认知行为疗法联合药物治疗惊恐障碍疗效Meta分析

目的:比较认知行为疗法(CBT)联合药物治疗与单纯药物治疗对惊恐障碍的疗效。方法:对CBT联合药物治疗与单纯药物治疗惊恐障碍的对照研究进行系统评价,使用Revman 5.2进行Meta分析。结果:共纳入6项符合标准的随机对照研究,合计样本量329人。6组数据比较了CBT联合药物治疗与单纯药物治疗惊恐障碍的有效率和显效率,结果显示,联合治疗组的有效率(OR=3.28,Z=2.75,P<0.05)与显效率(OR=2.85,Z=3.90,P<0.05)均优于单纯药物组;5组数据比较了CBT联合药物治疗与单纯药物治疗惊恐障碍的治愈率,结果显示,联合治疗组的治愈率优于单纯药物组(OR=2.08,Z=2.82,P<0.05)。结论:鉴于目前结果推测对于惊恐障碍的改善,认知行为疗法联合药物治疗优于单纯药物治疗,但仍需进一步研究证实。     

国内认知行为疗法联合药物治疗广泛性焦虑疗效的元分析

目的:分析认知行为疗法(CBT)联合药物治疗与单纯使用药物治疗对广泛性焦虑干预的疗效。方法:对CBT和药物联合治疗与单纯使用药物治疗广泛性焦虑的对照研究进行回顾研究,使用Revman 5.3进行系统评价。结果:共获得7篇文献符合本文的元分析选择标准,被试人数共435人。7组数据比较了CBT和药物联合治疗与单独使用药物治疗广泛性焦虑的治愈率、显效率和有效率,结果显示,联合治疗组的治愈率(OR=2.69,Z=4.33,P0.05)、显效率(OR=2.07,Z=3.58,P0.05)与有效率(OR=3.11,Z=3.50,P0.05)均优于单纯药物组。结论:在国内治疗广泛性焦虑中,认知行为疗法联合药物治疗8周后比单独使用药物治疗效果更好。     

重复经颅磁刺激治疗强迫症随机对照双盲研究的meta分析

目的:系统评价重复经颅磁刺激(rTMS)治疗治疗强迫症(OCD)的疗效。方法:计算机检索Pubmed、Web of Science、Google Scholar、中国知网期刊全文数据库、万方数据库、维普中文科技期刊所有关于rTMS治疗OCD患者的随机对照双盲试验,同时筛检纳入文献的参考文献。对符合纳入标准的文献使用CMA 2.0软件对文献数据进行统计学分析。结果:最终纳入16篇随机对照双盲临床研究,共有强迫症患者543例。Meta分析结果显示,与安慰剂rTMS组相比,rTMS组可有效的改善患者的强迫症状,合并的Hedge's g值为0.65,(95%CI=0.34～0.96,Z=4.12,P0.001),总体有效率54.6%,合并的OR值为3.28(95%CI=1.79～6.00,Z=3.85,P0.001);亚组分析结果显示,rTMS组较安慰剂rTMS组显示在高频(Hedge's g=0.54,95%CI=0.23～0.84,Z=3.39,P=0.001)、低频(Hedge's g=0.80,95%CI=0.25～1.35,Z=2.86,P=0.004)、刺激部位为背外侧前额叶(DLPFC)(Hedge's g=0.60,95%CI=0.31～0.89,Z=3.99,P0.001)均更能改善患者的强迫症状。rTMS组与安慰剂rTMS组退出率差异无统计学意义。结论:现有数据提示高频、低频刺激部位为DLPFC区rTMS治疗强迫症有效。     

认知行为治疗对精神分裂症患者应对方式的影响

目的:探讨药物联合认知行为治疗对精神分裂症患者应对方式的影响.方法:本研究为随机对照临床试验.选取符合美国精神疾病诊断与统计手册第4版(DSM-Ⅳ)中精神分裂症诊断标准的医院门诊和住院患者共132例,随机分配到认知行为治疗组(CBT组,n=66)和支持性心理治疗组(ST组,n=66),在药物治疗基础上分别接受15次CBT和ST.并在治疗前后采用应对方式问卷(CSQ)对两组患者进行评估.结果:经过24周治疗,CBT组CSQ的解决问题、自责、求助、逃避四个因子的得分均有显著改善(P＜0.05);而ST组只在自责因子分数有显著改变(P＜0.05).两组进行治疗后比较,CBT组的问题解决和求助因子显著高于ST组(P＜0.001).结论:认知行为治疗能够有效的改善精神分裂症患者的应对方式.     

