弓形虫抗体阳性与阴性精神分裂症患者临床症状差异性研究

目的分析弓形虫抗体阳性与阴性精神分裂症患者病情及临床症状的差异性,为临床治疗提供依据。方法采用简明精神病评定量表（BPRS）、阳性症状量表（SAPS）及阴性症状量表（SANS）,比较120例弓形虫抗体阳性精神分裂症患者和120例弓形虫抗体阴性精神分裂症患者病情及临床症状的差异性。结果弓形虫抗体阳性精神分裂症患者BPRS总分和SAPS总分分别为116.98±12.49和68.12±12.18,弓形虫抗体阴性精神分裂症患者分别为110.52±11.43和61.60±11.62,差异均有统计学意义（P〈0.01）;弓形虫抗体阳性精神分裂症患者SANS总分为60.42±13.83,弓形虫抗体阴性精神分裂症患者SANS总分为64.37±14.42,差异有统计学意义（P〈0.01）。结论弓形虫抗体阳性与阴性精神分裂症患者病情及临床症状存在较大差异,治疗时应区别对待。     

精神分裂症患者血清细胞因子水平变化及其与病情的关系

目的探讨精神分裂症患者血清IL-1α、IL-1β、IL-2、IL-6、IL-17水平变化及其与病情的关系。方法选择精神分裂症患者46例(观察组)、健康志愿者37例(对照组),检测两组血清IL-1α、IL-1β、IL-2、IL-6、IL-17。比较不同阳性和阴性症状量表(PANSS)评分、病程精神分裂症患者各因子水平变化。结果观察组血清IL-1α、IL-1β、IL-17水平明显高于对照组(P均<0.05),两组血清IL-2、IL-6水平比较差异均无统计学意义(P均>0.05)。随着PANSS评分升高,精神分裂症患者血清IL-1α、IL-1β、IL-17水平逐渐升高,其中90~96分明显高于70~79分(P<0.05);不同病程者血清IL-1α、IL-1β、IL-17水平变化不一,其中病程>29个月者血清IL-1α水平高于病程<17个月者,而血清IL-1β、IL-17水平病程>29个月者低于病程<17个月者。结论精神分裂症患者存在免疫激活现象,且其激活程度与病情密切相关。     

急性首发精神分裂症患者血浆S100B蛋白水平的变化及意义

目的 探讨首发精神分裂症急性期血浆S100B蛋白水平及临床意义.方法 用ELISA法检测患者血浆S100B蛋白水平,应用阳性和阴性症状量表(PANSS)评定患者精神症状.结果 首发精神分裂症23例急性期血浆S100B蛋白水平(0.055.4±0.042)μg/L显著高于对照组(0.019±0.009)μg/L,二者差异有统计学意义(P＜0.01).首发精神分裂症治疗6周后血浆S100B蛋白水平(0.072±0.054)μg/L与治疗前(0.055±0.042)μg/L比较差异无统计学意义(P＞0.05);治疗后血浆S100B持续增高者PANSS阴性症状评分较高(P＜0.05).结论 S100B蛋白持续增高与首发急性精神分裂症阴性症状相关.     

精神分裂症患者眼动特征及其相关因素研究

目的：探讨精神分裂症视觉搜索过程的眼动特征及其影响因素。方法将120例精神分裂症患者设为研究组,120名健康志愿者设为对照组,应用Eyelink 2000眼动仪器记录基于找数字、数字连线、迷宫三种任务的眼动数据。实验前对研究组采用阳性与阴性症状量表评定阳性和阴性症状。结果在三种任务中,研究组找数字和数字连线的刺激持续时间及注视时间均显著高于对照组（ P＜0.05或＜0.01）;“迷宫”的眨眼次数显著低于对照组（ P＜0.05）。相关分析显示,研究组阳性与阴性症状量表注意障碍因子与迷宫的注视时间呈正相关,反应缺乏因子与数字连线的眼跳次数呈正相关,偏执因子与找数字的眼跳幅度呈负相关,抑郁因子与迷宫的眼跳幅度呈正相关,补充因子与数字连线的眼跳幅度、刺激持续时间和总注视次数呈负相关。结论精神分裂症患者的眼动特征异常,提示注意功能、思维灵活性、推理和问题解决能力可能受损;以上神经功能的损伤与某些临床症状相关,提示可能与精神分裂症的病理生理过程有关。     

