The promises and pitfalls of sex difference research

Funding agencies in North America and Europe are recognizing the importance of the integration of sex differences into basic and clinical research. Although these mandates are in place to improve our knowledge of health for both men and women, there have been a number of implementation issues that require vigilance on the part of funders and the research community. Here we discuss issues on simple inclusion of both sexes in studies to specialisation of sex differences with attention paid to statistics and the need for sex-specific treatments. We suggest differing mandates need to be considered regarding simple integration versus the need for studies in the specialisation of sex differences and/or the need for research that recognises the importance of male-specific or female-specific factors that influence subsequent health such as menstruation, menopause or pregnancy.     

精神分裂症应用氯氮平228例初期血药浓度与临检指标水平的相关性

目的 研究精神分裂症病人使用氯氮平初期血药浓度与临检指标水平的相关性.方法 收集2018年1月至2019年1月在安徽医科大学附属心理医院住院治疗的精神分裂症病人228例氯氮平血药浓度及其人口学资料和实验室临检指标.采用Pearson相关检验和多元线性回归分析氯氮平血药浓度与实验室临检指标的关系.结果 Pearson相关...     

针对高中生自杀倾向的危机干预:1例动力性人际治疗案例报告

一、心理危机与危机干预的概念心理危机是Capland于1964年提出的概念,即当个体面临困境时,先前的处理危机的方式和惯常的支持系统不足以应对眼前的处境时,会出现暂时的心理失衡状态,即心理危机[1].危机干预是给处于危机中的个体提供有效帮助和心理支持的技术[1].当代危机干预往往采用Gilliland和James提出的六个步骤:明确问题、确保安全、提供支持、提出并验证变通的应对方法、制定计划、获得承诺[1].     

Thyroidal stimulation of tubulin and actin in rat brain cytoskeleton

In cultures of neonatal rat brain cells, labeled with ³⁵S-methionine in the presence or absence of triiodothyronine (T₃), the hormone promoted a significant enhancement of labeled tubulin and actin in the insoluble fraction (30,000 g pellet) of cell homogenate. To identify the specific sub-cellular fraction associated with this induction, organ cultures of 1 day rat cerebra were labelled with ³⁵S-methionine in the presence and absence of T₃ and the insoluble fraction (30,000 g pellet) was subfractionated into mitochondria, plasma membrane and cytoskeleton. Analysis of the labeled proteins by SDS-PAGE, autoradiography and densitometry revealed a T₃-induced increase of 50–80% for both tubulin and actin, only in the cytoskeleton fraction without any significant effect on the other fractions. Similar results were obtained when plasma membrane or cytoskeleton were isolated directly from labeled cerebrum by conventional methods instead of fractionating from the 30,000 g pellet. Analysis of relative stimulation of labeled tubulin and actin by T₃ in cytoskeleton fraction derived from primary cultures of neuronal (N) and glial (G) cells labeled with ³⁵-methionine show that the stimulatory effect is predominantly on the N cells. Studies on the kinetics of induction of labeled tubulin and actin by T₃ in the cytoskeleton fraction prepared from cerebra labeled with ³⁵S-methionine for 2, 8 and 18 hrs revealed no significant difference at 2 hrs; at 8 hrs, an increased incorporation into both tubulin and actin was reproducibly seen in the controls relative to T₃-treated samples. However by 18 hrs, this pattern reversed and an enhanced accumulation of both labeled tubulin and actin was observed under the influence of T₃. The mechanism of this apparently intriguing effect of T₃ on the kinetics of association of tubulin and actin with the cytoskeleton has been discussed in the light of the dual effect of the hormone on tubulin viz. enhancing its stability as well as rate of synthesis. The overall results indicate that the thyroid hormones play a major role in the cytoskeletal transport of tubulin and actin from their site of synthesis to that of assembly thus facilitating axodendritic outgrowth and morphological differentiation.     

Vasoconstrictor-mediated release of purines and pyrimidines from perfused rat hindlimb,perfused mesenteric arcade and incubated de-endothelialized aorta

• 1.1. Reperfusion of hindlimbs that had previously been exposed to either 10 or 60 min global ischaemia resulted in transient washouts of uracil and uric acid in approximate proportion to the interval of ischaemia. However, changing the interval of sequential angiotensin II infusions from 10 to 60 min did not affect the magnitude of sustained uracil and uric acid release.
• 2.2. Perfused rat mesenteric artery arcade released uracil and uric acid and each was further increased approximately 2-fold by exposure to the vasoconstrictor, serotonin (6.7 μM).
• 3.3. Incubated de-endothelialized rat aorta also released purines and pyrimidines and this was increased further when subjected to increased work loads.
• 4.4. The increased rates of release of purines and pyrimidines from hindlimb, and the simpler vascular preparations of mesenteric arcade and aorta, were in proportion to the relative rates of increase in oxygen consumption under maximum vascular load.
• 5.5. It is concluded that the release of purine and pyrimidine nucleosides and their catabolites from perfused rat hindlimb occurring as a consequence of vasoconstriction is not the result of release from previously ischaemic tissue. In addition, release of purines and pyrimidines appears to be a general feature of vascular smooth muscle subjected to high workloads.

