氟哌噻吨美利曲辛对良性阵发性位置性眩晕成功复位后残余头晕的影响

目的观察氟哌噻吨美利曲辛对良性阵发性位置性眩晕成功管石复位后残余头晕的影响。方法 60例良性阵发性位置性眩晕成功管石复位后发生残余头晕的患者随机分为对照组及观察组,对照组28例,观察组32例。对照组给予内科常规治疗,观察组在内科治疗的基础上加用氟哌噻吨美利曲辛治疗。于治疗前及治疗后第7天、第14天评估眩晕障碍量表(DHI)评分、医院焦虑抑郁量表(HADS)评分及前庭症状指数(VSI)。结果治疗后第7天及第14天,观察组DHI总分及各子项评分、HADS评分及VSI均低于对照组(P0.05)。结论氟哌噻吨美利曲辛可以通过抗焦虑、抗抑郁作用,改善良性阵发性位置性眩晕成功复位后的残余头晕症状,改善患者生活质量。     

眩晕伴焦虑状态的临床疗效分析

目的观察美利曲辛与氟哌噻吨联合治疗眩晕伴焦虑症状患者的疗效.方法选择以眩晕为主诉伴有明显焦虑情绪的患者,随机分2组,治疗组在口服尼莫地平的基础上联用美利曲辛与氟哌噻吨,连续4周,对照组口服尼莫地平4周.在治疗前后对眩晕等症状改善情况进行评分以及用汉米尔顿焦虑量表(HAMA)对焦虑状态进行评分,并在服药过程中对药物副作用进行观察.结果治疗组眩晕症状改善明显优于对照组(P＜0.01),并且焦虑情绪也明显好转,治疗前后HAMA评分下降明显优于对照组(P＜0.01).结论美利曲辛与氟哌噻吨联合治疗不但可改善焦虑症状患者的焦虑情绪,也可明显改善他们伴有的眩晕等躯体症状.     

氟哌噻吨美利曲辛片与高压氧治疗脑卒中后睡眠障碍

目的观察氟哌噻吨美利曲辛片与高压氧治疗脑卒中后睡眠障碍患者的效果。方法选取脑卒中后睡眠障碍患者86例,随机分为研究组和对照组,每组43例。对照组采用氟哌噻吨美利曲辛片治疗,研究组在氟哌噻吨美利曲辛片基础上加用高压氧治疗,比较2组患者AIS评分、睡眠率、NIHSS评分、有效率以及不良反应。结果治疗后研究组患者AIS评分显著低于对照组(P0.01),睡眠率显著高于对照组(P0.05),NIHSS评分显著低于对照组(P0.01),治疗有效率显著高于对照组(P0.05)。2组不良反应差异无统计学意义(P0.05)。结论氟哌噻吨美利曲辛片与高压氧治疗脑卒中后患者睡眠障碍的效果确切,具有临床应用价值。     

良性发作性位置性眩晕抗抑郁焦虑治疗疗效分析

目的探讨良性发作性位置性眩晕患者抗焦虑抑郁治疗疗效。方法我院2009—2012年收治病程>2周的良性发作性位置性眩晕患者58例,随机分为治疗组和对照组,治疗组进行常规眩晕治疗(药物及手法复位)+氟哌塞顿美利曲辛治疗,对照组进行常规眩晕治疗。2组患者在初诊时、治疗2周后分别进行DHI量表评分测定。结果治疗组DHI量表分值明显低于对照组,眩晕症状改善明显优于对照组。结论良性发作性位置性眩晕患者常伴随抑郁焦虑情绪,针对性进行抗抑郁焦虑治疗有益于改善患者眩晕症状。     

氟哌噻吨美利曲辛联合马来酸曲美布汀治疗肠易激综合征并焦虑抑郁的效果

目的 分析氟哌噻吨美利曲辛联合马来酸曲美布汀治疗肠易激综合征合并焦虑、抑郁患者的临床效果。方法选取2010-05—2013-06我院收治的肠易激综合征患者52例,随机分为观察组及对照组,均采用马来酸曲美布汀片治疗,观察组加用氟哌噻吨美利曲辛片,均治疗4周,观察2组治疗效果。结果 治疗前2组患者症状评分、SDS和SAS评分差异无统计学(P>0.05),治疗后2组症状评分、SDS和SAS评分均有所改善,而观察组改善情况优于对照组,差异有统计学意义(P<0.05)。治疗后观察组总有效率92.3%,对照组69.2%,观察组总有效率高于对照组,差异有统计学意义(χ2=4.46,P<0.05)。结论 氟哌噻吨美利曲辛联合马来酸曲美布汀治疗肠易激综合征并焦虑、抑郁患者临床效果满意,可有效改善患者临床症状和焦虑、抑郁情绪。     

