中国6城市中老年人群X射线颈椎骨关节炎流行病学分析

目的：颈椎骨关节炎是使颈椎关节发生障碍的疾病, 严重影响中老年人群的生活质量。采用X射线检查中国6个城市中老年人群颈椎骨关节炎患病情况,为了解颈椎骨关节炎的病因和防治研究提供科学依据。 目的：颈椎骨关节炎是使颈椎关节发生障碍的疾病,严重影响中老年人群的生活质量。采用X射线检查中国6个城市中老年人群颈椎骨关节炎患病情况,为了解颈椎骨关节炎的病因和防治研究提供科学依据。 方法：调查于2005-06/08在西安、石家庄、上海、广州、哈尔滨、成都六大城市完成。①调查对象为年龄≥40岁,具有常住户口男女汉族人群4 785人,其中男2 162人,平均年龄54.87岁;女2 623人,平均年龄54.78岁。男女性别比为0.82∶1.00。②调查方法：采用分层多阶段整群随机抽样方法对调查对象人群进行问卷调查：包括一般情况、现病史、既往史、体格检查、X射线平片检查情况、疾病诊断;颈椎X射线正侧位投照：判断标准为颈椎关节至少有1个关节Kellgren & Lawrence分级≥2级,3级,4级判定为重度骨关节炎。 结果：中国6个城市中老年人群X射线平片检测颈椎骨关节炎总患病率48.5%,其中男49.5%,女47.7%,男女之间比较差异无意义(P > 0.05);各城市间比较,差异有显著性意义(P < 0.01),广州(81.4%)>上海(76.6%)>哈尔滨(50.9 %)>成都(44.1%)>西安(32.2%)>石家庄(20.3%)。颈椎骨关节炎患病率随年龄增长而升高(P < 0.01);城乡比较差异无显著性意义(P > 0.05)。 结论：中国6个地区中老年男女人群X射线平片检测颈椎骨关节炎患病率均较高,地区、年龄、城乡分布有显著差异。     

广州地区常住人口精神障碍的患病率调查

目的 了解广州地区≥15岁人群各类精神障碍的患病率和分布特点.方法 2006年8月1～31日采取分层、整群和随机抽样法,使用复合性国际诊断交谈表3.0中文版(CIDI-3.0)对广州地区≥15岁的居民7418人完成访谈,其中"精神病性障碍"筛查阳性者由精神科医生按照美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)轴I障碍定式临床检查患者版(SCID-I/P)进行疾病诊断.结果 广州地区各类精神障碍加权时点患病率为4.33%,加权终生患病率为15.76%.在加权时点患病率中,排在前三位的是酒精使用障碍(1.38%)、重性抑郁障碍(0.80%)和精神分裂症(0.49%).各类精神障碍加权时点患病率农村明显高于城市(5.92%vs 3.73%,χ2=17.12,P＜0.001);酒精使用障碍男性明显高于女性(2.54%vs 0.17%,χ2=86.74,P＜0.001)、农村明显高于城市(2.19%VS 0.87%,χ2=20.65,P＜0.001);烟草依赖男性明显高于女性(0.50%vs 0.02%,χ2=17.78,P＜0.001);重性抑郁障碍、广泛性焦虑及未特定抑郁障碍女性明显高于男性(1.03%V8 0.59%,χ2=4.20,P=0.041;0.53%vs0.16%,χ2=6.88,P=0.009;0.43%vs 0.13%,χ2=5.75,P=0.016).结论 广州地区的精神卫生问题值得重视.其中,重性抑郁障碍、酒精使用障碍和精神分裂症患者是社区开展精神卫生服务中的重点人群.     

