高压氧治疗对血管性认知功能障碍患者的抑郁及焦虑状态的影响

目的确定血管性认知功能障碍患者抑郁及焦虑的发病情况,并进一步探讨高压氧疗对血管性认知功能障碍患者抑郁及焦虑状态的治疗价值。方法选取2011年1月~2013年5月在本院收治的血管性认知功能障碍患者114例,随机分为两组,对照组和实验组,分别进行常规治疗以及常规治疗配合高压氧治疗,入院时治疗前后进行抑郁及焦虑评分。分析各组患者抑郁及焦虑的差异。结果血管性认知功能障碍患者抑郁症发病率为54.39%,焦虑症发病率为47.37%。与常规治疗比较,高压氧治疗结合常规治疗,可显著降低抑郁及焦虑状态(P0.01)。结论血管性认知功能障碍患者抑郁及焦虑的发病率高,高压氧治疗可显著改善其抑郁及焦虑状态,具有重要临床价值。     

抗癫痫药物对认知功能的影响

认知功能是指接受、加工、储存和应用信息的能力。它是人们成功地完成各种活动最重要的心理条件。理解力、记忆力、注意力、学习能力、警觉和想象能力等均被认为是重要的认知能力。癫痫患儿的认知能力受癫痫发作、社会心理因素、抗癫痫药物（AEDs）等多种因素的影响。儿童较成人而言，由于大脑兴奋性和抑制性尚未达到平衡，更易罹患癫痫，且更易发生认知功能障碍。     

认知行为治疗对中度颅脑创伤患者焦虑抑郁情绪的影响

目的:探讨认知治疗结合音乐想象放松对中度颅脑创伤非手术患者焦虑、抑郁情绪的影响.方法:将40例中度颅脑创伤未手术患者随机分为实验组和对照组各20例.对照组给予常规护理;实验组在常规护理基础上给予认知治疗结合音乐想象放松,每日2次,每次20min,连续20天.采用Zung编制的焦虑自评量表(Self-Rating Anxiety Scale,SAS)、抑郁自评量表(Self-Rating Depression Scale,SDS)分别于人院当天和20天测量两组患者的SAS、SDS得分.结果:治疗前两组的SAS、SDS均值均显著高于常模,实验组治疗前后的SAS、SDS差值显著高于对照组(P＜0.05).结论:认知治疗结合音乐想象放松对缓解中度颅脑创伤患者的焦虑、抑郁情绪具有一定作用.     

丰富环境对脑功能的影响

哺乳动物的大脑从胚胎发育到出生后的精细塑形是复杂的遗传因素和后天环境因素共同作用的结果。由于人类所处的环境因素过于复杂,流行病学调查难以说明环境因素的贡献率,而动物实验则能相对有效地区分遗传因素和环境因素的效用。1947年Hebb提出了“丰富环境”（enrichedenvironment,EE）的概念[1],     

tDCS对甲基苯丙胺成瘾者认知功能、焦虑和抑郁的疗效评价

目的:探讨经颅直流电刺激(transcranial direct current stimulation,tDCS)对甲基苯丙胺成瘾者认知功能、焦虑及抑郁的治疗效果。方法:于2018年7-10月,采用分层整群随机抽样的方法,抽取辽宁省3个强制隔离戒毒所264例甲基苯丙胺成瘾戒毒人员为研究对象,随机分为试验组与对照组,每组各132例患者,试验组采用tDCS治疗,对照组采用假tDCS治疗;采用简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评价两组戒毒人员的认知功能、焦虑和抑郁情况。结果:tDCS治疗后试验组MMSE和MoCA得分均较治疗前显著升高(P<0.05);治疗后试验组HAMD和HAMA得分均较治疗前显著降低(P<0.05);试验组治疗后MMSE、MoCA、HAMD和HAMA得分与对照组之间差异有统计学意义(P<0.05)。结论:tDCS治疗可改善甲基苯丙胺成瘾者认知功能,并减轻其焦虑、抑郁症状。     

中风患者抗高血压药物治疗对认知功能和情绪状态的影响

20％～50％的中风患者可出现认知障碍，而其中的25％～30％为不可逆的痴呆。抑郁性情绪损伤可见于11％～68％的中风患者。认知障碍和情绪损伤严重影响患者的生存质量。     

