精神分裂症伴强迫症状与强迫症比较研究

目的比较强迫症患者与精神分裂症伴强迫症状患者的强迫症状的临床差异。方法采用强迫症状评定量表(Y-B0CS)、Hamilton抑郁量表(HAMD)、Hamilton焦虑量表(HAMA)、阳性症状与阴性症状量表(PANSS),对56例强迫症患者和49例伴有强迫症状的精神分裂症患者进行评定,比较分析二者的临床差异及治疗结果。结果强迫症组的Y-BOCS、HAMD、HAMA等总分明显高于的精神分裂症伴强迫症状组(P<0.O1);治疗后两组各量表分均有明显下降(P<0.01),但强迫症组的症状改善优于精神分裂症伴强迫症状组(P<0.05)。结论强迫症患者的强迫体验、抑郁、焦虑等较明显,对治疗的反应也更好,对精神分裂症伴强迫症状的患者可联合用药。     

奎硫平合并氯丙咪嗪治疗伴强迫症状的分裂症对照研究

目的了解奎硫平合并氯丙咪嗪治疗伴强迫症状的分裂症的疗效和副反应。方法对伴强迫症状的分裂症随机分为研究组和对照组,分别用奎硫平(国产)合并氯丙咪嗪、氯氮平合并氯丙咪嗪治疗8周。用PANSS、Y—BOCS评定疗效,用TESS评定副反应。结果研究组PANSS、Y—BOCS总分和各因子分与治疗前比较明显下降(P<0.01),与对照组相近(P>0.05);两组治疗后分裂症、强迫症状有效率、显效率、痊愈率、总有效率和总显效率结果无显著性差异(P>0.05);研究组治疗后TESS总分显著低于对照组(P<0.05)。结论奎硫平合并氯丙咪嗪治疗伴强迫症状的分裂症疗效肯定,副反应较轻,可作为治疗伴强迫症状分裂症的一个较好选择。     

强迫症患者的自知力及其影响因素分析

目的探讨强迫症患者的自知力及其影响因素。方法对门诊及住院的110例强迫症患者采用自知力评定表及耶鲁-布朗强迫量表(Y-BOCS)评定其自知力及强迫症状。结果①强迫症患者中自知力不良者占31.8%(35/110),其中绝大部分为轻度自知力不良(34/35);②自知力不良组患者Y-BOCS量表各项得分及总分均高于自知力完整组(t=-2.24～-4.93,P<0.05);③自知力不良组中强迫症状为重度者比率较高(χ2=9.011,P<0.05),强迫症状具有荒谬性的比率也较高(χ2=6.174,P<0.05)。结论部分强迫症患者中存在自知力不良,但基本为轻度;病情的严重程度及强迫思维的荒谬性对自知力的影响较明显。     

45～55岁女性精神分裂症患者氯氮平剂量与血药浓度分析

目的探讨45~55岁的女性精神分裂症患者氯氮平服用剂量与血药浓度的关系。方法采用高效液相反相色谱法对66例次氯氮平(CLO)和去甲基氯氮平(N-CLO)进行血药浓度监测,并对结果进行统计分析。结果 45~55岁女性精神分裂症患者的氯氮平血药浓度在服用剂量100m g、150m g时与精神分裂症患者的常模数据相比无显著性差异(t=0.55,1.546;P>0.05);在服用剂量200m g、250m g和300m g时有显著性差异(t=4.221,P<0.001;t=3.448,P<0.05;t=2.942,P<0.05);并且其氯氮平与去甲基氯氮平血药浓度之和的线性斜率也大于常模数据。结论随着服药剂量的增加,45~55岁的女性精神分裂症患者的氯氮平和去甲基氯氮平血药浓度增高幅度大于常模,在服用剂量200m g以上其血药浓度明显高于常模。     

对比强迫症与伴强迫症状的精神分裂症临床特点

目的对比强迫症和伴强迫症状的精神分裂症状不同的临床特点。方法选取我院在2012年1月~12月收治的80例强迫症患者作为强迫症组,选取80例伴强迫症患者作为分裂症组。结果分裂症组的强迫行为比率(63.8%)明显高于强迫症组(53.8%)(P<0.05)。结论强迫症患者承受的痛苦及功能障碍比伴强迫症者明显,但强迫行为没有伴强迫症者明显,临床在进行治疗时,要注意区分,做好鉴别,以便于采取对症的治疗方案。     

