精神分裂症患者一级亲属认知功能的比较

目的探讨精神分裂症高发与散发患者的一级亲属认知功能是否存在差异。方法基于高发或散发精神分裂症,将纳入的109名患者的一级亲属分为高发家系组和散发家系组,分别调查两组研究对象的一般资料、威斯康星卡片分类测验得分、持续操作测验得分和韦氏成人记忆量表修订版得分,并进行统计分析。结果高发家系组比散发家系组更易出现工作记忆-执行功能缺陷(χ2=10.285,P=0.001),但高发与散发家系组的注意功能障碍和记忆障碍的发生风险无明显差异(χ2=0.714,P=0.398和χ2=1.343,P=0.246)。结论与散发精神分裂症患者的一级家属相比,高发精神分裂症患者的一级家属更易出现工作记忆-执行功能缺陷。     

精神分裂症认知矫正治疗分析

精神分裂症患者存在多种认知缺陷,报道最多的是注意障碍、工作记忆和执行功能受损等.目前研究显示认知缺陷是影响精神分裂症患者社会功能康复和疾病预后的重要因素.寻找新的改善精神分裂症患者认知缺陷的方法成为当前精神疾病治疗学研究的重点之一.但精神分裂症患者认知缺陷如何影响社会功能障碍尚不清楚,故正确评测及了解患者的认知缺陷与社会功能的关系有重要意义.本研究选用认知矫正治疗与威斯康星卡片测验(WCST)为工具,探讨精神分裂症恢复期患者认知功能的改善对社会功能的影响,以及变化关系.     

精神分裂症伴发代谢综合征患者的认知功能特点

目的探讨伴代谢综合征(MS)的精神分裂症患者认知功能损害特点,为MS的早期干预提供理论依据。方法选取符合入组标准的精神分裂症患者268例做为研究对象,伴MS组64例,不伴MS组(非MS组)204例。收集两组患者一般资料,检测空腹血糖(FPG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)等代谢指标,采用精神分裂症认知功能成套测验中文版(MCCB)评估认知功能,阳性和阴性症状量表(PANSS)评定临床症状。应用SPSS 18.0对数据进行统计分析,计数资料的比较用χ~2检验,计量资料的比较用独立样本t检验。结果 MS组与非MS组比较,体质指数(BMI)、腰围、FPG、TG、HDL-C、收缩压(SBP)和舒张压(DBP)差异均有统计学意义(P0.05)。两组PANSS总分及各因子评分差异均无统计学意义(P0.05)。与非MS组相比,MS组在处理速度、工作记忆、注意或警觉、言语学习记忆、视觉学习记忆维度评分差异均有统计学意义(P0.05),而推理及问题解决、社会认知评分差异均无统计学意义(P0.05)。结论伴发MS的精神分裂症患者认知功能损害较不伴MS精神分裂症患者更严重,在精神分裂症患者的临床治疗过程中早期识别与干预MS尤为重要。     

社区精神分裂症患者综合干预前后认知功能改变分析

目的 探讨社区综合干预模式对精神分裂症患者认知功能的影响。方法 将符合纳入标准的192例精神分裂症患者随机分组,分别为综合干预组97例,对照组95例。所有患者均接受常规社区医疗卫生服务,根据病情接受相应的药物治疗。干预组患者及家属接受精神分裂症知识培训,社交技能康复训练,包括训练患者手工技能、角色扮演和情景交流等,持续一季度,干预过程中特别强调亲属对患者的交流和帮助。干预措施对各组的影响采用重复测量资料的方差分析分析主效应和交互效应;不同分组间比较采用独立样本的t检验;同一组不同时间点比较采用配对设计资料的t检验;定性资料间比较采用卡方检验。结果 干预6个月、12个月后,阳性和阴性症状量表、康复状态量表、社会功能缺陷筛选量表、世界卫生组织生存质量测定量表简表和精神分裂症认知功能成套测验得分均为综合干预组优于对照组（P＜0.05）,干预前后组内比较,综合干预组社交技能和认知功能改善良好（P＜0.05）,对照组没有改变。综合干预组患者复发率低于对照组（χ2 = 11.389,P = 0.001）。结论 社区综合技能干预模式能提高精神分裂症患者的社会功能,并可有效改善其认知功能。     

精神分裂症患者认知功能特点及干预分析

目的：探讨精神分裂症患者的认知功能特点及其干预措施.方法：选取2012年1月至2014年1月入住我院的180例精神分裂症患者作为观察组,并选取180 例正常人作为对照组,应用斯特鲁色词测验以及重复性神经心理测查系统对两组的研究对象进行测查,比较两组患者在测查结果上的差异,并对精神分裂患者的认知功能特点进行分析,将180例精神分裂症患者中随机的选取36例,对其实施干预治疗,将其均分为两组,每组18例患者,分别作为药物组与联合组,药物组的患者接受常规药物的治疗,而联合组的患者在常规药物的基础上,再实施视-空间工作记忆训练,对两组患者的治疗效果进行对比分析.结果：通过对测查结果进行分析发现,精神分裂症患者的认知功能较正常人具有明显的差异,并且在精神分裂症患者中男女患者在认知功能上存一定的差异;对患者实施干预治疗之后,联合组患者的治疗效果要明显的优于药物组.结论：精神分裂症患者的认知功能损害主要表现在执行功能、注意力、言语功能、视觉广度、记忆能力等方面;视-空间工作记忆训练在药物治疗的基础上,对精神分裂症患者认知功能具有积极的改善作用.     

