慢性精神分裂症病人的免疫功能测定

为探讨慢性精神分裂症免疫功能状况，对９６例病人Ｔ淋巴细胞亚群、异常淋巴细胞、淋巴细胞转化率和白细胞介素２（ＩＬ－２）分泌细胞进行检测，以２５名健康人为对照。结果显示，病人ＣＤ３阳性细胞、ＣＤ４阳性细胞及ＣＤ４／ＣＤ８、淋巴细胞转化率和体外ＩＬ－２分泌细胞明显降低（Ｐ均＜０．００１），而Ｐ型异常淋巴细胞明显增多（Ｐ＝０．０００１）。提示慢性精神分裂症病人存在免疫功能紊乱，主要表现为免疫功能低下，同时伴有自身免疫倾向。此结果与精神分裂症的病毒感染假说和自身免疫假说相符     

精神分裂症免疫功能紊乱机理的研究

为探讨精神分裂症免疫功能紊乱的机理，检测了２８例精神分裂症患者外周血Ｔ细胞亚群、Ｂ细胞百分率及外周血单个核细胞白细胞介素（ＩＬ－２）、白细胞介素－４（ＩＬ－４）的诱生能力。发现患者组外周血全体Ｔ细胞（ＣＤ＋３）及辅助Ｔ细胞（ＣＤ＋４）均值明显低于对照组，ＩＬ－２诱生能力低下而ＩＬ－４诱生能力、血清总ＩｇＥ含量明显增高，与正常对照组相比有显著性差异。提示精神分裂症患者免疫功能紊乱主要表现为ＴＨ１细胞减少，ＴＨ２细胞相对或绝对增多。     

银杏叶提取物对精神分裂症免疫功能的影响

目的：探讨银杏叶提取物对精神分裂症免疫功能的影响。方法：采用双盲、空白对照的方法,应用银杏叶提取物360mg/日（商品名舒血宁）结合固定剂量的氟哌啶醇治疗96例慢性精神分裂症12周,在治疗前后检测T细胞亚群和白细胞介素2（IL－2）分泌细胞。结果：治疗前患者免疫功能低下,表现为CD3＋、CD4＋细胞CD／4CD8以及IL－2分泌细胞显著减少,治疗后,氟哌啶醇组CD4＋细胞显著增高,银杏叶提取物合并氟哌啶醇治疗组CD3＋细胞、CD4＋细胞、CD4／CD8以及IL－2分泌细胞均显著增高。结论：氟哌啶醇治疗对慢性精神分裂症的免疫功能有一定程度的改善作用;银杏叶提取物合并氟哌啶醇可以进一步提高患者的免疫功能,同时可使紊乱的免疫功能得到改善。     

精神分裂症患者氯氮平治疗前后免疫指标的变化

目的　探讨精神分裂症患者抗精神病药物氯氮平治疗前后总T细胞 (CD3 )、T辅助 /T诱导细胞 (CD4)、T抑制 /T杀伤细胞 (CD8)及血清白细胞介素 6 (IL 6 )水平的变化。方法　对 6 6例精神分裂症患者 (男 32例 ,女 34例 )和 30名健康对照者 (男 16名 ,女性 14名 )的血清CD3 、CD4、CD8、CD4/CD8及IL 6的水平进行检测。用酶联免疫吸附法 (ELISA)及碱性磷酸酶抗碱性磷酸酶法 (APAAP)检测各受试者血清IL 6及T细胞亚群。结果　 (1) 6 6例精神分裂症患者治疗前CD3 、CD4、CD8、CD4/CD8比值均低于对照组 (P <0 0 1～ 0 0 0 1) ,而IL 6 [(1 8± 0 6 )ng/L]则高于对照组 [(1 2± 0 6 )ng/L],P <0 0 0 1;(2 )氯氮平治疗后CD3 、CD4、CD4/CD8高于治疗前 (P <0 0 1) ;(3)阳性、阴性组患者治疗前CD3 、CD4、CD8、CD4/CD8均低于对照组 (P <0 0 1) ,而IL 6水平则高于对照组高 (P <0 0 1) ;(4)治疗后阳性、阴性组患者IL 6水平 [(1 2± 0 3)ng/L、(1 1± 0 5 )ng/L]均较治疗前有所降低 ,与对照组的差异无显著性 (P >0 0 5 ) ;(5 )阳性、阴性组患者治疗后组间比较 ,阳性组CD3 、CD4、CD4/CD8明显高于阴性组 ,CD8低于阴性组 (P <0 0 5 ) ,两组间IL 6水平的差异无显著性 (P >0 0 5 ) ;(6 )多元逐步回归分析显示 ,阳     