rTMS联合常规药物治疗精神分裂症伴强迫症的临床观察

目的:探讨rTMS联合常规药物治疗精神分裂症伴强迫症的影响。方法:选取我院2013年3月-2016年3月72例精神分裂症伴强迫症患者为研究对象,将纳入患者随机抽签分为观察组与对照组,每组36例。对照组在抗精神病治疗基础上加用氟西汀,观察组在对照组基础上给予高频率重复经颅磁刺激,比较血清素、磁共振氢质子波谱、事件相关电位P300、精神症状、强迫症状、不良反应。结果:观察组治疗4周后额叶氮-乙酰天门冬氨酸(NAA)/肌酸(Cr)、N1波幅、P3波幅显著高于对照组(t=2.436,3.201,4.774;P0.05)。观察组治疗4周后精神症状总分(PANSS)、强迫症状总分(DY-BOCS)显著低于对照组的(t=7.236,3.721;P0.01)。结论:高频率重复经颅磁刺激可以提高大脑皮质兴奋性,联合氟西汀可以有效改善精神分裂症状与强迫症状。     

复发性抑郁患者的强迫症状及个性因素

目的探讨强迫症状对复发性抑郁障碍患者的影响以及复发性抑郁障碍患者个性因素分析。方法采用症状自评量表(SCL-90),结合临床,对56例复发性抑郁障碍患者进行评定;采用艾森克人格问卷(EPQ)对伴有强迫症状的复发性抑郁障碍患者42例与不伴强迫症状的复发性抑郁障碍患者14例进行对照研究。结果75%的患者伴有强迫症状,伴有强迫与无强迫患者相比EPQ的E分较低和N分较高,差异有显著性(P<0.01)。结论强迫症状是复发性抑郁障碍的一个重要的危险因素,人格因素中内向和神经质与强迫症状有关。     

自我和谐、创伤经历和家庭环境对大学生强迫症状的影响

目的考察自我和谐、家庭环境、童年创伤经历这3个因素对个体强迫症状的影响程度。方法对471名被试进行问卷施测,并对30名强迫症状突出的被试进行深度访谈。结果自我与经验的不一致是影响强迫症状最重要的因素(t=9.07,P<0.001);家庭环境的不同因素对强迫症状影响不同(组织性t=-3.85,P<0.001;控制性t=3.54,P<0.001;情感表达t=-2.51,P<0.05;成功性t=2.35,P<0.05);童年期创伤性经历对强迫症状的发生发展有显著影响(情感虐待t=4.5,P<0.001;身体忽视t=2.20,P<0.05)。结论对强迫症状起作用的依次是自我和谐、创伤经历和家庭环境。     

耶鲁-布朗强迫症状清单调查强迫症状的初步应用

目的初步使用耶鲁-布朗强迫症状清单调查我国强迫症的症状类型。方法采用耶鲁-布朗强迫症状清单调查78例强迫症患者的症状及出现的频率,分析症状类型与人口学资料的相关性。结果 78例强迫症患者,强迫思维的症状数量(9.6±6.8)个,强迫行为的症状数量(4.7±4.2)个;排在前3位的强迫思维依次为怕污染的强迫思维(42.3%)、怕冲动的强迫思维(35.9%)、要求对称或精确的强迫思维(17.9%)。强迫行为前3位依次为强迫洗涤行为(39.8%)、强迫检查行为(38.4%)、强迫重复行为(28.2%)。男性患者20.9%存在有关性的强迫思维高于女性2.9%,差异有统计学意义(U=2.38,P=0.0172)。无职业者50.0%存在强迫洗涤行为高于有职业者25.0%,差异有统计学意义(U=2.22,P=0.0265)。结论耶鲁-布朗强迫症状清单能够有效涵盖所有强迫症状,初步应用成功。强迫症状类型与人口学资料存在相关性。     

认知行为治疗对精神分裂症超高危人群的影响

目的:通过对精神分裂症超高危人群进行认知行为治疗干预,在不同时点来观察是否对其精神病性症状有改善或延迟。方法:将110例患者随机分成研究组(55例)和对照组(55例),研究组给予认知行为治疗,对照组仅问卷随访。并在干预前、3个月、6个月、12个月及18个月进行阴性及阳性症状评定量表(PANSS)评定,最终完成99例,研究组50例,对照组49例。结果:研究组与对照组PANSS阳性症状(F=4.14,P0.05)及总分(F=6.30,P0.05)之间的差异具有统计学意义;在阳性症状(F=3.47,P0.05)及总分(F=3.67,P0.05)的分组与时间的交互作用有统计学意义。职业是精神分裂症超高危人群的保护性因素(P0.05,OR=0.17)。结论:对精神分裂症超高危人群进行认知行为治疗干预,可以有效延缓此类人群的精神病性症状的进展。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.