Characteristics of inmates receiving prescribed benzodiazepines in a high-security Greek prison

The aim of the current study was to investigate the characteristics of Greek inmates that were taking regularly benzodiazepines (BZDs) at therapeutic doses, in the high-security prison of Patras, Greece. Three hundred eighty-four prisoners were included in the study. BZD users (BUs, n = 192), compared with non-BZD users (NBUs, n = 192), were significantly more often unemployed before imprisonment; were significantly more often single, divorced, or widowed; were significantly more often on remand; were taking in significantly greater proportions antidepressant and antipsychotic medications; had significantly more often a history of psychiatric hospitalization; and had significantly more often a history of illicit intravenous (IV) drug use. BUs were significantly more often positive on serum antibodies to hepatitis C (anti-HCV), and scored significantly higher on Hamilton's Rating Scale for Anxiety (HAM-A) and Zung's Self-Rating Depression Scale (SDS). Multivariable logistic regression analysis showed that the history of psychiatric hospitalization, history of illicit drug use, history of unemployment, symptoms of anxiety, and anti-HCV positivity were independently associated with BZD use in this prison. Medical and psychiatric interventions focusing on anxiety problems, depression, drug addiction, and HCV in this group of BUs are warranted.     

联合应用尤瑞克林治疗缺血性脑卒中对患者执行功能的影响

目的观察尤瑞克林治疗对缺血性脑卒中患者后期执行功能的影响。方法 98例缺血性脑卒中患者随机分为治疗组与对照组,根据卒中治疗指南,两组均给予常规基础治疗,治疗组在此基础上联合尤瑞克林治疗,分别于治疗21d及3m后对两组患者采用蒙特利尔认知评估量表(MoCA)、简明智能状态量表(MMSE)、威斯康星卡片分类测验(WCST)进行神经心理学测验,评估执行功能。结果在21d测试中,治疗组仅在WCST中持续性错误数少于对照组(P<0.05),完成分类数多于对照组(P<0.05),但在3m后,治疗组MoCA总分高于对照组(P<0.01),治疗组MMSE成绩显著高于对照组(P<0.05),治疗组错误应答数明显减少(P<0.05),持续性错误数也明显减少(P<0.01),完成分类数增多(P<0.01)。与21d测验成绩相比,3m后第2次测验,治疗组成绩所有下降均不明显(P>0.05),而对照组MoCA总分及MMSE成绩显著下降(P<0.05),WCST持续性错误次数明显增多(P<0.01),完成分类数明显减少(P<0.01)。结论联合尤瑞克林治疗缺血性脑卒中可有效阻止患者视空间能力、认知灵活性、工作记忆等多项执行功能减退,预防血管性认知功能障碍的发生。     

Why must some schizophrenic patients be involuntarily committed? The role of insight

Twenty-four of 52 (46%) schizophrenic patients hospitalized because of acute psychotic episodes associated with preadmission medication noncompliance required involuntary commitment. Committed patients were rated as significantly more severely ill than voluntary patients and were significantly more likely to be transferred to extended treatment facilities after acute care. However, committed patients were significantly less likely than were voluntarily admitted patients to acknowledge that they were psychiatrically ill and in need of treatment, i.e., to demonstrate insight. Although psychopathology diminished significantly in both committed and voluntary patients over the course of hospitalization, only in voluntary patients did insight increase significantly. Over a 21/2 to 31/2 year follow-up, those patients who had been involuntarily committed at the index hospitalization were significantly more likely to require involuntary admissions than were the initially voluntary patients. Inability to see the self as ill seems to be a persistent trait in some schizophrenic patients.     

Guanidino compound levels in the serum of healthy adults and epileptic patients.

