老年抑郁症的临床特征及西酞普兰的治疗效果

目的分析老年抑郁症的临床特征,评价西酞普兰治疗老年抑郁症的疗效和安全性。方法用西酞普兰治疗35例老年首发抑郁症患者,在治疗前及治疗第2、6周末行汉密尔顿抑郁量表（HAMD）及副反应量表评定临床疗效及安全性。根据HAMD各项评分总结老年抑郁症主要症状。结果抑郁情绪、睡眠障碍、焦虑、全身症状和疑病是这组患者的主要表现。西酞普兰治疗2周后HAMD评分较治疗前下降,差异明显（t=10.401,P〈0.05） 治疗6周后HAMD评分与治疗前比较明显降低,差异显著（t=15.815,P〈0.05）,治疗6周后显效率为66%,不良反应轻微。结论西酞普兰治疗老年抑郁症疗效显著,安全性高。     

电针对盐酸帕罗西汀治疗轻中度抑郁症患者增效减毒作用的临床研究

目的 观察电针对盐酸帕罗西汀治疗轻、中度抑郁症患者的临床疗效及药物不良反应的影响.方法 将55例轻、中度抑郁症患者随机分为A组(盐酸帕罗西汀对照组)29例,B组(电针+盐酸帕罗西汀组)26例,疗程6周.观察治疗前及治疗1,2,4,6周后汉密尔顿抑郁量表(HAMD)、抗抑郁药副反应量表(SERS)总评分变化情况.结果 HAMD评分显示,A组治疗2周后,B组治疗1周后,同组与治疗前比较,差异有显著性意义(P<0.05),治疗2周后2组间HAMD评分比较有显著性意义.A组总有效率71.4%,B组88.0%,差异有显著性意义(P<0.05).SERS评分B组在治疗4周后与治疗前比较差异有显著性意义(P<0.05),治疗6周后有极显著性意义(P<0.01).结论 电针能够增强盐酸帕罗西汀治疗抑郁症疗效且显著降低药物引起的不良反应.     

Myometrial electrophysiologic activity and gap junctions in the pregnant rabbit

Electromyographic activity of the myometrium, intrauterine pressure, and myometrial gap junctions were examined in rabbits at various stages of pregnancy and during parturition. Electromyographic activity occurred throughout pregnancy and was characterized by electromyographic bursts lasting up to 5 minutes at a frequency of one to four per hour. The gap junction area of plasma membrane showed a significant increase at delivery at a time when electromyographic activity changed to rhythmic bursts of short duration at a frequency of about one per minute. This study shows that the rabbit uterus is active throughout pregnancy; furthermore, the development of large numbers of gap junctions between myometrial cells occurs at a time when uterine activity changes to the expulsive activity required for labor.     

Outcome in infants 501 to 1000 gm birth weight delivered to residents of the McMaster Health Region

The mortality and morbidity for all 255 live births of infants with birth weight 501 to 1000 gm and delivered to residents of a geographically defined region between 1977 and 1980 are reported. In all, 117 (46%) infants were discharged alive; there were four postdischarge deaths, and three infants were lost to follow-up. The mean birth weight and gestational age of the survivors was 850 +/- 118 gm and 27.1 +/- 2 weeks, respectively. Neurosensory handicaps were detected in 26 (24%) of 110 survivors followed for a minimum of 2 years corrected age. In addition, 29 (26%) infants had nonneurologic problems and 55 (50%) were considered apparently normal. Within 100 gm birth weight groups, survival improved significantly with increasing birth weight, but the handicap rate among survivors remained relatively constant. These figures are proposed for use in describing the current prognosis at birth for liveborn tiny infants from comparable unselected populations.     

Interdependency of lithium ratio, plasma lithium level and clinical state in patients with affective disorders

The interrelationship between lithium ratio, lithium plasma level and the different clinical phases of 31 patients with bipolar affective disorder has been investigated. the interdependency of these variables was followed longitudinally during different phases of the illness while under lithium therapy. Although positive correlations between lithium ratio and lithium plasma levels were evident, the lithium ratio values in the euthymic group were significantly higher than those in the manic and depressive groups, independently of the plasma lithium level. Our data suggested that RBC/plasma lithium ratio might be a sensitive state dependent index in affective bipolar illness.     

