河北省农村酒精滥用和依赖性障碍的流行病学调查

目的了解河北省农村18岁及以上人群酒精滥用和依赖性障碍患病率及流行病学特点。方法采用多阶段、整群、分层随机抽样方法调查河北省农村18岁及以上人群共20696人,调查筛选工具采用改编后的一般健康问卷12项(GHQ-12),以《DSM-IV-TR轴I障碍定式临床检查》(SC ID-T/P)病人版为调查的诊断工具,采用功能大体评定量表(GAF)评价功能状况。结果河北省农村酒精滥用和依赖性障碍时点患病率为20.16‰,终生患病率为36.78‰,女性为0.78‰,男性为39.60‰,男性明显高于女性(U=19.81,P<0.01)。酒精滥用和酒精依赖性障碍以30~39岁、40~49岁、50~59岁患病率最高,分别为24.39‰、20.16‰、28.17‰,Log istic表明男性是最大的危险因素,是女性的48倍。结论酒精滥用和依赖性障碍发病率高、上升趋势明显,已经成为河北省农村精神疾病发病率最高的前4位疾病。     

重性抑郁障碍患病率的性别差异

目的了解重性抑郁障碍的患病率及其性别差异。方法采用多阶段分层整群抽样方法随机抽取≥18周岁的人群10073名,以改编后的一般健康问卷12项（GHQ-12）为筛选工具,以美国精神障碍诊断与统计手册-第4版（DSM-IV）轴I障碍定式临床检查病人版（SCID-I/P）为调查的诊断工具。功能状况评价采用大体功能评定量表（GAF）。结果重性抑郁障碍的终生患病率为41.90‰（95‰CI：37.77‰～46.04‰）,时点患病率为26.38‰（95‰CI：23.08‰～29.69‰）。女性终生及时点患病率均明显高于男性（P〈0.01）,农村女性的终生和时点患病率均明显高于农村男性（P〈0.01）。女性30岁以上患病率较高。重性抑郁障碍与其他精神障碍共病比率男性56.10%,女性55.95%,两性间差异无统计学意义（P〉0.05）。心理、社会和职业功能受损程度重度发生率男性为68.29%,女性48.81%,男性高于女性（P〈0.05）。结论重性抑郁障碍是一种患病率较高的精神障碍,女性,特别是农村女性的患病率高,男性心理、社会及职业功能损伤程度的重度发生率高于女性。     

河北省18岁以上人群疼痛障碍患病率调查

目的 调查河北省疼痛障碍的患病率及相关因素.方法 采用多阶段整群分层随机方法抽取河北省4个地市的年龄≥18岁的城区和农村常住居民,共24000人为样本.使用改编后的一般健康问卷12项(GHQ-12)为本次调查的筛选工具,以(SCIDF-I/P)病人版为本次调查的诊断工具.结果 实际完成20716例,其中女性10373例,男性10343例,平均年龄43.5±15.0岁,共诊断疼痛障碍61例,患病率为3.85‰.女性(51例)明显高于男性(10例)(P＜0.01),农村(60例)明显高于城市(1例)(P＜0.01),年龄分布以40～60岁为高发年龄段.结论 河北省人口的疼痛障碍患病率为3.85‰,高发人群为40～60岁的农村女性,与心理因素明显相关,疼痛部位多种多样,但是多数无精神科或心理科求治经历.     

河北省心境恶劣障碍的患病率及人口学特征

目的 了解心境恶劣障碍的患病率及人口学特征.方法 采用多阶段分层整群抽样方法随机抽取河北省18岁以上人群24000人,调查筛选工具采用改编后的一般健康问卷12项(GHQ-12),以《DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查》(SCID-I/P)病人版为调查的诊断工具.结果 心境恶劣障碍的患病率为23.12‰(95%CI21.07-25.17‰),女性患病率为25.70‰,男性为20.35‰.女性明显高于男性(u=2.57;P＜0.05).农村患病率为23.67‰,城市为19.36‰,两者无显著性差异(u=1.39;P＞0.05).随着年龄的增加患病率不断增高.人口社会学因素Logistic回归分析,低文化水平及低收入是心境恶劣障碍的高发人群.结论 心境恶劣障碍是一种患病率高的精神疾病.     

保定市躯体形式障碍的流行病学调查

目的了解保定市躯体形式障碍的患病率和分布特点。方法2004年10月～2005年3月采用多阶段分层整群抽样方法随机抽取≥18周岁的人群，共10073名，用扩展的一般健康问卷（GHQ-12）将调查对象分为高、中、低危险组，采用美国精神障碍诊断标准（DSM-Ⅳ），以美国精神障碍诊断与统计手册-第四版（DSM-Ⅳ）轴Ⅰ障碍定式临床检查患者版对调查对象进行躯体形式障碍的诊断。以大体功能量表（GAF）评定患者的心理、社会和职业功能。结果9021人完成调查，躯体形式障碍的时点患病率为0．99%。（95%CI=0．79％～1．20％）．躯体化障碍0．03％、未分化的躯体形式障碍0．24％、疼痛障碍0．56％、疑病症0．18％。女性（1．43％）明显高于男性（0．13％）（P〈0．01）；40～49岁及50～59岁患病率较高（1．84％及1．55％）；与抑郁症及焦虑障碍共病49．12％；心理、社会和职业功能受损程度无或轻度50．88％、中度33．33％、重度15．79％；躯体形式障碍就诊精神科门诊为3．51％。结论躯体形式障碍在女性及中年人群（40～59岁）中患病率高，与抑郁症及焦虑障碍共病常见．其精神科服务利用率低。     

赤峰市18岁及以上人群焦虑障碍现况调查

目的:描述赤峰市焦虑障碍的患病率及其分布特点,并探讨相关危险因素。方法:2010年11月至2011年4月以多级抽样的方法在赤峰市≥18岁居民中取样,采用复合性国际诊断交谈表-3.0-计算机辅助访谈版(CIDI-3.0-CAPI)进行入户访谈,以美国精神障碍诊断与统计手册第4版(DSM-IV)为诊断标准诊断焦虑障碍,采用单因素和多因素分析进行统计分析。结果:4528人完成调查,焦虑障碍12月患病率农村高于城市(4.62%vs.2.61%,P0.01),女性高于男性(4.92%vs.2.82%,P0.01),未婚离异或丧偶者高于已婚者(5.91%vs.3.70%,P0.01)。Logistic回归分析结果显示,城市、受教育年限7~9年是焦虑障碍的保护因素,女性、未婚离异或丧偶是焦虑障碍的危险因素;焦虑障碍患者求助精神科医生的比例仅为3.1%。结论:焦虑障碍是赤峰市常见的一类精神障碍,而患者很少求助精神科医生。应该针对焦虑障碍开展精神卫生服务和知识普及,重点关注农村、女性及低文化水平的高危人群。     

青岛市18岁及以上人群精神障碍流行病学调查

目的:了解青岛市≥18岁人群各类精神障碍的现患率和分布特点,为制定全市精神卫生规划提供科学依据。方法:采用多阶段分层整群抽样方法随机抽取青岛市≥18岁居民4800人。首先由精神科护士用扩展的一般健康问卷(GHQ-12)进行筛查,将调查对象分为精神障碍高、中、低危险组;然后用美国精神障碍诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的三组人群进行精神科检查。根据调查设计特征将计算出的患病率进行调整并推广至全市成年人口。结果:4776人完成调查。调整后精神障碍总的现患率(最近1个月)为21.96%(95%CI为19.21%～24.99%)。最常见的特定精神障碍为广泛性焦虑障碍(5.41%)、酒精使用障碍(5.33%)、重性抑郁障碍(3.43%)和心境恶劣障碍(2.72%)。女性总的现患率略低于男性(OR=1.2,95%CI为1.1～1.3),男性酒精使用障碍现患率高于女性(OR=131.2,95%CI为72.6～237.2)。农村与城市居民在精神障碍总的现患率方面的差异无统计学意义(OR=1.1,95%CI为0.6～2.3)。在有精神障碍的人群中,仅6.46%曾经因心理问题在医疗机构就诊,但36.97%精神障碍对其影响程度为中等到严重。结论:青岛市精神障碍的患病率较高,精神障碍已成为迫切需要解决的公共卫生问题,有必要在全市范围内开展和实施全面的精神卫生规划并定期评估其效果。     

甘肃省天水市18岁及以上人群精神障碍流行病学调查

目的:了解甘肃省天水市成年人群精神障碍的患病率及分布特点。方法:采用多阶段分层整群抽样方法随机抽取甘肃省天水市≥18岁人群11359人为调查对象,用扩展的一般健康问卷(GHQ-12)进行筛查,将调查对象分为精神障碍高、中、低危险3组,然后用美国精神障碍诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对3组人群进行诊断检查。将计算出的患病率进行调整并推广至天水230万成年人口。结果:10249人完成调查,调整后精神障碍总的现患率(最近1个月)为17.90%(95%CI为15.72%～20.32%);患病率前三位分别是酒精使用障碍(3.16%)、重性抑郁障碍(2.73%)和未特定焦虑障碍(2.67%)。男性精神障碍总的现患率为15.85%,女性为20.08%;农村为17.33%,城市为20.59%;男女、农村与城市之间精神障碍总的现患率差异无统计学意义[OR(95%CI)分别为0.75(0.52～1.07)和0.81(0.57～1.15)],但酒精使用障碍男性的现患率高于女性(6.00%vs.0.14%,OR=45.59,95%CI:17.98～115.57),农村居民低于城市居民(2.43%vs.6.57%,OR=0.35,95%CI:0.15～0.85)。在有精神障碍的人群中,功能损害程度为中等到严重者占37.10%,但仅8.58%的患者曾经因心理问题在医疗机构就诊,并且仅5.29%曾经就诊于精神科。结论:甘肃省天水市精神障碍的患病率较高。酒精使用障碍和重性抑郁是特别需要关注的问题。     

青海省18岁及以上人群精神障碍流行病学调查

目的:了解青海省成年人群精神障碍的患病率及分布特点。方法:采用多阶段分层整群抽样方法抽取青海省≥18岁人群12001人,用扩展的一般健康问卷(GHQ-12)筛查,将调查对象分为精神障碍高、中、低危险组,然后用美国精神障碍诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的三组人群进行诊断检查。将计算出的患病率调整并推广至青海省370万成年人口。结果:11178人完成了调查。调整后精神障碍总的现患率(最近1个月)为18.04%,95%可信区间(95%CI)为15.99%～20.28%;患病率前三位的分别是酒精使用障碍(12.24%)、广泛性焦虑障碍(1.40%)和心境恶劣障碍(1.13%)。男性精神障碍总的现患率及酒精使用障碍的现患率均明显高于女性[(27.92%vs.7.47%,23.39%vs.0.30%;OR(95%CI)=4.80(3.81～6.05),OR(95%CI)=100.22(35.07～286.38)];农村与城市居民精神障碍总的患病率差异无统计学意义(18.33%vs.17.08%,OR=1.09,95%CI:0.76～1.56)。在有精神障碍的人群中,功能损害程度为中等到严重者占15.48%,但仅2.59%有精神障碍者曾经因心理问题在医疗机构就诊,仅0.94%曾在精神科就诊。结论:青海省酒精使用障碍是特别需要关注的公共卫生问题。     

山东省18岁及以上人群精神障碍流行病学调查

目的:了解山东省≥18岁人群精神障碍的患病率及分布特点。方法:采用多阶段分层整群抽样方法,随机抽取山东省5个地级市的5个区和15个县的10个街道和30个乡镇,共计20个居委会和60个行政村,抽取≥18岁人群23987人,由精神科护士用扩展的一般健康问卷(GHQ-12)进行筛查,将调查对象分为精神障碍高、中、低危险组,然后由精神科医生用美国精神障碍诊断与统计手册(DSM-IV)轴Ⅰ障碍定式临床检查患者版对不同比例的高、中和低危人群进行调查,作出有无精神障碍及具体诊断。结果:完成调查22718人,调整后精神障碍总的现患率(最近1个月)为19.48%(95%CI:17.48%～21.64%)。各类精神障碍现患率由高到低依次为心境障碍(5.93%)、物质使用障碍(5.62%)、焦虑障碍(5.50%)、精神病性障碍(1.28%)。男性精神障碍总的现患率(22.78%)高于女性(16.17%)(OR=1.53)。城市居民精神障碍的现患率(18.88%)与农村(19.68%)之间的差异无统计学意义。最常见的精神障碍依次为酒精使用障碍(5.55%)、心境恶劣障碍(1.99%)、重性抑郁障碍(1.50%)和精神分裂症(1.12%)。有精神障碍者中仅10.53%曾因心理问题在医疗机构就诊,但仅7.69%曾在精神科就诊。结论:精神卫生问题,特别是酒精使用障碍、重性抑郁障碍、心境恶劣障碍和精神分裂症,已成为山东省突出的公共卫生问题。     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.Originally presented at ECCP 93.     

