三唑仑对失眠症患者睡眠脑电的影响

目的应用多导睡眠图(PSG)探讨三唑仑对失眠症患者睡眠脑电活动的影响.方法对28例失眠症患者连续进行4夜PSG描记,其中第3、4晚上睡前予0.5mg三唑仑,观察用药后PSG的变化.正常对照组33名,作2夜适应和基础PSG监测.结果失眠症患者服用三唑仑后夜间PSG显示睡眠效率提高[基线睡眠值(86±9)%,第3晚服药后(91±8)%,第4晚服药后(92±4)%,F值6.143,P＜0.01],觉醒时间减少[同前,(39±17)min,(29±8)min,(23±7)min,F值13.211,P＜0.01],S1减少[同前,(31±18)%,(23±11)%,(16±6)%,F值9.707,P＜0.01],S2增加[同前,(45±17)%,(59±18)%,(60±6)%,F值10.104,P＜0.01],睡眠潜伏期缩短[同前,(35±18)min,(28±17)min,(21±11)min,t值4.947,P＜0.05].结论短半衰期催眠药三唑仑不仅能改善患者对睡眠的主观评价,还对夜间睡眠脑电有影响.     

抑郁症患者的Quisi试验研究

目的　探讨Quisi在抑郁症辅助诊断中的价值。方法　应用德国Quisi仪 ,对 2 4例抑郁症患者 (抑郁症组 )的睡眠脑电进行 2次全夜测试 ,并与 2 1名正常受试者 (正常对照组 )进行对照。结果　 (1)抑郁症组在第 1夜的各项指标中 ,仅总记录时间短于第 2夜 [分别为 (478 1± 2 7 4 )min和(499 5± 2 5 7)min ;P <0 0 1]。 (2 )抑郁症组与正常对照组比较 ,睡眠潜伏期长 [分别为 (34 5± 17 9)min和 (2 3 9± 17 4 )min ;P <0 0 5 ],觉醒时间长 [分别为 (39 8± 2 1 9)min和 (19 3± 14 9)min],睡眠效率低 [分别为 (83 7± 6 9) %和 (93 3± 5 1) % ],睡眠维持率低 [分别为 (88 8± 9 1) %和 (99 8±4 9) % ],REM睡眠潜伏期短 [分别为 (6 9 9± 16 3)min和 (88 6± 15 9)min],第二阶段百分比高 [分别为 (5 5 3± 11 9) %和 (47 5± 7 8) % ;P <0 0 5 ],第三阶段百分比高 [分别为 (8 9± 6 9) %和 (14 1±6 1) % ],REM睡眠百分比低 [分别为 (10 1± 5 9) %和 (16 9± 5 1) % ],伪迹百分比高 [分别为 (3 9±1 3) %和 (1 9± 0 8) % ],P <0 0 5或P <0 0 1。结论　Quisi适合于全夜监测。在缺乏相关设备的基层医院 ,Quisi技术可用于对抑郁症的检测。     

失眠症的整夜多导睡眠图监测

目的探索建立失眠症的多导睡眠图(PSG)模式.方法应用日本Nihon Kohden公司的Neurofax-1518K多导睡眠生理仪,采用眼电图和下颌肌电图及脑电图技术,对39例失眠症患者和33名正常对照者进行PSG全夜监测.结果与正常组相比,失眠症组的PSG表现为睡眠总时间减少(正常组464.1±22.9分,失眠症组359.7±31.5分,P＜0.01),睡眠潜伏期延迟(正常组19.9±9.8分,失眠症组31.5±18.4分,P＜0.01),醒觉次数多(正常组1.4±0.7次,失眠症组4.9±2.1次,P＜0.01),睡眠效率低(正常组94.6±5.1%,失眠症组84.7±8.3%,P＜0.01),第一阶段睡眠增加(正常组9.1±1.9%,失眠症组27.9±17.9%,P＜0.01),第二阶段睡眠下降(正常组56.2±4.7%,失眠症组45.9±17.7%,P＜0.01),第3,4阶段睡眠降低(正常组16.7±4.9%,失眠症组9.1±5.1%,P＜0.01),REM睡眠潜伏期缩短(正常组87.8±11.7分,失眠症组53.8±19.7分,P＜0.01).此外,失眠症组有8例(N=8/39,20.5%)的睡眠潜伏期和睡眠效率综合分析正常,但患者主诉"无睡眠感",有"主观性失眠"存在.结论失眠症患者PSG存在睡眠进程、睡眠结构和REM值的变化.睡眠潜伏期延迟和慢波睡眠S1增加具有更高的临床价值.本组研究还发现失眠症患者中有一部分对象可能属于"主观性失眠".     

唑吡坦对失眠症患者睡眠影响的多导睡眠图研究

目的 应用多导睡眠图(PSG)探讨唑吡坦对失眠症患者睡眠脑电活动的影响.方法 对27例符合国际疾病分类标准第10版(ICD-10)非器质性失眠症诊断标准的患者连续进行3晚PSG描记,其中第3晚睡前予10 mg唑吡坦,观察用药后PSG的变化.正常对照组33名,作1夜适应和1夜基础PSG监测.结果 与基线睡眠比较,患者服用唑吡坦后睡眠效率提高[(91%±4%)vs(87%±8%),P＜0.05],觉醒时间减少[(24±6)min vs(39±16)min,P＜0.01],S1减少[(18%±6%)vs(30%±18%),P＜0.01],S2增加[(60%±5%)vs(44%±18%),P＜0.01],睡眠潜伏期缩短[(36±18)min vs(22±11)min,P＜0.01].结论 唑吡坦对失眠症患者夜间多导睡眠图脑电有影响.     

