精神分裂症患者的关联性负变异常变化主临床随访

目的 了解精神分裂症患者关联性负变（ＣＮＶ）的特征以及治疗缓解后ＣＮＶ的变化。方法 使用美国ＣＡ－１０００型电生理仪及光、声两种成对刺激方法,对３１例精神分裂症患者者（患者组）和３８名健康人（对照组）作ＣＮＶ测定,并对患者组中２５例作ＣＮＶ随访。结果 患者组在潜伏期ＣＮＶ起点（Ａ点）及命令信号后负变化上延迟（Ｐ〈０．０１或Ｐ〈０．０５）,命令信号前负相期待面积小于对照组（Ｐ〈０．０１）。患者康复时     

老年慢性精神分裂症的脑电地形图和多项诱发电位研究

为了解老年慢性精神分裂症患者与正常老人在脑电图（ＥＥＧ）、脑电地形图（ＢＥＡＭ）、视觉和听觉诱发电位（ＶＥＰ、ＡＥＰ）、脑干听觉反应（ＡＢＲ）和认知电位Ｐ３００（Ｐ３００）检测中的不同表现，对４０例正常老人及３４例老年慢性精神分裂症患者作６项电生理检测。结果发现，患者ＥＥＧ异常率达６６．７％，其ＢＥＡＭ趋向凹字形低密度带，ＶＥＰ（潜伏期Ｐ１、Ｐ２）、Ｐ３００（靶潜伏期Ｎ１—Ｐ２—Ｎ２—Ｐ３）均前移，ＡＥＰ（潜伏期Ｎ２、Ｐ３）延迟，ＡＥＰ、ＶＥＰ和Ｐ３００的Ｐ２、Ｐ３波幅均减低，均有显著性差异（Ｐ＜０．０５或Ｐ＜０．０１）。患者的ＡＢＲ于中央区左右侧不对称，绝对波幅波Ⅰ降低（Ｐ＜０．０１），这与本组对象ＣＴ结果吻合。采用多项诱发电位检测技术能较可靠反映精神分裂症患者脑的功能，可辅助患者的认知功能评定     

精神发育迟滞患者的单胺类物质代谢研究

用高效液相色谱法测定３３例精神发育迟滞（ＭＲ）患者及１２例对照者脑脊液（ＣＳＦ）和血清中单胺类物质，结果显示：精神发育迟滞患者ＣＳＦ中高香草酸（Ｃ－ＨＶＡ）和５－羟吲哚乙酸（Ｃ－５－ＨＩＡＡ）高于对照组（Ｐ＜０．０５）；先天愚型组Ｃ－ＨＶＡ明显高于其它三组（Ｐ＜０．０１），Ｃ－５－ＨＩＡＡ高于对照组和脆性Ｘ综合征组（Ｐ＜０．０１），而先天愚型组血清中５－羟色胺低于其它三组（Ｐ＜０．０１）；脆性Ｘ综合征组的游离色氨酸高于其它三组（Ｐ＜０．０５）。     

急性脑血管病患者血清及脑脊液胰岛素水平的初步探讨

对７２例急性脑血管病（ＡＣＶＤ）患者（脑出血３２例，脑梗塞４０例）的血清及脑脊液胰岛素水平进行测定。结果发现脑出血患者血清及脑脊液胰岛素水平均高于对照组（Ｐ＜０．０５，Ｐ＜０．０１）。脑梗塞患者与对照组比较未见明显差别（Ｐ＞０．０５），而两组血糖水平均高于对照组（Ｐ＜０．０５）。同时发现胰岛素水平与病人的病情及预后相关。建议对血糖水平升高而血清及脑脊液胰岛素水平较低的ＡＣＶＤ患者应积极使用胰岛素治疗。     

精神分裂症患者的脑脊液免疫球蛋白含量分析

作者对３４例精神分裂症患者的脑脊液中的免疫球蛋白（Ｉｇ）含量进行了测定分析。结果显示：精神分裂症患者脑脊液中ＩｇＣ（Ｐ＜０．００１）、ＩｇＡ（Ｐ＜０．０５）、ＩｇＭ（Ｐ＜０．０１）含量显著高于正常人对照组。这提示精神分裂症患者确有免疫学方面的异常。     

脑血管疾病急性期血浆ProAdM153—185含量变化及其意义

建立放射免疫分析方法，对出血性（ＨＣＶＤ，ｎ＝１０），缺血性（ＩＣＶＤ，ｎ＝３１）脑血管病急性期患者，以及健康对照者（ｎ＝１０）的血浆肾上腺髓质素前体（ＰｒｏＡｄＭ１５３－１８５）含量进行了研究发现，ＨＣＶＤ组血浆ＰｒｏＡｄＭ１５３－１８５含量显著高于对照组及ＩＣＶＤ组（分别Ｐ＜０．０５及＜０．０１），ＩＣＶＤ组与对照组之间则无显著差异（Ｐ＞０．０５）。在ＩＣＶＤ组中，大灶皮层梗塞患者血浆ＰｒｏＡｄＭ１５３－１８５含量又显著高于皮层下梗塞患者（Ｐ＜０．０１），发病后第３ｄ的患者血浆ＰｒｏＡｄＭ１５３－１８５含量显著高于第１ｄ及第２ｄ的患者（分别Ｐ＜０．０５，０．０１）。提示ＰｒｏＡｄＭ１５３－１８５在脑血管疾病的病理过程中具有作用。     

