Negative symptoms in schizophrenia: considerations for clinical trials

There is little agreement about the methodology of clinical trials of antipsychotic drugs in patients with negative symptoms. A literature review revealed wide variation in experimental design, rating scales and study duration. This reflects differing views as to the definition and response to treatment of negative symptoms. Some degree of standardization would improve comparability of studies and aid the development of new compounds. Patients included in such studies should have displayed negative symptoms for at least 6 months. Depressive symptoms, positive schizophrenic symptoms and extrapyramidal signs may all influence or be confused with negative symptoms and may respond to treatment; they should be at a low level at baseline and should be measured during the study period. Studies should last at least 8 weeks. Several scales are available for measuring negative symptoms and are reviewed; a global impression score should be used additionally.     

舟山海岛学生的碘营养状况对照研究

目的 :　海岛学生饮食结构中含有碘丰富的海产品。本研究旨在了解海岛学生的碘营养状况 ,评价食盐补碘的利弊。方法 :　对定海农村 (食用碘盐 )和岱山农村 (不食用碘盐 )的学校中随机抽取的 1 2个班级 ,对碘盐组和非碘盐组的饮食碘摄入和尿碘水平等变量进行描述 ,并分别以尿碘和甲状腺肿率为应变量进行单因素和多因素回归分析。结果 :　碘盐组除碘盐外每日碘摄入量中位数为 1 84μg,而不食用加碘盐的组为 1 0 5 μg,两组饮食碘摄入有显著性差异 (u=4.71 0 ,P=0 .0 0 0 ) ,而尿碘水平在食用碘盐组和不食用碘盐组分别为 1 6 9μg/L和 1 2 9μg/L,两组间有显著性差异 (u=6 .3 0 2 ,P=0 .0 0 0 )。多因素分析中性别和是否食用碘盐对尿碘水平有显著性意义 (P<0 .0 5 ,OR值分别为 0 .76 5 ,1 .93 3 )。甲状腺肿学生和正常学生的饮食碘和尿碘无统计学差异 (P>0 .0 5 )。Poisson回归分析中性别和是否食用碘盐对甲状腺肿率有影响 (P<0 .0 5 ,OR值分别为2 .2 5 ,3 .5 2 )。结论 :　舟山海岛学生要注意补碘过程中可能出现的碘过量问题。     

Dietary behaviour of an adolescent French male population

The dietary history method was used to determine the total energy and macronutrient intake, the distribution of daily energy from the different meals and the energy contribution of various food groups, in a population of 299 boys, aged between 10 and 15 years. The effects of age, the social status of the father (SPS), the ponderal index, the importance of breakfast or lunch, and the level of energy intake on dietary indicators, were studied. In our population, energy intake increased with increasing age but the energy contribution of macronutrients did not vary. The diet of boys whose fathers were in the upper SPS classes differed from the diet of those boys whose fathers were manual workers: for example they consumed less energy and pastries, but more animal protein (in percentage of energy intake), more dairy products, and more fruit. The ponderal index was negatively related to energy intake but positively related to protein intake, especially from meat and meat products. The energy intake from protein, animal protein and the energy contribution of dairy products, meat and meat products, fish and vegetables was lower among large eaters than among small eaters. The energy contribution of pastries, sugar and sweets was higher among large eaters.
Similarily, the energy intake from morning and evening snacks was also higher among large eaters. It should be noted that boys who had a substantial breakfast took in less energy from all other meals (including snacks and main meals). Such informaton is necessary in order to develop an effective health programme.     

Daily nutrient intake represents a modifiable determinant of nutritional status in chronic haemodialysis patients.

BACKGROUND: In maintenance haemodialysis patients, daily food intake is changeable; however, its relationship with nutritional status is unexplored. This study aimed to evaluate the isolated, long-term effect of daily nutrient intake on nutritional status in haemodialysis patients. METHODS: We performed a prospective 1-year controlled study in 27 chronic haemodialysis patients, without recognized risk factors for malnutrition. Each day for 1 week, four times in the year, we measured protein nitrogen appearance, and assessed dietary protein (DPI) and energy (DEI) intake from dietary diaries. We compared the nutritional outcome of patients spontaneously reducing nutrient intake below the threshold of 0.8 g/kg body weight/day for DPI and 25 kcal/kg body weight/day for DEI during the week (LOW, n = 8), with controls at adequate nutrient intake (CON, n = 19). An interventional 6-month study was then carried out in LOW to verify the cause-effect relationship. RESULTS: All patients showed a day-by-day reduction of whole nutrient intake during interdialytic period, which was mostly relevant in the third interdialytic day (L3). During the 1-year study, even in the presence of adequate dialysis dose and normal inflammatory indexes, body weight (68.0 +/- 5.5 to 65.8 +/- 5.9 kg), serum albumin (3.96 +/- 0.07 to 3.66 +/- 0.06 g/dl) and creatinine (9.2 +/- 1.1 to 8.1 +/- 0.7 mg/dl) significantly decreased in LOW but not in CON. Diaries evidenced in LOW a reduced number of meals at L3 that was explained by the fear of excessive interdialytic weight gain. During the interventional study, daily DPI and DEI increased at L3; this was associated with a significant increment of body weight, and serum albumin and creatinine levels. CONCLUSIONS: In maintenance haemodialysis patients the persistent, marked reduction of daily nutrient intake, even if limited to a single day of the week, is an independent determinant of reversible impairment of nutritional status.     