精神分裂症首次发病患者的睡眠Quisi研究

目的建立一种简便、快速检测分析睡眠脑电的新方法，并探讨精神分裂症首次发病（以下简称首发）患者睡眠Quisi特点。方法对50例首发精神分裂症患者（患者组）和44名正常受试者（正常对照组）同步进行Quisi和多导睡眠图（PSG）整夜检测。结果（1）两组分别用Qui8i和PSG二种方法检测12项睡眠指标[即睡眠潜伏期、醒觉时间、醒起时间、睡眠总时间、觉睡比、睡眠效率、睡眠维持率、快眼动睡眠（REM）潜伏期、REM睡眠时间、REM睡眠周期数和第1，2阶段百分比]，Quisi与PSG在两组内的差异均无统计学意义（均P〉0．05）。（2）患者组PSG、Quisi两项检测结果与正常对照组比较，经F检验，除REM睡眠周期外，余15项指标（上述Quisi 12项指标加第3，4阶段睡眠百分比、记录中的暂停和伪迹）的差异均有统计学意义（P〈0．05～0．01）。结论Quisi检测精神分裂症作用与PSG相似，为评估精神分裂症患者的睡眠提供了一种客观的检查方法。     

焦虑症患者的全夜Quisi实验研究

目的 探讨建立焦虑症(AN)的Quisi模式.方法 应用德国Quisi仪对24例AN患者的Quisi进行全夜监测,并与33名正常受试者(NC)对照.结果 与正常对照组比较,AN组Quisi主要有REM睡眠潜伏期前移(P＜0.01),醒觉时间增加(P＜0.01),睡眠潜伏期延迟(P＜0.01),睡眠效率下降(P＜0.05),第1阶段睡眠百分比增高(P＜0.01),第2阶段睡眠百分比降低(P＜0.05).结论 在缺乏相关设备的基层医院,Quisi技术可用于对焦虑症的检测.焦虑症患者Quisi的睡眠脑电特点有待进一步随访.     

睡眠脑电图导向下Quisi快速检测法的建立及其在健康成人中的试用

目的 建立一种简便、快速检测分析睡眠脑电的新方法,并探讨Quisi在健康成人中的试用. 方法 对28名健康成人同步作Quisi和多导睡眠图(PSG)整夜检测.并以 PSG为检测标准,与德国Quisi进行比较研究.结果 在28名正常对照组中,除暂停、伪迹2项参数在Quisi和PSG两种工具间不可比外,其他10项指标差异均无显著统计学意义(P均>0.05).结论 Quisi检测作用与PSG相似.     

睡眠障碍患者的Quisi试验研究

目的 建立一种简便、快速检测分析睡眠脑电的新方法,并探讨Quisi在健康成人中的试用. 方法 对28名健康成人同步作Quisi和多导睡眠图(PSG)整夜检测.并以 PSG为检测标准,与德国Quisi进行比较研究.结果 在28名正常对照组中,除暂停、伪迹2项参数在Quisi和PSG两种工具间不可比外,其他10项指标差异均无显著统计学意义(P均>0.05).结论 Quisi检测作用与PSG相似.     

抑郁障碍的多导睡眠图监测研究

目的 探讨抑郁障碍患者睡眠生理的变化.方法 应用日本1518K多导睡眠生理仪,采用眼电图和下颌肌电图及脑电图等技术,对19例抑郁障碍患者的多导睡眠图(PSG)进行整夜监测,并与21名正常受试者对照.结果 抑郁障碍组PSG主要指标表现为REM睡眠潜伏期(RL)前移,正常组(84±11)min,抑郁障碍组(61±19)min(P＜0.01);睡眠维持率(SMT)下降(正常组(99±3)%,抑郁障碍组(90±5)%,P＜0.01),第二阶段睡眠降低(正常组(56±4)%,抑郁障碍组(45±17)%,P＜0.05)及REM4个睡眠参数存在变异.结论 抑郁障碍患者具有PSG多项睡眠脑电指标的改变.其中REM睡眠潜伏期前移是本病的特点.     

轻度认知功能障碍老年人的睡眠实验研究

目的探讨轻度认知功能障碍（MCI）老年人多导睡眠图（PSG）变化特点。方法应用多导睡眠生理仪,采用眼电图和下颌肌电图及脑电图技术,对19例MCI老年人（MCI组）的PSG进行全夜监测,并与20名正常老年人（NC组）对照。结果与NC组比较,MCI组睡眠总时间减少[NC组（381±37）min,MCI组（313±67）min,P〈0.01],觉醒时间增加[NC组（30±10）min,MCI组（53±17）min,P〈0.01],睡眠维持率下降[NC组（94±10）%,MCI组（85±13）%,P〈0.05],第1阶段睡眠增加[NC组（14±2）%,MCI组（28±10）%,P〈0.01],第2阶段睡眠降低[NC组（60±4）%,MCI组（51±18）%,P〈0.05]和第3阶段睡眠降低[NC组（9±5）%,MCI组（4±3）%,P〈0.01],REM强度增强[NC组（21±4）%,MCI组（40±22）%,P〈0.01]。结论PSG中的浅睡眠增多,慢波睡眠S3减少可能是MCI病人所具有的电生理学指标之一。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.