精神分裂症患者治疗后多项诱发电位的变化

目的 了解精神分裂症患者P300、听觉诱发电位（AEP）和脑干听觉反应（ABR）的特征以及治疗前后诱发电位的变化。方法 应用美国Nicolet Spirit脑诱发电位仪．记录34例精神分裂症患者和31名正常成人的P300、AEP和ABR．于治疗6个月时进行P300、AEP和ABR随访。结果 1．与NC组比较,精神分裂症组三项诱发电位主成份（P300-P3靶潜伏期、AEP-P2潜伏期和ABR-波V波幅）延迟,波幅降低（P〈0．05～0．01）。2．随访提示：P300中的P3靶潜伏期和波幅,AEP中的P2潜伏期和波幅以及ABR中的波Ⅲ潜伏期和波V波幅改变可能是属于该疾病的状态标志。结论 本组精神分裂症患者的诱发电位变化为状态标志,多项诱发电位指标联合应用可作为精神分裂症治疗监测的有用指标。     

阿尔茨海默病与脑血管性痴呆的诱发电位比较

目的：探讨阿尔茨海默痴呆（AD）和脑血管性痴呆（VD）的诱发电位特点。方法：收集25例AD组、24例VD组及22名正常老年人（NC），完成听觉诱发电位（AEP）和视觉诱发电位（VEP）检查。结果：AD组和VD组及NC组在潜伏期AEP／N1、P2，VEP／P1，波幅AEP／P2、P3，VEP／P2、P3上有显著性差异（P＜0．05－0．01）。与NC组相比，AD组潜伏期AEP／N1、P2，VEP／P1延迟，波幅AEP／P2、P3，VEP／P2、P3降低。与NC组相比，VD组在潜伏期VEP／P1延迟，波幅P2、P3降低。AD组与VD组相比，在潜伏期AEP／N1、N2上有显著差异，AD组延迟于VD组。AD组VEP的P1潜伏期，VD组AEP的P3波幅及VEP的N1潜伏期改变上与其MMSE评分有关联。结论：AD组与VD组的诱发电位变化有类似的异常，但AD组病损范围广，经不同感觉系统诱发的脑诱发电位均有异常。两组痴呆中的三个指标与MMSE关联的特点，值得进一步随访。     

强迫症患者治疗前后脑诱发电位的比较研究

目的 探讨强迫症(OCD)诱发脑电指标变异的意义。方法 应用美国Nicolet Spirit脑诱发电位仪,记录35例OCD患者(OCD组)和28名健康人(NC组)的事件相关电位P300、脑干听觉反应(ABR)和视觉诱发电位(VEP)。对其中23例OCD患者于治疗5个月后再次检测P300、ABR和VEP。结果 (1)治疗前,OCD组P300-P3靶波幅[(3.51±1.60)μV]低于NC组[(5.90±2.10)μV,P<0.01];ABR-波V绝对潜伏期[(6.40±0.41)ms]长于NC组[(5.50±0.33)ms,P<0.01],波V波幅[(0.35±0.10)μV]高于NC组[(0.16±0.09)μV,P<0.01];VEP-P2潜伏期[(199±39)ms]长于NC组[(183±28)ms,P<0.05]。(2)治疗后,OCD组随强迫思维和行为改善,脑电诱发电位中仅P300-P3靶波幅升高[治疗前后分别为(4.50±1.30)μV和(6.01±1.50)μV;P<0.01],VEP-P2潜伏期缩短[分别为(199±30)ms和(183±28)ms;P<0.05],余各项差异均无显著性。结论 OCD患者P300和VEP变化与临床状态有关,ABR的变异则有待继续跟踪。     

抗精神病药对精神分裂症首次发病患者听感觉门控P50的影响

目的探讨抗精神病药对精神分裂症首次发病患者听感觉门控电位P50的影响。方法采用配对听觉条件（S1）、测试（S2）刺激范式，对33例未经抗精神病药治疗的精神分裂症首次发病患者（患者组），给予第一代和第二代抗精神病药治疗，分别于治疗前、治疗6周后进行听觉诱发电位P50检测，并与30名健康成年人（对照组）对照。结果（1）治疗前，患者组S1波幅[（1．86±0．90）μV]低于对照组[（2．79±1．70）μV]，波幅比值S2／S1（1．03±0．61）高于对照组（0．46±0．26），差异均有统计意义（P〈0．05～0．01）；两组s2波幅及潜伏期的差异均无统计意义。（2）治疗6周后，患者组P50检测结果与治疗前相比，差异均无统计意义。（3）与第一代抗精神病药相比，第二代抗精神病药能提高S1波幅（P〈0．05）。结论精神分裂症患者治疗前已存在P50抑制异常，经两类抗精神病药治疗6周仍未能明显改善；与第一代抗精神病药相比，第二代抗精神病药治疗可提高S1波幅。     

