慢性应激对大鼠血管平滑肌细胞的效应及与焦虑行为的关系

目的探讨慢性精神应激对血管平滑肌细胞的影响及与焦虑行为的关系。方法将38只SD大鼠按照随机数字表随机分为精神应激组(30只)和对照组(8只)。对应激组采用限制应激和饮水冲突应激,持续2个月;分别于应激前、应激后1,2个月用空场实验和高架十字迷宫实验观察大鼠焦虑水平,计算出中央格爬行次数、外周格爬行次数、开放臂进入次数及停留时间、闭合臂进入次数及停留时间。以免疫组化方法测定主动脉血管局部增殖细胞核抗原(PCNA)表达,并用苏木素-伊红染色法观察主动脉结构变化。结果(1)与对照组比较,应激1个月后,应激组大鼠在开放臂的次数和时间、闭合臂的次数少(P<0·05),闭合臂的时间多(均P<0·01);应激2个月后,应激组大鼠在外周格爬行的个数和闭合臂时间多(P<0·01),开放臂时间少(P<0·01)。(2)应激组大鼠主动脉失去原有的正常结构,中层血管平滑肌细胞排列紊乱,数目增多。(3)应激组大鼠血管壁PCNA表达的阳性细胞数为(16485±10694)个/MM2,对照组大鼠为(4012±2256)个/MM2,T=4·359,P<0·01。(4)中度焦虑组大鼠PCNA表达与大鼠焦虑呈正相关(PEARSON相关系数为0·718,P=0·004)。结论大鼠中度焦虑时,其血管平滑肌细胞增殖率与焦虑情绪呈正相关。     

慢性应激对大鼠行为和体重的影响

目的　观察慢性应激对大鼠行为和体重的影响。方法　采用慢性强迫游泳模型 ,应用行为追踪仪观察大鼠的活动量 ,以电子动物称监测大鼠体重变化。结果　应激组大鼠活动量明显高于对照组 (P <0 0 1) ,排便、排尿增加 ,修饰频繁。应激组大鼠体重增长明显低于对照组 (P <0 0 1)。结论　慢性强迫游泳使大鼠活动量增多 ,抑制体重增长。     

慢性应激对大鼠海马FAS蛋白表达的影响及帕罗西汀的干预作用

目的探讨慢性轻度不可预见应激对大鼠海马神经元FAS蛋白表达的影响以及抗抑郁剂（帕罗西汀）的拮抗作用。方法将24只SD雄性大鼠随机均分为正常组、慢性应激模型组、氟西汀治疗组。选用慢性轻度不可预见性应激模型,运用OPEN-FILED（旷野试验）观察大鼠的行为学的变化,TUNEL染色和免疫组织化学技术研究大鼠海马各区的细胞凋亡及FAS蛋白的表达。结果慢性应激抑郁大鼠旷野实验中水平穿越格数、竖立次数、修饰次数有减少中央格停留时间有增加。氟西汀可改善大鼠行为学变。TUNEL染色和免疫组织化学技术结果显示模型组大鼠海马细胞内的细胞凋亡数及FAS蛋白的表达量明显高于对照组组（P〈0.05）;氟西汀组大鼠海马细胞内PKA和P-CREB胞凋亡数及FAS蛋白的表达量明显低于模型组（P〈0.05）。结论慢性轻度不可预见性应激可促进大鼠海马神经元内细胞凋亡和FAS蛋白表达水平升高,氟西汀具有一定的拮抗作用。     

张北地震后应激障碍患者神经内分泌和细胞因子的研究

目的研究应激障碍患者血浆皮质醇、生长激素、泌乳素和白细胞介素(IL)2,6,8与正常个体的差异.方法于河北省张北尚义发生里氏6.2级地震后3个月,在当地选取因地震导致的创伤后应激障碍(PTSD)患者34例(PTSD组),未达到PTSD诊断标准且不符合其他精神障碍的受应激个体30例(非PTSD受应激组),未受应激者34名(对照组),进行血浆皮质醇、生长激素、泌乳素和白细胞介素(IL)2,6,8的检测.血浆皮质醇、生长激素、泌乳素、IL-2检测采用放射免疫法; IL-6和IL-8检测采用酶联免疫法.结果 PTSD组患者和非PTSD受应激组的血浆皮质醇浓度均明显高于对照组,差异有统计学意义(P=0.013,P=0.006);血浆IL-2浓度均明显低于对照组,差异均有统计学意义(P=0.000,P=0.000).三组间泌乳素及IL-6的差异无统计学意义(P=0.389,P=0.363).PTSD组的生长激素浓度与非PTSD受应激组(P=0.099)及对照组(P=0.511)的差异无统计学意义.非PTSD受应激组的生长激素浓度明显高于对照组(P=0.014).PTSD组患者IL-8浓度明显高于非PTSD受应激组 (P=0.021), 而与对照组的差异无统计学意义 (P=0.078).非PTSD受应激组IL-8浓度明显低于对照组(P=0.000).结论 PTSD患者的神经内分泌和免疫系统有异常改变.     

