利培酮合并氯氮平治疗精神分裂症的研究

目的　验证利培酮合并氯氮平治疗精神分裂症的疗效和安全性。方法　选取 60例精神分裂症住院患者 ,随机分为两组 ,第一组利培酮合并氯氮平为合并用药组 ,第二组为利培酮治疗组。用 PANSS量表评定其疗效 ,TESS量表评定其副反应。结果　 1合并用药组在第 2、4、8周减分 (9.4± 3 .6,1 8.2± 5 .3 ,41 .9± 1 3 .3 )与单一用药组 (1 0 .4± 2 .6,2 6.8±6.1 ,41 .6± 1 3 .0 )在疗效上没有显著差异。 2合并用药组在副反应方面明显多于单一用药组。结论　利培酮合并氯氮平并未给精神分裂症患者的治疗带来好处 ,我们的研究不主张合并用药。     

利培酮治疗儿童期首发精神分裂症70例临床分析

目的　了解利培酮治疗儿童期首发精神分裂症患者的疗效和安全性。方法　对 70例年龄 <1 4岁首次发病患儿用利培酮治疗 6周 ,以阳性和阴性症状量表 ( PANSS)和简明精神病评定量表 ( BPRS)评定临床疗效。以副反应量表 ( TESS)和实验室监测评价安全性 ,于基线时 ,实验第 1、2、4、6周末分别评定各量表。统计方法为描述性分析和配对 t检验。结果　共收集有效病例 70例 ,其中基本痊愈 3 4.3 % ( 2 4/ 70 ) ,显著进步 45 .7% ( 3 2 / 70 ) ,好转 1 0 % ( 7/ 70 )和无效 1 0 % ( 7/ 70 )。 BPRS总分、PANSS总分、PANSS各分量表分治疗前后比较均有显著性差异 ( P<0 .0 1 ) ,利培酮对阳性、阴性症状以及一般精神病性症状均有良好疗效。副反应主要为锥体外系反应。结论　对儿童期首发精神分裂症 ,利培酮疗效较好 ,安全性高     

利培酮和氯氮平治疗儿童少年精神分裂症患者疗效与安全性比较

目的评价氯氮平和利培酮治疗儿童少年精神分裂症的疗效和安全性。方法145例儿童少年精神分裂症患者被随机分为氯氮平组（73例）和利培酮组（72例）,住院治疗8周,用阳性与阴性症状量表（PANSS）和临床疗效总评量表（CGI）评定临床疗效,用副反应量表（TESS）评价安全性。结果在治疗4周和8周末,氯氮组患者阳性因子减分率均显著高于利培酮组（t=2．828,3．381,P〈0．01）,其它因子分及PANSS总分减分率两组患者比较均无显著差异（P〉0．05）;CGI疗效评定标准比较显示,氯氮平治疗效果优于利培酮（Ridit分析,μ=2．425,2．223,P〈0．05）。利培酮治疗无效的患者换用氯氮平治疗后50％有效,氯氮平治疗无效的患者换用利培酮治疗后20％有效。氯氮平的不良反应主要有心动过速、心电图异常、白细胞下降、嗜睡、流涎、尿失控、头昏和癫痫发作,利培酮的不良反应主要有急性锥体外系反应和嗜睡;氯氮平组有9．6％的患者、利培酮组有2．8％的患者因不能耐受副反应退出治疗。结论氯氮平和利培酮均是有效的治疗儿童精神分裂症的药物,氯氮平的治疗效果、特别在改善阳性症状方面优于利培酮,但利培酮较氯氮平副作用少,安全性高。     

情感稳定剂在难治性精神分裂症治疗中的应用

目的 探讨单一高剂量使用氯氮平治疗无效的难治性精神分裂症,合用心境稳定剂丙戊酸钠和碳酸锂后是否有效.方法 90例口服氯氮平治疗无效的精神分裂症患者随即分为3组,在氯氮平剂量不变的情况下,分别合用丙戊酸钠、碳酸锂和安慰剂治疗12周.于治疗前和治疗后第1、2、4、8、12周末用阳性和阴性症状量表(PANSS)和临床疗效总评量表(CGI)评定疾病严重程度和疗效；采用副反应量表(TESS)评定药物副反应.结果 丙戊酸钠组、碳酸锂组和安慰剂组患者在第12周末PANSS的总分、阳性、阴性和一般精神病理学症状分比合用药物前减低≥30％者分别为(13,11,4)例,(16,18,6)例,(3,3,1)例,(14,17,7)例.经方差分析发现:丙戊酸钠组、碳酸锂组与安慰剂组PANSS总分、阳性症状分和一般精神病理学症状分的治疗后得分有显著性差异(45.9±8.3,53.3±9.4,72.0±7.8,P＜0.05；8.8±4.8,15.8±9.7,20.9±9.6,P＜0.05；25.3±9.7,22.5±11.2,40.4±8.8,P＜0.05).TESS总分比较,治疗前后无差异.结论 单一使用氯氮平治疗效果不佳的难治性精神分裂症患者,合用心境稳定剂后有一定疗效.     