Some guanidino compounds are known to be convulsants and to change in the brain during seizures. In this study, we examined the serum levels of guanidino compounds in healthy adults (controls), non-epileptic neurological patients (NENP) and epileptic neurological patients (ENP). In healthy adults, serum levels of guanidinoacetic acid (GAA), creatinine (CRN) and homoarginine (HArg) were significantly lower in women than in men. Serum levels of GAA in ENP and NENP were significantly lower than in controls, with the exception of female NENP. In the male patients, CRN levels were significantly lower in ENP and NENP compared to the controls. Significantly higher arginine (Arg) levels were observed in both male and female ENP and NENP. HArg levels in the male patients were significantly lower in ENP compared with both controls and NENP. With regard to serum levels of guanidino compounds in ENP with symptomatic generalized epilepsy and with symptomatic partial epilepsy, significantly lower levels of HArg were observed in male ENP with symptomatic generalized epilepsy than in NENP. Serum levels of GAA and HArg in uncontrolled female ENP were significantly lower than those in controlled ENP. Furthermore, Arg and HArg levels in uncontrolled male ENP were significantly lower than in controlled ENP. Serum levels of Arg in male ENP and HArg in both sexes of ENP taking valproic acid were significantly lower than those in ENP not taking valproic acid. These results suggest that some metabolic disorder of guanidino compounds may exist in ENP and NENP and that guanidino compounds may be affected by seizure types, seizure severity and anticonvulsants.     

甲硫氨酸维B_1对创伤性癫痫大鼠的治疗机制研究

目的探讨甲硫氨酸维B_1(MVB_1)对创伤性癫痫(PTE)的治疗机制。方法将15只雄性SD大鼠随机分为假手术组、癫痫组和癫痫MVB1治疗组,Morris水迷宫方法观察各组大鼠学习和记忆行为变化,检测各组大鼠血清和海马组织中超氧化物歧化酶(SOD)、丙二醛(MDA)和还原性谷胱甘肽(GSH)浓度变化。结果癫痫组大鼠5d的逃避潜伏期显著延长,站台穿越次数显著降低,目标象限时间显著缩短,血清及海马组织SOD和GSH水平显著降低,MDA水平显著增加。癫痫大鼠MVB1处理后,5d的逃避潜伏期均显著缩短,站台穿越次数显著增加,目标象限时间显著延长,血清及海马组织SOD和GSH水平显著增加,MDA水平显著降低。结论 MVB1可改善PTE大鼠的学习记忆功能,可通过提高SOD和GSH浓度,降低MDA浓度来抑制脂质过氧化和减轻自由基损伤,为MVB1临床治疗癫痫提供了新的理论依据。     

Lumbar cerebrospinal fluid homovanillic acid concentrations are higher in female than male non-human primates

Concentrations of homovanillic acid and 5-hydroxyindoleacetic acid were determined in lumbar cerebrospinal fluid from intact male and female Macaca nemestrina. Concentrations of homovanillic acid, but not 5-hydroxyindoleacetic acid were significantly higher in the females under baseline conditions. Following probenecid treatment, 5-hydroxyindoleacetic acid concentrations were significantly elevated over baseline conditions in both sexes although only homovanillic acid concentrations were significantly higher in the female monkeys.     

Viral regulation of aquaporin 4, connexin 43, microcephalin and nucleolin

The current study investigated whether human influenza viral infection in midpregnancy leads to alterations in proteins involved in brain development. Human influenza viral infection was administered to E9 pregnant Balb/c mice. Brains of control and virally-exposed littermates were subjected to microarray analysis, SDS-PAGE and western blotting at three postnatal stages. Microarray analysis of virally-exposed mouse brains showed significant, two-fold change in expression of multiple genes in both neocortex and cerebellum when compared to sham-infected controls. Levels of mRNA and protein levels of four selected genes were examined in brains of exposed mice. Nucleolin mRNA was significantly decreased in day 0 and day 35 neocortex and significantly increased in day 35 cerebellum. Protein levels were significantly upregulated at days 35 and 56 in neocortex and at day 56 in cerebellum. Connexin 43 protein levels were significantly decreased at day 56 in neocortex. Aquaporin 4 mRNA was significantly decreased in day 0 neocortex. Aquaporin 4 protein levels decreased in neocortex significantly at day 35. Finally, microcephalin mRNA was significantly decreased in day 56 neocortex and protein levels were significantly decreased at 56 cerebellum. These data suggest that influenza viral infection in midpregnancy in mice leads to long-term changes in brain markers for enhanced ribosome genesis (nucleolin), increased production of immature neurons (microcephalin), and abnormal glial-neuronal communication and neuron migration (connexin 43 and aquaporin 4).     

