青霉素对体外培养鼠脑γ—氨基丁酸能神经元及胶质细胞的影响

经免疫细胞化学方法观察了分离培养４天，、１０天鼠大脑皮层、海马ＧＡＢＡ能神经元以及ＧＦＡＰ免疫反应阳性星形胶质细胞对大剂量致痫剂青霉素的反应。结果大剂量ＰＥＮ可引起培养海马及皮层γ－氨基丁酸能神经元数目明显减少，星形胶质细胞显著增生，且尤以海马胶质细胞增生明显。提示：（１）脑内尤其海马区星形胶南细胞增生与癫痫发生，发展有一定的关系。（２）传统致痫剂ＰＥＮ可能是通过抑制ＧＡＢＡ能神经元功能、刺激星形     

皮质醇对马桑内酯致痫大鼠大脑皮层、海马γ-氨基丁酸免疫组化分布的影响

为了解皮质醇对马桑内酯致痫大鼠大脑皮层、海马γ－氨基丁酸（ＧＡＢＡ）免疫组化分布的影响，应用免疫组化方法研究３组大鼠大脑皮层、海马γ－氨基丁酸免疫反应（ＧＡＢＡ－ＩＲ）阳性细胞的分布，以探讨马桑内酯致痫及人工合成皮质醇－地塞米松（Ｄｅｘ）的抗痫是否与ＧＡＢＡ系统相关。结果显示：马桑内酯致痫后大鼠大脑皮层、海马齿状回ＧＡＢＡ－ＩＲ阳性细胞较正常组明显减少，应用Ｄｅｘ后再致痫，大鼠大脑皮层、海马ＧＡＢＡ－ＩＲ细胞数居正常及致痫组之间，３组ＧＡＢＡ－ＩＲ细胞数经Ｆ检验有非常显著性差异（大脑皮层Ｆ值＝２０．９，Ｐ＜０．００１，海马Ｆ值＝４７．７，Ｐ＜０．０１），表明马桑内酯致痫可能有ＧＡＢＡ系统的参与，ＧＡＢＡ－ＩＲ阳性细胞的减少使大脑皮层及海马神经元脱抑制，临床表现抽搐。Ｄｅｘ可能通过抑制ＧＡＢＡ的再摄取、促使ＧＡＢＡ神经元蛋白合成，参与兴奋的抑制。     

戊四氮致痫对大鼠海马星形胶质细胞的影响

目的　探讨戊四氮（ＰＴＺ）致痫对大鼠海马星形胶质细胞的影响。方法　应用免疫组织化学方法观察ＰＴＺ致痫后大鼠海马内胶原纤维酸性蛋白（ＧＦＡＰ）变化的特点,同时观察了不同强度的痫性发作与ＧＦＡＰ改变的关系。结果　ＧＦＡＰ改变于ＰＴＺ致痫后１２ｈ 开始,２４ｈ 达到高峰,７２ｈ 已开始回落,并且痫性发作的强度与ＧＦＡＰ改变有一定的联系。结论　癫痫与星形细胞之间确有一定联系。     

皮质醇对马桑内酯致痫大鼠大脑皮层,海马γ—氨基丁酸免疫组化…

为了解皮质醇对马桑内酯蛭和痫大鼠大脑皮层、海马γ－氨基丁酸（ＧＡＢＡ）免疫组化分布的影响，应用免疫组化方法研究３组大鼠大脑皮层、海马γ－氨基丁酸免疫反应（ＧＡＢＡ－ＩＲ）阳性细胞的分布，以探讨马桑内酯致痫及人工合成皮持醇－地塞米松的抗痫 是民ＧＡＢＡ系统相关。结果显示；马桑内酯致痫 后大鼠大脑皮层海马齿状回ＧＡＢＡ－ＩＲ一细胞较正常组明显减少，应用Ｄｅｘ后再致痫 ，大鼠大脑ＧＡＢＡ－ＩＲ细胞数居正     

癫痫状态大鼠海马GAD67mRNA,GABA—TmRNA表达水平的动态观察

为了研究癫痫状态下大鼠海马区ＧＡＤ６７ｍＲＮＡ、ＧＡＢＡ－ＴｍＲＮＡ的表达水平，采用马桑内酯（ｃｏｒｉａｒｉａｌａｃｔｏｎｅ，ＣＬ）侧脑室注射所致大鼠癫痫状态模型，动态观察ＣＬ致痫前后大鼠海马ＧＡＤ６７ｍＲＮＡ、ＧＡＢＡ－ＴｍＲＮＡ表达水平的变化，同时观察了动物行为学改变及脑电图变化。实验结果显示，侧脑室注射ＣＬ后约１５分钟，大鼠海马及皮质ＥＥＧ出现阵发性棘慢波及高波幅慢波；ＣＬ注射后１５～３０分钟，实验鼠均出现明显的连续发作性四肢抽动、尖叫等症状，且持续６～８小时。ＣＬ侧脑室注射后３０分钟、１小时、２小时、４小时或８小时各时限点组大鼠海马ＧＡＤ６７ｍＲＮＡ表达水平均低于正常对照组。ＣＬ注射后３０分钟组大鼠海马ＧＡＢＡ－ＴｍＲＮＡ表达水平高于正常对照组，但３０分钟后各时限组ＧＡＢＡ－ＴｍＲＮＡ表达水平与正常对照组比较增加不明显。提示ＣＬ所致癫痫持续状态的后期，大鼠海马ＧＡＤ６７ｍＲＮＡ、ＧＡＢＡ－ＴｍＲＮＡ表达信号的减弱，可能与致痫因素及癫痫持续后期合并的缺血、缺氧性脑损害致使海马区ＧＡＤ、ＧＨＢＡ－Ｔ免疫反应阳性细胞死亡有关。     

TGF—β高调在鼻腔给予AChR抑制EAMG中起重要作用

用放射标记的ｃＤＮＡ寡核苷酸探针，使用原位杂交技术检测表达子γ干扰素（ＩＦＮ－γ）白细胞介素４（ＩＬ－４）和转移生长因子β（ＴＧＦ－β）ｍＲＮＡ的单个核细胞（ＭＮＣ）。结果表明，实验性自身免疫性重症肌无力（ＥＡＭＧ）对照组大鼠Ｇｕｏ窝和腹股沟淋巴结（ＰＩＬＮ）的ＭＮＣ乙酰胆碱受体（ＡＣｈＲ）诱导的ＩＦＮ－γ，ＴＧＦ－βｍＲＮＡ表达细胞数明显增高，与给予ＰＢＳＣＦＡ注射组比较差异显著。鼻腔耐受组与Ｅ     

TGF－β高调在鼻腔给予AChR抑制EAMG中起重要作用

用放射标记的ｃＤＮＡ寡核苷酸探针，使用原位杂交技术检测表达γ干扰素（ＩＦＮ－γ）、白细胞介素４（ＩＬ－４）和转移生长因子β（ＴＧＦ－β）ｍＲＮＡ的单个核细胞（ＭＮＣ）。结果表明，实验性自身免疫性重症肌无力（ＥＡＭＧ）对照组大鼠窝和腹股沟淋巴结（ＰＩＬＮ）的ＭＮＣ乙酰胆碱受体（ＡＣｈＲ）诱导的ＩＦＮ－γ、ＩＬ－４ＴＧＦ－βｍＲＮＡ表达细胞数明显增高，与给予ＰＢＳＣＦＡ注射组比较差异显著。鼻腔耐受组与ＥＡＭＧ对照组相比，某些淋巴器官中ＡＣｈＲ诱导的ＩＦＮ－γ、ＩＬ－４数降低，ＡＣｈＲ诱导的ＴＧＦ－β细胞明显上调。提示ＩＦＮ－γ、ＩＬ－４和ＴＧＦ－β与ＥＡＭＧ的发病有关，而ＴＧＦ－β高调在鼻腔ＡＣｈＲ耐受ＥＡＭＧ中起重要作用。     