广州市城乡55岁及以上人群痴呆患病率调查

目的调查广州市城乡≥55岁人口痴呆的患病率。方法采用分层整群抽样方法,将广州市12个区市分为老城区、新城区、郊区,根据各层≥55岁的人口数占广州市相应年龄段人口总数的比例确定各层应查人数,实查5276人。调查采用筛查和确诊两阶段法,按美国精神障碍诊断和统计手册第4版的标准诊断痴呆。结果①查出痴呆患者183人,粗患病率为3.47%,其中阿尔茨海默病(AD)、血管性痴呆(VD)和其他痴呆的粗患病率分别为2.43%、0.85%和0.19%。年龄标化后的痴呆、AD和VD患病率分别为1.94%、1.28%和0.55%。②女性痴呆粗患病率高于男性(4.35%vs2.21%,P<0.001),二者的年龄标化患病率分别为1.12%、2.72%。痴呆患病率随年龄增长而上升。③农村人口的痴呆患病率(4.32%)高于城镇人口(3.27%),差异有统计学意义(P<0.01)。④文盲者的痴呆患病率(6.17%)较小学(2.68%)和初中及其以上(1.41%)文化程度者高(P<0.001)。结论AD是广州地区老人中主要的痴呆类型,VD次之。老年期痴呆患病率随年龄的增长而升高。文化程度低者痴呆患病率较高。     

北京市大兴区6～16岁中小学生抽动障碍的现况调查

目的 了解大兴区中小学生抽动障碍(TD)的流行病学分布及就医、治疗状况.方法 采用分层整群随机抽样法,从大兴区6～16岁中小学生中抽取部分学生进行TD的横断面调查.根据TD国内外研究现况,制定TD初筛问卷,收集学生临床资料,对筛查阳性者及学校教师或同学报告有类似症状者进行面谈及临床评估.采用美国精神障碍诊断与统计手册第4版中TD标准进行诊断和分类.结果 TD总患病率为2.26%.其中短暂性抽动障碍(TT)、慢性运动性抽动或发声抽动(CMVT)、发声与多种运动联合抽动障碍(TS)的患病率分别为1.05%、0.73%和0.47%.男生TD患病率3.39%,女生1.04%,差异有统计学意义(χ~2=23.883,P＜0.001),患病率比3.27:1(95%可信区问为2.00～5.60).TD的3种临床亚型的患病率均表现为男生高于女生(TTχ~2=12.808,P＜0.001;CMVT χ~2=6.042,P=0.014;TSχ~2=4.861,P=0.027);平均发病年龄(8.0±2.0)岁,发病高峰年龄为5.5～12.0岁;各年龄组患病率以8～9岁组最高.86例TD患者仅16例(19%)因抽动症状就医,就医者中仅5例得到正确诊治.结论 TD在大兴区中小学生中较多见,男生患病率高于女生.疾病早期就医率低,正确治疗率低.     

颈椎终板Modic改变分布特点与退变的关系

背景：关于Modic改变在腰椎中分布及特点的相关性研究比较多,而在颈椎中的相关研究则较少。 目的：分析颈椎终板Modic改变的临床分布特点,并探讨其发生与颈椎退变的相关性。 方法：随机抽取因颈肩痛行颈椎MRI和常规X射线检查的患者共200例,年龄20~83岁。记录MRI颈椎Modic改变发生的节段,改变类型,改变的位置等,并分析其发生与性别、年龄、椎间盘退变节段及程度、椎间隙高度、颈椎曲度的相关性。 结果与结论：200例共计1 200个颈椎椎间盘中23例(11.5%),29个(2.4%)个椎间盘邻近终板发生Modic改变。Ⅰ型8例(4%),10个椎间盘(0.8%);Ⅱ型13例(6.5%),16个椎间盘(1.3%);Ⅲ型2例(1.0%),3个椎间盘(0.25%)。按照各个椎间盘节段发病数统计,C2/3节段O个,C3/4节段4个,C4/5节段6个,C5/6节段12个,C6/7节段7个,C7/T1节段0个,发病率分别为0%,0.33%,0.5%,1.0%,0.58%,0%。结果表明颈椎终板也存在Modic改变的现象,但发生率较腰椎低,Ⅱ型最多见,Ⅰ型次之,Ⅲ型最为少见,多发生于C5/6椎间盘,多位于邻近终板的后方。50岁以上为其好发年龄,其发生与年龄、椎间盘退变、椎间盘节段及颈椎曲度之间存在相关性。     

