西酞普兰联合护理干预治疗Ⅱ型糖尿病情绪障碍的研究

目的探讨西酞普兰联合护理干预2型糖尿病情绪障碍的疗效。方法将符合CCMD-3抑郁症诊断标准的2型糖尿病50例患者随机分成两组。研究组在降糖药物基础上联合西酞普兰20mg／d和护理干预治疗，对照组仅用降糖药物治疗，疗程8周。采用汉密顿抑郁量表（HAMD）评定疗效。结果经8周治疗后，研究组显效率为80．0％，对照组为32．0％，两组之间有显著性差异（P〈0．01），研究组比对照组抑郁评分下降显著（P〈0．05），两组间HAMD减分率于第2、4、8周末比较均有显著性差异（P〈0．05～0．01）。结论西酞普兰联合护理干预对2型糖尿病患者情绪障碍具有良好疗效，而且副作用没有明显增加。     

西酞普兰治疗广泛性焦虑的临床观察

目的探讨西酞普兰治疗广泛性焦虑症（GAD）的临床疗效和安全性。方法将87例广泛性焦虑患者随机分为研究组（西酞普兰治疗）43例和对照组（氯硝西泮）44例进行对照治疗,疗程6w。结果西酞普兰组HAMA减分平均为12．5±5．8分,对照组减分平均为7．7±6．8分,两组比较差异有统计学意义（t=3．35,P〈0．01）,西酞普兰治疗14天后及其后各随访点HAMA减分与观察组比较组比较,差异均有统计学意义（P〈0．05）;西酞普兰治疗组有效率88．4％;对照组有效率37％（χ^2=8．22,P〈0．01）;研穷组副反应较对照组少且轻。结论西酞普兰治疗广泛性焦虑起效快、安全有效、副反应低、依从性高。     

阿立哌唑配合西酞普兰治疗抑郁症的疗效观察

目的探讨小荆量阿立哌唑联合西酞普兰治疗抑郁症的疗效和安全性。方法采用随机开放对照研究，对52例抑郁症患者随机分为舍用组与单用组，疗程6周，采用汉密尔顿抑郁量表（HAMD），临床疗效总评量表一病情严重程度（CGI—SI）评定疗效，副反应量表（TESS）评定安全性。结果合用组显效率73．08％，单用组53．85％，合用组明显高于单用组，合用组HAMD评分第1、2周末显著低于单用组（P〈0．05），第6周评分有极显著性差异（P〈0．01），副反应两组间无明显差异（P〉0．05）。结论小剂量阿立哌唑联合西酞普兰治疗抑郁症，疗效明显优于单一应用西酞普兰治疗，起效快，副反应轻，安全性好。     

帕罗西汀合用心理行为干预治疗老年期抑郁症的疗效

目的探讨帕罗西汀合用心理行为治疗对老年期抑郁症的疗效。方法将60例老年期抑郁症随机分成两组，进行为期6周的对照研究，出院后随访1年，分别用心理行为合并帕罗汀治疗（研究组）和帕罗西汀治疗（对照组）；采用汉密尔顿抑郁量表（HAMD）和临床疗效总评量表（CGI—SI）进行评定。结果研究组在治疗6周后HAMD评分（9．32±2．28）较对照组（13.17±3．39）有显著性差异（P〈0．01），研究组CGI—SI较对照组有显著性差异（P〈0．01），1年末随访时HAMD评分研究组（9.19±2．33）较对照组（13．98±4．96）有显著性差异（P〈0.01）。且研究组复发率低于对照组（P〈0.05）。结论帕罗西汀合用心理行为治疗对老年期抑郁症的疗效优于帕罗西汀，且复发率低。     

艾司西酞普兰联合喹硫平治疗难治性抑郁症疗效观察

目的了解艾司西酞普兰联合喹硫平治疗难治性抑郁症的疗效和不良反应。方法将患者分为研究组和对照组,研究组服用艾司西酞普兰和喹硫平,对照组服用艾司西酞普兰,疗程为8周。治疗前、治疗后第2、4、6、8周末分别采用汉密尔顿抑郁量表（HAMD）和临床总体印象量表（CGI）评定,依据HAMD总分减分率判定临床疗效。不良反应采用副反应量表（TESS）评定。结果研究组有效率70.59%,对照组有效率45.16%,两组相比差异有统计学意义（χ2=4.32,P〈0.05）。在第4周时HAMD评分研究组与对照组相比有统计学差异（t=2.61,P〈0.05）,第6周时CGI评分研究组与对照组相比有统计学差异（t=2.24,P〈0.05）,不良反应两组无统计学意义。结论艾司西酞普兰联合喹硫平能提高治疗难治性抑郁症的疗效。     