齐拉西酮治疗精神分裂症阴性症状的临床观察

目的 探讨齐拉西酮与利培酮治疗以阴性症状为主的精神分裂症患者的疗效及安全性。方法将60例以阴性症状为主的精神分裂症患者随机分为齐扛西酮组（30例）与利培酮组（30例）,分别给予齐拉西酮与利培酮,疗程8周。以筒明精神病评定量袁（BPRS）和阴性症状评定量袁（SANS）评定疗效及不良反应。结果齐拉西酮与利培酮对阴性症状均有较好疗效,但齐拉西酮对意志缺乏及注意障碍的改善更明显,除恶心、头晕头痛外,齐拉西酮不良反应均较利培酮少而轻。结论齐拉西酮与利培酮治疗阴性症状为主的精神分裂症患者疗效相当,齐拉西酮依从性好,不良反应轻,疗效及安全性好。     

老年阿尔茨海默病与精神分裂症患者的行为症状和认知功能差异

目的探讨老年阿尔茨海默病(AD)与精神分裂症患者的行为症状和认知功能差异。方法选择老年AD与精神分裂症患者各60例,认知功能评价采用简明精神状态检查量表(MMSE)、WHO-加利福尼亚大学洛杉矶分校听觉词语学习测试(WHO-UCLA AVLT)量表进行,精神行为症状采用AD病理行为评分量表(BEHAVE-AD)进行,对比分析两组患者认知功能评分和精神行为发生情况。结果 AD组言语功能、计算和注意力、记忆力方面及总体MMSE评分比较均有统计学意义(P<0.05)。两组瞬时记忆、延时记忆和长时记忆得分比较均有统计学意义(P<0.05)。两组妄想与偏执,焦虑与恐惧,听幻觉、视幻觉和情感障碍发生率比较差显著(P<0.05)。结论老年AD认知功能损害较精神分裂症患者严重,特别是言语和记忆力损害明显,行为症状以听幻觉为主;精神分裂症行为症状发生率较为明显,妄想与偏执,焦虑与恐惧,幻觉和情感障碍较多见,幻觉以听幻觉为主。     

康复治疗对精神分裂症患者精神症状、认知功能的影响

目的观察康复治疗对精神分裂患者精神症状、认知功能的影响。方法将60例精神分裂症患者随机分为观察组和对照组,各30例。两组均口服利培酮6 mg/d,观察组在此基础上进行康复治疗,疗程3个月。比较两组治疗前后的精神症状[阳性和阴性症状量表(PANSS)评分、阴性症状评定量表(SANS)和阳性症状评定量表(SAPS)评分]、认知功能[采用精神分裂症认知功能成套测验(MCCB)]。结果与治疗前比较,两组治疗后PANSS、SAPS评分均降低,但观察组PANSS评分降低更明显,P均<0.01。观察组治疗后SANS评分低于治疗前及对照组治疗后,P均<0.01。两组治疗后MCCB评分均升高,但观察组升高更明显,P均<0.05。结论康复治疗有助于改善精神分裂症患者的精神症状,提高其认知功能。     

情感护理疗法对有阴性症状精神分裂症患者的治疗作用

抗精神病药物对控制精神分裂症患者精神症状、缓解病情起重要作用。但是，对有情感淡漠、思维贫乏、意志缺乏、行为懒散、退缩等阴性症状为主的精神分裂症患者，单纯抗精神病药物治疗作用甚微。为此，笔者对34例精神分裂症患者尝试情感护理疗法，收到了明显的效果。现报告如下。     

利培酮治疗老年期精神障碍患者200例的疗效

老年期精神障碍包括老年期抑郁、老年期痴呆、老年期功能性疾病等.因患者高龄,常合并有多系统疾病,并发症多,故老年期精神障碍的治疗较为困难.选择安全有效的抗精神病药物已成为治疗老年期精神障碍的一个重要问题.本文回顾性分析我院2004年1月至2010年10月应用利培酮治疗老年期精神障碍的临床疗效.     