硫喷妥钠治疗小儿难治性惊厥持续状态疗效观察

目的 探讨对小儿难治性惊厥持续状态的有效治疗方法。方法 对14例小儿难治性惊厥持续状态采用硫喷妥钠治疗并观察疗效。结果 硫喷妥钠治疗有效率为100％，1例出现呼吸抑制，3例于停药后复发。结论 硫喷妥钠对小儿难治性惊厥持续状态有明显疗效，但易发生呼吸抑制。惊止后应维持一段时间，以免复发。     

宁夏卫生人力资源现状分析

目的　了解宁夏卫生人力现状 ,提出建设性意见。方法　采用普查分类统计分析的方法。结果　现有卫生人员 2 3485名 ,其中卫生专业技术人员 18838名 ,每千人拥有 4 .35名卫生人员和 3.36名卫生专业技术人员。结论　年龄和职称分布合理 ,卫生人力资源总量较 16年前明显增加 ,卫生专业技术人员增长了 83.5 7% ,研究生偏少 ,本科学历比例较小 ,卫生人力资源过于集中在银川市     

Factors Affecting Cardiac Catheterization Rates in Elders with Acute Coronary Syndromes

Background: Elder patients with acute coronary syndromes (ACS) are less likely to receive cardiac catheterization. The reasons for this are unclear.
Objectives: To assess whether elder patients who had a documented history of dementia, lived in extended care facilities, or had do not intubate–do not resuscitate (DNR-DNI) advance directives were less likely to receive cardiac catheterization, despite having ACS with high-risk features.
Methods: This was a medical record review conducted at an urban teaching hospital. DNR-DNI status before hospitalization, extended care facility (nursing home or assisted living) residence, and a previous diagnosis of dementia were obtained from the medical record. Patients 65 years and older who presented to the emergency department with acute myocardial infarction or with unstable angina with ST segment deviation were included. Univariate and multivariate logistic regression were performed, and odds ratios (ORs) were reported with their 95% confidence intervals (CIs).
Results: Of the 201 eligible patients, 66 (32.8%) patients did not undergo cardiac catheterization. In the univariate analysis, patients who had dementia, resided in extended care facilities, or were DNR-DNI were less likely to receive cardiac catheterization. Only extended care facility residence (OR, 0.18; 95% CI = 0.04 to 0.83) and DNR-DNI status (OR, 0.19; 95% CI = 0.04 to 0.92) remained significantly associated with decreased cardiac catheterization in the multivariate analysis.
Conclusions: Elder patients with ACS residing in extended care facilities or who are DNR-DNI are less likely to receive cardiac catheterization. Future studies concerning the quality of ACS care for elders should take these variables into account.     

广州市4770名小学生营养状况调查及分析

目的了解广州市东山区4770名小学生的营养状况。方法对2005年广州市东山区农林街的小学生健康检查结果进行分析和评价。结果广州市东山区各年龄组小学生营养不良和肥胖的比例均较高,其中男生肥胖的检出率明显高于女生,女生营养不良的比例明显高于男生,贫血患病率明显低于国内同类研究结果。结论整个社会应加强联系与协作,开展有效的健康教育,倡导良好的健康习惯,加强体育锻炼,改善小学生的营养状况。     

南海某岛礁作业人员睡眠状况与身心健康状况关系的研究

目的 研究南海某岛礁作业人员睡眠状况与身心健康状况的关系。方法 由经过统一培训的医务人员连续91d每日逐人逐项当面调查、记录。其中的“指数”指标，采用视觉模糊评分法。结果 随着在礁时阃的延长，作业人员睡眠状况明显变差，其主要影响因素依次为值勤（28．73％）、情绪（20．09％）、多梦（10．16％）、噪音（8．86％）和气候（7．73％）等。睡眠状况与身心健康状况明显相关，相关系数7=0．937～0．980，P＜0．01；睡眠指数对身心健康状况各指标均有明显影响（P＜0．01），睡眠时间主要影响体能指数、健康指数、工作质量指数、工作积极性指数、注意力指数及情绪指数等（P＜0．05～0．01），对食欲指数、记忆力指数影响则不明显。结论 在岛礁期间，影响作业人员睡眠的主要因素是值勤和情绪，睡眠状况明显影响身心健康状况。     

北京农村居民健康状况及卫生服务需求调查

目的了解北京农村居民健康状况及卫生服务需求特点。方法从昌平区、顺义区、大兴区、房山区随机抽取25～64岁农民1605人进行统一问卷调查。结果农民高血压自报患病率为22．4％，超重和肥胖率为56．1％；现在吸烟率为34．4％，缺乏运动率为41．6％；家庭主要经济支出为学生上学(35．3％)，建房(25．4％)和疾病(21．2％)；54．9％家庭医疗费用支出占总收入的10％以上；最关心的健康问题主要是慢性疾病防治(70．2％)；最希望获得的健康知识是慢性病预防知识(72％)；希望获得健康知识的途径是广播和电视(81％)；家庭最希望获得的医疗保健服务是方便看病和获得药物(73．8％)。结论慢性病给农民带来沉重负担，并成为农民关心的主要健康问题。