The Role of Oxytocin Release in the Mediobasal Hypothalamus of the Sheep in Relation to Female Sexual Receptivity

In vivo microdialysis and retrodialysis were used to investigate the role of oxytocin (OXY) release in the mediobasal hypothalamus (MBH) of the ewe in the control of sexual receptivity. Initial experiments showed that OXY release was significantly increased in ovariectomized animals treated with progesterone and oestradiol when they were sexually receptive towards males and received intromissions. No such increases were seen during tests where the ewes were receptive but the males were prevented from achieving intromission. By contrast, OXY release was significantly reduced in tests where the ewes were not receptive to the male. In a second experiment artificial vaginocervical stimulation (VCS) was found to significantly increase OXY release when the animals were treated with oestradiol and this effect was potentiated by progesterone priming. OXY release in the MBH was not significantly altered by VCS in the presence of progesterone priming alone. Plasma OXY concentrations were significantly increased by VCS following all three hormone treatments but no one treatment was significantly more effective than another. Noradrenaline release in the MBH was only significantly increased following VCS when progesterone priming was given before oestradiol treatment. No effects of VCS on release of GABA, glutamate or dopamine were seen but their basal concentrations were significantly increased by the combined steroid treatment compared to oestradiol alone. In a third experiment it was found that OXY (10 μM) infused bilaterally into the MBH of receptive ewes, by retrodialysis, significantly decreased sexual receptivity and increased the release of noradrenaline and GABA. Finally, in a fourth experiment is was shown that multiple intromissions significantly reduced sexual receptivity. These results show that OXY release in the MBH is increased by natural or artificial VCS and that this is modulated by sex steroids. The inhibitory action of OXY infusions into the MBH on sexual receptivity suggests that a functional role of this peptide within this brain region might be to mediate decreases in sexual receptivity which we observed following multiple intromissions. It is probable that the behavioural effects of this peptide are primarily mediated directly rather than through a modulation of noradrenaline and GABA release.     

Depression in patients with early versus late onset of Parkinson's disease

We examined correlates of depression in patients whose onset of Parkinson's disease (PD) began before age 55 (early-onset group) compared with patients whose onset was after age 55 (late-onset group). The early-onset group showed a significantly higher frequency of depression than the late-onset group. When both groups were matched for duration of the disease, the early-onset group still showed a significantly higher frequency of depression, whereas tremor, akinesia, and rigidity were significantly more severe in the late-onset group. A stepwise regression analysis showed that in the early-onset group, depression scores were significantly correlated with scores of cognitive impairment and duration of the disease, while in the late-onset group, depression scores were significantly correlated with impairments in activities of daily living. These data suggest that depression in patients with early-onset PD may have a different etiology than in patients with late-onset PD.     

急性一氧化碳中毒后迟发性脑病患者血清内皮素-1、TNF-α的表达水平及其临床意义

目的 探讨血清内皮素-1(ET-1)、TNF-α的水平及其动态变化与急性一氧化碳(CO)中毒后迟发性脑病(DEACMP)患者病情变化的关系.方法 应用酶联免疫吸附法(ELISA)动态测定31例DEACMP患者血清ET-1、TNF-α水平,用日常生活能力量表(ADL)、常识-记忆-注意测验(IMCT)、长谷川痴呆量表(HDS)动态检查DEACMP患者病情变化,并与30例急性CO中毒后未发生迟发性脑病患者(急性CO中毒组)和30例同期健康体检者(正常对照组)进行比较.结果 急性CO中毒组、DEACMP组患者急性期血清ET-1、TNF-α水平明显高于正常对照组,差异均有统计学意义(P＜0.05);DEACMP组患者急性期TNF-α水平明显低于急性CO中毒组,差异有统计学意义(P＜0.05),ET-1水平与急性CO中毒组比较差异无统计学意义(P＞0.05).DEACMP患者恢复期血清ET-1水平明显低于急性期,差异有统计学意义(P＜0.05).DEACMP患者急性期ADL得分均高于常模(正常值≤20分),IMCT和HDS得分均低于常模(正常值分别为≥19分和＞16分).DEACMP患者恢复期ADL得分明显低于急性期,IMCT和HDS得分明显高于急性期,差异均有统计学意义(P＜0.05).DEACMP患者急性期和恢复期ADL、IMCT和HDS得分两两之间均有明显相关性(P＜0.05).结论 动态检测血清ET-1、TNF-α水平可以作为判定DEACMP患者病情程度的指标.     

