丙戊酸镁与碳酸锂对躁狂症预防治疗的对照研究

目的　评价丙戊酸镁预防治疗躁狂症的疗效和副反应。方法　１１５ 例躁狂症患者出院时按原服用丙戊酸镁或碳酸锂自然分为丙戊酸镁组（４６ 例） 和碳酸锂组（６９ 例） ,进行预防治疗研究。使用 Ｂ Ｒ Ｍ Ｓ、 Ｔ Ｅ Ｓ Ｓ 帮助评定疗效和副反应。结果　平均随访３６ 个月,丙戊酸镁组有效率８６９５ ％ ,副反应发生率４５６５ ％ ;碳酸锂组有效率８４０６ ％ ,副反应发生率４４９２ ％ ,经 Ｒｉｄｉｔ 分析２ 组比较无显著性差异。丙戊酸镁对碳酸锂预防治疗无效的病例依然有效。结论　丙戊酸镁可作为预防治疗躁狂症的选用药物。     

丙戊酸镁联用氯硝西泮治疗躁狂症对照研究

目的：探讨丙戊酸镁联用氯硝西泮治疗躁狂症的疗效与安全性。方法：对符合中国精神疾病分类方案与诊断标准第2版修订本62例躁狂症患者，其中40例用丙戊酸镁联用氯硝西泮，22例用碳酸锂治疗。疗程6周。以躁狂量表(BRMS)评定疗效，副反应量表(TESS)评定不良反应。结果：两组疗效差异无显著性。联用组不良反应明显低于对照组。结论：丙戊酸镁联用氯硝西泮治疗躁狂症．疗效确切，起效时间与安全性优于碳酸锂。     

丙戊酸镁与碳酸锂治疗躁狂症的对照研究

将32例躁狂症病人随机分为丙戊酸镁组和碳酸锂组,使用Bech-Rafaelson躁狂量表(BRMS)及副反应量表(TESS)进行评定。经5周治疗研究后,两组BRMS评分自身前后对照差异均非常显著(P<0.001)。两组对比的动态观察表明,第五周丙戊酸镁组BRMS评分及TESS评分均明显高于对照组,认为丙戊酸镁的疗效较低而副反应较高,仅可作为某些躁狂症的治疗选择用药,且剂量应控制在每日1.8以下。     

丙戊酸镁与碳酸锂治疗躁狂发作的对照研究

为了评价丙戊酸镁治疗躁狂发作的疗效及副反应，将１５６例情感性障碍躁狂发作的住院病人随机分配到丙戊酸镁组（１０４例）和碳酸锂组（５２例），治疗６周。使用Ｂｅｃｈ－Ｒａｆａｅｌｓｅｎ躁狂量表（ＢＲＭＳ）及临床疗效总评量表评定疗效，用副反应量表及有关实验室检查评定副反应。结果显示，两组疗后第６周ＢＲＭＳ各因子分及总分减分率均显著低于疗前（Ｐ＜０．０００１），说明丙戊酸镁能有效减轻躁狂症状，疗效与碳酸锂相近。丙戊酸镁的副反应主要是恶心或呕吐、心动过速、震颤、口干、头晕等与碳酸锂相似，但持续时间较短，病人耐受性较好。提示丙戊酸镁可作为治疗情感性障碍躁狂发作的选用药物。     

丙戊酸镁与碳酸锂治疗躁狂发作对照研究

目的:比较丙戊酸镁与碳酸锂治疗躁狂发作的疗效和不良反应。方法:对84例躁狂发作患者随机平分为丙戊酸镁组和碳酸锂组,在治疗前及治疗2、4、6周末分别用Bech-Rafaelsen躁狂量表(BRMS)、临床疗效总评量表(CGI)及副反应量表(TESS)评定疗效和不良反应。结果:丙戊酸镁组治疗2周末BRMS总分及各因子分比治疗前明显降低,且显著低于碳酸锂组。丙戊酸镁的不良反应与碳酸锂相似,但持续时间较短,患者耐受性好。结论:丙戊酸镁治疗躁狂发作疗效好,起效快,不良反应小。     

