浙南地区脑血管病与载脂蛋白E基因型关系分析

目的：探讨浙南地区脑血管病患与载脂蛋白E（apoE)基因多态性的关系。方法：将脑血管病患分为脑出血组与脑梗死组和对照组，分别以聚合酶链反应限制性片段长度分析法（PCR－RFLP）检测ApoE基因型。结果：对照组ApoE基因型以ε3/2最多，2组脑血管病患以ε3／3最多，其次为ε3／4。脑梗死组ε3／4基因型，ε4等位基因频率均显高于对照组（P＜0．05）；脑出血组则ε2、ε4等位基因频率略高于对照组，但差别无统计学意义（P＞0．05）。结论：ApoEε基因多态性与浙南地区脑血管病患关系密切，ε4 基因可能是脑梗死的危险因素之一，但与脑出血之间尚无明确的关系。     

某些神经系统疾病患者血清脂蛋白（a）与C—反应蛋白检测的研究

目的 研究脂蛋白(a)[Lp(a)]在某些神经系统疾病疾病中的变化以及Lp(a)与C－反应蛋白（CRP）之间的关系。方法 采用透射比浊法分别在急性期和恢复期检测60例神经系统疾病患者（脑卒中20例、病毒性脑炎8例、细菌性脑膜炎12例,脑肿瘤20例）的血清Lp(a)和CRP含量,并与30名正常人作对照。结果 （1）与正常对照组比较,脑卒中组Lp(a)两次结果均有显著性差异（均P＜0．05）。恢复期Lp(a)与对照组比无显著性差异,而CRP仍有显著性差异（P＜0．01）。（2）脑卒中组和病毒性脑炎两次Lp(a)和CRP之间比较均无显著性差异;细菌性脑膜炎组和脑肿瘤两次Lp(a)和CRP间比较均存在显著性差异（均P＜0．01）;（3）病毒性脑炎组与细菌性脑膜炎组比较,急性期Lp(a)存在显著性差异（P＜0．05）,恢复期Lp(a)没有显著性差异,两次CRP均存在显著性差异（均P＜0．01）。结论 Lp(a)与CRP同样可作为细菌感染的观察指标,并可作为病毒性脑炎与细菌性脑膜炎的鉴别指标之一,感染控制后Lp(a)明显下降,且较CRP恢复更早;而脑卒中组Lp(a)水平不受病程及治疗影响;Lp(a)可作为脑肿瘤手术动态观察病人状况的指标之一,Lp(a)的检测在某些神经系统疾病中有一定的应用价值。     

血清脂蛋白（a）与缺血性脑卒中关系的临床研究

目的探讨脂蛋白（a）（Lp（a））是否为缺血性卒中的危险因素,以及Lp（a）水平与缺血性脑卒中类型和预后的关系。方法将缺血性脑卒中患者按急性卒中治疗低分子肝素试验．TOAST）分型标准分为心源性脑栓塞（CE）、大动脉粥样硬化性卒中（LAA）、小动脉卒中（SAA）、其他原因引发的缺血性卒中（SOE）和原因不明的缺血性卒中（SUE）。以同期入院的非脑卒中患者（经头颅CT或磁共振排除）作为对照组。病例组和对照组均于入院次日清晨空腹抽取静脉血,测定Lp（a）及其他各项血脂指标,并于入院及病程两周时分别行NHISS评分评估神经功能缺损程度,分析Lp（a）与卒中类型及NIHSS评分之间的关系。结果缺血性脑卒中组Lp（a）浓度及异常率均高于对照组（P〈0．05）,Lp（a）进入大动脉粥样硬化卒中患病因素的回归方程Lp（a）水平与卒中患者的NIHSS评分无相关性（P〉0．05）。结论高浓度Lp（a）可能参与了缺血性脑卒中的发生,并且可能是大动脉粥样硬化性卒中发生的危险因素,但与神经功能缺失程度和早期功能修复无关。     

脑血管病长期存活者心电图异常、高血压病对照研究

本文报告78例脑血管病的病例对照研究的结果：心电图异常仅与女性患者有关（P＜0．05）；急性期神智丧失与后来心电图异常及严重神经功能障碍有关（P＜0．05）；高血压对脑血管病长期存活者仍是一种危险因素（P＜0．01）；65岁以上比65岁以下患者有高血压的更多（P＜0．05）。     

中青年人脑卒中与血脂关系的研究

目的 探讨血脂与中青年人脑卒中的关系。方法 检测了206例中青年脑卒中患者及80例对照者的甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL－C）、低密度脂蛋白胆固醇（LDL－C）、载脂蛋白A－I（ApoA-I)、载脂蛋白B100（ApoB100)和脂蛋白（a)[Lp(a)]血清含量。结果 脑梗死组TG、TC、LD-L－C、ApoB100及Lp(a)水平显著高于对照组,Lp(a)水平亦高于脑出血组,异常的血脂成分随年龄变化而发生改变;皮层动脉区脑梗死组Lp(a)水平显著高于穿通动脉区脑梗死组;脑出血组血脂指标与对照组比较差异无显著。结论 血脂代谢紊乱是中青年人脑梗死的危险因素。     