深圳市光明区新生儿父亲产后抑郁现状及其对家庭功能的影响

目的 探讨深圳市光明区新生儿父亲产后抑郁现状及其对家庭功能的影响。方法 调查2020年12月至2021年11月,深圳市光明区公明、合水口和上村社区的253名产后父亲,采用爱丁堡产后抑郁量表(EPDS)、家庭适应性和凝聚力量表(FACES)进行调查,分析新生儿父亲产后抑郁影响因素。结果 新生儿父亲的EPDS问卷回收率为94.5%,FACES问卷回收率为91.3%。新生儿父亲产后抑郁的EPDS筛查阳性率为10%。两组新生儿父亲平均每周工作时间、经济压力、性格、孕期抑郁/焦虑情绪、孕期上孕妇学校或学习育儿知识和喂养方式比较,差异有统计学意义(P<0.05)。logistic回归模型进行多因素分析结果显示,经济压力非常大(β=1.484,OR=4.411,95%CI:1.873～10.387),每周工作时间较短(β=1.469,OR=4.344,95%CI=1.268-14.875),性格(β=2.562,OR=12.965,95%CI:1.737～96.777),孕期是否上孕妇学校或学习育儿知识(β=1.732,OR=5.602,95%CI:1.151～27.277)是新生儿父亲产后抑...     

环境线索暴露对海洛因戒断者焦虑和抑郁状态及心理渴求的影响

目的:研究环境线索对海洛因戒断者心理渴求及焦虑和抑郁症状的影响。方法:选取70例处于戒断60-90d的海洛因依赖者及28例健康志愿者暴露于海洛因相关环境线索中,测量暴露前后视觉模拟尺记录的渴求程度,以及心率、汉密尔顿焦虑和抑郁量表评分,并完成自编海洛因依赖受试者基本情况登记表等社会学资料。采用配对t检验统计暴露前后的渴求程度、心率及焦虑和抑郁评分。结果:暴露后海洛因戒断者的心理渴求和心率明显高于暴露前,差别具有显著性统计学意义(P<0.01)。焦虑和抑郁评分在暴露后明显降低,差异有显著性(P<0.01)。结论:环境线索可以使戒断期海洛因依赖者心理渴求和心率明显增加,但同时可以缓解焦虑和抑郁情绪。     

卒中后抑郁对患者功能康复的影响

目的 探讨脑卒中后抑郁症的发生率及心理治疗对脑卒中患者功能康复的影响.方法 对60例脑卒中患者采用抑郁自评量表(SDS)、焦虑自评量表(SAS)进行评定,随机分为干预组和非干预组,干预组除进行常规方法功能康复训练外,同时加强心理评价及治疗,非干预组常规方法进行功能康复训练.用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、斯堪的那维亚脑卒中量表(SSS)、Barthel指数(BI)评定其疗效及预后.结果 干预组治疗6周后HAMD、HADA、SSS、BI分别为16.23±1.11,12.69±1.99,9.02±3.04,79.11±14.36,较非干预组有显著性差异(P＜0.05).结论 抑郁、焦虑明显降低患者神经功能康复程度和生活能力恢复,心理治疗对开展脑卒中功能康复有促进作用,对患者运动功能的康复起到关键性作用.     

认知治疗对慢性乙型肝炎患者焦虑和抑郁情绪的影响

目的 探讨认知治疗对慢性乙型肝炎患者焦虑和抑郁情绪的影响.方法 对87例存在不同程度焦虑抑郁症状的患者进行心理分析,有针对性的采取认知行为治疗.结果 接受认知治疗后,绝大部分患者(82.76%)焦虑抑郁症状消失.结论 认知行为干预对慢性乙型肝炎合并焦虑抑郁者是一种较好的心理治疗方法.     

Discontinued drugs 2007: central and peripheral nervous system drugs

The development of novel drugs falls into two completely different categories: truly novel drugs and drugs that can be considered as improvements of further advanced and eventually marketed drugs. The risk of failure and the reason for failure by these two classes of compounds obviously are very different. Truly novel drugs often rely on pharmacological data obtained in preclinical models paired with a scientific rationale for a mechanism thought to be relevant for the phenotype of the disease. The scientific insight into both the mechanisms underlying the disease and how these diseases can be manipulated by pharmacological means is therefore essential for the success of the drug. In practical terms, this means that a thorough understanding of the disease is a prerequisite for success. It is therefore a sobering thought that most of these compounds fail due to marginal efficacy in Phase II or III trials. The lack of success of these compounds may reflect either lack of knowledge of the disease, poor predictive value of the preclinical models, large heterogeneity in the underlying mechanisms for a given phenotype, or the use of the compound in a population that doesn't express a phenotype optimal for the drug. This year's list of discontinued compounds spans the range from truly innovative drugs to ‘me-too’ compounds and as such is highly useful in illustrating the current dilemmas for the pharmaceutical industry.     