丙戊酸镁在碳酸锂治疗躁狂发作的对照研究

为了评价丙戊酸镁治疗躁狂发作的闻效及副反应，将１５６例情感性障碍躁狂发作的住两 随机分配到丙戊酸镁组（１０４例）和碳酸锂组（５２例），治疗６周。使用Ｂｅｃｈ－Ｒａｆａｅｌｓｅｎ躁狂量表（ＢＲＭＳ）及临床疗效总评量表评定疗效，用副反应量表及有关检查评定副反应。结果显示，两组疗后第６周ＢＲＭＳ各因子分及总分减分率均显著低于疗前（Ｐ〈０．００１），说明丙戊酸镁能有效减轻躁狂症状，疗效与碳酸锂相近。丙戊     

丙戊酸镁治疗躁狂症36例

作者介绍了丙戊酸镁治疗36例躁狂症的疗效及副反应。显效率为80.6%,有效率为94.4%,发现该药治疗躁狂症显效率高,且疗效与病程有关,与日治疗剂量的大小无关。BRMS量表观察显示精神症状消退快,TESS评估发现该药副反应少,文章还就该药治疗蹂狂症的机理进行了初步探讨。     

丙戊酸镁与碳酸锂治疗躁狂症的对照性研究

３０例躁狂症病人随机分为丙戊酸镁与碳酸锂两个组，进行为期４周的治疗，使用Ｂｅｃｈ－Ｒａｆａｅｌｓｏｎ躁狂量表和１９８１年中华医学会神经精神科分会制定的５级疗效标准进行疗效评定，两组ＢＲＭＳ评分在治疗前后均有显著差异，丙戊酸镁的显效率为６４．２９％，碳酸锂为６８．７５％。两组间疗效无显著性差异。     

丙戊酸钠与卡马西平治疗躁狂发作临床观察

目的：评价丙戊酸钠与卡马西平对锂盐治疗无效的躁狂发作的疗效和副反应。方法：将符合CCMD－2－R躁狂发作诊断标准的5例患者随机分为丙戊酸钠组和卡马西平组,治疗6周。使用Bech-Rafaelsen躁狂量表及临床疗效总评量表的疗效总评评定疗效,用副反应量表及有关实验室检查评定副反应。结果：丙戊酸钠与卡马西平均能有效减轻躁狂症状,疗效相近,丙戊酸钠起效时间迟于卡马西平。丙戊酸钠的副反应主要为肠道反应、震颤等、而卡马西平以共济失调、头晕、嗜睡等多见。结论：丙戊酸钠与卡马西平均可用于锂盐治疗无效的躁狂发作。     

丙戊酸镁与碳酸锂治疗躁狂发作对照研究的循证医学评价

目的评价丙戊酸镁与碳酸锂治疗躁狂症的疗效与安全性。方法应用循证医学方法对符合标准的17项研究进行分析,评价丙戊酸镁与碳酸锂治疗躁狂症的有效率、症状学变化以及副作用的差异。结果丙戊酸镁与碳酸锂治疗躁狂症的疗效相似（287／491VS274／465,OR=0．99,95％CI：0．76～1．29,Z=0．10,P〉0．05）,但是丙戊酸镁比碳酸锂治疗躁狂症起效快,在第一周末（WMD：-1．73,95％CI：-2．75--0．70,Z=3．30,P〈0．001）和第二周末（WMD：-0．88,95％CI：-1.46--0．30,Z=2．98,P〈0．001）,丙戊酸镁比碳酸锂改善症状学明显（WMD：11．08,95％CI：-1．59--0．58,Z=4．22,P〈0．0001）。而且无论是副作用出现的频率（118／431vs162／375,OR=0．55,95％CI：0．40-0．76,Z=3．66,P〈0．001）还是严重程度（WMD：-1．33,95％CI：-1．86--0．81,Z=4．96,P〈0．001）,丙戊酸镁均比碳酸锂轻。结论丙戊酸镁与碳酸锂治疗躁狂症的疗效相似,但丙戊酸镁起效快、副作用更少。     

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.