舒血宁联合利培酮治疗精神分裂症阴性症状病人的安全性观察

目的探讨舒血宁联合利培酮治疗精神分裂症阴性症状的疗效夏安全性。方法将80例以阴性症状为主的精神分裂症病人随机分为实验组（舒血宁加利培酮）和对照组（单用利培酮）各40例，分别给予相应的药物治疗，疗程16周。治疗前后分别用阴性症状评定量表（SANS）评分评定临床疗效，用不良反应症状量表（TESS）评定副反应，以了解药物的安全性。结果实验组疗效优于对照组（P〈0．05）；起效时间早于对照组2周。舒血宁还可减少精神药物的副反应。绪论在以阴性症状为主的精神分裂症的治疗中联合使用舒血宁疗效好，起效快，安全性离。     

阿立哌唑联合小剂量氯氮平对以阴性症状为主的精神分裂症患者认知功能的影响

目的探讨阿立哌唑联合小剂量氯氮平治疗以阴性症状为主的精神分裂症患者的疗效、安全性及对认知功能的影响。方法将48例以阴性症状为主的慢性精神分裂症患者随机分为研究组和对照组,每组24例。研究组给予阿立哌唑联合小剂量氯氮平治疗,对照组仅给予常规剂量氯氮平治疗,疗程12周;采用阳性与阴性症状量表（PANSS）、治疗中的副反应量表（TESS）评定疗效和副反应,采用威斯康星卡片（WCST）和连续作业测验（CPT）评定患者的认知功能。结果治疗12周后,两组患者PANSS．6-分、三个因子分均低于治疗前（P〈0．05）;研究组PANSS总分、一般病理分、阴性症状分低于对照组（P〈0．05）;研究组WCST评定总错误数、持续反应数、持续错误数、正确应答数与对照组比较,差异均具有统计学意义（P均〈0．05）。研究组与对照组的CPT评定正确数值、反应时比较差异有统计学意义（P〈0．05）,研究组不良反应低于对照组（P〈0．05）。结论阿立哌唑联合小剂量氯氮平治疗以阴性症状为主的慢性精神分裂症患者,可明显改善精神分裂症患者的阴性症状及认知功能;与单用常规剂量氯氮平相比安全性更好。     

Gastrointestinal symptoms and associated factors in Chinese patients with functional dyspepsia

AIM:To study the evolution of gastrointestinal symptoms and associated factors in Chinese patients with functional dyspepsia(FD).METHODS:From June 2008 to November 2009,a total of 1049 patients with FD(65.3%female,mean age42.80±11.64 years)who visited the departments of gastroenterology in Wuhan,Beijing,Shanghai,Guangzhou,and Xi’an,China were referred for this study.All of the patients fulfilled the RomeⅢcriteria for FD.Baseline demographic data,dyspepsia symptoms,anxiety,depression,sleep disorder,and drug treatment were assessed using self-report questionnaires.Patients completed questionnaires at baseline and after1,3,6 and 12 mo follow-up.Comparison of dyspepsia symptoms between baseline and after follow-up was explored using multivariate analysis of variance of repeated measuring.Multiple linear regression was done to examine factors associated with outcome,both longitudinally and horizontally.RESULTS:Nine hundred and forty-three patients(89.9%of the original population)completed all four follow-ups.The average duration of follow-up was12.24±0.59 mo.During 1-year follow-up,the mean dyspeptic symptom score(DSS)in FD patients showed a significant gradually reduced trend(P<0.001),and similar differences were found for all individual symptoms(P<0.001).Multiple linear regression analysis showed that sex(P<0.001),anxiety(P=0.018),sleep disorder at 1-year follow-up(P=0.019),weight loss(P<0.001),consulting a physician(P<0.001),and prokinetic use during 1-year follow-up(P=0.035)were horizontally associated with DSS at 1-year followup.No relationship was found longitudinally between DSS at 1-year follow-up and patient characteristics at baseline.CONCLUSION:Female sex,anxiety,and sleep disorder,weight loss,consulting a physician and prokinetic use during 1-year follow-up were associated with outcome of FD.     