丰富环境对脑功能的影响

哺乳动物的大脑从胚胎发育到出生后的精细塑形是复杂的遗传因素和后天环境因素共同作用的结果.由于人类所处的环境因素过于复杂,流行病学调查难以说明环境因素的贡献率,而动物实验则能相对有效地区分遗传因素和环境因素的效用.1947年Hebb提出了丰富环境(enriched environment,EE)的概念[1],此后,这一模式被广泛用于研究环境因素对脑功能的影响.本文就丰富环境的基本概念和设置及丰富环境对脑功能影响的研究进展做一概要介绍.     

Effect of drugs on the noradrenaline content of brain and peripheral tissues and its significance

Large single doses of methoserpidine (12 mg/kg) given to rabbits lowered the noradrenaline content of sympathetic ganglia but not that of brain; no sedation was observed. Cats responded to doses ranging from 12 to 0.5 mg/kg with loss of noradrenaline from ganglia as well as from brain, and were sedated by the drug. The effect in man resembles that in the rabbit. Only within the group of reserpine-like drugs do sedation and loss in hypothalamic noradrenaline run parallel. These effects are therefore not causally related. Guanethidine lowers the noradrenaline content of sympathetic ganglia (cats and rabbits), but this effect does not explain the blocking action of the drug on the adrenergic nerve. Effects on the noradrenaline of the brain are variable and may be caused reflexly rather than by direct central action of guanethidine. Repeated intravenous injections of dimethylphenylpiperazinium iodide for a period of 4 hr did not produce any significant change in the noradrenaline content of ganglia or brain of rabbits. In contrast, dexamphetamine (20 mg/kg) produced a small but significant mean fall in noradrenaline content of the superior cervical ganglia and in that of the brain, but the effects were not seen in every rabbit. Prolonged administration of the mono-amine oxidase inhibitors pheniprazine and phenylhydrazinobutane raised the noradrenaline content of the brain of rabbits but not that of cats, whereas it raised the noradrenaline of the ganglia of cats but not (or rarely) that of rabbits. The question of correlation between a rise in the noradrenaline content of the brain and certain clinical signs is discussed. Finally, a comparison is made in rabbits between the changes produced by drugs in the noradrenaline content of the heart and of the superior cervical ganglion. The changes run parallel and are only occasionally more pronounced in the heart.     

伴焦虑抑郁的冠状动脉粥样硬化性心脏病介入治疗患者药物干预治疗的研究

目的探讨心理药物干预对伴有焦虑抑郁症状冠状动脉粥样硬化性心脏病（冠心病）介入治疗患者的临床疗效。方法对入选的168例冠心病介入治疗患者,通过症状自评量表（SCL-90）、Zung抑郁自评量表（SDS）、Zung焦虑自评量表（SAS）的测评对SDS得分粗分大于41以及SAS得分粗分大于40,定为有抑郁和焦虑倾向,共59人入选。将入选患者随分为干预组36例,对照组23例。干预组在冠心病介入治疗后常规心内科治疗的基础上＋抗精神药物＋心理干预。对照组在冠心病介入治疗后常规心内科治疗基础上＋安慰剂。2组治疗前后SAS、SDS、SCL-90评分,心绞痛分级和心电图ST段进行比较。结果（1）干预组不同时段SAS、SDS评分明显低于对照组（P〈0.01）。（2）干预组治疗后SCL-90评分除躯体症状人际关系敌对性外其余评分高于治疗前（P〈0.01）。（3）干预组治疗后与常模均值心理健康状况的差异无统计学意义（P〉0.05）（除躯体症状、人际关系、敌对性）。（4）干预组治疗后总有效率高于对照组（P〈0.05）。结论（1）冠心病介入治疗患者存在抑郁、焦虑、躯体化、人际关系、敌对性、精神病性等心理健康问题。（2）精神药物＋心理干预可明显改善伴有焦虑抑郁症状的冠心病介入治疗患者心理健康水平。通过认知的改变,可以减轻负性情绪对躯体状态的影响,抑制已改变的病理生理过程,从而提高临床疗效。     

