武汉市中学生精神卫生知识知晓情况调查

目的了解武汉市中学生对精神卫生知识的知晓情况。方法采用分层随机整群抽样方法,选择武汉市4所中学的24个班级的1237位中学生进行"精神卫生和心理保健知识问卷"调查。结果精神卫生和心理保健知识条目回答正确率较好,为48.4%~98.6%,精神卫生纪念日的条目回答正确率低,为10.0%~13.4%。中学生问卷得分均值为13.64±2.18分。多因素回归分析发现,性别、年龄、母亲受教育年限、学校级别和家庭居住地与问卷得分有关。结论武汉地区《中国精神卫生规划(2002~2010)》中的在校学生心理保健知识知晓率达到40%的目标基本达到,精神卫生纪念日知识的宣传工作需要加强。     

依达拉奉对脓毒血症大鼠肝及心肌线粒体SDH的影响

Objective To observe the effect on succinate dehydrogenase (SDH) of mitochondria in myocardium and liver in sepsis rats treated with edaravone. Methods 30 Sprague-Dawley rats were divided into 3 groups: sham operated group ( group A ), controlled operated group ( group B ), treated group with edaravone (group C). The model of sepsis rats was made by the way of caecum ligated and punctured and 20mg/kg lactate levofloxacin was subcutaneously injected (sci) 15min before and 3h after operation in three group. 5mg/kg edaravone were sci 15min before and 3h after operation in group C. Liver and myocardium were taken from all of them 18h after operation. The activities of SDH in myocardial and hepatic mitochondria were detected, pathological change of mitochondria in liver and myocardium were observed. Results The activities of SDH in myocardial and hepatic mitochondria in group B [ (0. 21 ± 0. 07 ) U/mgprot, (0. 23± 0. 08 ) U/mgprot ] were significantly decreased compared with group A [ ( 0. 33 ± 0. 10 ) U/mgprot, ( 0. 38±0. 12)U/mgprot]. The activities of those in group C[ (0.31 ±0. 08) U/mgprot, (0. 36 ±0. 11)U/mgprot] were significantly increased than group B. Myocardial and hepatic mitochondria swelling and endocytoplasmic reticulum expanding were found in group B by electron microscope, while it showed normal in group C. Conclusion Hepatic and myocardial mitochondrial structure were destroyed and activities of SDH were decreased in sepsis rats. They could be effectively protected by edaravone.     

TNF-α对血管内皮细胞VCAM-1诱导作用的研究

目的：探讨肿瘤坏死因子－α（ＴＮＦ－α）对血管内皮细胞ＶＣＡＭ－１表达的诱导作用。方法：通过血管内皮细胞培养,采用免疫组织化学方法分别观察不同浓度ＴＮＦ－α（０．２５０Ｕ．ｍＬ＾－１）２４小时内以及相同浓度（１００Ｕｍｌ＾－１）ＴＮＦ－μ０－α０－７２ｈ对内皮细胞ＶＣＡＭ－１表达的影响。结果：与对照组比较,ＴＮＦ－α对内皮细胞ＶＣＡＭ－１的诱导作用具有明显浓度与时间依赖性。结论：ＴＮＦ－α可诱导血     

脑干出血患者血糖、血压、血白细胞与预后关系探讨

目的　分析脑干出血患者血糖、血压、血白细胞与预后的关系。方法　回顾性分析我院45 例脑干出血病例,记录入院时患者收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP),血白细胞计数(WBC),血中性粒细胞比值(N),血糖(FBG),预后(死亡或存活)。以死亡和存活为二分类应变量,用SPSS 10 0 统计软件进行Binary Lo gistic回归分析。结果　脑干出血死亡率55. 60%,以桥脑出血最多见,入院时SBP、WBC、N、血糖升高,预后不良。结论　脑干出血SBP、WBC、N、血糖升高可作为脑干出血预后差的预测指标。     

