住院精神病患者攻击行为的临床特征

目的 了解精神病患者发生攻击行为特点,为减少攻击行为提供临床依据.方法 对2007年1月1日-2012年6月31日在我院住院期间发生攻击行为患者进行回顾性分析.结果 113名患者发生攻击行为133人次,男93人次,女40人次.平均年龄39.6岁,≤44岁者89名(66.9％).精神分裂症者最多(74.5％).攻击行为在白班(8:00～16:00)最多见,55人次(41.4％).好发地点为重病室(37.6％)、饭厅(24.8％)、普通病室(18.0％).以徒手伤人最多见,共发生118人次(88.7％).医护人员是患者攻击的主要对象,占84.2％.结论 住院精神病患者攻击行为高危因素:青年、男性、精神分裂症患者.攻击行为以徒手伤人最多见,对象主要为医护人员.     

住院精神病患者自杀行为的5年回顾分析

目的：了解住院精神病患者自杀行为的临床特征。方法：对2002年1月1日－2006年12月31日在我院住院治疗期间发生自杀行为的患者,以查阅病历、访谈和实地考察自杀环境获取资料进行回顾性分析。结果：共收集到住院期间发生自杀行为患者3l人。男性16人,女性15人,年龄24～68岁,平均年龄45岁。住院时间＜1个月者13人（41．9％）,1～3个月者4人（12．9％）,＞3个月者14人（45．2％）。诊断精神分裂症者最多（64．5％）,其次为情感障碍（13．0％）。自杀方式以上吊最多（41．9％）,其次是吞服异物（25．8％）。自杀地点以普通病室及洗手间最多见。自杀发生在0am～8am时间段12人（38．7％）,8am～4pm时间段11人（35．5％）,4pm～12pm时间段8人（25．8％）。休息日发生自杀多于工作日发生自杀（χ2＝13．520,P＝0．000）,差异有统计学意义。自杀死亡1人（3．2％）。年均自杀行为发生率为24．98‰。结论：发生自杀的住院精神病患者罹患精神分裂症及情感障碍最常见,新住院及长期住院患者为高危人群。自杀方式以上吊最多见。自杀地点以普通病室及洗手间最多见。休息日发生自杀的比例较高。     

门诊与住院精神分裂症患者首选药物调查

目的了解首次就诊患者抗精神药物应用现状。方法采用自行设计的调查表,顺序抽取我院每季度第一个月所有精神分裂症患者首次药物使用情况进行调查。结果①334例门诊精神病患者以使用非典型抗精神病药为主,奥氮平使用率最高(29.6%),其次为喹硫平(23.4%)、利培酮(23.1%)、阿立哌唑(14.4%);354例住院患者首选药物多为传统抗精神病药氟哌啶醇注射剂(28.8%),其他为非典型抗精神病药,依次为利培酮(28.5%)、喹硫平(17.8%)、奥氮平(8.8%)、阿立哌唑(6.5%);②住院患者合并使用抗精神病药者多于门诊患者,两者比较有非常显著的差异(χ2=144.91,P<0.01),使用最高的为非典型抗精神病药合并使用氟哌啶醇。门诊合并使用苯二氮卓类药物以及安坦者多于住院患者,两者比较均有非常显著的差异(2χ=6.91,P<0.01)、(2χ=19.5,P<0.01)。结论精神分裂症患者所接受的药物治疗比较规范和合理,非典型性抗精神病药已作为临床医生首选药物;部分医生对抗胆碱能药物和苯二氮卓类药物本身产生的不良反应给患者造成的危害认识不足。     

精神分裂症患者噎食原因分析

目的对住院精神分裂症患者发生噎食的原因进行分析,为临床预见性护理干预,减少意外事件的发生提供可靠依据。方法对2000年1月1日至2010年1月1日住院治疗期间发生噎食的30例精神分裂症患者的资料采用自制调查表进行记录和回顾性分析。结果发生噎食的30例患者中男21人(70%),女9人(30%);年龄50岁以上最多(57%);精神分裂症各型中以紧张型(50%)及青春型(30%)发生噎食最多;住院时间≥3个月者最常见(83%);噎食在午餐最多(50%),其次是早餐(37%);最容易引起噎食的食物是面食(47%),其次是米饭(27%);服用典型抗精神病药者(73%)较服用非典型抗精神病药者(27%)发生率高。结论高龄,长期住院,男性,服用高剂量典型抗精神病药,进食面食,精神分裂症紧张型及青春型是住院精神分裂症患者发生噎食的高危因素。     

住院精神病患者病耻感水平及相关因素调查

目的探讨住院精神病患者病耻感水平及相关因素。方法采用一般情况调查表及贬低-歧视感知量表对212例住院精神病患者进行问卷调查。结果 60.85%的被调查患者有病耻感;精神分裂症患者病耻感高于情感病患者(χ2=8.843,P<0.01);病程5年及以内的患者病耻感高于5年以上的患者(χ2=5.448,P<0.05)。结论精神病患者病耻感水平高,患者的病耻感与精神疾病诊断及病程有关。     

