哌罗匹隆联合艾司西酞普兰治疗阴性症状为主的精神分裂症临床观察

目的探讨哌罗匹隆联合艾司西酞普兰治疗以阴性症状为主的精神分裂症临床疗效。方法选取以阴性症状为主的精神分裂症患者60例,随机分为研究组(n=30)与对照组(n=30)。研究组给予哌罗匹隆联合艾司西酞普兰治疗,对照组给予哌罗匹隆治疗。观察8周,于治疗前、治疗后2、4、8周末采用PANSS量表、阴性症状量表(SANS)、不良反应量表(TESS)评定疗效及不良反应。结果研究组总有效率76.7%,对照组为53.3%比较,差异有统计学意义(P0.05)。研究组在治疗2周末SANS量表评分下降较显著(P0.01)。与治疗前相比,治疗8周末2组PANSS量表评分均显著下降(P0.05),TESS评分无明显差异(P0.05)。结论哌罗匹隆联合艾司西酞普兰治疗以阴性症状为主的精神分裂症起效快,疗效好。     

艾司西酞普兰合并认知行为治疗在老年抑郁症治疗中的作用

目的:探讨艾司西酞普兰合并认知行为治疗在老年抑郁症治疗中的作用。方法:将72例老年抑郁症患者随机分为艾司西酞普兰合并认知行为治疗组(研究组,36例)和艾司西酞普兰组(对照组,36例),给予相应的治疗8周。分别于治疗前及治疗1、2、4、6、8周给予汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床疗效总评量表病情严重程度量表(CGI-SI)评分;治疗8周以HAMD减分率评价疗效;随访6及12个月观察患者服药的依从性及复发率。结果:研究组和对照组分别有34例和32例完成8周疗程。治疗前两组HAMD、HAMA、CGI-SI评分差异无统计学意义;治疗后两组各时间点HAMD、HAMA、CGI-SI评分较治疗前明显下降(P均<0.01)。治疗1～4周末研究组HAMD、HAMA、CGI-SI评分明显低于对照组(P均<0.01);6～8周两组间各量表评分及疗效比较差异无统计学意义。治疗6及12个月时研究组服药依从率显著高于对照组(χ2=4.942、7.675;P均<0.01);12个月时复发率研究组显著低于对照组(χ2=9.021,P<0.01)。结论:艾司西酞普兰合并认知行为治疗能够更快地改善老年抑郁症患者症状,提高远期服药的依从性,降低复发率。     

艾司西酞普兰联合奎硫平治疗难治性抑郁症患者的对照研究

目的:比较艾司西酞普兰联合奎硫平治疗难治性抑郁症的疗效和安全性方法:74例门诊和住院的难治性抑郁症患者,随机分为研究组38例(艾司西酞普兰联合奎硫平治疗)和对照组36例(单用艾司西酞普兰治疗),治疗8周.采用17项汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HA-MA)评价症状严重程度,治疗中出现的症状量表(TESS)评定不良反应. 结果:两组治疗后HAMD和HAMA评分较治疗前均有显著性降低(P均＜0.01);第8周研究组与对照组有效率分别为57.9％、33.3％,两组疗效差异有统计学意义(P＜0.05).研究组和对照组与药物不良反应差异无统计学意义(P＞0.05). 结论:艾司西酞普兰合并奎硫平治疗难治性抑郁症与单用艾司西酞普兰相比,起效较快,疗效较好,同样安全.     

艾司西酞普兰治疗惊恐障碍疗效观察

目的 了解艾司西酞普兰治疗惊恐障碍的疗效和安全性.方法 将患者随机分为艾司西酞普兰组或西酞普兰组,疗程12周,使用汉密尔顿焦虑量表(HAMA)、惊恐相关症状量表(PASS)、不良反应量表(TESS)在两组患者治疗前及治疗第1、2、4、8、12周进行评分.结果 艾司西酞普兰组有效率为84.21%,司西酞普兰组有效率为81.08%,无统计学意义(χ＜'2＞=0.13,P＞0.05).治疗2周时,艾司西酞普兰组HAMA评分低于对照组,有统计学意义(t=2.87,P＜0.01).治疗2、4周时艾司西酞普兰组PASS评分低于对照组,有统计学意义(P＜0.05).结论 艾司西酞普兰治疗惊恐障碍同西酞普兰同样安全有效,和西酞普兰相比,能更快地控制患者的焦虑症状和惊恐障碍的核心症状.     

艾司西酞普兰与舍曲林治疗伴焦虑症状抑郁症患者疗效比较

目的:比较艾司西酞普兰与舍曲林治疗伴焦虑症状的抑郁症疗效和安全性. 方法:76例符合入组标准的患者随机分为艾司西酞普兰组和盐酸舍曲林组各38例,疗程6周.用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)评定疗效,采用治疗中出现的症状量表(TESS)评定安全性.结果:两组HAMD、HAMA评分均较治疗前显著降低(P＜0.01),以艾司西酞普兰组HAMD、HAMA评分在治疗1周时降分显著低于盐酸舍曲林组(t=-2.839,-2.862;P ＜0.01),其余各周差异无统计学意义(P＞0.05).艾司西酞普兰组与舍曲林组不良反应发生率分别为39.5％和42.1％ (P＞0.05).结论:艾司西酞普兰与舍曲林治疗伴焦虑症状的抑郁症疗效相当,但艾司西酞普兰起效更快.     

