181例新住院精神患者自杀未遂分析

目的 了解我院新住院精神患者的自杀行为,为加强对自杀行为者的防范提供理论依据,减少非正常死亡.方法 用自制自杀未遂统计表逐项填写临床资料,并用CCMD-3诊断标准进行回顾性诊断.结果 1991～2005年共新收住院精神患者2 100例,其中自杀未遂181例,占新住院患者的8.26%.诊断抑郁症112例,精神分裂症60例,急性应激障碍5例,其他4例.χ2=15.09,P＜0.01.自杀方式不一,以服药(毒),跳楼(崖),投水为多.结论 抑郁症是自杀的主要原因.女性比男性自杀行为多.     

A prospective study of cultural consonance and depressive symptoms in urban Brazil

Cultural consonance refers to the degree to which individuals, in their own beliefs and behaviors, approximate the prototypes for belief and behavior encoded in shared cultural models. In previous cross-sectional studies, lower cultural consonance in several cultural domains was associated with worse health outcomes, including greater psychological distress. The current paper extends these findings in three ways. First, the effect of cultural consonance on depressive symptoms is tested in a prospective study. Second, it is hypothesized that the effect of cultural consonance in a specific cultural domain will depend on the degree of cultural consensus within that domain: the higher the cultural consensus, the greater the effect of change in cultural consonance in that domain on depressive symptoms. Third, it is hypothesized that cultural consonance will have an inverse effect on depressive symptoms independent of the occurrence of stressful life events (a well-known risk factor for depression). We tested these hypotheses in a study conducted in urban Brazil, and found that change in cultural consonance (assessed as a general construct) was associated with depressive symptoms at a 2-year follow-up. Furthermore, cultural consonance in the domains in which there was highest cultural consensus—the domains of family life and lifestyle—was more strongly associated with depressive symptoms at follow-up than cultural consonance in domains with lower cultural consensus. Finally, all of these effects were independent of stressful life events. These results lend further support to the importance of cultural consonance in relation to human health.     

Subjective quality of life in outpatients with schizophrenia in Hong Kong and Beijing: relationship to socio-demographic and clinical factors

Purpose This study compared the subjective quality of life (SQOL) in schizophrenia patients living with their families in Hong Kong (HK) and Beijing (BJ) and explored the relationship between SQOL and basic socio-demographic and clinical factors. Materials and methods Two hundred and sixty-four clinically stable outpatients with schizophrenia were randomly selected in HK and 258 counterparts matched according to age, sex, age at onset, and length of illness in BJ. SQOL and psychiatric status were assessed with standard rating instruments. Results There was no significant difference in any of SQOL domains between the two cohorts after controlling for potentially confounding variables. Positive, depressive and anxiety symptoms and drug-induced extrapyramidal side effects (EPS) were all significantly correlated with SQOL. Multiple regression analysis revealed that only depressive symptoms predicted all SQOL domains in both groups. Having removed depressive symptoms from the model, positive symptoms predicted all domains, anxiety predicted all but social domains, use of benzodiazepines (BZD) predicted all but physical domains, EPS predicted physical domain, and history of suicide predicted social domain in HK; anxiety predicted all domains, positive symptoms predicted all but physical domains, EPS, use of BZD and history of suicide all predicted physical domains, and length of illness predicted environmental domain in BJ. Conclusion Despite considerable differences between the two sites in terms of health care delivery and the economic conditions of the subjects, SQOL did not differ between HK and BJ. The conclusion is in line with previous studies that suggested that patients’ SQOL was independent of their living standard as long as it reached a certain minimum level. SQOL was more strongly related to the severity of depressive symptoms and had weak association with socio-demographic factors.     

CSG中医辨证分型与血浆MTL、GAS、SS水平关系的临床研究

目的为探讨慢性浅表性胃炎肝胃不和、脾胃虚弱、脾胃湿热三种中医证型与胃泌素、胃动素和生长抑素三种胃肠激素水平的关系。方法将CSG患者肝胃不和、脾胃虚弱、脾胃湿热三种中医证型各25例及健康成年人25例，用放射免疫分析法测定空腹血浆MTL、GAS、SS。结果CSG的三种中医辨证分型脾胃湿热、脾胃虚弱、肝胃不和的血浆MTL、GAS、SS水平，不仅与健康人有显著差异，且CSG的三种中医辨证分型与血浆MTL、GAS、SS存在着较密切的关系，并有一定的规律性。结论检测CSG患者的血浆MTL、GAS、SS水平，对提高CSG的中医辨证分型有积极意义，结果可作为中医临床参考。     

