精神分裂症与情感障碍患者弓形虫感染率及相关因素分析

目的 比较精神分裂症和情感障碍患者弓形虫抗体阳性率及动物接触史，以进一步探讨弓形虫感染与精神分裂症的关系。方法 采用酶联免疫吸附法检测首次发病的精神分裂症患者和情感障碍患者（各600例）血清弓形虫免疫球蛋白（Ig）G、IgM抗体水平，并调查动物接触史。结果 （1）精神分裂症组IgG抗体阳性率为13.7％，高于情感障碍组[6．7％，P〈0．01；比值比（OR）=2．22]；两组IgM抗体阳性率的差异无统计学意义。（2）精神分裂症组，母孕期居住于农村（401例，66．8％；χ^2=21．72，OR=1．74）、母孕期家中养狗（89例，14．8％；χ^2=13．85，OR=2．00）和养猫（57例，9．5％；χ^2=21．63，OR=3．39）的比例、13岁前居住于农村的患者比例（394例，65．7％；χ^2=28．34，OR=1．88）均高于情感障碍组（分别为53．7％，8．0％，3．0％，50．5％；P〈0．01）。在精神分裂症组和情感障碍组母孕期家中养狗的患者中，母孕期居住于农村的比例（分别为17．2％和10．8％）均高于不居住于农村的比例（分别为9．8％和3．5％，P〈0．05和P〈0．01）。结论 精神分裂症患者IgG阳性率及动物接触史与情感障碍患者不同；既往弓形虫感染史可能与精神分裂症有关联。     

载脂蛋白E基因多态性与难治性精神分裂症关联分析

目的 比较汉族人群难治性精神分裂症与非难治性精神分裂症患者外周血载脂蛋白（apoE）基因多态性的差异。方法 采用聚合酶链反应和限制性片段长度多态性技术，检测75名正常人（以下简称对照组）、138例难治性精神分裂症患者（以下简称难治组）及97例非难治性精神分裂症患者（以下简称非难治组）的apoE基因型，分别比较精神分裂症患者与对照组、难治组和非难治组间的apoE基因多态性。结果精神分裂症患者apoE3／4基因型、￡。等位基因频率（39．6％，21．9％）明显高于对照组（6．7％，3．3％），而其2／2基因型、3／3基因型和￡3等位基因（0．0％，48．5％，72．3％）明显低于对照组（1．3％，78．7％，88．7％），P均〈0．01。难治组apoE3／4基因型、g4等位基因频率（46．4％，26．1％）高于非难治组（29．9％，16．0％），而其2／3基因型频率（4．3％）明显低于非难治组（13．4％），P均〈0．01～0．05。结论 apoE3／4基因型和￡。等位基因可能是精神分裂症及其难治性的危险因子之一。     

精神分裂症首次发病患者弓形虫感染率及其对临床症状的影响

目的探讨弓形虫感染与精神分裂症发病的关系，调查精神分裂症首次发病（以下简称首发）患者及其母亲弓形虫抗体阳性率，了解弓形虫抗体阳性与阴性患者在临床症状上的异同。方法采用酶联免疫吸附法，检测600例首发精神分裂症患者（患者组）、252例患者的母亲（患者母亲组）、正常对照组（200名）和非精神疾病的疾病对照组（200例）血清弓形虫抗体水平，并对患者组进行阳性和阴性症状量表评定。结果（1）IgG和IgM抗体阳性率，患者组分别为13．7％和5．3％，高于合并对照组（即正常对照组合并疾病对照组；分别为3．8％和2．8％；P〈0．01和P〈0．05）；患者母亲组分别为19．4％和9．1％，高于患者组和合并对照组（P〈0．01和P〈0．05）。（2）弓形虫抗体阳性组患者的母亲IgG和IgM抗体阳性率分别为34．8％和17．4％，高于阴性组患者的母亲（分别为16．0％和7．3％；P〈0．01和P〈0．05）。（3）阳性组患者在兴奋、敌对、装相和作态、意志障碍、冲动控制障碍、愤怒、延迟满足困难等项目的得分均高于阴性组（P〈0．01），猜疑／被害得分低于阴性组（P〈0．01）。（4）阳性组患者病程的中位数和四分位数（P25，P75）分别为3（1，9）个月，短于阴性组患者4（2，10）个月（P〈0．05）。结论弓形虫感染在首发精神分裂症患者中占有一定的比例，且弓形虫感染阳性患者的临床表现不同于未感染者，弓形虫感染可能与精神分裂症的发病有关。     

精神分裂症相关因素的调查研究

采用自编“精神分裂症患预后及相关因素调查表”对某部符合CCMD－2精神分裂症诊断标准的精神分裂症患共165例进行调查发现：（1）发病年龄与预后呈正相关，（χ^2=4.3,P<0.05);发病因素以精神因素为诱因的预后较不明原因为优（χ^2＝4．5，P＜0．05）；起病形式以亚急性和急性起病优于慢性起病，分别为（χ^2＝4．1，P＜0．05），和（χ^2＝10．7，P＜0．01）；有家族史的显进率明显高于无家族史（χ^2＝7．0，P＜0．01），无家族史的治愈率明显高于有家族史（χ^2＝5．9，P＜0．05）；病程与预后呈负相关（χ^2＝4．3，P＜0．05）；维持治疗与预后呈正相关（χ^2＝7．0，P＜0．01）。提示精神分裂症患的预后受多种因素影响，因此，在做好防治宣传的同时，应加强治疗，督促坚持服药，提高患服药的依从性。     

