抽动障碍共患强迫症研究进展

<正>抽动障碍(tic disorders,TD)是起病于儿童或青少年时期的一种神经精神障碍性疾病,临床分为短暂性抽动障碍、慢性抽动障碍和Tourette综合征(TS)。近年来研究发现,大约一半的TD患儿和80%以上的TS患儿共患至少一种躯体或精神疾病^[1],例如注意缺陷多动障碍(ADHD)、强迫障碍(OCD)、情绪障碍(ED)、睡眠障碍(SD)、学习困难(LD)、自伤行为(SIB)、品行障碍(CD)等。在各种共患疾病中,OCD日益受到关注,2018年的一篇系统评价提示TD共患OCD的概率为20.0%～61.5%,OCD共患TD的概率为1.74%～46.20%^[2],     

Cerebrovascular disorder

<正>209220 Clinical features and treatment of the hemorrhagic moyamoya disease/Duan Lian(Dept Neurosurg,Research Clinic,Acad Mil Med Sci,PLA,Beijing 100071)…∥Chin J Neurosurg.-2009,25(3).-201~204Objective To study the clinical features,bleeding reasons and strategies of the treatment of 61 patients with hemorrhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,characteristics of DSA images and therapeutic results were studied retrospectively.Results In all 61 patients,57 patients were adults.Most of them were cerebral hemorrhage breaking into ventricles.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AChA and P-CoM were observed in 52 patients,118 procedures of EDAS were performed,including superficial temporal basilar tip in 116 hemispheres and occipital artery in 2 hemispheres.There was no recurrence of hemorrhage in those operation patients.But 2 patients without EDAS died due to recurrence of hemorrhage Conclusion Dilatation and abnormal branching of the AChA and/or P-CoM are one of the main reasons for hemorrhagic events.The treatment of EDAS may be an effective method for preventing the recurrence of hemorrhage of hemorrhagic moyamoya disease.17 refs,2 figs.     

Cerebrovascular disorder

Effect of NF-kappaB decoy oligodeoxynucleotide on CVS after SAH in rabbits;Combination of the nero-interventional technique with hematoma puncture to treat the bleeding cereberal vascular disease;Application of CT angiography in emergency microsurgery of spontaneous intracerebral hemorrhage without hypertension;Analysis of the difference between the rigid model and the elastic model in rabbit aneurismal model by numerical simulation;Intracranial aneurysms with special morphology found in operations     

Cerebrovascular disorder

<正>210216 Survival and differentiation of transplanted human embryonic stem cells 48 h following cerebral infarction in rats/Chen Ling(陈凌,Dept Cytotherapy,Xuanwu Hosp,Cap Med Univ,Beijing 100053)….-2010,27(4).-487～489     

Cerebrovascular disorder

<正>209376 The comparison of medical treatment and surgical therapy on massive hemispheric infarction/Zhang Yajing(张雅静,Tianjin Huanhu Hosp,Tianjin 300060)…∥Chin J Neurosurg.-2009,25(5).-451～453Objective To analyze the therapeutic effect of the decompressive craniectomy and medical treatment for patients with the massive hemispheric infarction.Methods The mortality,overall prognosis and disability of 66 patients who were operated on decompressive craniectomy and 52 patients with medical treatment were analyzed.Results The mortality of the operative patients(35.6%)was lower(P=0.031)than the conservative patients(69.2%)in the group whose age were below 60,the mortality of the operative patients(52.4%)was lower(P=0.015)than the conservative patients(82.1%)in the group whose age were above 60;the prognosis of the operative patients(55.6%)was better(P=0.048)than the conservative patients(23.1%)in the group whose age were below 60,the prognosis of the operative patients (23.8%)was better(P=0.007)than the conservative patients(0%)in the group whose age were above 60;the disability of the operative survivors(13.8%)was lower than the conservative survivors(25%)in the group whose age were below 60,but had no statistical significance,the disability of the operative survivors(50%)was lower(P=0.004)than the conservative survivors(100%)in the group whose age were above 60.Conclusion The surgical therapy decreases mortality,improves the quality of life,decreases the disability of survivors,especially in the younger patients.18 refs.     