阿立哌唑与利培酮治疗女性精神分裂症对照研究

目的 比较阿立哌唑与利培酮治疗女性精神分裂症患者的临床疗效和安全性.方法 对60例符合CCMD-3诊断标准的精神分裂症病人随机分为两组,分别给予阿立哌唑和利培酮治疗8周.采用阳性症状和阴性症状量表(PANSS)评定临床疗效,副反应量表(TESS)评定副反应.结果 治疗8周,阿立哌唑组和利培酮的显效率分别为73.33%和76.67%,差异无显著性(P＞0.05),阿立哌唑组副反应(锥体外系、体重增加)的发生率明显低于利培酮组(P＞0.05).结论 阿立哌唑治疗女性精神分裂症疗效好,起效快,不良反应少.     

利培酮合并西肽普兰治疗精神分裂症阴性症状的疗效观察

目的 比较利培酮合并西肽普兰与单用利培酮治疗精神分裂症阴性症状的疗效及改善社会功能的作用.方法 将70例患精神分裂症阴性症状的患者随机分为2组:观察组利培酮合并西肽普兰治疗者;对照组单用利培酮治疗.治疗前采用PANSS[1]阴性症状量表评分,治疗6周后用PANSS、治疗中出现的症状量表TESS评定药物不良反应,以社会功能缺陷量表(SDSS)评定社会功能.结果 两组治疗前后PANSS总分及各因子分比较差异显著性.两组出现的药物副反应TESS评分差异无显著性.治疗6周后SDSS评定,在取业工作、婚姻职能、父母职能、社会性退缩、责任心和计划方面及总分,观察组明显优于对照组,有利于患者适应社会生活.结论 利培酮合并西肽普兰治疗精神分裂症阴性症状的疗效及改善社会功能方面效果显著,有利于患者恢复社会功能,重返社会,最大限度的延缓精神衰退的发生..     

阿立哌唑与利培酮治疗女性精神分裂症临床对照研究

目的比较阿立哌唑与利培酮治疗女性精神分裂症患者的副反应。方法将符合入组标准的100例女性精神分裂症患者随机分为阿立哌唑组与利培酮组各50例进行为期8周的治疗。采用副反应量表(TESS)评定副反应。并采用放射免疫法于治疗前和治疗后2、4、6、8周末分别测定血清催乳素(PRL)水平。结果阿立哌唑组TESS评分为3.4±2.3,利培酮组为3.6±2.5,两组副反应都比较轻微,差别无显著性意义(P>0.05)。8周末血清PRL水平,阿立哌唑组11.9±12.1μg/L,与治疗前比较差别无显著性意义(P>0.05);利培酮组121.4±76.3μg/L,与治疗前比较差别有显著性意义(P<0.01)。两组比较差别有显著性意义(P<0.01)。结论阿立哌唑副反应轻微,对女性患者血清PRL水平影响小,是一种较为理想的抗精神病药。     

利培酮与奎硫平治疗首发精神分裂症对照研究

目的探讨利培酮与奎硫平治疗首发精神分裂症的临床疗效及安全性。方法将60例患者随机分为利培酮组与奎硫平组各30例,治疗6周,采用阳性与阴性症状量表（PANSS）评定疗效,采用副反应量表（TESS）评定副反应。结果利培酮组总有效率为83.3%,奎硫平80%,两组差异无显著性（P〉0.05）。利培酮组主要副反应是肌强直,表情呆板;奎硫平组主要副反应是困倦,头晕。结论利培酮与奎硫平治疗首发精神分裂症均有良好疗效,两药副反应均较轻。     

利培酮合并阿普唑仑治疗急性期精神分裂症的对照分析

目的以氯氮平作对照,观察分析利培酮合并阿普唑仑治疗精神分裂症急性兴奋的疗效和副反应.方法将符合CCMD-3诊断标准的精神分裂症,随机分为利培酮合并阿普唑仑组和氯氮平组,观察4周,分别于治疗前、治疗后第4天、第7天、第14天、第28天评定PANSS量表总分、兴奋因子分（P4、P7、G8、G14）及TESS评定副反应.结果在治疗4天后,利培酮合并阿普唑仑组和氯氮平组兴奋因子均显著下降,但两组之间无显著性差异;28天时利培酮组PANSS总分高于氯氮平组,利培酮长期疗效优于氯氮平.氯氮平组嗜睡、便秘、流涎、心动过速高于利培酮组.结论利培酮合并阿普唑仑对治疗精神分裂症急性期兴奋与氯氮平组疗效相当,效果好,不良反应较氯氮平组轻,安全性好,病人易接受.     

利培酮与氯丙嗪治疗精神分裂症疗效及依从性比较

目的评价利培酮与氯丙嗪治疗精神分裂症的疗效及依从性.方法 98例精神分裂症患者随机分为2组,分别给予利培酮和氯丙嗪治疗,均治疗48周,于治疗前、8周末、48周末采用阳性症状阴性症状量表(PANSS)、药物副反应量表TESS评价其疗效、副反应及依从性.结果 8周后利培酮组有效率91.9%,氯丙嗪组有效率89.8%,2组治疗前后比较有非常显著性的疗效(p<0.01),但两组间比较差异无显著性(p>0.05);48周后利培酮组有效率91.9%,氯丙嗪组有效率69.4%.利组疗效有显著性(p<0.01),氯丙嗪组疗效有显著性(p<0.05),利组优于氯组(p<0.05).利培酮组的不良反应发生率远低于氯丙嗪组.结论精神分裂症患者对利培酮的依从性高主要是因疗效好和副反应轻.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.