癫痫敏感大鼠脑内GFAP——免疫反应活性的变化

用红藻氨酸（ＫＡ）１０ｍｇ／ｋｇ（ｓ．ｃ）诱发大鼠出现癫病发作一个月后，经免疫细胞化学方法观察大鼠脑内神经胶质原纤维酸性蛋自（ＧＦＡＰ）－免疫反应产物的查化。发现海马的ＣＡ１，ＣＡ２，海马下脚和腹侧海马的海马门都位以及梨状皮层，内嗅皮层，隔区，杏仁核，伏隔核和尾核尾部的ＧＦＡＰ免疫染色阳性明显增强，这一现象可能与动物癫痫发作及发作后，癫痫敏感脑区的神经元损伤有关。     

癫痫大鼠海马神经元和星形胶质细胞的病理演变

目的　探讨癫痫大鼠海马神经元和星形胶质细胞在点燃后各期的病理特点、时序及机制。方法　针对匹罗卡品癫痫大鼠模型,行Nissl、免疫组化和HE染色,观察海马神经元及星形胶质细胞的病理变化。结果　癫痫持续状态后超急性期（4h）,CA3区神经元呈嗜酸性变性、胞浆深染;急性期（24h）,嗜酸性变性最为显著,神经元固缩、核仁消失、突起断裂,星形胶质细胞水肿;缄默期（7d）,CA3、CA1区及门区神经元大量坏死、脱失,胶质增生肥大,海马构筑紊乱;慢性期（6w）,CA3、CA1区出现胶质瘢痕,遗有形态正常的神经元,且颗粒细胞层增厚。结论　癫痫时海马神经元先于星形胶质细胞发生病理改变,二者均参与癫痫发生。     

神经元GAD和GABA—T的活性与癫痫发病的关系

目的：研究探索神经元内谷氨酸脱羧酶（GAD）和γ－氨基丁酸转氨酶（GABA－T）的活性与癫痫发病的关系。方法：用致痫剂马桑内酯（CL）和抗痫剂苯妥因钠（PHT）处理大鼠培养海马神经元,用液体闪烁计数仪,紫外分光光度计检测培养神经元内GAD和GABA－T的活性。结果：与对照组比较,CL致痫组培养神经元内GAD活性和GABA－T的活性显著增高,运用抗痫剂PHT处理致痫神经元后,与CL致痫组比较,神经元内GABA－T活性显著降低,与对照组比较差异不显著。结论：在癫痫发病中,痫性神经元GAD和GABA－T活性增高。     

The neuroendocrinology of stress and the pathophysiology and therapy of depression and anxiety

Clinical and preclinical studies have gathered substantial evidence that stress response alterations play a major role in the development of major depression, panic disorder, and post-traumatic stress disorder. The stress response, the hypothalamic pituitary adrenocortical (HPA) system and its modulation by corticotropin-releasing hormones (CRH),corticosteroids,and their receptors, and the roles of natriuretic peptides and neuroactive steroids are described. We review the role of the HPA system in major depression, panic disorder, and post-traumatic stress disorder and its possible relevance for treatment. Impaired glucocorticoid receptor function in major depression is associated with an excessive release of neurohormones such as CRH, to which a number of signs and symptoms characteristic of depression can be ascribed. In panic disorder, a role of central CRH in panic attacks has been suggested. Atrial natriuretic peptide (ANP) is causally involved in sodium lactate-induced panic attacks. Furthermore, preclinical and clinical data on its anxiolytic activity suggest that nonpeptidergic ANP receptor ligands may be potentially useful in the treatment of anxiety disorders. Post-traumatic stress disorder is characterized by a peripheral hyporesponsive HPA system and elevated CRH concentrations in the CSF. This dissociation is probably related to an increased risk of this disorder. We further review recent data that describe an important role of GABA(A)-receptor modulatory,3 alpha-reduced neuroactive steroids in major depression, anxiety, and its treatment. Antidepressants are effective in both depression and anxiety disorders and have major effects on the HPA system,especially on glucocorticoid and mineralocorticoid receptors. Normalization of HPA system abnormalities is a strong predictor of the clinical course, at least in major depression and panic disorder. Currently,CRH-R1 or glucocorticoid receptor antagonists and ANP receptor agonists are being studied and may provide future treatment options more closely related to the pathophysiology of these disorders.     

Polymorphisms of DRD4 and DRD3 and risk of avoidant and obsessive personality traits and disorders

We investigated whether polymorphisms of the dopamine D4 receptor (DRD4) and polymorphisms of the dopamine D3 receptor (DRD3) were associated with personality disorder symptomatology rather than with personality traits such as novelty seeking. DNA was obtained from 145 depressed patients in a clinical trial. These patients were assessed for the presence of personality disorder symptoms and disorders. The 2-repeat allele of the DRD4 exon III polymorphism was associated with increased rates of avoidant and obsessive personality disorder symptomatology. The T,T genotype of the DRD4 -521 C>T polymorphism was also associated with increased rates of avoidant and obsessive personality disorder symptomatology. The Gly9,Gly9 genotype of the DRD3 Ser9Gly polymorphism was associated with increased rates of obsessive personality disorder symptomatology. None of these three polymorphisms were associated with novelty seeking or other temperament traits on the Temperament and Character Inventory. Our results suggest that genetic polymorphisms of DRD4 and DRD3 may well be associated with personality traits, and that conflicting findings to date may arise from the problem of phenotype definition.     

沙盘游戏疗法在地中海贫血患儿心理干预中的应用

本文目的是对沙盘游戏疗法在地中海贫血患儿心理干预中的应用进行综述,以期为地中海贫血患儿的心理康复提供参考。地中海贫血是以珠蛋白生成障碍为主要特征的遗传性疾病,由于长期输血治疗,患儿存在较多的心理和行为问题。沙盘游戏疗法作为一种有效、实用的儿童心理治疗方法,对提高地中海贫血患儿的康复效果、改善生存质量有重要的临床意义。     

癫痫共病抑郁的机制及临床诊疗

本文目的是探讨癫痫共病抑郁的可能机制及临床诊疗。癫痫是一种常见的、慢性的、致残性的神经疾病,癫痫患者生活质量下降,存在明显的负性情绪,常伴发各种精神疾病。癫痫与抑郁具有共同的神经生物学基础,可能存在共同的发病机制。本文从癫痫共病抑郁的发病机制、临床诊断及治疗方面予以总结归纳。     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Seclusion and restraint and prediction of violence

The authors studied the use of seclusion and restraint on an inpatient unit in a state psychiatric hospital. Of 69 randomly selected inpatients, 51% experienced seclusion or restraint at least once. More psychotic than nonpsychotic patients required seclusion or restraint. However, neither psychosis/nonpsychosis nor voluntary/involuntary admission status predicted the likelihood of violent threats or actions. Patients experiencing seclusion and restraint showed a nonsignificant trend toward longer mean length of stay in the hospital. The frequency of patient behavior leading to seclusion or restraint appeared to be directly related to the stimulation caused by the presence of many staff members and other patients.     

Comparison of trigeminal and spinal modulation of pain and nociception

Modulation of pain and nociception by noxious counterstimulation, also called "diffuse noxious inhibitory controls" or DNIC-like effect, is often used in studies of pain disorders. It can be elicited in the trigeminal and spinal innervation areas, but no study has previously compared effects in both innervation areas. Therefore, we performed a study comparing DNIC-like effects on the nociceptive flexion reflex (NFR) and the nociceptive blink reflex as well as the respective pain sensations. In 50 healthy volunteers, the blink reflex elicited with a concentric electrode and the NFR were recorded before and after immersion of the contralateral hand in cold water. Responses were recorded as the subjective pain sensation and the reflex size. The cold water immersion of the contralateral hand elicited a reduction of both subjective pain sensation and reflex amplitude following the stimulation of both reflexes. However, there were no strong correlations between the individual reductions of both subjective pain sensation and reflex amplitude for both reflexes, and neither when results of the two reflexes were compared with each other. The dissociation between DNIC-like effects on pain and on nociception, which had been found previously already for the NFR, implies that both effects need to be studied separately.