重症肌无力患者细胞免疫及免疫调节 与临床疗效关系的分析

目的探讨周围血中ＮＫ细胞、Ｔ细胞亚群、细胞膜白细胞介素－２受体（ｍＩＬ－２Ｒ）阳性细胞与重症肌无力（ＭＧ）发病及临床疗效的关系。方法用流式细胞仪计数３９例ＭＧ患者ＣＤ３、ＣＤ４、ＣＤ８、ＣＤ２５和ＣＤ５６抗体阳性细胞的百分率,应用许氏临床评分法对病情的严重程度和转归进行评定。结果ＭＧ患者的ｍＩＬ－２Ｒ（ＣＤ２５）阳性细胞无明显改变。ＣＤ３阳性细胞在肾上腺皮素激素治疗前、后无明显改变。ＮＫ细胞（ＣＤ５６）和ＣＤ４阳性细胞在治疗前均明显高于正常（Ｐ＜００１）,治疗２个月后均明显下降（Ｐ＜０．０１,０．０５）。ＣＤ８阳性细胞治疗前后明显降低和增高（Ｐ＜００５）。结论ｍＩＬ－２Ｒ阳性细胞百分率不能直接反映ＭＧ的免疫功能紊乱,并对ＮＫ细胞和Ｔ细胞亚群的变化无直接调节作用。ＮＫ细胞增高,可能为其功能下降的代偿性变化。ＣＤ４增高,ＣＤ８下降提示免疫功能紊乱,符合自身免疫性疾病的特点。     

帕金森病患者T淋巴细胞亚群、TNF、IL-2水平研究

此文报道 48例帕金森病 ( Parkinson disease,PD)患者T淋巴细胞亚群、肿瘤坏死因子 ( TNF)、白细胞介素 -2( IL-2 )检测结果。1　资料和方法　 PD患者组 :采用全国统一的 PD诊断标准筛选病例、临床分型 ,并经头颅 CT或 MRI证实 ,根据改良 Webster PD功能障碍记分法进行评分。 48例患者中 ,男2 7例、女 2 1例 ,年龄 46～ 81岁 ,平均 ( 62 .7± 9.8)岁。对照组 :为经严格体格检查排除神经系统疾病的健康者 3 0例 ,男 1 8例、女 1 2例 ,年龄 5 0～ 75岁 ,平均 ( 60 .3± 8.9)岁。采用 APAAP、ELISA法测定外周血 T淋巴细胞亚群、血…     

海洛因依赖者脱毒后白细胞介素-6及肿瘤坏死因子-α水平的变化

目的　观察海洛因依赖者脱毒后白细胞介素６ 和肿瘤坏死因子α的变化。方法　采用 Ｅ Ｌ Ｉ Ｓ Ａ 法检测１８ 例未给予任何治疗药物且停用阿片类药物４８ ～７２ 小时、１８ 例脱毒３３ ～５８ 天、１５ 例脱毒１１７ ～１２０ 天的海洛因依赖者的白细胞介素６ 和肿瘤坏死因子α水平,并同时对稽延性戒断症状或急性戒断症状进行评定。结果　与正常对照组相比,海洛因依赖者脱毒后的白细胞介素６ 和肿瘤坏死因子α显著高于正常对照组。白细胞介素６ 和肿瘤坏死因子α随着脱毒时间的延长逐步向正常恢复。结论　白细胞介素６ 和肿瘤坏死因子α可考虑作为海洛因依赖者脱毒后机体恢复的指标。     