Gender differences in the psychological determinants of cigarette smoking

Aims To compare the distributions of smoking‐related variables and the size of associations between these variables in men and women. Design and participants Mail survey in 2934 daily smokers (1533 women and 1401 men) who volunteered for a smoking cessation trial. Follow‐up after 7 months in 2456 people (84%). Setting Community setting (French‐speaking part of Switzerland, 1998). Findings Women smoked less than men (18 versus 22 cigarettes per day, p < 0.001), had lower confidence in their ability to refrain from smoking, used more frequently the strategy defined as ‘coping with the temptation to smoke’ and reported more drawbacks of smoking (gender differences ranged between 0.1 and 0.3 standard deviation units on these scales). There was no gender difference in the distribution of smokers by stage of change. At follow‐up, smoking cessation rates were similar in men and women (6% versus 5%, p = 0.3). Intention to quit, quit attempts in the previous year and a more frequent use of self‐change strategies predicted smoking cessation and were associated with tobacco dependence in both sexes. A more frequent use by women of coping strategies suggests that some women are ‘self‐restrained’ smokers who control their smoking permanently. This could explain lower smoking rates in women. The size of associations between smoking‐related variables was similar in men and women. Conclusions Even though there were gender differences in the distributions of some smoking‐related variables, associations between these variables were similar in men and women. This suggests that smoking behaviour is regulated by similar psychological mechanisms in men and women.     

中国人群心电图时间参数的年龄和性别差异

目的：调查和评估中国人群心电图时间参数（P波和QRS波时限、PR间期、QT及QTc间期）的年龄和性别差异。方法：采集5360例（男3614例,女1746例）健康人心电图并按性别分为5个年龄组,计算男、女各年龄组时间参数的平均值、标准差及96％范围上、下限。结果：各年龄组男性的P波时限、PR新时期以及QRS波时限均大于女性,而女性的QTc间期均大于男性;各年龄组时间参数的性别差异均具有极显性（P＜0．0001）。男性P波时限和PR间期上限值分别比女性平均长6ms和12ms;男性QRS波时限上限值为120ms,女性为109ms;女性QTc间期上限值比同年龄组男性长16－20ms,且女性QTc间期＞440ms的发生率（12．8％）明显高于男性（6．2％）。除QRS时限外,男、女其他时间参数上限值均随年龄增长而增加,显示明确的年龄趋势。比较各时间参数年龄组之间差异均具有极显性（P＜0．001或P＜0．0001）。结论：中国人群心电图时间参数存在明显的年龄及性别差异,有必要建立与年龄和性别相关的正常值标准。     

Association of the metabolic syndrome with physical activity performance in patients with schizophrenia

Aim

The primary aim of this study was to determine whether the presence of the metabolic syndrome (MetS) limits physical activity (PA) in patients with schizophrenia. A secondary aim was to investigate cross-sectional associations of leisure-time PA, sports participation and PA performance with MetS parameters.

Methods

Patients with schizophrenia who had MetS (n = 37) were compared with those without MetS (n = 69). Patients were assessed for PA performance using a 6-minute walk test (6MWT) and PA participation using the Baecke PA questionnaire, as well as for antipsychotic medication dose (expressed in chlorpromazine equivalents), negative symptoms and smoking behaviour.

