自制消郁丸治疗轻、中度抑郁症的临床研究

目的评价自制消郁丸治疗轻中度抑郁症的疗效和安全性。方法将符合CCMD-3抑郁症诊断标准60例抑郁症患者随机分成两组，分别采用消郁丸和氟西汀治疗，治疗6周，两组均以汉密尔顿抑郁量表（HAMD），汉密尔顿焦虑量表（HAMA）评定疗效，以不良事件量表评估药物安全性。结果两组患者的主要治疗指标HAMD评分，在治疗结束时较治疗基线均显著降低（P〈0.001）；治疗结束时，消郁丸组和氟西汀组HAMD总分减分率分别为54.87%、54.81%。说明两药对抑郁症均有良好的疗效。两组HAMA的总分较基线减分相似，且均较基线减分显著（P〈0.001）说明两药对抑郁症状伴有的焦虑症状也具有明显的改善作用。消郁丸组较多见的不良反应有恶心、口干、失眠、上腹部不适、体重变化等。不良事件症状严重程度多为轻度，少数为中度。试验期间没有严重不良事件发生。结论消郁丸对轻中度抑郁症疗效好，不良反应少，价格便宜，适合临床使用。     

开郁安神胶囊治疗轻中度抑郁症的Ⅱ期临床研究

目的 评价开郁安神胶囊治疗轻、中度抑郁症的临床疗效和安全性.方法 对符合CCMD-3抑郁症诊断标准的60例抑郁症患者进行开郁安神胶囊与氟西汀片的对照研究,其中开郁安神胶囊组30例(1.44g/d),氟西汀组30例(20mg/d),共治疗6周.采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床总体评定量表(CGI)评定临床疗效,不良反应量表(TESS)评定不良反应.结果 经6周治疗后,开郁安神胶囊组治疗总有效率为53.57%,氟西汀组为50.00%,两组比较无显著性差异(P＞0.05);两组的HAMD,HAMA评分治疗前后有极显著性差异(P＜0.01).两组常见的不良反应有恶心呕吐、腹泻、口干、头昏、食欲减退和厌食等,发生率无显著性差异(P＞0.05).结论 开郁安神胶囊治疗轻、中度抑郁症疗效好,且不良反应少而轻,适合临床应用.     

血清同型半胱氨酸水平对氟西汀治疗抑郁症疗效的影响

目的 探讨血清同型半胱氨酸对氟西汀治疗抑郁症疗效的影响.方法 应用荧光偏振免疫法(Fluo-rescence Polarization Immunoassay,FPIA)检测38例抑郁症患者血清同型半胱氨酸水平,并给予8周氟西汀系统治疗,分别于治疗前及治疗后第8周对患者进行17项汉密尔顿抑郁量表(Hamilton rating scale for depres-sion,HAMD17)评定.结果 治疗前抑郁症患者血清同型半胱氨酸水平为(16.45±5.96)μmol/L,高同型半胱氨酸血症的发生率为42.50%;治疗前HAMD评分为(28.38±2.91),与血清同型半胱氨酸水平呈正相关(r=0.724,P=0.000).经过治疗,全部样本中有显著疗效28例(占73.69%),有效8例(占21.05%),无效2例(占5.26%);HAMD减分率为(59.60±19.95)%,与治疗前患者的血清同型半胱氨酸水平呈负相关(r=-0.848,P=0.000).显效组、有效组和无效组患者治疗前血清同型半胱氨酸水平分别为(14.37±2.61)μmol/L,(21.86±3.55)μmol/L,(31.93±11.96)μmol/L,三组组间比较有显著性差异(P=0.000).高同型半胱氨酸血症组和非高同型半胱氨酸血症组患者HAMD减分率分别为(42.64±14.67)%和(73.33±11.03)%,两组比较有显著性差异(t=7.326,P=0.000).结论 血清同型半胱氨酸水平升高可能是抑郁症发病的重要危险因素之一,其对氟西汀治疗抑郁症患者的疗效有一定影响.     

电针刺激耳迷走神经对老年抑郁症的辅助治疗

目的:探讨电针刺激耳迷走神经对难治性老年抑郁症的辅助治疗作用. 方法:72例难治性老年抑郁症患者分为电针组和药物组,每组各36例.电针组采用改良电针刺激耳迷走神经治疗,每周5 d,12周为1个疗程;药物组给予抗抑郁药治疗.采用汉密尔顿抑郁量表(HAMD)及临床疗效总评量表(CGI)评定疗效. 结果:电针组HAMD减分率>50%及25%的患者显著多于药物组(P=0.015);CGI-I显效率38.9%明显高于药物组22.2%(P=0.016).电针组不良反应事件平均为(4.9±5.1)%,明显低于药物组(9.7±5.5)%,差异有显著性(P<0.05).以电针组疗效较好,不良反应较少. 结论:电针刺激耳迷走神经治疗难治性抑郁症与植入式迷走神经刺激法疗效相近,但不良反应较少.     