精神分裂症急性激越症状的药物治疗

本文对精神分裂症急性激越症状的治疗现状、专家意见、治疗指南和给药方式的选择进行了综述。     

急性脑出血患者B型利钠肽浓度变化及临床意义

目的 观察急性脑出血患者血浆B型利钠肽(BNP)浓度变化,初步探讨BNP在急性脑出血患者中的临床意义.方法 应用微粒子酶免分析 (MEIA)方法测定100例脑出血患者入院第2天BNP浓度,计算其脑出血量,在入院第1、3、7、15天进行格拉斯哥(GCS)评分、美国国立卫生院脑卒中患者神经功能缺损评分量表(NIHSS)评分,在出院或者死亡时进行格拉斯哥预后(GOS)评分.结果 脑出血患者入院第2天BNP浓度与脑出血量呈正相关(r=0.367,P=0.000),与入院第1、3、7、15天GCS评分呈负相关(r值分别为-0.553、-0.429、-0.473、-0.501,均P=0.000),与入院第1、3、7、15天NIHSS评分呈正相关(r值分别为0.491、0.444、0.427、0.458,均P=0.000),与GOS评分呈正相关(r=0.507,P=0.000).结论 血浆BNP浓度能有效预测脑出血预后,可能为判断患者病情危重程度提供新的思路.

Abstract：

Objective To observe the change and its clinical significance of serum B-type brain natriuretic peptide (BNP) concentration in patients with acute cerebral hemorrhage. Methods The plasma BNP level was measured by microparticle enzyme immunosorbent assay (MEIA) method in 100 patients with acute cerebral hemorrhage. The blood volume of cerebral hemorrhage was computed respectively. The Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) were used to evaluate nerve function on the 1st, 3rd, 7th and 15th day after admission, and the Glasgow Out-come Scale (GOS) was used when the patient was discharged from hospital or died. Results The plasma BNP level at the 2nd day after admission was positively correlated with the blood volume of cerebral hemorrhage in patients with acute cerebral hemorrhage (r=0.367, P=0.000), with NIHSS score at the 1st, 3rd, 7th and 15th after admission (r=0.491, 0.444, 0.427 and 0.458, all P=0.000), and with GOS score (r=0.507, P=0.000). In addition, it was negatively correlated with GCS score at the 1st, 3rd, 7th and 15th after admission (r=-0.553, -0.429, -0.473 and -0.501, all P=0.000). Conclusions The plasma level of BNP is good for predicting the strike of cerebral hemorrhage patient′s condition, it is likely to provide a original thread for judge the severe degree of patient′s condition.     

护理干预对CT导向下经皮细针穿刺活检术的影响

目的探讨护理干预对CT导向下经皮细针穿刺活检术的影响.方法将149例CT导向下经皮细针穿刺活检术的病人随机分成2组,对实验组76例进行护理干预,而对照组73例只行常规的护理,分析2组穿刺成功率、并发症发生率的差异.结果实验组护理干预后穿刺成功率及并发症发生率比对照组有显著性的差异(P＜0.05).结论护理干预对CT导向下经皮细针穿刺活检术有重要的辅助作用.     

以公益性为导向公立医院绩效评价指标体系构建

目的：研制一套以公立医院为单元的绩效考核评价指标体系。方法：根据文献研究和专家咨询法形成了公立医院绩效评价指标体系框架和指标库;采用德尔菲专家咨询结合专题小组讨论与个人深入访谈等定性研究方法对指标进行了筛选。结果：构建了4个维度、10个二级指标、30个三级指标的绩效评价指标体系,根据医院级别、类别不同对指标和权重进行调整,确定了三级、二级、专科医院不同的评价指标体系。结论：构建的指标体系能够对以公益性为导向的公立医院绩效进行考核评价,为构建公益性为核心的公立医院绩效考核制度奠定了基础。     