Results

The two patient groups were similar in age, gender, mean antipsychotic medication dose, negative symptomatology and smoking behaviour. Distance achieved on the 6MWT was 13.7% shorter (P < 0.001) in patients with versus patients without MetS (527.6 ± 108.9 m vs 610.0 ± 93.7 m, respectively). Patients with MetS were also significantly less involved in sports activities (P = 0.001) and less physically active during leisure time (P = 0.002). Also, the distance of the 6MWT was moderately correlated with body mass index (r = −0.44, P < 0.001), waist circumference (r = −0.43, P < 0.001), sports participation (r = 0.60, P < 0.001) and leisure-time PA (r = 0.42, P < 0.001).

Conclusion

MetS is associated with poorer PA performance in patients with schizophrenia. The additional burden of MetS places patients with schizophrenia at even greater risk for physical and functional limitations in daily life.     

Gastrointestinal symptoms in Chinese patients with Type 2 diabetes mellitus.

AIMS: To examine and compare gastrointestinal (GI) symptoms in Hong Kong Chinese Type 2 diabetic outpatients and non-diabetic control subjects. METHODS: A total of 149 Chinese Type 2 diabetic patients (66 men and 83 women, age (mean +/- SD) 46.8+/-11.1 years) newly referred to the diabetes clinic of the Prince of Wales Hospital, Hong Kong were examined. Sixty-five age and sex-matched non-diabetic subjects were recruited from the community as controls (22 men and 43 women, age (mean +/- SD) 46.5+/-6.6 years, P = 0.820). All patients were interviewed regarding GI symptoms over the past year, using a questionnaire that covered 14 items. A scoring system from 0 to 4 was used to grade severity. RESULTS: Diabetic patients had higher blood pressure, fasting plasma glucose and glycated haemoglobin and were more often smokers than control subjects. Of the 149 diabetic subjects, 105 (70.5+/-45.8%) had GI symptoms while only 20 (30.8%) of the 65 control subjects had GI symptoms (P<0.001). The respective percentages of upper and lower GI symptoms in diabetic and normal subjects were 44.3% vs. 24.6% (P = 0.006) and 54.4% vs. 13.9% (P<0.001). The three commonest GI symptoms in diabetic patients were diarrhoea (34.9%), constipation (27.5%) and epigastric fullness (16.8%). After adjustment for age, sex, duration of diagnosed diabetes and smoking, patients with or without metformin had similar percentages or scores for GI symptoms. On multivariate analysis using age, body mass index, fasting plasma glucose, glycated haemoglobin, duration of diagnosed diabetes and presence of peripheral neuropathy as independent variables, duration of diabetes was the only independent parameter associated with total score for GI symptoms (beta = 0.116, P = 0.003), for upper GI symptoms (beta = 0.073, P = 0.005) and for lower GI symptom (beta = 0.043, P = 0.020). CONCLUSIONS: Up to 70% of the Chinese Type 2 diabetic outpatients have GI symptoms, which is a much higher rate than in non-diabetic control subjects. Duration of diabetes is the most important factor associated with the presence of such GI symptoms.     

Gender differences in the association between socioeconomic status (SES) and depressive symptoms in older adults

With rapid population aging, increasing attention is given to the mental health of older people. This study examined the association between SES and depressive symptoms in older adults. The study population consisted of a representative community sample of 4165 persons aged 65 and older from Wave 1 of the Korean Longitudinal Study of Aging. The Center for Epidemiologic Studies Depression scale was used to measure the extent of depressive symptoms. Socioeconomic indicators included education, household income, and net worth. Analyses were conducted by gender, using multiple linear regression analysis, to identify independent effects of socioeconomic variables on depressive symptoms, controlling for demographics and health-related variables. There was an inverse association between higher levels of socioeconomic factors and depressive symptoms in the study population. A clear difference in the association between depressive symptoms and socioeconomic factors by gender was observed. In the multivariate analysis, wealth was significantly associated with depressive symptoms in men, whereas education and income was so in women. Gender disparities in depressive symptoms across social gradients suggest the need for gender-sensitive investments in health and social services for the disadvantaged segments of the older population.