郑州市卒中及其常见危险因素城乡流行现状对比

目的 研究郑州市40岁以上人群卒中患病率及其常见危险因素的城乡流行现状。 方法 以社区为基本单位进行整群抽样,纳入符合要求的郑州市40岁以上常住人口11 366例,采集 人口学、卒中危险因素、既往用药、体格检查和实验室检查等信息,用单因素和多因素Logistic回归分 析卒中及其常见危险因素的城乡差异。 结果 从2013年12月至2014年3月共纳入11 366例社区居民,其中卒中患者344例,卒中标化患病率农 村高于城市（3.3% vs 2.5%,Z =-2.649,P =0.004）,逐步调整各项影响因素后,卒中的患病率与居 住地为农村呈正相关（OR 1.77,95%CI 1.31～2.38）。心房颤动、明显超重或肥胖、缺乏运动和既往发 生过短暂性脑缺血发作的比例农村低于城市（P <0.001）,吸烟比例农村高于城市（P <0.001）。 结论 郑州市卒中及其危险因素的城乡差异显著,卒中防控工作应当针对当地卒中防控的薄弱环节, 制订更有针对性的卒中社区防治策略。     

青海省城乡社区中老年卒中患病率及危险因素研究

目的 了解青海省城乡中老年人群卒中患病率及卒中的人群和城乡分布特征,并进一步探讨发病的 危险因素。 方法 本研究采用整群抽样调查方法,对青海省西宁市中庄社区和民和县官亭镇40岁以上人群进 行卒中患病率和发病高危因素调查。收集问卷调查、体格检查、实验室化验、经颅多普勒（transcranial Doppler sonography,TCD）及颈动脉超声检查及头部影像检查资料,采用单因素和多因素Logistic回归方 法分析卒中发病的危险因素。 结果 共筛查40岁以上人群4100例,其中卒中患者314例,总患病率7.65%,其中城市居民的卒中患 病率明显高于农村（10.33% vs 4.85%,P =0.007)。城市居民男性卒中患病率高于女性（12.21% vs 8.00%,P =0.026)。多因素Logistic回归模型分析结果显示：高血压和增龄是本组研究人群卒中的危险 因素;其中城市居民卒中的危险因素包括增龄、高血压、高血脂;农村居民卒中的危险因素为高血压, 保护因素为体力劳动。 结论 青海省城乡社区卒中患病率处于较高水平,城乡居民卒中的危险因素有所不同。     

鲁北地区4～16岁学生注意缺陷多动障碍患病情况及其家庭环境调查

目的 了解鲁北地区低龄人群注意缺陷多动障碍(ADHD)的流行情况,并分析其家庭环境特征.方法 应用问卷调查和专科访淡相结合的方法 ,采用自制的注意力及多动问题量表和家庭环境量表-中文版(FES-CV)调查分层随机整群抽样的4～16岁学生8235名,ADHD的诊断依照美国精神障碍诊断和统计手册第四版(DSM-Ⅳ).家庭环境调查时选择550名与ADHD学生性别、年龄、班级、家庭经济状况相匹配的健康学生为对照组.结果 ①患病率:ADHD总患病率为6.3%(515/8235),其中男性患病率高于女性(8.1%vs 4.4%,P＜0.001);6～11岁组患病率高于4～5岁组(7.7%vs 6.1%,P=0.02)和12～16岁(7.7%vs 5.3%,P=0.002);②亚型分布:ADHD-1是4～16岁人群ADHD的主要类型,占56.3%;不同年龄组ADHD亚型分布差异有统计学意义(P＜0.001),高年龄组ADHD-1比例增加;4～5岁组不同性别的亚型分布差异有统计学意义(P＜0.001),男性以ADHD-HI为主,女性以ADHD-Ⅰ为主,6～11岁组、12～16岁组亚型分布的性别差异均无统计学意义(P＞0.05);③家庭环境:ADHD组FES-CV量表的亲密度、情感表达、知识性、道德宗教观、组织性分值低于正常组(P＜0.001),娱乐性和矛盾性分值高于正常组(P＜0.001).结论 6～11岁人群和男性的ADHD患病率较高,年龄和性别对亚型分布有影响,注意力缺陷是ADHD核心症状;ADHD患者的家庭环境差.     