针刺配合中西药治疗对脑出血术后患者神经功能康复的影响

目的 探讨针刺联合中西药治疗对脑出血术后患者神经功能康复的影响.方法 收集2011-01-2013-11我院收治的脑出血术后神经功能缺损患者 118例,随机分为观察组与对照组,各59例,对照组予以常规西药治疗,观察组在对照组的基础上加用中药及针刺治疗.结果 2组患者治疗后脑水肿范围均显著缩小,但观察组显著小于对照组（P＆lt;0.05）;2组NIHSS评分均显著降低,但观察组显著低于对照组（P＆lt;0.05）;2组Barthel指数均显著升高,但观察组显著高于对照组（P＆lt;0.05）;观察组的ADL分级明显低于对照组（P＆lt;0.05）.结论 针刺联合中西药治疗可有效改善脑出血术后患者的神经功能缺损症状,促进患者康复,值得推广应用.     

依达拉奉辅助亚低温对重型颅脑创伤的血清细胞因子及凝血功能的影响

目的探讨依达拉奉辅助亚低温治疗对重型颅脑创伤（TBI）患者的凝血功能及神经生长因子（NGF）、降钙素基因相关肽（CGRP）的影响。 方法选取沧州市中心医院神经外三科自2018年8月至2019年8月收治的62例重型TBI患者,按随机数字表法分为观察组（31例）和对照组（31例）。对照组患者给予亚低温治疗,观察组患者在亚低温治疗基础上给予依达拉奉辅助治疗14 d。比较2组患者的神经功能缺损评分和疗效,观察治疗前后患者的脑内凝血功能以及血清内NGF、CGRP含量的变化。 结果观察组患者的临床治疗有效率显著高于对照组（P<0.05）。观察组患者采用依达拉奉辅助亚低温治疗后颅内水肿面积显著降低,大脑中动脉平均血流速度明显升高,美国国立卫生研究院卒中量表评分水平显著下降,巴塞尔指数评定量表评分和GCS评分显著增高,差异有统计学意义（P<0.05）。观察组患者采用依达拉奉辅助亚低温治疗后NGF、CGRP水平明显升高,血浆D-二聚体、纤维蛋白原、凝血酶原时间、凝血酶原时间国际标准比值、活化部分凝血活酶时间、凝血酶时间显著下降,抗凝血酶显著上升,差异均有统计学意义（P<0.05）。 结论依达拉奉辅助亚低温治疗重型TBI的临床治疗效果较好,安全性较高,可有效恢复患者的凝血功能,促进NGF、CGRP表达。     

基于p38丝裂原活化蛋白激酶通路的胰高血糖素样肽-1对大鼠脑缺血再灌注损伤的影响及机制

目的基于p38丝裂原活化蛋白激酶(p38MAPK)通路探讨胰高血糖素样肽-1(GLP-1)对大鼠脑缺血再灌注(I/R)损伤的影响及机制。方法将雄性SD大鼠分为假手术组、模型组、GLP-1组和p38MAPK抑制剂组,每组12只。模型组、GLP-1组和p38MAPK抑制剂组通过大脑中动脉栓塞及再灌注建立脑I/R损伤模型,GLP-1组给予利拉鲁肽(70μg/kg)、p38MAPK抑制剂组给予p38MAPK抑制剂SB202190(10μmol/L、5μl)干预。比较四组大鼠的脑梗死体积、水迷宫行为参数及梗死脑组织细胞凋亡率、氧化应激指标、炎症细胞因子、p38MAPK通路分子的差异。结果与模型组比较,GLP-1组和p38MAPK抑制剂组大鼠的脑梗死体积明显降低,逃避潜伏期明显缩短、穿越平台次数明显增多,梗死脑组织中的细胞凋亡率及丙二醛(MDA)、超氧化物歧化酶(SOD)、TNF-α、IL-1β、IL-6、p-p38水平显著减少,SOD、谷胱甘肽过氧化物酶(GPx)水平明显增加(均P<0.05),p-ERK1/2、p-JNK的表达水平无明显变化。与假手术组比较,模型组大鼠的逃避潜伏期明显延长、穿越平台次数明显减少,梗死脑组织的细胞凋亡率及MDA、ROS、TNF-α、IL-1β、IL-6、p-p38水平明显增高,SOD、GPx水平明显减少(均P<0.05),p-ERK1/2、p-JNK的表达水平无明显变化。结论GLP-1能够通过抑制p38介导的氧化应激及炎症反应减轻大鼠脑I/R损伤。     

Pain perception in self-injurious patients with borderline personality disorder.