阿尔茨海默病长潜时视觉和听觉诱发电位改变

目的探讨阿尔茨海默病（ＡＤ）患者的长潜时感觉性诱发电位的特点。方法应用丹麦电生理仪以及光和声刺激，对３９例ＡＤ患者和４０名正常老年人的视觉诱发电位（ＶＥＰ）和听觉诱发电位（ＡＥＰ）进行对照研究。结果部分ＡＤ患者ＶＥＰ形成双峰，ＡＥＰ趋向低而宽大。ＡＤ患者ＶＥＰ和ＡＥＰ的Ｐ３潜伏期在顶区均右侧（ＶＥＰ３７７±４４毫秒，ＡＥＰ３８８±２７毫秒）长于左侧（ＶＥＰ３７２±４４毫秒，ＡＥＰ３８１±２６毫秒），Ｐ＜０．０５。与对照组比较，ＡＤ患者ＡＥＰ主成分以及ＶＥＰ的Ｐ３潜伏期和ＡＥＰ、ＶＥＰ的Ｐ２、Ｐ３波幅均延迟和下降（Ｐ＜０．０５或＜０．０１）。结论提示ＶＥＰ和ＡＥＰ５０～５００毫秒长潜时成分可能是反映ＡＤ患者认知功能的一个客观指标     

大鼠脑出血后部分脑区与垂体AVP含量的变化

目的观察大鼠脑出血后部分脑区与垂体ＡＶＰ含量的变化。方法采用胶原酶诱导的脑出血动物模型，干湿重法脑组织含水量测定，放射免疫法ＡＶＰ含量测定。结果与对照组相比，脑出血组大鼠脑组织含水量显著升高（Ｐ＜０．０１）的同时，在不同时程其额叶皮质、顶叶皮质、海马及尾壳核中ＡＶＰ含量非常显著升高（Ｐ＜０．０１），而下丘脑与垂体的含量显著降低（Ｐ＜０．０５，Ｐ＜０．０１）。结论内源性ＡＶＰ可能参与脑出血后脑水肿的病理过程。     

BAEP转颈试验与椎—基底动脉供血不足预后的相关性研究

本文对３９例Ｖ－ＢＡＩ脑干听觉诱发电位（ＢＡＥＰ）异常者（Ａ组）与３０例ＢＡＥＰ转颈试验异常者（Ｂ组）作了西比灵治疗的前瞻性随访分析。结果表明：ＢＡＥＰ转颈试验可使Ｖ－ＢＡＩ的ＢＡＥＰ异常率由转颈前的４４．８３％提高到７９．３１％（Ｐ＜０．０１）；Ａ组Ⅲ、Ⅴ（ＰＬ）及Ⅰ～Ⅲ、Ⅰ～Ⅴ（ＩＰＬ）延长（Ｐ＜０．０１），Ｂ组Ⅲ（ＰＬ）和Ⅰ～Ⅲ（ＩＰＬ）延长为著（Ｐ＜０．０５）；西比灵治疗后Ⅲ、Ⅴ（ＰＬ）、Ⅰ～Ⅲ、Ⅰ～Ⅴ（ＩＰＬ）有明显恢复（Ｐ＜０．０５），且与病情改善程度密切相关。     

精神分裂症患者视觉P300与临床特征及脑血流、眼球活动的相关研究

目的探讨精神分裂症患者脑功能异常的基础。方法对３９例精神分裂症患者的Ｐ３００与临床特征进行相关分析，并对其中８例混合型患者的Ｐ３００与探查性眼球活动及区域脑血流进行了相关分析。结果Ｐｚ点的Ｐ３００潜伏期与ＳＡＮＳ总分及情感平淡、思维贫乏、兴趣／社交缺乏呈显著正相关（ｒ分别＝０．７０、０．６９、０．６５、０．６６、０．５９，Ｐ均＜０．０１）；Ｐ３００幅度仅在Ｆｚ点与ＳＡＮＳ总分、情感平淡、思维贫乏、兴趣／社交缺乏呈显著负相关（ｒ分别＝－０．４５、－０．３３、－０．３８、－０．３８，Ｐ＜０．０５或０．０１）。Ｆｚ、Ｃｚ点的Ｐ３００幅度与探查性眼球活动的眼球凝视点数呈显著相关（ｒ分别＝－０．３７、０．６２，Ｐ均＜０．０５）；区域脑血流显示的缺损和稀疏区以额叶为主，与Ｐ３００幅度地形图的异常区基本符合。结论提示精神分裂症患者中存在额叶整合功能的异常，其异常可能与阴性症状有关     

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.     

Summary of Legislation of 1933 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -