急性脑梗塞患者红细胞膜脂质成分改变与血糖,血脂,血浆脂…

对４８例急性脑梗塞患者红细胞膜脂质成分及血糖，血脂，血浆脂蛋白，血尿酸等项进行测定的结果表明：急性脑梗塞组红细胞膜胆固醇，胆固醇／磷脂比值，过氧化脂质明显高于健康对照组；膜磷脂低于对照组；血糖，血脂，血尿酸正常的脑梗塞患者除膜过氧化脂质明显升高外，其余财时对照组无显著性差异。直线相关分析显示：红细胞膜指质成分改变与血糖，血脂，血尿酸，血浆脂蛋白异常有显著相关性。提示急性脑梗塞患者红细胞膜脂质成分改     

脑梗死患者红细胞变形性、膜脂流动性的改变及其与脂质过氧化的关系

目的 探讨脑梗死患者红细胞变形性、膜脂流动性的改变及其与脂质过氧化的关系。方法 采用激光衍射法和荧光偏振法测定了34例急性脑梗死患者红细胞变形指数(DI)和膜脂流动性。结果 急性脑梗死患者红细胞DI及膜脂流动性下降，且两者之间呈正相关，膜脂流动性与MDA含量呈负相关，与SOD含量呈正相关。结论 急性脑梗死患者红细胞膜脂流动性下降是导致红细胞DI降低的重要因素，红细胞膜脂流动性受脂质过氧化的影响，自由基清除剂的应用可能会提高脑梗死患者的红细胞变形性。     

急性脑梗塞患者红细胞膜脂质成分改变与血糖、血脂、血浆脂蛋白、血尿酸的关系

对48例急性脑梗塞患者红细胞膜脂质成分及血糖、血脂、血浆脂蛋白、血尿酸等项进行测定的结果表明:急性脑梗塞组红细胞膜胆固醇、胆固醇/磷脂比值、过氧化脂质明显高于健康对照组;膜磷脂低于对照组;血糖、血脂、血尿酸正常的脑梗塞患者除膜过氧化脂质明显升高外,其余同对照组无显著性差异。直线相关分析显示:红细胞膜指质成分改变与血糖、血脂、血尿酸、血浆脂蛋白异常有显著相关性。提示急性脑梗塞患者红细胞膜脂质成分改变与严重代谢紊乱有密切关系。     

脑梗塞患者红细胞膜ATP酶活性与膜脂质相关性研究

本文对５１例急性脑梗塞，１２例脑动脉硬化症患者和５１例健康人的红细胞膜ＡＴＰ酶活性、脂质含量以及红细胞变形能力进行了测定和相关研究，发现急性脑梗塞患者的红细胞变形能力下降，Ｎａ＋－Ｋ＋ＡＴＰ酶及Ｃ＋＋－Ｍｇ＋＋ＡＴＰ酶活性降低，膜胆固醇含量增高，胆固醇与磷脂比值升高；ＡＴＰ酶活性与红细胞滤过指数（ＩＦ）、胆固醇及胆固醇与磷脂比值呈明显负相关，而与膜磷脂含量呈正相关。脑动脉硬化患者酶活性、膜脂质与磷脂比值和红细胞变形性与对照组相差显著。提示缺血性卒中患者存在着能量代谢障碍，脂质成份改变，且在卒中发生前就有不同程度的改变。因此，治疗脑动脉硬化对预防卒中具有积极意义。     

缺血性脑卒中患者红细胞膜磷脂组分的改变及其与红细胞流变学的关系

目的探讨缺血性脑卒中患者红细胞膜磷脂各组分的改变及其对红细胞流变功能的影响。方法采用高效液相色谱法对５８例缺血性脑卒中、２３例有脑动脉硬化症状的患者和２６名健康人的红细胞膜磷脂各组分含量进行测定，并同时检测红细胞膜胆固醇含量、膜微粘度及红细胞变形能力。结果缺血性脑卒中患者红细胞膜总磷脂（ＴＰＬ）、磷脂酰胆碱（ＰＣ）、磷脂酰乙醇胺（ＰＥ）含量低于对照组；胆固醇（ＣＨＯ）、胆固醇与总磷脂比值（ＣＨＯ／ＴＰＬ比值）高于对照组；红细胞膜流动性、红细胞变形能力降低。直线相关分析，ＰＣ与红细胞膜微粘度、红细胞滤过指数呈负相关；ＰＥ与红细胞膜微粘度呈负相关；神经鞘磷脂（ＳＭ）与红细胞膜微粘度呈正相关。有脑动脉硬化症状的患者红细胞变形能力降低，膜胆固醇、胆固醇与总磷脂比值升高，但膜总磷脂及磷脂各组分无明显改变。结论缺血性脑卒中患者红细胞膜存在以ＰＣ、ＰＥ变化为主的磷脂代谢障碍，并对红细胞流变特性产生影响。     

缺血性中风患者红细胞变形能力与红细胞膜脂质及血浆脂质的相关性研究

本文通过对53例脑梗塞及20名健康对照者进行RBC膜胆固醇、磷脂、RBC变形能力及血浆脂质测定,发现脑梗塞患者RBC变形性显著低于对照者,其变形能力与RBC膜胆固醇/磷脂比值呈负相关,与血浆ApoA—Ⅰ呈正相关;RBC膜胆固醇含量与血浆ApoA—Ⅰ、HDL—ch呈显著负相关,与ApoB呈显著正相关,但与血浆胆固醇无直线相关关系。提示检测载脂蛋白可更好反映体内血脂代谢及细胞膜脂质水平。     

缺血性中风红细胞膜流动性与膜脂质及血脂关系的研究

目的探讨改变红细胞膜流动性的原因。方法对５８例缺血性中风患者及２６名健康对照者红细胞膜流动性、膜胆固醇、膜磷脂各组分及血浆脂质进行了测定。结果患者红细胞膜流动性、膜磷脂酰乙醇胺（ＰＥ）、膜磷脂酰胆碱（ＰＣ）显著降低，膜胆固醇、血浆总胆固醇、甘油三脂和神经鞘磷脂显著升高。相关分析，患者红细胞膜微粘度与膜ＰＥ、ＰＣ呈显著负相关，与膜神经鞘磷脂呈显著正相关，与血浆胆固醇、磷脂无显著相关性。结论缺血性中风患者红细胞膜存在胆固醇和磷脂组分代谢异常，并对红细胞膜流动性产生了影响     

红细胞变形性与脑缺血

红细胞变形性是指红细胞在外力作用下改变自身形态的能力,对于血循环中的红细胞,其作用力是血流中的剪切力。本文就红细胞变形性与脑缺血的关系作一综述。一、影响红细胞变形性的因素 1982年Stoltz对其以前有关红细胞变形性的研究曾作了较为详尽的综述,在分析红细胞变形性的自身因素时,归纳为三个方面: 1、细胞膜的粘弹性细胞膜由双层磷脂与胆固醇排列组成,中间嵌入可移动性蛋白,这些蛋白可做横向运动,近年来被称为“在脂质海洋中浮动的冰山”,因此膜本身也具有很大的流动性,故谓之“液态膜”。同时膜还具有很大的弹性和韧性,以保持细胞的完整。近期许多学者研究发现膜中ATP、Ca~(++)、Mg~(++)、胆固醇、磷脂等物质含量变化,均可使膜的流动性降低,影响红细胞变形性。     

不同类型痴呆患者红细胞及血小板膜脂质改变

目的：对照观察（Ａｌｚｈｅｉｍｅｒ病，Ｂｉｎｓｗａｎｇｅｒ病（ＢＤ），Ｐａｒｋｉｎｓｏｎ‘ｓ病痴呆）。患者血小板及红细胞膜脂质及磷脂各组成分的改变。方法；采用经典方法测定血小板及红细胞膜胆固醇及总磷脂含量，高效液相我以谱法测定膜以及血浆磷脂各组成分含量。     

缺血性中风红细胞膜流动性与膜奚质及血脂关系的研究

目的 探讨改变红细胞膜流动性的原因。方法 对５８例缺血性中风患者及２６名健康对照者红细胞膜流动性、膜胆固醇、膜磷脂各组分及血浆脂质进行了测定。结果 患者红细胞膜流动性、膜磷脂酯乙醇胺（ＰＥ）、膜磷脂酰胆碱（ＰＣ）显著降低，胆膜固醇、血浆总胆固醇、甘油三脂和神经鞘磷脂显著升高。相关分析，患者红细胞膜微粘度与膜ＰＥ、ＰＣ呈显著负相关，与膜神经鞘磷脂呈显著正相关，与血浆胆固醇、磷脂无显著相关性。结论 缺     

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.