安非他酮对精神分裂症患者认知功能影响

目的精神分裂症(schizophrenia,SCH)是一种常见的重性精神疾病,患者认知功能障碍给家庭和社会带来沉重的经济及精神负担。本研究探讨安非他酮对精神分裂症患者认知功能的干预效果。方法选取2017-01-01-2017-10-31泰安市精神病医院收治的80例精神分裂症患者为研究对象。根据配比的方法分为研究组和对照组各40例,研究组完成36例,对照组完成38例。研究组在原有利培酮剂量不变的基础上,联用安非他酮150mg/d;对照组原有利培酮剂量不变。两组患者于治疗前和治疗8周后分别接受量表评定。采用中文版认知功能成套测验工具(MATRICS consensus cognitive battery,MCCB)评定对认知功能的临床疗效;阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评定治疗前后患者精神病性症状的变化;不良反应量表(treatment emergent symptom scale,TESS)及化验和辅助检查进行安全性评定。结果治疗后研究组处理速度、注意警觉、工作记忆、视觉学习和记忆、推理与问题解决及MCCB测验成绩均高于对照组,差异有统计学意义,均P0.05。治疗后研究组阴性量表分为(12.01±2.18)分,低于对照组的(15.29±3.07)分,t=5.256,P0.001;PANSS总分为(46.22±7.02)分,低于对照组的(49.88±7.61)分,t=2.140,P=0.035。研究组不良反应发生率为33.33%(12/36),高于对照组的13.16%(5/38),χ2=4.25,P=0.04。结论利培酮联合低剂量安非他酮可以改善精神分裂症患者的认知功能。     

伴有与不伴有代谢综合征的首发精神分裂症患者认知功能的研究

目的 探讨伴有与不伴有代谢综合征首发精神分裂症患者认知功能的差别.方法 对57例伴有代谢综合征的首发精神分裂症患者（研究组）和57例不伴有代谢综合征的首发精神分裂症患者（对照组）进行事件相关电位检测和韦氏记忆量表（WMS）测定,并应用阳性和阴性症状量表（PANSS）对两组进行精神病理学评定.结果 记忆商数研究组（78.51±12.54）分,对照组（92.01±17.49）分,两组差异有统计学意义（t=-2.130、P=0.047）,研究组短时记忆、瞬时记忆受损均高于对照组（t=2.151 ～ 3.054、P=0.007～0.046）;P300潜伏期研究组（325.10±22.46）ms,对照组（284.60±22.46）ms,两组差异有统计学意义（t=3.454、P=0.003）,P300波幅研究组（6.56±1.61）μV,对照组（9.78±1.73） μV,差异有统计学意义（t=-4.307、P=0.000）.结论 伴有代谢综合征的首发精神分裂症患者比不伴有代谢综合征的首发精神分裂症患者存在更严重的认知功能损害.     

精神分裂症患者一级亲属的血清hs-CRP及其相关因素研究

目的探讨精神分裂症患者一级亲属的血清超敏C反应蛋白(hs-CRP)及其相关因素。方法选取2016年7月—2018年5月收治的24例精神分裂症患者的一级亲属作为研究对象(观察组),另选同期来医院的24例健康体检者作为参照对象(对照组)。检测对照组健康体检者与观察组患者的hs-CRP、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及尿酸(UA)水平,分析TC/HDL-C比值及UA水平与hs-CRP的相关性。结果 UA水平与精神分裂症患者一级亲属血清hs-CRP水平呈正相关(r=0. 836,P=0. 019)。TC/HDL-C比值与精神分裂症患者一级亲属血清hs-CRP水平呈负相关(r=-0. 451,P=0. 028)。结论 UA水平及TC/HDL-C比值与精神分裂症患者一级亲属血清hs-CRP水平有关。     

代币疗法与认知治疗对精神分裂症患者生活质量的影响

目的研究代币疗法与认知治疗对精神分裂症患者生活质量的影响。方法将200例长期住院的精神分裂症患者随机分组,对照组进行一般康复治疗,研究组加用代币疗法与认知治疗,两组进行对照研究观察。结果两组患者社会功能缺陷筛查量表（SDSS）评分具有显著差异,研究组（5.45±1.94）,对照组（8.25±2.23）,P〈0.01;两组患者服药依从性具有差异性,χ2=8.72,P〈0.05。结论代币疗法与认知治疗能有效提高精神分裂症患者生活质量。     

精神分裂症患者认知功能障碍范围和程度研究

目的 了解精神分裂症认知功能障碍的范围和程度,更好地为精神分裂症患者的治疗提供依据。方法 应用韦氏记忆量表（WMS-RC）、中国修订韦氏成人智力量表（WAIS-RC）、数字划销试验（CT）、威斯康星卡片分类测验（WCST）工具,对绍兴市88例精神分裂症患者（病例组）与50例正常健康人（对照组）进行了认知功能的对比研究。结果 两组WMS-RC量表测评显示,再认、再生、1→100、100→1、积累、图片、联想、触摸、理解、背数、总记忆商数11项评分差别有统计学意义（t值分别为2.40,4.66,2.90,3.48,4.03,4.40,2.13,3.01,3.97,2.29,4.87,均P〈0.05）。两组WMS-RC、CT评分显示,病例组语言智商、操作智商、总智商及CT净分值均低于对照组,CT失误率高于对照组,差别均有统计学意义（t值分别为4.79,7.10,9.21,5.48,-6.27,均P〈0.01）。两组WCST评分显示,病例组WCST的总测试次数、持续错误数、随机错误数均高于对照组,正确数和分类数低于正常组,差别均有统计学意义（t值分别为-2.89,-3.62,-2.03,3.28,2.14,均P〈0.05）。结论 精神分裂症患者认知功能障碍确实存在,并以注意、记忆、抽象思维和信息整合为主体。     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.