阿尔茨海默病、阿尔茨海默病混合型及血管性痴呆患者心理及行为症状的比较

目的 比较阿尔茨海默病(Alzheimer Disease，AD)、AD混合型痴呆(Mixed dementia，MD)、血管性痴呆(Vascular dementia，VD)心理和行为症状(Psychological and behavioral symptoms of dementia，PBSD)的特征。方法 AD、MD及VD患者各30名参加本研究。采用Alzheimer病行为症状评定量表(The Begavioral Pathlolgy in Alzheiner Disease Rating Scale，BEHAVE—AD)、Cohen—Masfield激惹性问卷(The Cohen Mansfield Agitation Inventory，CMAI)评定痴呆患者BPSD。结果 AD患者激惹、焦虑与恐惧发生率较高，VD患者无目的游荡发生率、严重程度较低，MD患者BPSD症状无特异性。结论 AD、VD患者BPSD症状有特异性，MD患者BPSD表现无特异性。     

难治性便秘综合治疗及影响因素的评价

目的评价综合治疗对难治性便秘的疗效及影响因素。方法将84例难治性便秘分为非重叠组和重叠组。应用个体化综合治疗4周,观察便秘症状评分变化及总有效率,分析IC患者的重叠症状和心理障碍状态对疗效的影响。结果(1)84例便秘患者中,重叠组和非重叠组分别占40.5%和59.5%。(2)重叠组和非重叠组的总有效率分别为50.0%和78.0%(P<0.05)。(3)对37例IC患者的心理测试调查显示,59.4%(22/37)有心理障碍状态,重叠组和非重叠组伴有心理障碍状态对治疗的总有效率分别为4.8%和31.5%(P<0.05)。结论适合个体化的综合治疗使多数难治性便秘缓解症状,但伴有重叠症状,尤其心理障碍状态则影响疗效。     

T helper cell-mediated interferon-gamma expression after human parvovirus B19 infection: persisting VP2-specific and transient VP1u-specific activity

Human parvovirus B19 is a small non-enveloped DNA virus with an icosahedral capsid consisting of proteins of only two species, the major protein VP2 and the minor protein VP1. VP2 is contained within VP1, which has an additional unique portion (VP1u) of 227 amino acids. We determined the ability of eukaryotically expressed parvovirus B19 virus-like particles consisting of VP1 and VP2 in the ratio recommended for vaccine use, or of VP2 alone, to stimulate, in an HLA class II restricted manner, peripheral blood mononuclear cells (PBMC) to proliferate and to secrete interferon gamma (IFN-gamma) and interleukin (IL)-10 cytokines among recently and remotely B19 infected subjects. PBMC reactivity with VP1u was determined specifically with a prokaryotically expressed VP1u antigen. In general, B19-specific IFN-gamma responses were stronger than IL-10 responses in both recent and remote infection; however, IL-10 responses were readily detectable among both groups, with the exception of patients with relapsed or persisting symptoms who showed strikingly low IL-10 responses. Whereas VP1u-specific IFN-gamma responses were very strong among the recently infected subjects, the VP1u-specific IFN-gamma and IL-10 responses were virtually absent among the remotely infected subjects. The disappearance of VP1u-specific IFN-gamma expression is surprising, as B-cell immunity against VP1u is well maintained.     

Are subjective health complaints a result of modern civilization?

Subjective health complaints without or with minimal somatic findings (pain, fatigue) are common and frequent reasons for encounter with the general practitioner and for long-term sickness leave and disability. The complaints are often attributed to the stressors of modern life. Is this true? We interviewed 120 Aborigine Mangyans (native population, M age = 33.5 years, 72.5% women) living under primitive conditions in the jungle of Mindoro, an island in the Philippines, and 101 persons living in a small coastal town on the same island (coastal population, M age = 33.8 years, 60.4% women). Both groups had more musculoskeletal complaints, fatigue, mood changes, and gastrointestinal complaints than a representative sample from the Norwegian population (N = 1,243). Our common subjective health complaints, therefore, are not specific for industrialized societies.     

Effects on inflammation parameters of a double-blind,placebo controlled one-year course of SLIT in children monosensitized to mites

BACKGROUND: Clinical documentation about effects on local markers of inflammation of sublingual immunotherapy (SLIT) in children is still poor. METHODS: Twenty-four children (age range 4-16 years, average 8.5 years) monosensitized to house dust mites (HDMs) were randomized to receive active or placebo SLIT for this allergen according to a double-blind, placebo-controlled design. Before treatment and 10-12 months later the following parameters were checked: ECP and tryptase in sputum and nasal secretion, serum and nasal mite-specific IgE (sIgE), allergen-specific nasal challenge test (sNCT), nasal symptoms and tryptase after sNCT. RESULTS: Nasal tryptase and nasal IgE in basal conditions were unchanged in treated children but significantly increased in untreated children (P = 0.0156 and P = 0.0313, respectively). The threshold for sNCT was unchanged in both groups of children, but the symptom score after sNCT was unchanged in the placebo group and significantly decreased in the active group (P = 0.0084). The nasal tryptase after sNCT was unchanged in the active group and significantly increased in the placebo group (P = 0.0218). Intergroup comparison showed a significant difference in oral tryptase and nasal tryptase after sNCT in favour of the active group. CONCLUSIONS: These interim results after only 1 year of treatment show that SLIT in children monosensitized to HDMs is able to avoid the spontaneous increase in both nasal sIgE antibodies and in local allergic inflammation in basal conditions. These outcomes are confirmed and supported by the decrease of symptoms in the active group combined with the increase of nasal tryptase only in the control group in both cases after sNCT.     