Using zebrafish to assess the impact of drugs on neural development and function

Background: Zebrafish is becoming an increasingly attractive model organism for understanding biology and developing therapeutics, because as a vertebrate, it shares considerable similarity with mammals in both genetic compositions and tissue/organ structures, and yet remains accessible to high throughput phenotype-based genetic and small molecule compound screening. Objective/method: The focus of this review is on the nervous system, which is arguably the most complex organ and known to be afflicted by > 600 disorders in humans. I discuss the past, present and future of using zebrafish to assess the impact of small molecule drugs on neural development and function, in light of understanding and treating neurodevelopmental disorders such as autism, neurodegenerative disorders including Alzheimer's, Parkinson's and Huntington's disease and neural system dysfunctions such as anxiety/depression and addiction. Conclusion: These studies hold promise to reveal fundamental mechanisms governing nervous system development and function, and to facilitate small molecule drug discovery for the many types of neurological disorders.     

常用新型抗癫痫药物对认知功能的影响

癫痫是一种常见的神经系统慢性发作性疾病,药物是癫痫治疗的主要手段。目前约75%的癫痫病人需要抗癫痫药物(antiepileptic drugs,AEDs)来控制痫性发作,而AEDs对认知功能的损害不同程度地影响了病人的生存质量及其对药物的依从性。本文对近10多年用于临床的新型抗癫痫药物对认知功能的影响作一综述。     

米氮平治疗老年期腔隙性脑梗死伴发抑郁和焦虑患者60例

目的探讨米氮平治疗老年期腔隙性脑梗死伴发抑郁和焦虑的临床疗效和安全性。方法将60例符合"中国精神障碍分类和诊断标准"(第3版)(CCMD-3)中抑郁症诊断标准的老年期腔隙性脑梗死患者在内科药物基础上联合米氮平治疗,剂量30～45 mg·d~(-1),疗程6 wk。采用汉密尔顿抑郁量表17项(HAMD-17)、汉密尔顿焦虑量表(HAMA)和副反应量表(TESS)在治疗前和治疗1、2、4、6 wk末评定临床疗效及不良反应。结果治疗wk 1末HAMD-17、HAMA评分较治疗前比较均明显下降(P<0.05);wk 2、4、6末评分持续下降,与治疗前比较有非常显著差异(P<0.01);治疗wk 1末TESS评分较治疗前比较明显升高(P<0.05),wk 2、4、6末评分与治疗前比较无显著差异(P>0.05),且不良反应轻微,耐受性较好。结论米氮平治疗老年期腔隙性脑梗死伴发抑郁和焦虑患者临床疗效良好,起效快且不良反应轻微。     

Effects of substance P on memory and mood in healthy male subjects

There is evidence from human and animal studies that substance P (SP) is involved in the etiopathology of depression and anxiety. Furthermore, animal studies have shown effects of SP on memory. In a double-blind, randomized cross-over study, 13 healthy young men received SP (1.5 pmol/kg/min) or placebo (NaCl) intravenously over 90 min at two different days. Before and during the infusion, symptoms of anxiety and depression were assessed by different self-rating questionnaires and cognitive functioning by the Auditory-Verbal Learning Test (AVLT) as well as by two subtests of the Test for Attentional Performance (TAP). Infusion of SP caused an increase of symptoms of inner tension and of anxiety as assessed by the Acute Panic Inventory (API) and a disturbance of short-term memory in the AVLT. The results may be interpreted as evidence for an anxiogenic and memory-disturbing effect of SP. Further studies will focus on the effects of SP in patients with depression, anxiety and cognitive disorders.     

治疗性沟通对妇科恶性肿瘤患者术后焦虑抑郁的干预分析

目的探讨治疗性沟通对妇科恶性肿瘤患者术后焦虑抑郁心理的影响。方法采用方便取样,选取安徽医科大学第一附属医院40例妇科恶性肿瘤术后伴焦虑抑郁的患者,按入院先后顺序分为干预组20例和对照组20例。干预组在术后常规护理的基础上给予治疗性沟通,对照组给予术后常规护理。结果干预前,两组各项指标均无差异(P0.05)。干预后,干预组焦虑和抑郁程度低于对照组,差异有统计学意义(P0.01)。结论治疗性沟通能有效地缓解妇科恶性肿瘤患者术后焦虑抑郁心理。