曲唑酮与氟西汀治疗抑郁症的临床对照研究

目的　比较曲唑酮与氟西汀治疗抑郁症的疗效及安全性。方法　符合中国精神障碍分类与诊断标准第三版 (CCMD 3 )的 42例抑郁症患者 ,随机分为实验组和对照组 ,进行 6周的治疗。采用汉密顿抑郁量表 (HAMD)、临床整体印象量表 (CGI)评定疗效 ,采用副反应量表 (TESS)、体格检查及实验检查评定安全性。结果　实验组曲唑酮用量 ( 193 85± 5 6 5 9)mg/d ,对照组氟西汀用量( 2 6 81± 5 87)mg/d。实验组和对照组的有效比例分别为 17/2 1和 16/2 1,治愈比例分别为 13 /2 1和 10 /2 1;两组HAMD量表总分治疗后各周与治疗前比较差异有显著性 (P <0 0 5 ) ,两组之间比较差异无显著性 (P >0 0 5 )。两组不良反应均轻微。结论　曲唑酮是一种安全、有效的新型抗抑郁剂。     

万拉法新联合阿普唑仑治疗抑郁症伴焦虑症状的疗效对照分析

目的　观察万拉法新联合阿普唑仑和单独氟西汀治疗抑郁症伴焦虑症状的临床疗效。方法　将符合入组条件的 6 2例患者分为两组 ,分别给予万拉法新联合阿普唑仑和单独氟西汀治疗 ,分别于治疗前及治疗 1、2、4、6周使用汉密尔顿抑郁量表 (HAMD)、汉密尔顿焦虑量表 (HAMA)、临床总体印象量表 (CGI)、不良反应量表(TESS)进行评分。结果　两组HAMD减分率第 1、2周末有显著性差异 (P <0 0 5 )和非常显著性差异 (P <0 0 1) ,HAMA减分率第 1、2、4周末有非常显著性差异 (P <0 0 1)和显著性差异 (P <0 0 5 ) ,CGI评定第 1周末两组有显著性差异 (P <0 0 5 )。结论　万拉法新联合阿普唑仑是一种疗效好、起效快而安全的治疗抑郁症伴焦虑症状的用药模式     

抑郁症患者的功能失调性认知初探

目的　探讨抑郁症状与功能失调性认知间的关系。方法　应用功能失调性状况评定量表 (DAS)、Beck抑郁自评量表 (BDI)和汉密尔顿抑郁量表 (HAMD)对 75例抑郁症患者 (抑郁症组 )于治疗前后 (抗抑郁剂 4～ 8周 )进行评定 ,采用DAS和BDI对 10 0名正常人 (对照组 )进行评定和比较。结果　 (1)抑郁发作期 (治疗前 )抑郁症组BDI总分 [(40 76± 10 6 7)分 ]、DAS总分 [(16 2 6 4± 19 4 8)分 ]及各项因子分 (除自主性态度 )均高于对照组 [BDI总分为 (6 6 4± 3 36 )分 ,DAS总分为 (12 5 0 5±2 0 34)分 ;P <0 0 1或P <0 0 5 ) ];(2 )恢复期 (治疗后 )抑郁症组的抑郁症状有所改善 ,BDI评分降至(9 6 5± 4 4 7)分 ,但DAS评分 [(15 0 6 3± 18 11)分 ]仍高于对照组 (t=4 738,P <0 0 1)。结论　功能失调性认知是抑郁症的一个特征性心理状态 ,构成了抑郁的易患性。     

氟西汀治疗继发于生活事件的抑郁症

目的 :探讨氟西汀治疗继发于明显生活事件的抑郁症的效果。　方法 :对 6 2例最近 1年内生活事件量表 (LES)总分 >30分的抑郁症患者采用氟西汀治疗 6周。　结果 :治疗结束时Hamilton抑郁量表 (HAMD)总分自 2 2 . 6 3± 4 . 2 3下降至 9 .97± 5 . 86。Hamilton焦虑量表 (HAMA)总分自 2 3 .13± 5 . 32下降至 10 . 2 4± 6. 4 1。HAMD迟滞因子、睡眠因子和临床疗效总评分也显著下降。第 1周即显著有效。不良反应轻微。　结论 :氟西汀可有效治疗继发于明显生活事件的抑郁症患者 ,起效较快 ,不良反应小。     

万拉法新治疗难治性抑郁症的临床研究

目的　观察万拉法新治疗难治性抑郁症的疗效和不良反应。方法　以万拉法新治疗难治性抑郁症 2 3例并与氟西汀治疗的 2 2例进行对照 ,万拉法新组平均剂量 2 3 0mg/d,氟西汀组 3 9mg/d ,用药 6周 ,分别于治疗后 7d、1 4d、2 8d、42d以汉密顿抑郁量表 (HAMD)、临床疗效总评量表 (CGI SI)、副反应量表 (TESS)评定治疗反应。结果　至 6周末万拉法新组HAMD平均分值从 3 3 1 7降至 2 1 0 0分 ,氟西汀组从 3 4 1 4降至 2 6 50分 ,两组有效者分别为 1 0例和 2例。万拉法新组副反应明显多于氟西汀组 ,但均能耐受而不影响治疗。结论　万拉法新疗效优于氟西汀 ,可用于治疗难治性抑郁症     

