利培酮口服液联合度洛西汀治疗慢性精神分裂症阴性症状的临床研究

目的 探讨利培酮口服液联合度洛西汀治疗慢性精神分裂症阴性症状的临床疗效及安全性.方法 将172例以阴性症状为主的慢性精神分裂症住院患者随机分为研究组(利培酮口服液联合度洛西汀治疗)和对照组(单用利培酮口服液治疗),疗程12周,采用阳性和阴性综合征量表(PANSS)和治疗中需处理的不良反应症状量表(TESS)评定疗效和安全性.结果 治疗后两组PANSS评分均较治疗前有显著降低(P＜0.05).治疗后第4、8、12周末,研究组PANSS评分显著低于对照组(P＜0.05或P＜0.01).两组不良反应均为轻至中度,两组比较无显著性差异.结论 利培酮口服液联合度洛西汀较单用利培酮口服液治疗慢性精神分裂症阴性症状具有起效快、疗效好、依从性好的特点.     

奥氮平和利醅酮治疗老年痴呆精神行为症状的比较研究

目的 探讨奥氮平治疗老年痴呆精神行为症状的疗效和安全性.方法 将80例老年痴呆患者随机分为两组,奥氮平组40例,利培酮组40例,分别给予两药治疗8周.采用阳性症状和阴性症状量表(PANSS)评定临床疗效,不良反应量表(TESS)及有关实验室检查评定不良反应.结果 治疗8周后两药的疗效近似(P＞0.05).利培酮组锥体外系、兴奋或激惹和失眠不良反应的发生率明显高于奥氮平组(P＜0.05).结论 奥氮平治疗老年痴呆精神行为障碍疗效与利培酮相当,但起效时间比较快、不良反应较利培酮少,更适用于老年患者.     

利培酮联合帕罗西汀治疗慢性精神分裂症阴性症状

目的:探讨利培酮联合帕罗西汀治疗慢性精神分裂症阴性症状的临床疗效以及安全性.方法:将126例以阴性症状为主的慢性精神分裂症住院患者随机分为研究组(利培酮联合帕罗西汀治疗)和对照组(单用利培酮治疗),疗程12周,采用阳性和阴性症状量表(PANSS)和治疗中出现的症状量表(TESS)评定疗效和安全性. 结果:治疗后两组PANSS评分均较治疗前有显著降低(P＜0.05).治疗后4、8、12周末,研究组阴性因子分及情感迟钝、情感退缩、情感交流障碍及社会退缩因子分均显著低于对照组,差异具有统计学意义(P＜0.05或P＜0.01).两组不良反应均为轻至中度. 结论:利培酮联合帕罗西汀较单用利培酮治疗慢性精神分裂症阴性症状具有起效更快、疗效更好、依从性好的特点.     

利培酮联合重复经颅磁刺激治疗首发精神分裂症疗效的随机对照研究

目的 探讨利培酮联合重复经颅磁刺激(rTMS)治疗首发精神分裂症的临床疗效,并观察其安全性及不良反应.方法 将60例首发精神分裂症患者随机分成研究组和对照组,研究组在利培酮基础上联合rTMS真刺激,对照组在利培酮基础上联合rTMS假刺激干预.分别于治疗前、治疗1周、2周及4周应用阳性和阴性症状量表(PANSS)评定临床疗效,采用不良反应量表(TESS)、生命体征、体格检查、临床实验室检查、心电图、脑电图评价安全性.结果 研究组和对照组PANSS总分及各因子分在治疗1周、2周及4周均显著下降(P＜0.01);研究组的有效率在治疗2周时即高于对照组,差异具有统计学意义(P＜0.01),而两组有效率在4周时差异无统计学意义(P=0.127);研究组阳性症状因子评分在治疗2周时即显著低于对照组(P＜0.05),在4周末时差异有统计学显著性(P＜0.01).研究组和对照组在治疗中均无严重不良反应发生,两组不良反应差异无统计学意义.结论 重复经颅磁刺激具有很好的安全性,联合利培酮使用可以提高治疗首发精神分裂症的疗效,尤其有助于改善阳性症状.     