Pain ratings during the cold pressor test were significantly lower in female inpatients with borderline personality disorder who report that they do not experience pain during self-injury (BPD-NP group, n = 11), compared with similar patients who report that they do experience pain during self-injury (BPD-P group, n = 11), and normal female subjects (n = 6). Pain ratings were not significantly different in the BPD-P and normal control groups. Self-report ratings of depression, anger, anxiety, and confusion were significantly lower, and ratings of vigor significantly higher following the cold pressor test in the BPD-NP group, but not in the BPD-P group. Only anxiety was significantly lower in the normal control group following the cold pressor test. The implications and limitations of these preliminary findings are discussed.     

亚低温通过抑制AIF核转位改善大鼠颅脑损伤

目的 探讨亚低温对颅脑损伤（TBI）大鼠脑组织凋亡诱导因子（AIF）核转位的影响。方法 将36只成年雄性SD大鼠随机分为假手术组、TBI组、亚低温组，每组12只。采用控制性皮质撞击建立TBI模型，亚低温组大鼠给予亚低温处理。TBI后24 h，HE染色观察大鼠脑组织病理学变化；免疫组织化学方法检测大鼠脑组AIF的表达部位；免疫印迹法检测损伤脑组织线粒体和细胞核AIF、caspase-3的表达情况。结果 HE染色结果显示，TBI后，损伤侧脑组织可见沿灰白质界面的挫伤和出血，亚低温组挫伤和出血灶明显减轻。免疫印迹法检测结果显示，TBI后，损伤脑组织caspase-3表达量明显增加（P<0.01），细胞核AIF表达量明显增加（P<0.01），而线粒体AIF表达量明显降低（P<0.05）；亚低温组损伤脑组织caspase-3表达量明显下降（P<0.01），细胞核AIF表达量明显下降（P<0.01），而线粒体AIF表达量明显升高（P<0.05）。免疫组织化学染色结果显示，假手术组AIF位于大脑皮质和海马神经元细胞核外；TBI组后，损伤侧皮质及海马区AIF从线粒体转移至细胞核内的阳性细胞数量明显增多（P<0.01）；亚低温组损伤侧皮质及海马区AIF发生核内转移的阳性细胞数量减少（P<0.01）。结论 亚低温可能通过抑制AIF的核转位减轻颅脑损伤后神经细胞凋亡，从而起到神经保护作用。     

盐酸洛美利嗪治疗偏头痛的疗效及安全性研究

目的探讨盐酸洛美利嗪治疗偏头痛的疗效及安全性。方法 60例偏头痛患者随机分为A、B两组,每组30例。两组均给予盐酸洛美利嗪和安慰剂进行为期30周的双盲自身交叉对照试验。记录患者治疗第2、8、14、16、22、28、30周末的头痛发作频率,进行偏头痛致残评定量表(MIDAS)评定。结果与治疗前比较,A组第8周的MIDAS2～5、第14、16周的MIDAS1～5和第22周的MIDAS1～4评分显著下降(均P<0.05);B组第14周MIDAS1～3及第16～30周的MIDAS1～5评分显著下降(均P<0.05)。A组第14周的头痛发作频率显著低于B组,B组第28周头痛发作频率显著低于A组(均P<0.01)。A组第14周头痛发作强度改善率、发作频率改善率显著高于第28周;B组第28周显著高于第14周(P<0.05～0.001)。A组治疗第14周时总有效率显著高于B组;B组治疗第28周时总有效率显著高于A组(均P<0.001)。两组患者治疗期间均无严重不良反应。结论盐酸洛美利嗪预防性治疗偏头痛安全、有效,停药后疗效仍有一定持久性。     

Reaction-times of normal subjects to monaurally presented verbal and tonal stimuli

Sixteen right-handed subjects responded to monaurally presented verbal and tonal stimuli with their right and left hands at separate times. Subjects' reaction-times to speech were significantly faster when they heard words in their right ears, while their reaction-times to tones proved significantly faster after left-ear stimulations. Reaction-times to speech were significantly faster when subjects responded with their right hands, but after tonal stimulations, left-handed responses were significantly faster. These results were interpreted as demonstrating consistent laterality effects—the faster response occuring after intrahemispheric processing. Furthermore, the interactions between ear stimulated and hand of response were suggestive of minor hemisphere processing.     