银杏叶提取物改善学习记忆障碍老龄大鼠痴呆模型的作用途径

背景：近年研究显示,银杏叶提取物是一种天然的自由基清除剂,可保护机体免受自由基引起的损害,改善脑循环障碍和神经元的功能,而关于银杏叶提取物对认知功能等高级神经功能活动影响的实验或临床研究相对滞后.目的：探讨银杏叶提取物对中枢神经系统高级功能活动的作用,为临床应用银杏叶提取物治疗认知功能障碍提供实验依据.设计：随机对照实验.单位：华中科技大学同济医学院附属精神病医院老年科,华中科技大学同济医学院病理生理教研室,华中科技大学同济医学院附属协和医院神经内科.材料：实验于2002-06在华中科技大学同济医学院基础部完成.选择Wistar大鼠40只,随机分为5组：正常老龄对照组、模型组、银杏叶提取物75 mg/kg组、银杏叶提取物150 m/kg组,银杏叶提取物500 mg/kg组,每组8只.方法：采用东莨菪碱致老龄大鼠学习记忆障碍的拟老年性痴呆动物模型,其中正常老龄对照组和模型组以相同体积的生理盐水灌胃,银杏叶提取物各组分别按75,150,500 mg/kg银杏叶提取物灌胃,50～400g/次,单次连续给药5 d,于第6天测试水迷宫及避暗试验,测试期间停止灌药,以水迷宫和避暗实验等学习记忆行为训练及生化检测方法,观察用药前后动物学习记忆行为和脑海马区乙酰胆碱及蛋白质含量的变化.主要观察指标：①各组大鼠游迷宫所需时间.②各组大鼠游迷宫错误次数.③各组大鼠避暗试验所需时间及错误次数.④各组大鼠脑海马区乙酰胆碱及蛋白质含量.结果：银杏叶提取物150 mg/kg组中除1只大鼠不明原因死亡外,银杏叶提取物75,500 mg/kg组各有1只大鼠在灌胃时逃走,最终进入结果分析大鼠为37只.①银杏叶提取物各剂量组造模大鼠游迷宫所需时间和途中错误次数均明显少于模型组（P＜0.05或P＜0.01）,模型组大鼠游迷宫所需时间和途中错误次数明显高于正常老龄对照组（P＜0.01）.②银杏叶提取物500,150,75 mg/kg组大鼠为达到暗环境被动回避试验内容,学习过程明显短于模型组[（156.78&;#177;25.97）,（172.66&;#177;13.56）,（198.54&;#177;17.12）,（208.34&;#177;28.56）s,P＜0.05或P＜0.01].模型组学习时间较正常老年对照组显著延长[（208.46&;#177;28.56）,（127.46&;#177;11.03）s,P＜0.01];银杏叶提取物500,150,75 m/kg组发生电击的错误次数也明显少于模型组[（3.41&;#177;0.26）,（6.97&;#177;0.35）,（7.23&;#177;0.62）,（8.38&;#177;0.92）次,P＜0.01],银杏叶提取物500mg/kg组电击次数显著少于150mg/kg组（P＜0.01）,150mg/kg组明显少于75mg/kg组（P＜0.05）.③银杏叶提取物500,150,75 mg/kg组造模大鼠海马乙酰胆碱含量明显高于模型组[（421.89&;#177;36.32）,（387.45&;#177;32.76）,（380.17&;#177;41.25）,（36528&;#177;11.42）mg/g,P＜0.05或P＜0.01],而银杏叶提取物500 mg/kg组的海马乙酰胆碱含量显著高于银杏叶提取物150,75 mg/kg组（P＜0.01）.另外,与正常老龄对照组比较,东莨菪碱致学习记忆障碍模型组大鼠海马脑区的蛋白质含量显著降低[（41.75&;#177;3.82）,（95.13&;#177;6.34）mg/kg,P＜0.01],在给予银杏叶提取物后,造模后的实验大鼠海马脑区蛋白质含量虽有所增加,但差异无显著性意义（P＞0.05）.结论：银杏叶提取物呈剂量依赖性显著改善实验动物的学习记忆能力,并显著增加海马脑区乙酰胆碱含量.     

Fibroblast growth factor-2 counteracts the effect of ciliary neurotrophic factor on spontaneous differentiation in adult hippocampal progenitor cells

Neural stem/progenitor cells (NSCs) can spontaneously differentiate into neurons and glial cells in the absence of mitogen fibroblast growth factor-2 (FGF-2) or epidermal growth factor (EGF) in medium and the spontaneous differentiation of NSCs is mediated partially by endogenous ciliary neuro-trophic factor (CNTF). This study examined the relationship of FGF-2 and CNTF in the spontaneous differentiation of adult hippocampal progenitor cells (AHPs). AHPs were cultured in the medium containing different concentration of FGF-2 (1-100 ng/mL). Western blotting and immunofluorescence staining were applied to detect the expression of the astrocytic marker GFAP, the neuronal marker Tuj1, the oligodendrocytic marker CNPase and, Nestin, the marker of AHPs. The expression of endogenous CNTF in AHPs at early (passage 4) and late stage (passage 22) was also measured by Western blotting. The results showed that FGF-2 increased the expression of Nestin, dramatically inhibited the expression of GFAP and Tuj1 and slightly suppressed the expression of CNPase. FGF-2 down-regulated the expression of endogenous CNTF in AHPs at both early (passage 4) and late stage (passage 22). These results suggested that FGF-2 could inhibit the spontaneous differentiation of cultured AHPs by negatively regulating the expression of endogenous CNTF in AHPs.