海洛因依赖的亚冬眠疗法与美沙酮疗法对照观察

对自愿戒断海洛因依赖住院患者１１６例，分别用亚冬眠与美沙酮替代递减进行治疗。结果表明：亚冬眠和美沙酮替代递减之间效果存在着明显差异；后者能有效控制戒断症状，且容易递减和停药，病人依从性好，不影响病人意识，生活能自理，情绪平稳，副反应极少。     

Th22细胞及相关因子在重症肌无力患者外周血中的表达

目的研究重症肌无力(myasthenia gravis,MG)患者外周血辅助性T细胞22(T helper 22cells,Th22)和白细胞介素-22(interleukin-22,IL-22)的表达以及两者间的相关性。方法收集25例MG患者和24例健康对照者,其中眼肌型重症肌无力(ocular myasthenia gravis,OMG)患者14例,全身型重症肌无力(general myasthenia gravis,GMG)患者11例。采用流式细胞仪检测MG患者和健康对照者外周血单个核细胞(peripheral blood mononuclear cells,PBMC)中Th22细胞的比例,采用酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)检测血浆IL-22的表达。比较各组间Th22细胞比例和IL-22表达水平差异,以及Th22细胞比例和IL-22表达间的相关性。结果 MG患者PBMC中Th22细胞比例、血浆IL-22表达水平均显著低于健康对照组[(0.60±0.07)%比(0.92±0.09)%,P0.01;(18.65±1.38)pg/mL比(24.54±1.85)pg/mL,P0.05];OMG与GMG患者间Th22细胞比例、IL-22表达水平均无统计学差异(均P0.05);MG患者PBMC中Th22细胞比例与IL-22表达水平间呈中度正相关(r=0.59,P0.01)。结论 MG患者体内Th22细胞比例及血浆IL-22表达水平减低可能导致免疫功能紊乱进而影响MG的发病。     

孤独症患者T淋巴细胞功能及其亚群的研究

为研究孤独症患者免疫学方面的异常，探索孤独症的病理学机制，对２７例孤独症、１６例精神发育迟滞（ＭＲ）和１８名正常儿童进行了Ｔ淋巴细胞增殖反应及其亚群的测定，应用ｔ检验进行统计学处理。结果显示：孤独症组的ＣＤ４阳性细胞百分数明显低于其它两组（ｔ值分别为２．６４，２．２１；Ｐ平均值＜０．０５），孤独症ＣＤ３阳性细胞也较ＭＲ组显著为低（ｔ＝２．４７４，Ｐ＜０．０２）。在淋巴细胞增殖反应方面，孤独症组也较对照组明显降低（ｔ＝２．１７５，Ｐ＜０．０５）。提示ＣＤ４阳性细胞数下降与孤独症的发病有关，并讨论了孤独症与Ｔ淋巴细胞功能间的联系     

Changes in the cAMP-related signal transduction mechanism in postmortem human brains of heroin addicts

Summary. Immunoreactivities of adenylyl cyclase (AC) type I (AC-I), and basal, forskolin- and Mn²⁺-stimulated AC activities with or without calcium and calmodulin (Ca²⁺/CaM) were estimated in temporal cortex (TC)-and nucleus accumbens (NAc) membranes from brains of heroin addicts and controls. Immunoreactivity of AC-I was significantly decreased in TC from brains of heroin addicts, but that did not change in NAc. Ca²⁺/CaM-sensitive AC activity was significantly lower in TC from brains of heroin addicts, but that activity in NAc did not show significant difference compared with the control. Some previous reports demonstrated that Ca²⁺/CaM-sensitive AC activity in membranes from postmortem human brain reflected the function of AC-I. Therefore, the downregulation of AC-I in TC plays an important role in the molecular mechanism of chronic opiate addiction in human brain. Received August 1, 2000; accepted August 28, 2000     

