西藏农村地区惊厥性癫(癎)患病率初步调查

目的 初步调查西藏农村地区惊厥性癫(癎)患病率、治疗缺口及患者生活质量.方法 利用统一的调查表,对西藏拉萨市墨竹工卡县工卡镇和扎西岗乡、昌都地区芒康县曲孜卡乡进行整群逐户问卷调查.结果 共调查14 822人,确诊惊厥性癫(癎)患者37例,患病率0.25%,其中活动性癫(癎)患者35例(94.59%),患病率为0.24%.调查前1周内接受西药正规治疗者1例,治疗缺口为97.1%.癫(癎)患者生活质量评定量表-31(QOLIE-31)总评分平均为(42.15±17.63)分,其中各分项得分中发作担忧得分最低[(22.59±20.31)分]、药物影响的评分最高[(85.83±18.59)分].年龄、职业、文化程度、经济状况、起病年龄、发作次数为QOLIE-31低评分的影响因素(P＜0.05).结论 西藏农村地区惊厥性癫(癎)患病率为0.25%,西药治疗缺口大,主要以藏医藏药治疗为主,对西药治疗癫(癎)的了解很少,生活质量评分低.探索藏西医结合防治癫(癎)、提高当地医护人员的癫(癎)防治知识及公众的健康意识迫在眉睫.     

老年隐源性癫(癎)患者临床特点和生活质量的研究

目的 研究老年隐源性癫(癎)患者的临床特点和生活质量.方法 采用临床调查表、癫(癎)患者生活质量量表-31(QOLIE-31)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA),对35例老年隐源性癫(癎)的患者(老年组)和70例青年患者(青年组)进行评定.结果 与青年组比较,老年组有发作诱因和服多种药的比率低,有共病的比率高(均P<0.05).QOLIE-31中在发作担忧和药物影响两个子项目的 评价上优于青年组,但老年组总体生活质量与青年组的差异无统计学意义.单因素分析显示性别、发作类型、药物不良反应、发作后不适感、抑郁和焦虑是影响老年组生活质量的因素;多元逐步回归分析显示,对老年组生活质量评分起主要作用的是焦虑和发作后不适感(均P<0.01).结论 老年隐源性癫(癎)患者具有发作诱因少、共病多和服单种抗癫(癎)药物为主的临床特点.老年患者和青年患者的总体生活质量水平相近.焦虑和发作后不适感是影响老年患者生活质量的重要因素.     

甘肃农村地区癫痫患者生活质量及其影响因素调查

目的研究甘肃农村地区成年癫痫患者的生活质量及其影响因素。方法采用癫痫患者生活质量量表-31(quality of life in epilepsy inventory,QOLIE-31)对甘肃省农村地区154例癫痫患者及149名正常对照进行生活质量评估,分析社会人口学因素(性别、年龄、婚姻状况、职业、教育程度等)和临床因素(癫痫起病年龄、病程、发作类型、发作频率、服用药物种数等)对患者生活质量的影响。结果患者生活质量得分低于对照组[(47.63±7.74)vs.(52.28±5.75)],差异有统计学意义(P<0.05)。不同性别、婚姻状况、职业、受教育程度、发作类型的患者生活质量得分无统计学差异(P>0.05),不同人均年收入、服用药物种数的患者生活质量得分有统计学差异(P<0.05)。经多因素线性回归分析,患者家庭人均年收入(β=3.115,P=0.002)、服用药物种数(β=3.261,P=0.027)是影响其生活质量的因素。结论成年癫痫患者生活质量较低,家庭经济状况、服用药物种类对患者生活质量影响较显著,合理选择药物是控制癫痫发作、减轻家庭经济负担、提高癫痫患者生活质量的有效措施。     

癫癎患者生活质量的研究

目的探讨成年癫癎患者生活质量状况及其影响因素.方法实验组86例癫癎患者,对照组59名健康自愿受试者.用世界卫生组织生存质量量表中文版简表(Q0 L-BREF)、癫癎患者生活质量量表(QOLIE-31)评定生活质量;用症状自评量表评价心境健康;分析各种影响因素的作用.结果实验组生活质量在心理领域得分比对照组低(P＜0.05);除精力/疲乏领域外的各领域均有50%以上实验组QOLIE-31得分低于平均水平;实验组的抑郁、焦虑分均比对照组明显增高(P＜0.0001);影响QOLIE总分的三个因素按作用大小依次是抑郁、焦虑和用药种数.结论癫癎患者生活质量下降,心境健康恶化;对总体QOLIE影响最大的因素是抑郁、焦虑和用药种数.     

影响首次(癎)性发作后与复发间隔时间的危险因素

目的探讨影响首次癎性发作后与复发间隔时间的危险因素,以指导首次癎性发作后的治疗。方法回顾性分析667例发作至少2次以上癫癎患者的临床资料,应用单变量分析和Cox回归分析,建立比例风险度模型,判断影响首次癎性发作后与复发间隔时间的危险因素。结果所有患者首次癎性发作后平均复发时间为(7.03±17.52)个月,其中性别、起病年龄、发作类型、睡眠发作、热惊厥史、癫癎家族史对首次癎性发作后复发间隔时间的影响无统计学意义(均P>0.05);而病因、部分性或全面性发作、全面性强直阵挛发作、继发性癫癎、神经系统体征、脑电图慢波、异常放电、影像学异常及首次发作后是否正规治疗对复发间隔时间的影响有统计学意义(均P<0.05)。结论有明确病因、脑电图有慢波、异常放电、影像学异常、有神经系统体征为影响首次癎性发作后复发间隔时间的危险因素。对这些患者最好在首次发作后正规服用抗癎药物。     

