氯氮平合并帕罗西汀治疗精神分裂症阴性症状临床研究

目的　观察氯氮平合并帕罗西汀治疗精神分裂症阴性症状的疗效和副作用。方法　将 66例女性慢性精神分裂症患者平均分为研究组 (氯氮平加帕罗西汀 )和对照组 (氯氮平加安慰剂 )。在治疗前、治疗后 4、8、12周末分别以阳性症状和阴性症状量表(PANSS)和副反应量表 (TESS)评定疗效和副作用。同时测定氯氮平与去甲氯氮平的血浓度。结果　治疗 8周后研究组PANSS总分、阴性因子分比治疗前明显降低 ,且阴性因子分值显著低于对照组 ,氯氮平及去甲氯氮平血浓度明显升高。治疗后 4、8、12周末TESS评分 ,研究组均低于对照组 ,且治疗后低于治疗前 ,均有显著性差异。结论　氯氮平合并帕罗西汀能明显改善精神分裂症患者的阴性症状 ,且副作用减少。     

帕罗西汀合并氯氮平治疗精神分裂症的阴性症状

目的探讨氯氮平合并帕罗西汀治疗精神分裂症的阴性症状的疗效。方法以阴性症状为主、单用氯氮平的住院精神分裂症病人58例,随机分成研究组和对照组,分别加用帕罗西汀和安慰剂治疗,疗程12周,使用阳性症状与阴性症状量表（PANSS）和副反应量表（TESS）评定,在治疗前和治疗4、8、12周末备评定一次。结果研究发现两组疗效相比较,两组疗效相仿（P〉0．05）。两组治疗前后PANSS总分、阴性因子分评分比较,显效时间均在用药8周后。12周末研究组PANSS总分、阴性因子分明显低于治疗前,而且两组间比较发现研究组阴性因子分比对照组明显降低,提示存在显著差异（P〈0．01）。结论帕罗西汀合并氯氮平能够显著改善精神分裂症的阴性症状。且少有副反应。     

奥氮平合并氯氮平对男性难治性精神分裂症阴性症状的疗效及安全性的研究

目的观察奥氮平合并氯氮平治疗男性以阴性症状为主的难治性精神分裂症的疗效以及安全性。方法对43例男性原服用氯氮平且以阴性症状为主的难治性精神分裂症患者合并奥氮平5～20mg／d治疗8周,同时于2周内将氯氮平减量且氯氮平剂量2周后不再变化,并于合并治疗前及后2周、4周、8周评定阳性症状与阴性症状量表（PANSS）、副反应量表（TESS）。结果合并奥氮平治疗后2周、4周、8周末PANSS总分和TESS评分较合并前有明显差异。结论奥氮平合并氯氮平对于男性难治性精神分裂症患者的阴性症状有明显的改善,副反应也有减少。     

联用帕罗西汀治疗精神分裂症阴性症状研究

目的:探讨抗精神病药联用帕罗西汀治疗精神分裂症阴性症状的疗效.方法:以阴性症状为主的住院慢性精神分裂症33例,在原用抗精神病药基础上,联用帕罗西汀,疗程12周.使用阳性 与阴性症状量表(PANSS)和副反应量表(TESS)评定,在治疗前和治疗4、8、12周末各评定1次.结果:联用帕罗西汀12周后,PANSS总分、阴性症状因子分及情感迟钝、情感退缩、情感交流障碍、被动/淡漠及社交退缩因子分均比治疗前显著降低.结论:以阴性症状为主的慢性精神分裂症,在使用抗精神病药物的同时联用帕罗西汀,对改善阴性症状有明显作用.     

抗精神病药合并帕罗西汀治疗慢性精神分裂症

目的：探讨抗精神病药合并帕罗西汀治疗慢性精神分裂症阴性症状的疗效。方法：对68例以阴性症状为主的慢性精神分裂症患者，在原用抗精神病药基础上，随机分为合用组和对照组，分别给予帕罗西汀和安慰剂，疗程12周。疗效和药物不良反应评定采用阳性与阴性症状量表（PANSS）和治疗中出现的症状量表（TESS），于治疗前及治疗4、8、12周各评定一次。结果：治疗第8周起合用组PANSS总分及阴性因子分均比治疗前显著降低。结论：以阴性症状为主的慢性精神分裂症患者，在使用抗精神病药同时联用帕罗西汀可改善阴性症状，两组不良反应无明显差异。     