Pseudo dicentric chromosome (5;21): a rare example of maternal germline mosaicism

Karyotyping of a malformed male newborn revealed the unbalanced karyotype of 46,XY, psudic(5;21)(q12;p13), +5 resulting in trisomy for the short arm of chromosome 5 and partial trisomy for 5q. Both parents had normal karyotypes in their peripheral blood lymphocytes. A second pregnancy ended in a miscarriage at 16 weeks gestation, sonographically 12 weeks. Karyotyping of chorionic villi from the abortus revealed the same unbalanced karyotype that had been identified in the first child. Fluorescence in-situ hybridization analysis confirmed a trisomy 5p. Microsatellite marker analysis ruled out illegitimacy and proved the maternal origin of the trisomic section of chromosome 5. Extended chromosome analysis of 60 metaphase cells from maternal skin fibroblasts and 40 metaphase cells from lymphocytes did not reveal mosaicism for psudic(5;21). These findings suggest the presence of a maternal germline mosaicism.     

Impact of Parental Health Problems on Children: Concepts, Methods, and Unanswered Questions

Described conceptual and methodological issues that arise inthe design and analysis of data from studies of the impact ofparental health problems on children. Researchers should considerhow the functional effects, duration, and type of exposure ofparental health problems affect children's psychological experience.Multiple pathways (e.g., parental modeling, family socializationpractices, and genetic factors) that affect the transmissionof psychological and/or health risk to children need to be considered.Important methodological issues in this area of research includesample selection and bias, confounding factors, and limitedassessment of family influences. Future work should identifyfactors that enhance child and family resilience to the effectsof parental health problems. Studies are also needed to developand test interventions to reduce the psychological morbidityassociated with parental health problems.     

Intranasal and inhaled fluticasone propionate for pollen-induced rhinitis and asthma

BACKGROUND: Studies suggest that nasal treatment might influence lower airway symptoms and function in patients with comorbid rhinitis and asthma. We investigated the effect of intranasal, inhaled corticosteroid or the combination of both in patients with both pollen-induced rhinitis and asthma. METHODS: A total of 262 patients were randomized to 6 weeks' treatment with intranasal fluticasone propionate (INFP) 200 microg o.d., inhaled fluticasone propionate (IHFP) 250 microg b.i.d., their combination, or intranasal or inhaled placebo, in a multicentre, double-blind, parallel-group study. Treatment was started 2 weeks prior to the pollen season and patients recorded their nasal and bronchial symptoms twice daily. Before and after 4 and 6 weeks' treatment, the patients were assessed for lung function, methacholine responsiveness, and induced sputum cell counts. RESULTS: Intranasal fluticasone propionate significantly increased the percentages of patients reporting no nasal blockage, sneezing, or rhinorrhoea during the pollen season, compared with IHFP or intranasal or inhaled placebo. In contrast, only IHFP significantly improved morning peak-flow, forced expiratory volume in 1 second (FEV1) and methacholine PD20, and the seasonal increase in the sputum eosinophils and methacholine responsiveness. CONCLUSIONS: In patients with pollen-induced rhinitis and asthma, the combination of intranasal and IHFP is needed to control the seasonal increase in nasal and asthmatic symptoms.     

社会技能训练对慢性精神分裂症疗效的对照研究

目的:探讨社会技能训练对慢性精神分裂症阳性症状、阴性症状及认知功能的疗效.方法:将100例慢性精神分裂症患者随机分为训练组(50例)和对照组(50例).对训练组按照Liberman RP编写的<社会独立生活技能>训练程式进行训练,共12周.用BPRS、SANS、SDSI和WCST进行评定.结果:(1)训练组BPRS在总分和焦虑抑郁及缺乏活力因子分低于对照组,差异有显著性(P<0.05).(2)接受12周社交技能训练后,训练组的SANS量表全部五个因子和总分低于对照组,均有显著差异(P<0.05).(3)训练组和对照组在WCST的5个指标,差异有显著性(P<0.05).(4)SDSI评定结果表明,训练后明显降低,差异有显著性(P<0.05).结论:社会技能训练能够改善慢性精神分裂症的阳性症状、阴性症状及认知功能.