情感性精神障碍感觉性诱发电位变异与自杀行为史的关联性研究

目的　探讨情感性精神障碍患者感觉性诱发电位 (SEP)变异与自杀行为史的关系及其临床意义。方法　应用美国尼高力公司Spirit脑诱发电位仪 ,检测 39例抑郁症 (抑郁症组 )患者、2 2例躁狂症 (躁狂症组 )患者和 33名正常对照者 (对照组 )的视觉诱发电位 (VEP)、听觉诱发电位 (AEP)和体感诱发电位 (SSEP) ,并对两患者组中有无自杀史者的测定结果进行比较。结果　 (1 )抑郁症组在VEP中的P2 潜伏期 [有自杀史者为 (2 1 1± 2 1 )ms,无自杀史者为 (2 0 9± 1 7)ms]长于正常对照组 [(1 94±1 9)ms;P <0 0 1和P <0 0 5]。 (2 )抑郁症组和躁狂症组SEP主成分的波幅均低于对照组。 (3)在VEP中 ,抑郁症组中有自杀史者的P3波幅 [(2 7± 1 8) μV]低于无自杀史者 [(5 5± 2 3) μV] ;躁狂症组中有自杀史者的P2 波幅 [(2 9± 1 8) μV]低于无自杀史者 [(5 5± 2 3) μV] ;在AEP中 ,躁狂症组中有自杀史者的P2 波幅 [(3 7± 1 9) μV]低于无自杀史者 [(5 1± 2 3) μV] ,差异有显著性和非常显著性 (P <0 0 5和P <0 0 1 )。结论　感觉性诱发电位是辅助评价自杀倾向的客观方法之一     

军人创伤后应激障碍患者认知性电位变化及其与精神症状的关系

目的　探讨军人创伤后应激障碍(PSTD)患者认知性电位(CEP)的特征和治疗缓解后变化及其与精神症状的关系。方法　应用美国Nicolet Bravo型脑诱发电位仪,对 66 例发病期及其 60 例康复期 PTSD患者进行关联性负变(CNV)、视觉诱发电位(VEP)和听觉诱发电位(AEP)测定,并进行症状自评量表(SCL -90)和事件影响量表(IES)评定。结果　患者组发病期与对照组比较,CNV/M1、VEP/P2 和 AEP/N2 潜伏期延迟(P<0.01或0.05),CNV/M2 和AEP/P3 波幅增高(P<0.01),命令信号后负变化(PINV)出现率增高(P<0.01),SCL-90和IES总分及其部分因子分升高(P<0.01),且 CEP指标与 SCL 90 及 IES总分及其部分因子分显著相关(P<0.01 或 0.05)。患者组康复期 CNV/M1、VEP/P2 和 AEP/N2 潜伏期,CNV/M2、AEP/P3 波幅,PINV出现率以及SCL- 90和IES总分及其部分因子分均恢复至正常值内(与发病期比较P<0.01或0.05,与对照组比较 P>0.05)且治疗前后 CEP指标差值与 SCL 90 及 IES总分及其部分因子减分率显著相关(P<0.01或0.05)。结论　CNV、VEP与AEP的变化可能是PTSD的状态标志。     

