精神分裂症一级亲属认知功能与血小板5-羟色胺浓度的相关研究

目的探讨精神分裂症患者一级亲属认知功能及血小板内5-羟色胺(5-HT)浓度,并探讨两者之间的关联.方法共收集精神分裂症单发家系27个,其中先证者22名(另5名先证者无法配合测验)、一级亲属62名;高发家系15个,其中先证者15名、共病一级亲属10名、无精神病一级亲属29名;对照家系15个,其中对照者15名、一级亲属35名.对所有受试分别采用威斯康星卡片分类测验和持续注意测验评估其执行功能及持续注意,采用HPLC-荧光法检测外周血血小板内5-HT浓度.结果分裂症一级亲属的WCST、持续注意测验成绩明显差于对照组;高发家系亲属组的各项神经心理学测验成绩最差,单发家系组成绩介于高发家系与对照组之间.如持续错误个数:高发家系亲属24.52＞单发家系亲属21.03＞对照亲属18.49.单发家系一级亲属血小板内5-HT浓度为(2.82±1.23)mmol/L、高发家系为(3.05±1.38)mmol/L,均显著低于对照组的(3.60±1.48)mmol/L(P＜0.05),但未发现此种浓度差异与认知功能损害存在关联.结论精神分裂症一级亲属存在一定程度的认知功能损害,且随遗传负荷的增加而加重,其血小板内5-HT浓度呈一种倾向性改变,但两者间无显著相关性.     

缓解期的精神分裂症患者及其一级非患病亲属的认知功能比较分析

目的 了解缓解期精神分裂症患者及一级非患病亲属的认知功能,找寻认知功能中具有内表型特征的项目.方法 对86名缓解期精神分裂症患者(患者组),86名患者的一级非患病亲属(亲属组)及86名健康人(对照组)使用精神分裂症认知功能成套测验工具进行认知功能测验.结果 患者组和亲属组的连线测验、符号编码、霍普金斯词语学习测验、迷宫、流畅性、情绪智商和持续操作性得分低于对照组(P＜0.05).患者组霍普金斯词语学习测验、迷宫、情绪智商和持续操作性得分低于亲属组(P＜0.05).结论 缓解期患者和其一级非患病亲属的认知功能存在选择性缺陷,其中词语学习、注意/警觉、推理和问题解决及社会认知可能是精神分裂症潜在的内表型.     

偏执型精神分裂症患者一级亲属的神经认知功能指标研究

目的:研究偏执型精神分裂症患者一级亲属神经认知功能指标的情况。方法:将本院偏执型精神分裂症患者一级亲属60例作为研究对象,设为研究组,另将普通人60例作为参照对象,设为对照组。两组入选者均进行持续注意测验、威斯康辛卡片分类测验、木块图测验、数字广度测验、Stroop颜色干扰测验,比较两组入选者的神经认知功能情况。结果:研究组持续注意测验、威斯康辛卡片分类测验、木块图测验、数字广度测验、Stroop颜色干扰测验结果均优于对照组,差异均有统计学意义(P0.05)。结论:偏执型精神分类症患者一级亲属存在不同程度的神经认知功能缺陷。     

住院精神分裂症病人一级亲属认知功能研究

目的探讨住院精神分裂症病人一级亲属的认知功能。方法采用威斯康星卡片分类测验(WCST)、韦氏记忆量表修订版(WMS-RC)与持续操作测验(CPT)对100例住院精神分裂症病人的一级亲属(亲属组)与90例对照者(对照组)认知功能进行评估。结果亲属组WCST中总测验次数、持续错误数、随机错误数及分类数等均显著高于对照组(t=9.587～83.278,P<0.01);但亲属组WMS-RC、CPT评分与对照组比较差异无显著性(P>0.05);亲属组WCST中有认知功能障碍例数显著高于对照组(χ2=25.82,P<0.01),而两组WMS-RC、CPT中有认知障碍的例数比较差异无显著性(P>0.05)。WCST中的持续错误数与MQ得分、CPT得分无显著相关性(P>0.05),WCST中的持续错误数、MQ及CPT得分与病人性别、年龄及文化程度之间无显著相关性(P>0.05)。结论部分精神分裂症病人的一级亲属存在认知功能缺陷,必要时应进行心理干预。     

