度洛西汀与帕罗西汀治疗糖尿病伴发抑郁焦虑症状患者的效果比较分析

目的对比帕罗西汀与度洛西汀治疗糖尿病伴发抑郁焦虑症状患者的效果。方法随机数字表法将87例糖尿病伴发抑郁焦虑的患者分为2组,常规治疗基础上,观察组44例服用度洛西汀治疗,对照组43例予帕罗西汀口服,均治疗1个月,对比两组治疗前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分及空腹和餐后2h血糖、相关神经细胞因子和炎症因子变化及安全性。结果观察组1月末空腹及餐后2h血糖、SDS及SAS评分、白细胞介素-6(IL-6)及超敏C反应蛋白(hs-CRP)水平均低于对照组,神经生长因子(NGF)及脑源性神经营养因子(BDNF)水平高于对照组,差异有统计学意义(P0.05),不良反应发生情况两组无统计学差异(P0.05)。结论度洛西汀比帕罗西汀更有效的缓解糖尿病伴发抑郁焦虑症状患者的抑郁焦虑状态,降低血糖,改善相关炎症及神经因子水平。     

文拉法辛对老年骨质疏松性椎体压缩骨折患者心理健康状况的影响

目的探讨文拉法辛对老年骨质疏松性椎体压缩骨折(OVCF)患者心理健康状况的影响。方法选取我院2018年1月1日~2019年9月30日的老年骨质疏松性椎体压缩骨折合并焦虑抑郁患者100例,采用随机数字表法分为观察组和对照组。对照组50例患者给予唑来膦酸注射液和心理治疗,观察组50例患者在此基础上增加文拉法辛治疗。治疗2个月后,观察比较两组患者治疗前后焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数(PSQI)量表评分,及血钙(Ca)、碱性磷酸酶(AKP)和磷(P)的水平变化。结果治疗后,两组患者的SAS、SDS和PSQI评分较前降低,且观察组患者的评分低于对照组(P<0.05);两组患者的血清Ca、P较前升高、AKP较前降低,且观察组患者血清各指标改善优于对照组(P<0.05)。结论文拉法辛可有效缓解OVCF合并焦虑抑郁患者的焦虑抑郁情绪,提高睡眠质量,改善骨代谢能力,值得临床推广应用。     

小剂量奥氮平联合文拉法辛对重度抑郁患者急性期治疗临床效果的观察

目的探讨小剂量奥氮平联合文拉法辛对重度抑郁患者急性期治疗的临床效果。方法选取2013年3月~2015年10月我院门诊明确诊断为重度抑郁症的患者80例。按随机数字表法平均分为两组:实验组与对照组。对照组予以盐酸文拉法辛缓释片150mg早餐后服用,同时予以淀粉制作的安慰剂5mg晚餐后服用;实验组予以盐酸文拉法辛缓释片150mg早餐后服用,同时予以奥氮平5mg晚餐后服用。两组患者在服药前、服药4w后均予以评估蒙哥马利抑郁量表(MADRS)、焦虑自评量表(SAS)。服药4周后均予以评估药物副反应量表(TESS)。结果两组患者在服药前MADRS、SAS评分对比,组间差异不明显义(P0.05);服药4周后,两组患者MADRS、SAS评分较服药前评分均显著降低(P0.05);且实验组的MADRS、SAS评分明显低于对照组,(P0.05);服药4周后两组的TESS评分对比,组间差异无统计学意义(P0.05)。结论小剂量奥氮平联合文拉法辛在急性治疗期治疗重度抑郁症,比单用文拉法辛可以取得更好的临床疗效,更好更快的缓解患者的抑郁焦虑情绪,减低自杀风险,且具有较好的安全性。     

文拉法辛对慢性乙肝合并焦虑、抑郁患者情绪及睡眠的影响

目的探讨慢性乙肝合并焦虑抑郁患者应用文拉法辛的治疗效果。方法将我院91例慢性乙肝合并焦虑抑郁患者采用随机数字表法进行分组,对照组45例给予心理治疗,观察组46例增加文拉法辛联合治疗,对比两组患者治疗后5-羟色胺(5-HT)、去甲肾上腺素(NE)、血清脑源性神经生长因子(BDNF)水平、焦虑抑郁情绪、睡眠质量及生活质量。结果治疗后,观察组BDNF、NE、5-HT水平及SF-36评分高于对照组,SAS、SDS及PSQI评分低于对照组(P0.05);观察组不良反应发生率和对照组无统计学差异(P0.05)。结论文拉法辛能够有效改善慢性乙肝合并焦虑抑郁患者睡眠质量,消除负面情绪,提升患者生活质量,安全性高。     

文拉法辛治疗广泛性焦虑对照观察

目的:比较文拉法辛与帕罗西汀治疗广泛性焦虑的临床疗效及不良反应。方法:将60例广泛性焦虑患者随机分为文拉法辛组(30例)及帕罗西汀组(30例),疗程8周。用焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)和治疗中出现的症状量表(TESS)评定疗效和不良反应。结果:治疗第2周末文拉法辛组SAS、HAMA总分与治疗前相比下降较帕罗西汀组更明显(P均<0.05)。治疗第2、4周末,文拉法辛组有效率分别为20%和56%,帕罗西汀组分别为3%和26%,组间差异均有显著性(P均<0.05);治疗第6周末,文拉法辛组治愈率为50%,帕罗西汀组为23%,组间差异有显著性(P<0.05);而两组间有效率差异无显著性(P>0.05)。结论:文拉法辛治疗广泛性焦虑安全有效,不良反应少。     