“双心医学”模式下社区老年心脏病患者的抑郁症状

目的：探讨双心医学模式下社区老年常见心脏疾病与抑郁症状共患情况。方法采用横断面调查法,共调查771名社区老年患者,采用流调研究用抑郁量表（CES-D）调查抑郁症状,追踪老年患者的门诊或住院病历记录调查其心血管疾病：包括心绞痛、冠心病和高血压。结果心血管疾病（不包括高血压）总患病率为22.7%,其中冠心病为20.5%,心绞痛为10.9%;高血压患病率为49.3%。抑郁症状在所有心血管疾病患者中的发生率是20.9%。伴心血管疾病老年人的抑郁症状发生率（33.1%）高于无心血管疾病者（18.3%）,差异有统计学意义（χ^2=17.59,P〈0.001）;有冠心病者的抑郁症状发生率（34.8%）高于无冠心病者（18.3%）,差异有统计学意义（χ^2=20.25,P〈0.001）;有心绞痛疾病患者的抑郁症状发生率（34.5%）高于无心绞痛疾病者（20.1%）,差异有统计学意义（χ^2=9.19,P=0.002）;有高血压患者的抑郁症状发生率（25.0%）高于无高血压者（18.4%）,差异有统计学意义（χ^2=4.93,P=0.026）。结论社区老年人心血管疾病的罹患率高,在心血管疾病患者中抑郁症状的检出率比无心血管疾病患者高。需加强双心医学模式下对伴心血管疾患老年人的心理干预。     

“双心医学”模式下社区老年心脏病患者的抑郁症状（英文）

目的探讨双心医学模式下社区老年常见心脏疾病与抑郁症状共患情况。方法采用横断面调查法,共调查771名社区老年患者,采用流调研究用抑郁量表(CES-D)调查抑郁症状,追踪老年患者的门诊或住院病历记录调查其心血管疾病:包括心绞痛、冠心病和高血压。结果心血管疾病(不包括高血压)总患病率为22.7%,其中冠心病为20.5%,心绞痛为10.9%;高血压患病率为49.3%。抑郁症状在所有心血管疾病患者中的发生率是20.9%。伴心血管疾病老年人的抑郁症状发生率(33.1%)高于无心血管疾病者(18.3%),差异有统计学意义(χ2=17.59,P0.001);有冠心病者的抑郁症状发生率(34.8%)高于无冠心病者(18.3%),差异有统计学意义(χ2=20.25,P0.001);有心绞痛疾病患者的抑郁症状发生率(34.5%)高于无心绞痛疾病者(20.1%),差异有统计学意义(χ2=9.19,P=0.002);有高血压患者的抑郁症状发生率(25.0%)高于无高血压者(18.4%),差异有统计学意义(χ2=4.93,P=0.026)。结论社区老年人心血管疾病的罹患率高,在心血管疾病患者中抑郁症状的检出率比无心血管疾病患者高。需加强双心医学模式下对伴心血管疾患老年人的心理干预。     

Neuroimaging in epilepsy in tropics

Epilepsy is a major public health problem in many tropical countries. Also, some of the tropical diseases are major contributors to the higher prevalence of epilepsy in these countries. The etiologic factors responsible for epilepsy in these countries are quite different from those in the developed world. This article discusses the etiologic factors and neuroimaging of epilepsy in light of the conditions in these tropical countries.     

癫痫与抑郁关系的研究进展

抑郁是癫痫患者中常见的精神障碍,严重地影响了患者的生活质量。传统的观点认为癫痫患者因为存在着诸多社会学问题易出现抑郁倾向,癫痫和抑郁是单向的联系,但大量的研究已经证明癫痫和抑郁之间存在双向的联系,一种异常状态的存在可能易转化为另一种异常状态的发展。癫痫和抑郁存在着共同的发病机制。本文主要就癫痫和抑郁的双向联系以及抗抑郁药物在癫痫患者中的应用进行阐述。     

Sudanophilic lipid accumulation in astrocytes in periventricular leukomalacia in monkeys

