文拉法辛治疗,疗程6周,用汉密尔顿抑郁量表(HAMD)评定临床疗效,副反应量表(TESS)评定不良反应.结果:西酞普兰组显效率64.0%,有效率88.0%,文拉法辛组为60.0%,80.0%,两组疗效相仿.在治疗2周末时,文拉法辛组减分多于西酞普兰组,差异有显著性.两组不良反应均轻微.结论:西酞普兰和文拉法辛抗抑郁疗效肯定,不良反应轻.     

文拉法辛与舍曲林治疗抑郁症对照研究

目的：比较文拉法辛与舍曲林治疗抑郁症的临床疗效和安全性。方法：将76例抑郁症患者随机分为文拉法辛组（38例）和舍曲林组（38例）,疗程6周。采用汉密尔顿抑郁量表17项（HAMD）评定疗效,治疗中出现的症状量表（TESS）评定不良反应和安全性。结果：文拉法辛组治疗1周起效;疗程结束时,两组疗效和HAMD评分差异无显著性,不良反应少而轻。结论：文拉法辛与舍曲林治疗抑郁症疗效相似,文拉法辛起效较快。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

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.     

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.