成年癫(癎)患者的抑郁情绪相关因素及生活质量研究

目的 调查成年癫(癎)患者抑郁的患病率及可能的危险因素;评价各种危险因素对癫(癎)伴发抑郁患者生活质量的影响.方法 采用Beck抑郁问卷(BDI)及癫(癎)患者生活质量量表-31(QO-LIE-31 中文版),并自制一般情况调查表对患者进行测查.用χ2检验、t检验及Logistic多元回归分析.结果 在120例成年癫(癎)患者中47.5%伴发抑郁.负性影响癫(癎)患者伴发抑郁的因素为发作频率,而正性影响因素根据影响程度的大小依次为职业和对癫(癎)相关知识的掌握情况.结论 癫(癎)患者抑郁发生率高且受多种因素的影响.积极控制癫(癎)发作、为癫(癎)患者提供更多的就业机会及对癫(癎)患者做好相关知识宣传、增加患者对癫(癎)相关知识的掌握程度是改善癫(癎)患者生活质量的重要因素.     

扬州市头桥农村地区的癫癎流行病学调查

目的了解扬州市头桥农村地区的癫癎流行病学特征及状况.方法采用随机整群抽样方法,对扬州市头桥农村地区8个自然村人群进行入户见面表格癫癎普查.结果实际被调查的11 118人中,共查出各类型癫癎患者87例,患病率为7.83‰,年发病率为53.4/10万.76例(85.05%)未发现明确病因,仅3例(3.45%)有家族史.首次发病年龄<20岁者33例(37.93%);≥20岁者54例(62.07%);平均病程17.51年;发作类型以全面强直阵挛性发作为主(78.16%),年发作次数在10～29次;87例患者中从未进行抗癫癎治疗50例(57.47%).结论该地区癫癎患病率、发病率均高于国内其他农村地区;发作类型仍以全面强直阵挛性发作为主.癫癎治疗管理水平较低.     

拉莫三嗪对癫癎患者生活质量影响的研究

目的:评价拉莫三嗪对癫癎患者生活质量的影响.方法: 采用多中心、前瞻性的研究方法,对新诊断癫癎患者应用拉莫三嗪治疗,并在基线期及用药6个月后,采用QOLIE-31、MOS SF-36量表、数字符号转换测验、HAMD抑郁量表和女性专用调查问卷对患者进行生活质量评价.结果: 共纳入新诊断癫癎患者282例.MOS SF-36量表的8个项目得分在用药后均有显著提高(P<0.01);QOLIE-31问卷中"对癫癎的担心","情绪"、"活力","认知","药物不良反应"、"社会功能"及"总体自身健康评价"项目得分在用药后均有显著提高(P<0.01).用药后,患者Hamilton抑郁量表平均3.65分,显著低干基线期6.42分(P<0.01);数字符号转换测验得分在用药后与基线期比较有显著提高(P<0.01).结论: 拉莫三嗪初始单药治疗能在一定程度上改善新诊断癫癎患者的生活质量.     

成年女性癫■患者生活质量的影响因素分析

目的研究成年女性癫■患者的生活质量损害特点及影响因素,为提高成年女性癫■患者生活质量提供临床依据。方法收集2013至2018年就诊于上海交通大学医学院附属新华医院神经内科门诊及住院的107例女性癫■患者,依据年龄分为3组:18～27岁组、28～37岁组和38～49岁组。所有患者完成一般情况调查表和癫■患者生活质量调查表-31 (QOLIE-31)评分,采用单因素及多因素分析各影响因素与生活质量的关系。结果 107例患者中,①生活质量各项条目:除"认知功能"与"社会功能"评分分数较高,其余各项条目分数均偏低,以"综合生活质量"分数最低。②3组患者生活质量各项条目的评分:"药物影响"及"综合生活质量"项差异有统计学意义,其余各项评分差异无统计学意义。③单因素相关分析:年龄、婚姻、就业情况、药物数量和发作频率等为患者生活质量的影响因素;多元逐步回归分析:发作频率、就业情况为主要影响因素。结论女性癫■患者的癫■发作频率和就业情况为其生活质量的主要影响因素,备孕期女性患者对抗癫■药物对胎儿的影响更为担心。     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

目的 调查癫(癎)患者健康相关生存质量和情绪健康状况,探讨各种因素对患者生存质量的影响.方法 使用世界卫生组织(WHO)生存质量量表中文版简表(QOL-BREF)附加癫(癎)生存质量量表(QOLIE)-31(中文版)、抑郁自评量表(SD5)、焦虑自评量表(SAS)进行生存质量和心境健康状况调查.多元逐步回归分析各种因素对生存质量的影响.结果 癫(癎)患者(n=141)在WHOQOL-BREF的生理、心理领域得分(分别为12.7±1.8、12.4 4-1.9)比常模下降(15.1±2.3、13.9±1.9,t=11.75、8.625,P<0.05);有抑郁情绪者占57.4 % ,有焦虑情绪者占39.7 % .合并抑郁、焦虑情绪的癫(癎)患者在除外QOLIE-31药物的影响领域的生存质量各个领域得分均减低;多元逐步回归结果显示,影响QOLIE总分的3个因素按影响作用大小依次是焦虑、抑郁和病程.结论 合并抑郁、焦虑情绪障碍,病程长是癫(癎)患者生存质量下降的重要因素.     

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.     

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.     

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.     

《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。