首发精神分裂症治疗前后细胞因子水平的变化

目的 :探讨典型、非典型抗精神病药对精神分裂症细胞因子的影响以及I型、II型患者免疫功能的差异。方法 :3 8例首发精神分裂症 (其中I型 2 0例 ,II型 18例 )用固定剂量的氯氮平、氯丙嗪进行 8周治疗 ,采用放射免疫法对治疗前后血浆白细胞介素 1β (IL -1β)、白细胞介素 2 (IL -2 )、白细胞介素 6(IL -6)、α -肿瘤坏死因子 (TNFα)进行了检测 ,同时以简明精神病评定量表、阳性症状评定量表和阴性症状评定量表测查精神分裂症患者。以 2 0例健康人为对照。结果 :氯氮平、氯丙嗪治疗均仅显著降低精神分裂症过高的IL -2水平 (P <0 0 5 ) ;I型患者治疗后IL -2水平显著低于疗前 (P <0 0 5 ) ;II型患者治疗后IL-1β水平显著低于疗前 (P <0 0 5 )。 结论 :非典型和典型抗精神病药对精神分裂症激活的免疫应答均产生一定程度的抑制作用 ;细胞因子水平的变化可能与精神分裂症的亚型有关     

利培酮与氯氮平对女性首发精神分裂症患者血脂的影响

目的 探讨利培酮与氯氮平对女性首发精神分裂症患者血脂的影响.方法 将55例女性首发精神分裂症患者随机分为利培酮组25例,氯氮平组30例,于治疗前及治疗8周末检测血脂水平并进行比较.结果 氯氮平组治疗后甘油三脂(TG)、总胆固醉(TC)、低密度脂蛋白胆固醇(LDL)、载脂蛋白B(APOB)明显升高(P＜0.05),高密度脂蛋白胆固醇(HDL)明显降低,利培酮组治疗后TG、APOB明显升高,而TC、LDL、HDL治疗前后无明显变化.结论 利培酮、氯氮平均可导致女性首发精神分裂症患者的血脂异常.利培酮较氯氮平对血脂影响较小.临床用药时应注意监测血脂的变化,及早采取相应的预防措施.     

利培酮和氯氮平治疗儿童少年精神分裂症患者疗效与安全性比较

目的评价氯氮平和利培酮治疗儿童少年精神分裂症的疗效和安全性。方法145例儿童少年精神分裂症患者被随机分为氯氮平组（73例）和利培酮组（72例）,住院治疗8周,用阳性与阴性症状量表（PANSS）和临床疗效总评量表（CGI）评定临床疗效,用副反应量表（TESS）评价安全性。结果在治疗4周和8周末,氯氮组患者阳性因子减分率均显著高于利培酮组（t=2．828,3．381,P〈0．01）,其它因子分及PANSS总分减分率两组患者比较均无显著差异（P〉0．05）;CGI疗效评定标准比较显示,氯氮平治疗效果优于利培酮（Ridit分析,μ=2．425,2．223,P〈0．05）。利培酮治疗无效的患者换用氯氮平治疗后50％有效,氯氮平治疗无效的患者换用利培酮治疗后20％有效。氯氮平的不良反应主要有心动过速、心电图异常、白细胞下降、嗜睡、流涎、尿失控、头昏和癫痫发作,利培酮的不良反应主要有急性锥体外系反应和嗜睡;氯氮平组有9．6％的患者、利培酮组有2．8％的患者因不能耐受副反应退出治疗。结论氯氮平和利培酮均是有效的治疗儿童精神分裂症的药物,氯氮平的治疗效果、特别在改善阳性症状方面优于利培酮,但利培酮较氯氮平副作用少,安全性高。     

齐拉西酮与利培酮治疗青少年首发精神分裂症的对照研究

目的:比较齐拉西酮与利培酮治疗青少年首发精神分裂症的疗效与安全性。方法:将140例13~18岁首发精神分裂症患者随机分为齐拉西酮组与利培酮组,每组70例,分别给予齐拉西酮与利培酮治疗8周,于治疗前及治疗2、4、8周末采用阳性与阴性量表(PANSS)评定疗效,药物不良反应量表(TESS)评定不良反应,分别在治疗前及治疗药物达到临床最大剂量进行心电图检查,对心电图QT/QTC间期进行对比分析。结果:治疗8周后齐拉西酮组痊愈率34.3%,有效率77.1%,利培酮痊愈率32.9%,有效率75.7%,两组疗效比较差异无统计学意义(P0.05);两组治疗后PANSS评分均明显低于治疗前(P0.01),且两组间PANSS减分率差异无统计学意义;齐拉西酮组不良反应发生率21.3%,利培酮组发生率为38.5%,两组差异有统计学意义(P0.05);齐拉西酮组治疗后QT间期较治疗前显著延长,差异有显著统计学意义(t=-4.330,P=0.000),QTC间期较治疗前虽然延长,但无统计学意义(P0.05),利培酮组治疗后QT/QTC间期变化与治疗前比较,差异无统计学意义(P0.05)。结论:齐拉西酮与利培酮治疗青少年首发精神分裂症的疗效相当,但齐拉西酮不良反应少。     

氯氮平和利培酮对精神分裂症患者体重和血糖的影响

目的 探讨氯氮平和利培酮对精神分裂症患者体重和血糖的影响。方法 50例首发精神分裂症患者随机分为2组,分别给予利培酮和氯氮平的治疗,疗程8周,两组惠者治疗前及治疗后2、4、6、8周末观察体重压血糖,分析其变化。结果 氯氮平组体重明显增加,平均增重4.6kg,治疗前后经统计学处理,有非常显著性差异（P〈0．01）,利培酮组体重增加1．5kg,差异有显著性（P〈0．05）。结论 氯氮平和利培酮均能引起体重增加,但利培酮的影响较轻,氯氮平还能引起血糖升高,其发生与体重增加有关,应予以关注。     

