男性海洛因依赖者认知功能及相关因素研究

目的:评估男性海洛因依赖者(MPHD)记忆力与执行功能,探讨二者可能的影响因素。方法:采用韦氏记忆量表(WMS)与威斯康星分类卡片改良版(M-WCST)对140例MPHD及75例健康对照进行认知功能评估;应用一般情况调查表(自拟)、症状自评量表(SCL-90)、抑郁(SDS)及焦虑自评量表(SAS)对MPHD进行心理评估。结果:①MPHD组WMS与M-WCST测验成绩显著差于对照组(P<0.05或P<0.01)。②MPHD年龄与记忆商数(MQ)及M-WCST大部分指标呈负相关,受教育年限与WMS及M-WCST大部分指标呈正相关(P<0.05或P<0.01);海洛因使用年限、日使用次数、使用方式、中毒次数等与WMS及M-WCST部分指标呈现显著的相关性(P<0.05或P<0.01)。③SCL-90总分、SDS总分及SAS总分与MQ呈负相关(P<0.05或P<0.01);SAS总分与M-WCST分类正确数呈负相关,与分类错误数及持续性错误数呈正相关(P<0.05)。④戒断前有无“飘”的感觉、SDS总分及受教育年限依次进入记忆力的多元回归方程;SAS总分与使用方式依次进入执行功能的多元回归方程。结论:MPHD记忆与执行功能呈现一定程度的损害,“飘”的感觉、受教育年限、药物使用方式及负性情绪可能是海洛因依赖者认知功能受损的重要因素。     

海洛因依赖者执行功能的对照研究

目的:探讨海洛因依赖患者执行功能的变化情况.方法:对36例海洛因依赖患者、36例健康志愿者用木块图形测验、Stroop Test(C,CW)、威斯康星卡片分类试验(Wisconsin Card Sort Test,WCST-M)进行检测,测验结果进行对照分析.结果:海洛因依赖组木块图形总分低于正常对照;Stroop(C、CW)总时间、错误次数高于正常对照,差异有统计学显著性(P<0.01);海洛因依赖组WCST-M测验的错误总数、持续错误总数高于正常对照,分类个数低于正常对照,差异有统计学意义(P<0.01).患者海洛因成瘾时间与WCST分类个数呈负相关(n=36,r=-0.39;P<0.05).结论:海洛因依赖患者大脑执行功能有一定程度的损害.     

冠心病患者血清血管生成素样蛋白4水平检测分析

目的:观察冠心病(CHD)患者血清血管生成素样蛋白4(ANGPTL4)水平变化并分析其与血脂、炎症、氧化应激指标相关性以及对CHD的诊断价值。方法:检测117例CHD患者(CHD组)以及117例健康人群(对照组)血清ANGPTL4、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、超敏C-反应蛋白(hs-CRP)、丙二醛(MDA)、超氧化物歧化酶活性(SOD)水平。Spearman's等级相关分析以及多元逐步线性回归分析ANGPTL4与其它参数之间关系, ROC曲线分析ANGPTL4对CHD诊断效能。结果:CHD组患者血清ANGPTL4水平显著低于对照组(19.86±5.13ng/ml vs 29.68±6.11ng/ml,P<0.01)。Spearman's等级相关分析血清ANGPTL4与腰围(r=-0.125,P=0.011)、BMI(r=-0.217,P=0.039)、TC(r=-0.321,P=0.041)、LDL-c(r=-0.377,P=0.047)、MDA(r=-0.326,P=0.042)及hs-CRP (r=-0.269,P=0.000)均相关,多元线性回归显示MDA、TC、hs-CRP是ANGPTL4的独立预测因子, ANGPTL4诊断CHD的ROC曲线下面积为0.745,95%CI(0.715, 0.875),最佳截点24.35ng/ml。结论:血清ANGPTL4在CHD中可能参与脂代谢、炎症以及氧化应激调节,或可成为血清标记物用于预测CHD。     

美沙酮维持治疗及心理干预对海洛因依赖者家庭功能的影响

目的:探索美沙酮维持治疗及心理干预对海洛因依赖者家庭功能的作用。方法:选取96名参加美沙酮维持治疗的海洛因依赖者作为研究组,37名社区海洛因依赖者为对照组,用家庭功能评定(FAD)问卷进行家庭功能评定。结果:经过一年的干预,研究组的问题解决、沟通、角色、情感反应和总的功能评分均明显优于社区对照组(2.2±0.4/2.3±0.4,2.2±0.3/2.6±0.3,2.4±0.3/2.5±0.3,2.4±0.5/2.6±0.3,2.2±0.4/2.5±0.3;t=1.96~6.74,P<0.05~0.01),干预后的沟通、角色、情感反应、情感介入、行为控制和总的功能评分较干预前改善明显(2.2±0.3/2.3±0.3,2.4±0.3/2.6±0.3,2.4±0.5/2.6±0.4,2.3±0.4/2.6±0.4,2.3±0.3/2.6±0.4,2.2±0.4/2.4±0.3;t=11.17~13.07,P<0.01),而问题解决分量表得分较干预前增高(2.2±0.4/2.1±0.4,t=8.59,P<0.01)。结论:海洛因依赖者参加美沙酮维持治疗及相应的心理和行为干预,家庭功能明显改善。     