慢性应激抑郁模型大鼠海马GSK-3β的表达

目的 研究慢性应激对大鼠海马糖原合成酶激酶-3β(GSK-3β)表达的影响.方法 实验组大鼠通过21d的应激刺激制作抑郁动物模型,此期间对照组大鼠正常饲养.Open-field法检测行为学改变,Western blot法测定大鼠海马GSK-3β的表达.结果 慢性应激后,实验组大鼠体重、水平穿越格数、直立次数和修饰次数均显著低于对照组(P<0.01);实验组大鼠海马GSK-3β表达的整合光密度值(28413.30±2501.31)高于对照组(23149.50±3107.25),差异有统计学意义(P<0.05).结论 慢性应激使大鼠海马GSK-3β的表达上调.     

氟西汀和丙米嗪对应激诱导的青幼期大鼠抑郁和焦虑样行为的不同影响

目的建立青幼期大鼠的慢性应激抑郁模型,并探讨不同类型抗抑郁药物对其抑郁和焦虑样行为表现的影响。方法青幼期大鼠(日龄30～50d)接受3周慢性温和应激,同时随机分别给予选择性5-羟色胺重摄取抑制剂氟西汀和三环类抗抑郁剂丙米嗪(10mg/kgi.p.)。采用蔗糖水偏好、旷场和高架十字迷宫测试评估大鼠的抑郁和焦虑样行为。结果与对照组(n=10)相比,慢性应激模型组(n=11)大鼠体质量增长减慢,糖水偏好指数降低,上述差异均有统计学意义(P0.05)。丙米嗪干预组(n=10)的糖水偏好明显低于丙米嗪对照组(n=10),差异有统计学意义(P0.05),而氟西汀干预组(n=11)与氟西汀对照组(n=11)相比则没有明显差异(P0.05)。在旷场测试中,青幼期后期(PND52)正常对照组大鼠与其早期(PND29)相比旷场直立行为次数降低(P0.05),但自发活动量(水平运动距离)没有明显差异(P0.05),氟西汀干预明显增加大鼠直立行为次数(P0.05)。此外,PND52正常对照组大鼠与PND29相比在高架十字迷宫开放臂的进入次数和停留时间减少,而在闭合臂停留时间增加;应激模型组与正常对照组相比开放臂进入次数增加,闭合臂停留时间减少,上述差异均有统计学意义(P0.05)。结论慢性应激诱导了青幼期大鼠的抑郁样行为。氟西汀而非丙米嗪可逆转大鼠的抑郁样行为。应激降低了青幼期大鼠的焦虑水平,而两种药物对焦虑行为均没有明显作用。     

慢性冷水游泳应激对大鼠海马、前脑皮层神经颗粒素含量的影响

目的探讨慢性应激对大鼠海马和前脑皮层神经颗粒素(NG)含量的影响。方法将雄性SD大鼠随机分为应激组(予10℃冷水游泳应激,共2周)、装置对照组和正常对照组,每组10只。于应激前后测量三组大鼠的体质量变化情况,并记录每天应激过程中应激组和装置对照组的排便量以考察应激的强度,应激后以Westernblotting方法测定海马和前脑皮层中的NG含量(以NG含量与βActin含量的比值表示)。结果(1)应激前后,三组大鼠的体质量比较,差异均无统计学意义(P>0.05),但应激组的体质量增长相对缓慢;(2)应激第4—14天应激组的排便量多于装置对照组(P<0.01);(3)应激组和装置对照组海马的NG含量[分别为(0.66±0.13)和(0.94±0.26)]低于正常对照组[(1.93±0.53)],差异有统计学意义(P<0.01);(4)应激组前脑皮层的NG含量[(0.45±0.00)]低于装置对照组和正常对照组[分别为(2.76±1.74)和(2.87±1.63)],差异有统计学意义(P<0.01);(5)应激组海马NG含量高于前脑皮层(P<0.01);装置对照组海马NG含量低于前脑皮层(P<0.01);正常对照组海马与前脑皮层NG含量的差异无统计学意义。结论慢性应激导致海马和前脑皮层NG含量显著下降;对于时程长、程度严重、适应不良的冷水游泳应激,前脑皮层受损比海马更为严重;而对于时程长、程度微弱的装置应激,海马则比前脑皮层更为敏感。     