抗精神病药物对儿童少年精神分裂症患者血浆白细胞介素-6的影响

目的探讨抗精神病药物对儿童少年精神分裂症患者白细胞介素-6(IL-6)的影响及IL-6与精神病理的关系。方法对41例儿童少年首发精神分裂症患者用酶联免疫吸附法检测抗精神病药物治疗前后IL-6血浆水平,用健康儿童少年作对照,并用阳性和阴性症状量表(PANSS)评估精神症状及其变化。结果治疗前患者组血浆IL-6水平显著高于正常对照组,治疗后4、8周末IL-6水平显著低于治疗前。治疗后4周末IL-6水平与阳性症状呈正相关,治疗后4、8周末一般病理分减分率、治疗后8周末PANSS总分减分率与IL-6减分率呈正相关。结论儿童少年精神分裂患者存在细胞免疫异常,抗精神病药物对儿童少年精神分裂症患者有免疫抑制作用,血浆IL-6与精神分裂症精神病理之间有一定的关系。     

齐拉西酮治疗青少年首发精神分裂症的临床疗效及安全性

目的 比较齐拉西酮与利培酮治疗青少年首发精神分裂症的临床疗效与不良反应.方法 将97例13～18岁的首发精神分裂症患者随机分为两组,齐拉西酮组49例与利培酮组48例治疗,疗程均为8周.采用阳性与阴性症状量表(PANSS)评估药物的有效性;采用副反应量表(TESS)、血清泌乳素、糖代谢、脂代谢等测查数据评估药物安全性及不良反应.结果 治疗8周后,齐拉西酮组有效率85.7％,利培酮组有效率87.5％,两组PANSS评分均明显低于治疗前(t=8.69,9.82;P＜0.001),且两组间PANSS减分率差异没有统计学意义(t=0.580,P＞0.05).齐拉西酮组未发现月经紊乱及体重增加;利培酮组发现11倒月经紊乱(x2=12.67,P=0.0001),8例体重增加(x2=8.71,P＜0.005),显著高于齐拉西酮组.锥体外系不良反应,齐拉西酮组明显少于利培酮组(x2=4.62,P＜0.05).结论 齐拉西酮与利培酮治疗青少年首发精神分裂症均有确切的临床疗效,但齐拉西酮的不良反应较少,安全性高.     

利培酮与阿立哌唑对女性首发精神分裂症患者雌二醇水平影响

目的:观察利培酮和阿立哌唑对女性首发精神分裂症患者血清雌二醇(E2)水平和疗效影响。方法:收集138例符合入组标准的女性首发精神分裂症患者,用简单随机法分为利培酮组和阿立哌唑组,分别在基线时和治疗后1月、3月、6月末,检测血清E2水平,并评定阳性和阴性症状量表(PANSS)和副反应量表(TESS);同时检测健康对照组的血清E2水平。结果:共入组利培酮组70例(治疗6月末脱落20例)、阿立哌唑组68例(治疗6月末脱落18例)、健康对照组30例。基线时,利培酮组和阿立哌唑组的E2水平且均显著低于健康对照组(t=-2.804,-2.748;P0.01);治疗后,利培酮组E2水平进一步降低,患者的E2水平在治疗1月、3月、6月末均显著低于基线时(t=-7.617,-7.613,-5.262;P0.01),阿立哌唑组的E2水平逐渐升高,患者的E2水平在治疗1月、3月、6月末均显著高于基线时(t=6.309,4.963,4.967;P0.01);研究组患者的PANSS评分随治疗时间延长逐渐下降(P0.01),同时TESS评分逐渐升高(P0.01)。研究组患者在基线时E2水平与阴性症状量表评分呈负相关(r=-0.279,P=0.028)。结论 :女性首发精神分裂症患者E2水平异常;阴性症状可能与较低的E2水平有关;阿立哌唑和利培酮治疗精神分裂症疗效相当,而阿立哌唑可升高患者E2水平,且副作用小。     

小剂量氨磺必利联合利培酮治疗首发精神分裂症阴性症状随对照研究

目的 比较小剂量氨磺必利联合利培酮和单用利培酮治疗精神分裂症阴性症状的疗效.方法 住院首发精神分裂症患者,经利培酮治疗6周后使用阳性和阴性症状量表(PANSS)评定,阴性症状量表分≥20分78人,被随机分为小剂量氨磺必利联合利培酮治疗组(联用组)和利培酮治疗组(对照组).于基线和治疗8周后评定PANSS量表、卡尔加精神分裂症抑郁量表(CDSS)评定临床疗效,Simpson锥体外系副反应评定量表(SEPS)评定锥体外系副反应.结果 治疗8周后两组有效率分别为94.6％和77.8％,差异有统计学意义(x2＝4.365,P=0.037),实验组PANSS阴性量表减分(P=0.000)、CDSS减分(P=0.019)大于对照组,差异有统计学意义,两组SEPS无明显差异.结论 小剂量氨磺必利联合利培酮治疗精神分裂症阴性症状疗效更好.     

利培酮和氯氮平对儿童精神分裂症患者血清IL-6的影响

近年来越来越多的研究表明细胞因子在精神分裂症中起重要作用，但对儿童精神分裂症细胞因子的研究较少。本研究动态观察了儿童首发精神分裂患者在氯氮平和利培酮治疗前及治疗后4、8周和6月末血清IL-6水平变化。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.