Patient, parent, and staff attitudes toward allowing adolescent psychiatric inpatients to smoke

A smoking attitude survey was developed and administered to adolescent patients, parents, and staff members at a psychiatric hospital for adolescents 6 months before and 6 months after the institution of a patient smoking ban. Attitudes before the ban were significantly more favorable toward allowing patient smoking than attitudes after the ban; smokers were significantly more in favor of allowing patient smoking than nonsmokers; and patients were significantly more in favor of allowing patient smoking than parents, who were significantly more in favor of allowing patient smoking than staff (overall ps less than 0.0001; post-hoc ps less than 0.05). The findings support the feasibility of implementing smoking bans in adolescent inpatient facilities.     

儿童期虐待对新兵社会支持及应对方式的影响

目的研究儿童期虐待对新兵社会支持及应对方式的影响。方法对505名入伍新兵进行儿童受虐问卷（CTQ-SF）、简易应对方式问卷（SCSQ）、青少年社会支持量表评定。结果遭受儿童期虐待的新兵在应付方式选择及社会支持上显著低于无虐待组（P〈0．05）。简单相关分析显示儿童期情感虐待、情感忽视、躯体忽视及总虐待分均与积极应对呈负相关（P〈0．01）;儿童期经历过情感虐待、情感忽视、性虐待、躯体虐待、躯体忽视及虐待总分均与消极应对呈正相关（P〈0．05,P〈0．01）。儿童期情感虐待、躯体虐待、情感忽视、躯体忽视及总虐待分均与社会支持总分、客观支持、支持利用度呈负相关（P〈0．01）;儿童期经历过情感虐待、情感忽视、性虐待、躯体虐待、躯体忽视及虐待总分均与主观支持成负相关（P〈0．05,P〈0．01）。情感忽视、躯体忽视与积极应对方式呈负相关（P=0．000,P=0．003）;虐待总分、情感虐待与消极应对方式呈正相关（P=0．032,P=0．026）,与社会支持总分呈负相关（P=0．000,P=0．011）。结论儿童期遭受虐待的新兵在应对方式上往往采取消极应对,且社会支持不良。     

应激有关因素与缓解期精神分裂症患者应对方式的相关研究

目的探讨应激有关因素与缓解期精神分裂症患者应对方式的相关性。方法选取142例缓解期精神分裂症患者为研究组,85例正常人为对照组,采用应对方式问卷对研究组和对照组进行评定,对研究组患者单独评定症状自评量表（SCL-90）、领悟社会支持量表（PSSS）、自动思维问卷（ATQ）及艾森克人格问卷（EPQ）。结果研究组解决问题分低于对照组,自责、回避、合理化分高于对照组,成熟应对方式得分明显低于对照组,不成熟应对方式得分明显高于对照组（P〈0.05）。研究组中,ATQ与应付方式问卷中除合理化外各因子均有相关性（P〈0.05）,PSSS量表中的家庭外社会支持和社会支持总分与解决问题、求助、成熟应对方式有相关性（P〈0.05）,SCL-90与所有应对方式因子均有相关性（P〈0.05）,EPQ中的内外向与解决问题、自责、求助、成熟应对方式有相关性（P〈0.01）,神经质与除解决问题外各因子均有相关性（P〈0.01）,精神质与除回避外各因子均有相关性（P〈0.05）,掩饰与所有因子均有相关性（P〈0.05）。多元逐步回归分析结果显示,与成熟应对相关的因子包括内外向、家庭外支持、家庭内支持、精神质,与不成熟应对相关的有ATQ、掩饰因子,与混合型应对方式相关的有SCL-90总分。结论缓解期精神分裂症患者存在不成熟应对方式,其与应激因素相关。