绘画疗法对慢性精神分裂症的康复效果

目的探讨绘画疗法对精神分裂症的远期疗效。方法将80例精神分裂症患者随机分成绘画组和对照组各40例,分别进行药物加用绘画治疗和单纯药物治疗。用BPRS量表和自知力与治疗态度问卷(ITAQ)、社会功能缺陷筛选量表(SDSS)于入院时、出院时和出院后1年对患者进行评估。结果治疗后两组BPRS、ITAQ评分、治疗依从性和社会功能均较治疗前有明显改善,但以绘画组显著较好(P0.05);并维持至出院后1年仍显著优于对照组(P0.05)。入院时绘画组和对照组SDSS评分分别为(10.7±1.3)分和(10.3±1.2)分,出院后1年分别为(7.2±0.9)分和(4.2±0.8)分,以绘画组优于对照组(P0.05);病情复发率和再住院率均以绘画组显著较低(P0.05)。结论绘画治疗增强了精神分裂症病人的治疗依从性,提高了自知力,对精神分裂症患者的治疗效果能长期保持,有效降低病人的复发率和再住院率,有益于精神分裂症病人的社会功能恢复。     

齐拉西酮对女性精神分裂症疗效的随访研究

目的探讨齐拉西酮对女性精神分裂症患者的远期疗效。方法将100例女性精神分裂症患者随机分为两组,分别予齐拉西酮和利培酮治疗,疗程8周,治疗结束后作1年的随访研究。用简明精神病评定量表(BPRS)、副反应量表(TESS)和生活质量综合评定问卷(GQOLI-74)进行相关评定。结果治疗前两组间各项评分均无统计学差异;治疗后两组BPRS、GQOLI-74总分及治疗依从性与治疗前相比均显著提高(P<0.05～0.01);两组有效率分别为94%和92%,无统计学差异(P>0.05);8周内两组间各时点BPRS总分无统计学差异。出院1年后,研究组的BPRS总分及社会功能分均优于对照组;复发率、再住院率均低于对照组。结论齐拉西酮是一种安全有效的非典型抗精神病药,能较好地控制精神症状;不良反应小,治疗依从性好,尤其适合女性精神分裂症患者的长期康复。     

认知治疗对精神分裂症患者自知力及治疗依从性的影响

目的探讨认知治疗对精神分裂症患者自知力及治疗依从性的影响。方法将精神分裂症患者200例随机分为药物治疗(药物组)100例,药物加认知治疗(联合组)100例,两组分别于入院和出院时进行简明精神病评定量表(BPRS)和自知力与治疗态度问卷表(ITAQ)测定及治疗依从性评定。结果两组BPRS评分及ITAQ评分在入院时差异无统计学意义(t=0.139,0.060,P0.05);在出院时两组BPRS评分差异有统计学意义(t=2.182,P0.05)。出院时ITAQ评分联合组高于药物组,有显著性差异(t=5.213,P0.01);治疗依从性联合组明显优于药物组(χ2=17.21,P0.01)。结论认知心理治疗有助于精神分裂症患者自知力恢复及提高患者的治疗依从性。     

家庭干预对首发精神分裂症患者康复的影响

目的探讨家庭干预对首发精神分裂症患者康复的作用。方法将90例首发期精神分裂症患者随机分为研究组和对照组各45例。对照组进行药物干预,研究组在药物干预的基础上进行家庭干预。所有患者均评定简明精神病量表(BPRS)、社会功能缺陷筛选量表(SDSS)和自知力与治疗态度问卷(ITAQ),并评定康复效果。结果 9个月后,研究组BPRS评分低于对照组(t=2.74,3.85;P0.01);6个月后,研究组SDSS评分和ITAQ评分均低于对照组(t=2.87,4.89,5.31,2.77,6.31;P0.01);12个月后,总有效率研究组高于对照组(χ2=3.91,P0.05)。结论家庭干预可以显著改善首发精神分裂症患者的社会功能和康复效果,延缓其社会功能衰退。     