Age-related changes in polyamines in memory-associated brain structures in rats

Polyamines putrescine, spermidine and spermine are positively charged aliphatic amines and have important roles in maintaining normal cellular function, regulating neurotransmitter receptors and modulating learning and memory. Recent evidence suggests a role of putrescine in hippocampal neurogenesis, that is significantly impaired during aging. The present study measured the polyamine levels in memory-related brain structures in 24- (aged), 12- (middle-aged) and 4- (young) month-old rats using liquid chromatography/mass spectrometry and high performance liquid chromatography. In the hippocampus, the putrescine levels were significantly decreased in the CA1 and dentate gyrus, and increased in the CA2/3 with age. Significant age-related increases in the spermidine levels were found in the CA1 and CA2/3. There was no difference between groups in spermine in any sub-regions examined. In the parahippocampal region, increased putrescine level with age was observed in the entorhinal cortex, and age did not alter the spermidine levels. The spermine level was significantly decreased in the perirhinal cortex and increased in the postrhinal cortex with age. In the prefrontal cortex, there was age-related decrease in putrescine, and the spermidine and spermine levels were significantly increased with age. This study, for the first time, demonstrates age-related region-specific changes in polyamines in memory-associated structures, suggesting that polyamine system dysfunction may potentially contribute to aged-related impairments in hippocampal neurogenesis and learning and memory.     

休克过程中肾上腺髓质素变化的研究进展

Adrenomedullin (AM) is a new peptidergic regulator of vascular function. AM serves as a hormone, which has many biological properties, plays an important role in the many pathophysiological processes, especially shock. This review will highlight the structure, biological properties of AM and the relationship between AM and shock.     

Seasonal variations in acute toxoplasmosis in pregnant women in Slovenia

Between December 1999 and December 2004, 40 081 pregnant women were examined for toxoplasmosis with Toxo-IgG, Toxo-IgM enzyme immunoassay. Women with positive results were then retested with the Toxo-IgG avidity assay for recent toxoplasmosis. Recent acute toxoplasmosis in pregnant women was found to be significantly more frequent (p < 0.01) during winter than summer. The incidence of acute toxoplasmosis during winter-spring was also significantly more frequent (p < 0.025) than summer-autumn. This phenomenon should be taken into account when formulating preventive measures for toxoplasmosis, especially for pregnant women.     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Uteroglobin in the developing rabbit conceptus in vivo and in vitro

Summary Uteroglobin (UGL) was measured in day- 4 to day-10 rabbit conceptuses by a competitive ELISA. Levels in blastocyst fluid, tissues, coverings and in the early fetus were determined separately. The total amount of UGL increased from 18.4 ng to 6.8 g per conceptus. The UGL content of individual day-6 blastocysts was studied in vitro. Culturing was carried out up to 60 h in Ham's F10 medium with polyvinylpyrrolidone as macromolecular component, with and without progesterone, and with progesterone plus estradiol. UGL was determined in the blastocyst fluids, tissues with coverings and in the culture media. After labelling with [³⁵S]-methionine, protein patterns of total blastocysts and of culture media were analysed by two-dimensional gel electrophoresis and fluorography. The morphology of cultured blastocysts was examined by electron microscopy. During 60 h of culture, the blastocysts expanded in diameter by 84%, and released 19% of their initial UGL content into the medium, independent of the hormonal substitution. Neither de novo synthesis, nor degradation of UGL was found: the protein remained unlabelled in fluorography, and its total quantity was not significantly different from that of non-cultured controls. Trophoblast, endoderm and embryoblast cells showed well preserved cell organelles and intercellular junctions, while the morphological differentiation of the germ layer was inhibited.