青少年冲动攻击行为与应激及下丘脑-垂体-肾上腺轴活性的关系初探

目的初步探讨青少年冲动性攻击行为与生活应激水平及基础状态时下丘脑-垂体-肾上腺皮质(hypothalamic-pituitary-adrenal,HPA)轴活性的关系。方法采用修订版外显攻击行为量表(modified overt aggression scale,MOAS)和冲动性量表(barratt impulsivity scale-11,BIS-11)对某所工读学校的男性初中生近半年内的攻击行为和冲动性进行评估,纳入其中51名有冲动性攻击行为(体力攻击次数≥3、MOAS总分≥5分、BIS-11总分≥70分)的学生为研究组,对照组为53名无冲动性攻击行为(体力攻击次数为0、MOAS总分4分、BIS-11总分70分)的学生,使用青少年生活事件量表(adolescent self-rating life events checklist,ASLEC)调查受试者近半年内的生活应激水平,同时采用酶联免疫吸附试验法测定血清皮质醇、血浆促肾上腺皮质激素(adrenocorticotrop hichormone,ACTH)水平。结果研究组近半年内的ASLEC应激总分(P0.05)、"人际关系"因子(P0.01)、"受惩罚"因子(P0.05)、"健康适应"因子(P0.01)分值均高于对照组,而血清皮质醇浓度(P0.01)、血浆ACTH浓度(P0.05)均低于对照组。相关分析结果显示,冲动性与ASLEC应激水平呈弱正相关(r=0.26,P0.01),与ACTH浓度呈弱负相关(r=-0.20,P0.05);攻击性与ASLEC应激水平呈弱正相关(r=0.26,P0.01),与皮质醇浓度呈弱负相关(r=-0.21,P0.05)。结论青少年冲动性攻击行为可能与较高的环境应激水平、机体HPA轴活性异常有关。     

慢性应激对大鼠认知及脑脊液单胺类神经递质的影响

目的探讨慢性应激对大鼠脑单胺类神经递质以及认知功能影响的研究。方法75只SD大鼠随机分为对照组(25只)和慢性应激组(50只),后者以束缚浸水应激方式连续应激21天,每日记录大鼠体重及进食量并进行两组比较,三周后行水迷宫实验、大鼠脑单胺类神经递质测定。结果(1)应激组大鼠体重的增加、进食量较对照组明显减少(P<0.05);(2)水迷宫实验:应激组大鼠的游出时间较对照组明显增加(P<0.05),但错误次数无明显差异(P>0.05)。(3)大鼠脑脊液单胺类神经递质含量(ug/L):5-HT、5-HIAA及MHPG的含量应激组明显低于对照组(P<0.05),NA、DA及HVA在应激组均为升高,但无显著差异(P>0.05)。结论慢性束缚浸水应激三周使大鼠脑脊液中5-HT、5-HIAA及MHPG的含量降低,但对认知功能无明显影响。     

综合心理干预对空降兵新兵跳伞应激水平的影响

目的探讨综合心理干预对空降兵新兵跳伞训练前后的心理及跳伞应激反应的影响。方法选取参加跳伞空降兵新兵256名,随机分为综合心理干预组和对照组。利用症状自评量表(SCL-90)、焦虑自评量表(SAS)、抑郁自评量表(SDS),在跳伞训练前后进行心理测量,并用放射免疫方法检测跳伞前后血清皮质醇、醛固酮、促肾上腺皮质激素及IL-2、IL-6、IL-8应激指标水平的变化。结果跳伞后综合心理干预组在SCL-90中的躯体化、抑郁、焦虑、恐怖等项分值,SAS和SDS总分值明显低于对照组(P<0.05);综合心理干预组新兵跳伞训练后血清皮质醇和醛固酮、ACTH、IL-6、IL-8升高和IL-2下降均明显低于对照组(P<0.05)。结论综合心理干预对提高空降兵新兵心理健康和降低跳伞训练时过度的应激水平具有积极作用。     