Mortality in heroin addiction: impact of methadone treatment

The mortality within a cohort of 115 street heroin addicts was studied for 5-8 years using the Kaplan-Meier survival estimate technique. This differed markedly from the relatively low mortality of 166 comparable heroin addicts given methadone maintenance treatment (MT). The street addicts' mortality rate was 63 times that expected, compared with official statistics for a group of this age and sex distribution. When 53 patients in MT were involuntarily expelled from treatment, due to violation of programme rules, they returned to the high mortality of street addicts (55 times that expected). A group of 34 rehabilitated patients who left MT with medical consent retained the low mortality of MT patients (their mortality rate was 4 times that expected). Despite this great improvement in survival, even patients in MT showed a moderately elevated mortality (8 times that expected), mainly due to diseases acquired before entering the treatment programme. It is concluded that MT exerts a major improvement in the survival of heroin addicts.     

性别对海洛因相关环境线索诱发心理生理反应的影响

目的 了解康复期海洛因依赖者对吸毒相关环境线索的心理生理反应的性别差异.方法 采用自身配对设计,173例男性和235例女性康复期海洛因依赖者观看吸毒相关视频的同时给予海洛因模拟物及吸毒用具刺激,用生物反馈仪记录诱发前、中、后的心理生理反应.结果 环境线索诱发使男女海洛因依赖者的皮温随时间变化而不同,其中诱发中与诱发后阶段比较差异有统计学意义(P＜0.05);环境线索诱发导致女性诱发中阶段的呼吸频率和诱发后阶段的皮温均低于男性(P＜0.01).结论 环境线索诱发对男女性的呼吸频率和皮温指标反应具有不同影响,且性别对皮温的影响随时间阶段的变化而不同.     

The dynamics of disclosure: its impact on recovery and rehabilitation

Disclosure of one's own experiences with psychiatric disability can be both exhilarating and depressing. This article shares experiences of the author and others in their disclosure, and provides some ideas about the risks and benefits of disclosure.     

Racism and its impact on psychotherapy

It is necessary to deal with racial material in therapy as well as in the real world outside of therapy. When this is not done, patients terminate their treatment feeling that the therapist did not understand them as patients and individuals. Black therapists have heard this often from their black patients who have previously seen nonblack therapists. The author does not propose that all therapy of black patients be done by black therapists but that a definite concern for racial issues should prevail in any therapeutic encounter to which a black patient brings problems related to racial prejudice and/or discrimination.     

Postmodernism and its impact on psychoanalysis

This article explores the heterogeneity of postmodern thought and its contributions to contemporary psychoanalytic theory and practice; the heterogeneity of psychoanalytic theory and the claims of privilege and standing made by individual theories; and the postmodern terrain and its conflicting points of view. Its origins are also traced back to the work of classical analytic authors, notably Erikson, Gill, Hartmann, Klein, and Rapaport. A solution to the problem of theoretical plurality is suggested, addressing its ontological and epistemological roots.     

The effects of heroin administration and drug cues on impulsivity

Drug addiction is a chronic relapsing disorder characterized by compulsive drug seeking and continued use despite negative consequences. Behavioral impulsivity is a strong predictor of the initiation and maintenance of drug addiction. Preclinical data suggest that heroin may exacerbate impulsive characteristics in an individual but this has yet to be assessed in clinical samples. The current secondary data analysis sought to investigate the effects of heroin on impulsivity along with the effects of exposure to drug cues. Using the current data set, we also tentatively assessed the etiological relationship between impulsivity and heroin abuse. Sixteen heroin-dependent participants were recruited to complete Immediate Memory Task/Delayed Memory Task (IMT/DMT) and GoStop tasks following repeated heroin administration, following acute heroin administration, and following a drug cue exposure session. Four preceding days of active heroin availability, compared to four preceding days of placebo drug availability, increased impulsivity assessed using the IMT and DMT. Presentation of drug cues similarly acted to increase impulsivity assessments on all three tasks. It also appears that heavier users were more susceptible to the influence of drug cues on impulsivity. The present study represents a step toward a more comprehensive understanding of the interaction between opioid abuse and impulsivity. A better understanding of these factors could provide critical insight into the maintenance of heroin use and relapse.