维生素B〈sub〉12〈/sub〉对抑郁症的辅助治疗

目的观察抑郁症患者血清维生素B12水平,探讨抗抑郁剂合并维生素B12治疗维生素B12缺乏抑郁症的疗效及安全性。方法对400名抑郁症患者进行血清维生素B12浓度测查,将筛查出的维生素B12缺乏的抑郁症患者70例,随机分为两组,各35例。对照组根据病情口服西酞普兰20～40 mg/次,每日1次,治疗8周;研究组根据病情口服西酞普兰20～40 mg/次,每日1次,同时合并使用维生素B12,治疗8周。研究组及对照组治疗前后1,2,4,8周末分别进行汉密尔顿抑郁量表（HAMD）评定;治疗后1,2,4,8周末分别评定副反应量表（TESS）;治疗前及治疗后4,8周末分别查血清维生素B12浓度。结果抑郁症患者血清维生素B12平均水平（359.7±183.2）pg/ml,维生素B12缺乏发生率为19.5%,研究组与对照组第1周末汉密尔顿抑郁量表评分差异无显著性（P＞0.05）,治疗第2,4、8周末有显著性差异（P〈0.01）,研究组有效率为94.3%,对照组为74.3%,两组差异有显著性（P〈0.01）,血清维生素B12浓度治疗后4,8周末有显著性差异（P〈0.01）,且研究组汉密尔顿抑郁量表评分与血清维生素B12浓度负相关。两组不良反应均较轻微,TESS评分比较差异无显著性（P＞0.05）。结论抑郁症患者血清维生素B12平均水平较正常明显降低,维生素B12缺乏发生率高,维生素B12辅助抗抑郁剂治疗可明显提高疗效,且不增加不良反应。     

西酞普兰治疗老年性抑郁症对照研究

目的 探讨西酞普兰治疗老年性抑郁症的疗效及安全性。方法 将老年性抑郁症患者随机分为两组。分别给予西酞普兰和马普替林治疗,采用HAMD抑郁量表、临床疗效总评量表病情严重程度（CGI-SI）、TESS量表评定疗效及副犀应,并记录不良反应。结果 西酞普兰与马普替林治疗老年性抑郁症疗效相当,差异无显著性,但西酞普兰不良反应更少。结论 西酞普兰治疗老年性抑郁症安全有效。     

西酞普兰与米氮平治疗老年抑郁症的对照研究

目的比较西酞普兰与米氮平治疗老年抑郁症的疗效和不良反应。方法将50例老年抑郁症患者随机分为西酞普兰组和米氮平组．分别给予西酞普兰和米氮平治疗,疗程8周,采用汉密尔埙抑郁量表（HAMD）及副反应量表（TESS）评定疗效和副反应．结果西酞普兰组和米氮平组显效率分别为84．0％和80.0％．二者疗效相当（P〉0.05）。HAMD评分西酞普兰组第2周末显著下降．而米氮平组治疗第1周末即显著下降,副反应方面,西酞普兰组以口干、恶心、出汗增多、睡眠时间缩短为主,米氮平组则以嗜睡、眩晕、头疼为主．结论西酞普兰和米氮平均为治疗老年抑郁症的安全有效的药物。     

西酞普兰结合心理治疗对产后抑郁疗效观察

目的：比较单用西酞普兰与西酞普兰结合心理疗法治疗产后抑郁的临床疗效。方法：将58例符合CCMD-3抑郁症诊断标准的产后抑郁患者随机分成两组，分别给予单用西酞普兰20mg／日与西酞普兰20mg／日结合心理治疗，疗程6周。治疗前及治疗后1、2、4、6周末分别用汉密顿抑郁量表（HAMD）进行评定。结果：单用西酞普兰与西酞普兰结合心理疗法治疗产后抑郁均有比较理想的效果，但后者疗效更佳（t=2.24-6、64，P〈0．05）。结论：两酞普兰结合心理疗法治疗产后抑郁效果更好。     

森田疗法与西酞普兰联合治疗强迫症的对照研究

目的：探讨森田疗法与西酞普兰联合治疗强迫症的的疗效及安全性。方法：将56例强迫症患者随机分为观察组和对照组，每组28例。观察组采用森田疗法和西酞普兰治疗，对照组单纯以西酞普兰治疗，疗程2个月。采用Y-BOCS、CGI-SI、HAMD、TESS等量表评定疗效及安全性。结果：在治疗后第4、8周及半年随访时，观察组Y-BOCS、CGI-SI、HAMD等量表评分均显著低于对照组（均P〈0．05），两组不良反应比较差异无显著性（P〉0．05）。结论：森田疗法与西酞普兰联合治疗强迫症的疗效优于单用西酞普兰。     

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.     

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.     

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.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.