精神分裂症不同亚型与出生季节分析

目的探讨精神分裂症不同亚型与出生季节的关系。方法采用回顾性分析的方法，以2004年1月～2007年1月在我院住院的324例精神分裂症患者为病例组，以常州市出生的167例正常人为对照组，比较两组出生季节的差异。结果病例组中以冬季出生比率最高（37．3％），夏季出生比率最低（17．3％），但与正常对照比较无显著性差异（χ^2=1．06，P〉0．05）；不同亚型（Ⅰ型、Ⅱ型；偏执型、非偏执型）精神分裂症的出生季节与正常对照比较均无显著性差异（P均〉0．05）。结论精神分裂症不同亚型与出生季节无关。     

精神疾病患者血浆多巴胺β羟化酶活性的初步探讨

作者测定97例精神分裂症与36例躁郁症的血浆DβH活性，发现兴奋组偏执型精神分裂症和青青型均较高，非兴奋组偏执型和未定型均较低；躁 狂症DβH较高，而抑郁症较低，差别均极显著（P＜0．001）。结果提示不论病种为何，凡处兴奋状态者DβH均见升高，可能与肾上腺素及交感神经系功能增高有关。     

苯丙胺类兴奋剂所致精神病性障碍与偏执型精神分裂症的临床特征比较

目的：对苯丙胺类兴奋剂所致精神病性障碍与偏执型精神分裂症的临床特征进行对照研究,以便于二者的鉴别诊断。方法：将38例苯丙胺类兴奋剂所致精神病性障碍患者作为研究组,以同期入院的38例首发偏执型精神分裂症患者作为对照组;采用回顾性调查,自制调查表,对社会人口学资料、主要精神症状、治疗效果等进行统计分析。结果：研究组已婚率、文化程度及有正当职业均低于对照组（x2=9．810,x2=18．321,X2=6．592;P〈0．01或P〈0．001）。研究组视幻觉、兴奋激越、恐惧不安出现率多于对照组（x2=9．051,x2=15．306,x2=15．745;P〈0．01或P〈0．001）,对照组思维散漫、嫉妒妄想、自知力缺乏多于研究组（x2=4．094,x2=5．050,X2=18．689;P〈0．05或P〈0．001）。研究组出现精神症状至就诊时间的中位数仅16d,而对照组长达5个月。研究组治疗显效率97．14％,对照组显效率65．79％（x2=11．555,P〈0．001）。结论：苯丙胺类兴奋剂所致精神病性障碍多急性起病、病程短暂、疗效较好;且部分社会人口学资料和精神症状与偏执型精神分裂症有明显不同。     

凶杀与非凶杀偏执型精神分裂症患者防御方式的差异

目的 探索具有凶杀行为的偏执型分裂症患特定的防御方式。方法 采用防御方式问卷，对53例具有凶杀行为的偏执型分裂症患进行测试，并与58例无凶杀行为的偏执型分裂症患作对照研究。结果 试验组不成熟防御方式得分高于对照组(P＜0．05)，其中被动攻击、投射、潜识显现、抱怨的得分明显高于对照组(P＜0．01)。试验组成熟防御方式得分低于对照组，但未达到显性水平，而其中的压抑条目得分明显低于对照组(P＜0．05)。在中间型防御方式运用上，两组得分无差异；但其中的回避、伴无能之全能的得分试验组低于对照组(P＜0．05)。结论 具有凶杀行为的偏执型分裂症患在保持内心平衡和调节行为以适应环境时多运用不成熟防御方式，而在成熟和中间型防御方式之压抑、回避的使用上是低的。因此，他们的行为是不成熟的，在精神疾病的作用下多出现凶杀行为。     

精神分裂症患者脑脊液细胞学对照研究

目的：探讨精神分裂症患者中枢神经系统免疫学改变的细胞学基础。方法：对40例精神分裂症患者治疗前后各进行1次脑脊液细胞学检查，并以9名外科手术腰麻者的脑脊液作为对照.结果：（1）精神分裂症患者淋巴细胞减少，单核细胞增多，出现吞噬细胞，治疗前及治疗后与对照组相比，其差异有非常显著性（P＜0．01），（2）精神分裂症治疗前青春型的脑脊脑淋巴细胞减少，单核细胞增多比偏执型更为突出（P＜0．01），与治疗后比较，其差异无显著性，（3）精神分裂症治疗前病程在半年以内者脑脊液淋巴细胞减少比3年以上者突出，两者相比差异显著（P＜0．02），与治疗后相比，其差异无显著性，结论：提示精神分裂症患者中枢神经系统存在免疫在免疫反应，这种免疫反应可能参与了精神分裂症发病的病理过程。     

Ⅰ型和Ⅱ型精神分裂症血清5—羟色胺功能的初步研究

本采用荧光分光光度法测定38例I型精神分裂症患和23例Ⅱ型精神分裂症患治疗前血清5－羟色胺浓度，并于36例健康对照组作比较, 步结果表明，I型患血清5－羟色胺浓度显低于Ⅱ型患和对照组（P＜0．01），而后两无明显差异（P＞0．05），I型患治疗前后血清5－羟色胺浓度有显差异（P＜0．05），Ⅱ型患治疗前后轿清5－羟色胺浓度无明显差异（P＞0．05），作从5－羟色胺代谢中的生化联系对I型和Ⅱ型精神分裂症的病理生理机制作了初步讨论。     

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.     

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.     

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。     

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.     

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.     

《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。     

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.     

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。