短期、长期住院精神分裂症主观生活满意度调查

目的　了解短、长期住院精神分裂症病人的主观生活质量。方法　对符合入组条件的 2 8例短期住院 (住院时间≤ 1年 )、71例长期住院 (≥ 3年 )的住院精神分裂症病人进行一般情况的调查 ,并作阴性阳性症状量表 ( PANSS)、功能总体评定 ( GAF)、自知力及治疗态度评定问卷 ( ITAQ)的评定 ,由病人本人完成贝克氏抑郁 1 3例自评量表 ( BDI-1 3)、精神分裂症生活质量量表 ( SQLS)、总体生活满意度 ( LS)、病人对医疗服务满意度问卷 ( PSQ)。结果　短期与长期组病人的生活及医疗服务满意度分相似 ,逐步回归分析发现 ,BDI与满意度各分值均呈明显相关。性别、文化等也与部分因子相关 ,在短期组中尤为明显。在长期组 ,ITAQ分与 PSQ分呈负相关。结论　加强对住院精神分裂症病人尤其是短期住院病人抑郁的干预 ,可提高其主观生活质量     

免费服药对农村社区精神分裂症的作用

目的探讨免费服药对农村社区精神分裂症的作用。方法通过现况调查并结合回顾性研究,对平谷区享受免费治疗政策的598名精神分裂症患者进行调查,填写简明精神病量表(BPRS)、个人和社会功能量表(PSP)、自知力与治疗态度问卷(ITAQ)、临床总体印象量表(CGI)、自制一般情况调查表。结果免费治疗1年后,患者的服药依从性较免费治疗前明显提高(χ2=9.245,P0.01);BPRS、ITAQ、CGI、PSP量表均较免费治疗前有明显差异,(t=9.737,-12.59,7.15,-9.41;P均0.001)。结论免费服药治疗能够提高患者服药依从性,缓解病情,提高社会功能,但需要政府部门的多方投入。     

非专业人员开展药物自我处置技能训练的对照研究

目的探讨非专业人员对精神分裂症患者开展药物自我处置技能训练的疗效。方法由8名非专业人员作为研究组,8名专业人员作为对照组,经过培训合格后分别对A(n=30)、B(n=30)两组精神分裂症患者实施药物自我处置技能训练。在训练前与训练结束后用自知力与治疗态度问卷(ITAQ)、中文版简明精神病评定量表(BPRS)、社会功能缺陷筛选量表(SDSS)进行疗效评估。结果 A、B两组患者ITAQ、BPRS、SDSS总分在训练前比较与训练后比较差异均无统计学意义(t=0.23～0.97,P>0.05);同组之间在训练前后比较差异均具有统计学意义(t=5.65～14.95,P<0.001)。结论经过培训后的非专业人士能够有效开展药物自我处置技能训练,可以考虑吸收一些非专业人士加入到社区精神卫生服务队伍中去。     

朋辈式心理辅导对恢复期精神分裂症患者康复疗效的影响

目的探讨朋辈式心理辅导对恢复期精神分裂症患者康复疗效的影响。方法将入组的98例精神分裂症患者随机分成对照组与干预组,对照组按常规进行护理,干预组采用朋辈式心理辅导模式进行护理,在入组时,出院3个月,出院6个月评定自知力与治疗态度问卷(ITAQ)、社会功能缺陷量表(SDSS),并于出院6个月统计依从服药的例数。结果入组时两组患者的ITAQ总分、SDSS总分比较无统计学意义。出院3个月干预组的ITAQ总分高于对照组的ITAQ总分,差异有统计学意义(t=5.69,P﹤0.05);干预组的SDSS总分低于对照组的SDSS总分,差异有统计学意义(t=2.56,P﹤0.05)。出院6个月干预组的ITAQ总分高于对照组的ITAQ总分,差异有统计学意义(t=3.39,P﹤0.05);干预组的SDSS总分低于对照组的SDSS总分,差异有统计学意义(t=5.47,P﹤0.05)。出院6个月干预组有43依从服药(87.8%),对照组有32例依从服药(65.3%),两组比较存在统计学差异(χ2=6.87,P﹤0.01)。结论将朋辈式心理辅导理念运用到精神康复护理中,能改善精神分裂症患者的治疗态度,提升对疾病的自知力,提高服药的依从性,同时改善其社会功能。     

Comparative Study between Quetiapine and Risperidone in the Treatment of 79 Childhood Schizophrenia

目的 探讨喹硫平治疗儿童精神分裂症的疗效、安全性及依从性.方法 79例儿童精神分裂症患者随机分为两组,分别予以喹硫平和利培酮治疗8周.采用简明精神病评定量表(BPRS)、副反应量表(TESS)在治疗前及治疗第2、4、8周末分别评定疗效与不良反应,并于16周后随诊或电话随访调查.结果 TESS治疗组显效率为82.50％,总有效率为95.00％;对照组显效率为82.05％,总有效率为92.30％,两组显效率、总有效率比较无明显差异(U=0.16,P＞0.05).结论 喹硫平与利培酮治疗儿童精神分裂症疗效相仿,而喹硫平组依从性好于利培酮组.     