氟西汀合并奥氮平治疗难治性抑郁症的双盲对照研究

目的本研究探讨氟西汀合并奥氮平治疗难治性抑郁症的安全性和疗效。方法采用双盲对照研究,将52例诊断为难治性抑郁症的患者随机分为两组,一组采用氟西汀治疗,一组采用氟西汀合并奥氮平治疗,分别在治疗后第2、4、6、8周末,评定汉密顿抑郁量表(HAMD)和临床总体印象量表(CGI),同时采用Asberg抗抑郁剂副反应量表评定两组的药物副反应。结果氟西汀联合奥氮平治疗难治性抑郁症的疗效要明显优于单一应用氟西汀治疗(P<0.05),药物副反应两组间无明显差异(P>0.05)。结论氟西汀联合奥氮平治疗难治性抑郁症的疗效要明显优于单一应用氟西汀治疗(P<0.05),药物副反应两组间无明显差异(P>0.05)。     

噻奈普汀与氟西汀治疗抑郁症疗效与安全性的多中心开放研究

目的　验证噻奈普汀治疗抑郁症的疗效和安全性。方法　对 2 6 4例患者进行噻奈普汀和氟西汀的多中心开放、对照治疗 ,其中噻奈普汀组 14 4例 (37 5mg/d) ,氟西汀组 12 0例 (2 0mg/d) ,治疗 6周。采用汉密尔顿抑郁量表 (HAMD)、汉密尔顿焦虑量表 (HAMA)、临床总体评价量表 (CGI)评定临床疗效 ,采用需要处理的不良反应量表 (TESS)评定安全性。结果　噻奈普汀组治疗和氟西汀组总有效率分别为 79 9%和 71 5 % ,两组无显著差异 (χ2 =2 4 1,P≥ 0 0 5 )。起效时间均在两周末。噻奈普汀在治疗 2、4、6周时的HAMD、HAMA减分率均高于氟西汀组 ,并有显著性差异 (P <0 0 1)。噻奈普汀组不良反应主要有口干、入睡困难、胃肠道不适、头痛、便秘等 ,不良反应较氟西汀少而轻。结论　噻奈普汀对抑郁症具有良好的疗效和安全性 ,且其安全性优于氟西汀。     

万拉法新、阿米替林、氟西汀治疗抑郁症的对照研究

目的　比较万拉法新、阿米替林和氟西汀治疗门诊抑郁症的疗效和副反应。方法　对符合CCMD Ⅲ抑郁发作诊断标准的患者随机分为三组 ,分别给以万拉法新、阿米替林及氟西汀治疗 ,治疗疗程为 6周 ,用Hamilton抑郁量表 (HAMD) ,临床大体印象量表 (CGI)、副反应量表 (TESS)进行评分。结果　治疗 6周后的显效率万拉法新组为 75 % ,阿米替林组为 70 % ,氟西汀组为 6 5 % ,差异无显著统计学意义 (χ2 =0 .4 2　P >0 .0 5 )。万拉法新组显效快 ,2周内的HAMD总分低于阿米替林和氟西汀组 ,差异有显著统计学意义 (F =5 .2 4　P <0 .0 1)。阿米替林组的副反应明显多于万拉法新和氟西汀组。结论　万拉法新是一种疗效较好而副反应较少的抗抑郁药。     

以躯体症状为主要表现的抑郁症的诊断和治疗观察

目的 :探讨以躯体症状为主要表现的隐匿性抑郁症的诊断和治疗。方法 :长期按神经症诊治无效、排除器质性病变、HAMD评分大于 2 0分的病人 ,口服盐酸氟西汀 10～ 2 0mg/日治疗 3周和 6周后评分并和治疗前对比 ,治疗 3周和 6周的评分也相互对比。行T检验。结果 :治疗 3周和 6周后的HAMD的评分分别为 17 6 5± 3 77,10 97± 4 6 5 ,均显著低于治疗前 2 6 4± 5 (P均 <0 0 1)。治疗 6周后的疗效又显著好于 3周 ,差值为 6 6 8± 4 2 1(P <0 0 1)。结论 :盐酸氟西汀对治疗隐匿性抑郁症病人疗效良好 ,并且和用药时间长短呈正相关。本文也表明对以躯体症状为主要表现者 ,排除器质性病变 ,HAMD达到诊断标准的病人 ,可进行抗抑郁治疗。     

氟西汀与阿米替林治疗老年期抑郁症的疗效比较

采用氟西汀治疗老年期抑郁症 ,并与阿米替林进行疗效对比。现将结果报告于后。1　对象与方法1 1　对象　系 2 0 0 1年 1月～ 2 0 0 2年 1月我院住院患者 ,共6 9例 ;年龄≥ 6 5岁 ;均符合ＣＣＭＤ - 2 -Ｒ抑郁症诊断标准 ;伴有自杀观念或行为者 ;平均年龄为 (6 7 6± 3 4 )岁 ;入组前Ｈａｍｉｌｔｏｎ抑郁量表 (ＨＡＭＤ前 17项 )评分≥ 2 0分 ;排除伴有严重躯体疾病和药物过敏者 ;并随机分为氟西汀组 (34例 ) ,其中男 16例 ,女 18例 ,平均年龄为 (6 6 10± 3 10 )岁 ,ＨＡＭＤ(2 6 2 4± 3 12 )分 ;阿米替林组 (35例 ) ,其中男 17例 ,女 1…     

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     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。