Measurement of urinary epinephrine in screening for pheochromocytoma in multiple endocrine neoplasia type II

A sensitive screening test for the pheochromocytoma component of multiple endocrine neoplasia type II (MEN-II), comparable to the calcitonin radioimmunoassay for medullary carcinoma of the thyroid (MCT), has been lacking. A large family with MEN-II was screened for pheochromocytoma measuring 24 hour urinary catecholamines as norepinephrine and epinephrine fractions. Pheochromocytomas have been confirmed at surgery in six family members and at autopsy in one. All seven have had associated MCT. In an additional six family members, MCT only has been detected. In five of the six patients treated surgically, the urinary epinephrine fraction was either the dominant or sole abnormality, and an epinephrine level above 20 μ/24 hours, by itself, was diagnostic of a pheochromocytoma. An increased urinary epinephrine fraction appears to be a characteristic feature of the pheochromocytoma of MEN-II, and measurement of this fraction is a sensitive and reliable screening test in afflicted families.     

Pulmonary mixed-function oxidation: stimulation by glucose and the effects of metabolic inhibitors

Substrate requirements for pulmonary mixed-function oxidation of p-nitroanisole to p-nitrophenol were evaluated using the isolated perfused rabbit lung and a lung microsomal fraction. Addition of glucose (5 mM) to the lung perfusate (Krebs bicarbonate buffer) increased the mean rate of p-nitroanisole oxidation by 25–55 per cent; addition of pyruvate (5 mM) or palmitate (0.5 mM) gave similar results. Sucrose (5 mM) had no effect. Antimycin A, KCN, oligomycin and bis-hexafluoroacetonyl acetone (an uncoupling agent) markedly depressed p-nitroanisole metabolism by the isolated lung. KCN also inhibited p-nitroanisole metabolism by lung microsomes, but antimycin A was without effect. These results indicate that pulmonary mixed-function oxidation requires substrate for intermediary metabolism as well as ATP, for maintenance of maximal rates. Glucose and mitochondrial substrates are equally effective in providing the energy requirements and the reducing potential for this reaction.     

Studies using releasing factors in Klinefelter's Syndrome: The responses of LH and FSH to luteinizing hormone-releasing hormone and of prolactin and TSH to thyrotropin-releasing hormone before and after testosterone

(1) During an investigation of their pituitary function, the TSH prolactin (PRL) and gonadotropin, (LH, FSH) response to TRH was measured in four patients with documented euthyroid Klinefelter's syndrome. (2) In all four patients, the serum testosterone was low, the gonadotropins were elevated and thyroid antibodies undetectable. (3) The identical study was repeated after each patient had received intramuscular testosterone cypionate 200 mg bi-weekly for three doses. This raised the serum testosterone at least four-fold. (4) Basal TSH was normal in all four patients but its response to TRH was blunted (mean peak TSH 9.6 μU/ml), compared with normal controls (mean peak TSH 18 μU/ml). Following testosterone this response to TRH was further suppressed to a mean peak of 3.4 μU/ml TSH. (5) Basal PRL levels were also normal and the mean peak response to TRH, 28 ng/ml. When repeated after testosterone, TRH produced a mean peak PRL of 58 ng/ml. (6) LH and FSH, both elevated basally, did not change with TRH administration, but both were stimulated by LHRH 100 μg i.v., LH briskly, FSH more variably. (7) FSH was suppressed sharply but LH only partially with testosterone therapy. (8) Our studies indicate that the TSH response to TRH in Klinefelter's syndrome is blunted and further suppressed with short term testosterone replacement. The PRL response to TRH under these same circumstances, however, is enhanced. Previous reports of abnormal LH feedback control are confirmed. (9) Klinefelter's syndrome is associated with subtle abnormalities in hypothalamic pituitary regulation not expected in typical primary hypogonadism.