沙盘游戏疗法在地中海贫血患儿心理干预中的应用

本文目的是对沙盘游戏疗法在地中海贫血患儿心理干预中的应用进行综述,以期为地中海贫血患儿的心理康复提供参考。地中海贫血是以珠蛋白生成障碍为主要特征的遗传性疾病,由于长期输血治疗,患儿存在较多的心理和行为问题。沙盘游戏疗法作为一种有效、实用的儿童心理治疗方法,对提高地中海贫血患儿的康复效果、改善生存质量有重要的临床意义。     

癫痫共病抑郁的机制及临床诊疗

本文目的是探讨癫痫共病抑郁的可能机制及临床诊疗。癫痫是一种常见的、慢性的、致残性的神经疾病,癫痫患者生活质量下降,存在明显的负性情绪,常伴发各种精神疾病。癫痫与抑郁具有共同的神经生物学基础,可能存在共同的发病机制。本文从癫痫共病抑郁的发病机制、临床诊断及治疗方面予以总结归纳。     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Cultural Identity and Experiences of Prejudice and Discrimination of Afghan and Iranian Immigrant Youth

In culturally diverse and immigrant receiving societies, immigrant youth can be subject to prejudice and discrimination. Such experiences can impact on immigrant youth’s cultural identity and influence their psychosocial outcomes. This paper presents findings of a study that examined cultural identity and experiences of prejudice and discrimination among Afghan (N = 9) and Iranian (N = 17) immigrant youth in Canada. The study had a prospective, comparative, longitudinal qualitative design. Data was gathered through focus groups, interviews, journals and field logs. Four main themes emerged on participants’ experiences of prejudice and discrimination: (a) societal factors influencing prejudice; (b) personal experiences of discrimination; (c) fear of disclosure and silenced cultural identity; and (d) resiliency and strength of cultural identity. Drawing from Rosenberg’s (Conceiving the self, Basic Books, New York, 1979) self-concept framework and Romero and Roberts (J. Adolesc., 21:641–656, 1998) distinction between prejudice and discrimination, results indicated that youth’s extant and presenting cultural identity were affected. Inclusive policies and practices are needed to promote youth integration in multicultural and immigrant receiving settings.

发作性睡病与异态睡眠的诊治

本文目的是探讨发作性睡病与异态睡眠的诊断与治疗.发作性睡病被漏诊和误诊的几率较高,危害较大,共患异态睡眠比例高.文章从发作性睡病临床特征、REM睡眠的作用、发作性睡病与异态睡眠(睡眠瘫痪、睡眠幻觉、快眼动睡眠期行为障碍)共病特征及治疗这四个方面进行了讨论.     

Effects of Agonists and Antagonists of Cholecystokinin on Contractile and Myoelectric Activity of Isolated Muscle of Colon and Ileum in the Dog and Guinea Pig

This study evaluates the effects of agonists and antagonists of cholecystokinin (CCK) on contractile and myoelectrical activity in isolated longitudinal muscle strips from colon or ileum of guinea pigs or beagle dogs. Caerulein and CCK-8 caused a dose-dependent increase of contractile and myoelectrical spike activity in both species with maximal effects seen between 10⁻⁸ and 3 × 10⁻⁸ M. The dose responses were identical for both CCK agonists and species. The dose-related effects of CCK compounds on colonic muscle were slightly shifted to the right when compared to ileum in both species. All antagonists, the proglumide-derivatives CR1409, CR1392, and CR1505, as well as the nonpeptide substances asperlicin and L-364,718, caused a parallel rightward shift of CCK's dose-dependent motor activity response, indicating the competitive nature of inhibition. The antagonists displayed a rank order of potency in antagonizing CCK's action on intestinal motility similar to their ability to antagonize CCK's action on pancreas and gallbladder. L-364,718 was the most potent antagonist, followed by CR1409, CR1505, CR1392, asperlicin, and proglumide. The antagonists did not affect contractile or myoelectrical responses to acetylcholine, histamine, motilin, or substance P. Thus compounds that have been described as CCK antagonists for pancreas and gallbladder also act as specific and competitive antagonists of CCK's action on contractile and myoelectrical activity of Heal and colonie muscle.     