载脂蛋白E基因对轻度认知障碍患者听觉诱发电位的影响

目的探讨载脂蛋白(ApoE)基因型对轻度认知障碍(MCI)患者听觉诱发电位(AEP)的影响。方法健康老年对照60名,MCI患者60例,其中MCI低危组(未携带ApoE ε4基因的MCI患者)和高危组(携带ApoEε4基因的MCI患者)各30例。对所有观察对象均进行AEP和ApoE基因检测,并对脑干AEP Ⅰ波、Ⅲ波、Ⅴ波潜伏期和波峰间潜伏期,N200、P300潜伏期和波幅进行比较。结果 (1)MCI低危组、高危组与健康对照组Ⅰ、Ⅲ、Ⅴ波潜伏期及波峰间潜伏期均无统计学差异(P0.05)。(2)与健康对照组[N200、P300波幅分别为(5.97±0.76)、(10.69±1.57)μV、潜伏期分别为(240.20±16.45)、(300.06士20.50)ms]比较,MCI高危组患者N200、P300波幅[分别为(5.36±0.62)、(9.95±1.20)μV]降低、潜伏期[分别为(246.97±11.6)、(313.34士26.19)ms]延长(P0.05)。与MCI低危组N200波幅[(5.81士0.62)μV]相比,高危组N200波幅降低(P0.05)。高危组、低危组及健康对照组三组间N200、P300波幅比较均有统计学差异(分别P0.01、P0.05)。结论携带ApoEε4基因的MCI患者N200、P300波幅减小,潜伏期延长。AEP有可能作为个人认知功能变化的测量指标。     

首发精神分裂症患者的脑诱发电位研究

目的：观察首发精神分裂症患者的脑诱发电位变化特点。方法：使用32导脑诱发电位仪对48例首发精神分裂症患者和46例正常人进行听觉和视觉诱发电位检测。结果：首发精神分裂症患者的脑诱发电位变化特点为：①波形变异性大，以主波群为主，后节律成分活跃性降低；②除潜伏期AEP-P1延长外，潜伏期。AEP-P2、N2和潜伏期VEP-N1、P2、N2、P3均显著缩短；③AEP、VEP的波幅N1-P2、P2-N2、P2均降低；④左右半球对称；⑤女性AEP、VEP的波幅均显著高于男性。结论：脑诱发电位变化对精神分裂症的诊断具有参考意义。     

抑郁症的事件相关脑电位P300实验研究

目的探讨抑郁症听觉事件相关电位P300的变化特点。方法对35例抑郁症患者和31名健康成年人，应用美国NieoletBravo脑诱发电位仪进行P300检测。结果与正常组相比，抑郁症组Oz点P3潜伏期延迟[正常组（315±29）ms，抑郁症组（341±31）ms，t=3．50，P〈0．01]，P2潜伏期延迟[正常组（165±19）ms，抑郁症组（175±21）ms，t=2．02，P〈0．05]，P3波幅降低[正常组（9．5±6．1）μV，抑郁症组（4．5±3．1）μV，t=4．27，P〈0．01]，非靶P2波幅降低[正常组（4．2±1．2）μV，抑郁症组（2．3±1．3）μV，t=6．14，P〈0．01]。结论P300是评定抑郁症患者大脑综合功能的有效工具，在临床上值得进一步推广应用。     

精神分裂症Ⅰ型与Ⅱ型患者的诱发电位比较

目的　了解精神分裂症Ⅰ型和Ⅱ型的感觉性诱发电位差异。方法　对 2 7例Ⅰ型精神分裂症、2 8例Ⅱ型精神分裂症及 5 2名正常成人 ,应用光、声、触刺激 ,进行视觉诱发电位 (VEP)、听觉诱发电位 (AEP)和体感诱发电位 (SEP)检查。结果　Ⅰ型组和Ⅱ型组及正常对照组在VEP/P2 ,AEP/P1、P2 、P3 潜伏期 ,波幅VEP/N1 P2 、P2 ,AEP/N1 P2 ,SEP/P2 N2 上有显著性差异 (P <0 0 5或 <0 0 1)。与正常对照组相比 ,Ⅰ型组潜伏期VEP/P2 ,AEP/P1、P2 前移 ,AEP/P3 延迟 ;波幅VEP/N1 P2 、P2 ,AEP/N1 P2 ,SEP/P2 N2 降低。与正常对照组相比 ,Ⅱ型组潜伏期AEP/P3 延迟 ,波幅VEP/N1 P2 ,P2 ;AEP/N1 P2 ,SEP/P2 N2 降低更甚。Ⅰ型组与Ⅱ型组比较 ,在潜伏期VEP/P2 、AEP/P1、P2 、P3 以及波幅VEP/P2 、AEP/N1 P2 上两者有显著性差异 ,Ⅱ型组延迟于Ⅰ型组 ,波幅亦低。结论　Ⅰ型与Ⅱ型精神分裂症患者的诱发电位潜伏期变化有其特点 ,值得进一步随访观察。     

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     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。