脑梗死患者血尿酸、脂蛋白（a）含量的研究

目的探讨脑梗死患者血尿酸、血清脂蛋白（a）含量的变化及其意义。方法对85例脑梗死患者测定其血总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、脂蛋白（a）及血尿酸（UA）水平，与对照组40例结果进行比较。结果脑梗死患者TC、TG、HDL水平与对照组相比无明显差畀（P〉0．05），UA、LDL、Lp（a）水平较对照组明显升高（P〈0．01）；其中脑梗死合并糖尿病者较无糖尿病者，血UA、Lpo（a）亦有明显升高（P〈0．05），两组与正常对照组比较均有显著性差异（P〈0．05）。结论血尿酸、Lpo（a）含量增高与脑梗死存在一定关系，是脑梗死的重要危险因素。     

颈内动脉闭塞患者危险因素的Logistic回归分析

目的探讨颈内动脉闭塞的相关危险因素。方法回顾性分析2003年1月～2008年3月北京友谊医院收治的94例颈内动脉闭塞患者的危险因素,并与2007年1月～2007年6月收治的105例（无颈内动脉闭塞）缺血性脑血管病患者（对照组）的危险因素进行比较,并进行多因素Logistic回归分析。结果2组间缺血性脑血管病常见的危险因素如高血压病、高脂血症、糖尿病、高龄和饮酒史,无统计学差异（P〉0．05）,而性别、脑卒中病史及吸烟史3个因素在2组间具有统计学意义（P〈0．05）。将男性、脑卒中病史及吸烟史3个变量代入Logistic回归方程行多因素分析显示,3种相关危险因素中性别与颈内动脉闭塞相关性最高（P=0．041）,吸烟史和脑卒中病史为仅次于性别的危险因素。结论性别、脑卒中病史及吸烟史是颈内动脉闭塞的重要相关危险因素,临床应加强脑卒中的二级预防,并加强戒烟宣传等工作。     

脑白质疏松症与脑血管病的关系

目的：研究脑白质疏松症（LA）与脑血管病的关系。方法：对102例LA伴发脑血管病患者与同期随机抽样的102例无LA的脑血管病患者作对照组进行对比分析。结果：脑血管伴发LA组年龄、高血压史≥10年，冠心病和脑卒中与对照组比较均有显著性差异（P＜0．05－0．01）。伴有LA的患者脑血管病类型以腔隙梗死最多见，与对照组比较有非常显著性差异（P＜0．01）。结论：高血压引起的动脉硬化是腔隙梗死、脑出血及LA的共同病因，长期高血压更易导致腔隙梗死及LA。     

动脉硬化性脑梗死患者载脂蛋白E基因多态性与血脂、脂蛋白和载脂蛋白的关系

采用聚合酶链反应-限制性片段长度多态性（PCR－RFLP）技术检测50例动脉硬化性脑梗死（ABI）患者和113例正常人戴脂蛋白E（apoE）基因型，并分析apoE基因多态。队与血脂脂蛋白和载脂蛋白之间的关系。结果表明：ABI组ε4/3基因型与ε4等位基因频率分别为30．0％与18．0％，均显著高于正常对照组的11．5％与7.5％（P＜0．01）。apoE基因多态性明显影响血脂水平，不同基因型组间血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL－C）和载脂蛋白B（apoB）水平有显著性差异，ε4／3组上述3项指标均显著高于ε3／3、ε3／2组。各组间血清甘油三酯（TG）、高密度脂蛋白胆固醇（HDL－C）和载脂蛋白AI（apoAI）水平无明显差异。多元逐步回归与相关分析均证实，ε4等位基因与TC、LDL－C和apoB呈显著正相关。上述结果提示，apoE基因多态性与ABI之间存在着密切关系，ε4等位基因可作为我国汉族人群ABI易感个体的一种遗传标记。     

脂蛋白（a）与脑卒中的相关性分析

目的探讨血清中脂蛋白（a）[Lp（a）]的水平与脑卒中（包括缺血性卒中、出血性卒中）的关系,为进一步研究脑卒中的可能病因及治疗提供参考。方法采用颗粒增强免疫透射比浊法测定Lp（a）。结果 （1）各组脑卒中患者Lp（a）均有不同程度的升高,其中脑出血、血栓形成性脑梗死、短暂性脑缺血发作与对照组比较Lp（a）血浆浓度增高,差异有统计学意义（P〈0.01）;腔隙性梗死组Lp（a）浓度稍高于对照组,但差异无统计学意义（P〉0.05）。（2）血清Lp（a）水平在缺血性脑卒中与出血性脑卒中的差异有统计学意义（P〈0.05）。结论血清Lp（a）水平升高是脑卒中的重要危险因素之一,高Lp（a）水平对缺血性脑卒中的作用更大。     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

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.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.