尼古丁依赖与烟瘾戒除

吸食烟草是世界上可以预防的致死、致残、致引发疾病的重要因素之一,至2020年它将成为所有发达国家和发展中国家要面对的头号健康公敌。尼古丁是导致机体对烟草产生依赖的重要首要活性物质,作用于中枢神经系统,引起多巴胺等神经递质的释放。像其他产生化学物质的依赖一样,尼古丁被认为是激活中脑边缘多巴胺系统产生犒赏作用。有很多治疗方法在商业中用于治疗尼古丁依赖,只有两种证实的确有效：一种是行为治疗（包括5A简单干预）干预,另一种则是药物疗法。研究发现,5A简单干预是最好的简短干预方法之一,特别适用于工作繁忙的内科医师。     

青少年犯罪危险因素、保护因素及其社会生态学预防模式的探讨

有关青少年犯罪的危险因素与保护因素是目前该领域国内外研究的热点,多项研究认为青少年犯罪是个人、家庭、学校和社会等多方面危险因素相互作用的结果,而保护因素则可减少危险因素的影响.本文对有关青少年犯罪危险因素和保护因素的研究进行了系统的回顾和总结,并从减少危险因素和强化保护因素的角度出发,对预防青少年犯罪的社会生态学预防模式进行了初步探讨.     

(英文)SD大鼠新奇环境反应性与海洛因依赖易感性的关系

目的:建立大鼠海洛因依赖易感性差异的条件性位置偏爱模型,进一步探讨新奇环境反应性与海洛因成瘾易感性之间的关系.方法:70只雄性SD大鼠分别进行旷场实验以了解其在新奇环境中的反应性,然后根据海洛因诱导的条件性位置偏爱的强度不同分为高CPP组和低CPP组,各占总数的30%, 并分析其与新奇环境反应性之间的关系.结果:海洛因处理前后实验大鼠CPP值差异有统计学意义(P<0.01);高CPP组旷场实验跨格总数及运动总距离均明显高于低CPP组(P<0.01);CPP的差值与旷场实验结果呈正相关(P<0.05).结论:小剂量递增法可以有效地建立海洛因CPP易感性差异模型.大鼠在新奇环境中的反应性能够较好地预测其形成海洛因依赖的强度.     

内镜诊治35例小儿上消化道异物的体会

小儿上消化道异物是临床常见急症，既往多需手术治疗，近年来随着内镜的普及手术率已逐年降低，近三年来，我们应用胃镜诊治小儿上消化道异物35例，取得了良好的效果，现报告如下。     

中国部分地区精神科医生对精神障碍者及其处置政策态度的调查

目的了解我国精神科医生对精神障碍患者及其处置政策的态度,以及卫生部"重性精神疾病防治师资培训"项目对精神科医生上述态度的影响情况。方法使用自制的"精神卫生相关知识"问卷对157名参加卫生部"重性精神疾病防治师资培训"的精神科医生在培训前后进行调查。结果34.4%的精神科医生认同"精神分裂症难以治愈"。培训后上述认同率均有下降,但培训前后认同率差异无显著性(P0.05)。超过80%的医生认同"精神病人接受治疗前应签署知情同意书",且培训后认同率仍有明显增加(P0.05)。"精神病人应以自愿开放治疗方式为主"和"精神病人有权拒绝治疗"培训前医生的认同率分别为40.8%和26.1%,培训后显著提高到75.2%和68.1%(P0.01)。超过50%的精神科医生认同"精神病人具有暴力倾向";超过80%的医生认同"无责任能力精神病罪犯应由国家监禁治疗";不到40%的医生认同"精神病人犯罪可以免除刑事责任"。结论精神科医生一方面赞同要尊重精神障碍者的自决权,如治疗前要签署知情同意,另一方面对于有危险行为或司法精神障碍者,则主张使用更严格的处置措施,因此对精神障碍者的自愿开放治疗尚认识不足。卫生部培训班可以影响精神科医生对精神卫生处置政策的态度。     