奎硫平与利培酮治疗老年期精神分裂症的对照研究

目的　比较奎硫平与利培酮治疗老年期精神分裂症的临床疗效与安全性。方法　将68 例住院老年期精神分裂症患者,随机分成两组,分别给予奎硫平与利培酮治疗,疗程8 周。采用阳性症状量表和阴性症状量表(PANSS)评定疗效,用副反应量表(TESS)评定不良反应。结果　治疗8 周后PANSS总分较治疗前显著下降奎硫平组有效率91.2%,显效率为76.5%,利培酮组分别为88.2%和73.5%,两组比较差异无显著性(P>0.05)。奎硫平组不良反应少而轻。结论　奎硫平与利培酮治疗老年期精神分裂症患者疗效相当,奎硫平不良反应较轻,安全性好。     

阿立哌唑与利培酮治疗精神分裂症对照研究

目的:探讨阿立哌唑治疗精神分裂症的疗效和安全性,并与利培酮对照.方法:将64例符合中国精神障碍分类与诊断标准第3版诊断标准的精神分裂症患者随机分为两组,分别给予阿立哌唑及利培酮治疗8周,采用阳性与阴性症状量表(PANSS)评定临床疗效,治疗中出现的症状量表(TESS)评定不良反应.结果:两组治疗后PANSS总分及各因子分减分率差异无显著性(P》0.05),阿立哌唑组显效率93.9%,利培酮组显效率96.8%,阿立哌唑与利培酮治疗精神分裂症均有较好的疗效,对治疗精神分裂症的阳性及阴性症状均有良好的效果,阿立哌唑的不良反应小.结论:阿立哌唑治疗精神分裂症的疗效与利培酮相当,但不良反应较利培酮少.     

丙戊酸钠对精神分裂症攻击行为的辅助治疗作用

目的：观察丙戊酸钠合用利培酮治疗精神分裂症攻击行为的疗效与不良反应。方法：63例伴有攻击行为的精神分裂症住院患者分为丙戊酸钠合用利培酮组（研究组）32例和单用利培酮组（对照组）31例,治疗12周。应用阳性和阴性症状量表（PANSS）及治疗中出现的症状量表（TESS）评定疗效及不良反应。结果：研究组PANSS评分（包括兴奋症状分及攻击因子分）改善明显优于对照组（P〈0.05）。研究组较对照组不良反应少且程度轻（P〈0.05）。结论：丙戊酸钠合并利培酮治疗精神分裂症攻击行为的疗效肯定,安全性与耐受性较好。     

阿立哌唑治疗老年精神分裂症的疗效对比观察

目的比较阿立哌唑与利培酮治疗老年精神分裂症的临床疗效和安全性。方法将50例住院的老年精神分裂症患者，随机分为阿立哌唑组25例和利培酮组25例，治疗8周。采用阳性与阴性症状量表（PANSS）评定疗效，用不良反应量表（TESS）及锥体外系不良反应量表（ESRS）评定不良反应。结果阿立哌唑组有效率为84％，显效率为60％；利培酮组有效率为88％，显效率为56％，两组无显著性差异。治疗8周后，两组PANSS总分及各因子分较治疗前均有显著性下降。两组TESS及ESRS评分比较，阿立哌唑组不良反应少而轻微。结论阿立哌唑与利培酮治疗老年精神分裂症疗效相当，但阿立哌唑不良反应更轻，安全性更高。     

利培酮与奋乃静治疗老年精神分裂症对照研究

目的:比较利培酮和奋乃静治疗老年精神分裂症的临床疗效和安全性。方法:对66例老年精神分裂症患者随机分为两组,分别服用利培酮和奋乃静。疗程8周。采用阳性与阴性症状量表(PANSS)评定疗效,用治疗中出现的症状量表(TESS)评定不良反应。结果:利培酮和奋乃静疗效相当。利培酮对阴性症状起效更快。结论:利培酮和奋乃静治疗老年精神分裂症疗效相仿,利培酮不良反应少而轻。     

奥氮平联用氟西汀治疗精神分裂症阴性症状的对照研究

目的 探讨奥氮平合并氟西汀治疗精神分裂症阴性症状的疗效和安全性.方法 将59例以阴性症状为主的精神分裂症患者随机分为研究组(奥氮平合用氟西汀治疗,30例)和对照组(单用奥氮平治疗,29例),于治疗前和治疗后第2、4、8、12周末使用阳性和阴性综合征量表(PANSS)和阴性症状量表(SANS)评定两组的疗效,药物治疗中需处理的不良反应症状量表(TESS)评定两组的不良反应.结果 治疗后第2周末研究组PANSS总分、阴性因子分较治疗前降低,差异有统计学意义(P＜0.05),治疗后第4周末研究组PANSS总分、阴性因子分及SANS总分、情感平淡因子分明显低于对照组,差异有统计学意义(P＜0.05,P＜0.01).两组TESS评分体质量改变差异有统计学意义(P＜0.05),余无明显差异.结论 奥氮平合并氟西汀能显著改善精神分裂症患者的阴性症状,且安全性好.     

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。