Summary Sudanophilic lipid accumulation is a characteristic feature of periventricular leukomalacia (PVL) of infants. At least two types of lipid-containing cells have been identified, one being the macrophage, the other the pre-myelin glial cell. A third type of lipid-containing cell has been seen in two monkeys with spontaneous PVL. Electron microscopically this cell appears to be an astrocyte. This probably represents a reaction of the astrocyte to hypoxia and may be the equivalent of the hypertrophic astrocytes found in human infants.Supported in part by NIH grant HDO 8633 and the Regional Primate Research Center Grant RR-00166     

Increase in cathepsin D activity in rat brain in aging

Cathepsin D-like activity in homogenates of five brain areas of 3-month-old and 24-month-old Fischer 344 rats was measured. With hemoglobin as substrate at pH 3.2, more than 90% of the activity was inhibited by pepstatin. In each area studied, activity was more than twice as high in the old rat brain: 140-160% higher in the cortex, cerebellum, pons-medulla, and striatum and 90-100% higher in the hippocampus and spinal cord. The greatly increased metabolic capacity in the absence of an increase in protein turnover may have a role in age-related pathological degeneration in the brain.     

Characteristics of nociceptors in the periodontium--an in vitro study in rats

Recent studies have indicated that nociceptors can be classified into various types according to their physiological properties. These studies have clarified that the frequency distribution of various nociceptor types is different among body sites and animal species. In the present study, we investigated the physiological properties of rat's periodontal nociceptors in an in vitro jaw-nerve preparation. Responses were recorded from functional single filaments in the inferior alveolar nerve. To determine the nociceptor type, calibrated von Frey filaments, heat, and bradykinin (BK) stimuli were used. We found five subtypes of nociceptors in the periodontal ligaments of the lower incisor: Adelta-high threshold mechanonociceptors (Adelta-HTM, n=28), Adelta-mechanoheat nociceptors (Adelta-MH, n=6), Adelta-polymodal nociceptors (Adelta-POLY, n=26), C-high threshold mechanonociceptors (C-HTM, n=3) and C-polymodal nociceptors (C-POLY, n=4). Most nociceptors were Adelta-innervated, while only a small number of C-innervated nociceptors were found. The present results suggest that periodontal nociceptors transmit mainly fast pain, and may thus play a role in rapid detection of injure-related stimuli during mastication.     

Defects in Bioenergetic Coupling in Schizophrenia

Synaptic neurotransmission relies on maintenance of the synapse and meeting the energy demands of neurons. Defects in excitatory and inhibitory synapses have been implicated in schizophrenia, likely contributing to positive and negative symptoms as well as impaired cognition. Recently, accumulating evidence has suggested that bioenergetic systems, important in both synaptic function and cognition, are abnormal in psychiatric illnesses such as schizophrenia. Animal models of synaptic dysfunction demonstrated endophenotypes of schizophrenia as well as bioenergetic abnormalities. We report findings on the bioenergetic interplay of astrocytes and neurons and discuss how dysregulation of these pathways may contribute to the pathogenesis of schizophrenia, highlighting metabolic systems as important therapeutic targets.     

Gender in Voice Perception in Autism

Deficits in the perception of social stimuli may contribute to the characteristic impairments in social interaction in high functioning autism (HFA). Although the cortical processing of voice is abnormal in HFA, it is unclear whether this gives rise to impairments in the perception of voice gender. About 20 children with HFA and 20 matched controls were presented with voice fragments that were parametrically morphed in gender. No differences were found in the perception of gender between the two groups of participants, but response times differed significantly. The results suggest that the perception of voice gender is not impaired in HFA, which is consistent with behavioral findings of an unimpaired voice-based identification of age and identity by individuals with autism. The differences in response times suggest that individuals with HFA use different perceptual approaches from those used by typically developing individuals.     

