脑卒中患者急性期伴发抑郁症的临床研究

随着医学模式由生物医学模式向生物-心理-社会医学模式的转变,国内外学者对脑卒中后抑郁症的研究越来越广泛、深入,早期对其进行诊治是影响患者预后的关键.本文对97例脑卒中患者急性期伴发抑郁症的发病率、影响因素、治疗进行研究,报告如下.     

妊娠高血压综合征并发脑卒中15例临床分析

脑卒中虽为妊娠高血压综合征(妊高征)一种少见的并发症，由于发作突然，病情危重，如不及时诊治，直接影响到母婴生命。自1998-10～2003-09，我院共诊治妊高征并发脑卒中15例，现报道如下。     

急性脑卒中神经源性心脏损害67例分析

目的探讨急性脑卒中神经源性心脏损害的发生机理及诊治原则。方法对104例急性脑卒中患入院后作心电图、心肌酶谱测定，并结合临床资料分析。结果急性脑卒中患心电图改变占64．42％，心肌酶谱均有不同程度增高，以脑出血为明显，预后更差。结论其发生机理可能与脑对心脏神经支配紊乱，神经、体液调节障碍，血管痛变及动力学变化等有关。应时急性脑卒中加强心脏监护，积极诊治神经源性心脏损害。     

脑卒中继发癫痫49例临床分析

目的 探讨脑卒中继发性癫痫的发病情况、发病原因、临床特点及诊治。方法 回顾性调查我院自1995-05～2004-05期间，收治脑卒中487例，继发49例癫痫的诊治情况。结果 继发性癫痫死亡11例，占22．4％，未发生癫痫的438例，脑卒中死亡42例，占9．6％，两者相比有明显差异性(P<0．01)。结论 癫痫是脑卒中的常见并发症，且死亡率高，早期诊断及正确处理是治疗成功的关键。     

糖尿病合并脑卒中的研究现状

脑卒中在人类死亡原因中排第3位，是造成严重残疾的首要原因，而且脑卒中的发病率呈明显的上升趋势。大量临床研究发现，糖尿病患者合并脑卒中的风险较非糖尿病患者显著提高，糖尿病是急性脑卒中的独立危险因素之一。并且糖尿病患者在脑卒中后的病死率和残障程度较非糖尿病患者明显升高。本文通过阐述糖尿病患者脑卒中的临床表现、脑损伤机制及预后的特点，以提高糖尿病性脑卒中的诊治效果，改善患者预后。     

急性脑血管病的若干问题讨论

<正> 据我国多省市心血管病人群监测协作研究显示,1987～1993年我国脑卒中事件的年发病率和死亡率高于国际平均水平,在脑卒中的诊治中还存在一些模糊认识。在此,就几个有代表性的问题与大家共同探讨,统一认识,更好地提高脑血管病的防治水平。 一、“中风预报”在临床中的意义     

积极开展缺血性脑血管病的外科治疗

脑血管病是当今人类三大死亡原因之一。流行病学研究资料表明，我国城乡脑卒中平均年发病率为１２０～１８０／１０万，年死亡率为８０～１２０／１０万。以此推算，全国每年新发病例约１８０万，死亡约１１０万，发病后存活者中约３／４不同程度地丧失劳动力，给家庭和社会带来巨大的负担和影响。而在脑卒中病人中，７５％～９０％为缺血性卒中。因此，进一步加强缺血性脑血管病的临床和实验研究，不断提高其诊治水平，必将造福于广大病人和整个社会。目前，缺血性脑血管病的治疗大致分为三类：（１）药物治疗，（２）外科治疗，（３）血管…     

缺血性与出血性脑卒中患者危险因素对比分析

正脑卒中是造成居民死亡和致残因素,每年100万患者中死于脑卒中,是心脏病的3倍以上~([1])。研究证实,高血压、高血糖、冠心病、糖尿病、吸烟、饮酒等是造成脑卒中危险因素。而缺血性和出血性脑卒中是两种发病机制不同的脑卒中类型。本研究对缺血性与出血性脑卒中患者的危险因素进行总结,以期提高临床诊治水平。1资料与方法1.1一般资料缺血性脑卒中患者76例,男39例,女37     

人工智能在脑卒中管理中的研究进展

人工智能作为一种新兴技术,已应用于脑卒中预防、诊治和康复等多领域,并突显出巨大的潜力.人工智能与大数据相结合,可用于脑卒中高危人群的精准识别、自动化病因分型、辅助脑卒中急性期和二级预防策略的制定,从而提高脑卒中患者康复治疗效果.本文综述人工智能在脑卒中预防、诊治和康复中的研究进展.     

第一届脑卒中临床规范化诊治培训班主要内容集锦

在北京美丽的金秋10月,来自全国各地的神经病学医师和学者90余人汇集一堂,倾听中国著名的脑卒中专家、北京天坛医院副院长王拥军教授的专题讲座:脑卒中临床规范化诊治培训。培训期间,王拥军教授精神饱满,讲课节奏明快,幻灯花样繁多,内容新颖、充实,充分体现了脑卒中规范化培训的理念。这次脑卒中临床规范化诊治培训班的主要内容包括几下几个方面。     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Antidepressants and cytokines--clinical and experimental studies

Clinical and experimental studies indicate that stress and depression are associated with the up-regulation of the immune system, including increased production of pro-inflammatory cytokines. When administered to patients or laboratory animals, some of these cytokines induce typical symptoms of depression. It is known that cytokines modulate brain neurotransmission and the activity of the hypothalamic-pituitary-adrenal axis, both of which are disturbed in depression. This review summarizes in vivo, ex vivo and in vitro clinical and experimental studies of the effect of antidepressants on cytokine production. In vitro culture and animal studies in particular suggest that antidepressants of several classes decrease the production of pro-inflammatory cytokines and shift the pro/anti-inflammatory cytokine balance towards the latter. Some studies suggest that immunological disturbances, including changes in cytokine levels, are not shared by all depressive patients, which means that only in certain groups of patients may the immunomodulatory action of antidepressants play a significant role in producing the therapeutic effect.     

Anger and depression--theoretical and clinical considerations

The Freudian idea of inhibited anger being central to the pathogenesis of depression has been one of the cornerstones of psychiatric thinking. The aim of this article is to review the literature on psychotherapy theory and the relevant research with regard to the association of anger and depression, and to discuss clinical implications in treating depressive patients. Choice of research articles was based on systematic search of databases. Psychotherapy theories are mostly found in books not included in databases. Literature on psychotherapy theory was selectively chosen. Over-control, under-control and mixtures of the two may be present in depression, indicating problems in anger regulation. The links between anger and depression form a complex network. When treating patients with depression, explicit or implicit dealing with anger often seems to be helpful. In clinical reality, the relative amounts of elicitation of anger experience and training in expressive control needed by depressive patients may vary between different types of patients, different phases of depressive disorder, and different phases of therapy.