神经病理性疼痛与抑郁和焦虑精神症状的相关性

目的 探讨神经病理性疼痛与焦虑和抑郁精神症状之间的相关性。方法 选择神经病理性疼痛初诊患者36例（病例组）,根据病情需要分别采用阿米替林、阿片类药物和神经阻滞药物进行镇痛治疗,治疗前进行视觉模拟疼痛评分（VAS）、Zung焦虑评分（SAS）和Zung抑郁评分（SDS）,治疗后2和4周再进行SAS和SDS评分。同时选15名健康志愿者作为对照,进行SAS和SDS评分。结果 病例组患者神经病理性疼痛病程均超过3个月,其疼痛程度与焦虑和抑郁情绪的发生率成正相关（P<0.01）,其焦虑和抑郁情绪的发生率均显著高于对照组（P<0.01）;治疗后2周和4周病例组患者疼痛均得到有效缓解（P<0.05）,但疼痛程度与焦虑、抑郁情绪仍呈正相关（P<0.05）,且其焦虑和抑郁情绪的发生率仍显著高于对照组（P<0.05）。结论 神经病理性疼痛患者往往伴随焦虑和抑郁情绪,两者密切相关。随着疼痛的缓解,焦虑和抑郁症状均可不同程度缓解,但无法完全消除。     

创伤后应激障碍

许多世纪以来,人们对于创伤事件后的反应一直有着各种生动的描述,但是随着时间的流逝,这些描述已经发生了本质的变化。最早将创伤后应激障碍纳入精神疾病诊断的是精神疾病诊断与统计手册第三版（DSM—Ⅲ）和国际疾病分类法第10版（International Classification of Diseases,10thedition）^2。这一创伤后出现的可以理解的情感反应是否应该被诊断为疾病（创伤后应激障碍）仍然存在争议砣,目前大家更关注的是对于该病是否存在过度诊断的问题,其次是一些创伤后应激障碍的患者是否归属为严重精神卫生问题。本文对该病的现状与进展进行了回顾,介绍了该病的易感者以及适宜的防治措施。     

广泛性焦虑障碍

广泛性焦虑障碍是一种对日常生活事件或想法持续担忧和焦虑的综合征，患者往往能够认识到这些担心是过度和不恰当的。然而，这种“广泛性担忧”的性质难以用分类方式来描述。诊断标准也在不断地变化，这些标准显然增加或降低了诊断的门槛。     

Body dysmorphic disorder

Body dysmorphic disorder (BDD) is defined as a preoccupation with an "imagined" defect in one's appearance. Alternatively, where there is a slight physical anomaly, then the person's concern is markedly excessive. The preoccupation is associated with many time consuming rituals such as mirror gazing or constant comparing. BDD patients have a distorted body image, which may be associated with bullying or abuse during childhood or adolescence. Such patients have a poor quality of life, are socially isolated, depressed, and at high risk of committing suicide. They often have needless dermatological treatment and cosmetic surgery. The condition is easily trivialised and stigmatised. There is evidence for the benefit of cognitive behaviour therapy and selective serotonin reuptake inhibitors in high doses for at least 12 weeks, as in the treatment of obsessive-compulsive disorder. There is no evidence of any benefit of antipsychotic drugs or other forms of psychotherapy.     

Borderline personality disorder

BORDERLINE PERSONALITY DISORDER is a chronic psychiatric disorder characterized by marked impulsivity, instability of mood and interpersonal relationships, and suicidal behaviour that can complicate medical care. Identifying this diagnosis is important for treatment planning. Although the cause of borderline personality disorder is uncertain, most patients improve with time. There is an evidence base for treatment using both psychotherapy and psychopharmacology. The clinical challenge centres on managing chronic suicidality.     

Cerebral vascular disorder

<正>209527 Transvenous embolization of cavernous sinus dural arteriovenous fistulaes/Liu Lian(刘恋, Beijing Neurosurg Inst,Cap Univ Med Sci,Beijing 100050)…∥Chin J Neurosurg. -2009,25(8). -695 ～698