Ethnic disparities in problem behaviour in adolescence contribute to ethnic disparities in social class in adulthood

BACKGROUND: It is important for prevention of social class disparities to know how ethnic disparities in social class arise among migrant children. We contribute to this understanding by examining the role of problem behaviour in adolescence. METHODS: Prospective observational study with 753 Dutch native and 217 Turkish migrant adolescents (11-18 year) followed for 10 years. Internalising and externalising problems were assessed in adolescence and employment status and occupational level were assessed in adulthood. The difference in odds ratios (OR) before and after adjustment for internalising and externalising problems was an indication of the predictive value of disparities in internalising and externalising problems for the development of social class disparities. RESULTS: A total of 135 (62%) of the Turkish and 602 (80%) of the Dutch adults were employed. Internalising and externalising problems were not associated with employment status. Of the employed, 65 (48%) Turkish and 179 (30%) Dutch adults worked in low-level occupations (p < 0.0001). Internalising and externalising problems were associated with both ethnicity and occupation. The OR for low-level occupation for Turkish adults was 1.78 (1.19-2.65), indicating ethnic disparities. Adjustment for internalising problems lowered the OR with 36% to 1.50 (0.97-2.31), and adjustment for externalising problems lowered it with 8% to 1.72 (1.15-2.57). Findings were similar for men and women and did not vary by age. CONCLUSIONS: Ethnic disparities in occupational level in adulthood could partly be attributed to disparities in mental health between Turkish migrants and Dutch natives in adolescence. Prevention of ethnic disparities in mental health at young age may therefore also contribute to the prevention of occupational differences in adulthood.     

Progress in neuroprotection in Parkinson's disease

Slowing or aborting the progress of neurodegeneration in Parkinson's disease (PD) remains the most important unmet need of this disorder. There are several recent developments in trial design and also in drugs under investigation for possible neuroprotective effect. Emphasis has been placed on clinical as opposed to imaging end-points and these include change in a clinical rating scale, e.g. United Parkinson's disease Rating Scale (UPDRS), or time to additional therapy. The introduction of the delayed-start, or wash-in, trial design adds an additional dimension to drug evaluation for neuroprotection. Compounds that have been recently tested in clinical trial include the monoamine oxidase-B inhibitor rasagiline, the anti-apoptotic agents TCH346 and CEP1347, and the promitochondrial agent creatine. The dopamine agonists have been evaluated for a neuroprotective effect using imaging end-points. Perhaps the most important and simplest concept for neuroprotection has been the theory that early dopaminergic support for the degenerating dopaminergic system per se provides significant long-term clinical benefit for PD patients.     

Changes in parasympathetic system in medulla oblongata in male pigs in the course of tachycardia-induced cardiomyopathy

Background

Autonomic imbalance constituting a fundamental feature of heart failure (HF) has been assessed mainly at the periphery. Changes in the functioning of autonomic centers in the brain remain unclear. We investigated the molecular elements of parasympathetic system, i.e. α7 nicotinic acetylcholine receptor (α7nAChR) and enzymes metabolizing acetylcholine (acetylcholinesterase, AChE, choline acetyltransferase, ChAT) in medulla oblongata (MO) of male pigs with chronic tachycardia-induced cardiomyopathy.

Methods

The mRNA levels of AChE, ChAT, α7nAChR and X-box binding protein 1 (spliced form, XBP1s) in MO were analyzed using qPCR, AChE and ChAT activities using spectrophotometry, proteasome activity using fluorometry, and the protein level of α7nAChR using Western blotting.

Results

The development of systolic HF was accompanied by an increase in circulating catecholamines, a decrease in the AChE and α7nAChR mRNA in MO, an increase in AChE activity (all p < 0.05), and no change in either the mRNA or activity of ChAT. Both circulating catecholamine levels and AChE activity were inversely related to systolic function of left myocardial ventricle (p < 0.05). The level of α7nAChR protein in MO and its cytoplasmatic fraction were higher in pigs with moderate and severe HF as compared to the other animals (p < 0.01). There was no difference in proteasome activity in MO between diseased and healthy animals, whereas the XBP1s mRNA decreased during HF progression (p < 0.05).

Conclusions

Molecular elements of parasympathetic system are changed within the medulla oblongata during the progression of systolic non-ischemic heart failure in male pigs, indicating a functional link between MO and heart in HF.