68例精神损伤司法精神病学鉴定分析

目的调查司法精神病学鉴定中精神损伤赔偿案例的特点,并对与其相关的医疗终结期、精神障碍的伤残等级等问题进行探讨。方法调查近四年半内鉴定的案例中精神损伤赔偿的案例,依鉴定报告内容逐项进行调查。结果精神损伤赔偿案例占全部调喳案例的-18．28％（68／372）;男：女=1：4．67;文化程度在初中（含初中）以下者占76．47％（52／68）;诊断分类中以癔症居首位,占58．82％（40／68）;诱发因素中以殴打居多,占70．59％（48／68）;直接要求鉴定医疗终结期、精神障碍程度或伤残等级者共12例（占17．65％）。结论精神损伤的评定工作较复杂,尚需制定统一的行业评定标准。     

鉴定结论的法律地位与评价

目的探讨精神疾病司法鉴定结论的法律属性与地位。方法对精神病人恤刑制度的历史发展、精神疾病司法鉴定的法律依据、法定程序、鉴定机构及鉴定人的法定性等几个方面进行分析论证。结果对精神病人的恤刑制度是一种人道主义的保护,刑事责任能力鉴定较20世纪80年代已趋于严格。结论鉴定结论符合证据学的一般特征。     

31例精神发育迟滞性犯罪和性受害者分析

精神发育迟滞,在司法鉴定工作中比较常见。国内精神发育迟滞在精神医学同司法鉴定中仅次于精神分裂症而居第二位。精神发育迟滞以性犯罪和性受害为多见[1]。1资料和方法1．1资料来源1995年7月～1998年6月,由县公检法以上司法部门委托我院做司法鉴定共计298例．其中精神发育迟滞58例（占19,46％）,性犯罪10例（32．26％）·性受害21例（67．74％）。1．2诊断根据CCMD－2－R关于精神发育迟滞的诊断标准。1．3一般资料性犯罪和性受害者年龄最大47岁．最小15岁,平均24．51岁;以农民居多21例·学生3例·无业3例·工人2例,在外流浪2例;以…     

肌电图在外伤司法鉴定中的应用61例分析

目的:探讨外伤司法鉴定中肌电图检查的特点和方法。方法:对61例肌电图外伤司法鉴定的结果进行分析,讨论典型案例。结果:因车祸需鉴定的比例最高(41%),多神经损伤最多(38%),诈伤者(12%)和复检者(28%)较多。复检的主要原因是初检时病程过短或肌电图检查不全面所致。结论:外伤司法鉴定肌电图有其特点,检查不仅要全面,肌电图诊断一定要有充分的依据。     

司法鉴定癫癎性精神障碍者的脑电图分析

目的:探讨经司法机关鉴定为癫性精神障碍者的脑电图特点及案件类型与精神障碍者的关系。方法:对113例司法机关提供的癫性精神障碍者的脑电图资料进行分析。结果:脑电图异常40例,异常率为35·4%。有34例表现为广泛异常,6例为局限性异常,经临床医学诊断为人格改变和智力障碍的患者脑电图异常率高,且大部分为广泛异常,经司法机关鉴定为伤害罪、纵火罪和杀人罪的异常率较其他犯罪类型高。结论:癫性精神障碍者的脑电图有其特征性改变,与精神障碍的类型有关,与案件类型无关。     

司法鉴定为癫癎性精神障碍者的脑电图分析

目的：探讨经司法精神病鉴定为癫癎性精神病障碍者的脑电图（ＥＥＧ） 改变特点,及与精神障碍表现、临床发作类型、案件类型的关系。方法：对５２ 例经司法精神病鉴定为癫癎性精神障碍患者的ＥＥＧ 资料进行回顾性分析。结果：常规ＥＥＧ 异常率为５８ ％ 。广泛异常２２ 例,其中轻度１１ 例,中度９例,重度２ 例;局灶性异常８ 例。智能障碍、人格改变并智能障碍异常率均较高,且大多为广泛异常。伤害罪、抢劫罪、纵火罪、杀人罪及被奸淫案异常率比其他案件类型高。结论：癫癎性精神障碍ＥＥＧ 有其特征性改变,与其病因、发作频次、精神障碍表现和临床发作类型有关,但与案件类型无关。     

癔症性失明6例误诊分析

癔症性失明是一种常见的精神疾病,临床表现为失明.据病史和临床表现首先考虑为癔症.但对于年轻的门诊值班医生缺乏诊断意识、思维狭隘,多诊断为球后视神经炎,从而产生治疗偏差,久治不愈.在此,回顾性分析6例癔症性失明的患者误诊的原因进行分析.     