首发精神分裂症患者及不同样本健康一级亲属的认知功能研究

目的 探讨首发精神分裂症患者及不同样本首发精神分裂症患者健康一级亲属的认知功能特点.方法 对52例首次发作未接受过抗精神病药物治疗的精神分裂症患者（患者组）、48例不同样本来自不同于患者组的另一组首发精神分裂症的健康一级亲属（亲属组）及50例健康志愿者（对照组）,采用数字划销测验、连线测验、数字广度测验、视觉再生、言语流畅性测验、威斯康辛卡片分类测验和汉诺塔测验评定注意、记忆及执行功能.结果 三组间数字划销测验净分、连线测验A时间及B时间、数字广度倒背及总分、视觉再生总分、言语流畅性音位及语义、威斯康辛卡片分类测验（WCST）总错误数及持续错误数、汉诺塔测验所有指标的差异有统计学意义（P ＜0.05或P＜0.01）.两两比较发现,患者组的上述所有指标和亲属组除连线测验A时间外的上述指标均差于对照组（P ＜0.05或P＜0.01）,但亲属组数字划销测验净分、连线测验A时间及B时间、视觉再生总分、言语流畅性音位及语义、WCST总错误数及持续错误数的成绩要好于患者组（P＜0.05或P＜0.01）.结论 首发精神分裂症患者存在广泛的认知功能损害,且来自不同家族的健康一级亲属也存在不同程度的认知功能损害,提示认知功能受损可能是精神分裂症遗传易感性的生物学指标.     

青少年期与成年期发病精神分裂症一级亲属认知功能对照研究

目的 探讨青少年期与成年期发病精神分裂症患者健康一级亲属认知功能损害的差异. 方法 选取年龄、性别、文化程度等匹配的青少年期发病精神分裂症患者一级亲属49例、成年期发病患者一级亲属50例及健康对照50例,利用Stroop测验、威斯康辛卡片分类测验（WCST）、字母划消测验及数字倒背测验,测评上述健康被试的注意、记忆及执行功能.结果 威斯康辛卡片分类测验结果中,完成分类数及持续错误数三组间差异有统计学意义（均P ＜0.05）,其中完成分类数两亲属组差异有统计学意义（P＜0.05）.Stroop测验中色-词项目三组间差异有统计学意义（P＜0.01）,两亲属组间差异有统计学意义（P＜0.01）.字母划消及数字倒背测验中,三组遗漏数及倒背数差异均有统计学意义（P分别＜0.01和＜0.05）,遗漏数项目两亲属组差异有统计学意义（P＜0.05）. 结论 精神分裂症患者健康一级亲属注意稳定性、注意灵活性及注意分配功能下降,工作记忆及执行功能均受损.且在额叶执行功能、注意分配功能及注意稳定性方面,青少年期发病精神分裂症患者一级亲属较成年期发病者一级亲属受损更严重.     

精神分裂症和抑郁症患者及其Ⅰ级亲属认知功能的比较研究

目的研究精神分裂症、抑郁症患者及其Ⅰ级亲属的认知功能。方法采用词汇测验、木块图测验、逻辑记忆测验、视觉再生测验、Benton线方向判断测验、威斯康星卡片分类测验等评估认知功能。结果1.精神分裂症、抑郁症患者在词汇测验、木块图测验、逻辑记忆测验、视觉再生测验、Benton线方向判断测验、威斯康星卡片分类测验方面差于正常对照,亦分别差于其Ⅰ级亲属。2.精神分裂症患者Ⅰ级亲属与抑郁症Ⅰ级亲属间仅在智商[(99.46±11.63)分Vs(105.13±10.56)分]、WCST的持续错误数[(30.15±19.69)分Vs(22.75±18.75)分]方面有差异。3.精神分裂症Ⅰ级亲属在词汇、智商、视觉再生、逻辑记忆以及WCST的总应答数、持续错误数方面较正常对照差,抑郁症患者Ⅰ级亲属仅在词汇[(11.45±1.55)分Vs(12.05±2.35)分]、视觉再生[(9.36±2.47)分Vs(10.87±2.50)分]、逻辑记忆[(12.45±3.67)分Vs(16.12±4.25)分]以及WCST的总应答数[(110.06±6.62)分Vs(105.81±20.88)分]方面较正常对照差。结论精神分裂症、抑郁症患者存在认知功能损害,前者较后者更严重;精神分裂症、抑郁症Ⅰ级亲属存在不同程度的认知功能损害,认知功能受损具有一定的遗传特质性。     