帕罗西汀治疗精神分裂症的辅助作用

目的：探讨利培酮合并帕罗西汀治疗以阴性症状为主的精神分裂症的疗效和不良反应。方法：将80例以阴性症状为主的精神分裂症患者随机分为合用组（利培酮合并帕罗西汀治疗）与单用组（单用利培酮治疗）,每组各40例,疗程12周。用阳性与阴性症状量表（PANSS）评定疗效,治疗中出现的症状量表（TESS）评定不良反应。结果：治疗12周后合用组有效率显著高于单用组,PANSS总分和阴性症状分低于同期单用组,TESS评分无显著差异。结论：利培酮合并帕罗西汀治疗以阴性症状为主的精神分裂症有较好的疗效,不良反应少。     

氟西汀合并氯氮平治疗精神分裂症临床观察

目的：观察氟西汀合并氯氮平治疗精神分裂症阴性阴性症状的疗效和副反应。方法：将40例男性慢性精神分裂症病人平分为研究组（氟西汀加的氯氮平）和对照组（安慰剂加氯氮平），分别评定疗效及副反应。并同步测定氯氮平与N-去甲基氯氮平的血浓度。结果：治疗8周后研究组PANSS总分、阴性因子分比治疗前明显降低，且阴性因子分值显著低于对照组，同期氯氮平及N-去甲苦氯氮平血浓度明显升高。结论：氟西汀合并氯氮平能明显改善精神分裂症病人的阴性症状，并少有副反应。     

氯氮平与米氮平治疗慢性精神分裂症临床观察

目的:观察氯氮平合用米氮平治疗慢性精神分裂症阴性症状的疗效和安全性。方法:将72例慢性精神分裂症患者随机分为合用组和单用组,分别给予氯氮平合用米氮平及单用氯氮平治疗。疗程12周。采用阳性与阴性症状量表(PANSS)、副反应量表(TESS)评定疗效和不良反应。结果:治疗4周后合用组阴性症状因子分及8、12周后两组PANSS总分和各因子分与治疗前比较有显著下降。治疗8周及12周末两组间比较PANSS总分及阴性症状分以合用组下降显著为多。结论:氯氮平合并米氮平较单用氯氮平治疗精神分裂症阴性症状疗效好。     

加用银杏叶片对氯氮平合并心得安治疗慢性精神分裂症的疗效和安全性的影响

目的 探讨银杏叶片对氯氮平合并心得安治疗慢性精神分裂症的疗效和安全性的影响.方法 将80例慢性精神分裂症病人随机分为研究组和对照组各40例,对照组给予抗精神病药物氯氮平、心得安治疗,研究组在此基础上,加用银杏叶片治疗,治疗12周.治疗前和治疗4、8、12周末分别用阳性与阴性症状量表(PANSS)评定临床疗效,用不良反应症状量表(TESS)评定不良反应,了解药物的安全性.结果 两组PANSS各因子评分比较差异无统计学意义(P＞0.05),但是阴性症状评分(P ＝0.053),有异质性和可比性,银杏叶片还可减少氯氮平的不良反应.结论 以阴性症状为主的精神分裂症在氯氮平合并心得安治疗过程中适合加用银杏叶片以增强疗效,减少不良反应.     

利培酮联合帕罗西汀治疗慢性精神分裂症阴性症状

目的:探讨利培酮联合帕罗西汀治疗慢性精神分裂症阴性症状的临床疗效以及安全性.方法:将126例以阴性症状为主的慢性精神分裂症住院患者随机分为研究组(利培酮联合帕罗西汀治疗)和对照组(单用利培酮治疗),疗程12周,采用阳性和阴性症状量表(PANSS)和治疗中出现的症状量表(TESS)评定疗效和安全性. 结果:治疗后两组PANSS评分均较治疗前有显著降低(P＜0.05).治疗后4、8、12周末,研究组阴性因子分及情感迟钝、情感退缩、情感交流障碍及社会退缩因子分均显著低于对照组,差异具有统计学意义(P＜0.05或P＜0.01).两组不良反应均为轻至中度. 结论:利培酮联合帕罗西汀较单用利培酮治疗慢性精神分裂症阴性症状具有起效更快、疗效更好、依从性好的特点.     

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.