31例关锁重性精神疾病患者解锁前后社会功能比较

目的了解31例关锁重性精神疾病患者解锁治疗后社会功能恢复状况。方法选择2008年5月～2009年5月河北省精神卫生中心解锁工程救助的31例解锁重性精神疾病患者为入组对象,应用卫生部重性精神疾病管理治疗项目(686项目)《解锁患者社会功能评价表》对关锁患者解锁前后的社会功能进行评分,然后进行统计分析。结果患者解锁治疗后的生活料理能力、家务劳动和工作能力、婚姻状况明显好于解锁前,差异具有统计学意义(P0.01);学习能力和人际能力无明显改善,说明长期关锁对患者造成的社会功能损害难以短时间恢复。结论被关锁的重性精神疾病患者只要进行正规、系统的治疗,其基本社会功能会有较好的恢复。     

关锁重性精神疾病患者解锁后治疗效果分析

目的了解31例解锁患者经住院治疗后的效果。方法采用卫生部686项目《解锁患者信息采集表》,对2008年5月～2009月5月期间实施解锁工程的31例出院患者进行调查,对调查结果进行统计分析。结果解锁患者经住院治疗,出院时病情好转者30例,占96.77%;无变化者1例,占3.23%。出院6个月后随访,坚持门诊服药维持治疗25例(80.65%),继续关锁4例(12.90%),诊断2例(6.45%)。结论解锁工程拯救了被长期关锁的贫困重性精神疾病患者,产生了较好的治疗效果,但由于缺乏社区精神康复机构,患者出院后的康复效果难以保证。     

146例胎儿染色体易位核型分析

目的:探讨羊水染色体平衡易位的来源及新生突变。方法:收集8635例羊水标本,应用染色体核型分析技术诊断胎儿是否为染色体易位核型,并分析易位核型的来源。结果:本研究共有146例胎儿染色体易位,其中平衡易位110例,罗伯逊易位36例。110例胎儿染色体相互易位中,57例胎儿染色体易位来自父亲,34例胎儿染色体易位来自母亲,...     

146311例阴道分泌物检查结果分析

目的：了解南宁地区女性生殖道病原体感染情况,探讨其与清洁度、年龄的关系。方法对146311例门诊、住院患者阴道分泌物进行生理盐水涂片显微镜检查。结果146311例患者中,滴虫、霉菌和加德纳菌的总感染率为21.60%,表现为6种感染模式。病原体感染患者阴道清洁度主要在芋度占93.28%,阴道清洁度郁度者感染率高达88.50%;21~30岁感染率最高为24.75%,不同阴道清洁度及年龄组间感染率比较差异均有统计学意义(<0.01)。结论南宁地区女性生殖道感染较严重,分泌物的清洁度与病原体感染有关,各年龄段女性均有感染,应加强妇女儿童健康宣传、积极开展生殖道健康普查。     

Victims of violence and the general practitioner.

BACKGROUND: Violent crime is on the increase in Britain, with 17% of the 15 million incidents of crime reported in 1991 being of a violent nature. Although there is some information on the role of accident and emergency departments for victims who sustain physical injury, little is known about the role of the general practitioner (GP) in managing the acute and longer-term sequelae of violence. AIM: To examine the links between experiencing physical of sexual assault and seeking help from GPs in London. METHOD: A cross-sectional survey of all adult attendees in one large group practice was carried out. The main outcome measures were prevalence of assault, reporting to the doctor and other people, and scores on the General Health Questionnaire (GHQ) and the Impact of Events scale. RESULTS: Of the 195 people who took part, 33 (17%) reported a physical or sexual assault in the previous year. Women were three times more likely than men to report any type of assault. Women rarely spontaneously disclosed these experiences to the GP and yet the experience of violence was associated with higher levels of distress, as measured on the GHQ and the Impact of Events Scale. CONCLUSIONS: Assault is a relatively common event in the lives of people who consult their GP. Doctors could help these patients through gaining an awareness of the problem and by fostering links with voluntary services, such as victim support schemes, which can provide support, practical assistance, and advice on compensation claims and legal procedures.     