The neuroendocrinology of stress and the pathophysiology and therapy of depression and anxiety

Clinical and preclinical studies have gathered substantial evidence that stress response alterations play a major role in the development of major depression, panic disorder, and post-traumatic stress disorder. The stress response, the hypothalamic pituitary adrenocortical (HPA) system and its modulation by corticotropin-releasing hormones (CRH),corticosteroids,and their receptors, and the roles of natriuretic peptides and neuroactive steroids are described. We review the role of the HPA system in major depression, panic disorder, and post-traumatic stress disorder and its possible relevance for treatment. Impaired glucocorticoid receptor function in major depression is associated with an excessive release of neurohormones such as CRH, to which a number of signs and symptoms characteristic of depression can be ascribed. In panic disorder, a role of central CRH in panic attacks has been suggested. Atrial natriuretic peptide (ANP) is causally involved in sodium lactate-induced panic attacks. Furthermore, preclinical and clinical data on its anxiolytic activity suggest that nonpeptidergic ANP receptor ligands may be potentially useful in the treatment of anxiety disorders. Post-traumatic stress disorder is characterized by a peripheral hyporesponsive HPA system and elevated CRH concentrations in the CSF. This dissociation is probably related to an increased risk of this disorder. We further review recent data that describe an important role of GABA(A)-receptor modulatory,3 alpha-reduced neuroactive steroids in major depression, anxiety, and its treatment. Antidepressants are effective in both depression and anxiety disorders and have major effects on the HPA system,especially on glucocorticoid and mineralocorticoid receptors. Normalization of HPA system abnormalities is a strong predictor of the clinical course, at least in major depression and panic disorder. Currently,CRH-R1 or glucocorticoid receptor antagonists and ANP receptor agonists are being studied and may provide future treatment options more closely related to the pathophysiology of these disorders.     

小胶质细胞和少突胶质细胞前体的培养和鉴定

目的 探讨新生大鼠脑组织小胶质细胞(MG)和少突胶质细胞(OL)前体的分离和体外培养方法 . 方法 取新生2 d SD大鼠脑组织,体外原代培养混合胶质细胞7 d后,分别采用"改良振荡伴差速贴壁"法和"营养缺失伴振荡"法纯化培养MG和OL前体,并分别应用免疫荧光染色异凝集素-B4(IB4)和OL前体标记物(O4)进行鉴定.结果 混合胶质细胞培养7 d后呈明显三层增长,其中MG位于上层,星型胶质细胞位于底层,两者之间为2型少突星型(O2A)祖细胞.纯化培养后OL前体胞体呈小圆形,有双极或三极突起,MG则以阿米巴形、圆形居多,或边缘呈毛刺状.免疫荧光染色IB4显示绿色荧光,MG纯度达到90%以上.免疫荧光染色O4显示棕黄色荧光,OL前体纯度达到95%以上. 结论 采用"改良振荡伴差速贴壁"法以及"营养缺失伴振荡"法分别成功获取大量纯度高、活力好的MG和OL前体.     

Review and meta-analysis of the phenomenology and clinical characteristics of mania in children and adolescents

OBJECTIVE: Using predetermined criteria for study quality and methods, a literature review and meta-analysis of seven reports about pediatric bipolar disorder (BPD) was conducted to determine if there is a consistent picture of the phenomenology and clinical characteristics of BPD in children and adolescents. METHODS: Searches were conducted in MedLine and PsycINFO using the terms mania, BPD, children and adolescents, and was limited to published articles in peer-reviewed journals. Seven reports were selected that met the following criteria: a systematic method for the elicitation and reporting of symptoms and clinical characteristics of subjects; subjects were interviewed by a trained researcher or clinician; ages 5-18 years; use of a diagnostic system, either DSM or RDC for categorization; a consensus method for the establishment of the diagnosis of BPD. RESULTS: Most DSM-IV symptoms of mania were common in the children and adolescents with BPD with the most common symptoms being increased energy, distractibility, and pressured speech. On average, four of five bipolar cases also showed threshold levels of irritable mood and grandiosity, and more than 70% of all cases showed elated/euphoric mood, decreased need for sleep, or racing thoughts. Roughly 69% of cases also showed poor judgment, whereas only half of bipolar cases demonstrated flight of ideas, and slightly more than one-third showed hypersexuality or psychotic features. CONCLUSIONS: The clinical picture that emerges is that of children or adolescents with periods of increased energy (mania or hypomania), accompanied by distractibility, pressured speech, irritability, grandiosity, racing thoughts, decreased need for sleep and euphoria/elation.