精神分裂症和抑郁症患者及其Ⅰ级亲属认知功能的比较研究

目的研究精神分裂症、抑郁症患者及其Ⅰ级亲属的认知功能.方法采用词汇测验、木块图测验、逻辑记忆测验、视觉再生测验、Benton线方向判断测验、威斯康星卡片分类测验等评估认知功能.结果1.精神分裂症、抑郁症患者在词汇测验、木块图测验、逻辑记忆测验、视觉再生测验、Benton线方向判断测验、威斯康星卡片分类测验方面差于正常对照,亦分别差于其Ⅰ级亲属.2.精神分裂症患者Ⅰ级亲属与抑郁症Ⅰ级亲属间仅在智商[(99.46±11.63)分Vs(105.13±10.56)分]、WCST的持续错误数[(30.15±19.69)分Vs(22.75±18.75)分]方面有差异.3.精神分裂症Ⅰ级亲属在词汇、智商、视觉再生、逻辑记忆以及WCST的总应答数、持续错误数方面较正常对照差,抑郁症患者Ⅰ级亲属仅在词汇[(11.45±1.55)分Vs(12.05±2.35)分]、视觉再生[(9.36±2.47)分Vs(10.87±2.50)分]、逻辑记忆[(12.45±3.67)分Vs(16.12±4.25)分]以及WCST的总应答数[(110.06±6.62)分Vs(105.81±20.88)分]方面较正常对照差.结论精神分裂症、抑郁症患者存在认知功能损害,前者较后者更严重;精神分裂症、抑郁症Ⅰ级亲属存在不同程度的认知功能损害,认知功能受损具有一定的遗传特质性.     

精神分裂症患者一级亲属执行功能测验初步研究

目的:探讨精神分裂症患者一级亲属的执行功能。方法:采用威斯康星分类卡片测验(Wisconsin Card Sorting Test,WSCT)对精神分裂症患者的一级亲属50例和健康对照者50例的执行功能进行评估。结果:在WSCT测验中,精神分裂症患者一级亲属的持续性应答数和持续性错误数、完成第一个分类所需应答数明显高于正常对照;而完成分类数、正确应答数、概念化水平百分比均明显低于正常对照,差异具有统计学意义(P<0.01)。结论:精神分裂症患者一级亲属可能存在执行功能受损,这是否与遗传或者共同的生活环境有一定关系,尚需更严格的研究证实。     

精神分裂症一级亲属认知功能缺陷的研究与干预

目的：探讨精神分裂症一级亲属认知功能缺陷及其干预。方法：对收集的130例精神分裂症一级亲属（研究组）与117例对照者（对照组）采用威斯康星卡片分类测验（WCST）与持续操作测验（CPT）评估与比较其认知功能,并将有认知功能缺陷的精神分裂症一级亲属随机分为空白干预组（A1）和心理干预组（A2）进行干预前、干预12周末与1年后的评估与比较。结果：（1）研究组在WCST的总测验次数、持续错误数、随机错误数等方面均显著高于对照组（P〈0．01）,但在CPT中两组间差异无显著性（P〉0．05）;研究组在WCST中有认知功能缺陷的例数显著高于对照组（P〈0．01）,而在CPT中两组间差异无显著性（P〉0．05）;在WCST中的持续错误数和CPT的得分与文化程度、性别、年龄的相关性无显著意义（P〉0．05）,且WCST的持续错误数与CPT的得分的相关性也无显著意义（P〉0．05）;（2）A1、A2两组在干预前的各项指标均无显著性差异（P〉0．05）;在干预12周末与1年后评估,A1组与干预前无显著差异（P〉0．05）,A2组在WCST的总测验次数、持续错误数等方面均显著高于干预前（P〈0．05）,且A1、A2两组间在WCST的持续错误数差异有极显著性（P〈0．01）,但在CPT中两组干预前后及组间的得分差异无显著性（P〉0．05）。结论：部分精神分裂症一级亲属存在认知功能缺陷;心理干预对精神分裂症一级亲属的认知功能缺陷有明显改善作用,对精神分裂症一级亲属有认知功能缺陷者进一步发展成为精神分裂症具有预防作用,展现了精神分裂症的早期发现、早期干预与治疗的新前景。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.