国产帕罗西汀治疗抑郁症的比较分析

目的评价国产帕罗西汀与文拉法辛治疗抑郁症的疗效和不良反应。方法将符合中国精神障碍分类与诊断标准第3版诊断标准的62例门诊抑郁症患者,随机平分为两组,分别给予国产帕罗西汀和文拉法辛治疗,疗程6周;用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床疗效总评量表的病情严重程度(CGI-Sl)和治疗中出现的症状量表(TESS)评定疗效和不良反应。结果国产帕罗西汀与文拉法辛治疗抑郁症疗效相当,但前者起效更快,且不良反应少于后者。结论国产帕罗西汀治疗抑郁症安全、有效。     

帕罗西汀治疗偏头痛疗效临床观察

目的探讨帕罗西汀治疗偏头痛的临床疗效。方法对32例偏头痛患者使用帕罗西汀治疗,治疗前及治疗6周后采用抑郁自评量表(SDS),焦虑自评量表(SAS)量表评定。结果经帕罗西汀治疗后,32例患者28例头痛明显改善,有效率87.5%;32例患者SDS、SAS治疗后评分均较治疗前显著降低(P0.01)。结论帕罗西汀治疗偏头痛是安全有效的。     

文拉法辛缓释剂联合综合心理干预治疗产后抑郁症的临床疗效

目的讨文拉法辛缓释剂联合综合心理干预治疗产后抑郁症的临床疗效。方法选取2015年3月~2017年3月我院收治的产后抑郁症患者160例,随机分为观察组和对照组,各80例。对照组给予文拉法辛缓释剂,观察组在对照组的基础上给予综合心理干预治疗。采用抑郁自评量表(SDS)、焦虑自评量表(SAS)评估患者焦虑抑郁及临床症状情况。观察比较两组患者临床疗效,治疗前后SDS、SAS值的变化。结果观察组临床总有效率93.75%高于对照组(73.75%),差异有统计学意义(P0.01);治疗后,两组患者SAS、SDS评分均较治疗前降低,且观察组患者SAS、SDS评分降低幅度较对照组大,差异有统计学意义(P0.001);观察组治疗总依从率为91.25%优于对照组(62.50%),差异有统计学意义(P0.01)。结论文拉法辛缓释剂联合综合心理干预治疗产后抑郁症患者,临床疗效确切,能有效的改善患者的焦虑抑郁状态,提高患者的治疗依从性。     

帕罗西汀联合重复经颅磁刺激治疗女性更年期抑郁症的对照研究

目的探讨帕罗西汀联合重复经颅磁刺激(r TMS)对女性更年期抑郁症的疗效。方法采用随机数字表法将符合《国际疾病分类(第10版)》(ICD-10)抑郁症诊断标准的72例更年期女性患者分为研究组和对照组各36例,研究组采用帕罗西汀联合r TMS治疗,对照组单用帕罗西汀治疗,采用汉密尔顿抑郁量表17项版(HAMD-17)、汉密尔顿焦虑量表(HAMA)、流调用抑郁自评量表(CES-D)于治疗前及治疗后第2、4、6、8周评定疗效,采用副反应量表(TESS)评定不良反应。结果研究组与对照组有效率分别为94.4%和75.0%,差异有统计学意义(P0.01)。从治疗第1周末开始,研究组HAMD-17、HAMA及CES-D评分与治疗前比较,差异均有统计学意义(P均0.01),从治疗第2周末开始,对照组HAMD-17、HAMA及CES-D评分与治疗前比较,差异均有统计学意义(P均0.01)。治疗后两组同期比较差异有统计学意义(P0.01)。治疗结束时两组TESS评分差异无统计学意义(P0.05)。结论帕罗西汀联合r TMS对女性更年期抑郁症疗效优于单用帕罗西汀,起效较快。     

帕罗西汀联合低频重复经颅磁刺激治疗抑郁症的对照研究

目的:探讨帕罗西汀联合低频重复经颅磁刺激(r TMS)治疗抑郁症的疗效及安全性。方法:60例抑郁症患者随机分为研究组和对照组各30例,研究组在接受帕罗西汀治疗的同时联合低频(1Hz)r TMS,对照组则单一帕罗西汀,疗程均为6周。分别在基线、治疗2,4、6周末对患者进行汉密尔顿抑郁量表(HAMD)以及治疗中出现的症状量表(TESS)评定。结果:治疗2周与4周末,研究组HAMD总分、焦虑/躯体化、绝望感因子,以及抑郁情绪、自杀、躯体性焦虑、精神性焦虑条目评分显著低于对照组,差异有统计学意义(P均0.05);治疗6周末HAMD评分两组差异无统计学意义(P0.05)。两组不良反应发生率分别为26.7%和30%(P0.05)。结论:帕罗西汀联合低频r TMS治疗抑郁症较单一帕罗西汀起效快,能早期改善患者抑郁、焦虑情绪。     

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.