阿立派唑对精神分裂症认知功能及神经元特异性烯醇化酶水平的影响

目的探讨阿立哌唑对精神分裂症认知障碍的影响及其与血清神经元特异性烯醇化酶(NSE)变化的关系。方法对60例精神分裂症患者予阿立哌唑治疗8周;治疗前后分别采用数字划销测验(CT)、修订韦氏成人记忆量表(WMS-RC)、威斯康星卡片分类测验(WCST)评估注意功能、记忆功能和执行功能,同时采用酶联免疫吸附法(ELISA)检测血清NSE浓度。对60名健康人(对照组)进行相同的认知功能和血清NSE浓度检测。结果治疗前患者组认知功能测验成绩各项目显著差于对照组(P<0.01),血清NSE水平显著高于对照组(t=7.00,P<0.01)。阿立哌唑治疗8周后,患者组CT的净分、WMS-RC的记忆商数有显著提高(t=-3.19,-6.97;P<0.05),CT的失误率及WCST的总测验次数、持续错误数、随机错误数均显著下降(t=4.37,2.05,3.86,2.88;P<0.05),同时血清NSE水平显著降低(t=5.67,P<0.05);治疗前患者组的CT失误率与NSE水平呈显著正相关(r=0.35,P<0.05),记忆商数与NSE水平呈显著负相关(r=-0.33,P<0.05),治疗8周末CT失误率下降值和记忆商增加值均与血清NSE水平下降值呈显著正相关(r=0.36,0.29;P<0.05)。结论阿立哌唑能显著改善精神分裂症患者的注意功能、记忆功能和执行功能。精神分裂症患者NSE水平与注意障碍,记忆障碍关系密切。     

中学生抑郁症与认知倾向、D型人格及家庭环境的研究

目的:探讨中学生抑郁症与认知倾向、D型人格及家庭环境因素的关系。方法:采用认知倾向问卷(CAOT),D型人格量表(DS),家庭环境量表(FES),抑郁自评量表(SDS)对86例中学生抑郁症患者和108名健康对照者进行评定。结果:①抑郁症组乐观因子分(7.62±3.20)显著低于对照组(t=-11.59,P<0.01),且抑郁程度与乐观因子呈显著负相关(r=-0.75,P<0.01);D型人格消极情感(14.83±6.18)、社会抑制(14.90±6.04)分显著高于对照组(t=11.60,t=7.92,P<0.01),且抑郁程度与消极情感、社会抑制因子呈显著正相关(r=0.72,r=0.59,P<0.01);家庭亲密度(5.56±2.66)、知识性(3.23±1.96)等因子分低于对照组,矛盾性(4.48±2.78)因子分高于对照组(t=-5.83,t=-4.08,t=3.84,P<0.01),且抑郁程度与亲密度、知识性因子呈负相关(r=-0.49,r=-0.38,P<0.01),与矛盾性因子呈正相关(r=0.37,P<0.01)。②回归和路经分析发现,乐观因子、消极情感、亲密度和知识性是抑郁症的预测变量,其中乐观因子的预测作用较强,对抑郁症产生直接影响效果。结论:中学生抑郁症可能是认知倾向、D型人格及家庭环境等多因素影响的结果,认知倾向是重要的影响因素。     

中学生焦虑障碍与认知倾向、D型人格及家庭环境的关系

目的:探讨中学生焦虑障碍与认知倾向、D型人格及家庭环境因素的关系。方法:采取横断面调查,对77例中学生焦虑障碍患者和108名健康对照者采用认知倾向问卷(CAOT)、D型人格量表(DS)、家庭环境量表(FES)、焦虑自评量表(SAS)进行评定,并进行相关、回归和路经分析。结果:焦虑障碍组乐观因子分低于对照组(8.1±3.1/12.0±2.1,t=-10.5,P<0.01),且焦虑程度与乐观因子呈负相关(r=-0.57,P<0.01);焦虑障碍组D型人格量表消极情感、社会抑制分高于对照组(14.4±5.2/5.9±4.6,t=11.7,13.1±7.3/8.5±5.5,t=5.0,P<0.01),焦虑程度与消极情感呈正相关(r=0.69,P<0.01);焦虑障碍组家庭亲密度(5.7±2.5)等因子分低于对照组(7.4±1.8,t=-2.7～-5.3,P<0.01),焦虑程度与亲密度呈负相关(r=-0.48,P<0.01)。消极情感、亲密度依次进入焦虑障碍的回归方程(β值=0.56、-0.26),其中消极情感对焦虑障碍产生直接影响作用。结论:中学生焦虑障碍可能是D型人格及家庭环境等多因素影响的结果,D型人格对焦虑的影响值得关注。     