社会技能训练对慢性精神分裂症疗效的对照研究

目的:探讨社会技能训练对慢性精神分裂症阳性症状、阴性症状及认知功能的疗效.方法:将100例慢性精神分裂症患者随机分为训练组(50例)和对照组(50例).对训练组按照Liberman RP编写的<社会独立生活技能>训练程式进行训练,共12周.用BPRS、SANS、SDSI和WCST进行评定.结果:(1)训练组BPRS在总分和焦虑抑郁及缺乏活力因子分低于对照组,差异有显著性(P<0.05).(2)接受12周社交技能训练后,训练组的SANS量表全部五个因子和总分低于对照组,均有显著差异(P<0.05).(3)训练组和对照组在WCST的5个指标,差异有显著性(P<0.05).(4)SDSI评定结果表明,训练后明显降低,差异有显著性(P<0.05).结论:社会技能训练能够改善慢性精神分裂症的阳性症状、阴性症状及认知功能.     

Asymmetry of the internal connections of the striate cortex of the cat in the projection zone of the center of the field of vision

Studies were carried out on the organization of the internal connections of the striate cortex in cats in the projection zone of the center (0–5°) of the field of vision by microintophoretic application of horseradish peroxidase to electrophysiologically identified orientational columns. The area containing neurons showing retrograde labeling in most cases extended in the mediolateral direction. Labeled cells were located in the upper (II, III) and lower (V, VI) layers of the cortex, and the shapes and orientations of the areas containing labeled neurons in these layers coincided. Spatial asymmetry was detected in the distribution of labeled neurons relative to the orientational column studied. Labeled cells were located predominantly medial to the columns, regardless of the distance from the projection of the area centralis. Considering the visuotopical map of field 17, the asymmetry detected here provides evidence that neurons in orientational columns have more extensive connections with neurons of the peripheral part of the cortex. An asymmetrical distribution of “silent” zones around the receptive fields of neurons in orientational columns is suggested, and that these appear to receive influences from the periphery of the visual field. Laboratory of Visual Physiology and Laboratory of Central Nervous System Morphology, I. P. Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Makarov Bank, 199034 St. Petersburg, Russia. Translated from Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 82, No. 12, pp. 23–29, December, 1996.     

Effects of the lesion of the postcommissural part of the septum on the behavior of the rat.

The effects of the lesion of the postcommissural part of the septum on behavior of the rat has been studied. Results may be summarized as follows. An increase in the exploratory behavior in the open field which decreases rapidly; a decrease in the number of defecations in this test and a decrease in time leaving a dark environment for exploration. In the shuttle box test, no facilitation of the acquisition, but a permanent and quite significant increase in the intertrial activity has been found. We conclude that the lesions tend to decrease the emotivity of the subjects. An interpretation on the basis of the species -- specific defensive reactions explains the transitory and permanent effects of the lesions on the spontaneous activity.     

The development of the ligament of the head of the femur

The hip joints of 30 human male and female fetuses and stillborns between 20 mm and 350 mm crown-rump length were studied by light microscopy. The ligament of the head of the femur developed in situ as a condensation of mesenchyme at the end of the second month of intra-uterine life (IUL), and was vascularized by branches of acetabular vessels early in the fourth month. In the majority of fetuses older than 5.5 months IUL, vessels in the ligament passed a short way into the femoral head within cartilage canals, to supply a small region around the fovea capitis. The remainder of the head was supplied by vessels in canals from around the upper part of the neck. The ligament changed from predominantly cellular to fibrous during the last 4 months of IUL. This increase in strength suggested significant mechanical functions in utero: limitation of adduction-flexion and opposition to postero-superior dislocation were the most likely.     

