丙戊酸钠静脉滴注治疗偏头痛持续状态

目的评估丙戊酸钠治疗偏头痛持续状态的有效性和安全性。方法我们前瞻性地用静脉滴注丙戊酸钠来治疗偏头痛持续状态,然后比较患者治疗前与出院时视觉模拟评分(VAS)。并比较各种因素(一般情况,累计的丙戊酸钠剂量,合并用药)与治疗之间的关系。结果首次治疗中,26次(74.3%)治疗时患者VAS评分较治疗前减少50%或50%以上。所有治疗中,37次(82.2%)治疗使患者VAS评分较治疗前减少50%或50%以上。患者的性别与治疗反应无关。所有治疗中,合并用药(强痛定,索密通,散粒痛和达宁)和治疗时间与治疗反应呈负相关。仅3例(8.6%)出现短暂性眩晕。结论丙戊酸钠静滴是快速,有效和安全的止痛治疗。它对偏头痛持续状态有效。     

中药混乱品种鉴别研究——7. 蕲蛇及其混淆品鉴别之二

作者前已报道蕲蛇及其伪品滑鼠蛇的鉴别,又据报道有些省发现蕲蛇商品药材中混有烙铁头、山烙铁头两种蛇的干燥体。作者对这两种混淆品与蕲蛇在体表花纹、鳞片以及骨骼的形态与组织特征等方面进行了鉴别研究。     

Diagnosing the personality organization of drug abusers by rating ego balance

A community-based case-finding sample of 1824 narcotic abusers in Stockholm County was used to standardize a set of rating scales in order to reflect levels of personality organization (PO), in the spirit of Kernberg's theory. PO is assumed to be a function of the ego's capacity to endure inner and outer stress, which manifests itself in the frequency and depth of regressions and the rate of recovery from them. The principles of a method, Rating Ego Balance, for charting the person's characteristic pattern of regression are presented, and its psychometric properties are described on the basis of item response theory. The scales have satisfactory reliabilities and maximal discrimination at subneurotic levels of PO. They show strong construct validity in relation to Kernberg's theory.     

A blinded,controlled evaluation of anxiety and depressive symptoms in patients with fibromyalgia,as measured by standardized psychometric interview scales

The objective of the study was to evaluate the presence of psychopathology in fibromyalgia patients compared with a control group of other rheumatologic patients with pain. Forty-nine fibromyalgia patients and 33 control patients were interviewed blinded, using standardized psychometric scales. Pain was scored on a visual analogue scale. Fibromyalgia patients scored significantly higher than the controls on the Bech-Rafaelsen Melancholia Scale, the Atypical Depression Scale and the Hamilton Anxiety Rating Scale. On the Newcastle Depression Scale there was no difference. In both groups a correlation was found between pain score and psychometric scoring. The fibromyalgia patients scored significantly higher on pain than the controls. After correcting for this difference, the fibromyalgia patients still scored higher on anxiety and depression.     

A new self-rating scale for depression and anxiety states based on the Comprehensive Psychopathological Rating Scale

Self-assessment scales have long been used in psychiatric research even if their validity has often been questioned, one reason being poor the concordance of expert ratings. In clinical practice the use of rating scales is restricted, since they are considered to be time-consuming and perhaps even to disrupt the clinician's rapport with the patient. In the present study, a self-assessment scale, the CPRS Self-rating Scale for Affective Syndromes (CPRS-S-A), was constructed by re-phrasing in a self-rating format 19 items from the original Comprehensive Psychopathological Rating Scale (CPRS) and covering depression, anxiety and obsessional symptoms. In a group of 30 patients with depression syndromes and anxiety syndromes, the CPRS-S-A and the original CPRS were both used on 2 occasions. The patient's Global Assessment of Functioning scores ranged from 30 to 76 (mean 58), which suggests a moderate severity of illness, as does the fact that the majority were outpatients. There was a high degree of concordance between the instruments for most items and for the scores on the subscales for both diagnostic groups (i.e., the Montgomery-Åsberg Depression Rating Scale and the Brief Anxiety Scale, which are both subscales drawn from the CPRS). The time taken to complete the CPRS-S-A varied from 5 to 30 min (mean 19 min for depressive and 16 min for anxiety patients on the first occasion, 13 min for both groups on the second), and the self-rating procedure was readily accepted by both groups of patients. The CPRS-S-A would thus seem to be a promising instrument for quantitative rating of symptoms in ambulatory patients, both in clinical practice and in research.     

Salivary gland 99mTc-scintigraphy: a grading scale and correlation with major salivary gland flow rates

Sequential salivary gland scintigraphy with 99mTc-technetium pertechnetate (Tc-99) is a safe, minimally invasive test for study of major salivary glands. However, its relationship to salivary function has not been investigated in detail. We have investigated the relationship between major salivary gland flow rates and Tc-99 scans and developed a new rating scale using scans of a control group with normal salivary function. Salivary flow rates and Tc-99 scans were obtained from healthy, non-medicated subjects (n = 33) and from xerostomic patients (n = 22). There were significant differences between the groups for salivary flow rates and Tc-99 ratings. Significant correlations were found between salivary flow rates and Tc-99 ratings in the control and xerostomic groups. The Tc-99 rating scale proved reliable in assessing salivary dysfunction, and showed a high inter-examiner correlation. These results demonstrate the usefulness of salivary gland scintigraphy in assessing major salivary gland flow rates and the utility of a new rating scale.     

Separation discrimination with embedded targets

Previous research has shown that separation discrimination thresholds are independent of the internal spatial scale (local spatial frequency) of the targets whose separation is being judged. The experiments reported here tested the generality of this conclusion for separation discrimination of targets that were embedded in an array of identical objects, where crowding could enhance the importance of the scale at which the individual target locations are encoded. No effect of the local spatial scale of the targets was found under these conditions.     

Scales of depression,ill-being and the quality of life—is there any difference? An assay in taxonomy

The application of a model based on the three time dimensions of past, present and future can be used to generate an alternative taxonomy for the classification of depression, ill-being and quality of life. In relation to time, depression can be defined as the passage from a healthy past to a painful present, ill-being as the painful present of the individual and the quality of life (QOL) as the degree to which the subject's present life is commensurate with his aspirations. Such an approach opens up conceptual and methodological areas of research which will allow the construction of a new type of scale. Depression scales should be constructed with two time dimensions: past and present; ill-being scales only refer to the present and QOL scales should have two time dimensions: present and future. It would be possible to combine these three scales into a single scale with three dimensions. Such a scale would enable depression and ill-being to be quantified, accurately diagnosed and monitored. The relative importance of principal symptoms could be assessed, facilitating the choice of therapy and follow-up methods.     

Conners教师评定量表的中国城市常模和信度研究

目的　建立Conners教师评定量表 (TRS)的中国城市常模 ,并对其进行信度检验。方法　在全国 14个城市对 35 76名儿童年进行Conners教师量表的评定 ,对其中 4 0名儿童间隔二周进行重测。结果　TRS各条目分与量表总评分之间的相关系数在 0 2 6 5～ 0 6 89;总问卷Cronbachα系数为 0 94 1,Spearman brown分半信度为 0 896 ,间隔二周量表总分的重测相关系数为 0 5 4 4 ,4个因子的重测相关系数在 0 391～ 0 6 71(P <0 0 1)。结论　Conners教师评定量表的中国城市常模符合我国国情 ,具有良好的信度 ,值得推广和应用。