艾司西肽普兰联合利培酮对精神分裂症阴性症状疗效和安全性

目的 观察艾司西肽普兰辅助治疗精神分裂症患者阴性症状的疗效及安全性。方法 采用随机双盲对照研究方法。将我院86例住院精神分裂症患者分为两组,排除脱落人数后最终人数为：研究组利培酮联合艾司西肽普兰组39例;对照组利培酮联合安慰剂组41例。分别于基线及治疗第4、8、12周末采用阳性和阴性症状量表（PANSS）、阴性症状量表（SANS）、个人和社会功能量表（PSP）评估疗效,不良反应量表（TESS）评估安全性。结果 两组中PANSS总分、阴性因子总分、SANS总分于治疗第4周末开始均低于治疗前,两组中PSP总分于治疗第4周开始均高于治疗前（P<0.01）;在第8周末及第12周末利培酮联合艾司西酞普兰组PANSS阴性因子总分、SANS总分、分量表综合评价分均低于对照组（P<0.01）,PSP总分均高于对照组（P<0.01）;利培酮联合艾司西酞普兰组与利培酮联合安慰剂组PANSS阴性因子总分、SANS总分、PSP总分组间效应、时间主效应、交互效应均有统计学意义（P<0.01或P<0.05）。两组间不良反应差异无统计学意义（P>0.05）。结论 艾司西酞普兰对治...     

阿立哌唑联合艾司西酞普兰对首发精神分裂症患者认知功能及社会功能的疗效

目的探讨阿立哌唑联合艾司西酞普兰对首发精神分裂症患者认知功能及社会功能的临床效果。方法将140例首发精神分裂症患者随机分为观察组和对照组,各70例,对照组给予阿立哌唑治疗,观察组给予艾司西酞普兰联合阿立哌唑治疗。治疗前及治疗6个月后,采用阳性和阴性症状量表(PANSS)、威斯康星卡片分类测验(WCST)、社会功能缺陷筛选量表(SDSS)评估患者临床症状、认知功能、社会功能。结果治疗前两组患者上述量表评分组间无明显差异(P0.05);治疗6个月后观察组PANSS各项评分明显低于对照组,WCST量表中的完成分类数、正确应答数、概念化水平百分比评分明显高于对照组,持续性错误数明显低于对照组,SDSS量表中的社会性退缩、家庭外活动、家庭内活动、家庭职能、个人生活自理、对外界兴趣评分均明显低于对照组,上述差异均有统计学意义(P0.05)。结论阿立哌唑联合艾司西酞普兰能更有效地缓解首发精神分裂症患者精神病性症状,改善其认知功能与社会功能。     

表达性艺术治疗对抑郁症残留症状疗效随机对照研究

目的 探讨艾司西酞普兰合并表达性艺术治疗对于抑郁症残留症状的疗效.方法 60例单用艾司西酞普兰治疗6周后存在残留症状的抑郁症患者被随机分为研究组（n=30）和对照组（n=30）,分别给予为期4周的艾司西酞普兰合并表达性艺术治疗和单用艾司西酞普兰治疗.在基线期和4周末采用汉密尔顿抑郁量表（Hamilton DepressionScale-17,HAMD-17）、汉密尔顿焦虑量表（Hamilton anxiety scale,HAMA）评定疗效.结果 基线期研究组和对照组HAMD-17、HAMA评分无统计学差异（P＞0.05）;治疗后第4周末,研究组HAMD-17减分显著高于对照组（P =0.009）,研究组HAMA减分显著高于对照组（P =0.000）.结论 艾司西酞普兰合并表达性艺术治疗较单用艾司西酞普兰能更好地改善抑郁症的残留症状.     

艾司西酞普兰合并正念认知治疗对广泛性焦虑障碍患者自尊和应对方式的影响

目的:探讨艾司西酞普兰合并正念认知治疗(MBCT)对广泛性焦虑障碍(GAD)患者自尊和应对方式的影响。方法:采用随机数字法将72例GAD患者分为研究组和对照组各36例;两组均给予艾司西酞普兰治疗,同时给予研究组MBCT;于治疗前和治疗8周后应用汉密尔顿焦虑量表(HAMA)、自尊量表(SES)和简易应对方式问卷(SCSQ)进行评定。结果:治疗后研究组HAMA评分明显低于对照组,SES评分明显高于对照组, SCSQ积极应对评分明显高于对照组,消极应对评分低于明显对照组(P均0.01)。结论:艾司西酞普兰合并MBCT能有效改善GAD患者的焦虑症状、自尊水平和应对方式。     

认知疗法合并艾司西酞普兰治疗女性抑郁症患者的疗效

目的:比较艾司西酞普兰合并认知治疗与单用艾司西酞普兰对女性抑郁症患者的疗效。方法:60例女性抑郁症患者随机分为研究组(艾司西酞普兰合并认知治疗组)30例,对照组(单用艾司西酞普兰组)30例,治疗8周。治疗前及治疗1、2、4和8周分别采用汉密尔顿抑郁量表(HAMD)评定疗效。结果:治疗2周开始,两组HAMD评分均显著下降。研究组治疗1周HAMD明显下降。研究组较对照组HAMD下降更显著。两组不良反应差异无显著性。结论:艾司西酞普兰合并认知治疗对女性抑郁症患者疗效明显,安全性高。     

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.     

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.     

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。     

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.     

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.     

《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。     

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.     

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。