小剂量舍曲林合并电针治疗抑郁症的疗效观察

目的观察舍曲林合并电针治疗抑郁症的临床疗效。方法采用随机分组方法,将抑郁症患者分为舍曲林合并电针治疗组(合用组)和单用舍曲林治疗组(单用组),治疗6周,以汉密顿抑郁量表(HAMD)、抑郁自评量表(SDS)和副反应量表(TESS)评定疗效和副反应。结果治疗2周后,两组的HAMD、SDS评分均显著低于治疗前(P<0.05),合用组在第2周末HAMD减分率显著大于单用组,在第4周末、第6周末两组减分率无明显差异。两组的显效率分别为87.5%和79.2%,经统计学处理两组无显著差异。合用组的副反应少于单用组。结论舍曲林合并电针治疗与单用舍曲林治疗均对抑郁症有较好疗效,前者起效快,副反应更少。     

消郁汤与舍曲林治疗抑郁症的对照研究

目的 探讨中药消郁汤与西药舍曲林治疗抑郁症的疗效与副作用.方法 将260例和180例抑郁症患者分别用中药消郁汤(治疗组)及西药舍曲林(对照组)治疗,共治疗6周.用汉密尔顿抑郁量表(HAMD)评估疗效,不良反应和安全性用副反应量表(TESS)和实验室检查评定.结果 两组在治疗后第1、2、4、6周末HAMD评分与疗前相比均明显下降,均有显著性差异(P<0.01).治疗组成本较对照组低,患者更易接受.治疗期间治疗组副反应明显低于对照组,差异非常显著(P<0.01).结论 消郁汤和舍曲林治疗抑郁症疗效好,消郁汤较舍曲林的副反应少且症状轻微,依从性好,安全性高.     

首次发作抑郁症患者血清性激素水平研究

目的:探讨性激素(睾酮、雌二醇、孕酮)对首次发作抑郁症患者的药物治疗疗效的影响。方法:对93例住院抑郁症患者给予5-羟色胺再摄取抑制剂(SSRIs)治疗4周,分别于治疗前后检测血清性激素。按治疗前后汉密尔顿抑郁量表(HAMD,17)减分率分为痊愈组(减分率≥75%)和未愈组(减分率<75%),分析两组性激素水平。结果:男性患者中,治疗后睾酮及雌二醇水平均比治疗前有显著提高,孕酮水平较治疗前有明显降低,痊愈组治疗后睾酮及雌二醇水平均高于未愈组,孕酮的差异无显著性,睾酮及雌二醇增加率与HAMD减分率存在显著正相关,而孕酮的减少率则与HAMD无显著相关。女性患者中,治疗前后及两组间睾酮水平的差异无显著性,治疗后雌二醇有显著性增高,但痊愈组与未愈组治疗前后差异无显著性,雌二醇的增加率与HAMD减分率之间未发现显著相关;同时治疗后孕酮显著降低,且治疗后两组间孕酮水平差异显著,孕酮的减少率与HAMD减分率之间存在显著正相关。结论:血清睾酮、雌二醇水平的升高对首次发病的男性抑郁症患者药物疗效有影响,而女性患者的治疗效果与孕酮降低程度有关。     

抑郁症患者血浆P物质含量变化及其相关性研究

目的探讨抑郁症患者血浆P物质水平的变化及其与抑郁症的关系。方法对32例抑郁症患者(抑郁症组)应用帕罗西汀治疗6周,分别于治疗前和治疗后第6周末采用放射免疫法测定患者血浆P物质含量;同时以汉密尔顿抑郁量表(24项,HAMD)、汉密尔顿焦虑量表(18项,HAMA)评定症状严重程度,以HAMD减分率评定疗效。以32名健康志愿者为对照组。结果抑郁症组患者治疗前血浆P物质水平[(51±13)ng/L]明显高于对照组[(43±11)ng/L],差异有统计学意义(P=0.010);治疗后血浆P物质水平[(44±10)ng/L]较治疗前明显下降,差异有统计学意义(P=0.001);治疗前后血浆P物质的变化与HAMD总分值的减分率呈显著正相关(rs=0.826,P=0.000)。结论抑郁症患者的血浆P物质存在异常,动态观察血浆P物质水平变化可能有助于判断疗效。     

不同治疗方案对难治性抑郁症疗效的比较

目的:比较不同治疗方案对难治性抑郁症疗效及影响疗效的因素分析。方法:60例难治性抑郁症患者随机分为文拉法法辛新+碳酸锂组及文拉法辛+奥氮平组,疗程12周。治疗前后进行汉密尔顿抑郁量表17项(HAMD-17)评定;治疗后进行治疗中出现的症状量表(TESS)评定。HAMD减分率50%的患者进行艾森克人格问卷(EPQ)调查及12周药物联合心理治疗;分析影响HAMD评分的因素。结果:治疗后两组HAMD总分、总有效率及不良反应发生率差异无统计学意义;两组共有17例患者进行药物联合心理治疗,其中14例(82.4%)有效;患者EPQ的神经质(N)分、内外向(E)分与药物联合心理治疗的疗效相关(r=-0.447,r=0.883;P均0.01)。结论:结合心理治疗可使80%以上药物治疗无效的患者改善,人格特征影对心理治疗的疗效。     

抑郁症和糖尿病共病患者临床对照研究

目的:探讨抑郁症和糖尿病共病患者的临床特征及疗效。方法:将40例伴有糖尿病的抑郁症患者和40例单纯抑郁症患者分成共病组和抑郁组,使用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和社会功能缺陷筛选量表(SDSS)评定两组患者的临床表现和社会功能,使用选择性5-羟色胺再摄取抑制剂治疗12周再次评定。结果:入组及治疗12周时,共病组HAMD、HAMA及SDSS总分均显著高于抑郁组(P<0.05),入组时HAMD焦虑/躯体化、认知障碍、迟缓、绝望感等因子分显著高于抑郁组(P<0.05),治疗12周共病组的减分率显著低于抑郁组(P<0.05)。结论:抑郁症和糖尿病共病患者的抑郁及焦虑症状重、社会功能缺陷明显,治疗效果显著差于单纯抑郁症患者。     

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     

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。     

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.     

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.     

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.     

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.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

《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。     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高,而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。