     

The attentional networks in benign epilepsy with centrotemporal spikes

Benign epilepsy affecting children with normal mental development often occurs at a particular age, responds well to medication, and could be resolved completely by puberty. Although several studies have shown neuropsychological disabilities of children with benign epilepsy with centrotemporal spikes (BECTS), there is no clear evidence about the impairment of attentional systems and the comorbidity of attentional problems. Our research was based on the attention network model and assessed the characteristics of three anatomically defined subnetworks (alerting, orienting, and executive control) of 90 children with BECTS and 90 healthy children. All the subjects enrolled in the study participated in the attention network test (ANT) with assessment of both the reaction time (RT) and accuracy of the test. The results indicated that the performance of healthy controls was significantly better in orienting of attentional system (P < 0.001) and the accuracy of attention network test (P < 0.001), compared with that of children affected by BECTS. The grand mean effect (higher score worse) was significantly higher (P < 0.001) in the patient group than that in the control group. The multiple linear regression analysis revealed a positive correlation between the age of onset and the accuracy of attention network test results, and a negative correlation between the age of onset and the results of grand mean effect. A negative correlation was observed between spike index (SI) of the non-REM sleep stage and the accuracy of attention network test results. We found no relationship between the grand mean effect and clinical factors such as gender, duration of clinical course, duration of seizures, total number of seizures, severity of seizures (seizure frequency), hemispheric lateralization of electroencephalograph (EEG), and the awake SI. Furthermore, no relationship was observed between the clinical factors and the accuracy of the test results. The findings showed that BECTS is associated with impaired attentional networks, and impairments are greater at younger ages of onset.     

Electroconvulsive therapy modulates critical brain dynamics in major depressive disorder patients

BackgroundElectroconvulsive therapy (ECT) is widely considered as an effective and fast-acting option for treating patients with major depressive disorder (MDD). However, the neural basis underlying this powerful therapy remains uncertain. Recent studies have suggested that the healthy brain may operate near a critical state, which may reflect a balance between neuronal excitation and inhibition.ObjectiveIn the present study, we investigated whether there are any changes regarding criticality in MDD and, if so, whether ECT can reverse them. Critical dynamics analyses were performed on resting-state functional magnetic resonance imaging (rs-fMRI) data collected from 39 MDD patients and 38 healthy controls (HCs).ResultsWe found that compared with HCs, MDD patients, especially those who responded positively to ECT, tended to have smaller average avalanch sizes and lower branching ratios, suggesting a sub-critical state, at both the whole-brain and functional network levels. Importantly, ECT effectively corrected such anomalies, accompanied by enhanced degree centrality and functional connectivity of high-degree nodes located in the networks including the default-mode and the frontoparietal networks.ConclusionThese results indicate that ECT can modulate large-scale brain dynamics of MDD patients to be closer to criticality. Our study sheds new light on the pathology of MDD and the network mechanism by which ECT influences treatment.     

缺陷型精神分裂症认知功能与病耻感相关性研究

目的： 探讨缺陷型精神分裂症患者认知功能损害及其阴性症状与病耻感之间的关联性。 方法： 收集72例稳定期精神分裂症患者,采用RBANS量表、Stroop测试、Link系列病耻感量表测量其认知功能及病耻感,后根据缺陷型精神分裂症诊断量表（SDS量表）分为缺陷型组（29例）与非缺陷型组（43例）,并招募正常对照组40例,采用RBANS、Stroop测试测量其认知功能。 结果： 缺陷型精神分裂症患者在RBANS量表（P<0.05）及病耻感量表除教育（P>0.05）外各维度评分（P<0.05）明显高于非缺陷型精神分裂症;Stroop测试中缺陷型精神分裂症在各组测试用时明显高于非缺陷型组（P<0.05）;72例精神分裂症患者斯皮尔曼相关分析提示RBANS各维度与贬低-歧视、退缩、应对、误解、不同/羞耻、情感体验、病耻感总分斯皮尔曼相关系数绝对值>0.3,呈负相关关系;Stroop测验各维度评分以色时间与贬低-歧视、不同/羞耻、情感体验、病耻感总分斯皮尔曼相关系数绝对值>0.3,字时间与除保密、教育、挑战、分离、应对外各维度斯皮尔曼相关系数绝对值>0.3,色字时间与除保密、教育、挑战、分离外各维度斯皮尔曼相关系数绝对值>0.3,以色字时间-字时间与病耻感除教育、分离维度外各维度斯皮尔曼相关系数绝对值>0.3,呈正相关关系;SDS量表评分与病耻感相关性分析提示除教育外各维度斯皮尔曼相关系数均>0.3,呈正相关关系。 结论： 缺陷型精神分裂症较非缺陷型精神分裂症认知功能损害及病耻感更严重;相关分析结果提示病耻感与非社会认知功能损害存在负相关关系,与阴性症状存在适度的正相关。     

预防老年抑郁症复发的最佳证据总结

背景老年抑郁症复发率高,但目前国内外较缺乏预防老年抑郁症复发干预方案的研究。课题组前期探究了老年抑郁症复发的危险因素,其中可控性危险因素为服药依从性差、活动少、进食少。目的 根据以上3个危险因素检索、评价和总结预防老年抑郁症复发的相关证据。方法 2022年10月,计算机检索Web of Science、PubMed、Cochrane Library、美国指南网、英国指南库、加拿大安大略护理学会网站（RNAO）、复旦大学循证护理中心、中国知网等数据库,收集关于预防老年抑郁症和老年疾病伴发抑郁症复发方面的相关证据,包括指南、系统评价、专家共识、证据总结等,检索时限为从建库至2022年10月。由接受过循证医学系统培训的研究者分别采用临床指南研究与评估系统Ⅱ（AGREEⅡ）、AMSTAR、澳大利亚乔安娜布里格斯研究所（JBI）循证中心评价标准（2016版）对纳入的指南、系统评价、专家共识和原始研究进行质量评价。最后采用2014年澳大利亚版本JBI循证卫生保健中心证据分级及证据推荐级别系统进行证据汇总、评价和等级划分。结果 共纳入15篇文献,包括指南3篇、系统评价11篇、随机对照试验1篇。纳入的...