慢性失眠症患者思维控制方式的特点

目的:探讨思维控制方式与失眠症的关系。方法:79名慢性失眠症患者和配对睡眠正常者完成匹兹堡睡眠质量指数问卷、思维控制问卷和入睡前唤醒水平问卷。结果:1.慢性失眠症患者担心的思维控制方式得分高于睡眠正常组(10.7±2.6/8.5±2.9,t=5.08,P<0.01);惩罚的思维控制方式得分高于睡眠正常组(11.6±2.8/9.0±3.1,t=5.43,P<0.01);入睡前唤醒水平问卷的认知唤醒和重量唤醒因子得分均高于睡眠正常者(15.1±4.8/9.5±2.3,t=8.64;19.2±4.7/11.3±3.7,t=11.53,均P<0.01)。2.采用担心的思维控制方式与入睡前认知唤醒水平正相关(r=0.40,P<0.01);3.多元回归分析显示担心和惩罚的思维控制方式越多,入睡时间越长(标化回归系数分别为0.31和0.21)。结论:评估对于侵入性思维采用的思维控制方式对于失眠症患者入睡前的唤醒水平和入睡时间有一定的预测作用。     

抑郁症患者治疗前后认知、内分泌、细胞因子的变化

目的:了解抗抑治疗前后抑郁症患者的认知功能及血浆皮质醇、细胞因子水平。方法:符合ICD-10抑郁症诊断标准的抑郁症患者60例,30例正常对照。用Stroop测试(一种阅读流畅性作业)、词语流畅性(VFT)和威斯康星卡片分类(WCST)测验测评认知功能,用放射免疫法测定血浆皮质醇、细胞因子的浓度。患者在治疗前和抗抑郁治疗6周后完成两次测评。结果:治疗前抑郁症病人VFT成绩低于对照组(90·80±26·78/114·83±18·25,t=-4·087,P<0·01)Stroop成绩高于对照组(110·37±132·41/87·55±19·74,t=2·69,P<0·05),WCST除分类数和持续性错误百分数低于对照组(3·18±2·17/5·07±1·41,t=-3·17,40·87±22·83/60·39±17·90,t=-2·74,P<0·01)外,其它项目均高于对照组(t=2·05~2·74,P<0·05,0·01),药物治疗六周后VFT成绩较治疗前提高(98·55±25·72,t=3·28,P<0·01),WCST结果大多数项目均较治疗前评分提高(t=-2·05~-3·65,P<0·05)持续性错误的比较治疗前提高(54·22±27·5/40·87±22·83,t=3·60,P<0·01)治疗前抑郁症患者血浆皮质醇浓度与WCST的持续性汇合、持续性错误及持续性错误百分比呈正相关(r=0·34~0·38,P<0·01),HAMD评分与VFT、Stroop测查结果呈负相关(r=-0·43,-0·32,P<0·05)。结论:抑郁症患者血浆皮质醇浓度的升高与认知功能损害相关。抗抑郁药能改善抑郁症病人的认知功能。     

冠心病患者血清TBIL与OX-LDL水平的变化及其临床意义

目的:探讨冠心病(CHD)患者血清总胆红素(TBIL)与氧化修饰低密度脂蛋白(OX-LDL)水平的变化及其临床意义。方法:采用日立7600-20型全自动生化分析仪氧化酶法检测血清TBIL含量;采用酶联免疫吸附试验双抗体夹心法检测OX-LDL水平。结果:冠心病组血清TBIL明显低于健康对照组(7.93±2.68μmol/L vs 15.51±3.92μmol/L,P<0.01),而血浆OX-LDL明显高于健康对照组(97.25±37.44mmol/L vs29.21±11.36mmol/L,P<0.01);冠心病患者血清TBIL与血浆OX-LDL的变化呈显著负相关(r=-0.64,P<0.01),而健康对照组中血清TBIL与血浆OX-LDL间的相关性则不明显(r=-0.15,P>0.05)。结论:冠心病时血清TBIL显著降低而OX-LDL显著升高;冠心病患者血清TBIL抗LDL氧化能力的减弱可能是导致OX-LDL升高的重要原因之一。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.