Counterpointing the functional role of the forebrain and of the brainstem in the control of the sleep-waking system

This paper reviews the lifetime contributions of the author to the field of sleep-wakefulness (S-W), reinterprets results of the early studies, and suggests new conclusions and perspectives. Long-term cats with mesencephalic transection show behavioral/polygraphic rapid eye movement sleep (REMS), including the typical oculo-pupillary behavior, even when the section is performed in kittens prior to S-W maturation. REMS can be induced as a reflex. Typical non-rapid eye movement S (NREMS) is absent and full W/arousal is present only after a precollicular section. The isolated forebrain (IF) rostral to the transection exhibits all features of W/arousal and NREMS [with electroencephalographic (EEG) spindles and delta waves], arousal to olfactory stimuli, and including the appropriate oculo-pupillary behaviors. These features also mature normally after neonatal transection. REMS is absent from the IF. After deprivation there is NREMS pressure and rebound in the IF, but the decerebrate cat only shows pressure for REMS. Most IF reactions to pharmacologic agents are within expectations, except for the tolerance/withdrawal effects of long-term morphine use which are absent. In contrast, these effects are supported by the brainstem (i.e. seen in the decerebrate cat). In cats with ablation of the telencephalon, or diencephalic cats, delta waves are absent in the thalamus. EEG thalamic spindle waves are seen triggering S for only 4-5 days after ablation. Therefore, true NREMS is absent in chronic diencephalic cats although pre- and postsomniac behaviors persist. These animals are hyperactive and show a pronounced, permanent insomnia; however, a low dose of barbiturate triggers a dramatic REMS/atypical NREMS rebound. Cats without the thalamus (athalamic cats), initially show a dissociation between behavioral hyperactivity/insomnia and the neocortical EEG, which for 15-20 days exhibits only delta and slower oscillations. Fast, low-voltage W rhythms appear later on, first during REMS, but spindle waves and S postures are absent from the start, such that these cats also display only atypical NREMS. Athalamic cats also show barbiturate-sensitive insomnia. Cats with ablation of the frontal cortices or the caudate nuclei remain permanently hyperactive. They also show a mild, but significant hyposomnia, which is permanent in afrontal cats, but lasts for about a month in acaudates. The polygraphic/behavioral features of their S-W states remain normal. We conclude and propose that: (a) the control of the S-W system is highly complex and distributed, but is organized hierarchically in a well-defined rostro-caudal manner; the rostral-most or highest level (telencephalon), is the most functionally complex/adaptative and regulates the lower levels; the diencephalic/basal forebrain, or middle level, has a pivotal role in inducing switching between S and W and in coordinating the lowest (brainstem) and highest levels; (b) W can occur independently in both the forebrain and brainstem, but true NREMS- and REMS-generating mechanisms exist exclusively in the forebrain and brainstem, respectively; (c) forebrain and brainstem S-W processes can operate independently from each other and are preprogrammed at birth; this helps understanding normal and abnormal polygraphic/behavioral dissociations in humans and normal dissociations/splitting in aquatic mammals; (d) NREMS homeostasis is present in the IF, but only REMS pressure after deprivation persists in the decerebrate cat; (e) the thalamus engages in both NREMS and W; (f) insomnia in diencephalic cats is the result of an imbalance between antagonistic W- and S-promoting cellular groups in the ventral brain (normally modulated by the telencephalon); (g) the EEG waves, which are signature for each S-W state, appear to truly drive the concomitant behaviors, e.g. a hypothetical human IF could alternate between behavioral NREMS and W/arousal/awareness; (h) a role for REMS is to keep the individual sleeping at the end of the self-limiting NREMS periods. The need for accelerating research on telencephaling NREMS periods. The need for accelerating research on telencephalic S-W processes and downstream control of the lower S-W system levels is emphasized.     

Topical organization of the projections of neurons of the substantia nigra and the ventral field of the tegmentum of the midbrain to the head of the caudate nucleus of the cat

Neuroscience and Behavioral Physiology -     

Involvement of the striatum in the central regulation of the hormonal functions of the gonads

Studies reported here show that intrastriatal administration of corticoliberin to rats decreases the blood testosterone level. However, in conditions of chemical deficiency of dopaminergic transmission in the dorsal striatum induced by injection of 6-hydroxydopamine, the effect of this neurohormone did not appear. It is concluded that extrahypothalamic corticoliberin is involved in regulating the hormonal reproductive system acting via dopaminergic mechanisms. Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 85, No. 4, pp. 594–597, April, 1999.     

Ultrastructure of the endothelium of the drainage system of the eye

The endothelium of the ocular drainage system (Schlemm’s canal, collector tubules, and aqueous veins) in primary juvenile glaucoma undergoes degenerative dystrophic changes with compensatory hypertrophy and proliferation at the initial stages of the glaucomatous process and atrophy and desquamation at advanced and terminal stages. Progressive decrease in the pinocytous function of endotheliocytes, reduction of the protein-synthesizing and mitochondrial compartments of the cytoplasm, and formation of autophagosomes reflect the process of endotheliocyte degeneration in general. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 145, No. 5, pp. 574–577, May, 2008