普拉克索、氟哌噻吨美利曲辛治疗帕金森病合并抑郁症的疗效

目的比较普拉克索、氟哌噻吨美利曲辛治疗帕金森病(PD)合并抑郁症的疗效。方法 102例PD合并抑郁症患者随机分为普拉克索治疗组和氟哌噻吨美利曲辛治疗组,治疗半年以上。用PD统一评分量表(UPDRS)评价PD症状改善情况,用汉密顿抑郁量表17项(HAMD)和抑郁自评量表(SDS)评价抑郁症状改善情况。结果 2组患者经过治疗后UP-DRS、HAMD和SDS均较治疗前有所改善,普拉克索组UPDRS评分高于氟哌噻吨美利曲辛治疗组,HAMD和SDS比较无明显差别。结论普拉克索和氟哌噻吨美利曲辛都能改善PD合并抑郁症患者症状,且普拉克索在改善帕金森症状方面优于氟哌噻吨美利曲辛。     

黛力新治疗围绝经期妇女焦虑抑郁疗效观察

目的探讨氟哌噻吨-美利曲辛片(黛力新)治疗围绝经期及绝经后妇女心理精神障碍的效果。方法对60例围绝经期及绝经后妇女心理精神障碍患者分别给予氟哌塞吨-美利曲辛片(黛力新)+雌激素替代疗法或单纯雌激素替代治疗,在治疗前后应用抑郁自评量表(SDS)及汉密尔顿焦虑量表(HAMA)进行评分比较。结果2组治疗前的评分比较无差异(P0.05),治疗后相比均有差异(P0.01)。结论氟哌噻吨联合雌激素治疗更年期精神障碍有效,且较单纯雌激素替代疗法好。     

心理疏导联合氟哌噻吨美利曲辛片治疗冠心病合并焦虑抑郁患者的疗效

目的探讨心理疏导联合氟哌噻吨美利曲辛片治疗冠心病(CHD)合并焦虑抑郁患者的负性情绪,生活质量的疗效,并记录药物不良反应情况。方法将104例CHD合并焦虑、抑郁患者,按照随机数表法分为两组,各52例。其中对照组予以CHD常规治疗,观察组在此基础上给予氟哌噻吨美利曲辛片联合心理疏导疗法。对比两组治疗前后负性情绪评分、生活质量评分及不良反应发生率。结果观察组治疗前负性情绪评分及生活质量评分与对照组比较,差异无统计学意义(P0.05),治疗后,观察组负性情绪评分低于对照组,生活质量评分高于对照组(P0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P0.05)。结论给予CHD并焦虑、抑郁患者心理疏导联合氟哌噻吨美利曲辛片治疗,可有效缓解患者焦虑、抑郁情绪,而且安全性高,利于改善患者生活质量。     

氟哌噻吨美利曲辛联合个性化心理干预治疗对COPD合并抑郁患者的影响

目的研究氟哌噻吨美利曲辛联合个性化心理干预治疗对慢性阻塞性肺疾病(COPD)合并抑郁患者焦虑抑郁情绪、肺功能及生活质量的影响。方法选取我院从2015年4月至2016年3月收治的100例COPD合并抑郁患者,随机分为观察组(50例)和对照组(50例);两组均予以COPD的相关治疗,此外对照组采取氟哌噻吨美利曲辛进行治疗,观察组在此基础上采取为个性化心理干预治疗,将两组患者的肺功能情况、汉密尔顿焦虑量表(HAMA)评分与汉密尔顿抑郁量表(HAMD)评分、生活质量进行对比分析。结果两组患者治理前肺功能、焦虑抑郁评分及生活质量评分,组间无明显差异(P0.05);治疗后观察组的HAMA评分与HAMD评分低于对照组,生活质量评分高于对照组且肺功能各项指标均优于对照组(P0.05)。结论 COPD合并抑郁患者应用氟哌噻吨美利曲辛联合个性化心理干预治疗可有效缓解患者的抑郁焦虑情绪,改善患者的肺功能和生活质量,因此值得在临床上推广应用。     

氟哌噻吨美利曲辛治疗躯体化障碍的疗效观察

目的观察氟哌噻吨美利曲辛对躯体化障碍的疗效及不良反应。方法将60例符合CCMD-3诊断标准的躯体化障碍患者,随机分成氟哌噻吨美利曲辛组和氯米帕明组,治疗6周,用症状自评量表(SCL-90)、临床疗效大体评定量表(CGI)评定疗效,不良反应量表(TESS)评定不良反应,于治疗前及治疗第2、4、6周末分别进行疗效评价。结果治疗6周后,氟哌噻吨美利曲辛和氯米帕明的疗效相当;氟哌噻吨美利曲辛较氯米帕明起效迅速,不良反应较小。结论氟哌噻吨美利曲辛治疗躯体化障碍疗效明确、起效迅速、不良反应小,可作为躯体化障碍治疗的首选药物之一。     

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.