中西医结合治疗房颤临床观察

目的:观察中西医结合治疗房颤的临床疗效。方法:40例随机分为治疗组和对照组各20例,两组均用西医常规治疗,治疗组加服参松养心胶囊。结果:总有效率治疗组90.0%、对照组75.0%,两组比较差异有统计学意义(P0.05)。结论:中西医结合治疗房颤疗效明显,不良反应少,能够显著改善临床症状。     

眼外肌麻痹综合征的诊断和鉴别诊断(附15例临床分析)

眼肌麻痹患者常以眼睑下垂、复视、头痛等症状就诊于眼科、神经内科及内分泌科，而其中多数为神经系统疾病，因此，非专科医师对其病因诊断及鉴别诊断认识不足，现将2003—2007年所遇15例眼肌麻痹病例予以分析。     

大鼠伏隔核多巴胺D2受体及转运体与吗啡条件性位置偏爱易感性的关系

Objective To explore the possible role of the expression of dopamine D2 receptor (D2R)and dopamine transporter(DAT)located in the nucleur accumben(Nac)in rats with difierent CPP susceptibility.Methods Altogether 160 male Sprague-Dawley rats were randomly assigned into experiment group(n=130)and control group(n=30).The experiment rats were re-classified into three groups according to the numerical value of the CPP(conditioned place preference),high preference group(HP group,n=26),moderate preference group(n=78)and low preference group(LP group,n=26).At the time of 3 hours,72 hours and 14 days after the final injection,rats in each group were scarified,and the mRNA levels of D2R and DAT in Nac were estimated with in situ hybridization.Results No significant difference of pretest scores staying at the non-preference chamber exist among the three groups(P=0.470),however.the time stayed at the conditioned preference chamber during the test period minus the time stayed at pretest natural preference was significantly higher in the HP group than the LP group(P＜0.01).In each time-point,the expression of D2R mRNA in HP group,were lower that in LP group[(131±3,122±5,119±5)and(125±4,117±8,114±5),P＜0.01].In each time-point,the expression of DAT mRNA in HP group,were significantly lower than that in LP group[(161±5,143±4,134±6)and(156±5,139±3,130±4),P＜0.01].Conclusions It can be inferred that D2R and DAT may be correlated closely and underlie the difierent susceptibility to morphine induced CPP.     

大鼠伏隔核多巴胺D2受体及转运体与吗啡条件性位置偏爱易感性的关系

Objective To explore the possible role of the expression of dopamine D2 receptor (D2R)and dopamine transporter(DAT)located in the nucleur accumben(Nac)in rats with difierent CPP susceptibility.Methods Altogether 160 male Sprague-Dawley rats were randomly assigned into experiment group(n=130)and control group(n=30).The experiment rats were re-classified into three groups according to the numerical value of the CPP(conditioned place preference),high preference group(HP group,n=26),moderate preference group(n=78)and low preference group(LP group,n=26).At the time of 3 hours,72 hours and 14 days after the final injection,rats in each group were scarified,and the mRNA levels of D2R and DAT in Nac were estimated with in situ hybridization.Results No significant difference of pretest scores staying at the non-preference chamber exist among the three groups(P=0.470),however.the time stayed at the conditioned preference chamber during the test period minus the time stayed at pretest natural preference was significantly higher in the HP group than the LP group(P＜0.01).In each time-point,the expression of D2R mRNA in HP group,were lower that in LP group[(131±3,122±5,119±5)and(125±4,117±8,114±5),P＜0.01].In each time-point,the expression of DAT mRNA in HP group,were significantly lower than that in LP group[(161±5,143±4,134±6)and(156±5,139±3,130±4),P＜0.01].Conclusions It can be inferred that D2R and DAT may be correlated closely and underlie the difierent susceptibility to morphine induced CPP.     

土豆湿敷治疗长春瑞滨所致静脉炎60例

2003年2月～2004年12月，我科采用土豆湿敷治疗长春瑞滨所致静脉炎，取得较好效果。现报告如下。