精神分裂症患者缓解期抑郁的临床分析及心理危机干预

目的：探讨精神分裂症患者缓解期出现的抑郁症状，以便有针对性地实施心理危机干预。方法：用HAMD和BPRS量表对符合诊断的89例精神分裂症患者进行量表评定和分析。结果：50.7％的患者有抑郁症状，心理干预前与心理干预后HAMD减分率有显著差异。结论：住院精神分裂症患者缓解期的抑郁症状并不少见，应针对抑郁情绪给予及时的心理危机干预。     

男性服刑在押犯65例服刑能力鉴定

目的：探讨男性服刑在押犯罹患精神疾病与服刑能力的关系。方法：对65例男性服刑在押犯人的司法鉴定资料进行回顾性统计分析。结果：65例中被鉴定患有精神分裂症、偏执性精神病、躁狂抑郁症者有46例（70．8％），均被评定为无服刑能力；被鉴定患有应激相关障碍、癔病、人格障碍、无精神病等19例（29．2％），其中17例评定为有服刑能力。36例（55．4％）被鉴定者病程≤0.5年，22例（33．8％）病程0．5—1．0年。结论：服刑在押犯人在服刑期间易出现精神心理问题，应加强对服刑犯的心理卫生辅导，提高服刑人员的服刑能力。     

大豆异黄酮对绝经早期妇女围绝经期症状的改善效应观察

目的确定大豆异黄酮(soybean isoflavone,SI)改善由于雌激素缺失导致的围绝经期症状的生理效应有效剂量,并探讨其可能机制。方法90例45～60岁的绝经早期妇女,随机单盲分为SI84、126mg/(kgbw·d)两个剂量组和安慰剂对照组,每组30人接受追踪观察24w,每4w要求对象记录1w的潮热、出汗次数,做1次围绝经期症状评分(Kuppermanuscore),并在试验前、12w和24w时测定血清雌二醇(E2)、促卵泡生成素(FSH)和黄体生成素(LH)的浓度。结果在试验期间低、高剂量两组的潮热次数(%)分别为57.8±37.4和56.7±26.7和症状评分的下降率(%)分别为44.3±19.1和48.5±27.2,两组间无显著差异,而安慰剂组的潮热次数和症状评分下降率仅为(34.6±46.2)%和(27.8±15.5)%,显著低于前两组。血清E2、FSH和LH在试验各期各组间没有显著差异。结论大豆异黄酮84mg/d可以改善各种围绝经期症状,尤其是潮热、出汗症状,此效应与激素的调节关系不明显。     

李庆海教授辨证治疗难治性心力衰竭临证经验

李庆海教授系河南中医学院第三附属医院心内科主任医师，中华中医学会心病专业分会副主任委员，临证20余栽，对心血管疾病的中医药治疗积累了丰富的经验，尤其运用中医中药辨证治疗难治性心力衰竭颇多效验。     

中医辨证治疗耳鸣22例疗效观察

目的：观察中医药辨证治疗耳鸣的临床疗效。方法：将42例耳鸣患者随机分为两组，治疗组22例中医辨证治疗，对照组20例，给卡马西平治疗。结果：中医辨证治疗的有效率77．27％，对照组有效率45.00％，两组有效率比较有统计学意义（P〈0.05）。结论：中医辨证治疗耳鸣明显优于西医治疗。     

健脾祛痰汤合并喹硫平治疗精神分裂症阴性症状的临床观察

目的 观察健脾祛痰汤合并喹硫平治疗精神分裂症阴性症状的疗效和不良反应.方法 采用随机数字表,将60例精神分裂症患者分为治疗组(健脾祛痰汤合并喹硫平)和对照组(喹硫平).在治疗前、治疗第1、4、8周末以阳性和阴性症状量表(PANSS)总分减分率和不良反应量表(TESS)评定疗效和不良反应.结果 两组总体疗效比较无显著性差异,治疗组阴性症状和激活性方面的改善较对照组明显(P＜0.05),且治疗组药物不良反应出现频率较对照组低,而凡轻微.结论 健脾祛痰汤合并喹硫平治疗精神分裂症阴性症状的疗效显著,且可以减少精神科药物的用量,减少和缓解抗精神药物引起的副反应,同时改善患者的躯体情况,具有一定的安全性.