首发精神分裂症患者心电图特征分析

目的:探讨首发精神分裂症患者心电图特征以及定期监测心电图对早期发现抗精神病药物所致心脏副作用的意义。方法:选择2016年5-10月住院治疗的首发精神分裂症患者239例,在治疗开始前及应用抗精神病药物治疗后连续6周监测心电图,并在治疗的3、6、9、12月末随访心电图,对结果进行分析。结果:心电图异常诊断及最早检出时间以窦性心率失常为主,占67.33%,其中窦性心动过速31例(30.69%),检出时间(10.65±2.61)天;窦性心律不齐20例(19.80%),检出时间(15.44±1.99)天;窦性心动过缓17例(16.83%),检出时间(13.37±3.10)天;女性患者心电图异常率显著高于男性患者(χ~2=5.89,P0.05);年龄越大,心电图异常率越高(χ~2=5.18,P0.05);联合用药患者的心电图异常率显著高于单一用药患者(χ~2=9.32,P0.01)。结论:抗精神病药物对心肌代谢有不同程度的影响,在治疗过程中定期监测心电图,有助于早期发现抗精神病药物的心脏副作用。     

住院精神病患者跌倒特点分析

目的了解精神病患者发生跌倒的特点,为减少精神病患者发生跌倒提供依据。方法对2002年1月1日-2007年6月31日在我院住院治疗期间发生跌倒的患者,以查阅病历、访谈和实地观察跌倒环境获取资料进行回顾性分析。结果117名患者共发生跌倒139人次,男77人次,女62人次。发生跌倒患者平均年龄57.5岁,其中≥60岁者66人次,占47.5%。跌倒在日间发生73次,占52.5%,夜间66次,占47.5%。跌倒地点以洗漱室38人次（27.3%）,普通病室29人次（20.9%）,饭厅28人次（20.1%）最多见。跌倒的形式以行走时不慎滑倒42人次（30.2%）,体位改变时跌倒26人次（18.71%）常见。跌倒后致外伤81人次（58.27%）,骨折53人次（38.13%）,外伤合并骨折2人次（1.44%）,其它3人次（2.16%）。结论精神科老年患者容易跌倒,易致外伤及骨折。     

住院精神分裂症患者高血糖发生率及其相关因素

目的:对住院精神分裂症患者高血糖发生率及其相关因素进行调查.方法:采用 自制的调查表对287例住院精神分裂症患者进行了调查,分别收集了患者的性别、年龄、受教育年限、病程、精神疾病家族史、既往病史(高血压、高脂血症)、服用抗精神病药物等相关资料,同时测了体质量、身高、血糖、甘油三酯、总胆固醇、高密度脂蛋白及低密度脂蛋白等相关指标.结果:287例住院精神分裂症患者中,存有高血糖65例,发生率为22.6％.住院精神分裂症患者中,高血糖组年龄明显大于非高血糖组(t=-2.310,P＜0.05);高血糖组甘油三酯明显高于非高血糖组(t=-2.512,P＜0.05);高血糖组高密度脂蛋白明显低于非高血糖组(t=2.687,P＜0.01).≥50岁的住院精神分裂症患者伴有高血糖比率明显高于＜50岁的患者(x2=6.609,P＜0.05);≥50岁的住院精神分裂症患者空腹血糖明显高于＜50岁的患者(t=-2.978,P＜0.01).Logistic回归分析显示,年龄、家族史、甘油三酯与高血糖的发生有关(P＜0.05).结论:住院精神分裂症患者高血糖发生率较高,年龄越大、有精神疾病家族史、甘油三酯值越高的患者,发生高血糖的风险越大.     

住院精神分裂症患者病耻感与抑郁的关系

目的探讨住院精神分裂症患者病耻感与抑郁的关系。方法采用精神病患者病耻感评估量表、卡尔加里精神分裂症抑郁量表对77例住院精神分裂症患者进行问卷调查。结果精神分裂症患者的抑郁发生率为25.97%;不同受教育程度患者的病耻感总分及能力因子得分差异显著(P0.05);与抑郁总分相关性具有显著意义的变量包括:病耻感总分能力因子(r=0.39,0.35;P0.01),治疗因子(r=0.28,P0.05)。与抑郁体验因子相关性具有显著意义的变量包括:病耻感总分社交因子,能力因子(r=0.34,0.30,0.32;P0.01);与自我评价因子相关性具有显著意义的变量包括:病耻感总分社交因子(r=0.34,0.40;P0.01)。结论住院精神分裂症患者抑郁较常见,且病耻感越强,住院精神分裂症患者抑郁症状越明显。     

流浪乞讨精神病患者临床特征对比分析及综合性救治

目的 调查分析流浪乞讨精神病患者临床特征,以利于开展针对性救助.方法 将我院收治的100例流浪乞讨精神病患者作为研究组,选择同期在唐山精神病院住院治疗的100例非流浪精神病患者作为对照组.对两组一般情况,躯体状况,精神疾病诊断分型及严重程度进行临床特征对比.结果 ①两组一般情况,躯体状况比较:研究组男性多于女性(x2=49.42,P＜0.01),大多数为外省市户籍(x2=115.94,P＜0.01),平均年龄大(t=14.02,P＜0.01),伴躯体疾病明显多于对照组(x2=75.00,P＜0.01);②精神疾病诊断分型及严重程度方面:研究组前3位为精神分裂症,精神发育迟滞,其它待分类精神病;对照组为精神分裂症,情感障碍,其它功能性精神病;研究组以慢性阴性症状(t=51.43,P＜0.01)和行为症状(t=15.56,P＜0.01)为主,对照组则以短暂阳性(t=36.01,P＜0.01)和情感症状(t=10.44,P＜0.01)为主.结论 流浪乞讨精神病患者临床特征与普通精神病患者相比病情复杂而严重,需要进行综合性特殊救治.     

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.     

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.     

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.     

'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.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.