MicroRNA 146a基因单核苷酸多态性与卵巢上皮性肿瘤易感性的研究

目的 分析microRNA 146a(miR-146a)基因单核苷酸多态(single nucleotide polymorphisms,SNPs)位点rs2910164(G/C)与卵巢上皮性肿瘤易感性的关系.方法 采用病例-对照研究方法,纳入卵巢上皮性肿瘤患者184例为病例组,无卵巢肿瘤病史的人群200例为对照组.使用基因测序方法确定miR-146a基因rs2910164 (G/C)位点的多态基因型,比较不同基因型在病例组和对照组中的分布情况,并对年龄、月经周期、产次、口服避孕药、家族病史因素进行分层研究.结果 在miR-146a基因多态位点rs2910164(G/C)处,病例组和对照组均有GG、GC和CC 3种基因型,且两组的基因型总体分布差异具有统计学意义(P=0.002).与CC基因型相比,GG和GC基因型携带者的卵巢上皮性肿瘤发病风险较低(OR=0.396,95％ CI=0.219～0.717,P=0.002;OR=0.502,95％ CI =0.308～0.818,P=0.006).分层分析显示,这种影响在年龄≤50岁、产次≤2、未口服避孕药、无家族病史的情况下差异显著,x2检验P值分别为:0.001、0.000、0.001、0.001.结论 miR-146a单核苷酸多态位点rs2910164(G/C)与卵巢上皮性肿瘤易感性相关.GG和GC基因型携带者患卵巢上皮性肿瘤的发病风险低于CC基因型携带者.     

Critical roles of CD146 in zebrafish vascular development.

In this report, we use zebrafish as a model system to understand the importance of CD146 in vascular development. Endothelial-specific expression of CD146 was verified by whole-mount in situ hybridization. Suppression of CD146 protein expression by antisense morpholino oligonucleotides (MO) resulted in poorly developed intersomitic vessels (ISVs). In CD146 morphants, we observed a lack of blood flow through the ISV region, despite that fluorescence microangiography showed that the ISVs were present. This finding suggests that the lumens of the developing ISVs may be too narrow for proper circulation. Additionally, remodeling of the caudal vein plexus into functional vascular tubes appeared to be affected. Suppression of CD146 protein expression resulted in a circulation shunt that caused the circulation to by-pass part of the caudal artery/vein system. The same vascular defects were recapitulated by using a second morpholino oligonucleotide. This morphant expressed a truncated CD146 protein with amino acids V32 to T57 at the N terminus deleted in an in-frame manner. This region, therefore, is likely to contain elements critical for CD146 function. This study provides the first in vivo functional assessment of CD146 in embryonic development by showing that knockdown of CD146 protein expression severely hinders vascular development in zebrafish.     

MicroRNA-146在糖尿病心肌病中的调控作用

目的:探讨微小RNA-146 (miR-146)在糖尿病心肌病(DCM)发病机制中的作用,观察miR-146及其下游靶基因表达水平的变化。方法:60只雄性C57BL/6小鼠随机分为实验(DCM)组和对照(control)组,每组30只,实验组采用低剂量(50 mg/kg链脲佐菌素(STZ)腹腔注射诱导建立糖尿病心肌病模型,对照组给予等量枸橼酸钠缓冲液腹腔注射,建模12周后取心脏做HE和Masson染色观察心脏病理改变,RT-qPCR检测miR-146 a和miR-146b及其下游靶基因白细胞介素-1受体相关激酶1(IRAK1)和TNF受体相关因子6(TRAF6)的mRNA表达,Western blot检测IRAK1和TRAF6的蛋白表达。结果:12周末HE染色显示,DCM组心肌肥大,结构紊乱;Masson染色显示,DCM组心肌内胶原纤维增多;RT-qPCR检测结果显示,DCM组中miR-146a及miR-146b较control组表达明显减少(P 0. 01),IRAK1的mRNA水平明显增高(P 0. 01),而TRAF6的mRNA水平下降(P 0. 01);Western blot检测结果显示DCM组的IRAK1蛋白表达增加,TRAF6的蛋白表达降低(P 0. 01)。结论:miR-146可能通过调节IRAK1介导的炎症反应参与糖尿病心肌损伤的发生发展。     

From Wounded Victims to Scarred Survivors

The author reports on working psychotherapeutically with refugees who are 'victims', or rather 'survivors', of torture. He argues for the importance of understanding their experience of loss and also considers the problem of the recovery of painful memories by suggesting that these patients are trapped by the need to remember what they only wish to forget. As illustration he presents clinical material on patients suffering from anxiety states, sleeplessness and terrifying nightmares resulting from imprisonment and torture, and focuses on the specific aspects of transference and countertransference that emerged in their therapy.