联合动机访谈与单用认知行为疗法治疗强迫症疗效的meta分析

目的:用meta分析的方法,探究动机访谈联合认知行为疗法对强迫症患者的疗效与依从性。方法:全面收集关于动机访谈联合认知行为疗法治疗强迫症的随机对照研究资料,根据纳入和排除标准进行文献筛选,对符合条件的研究结果用Revman5.3软件从疗效、脱落率两个方面进行Meta分析,并对其增效机制进行综合概述。结果:共有4篇文献符合纳入标准,合并后效应量SMD=-0.54,95%CI[-0.85,-0.24];Z=3.53,P=0.0004。显示合并动机访谈组与单用认知行为治疗组在疗效上有统计学上的差异,合用组的疗效显著优于单用组。结论:动机访谈合用认知行为疗法组治疗强迫症的疗效显著优于单用认知行为疗法组。     

认知行为治疗对强迫障碍患者药物治疗依从性的影响

目的:通过随机对照研究,分析评价认知行为治疗(CBT)对强迫障碍(OCD)患者药物治疗依从性的影响。方法:对分别接受5-羟色胺再摄取抑制剂(SSRIs)治疗(简称药物治疗组)或SSRIs联合CBT组(简称联合治疗组)的80例门诊OCD患者的药物治疗依从性进行随访研究。按照治疗方案随机分为SSRIs组(40例)和SSRIs联合CBT组(40例),被试在24周之前终止药物治疗则定义为脱落;基线时Y-BOCS的评分大于24分,则定义为高分组,反之则是低分组。结果:联合治疗组的脱落率为15%(6/40),药物治疗组的脱落率为40%(16/40),差异具有统计学意义(χ2=6.270,P0.05);基线时Y-BOCS低分组的脱落率为36.4%(16/44),Y-BOCS高分组脱落率为16.7%(6/36),差异具有统计学意义(χ2=3.853,P0.05);24周末完成组和脱落组Y-BOCS第4周末减分率分别为(14.62%±27.96%)和(4.42%±9.56%),差异具有统计学意义(t=-2.43,P0.05)。回归分析结果显示:药物治疗脱落的发生和治疗的方案相关,药物治疗时联合运用CBT可降低脱落率(OR=0.279,95%CI(0.092,0.848)),有助于提高OCD患者药物治疗的依从性。结论:相对于单纯药物治疗,药物联合CBT治疗能够显著提高OCD患者的服药依从性,使患者从随后的治疗中获得更多的收获,减少症状反复。     

无抽搐电休克治疗(MECT)合并药物与单纯药物治疗双相情感障碍躁狂相临床对照研究

目的探讨无抽搐电休克治疗(MECT)合并药物与单纯药物治疗双相情感障碍躁狂相在起效时间、疗效及住院天数、治疗费用方面的差异。方法运用MECT合并药物治疗的30例双相情感障碍躁狂相患者的起效时间、住院天数、住院费用等指标与同期单纯药物治疗的32例患者进行比较并做回顾性分析。疗效评定依据简明精神病评定量表(BPRS)、贝克躁狂量表(BRMS)评分。结果 MECT合并药物治疗组和单纯药物治疗组治疗前BPRS和BRMS评分没有显著性差异(t=1.345,P0.05和t=1.087,P0.05);治疗后1、2、3周、出院前两组间有显著性差异(P0.01);两组不同时点BPRS、BRMS评分与治疗前比较,差别均有显著性(P0.01)。MECT合并药物治疗组平均住院31.6天,单纯药物治疗组平均住院50.1天,两组比较差异有显著性(U=6.0652,P0.01);合并药物治疗组平均治疗费4169.90元,单纯药物治疗组平均治疗费5556.06元,两组比较差异有显著性(Z=4.790,P0.01)。结论 MECT合并药物治疗组较单纯药物组治疗双相情感障碍躁狂相患者疗效好,起效快,减少了住院天数和住院费用。     

认知行为治疗联合药物治疗广泛性焦虑障碍的随机单盲对照试验

目的:评估认知行为治疗(CBT)联合选择性5-羟色胺再摄取抑制剂(SSRI)类抗抑郁药治疗广泛性焦虑障碍与单纯使用SSRI类药物的疗效差异。方法:选择某三级甲等精神专科医院门诊符合ICD-10广泛性焦虑障碍诊断标准的48例患者,随机分为联合治疗组和单纯药物组,治疗周期为24周。采用汉密顿焦虑量表(HAMA)评估疗效,采用广义估计方程对两组间临床疗效的差异进行检验。结果:两组各入组24例患者,至24周末联合治疗组脱落8例,单纯药物组脱落11例。控制性别、年龄、病程、HAMA基线得分后,联合治疗组的疗效优于单纯药物组(P0.001),OR值即疗效好一个等级的可能性之比为21.83(95%CI:5.92～80.41)。联合治疗组患者脱落与疗效无关(P0.05),治疗间隔为每6周1次时的脱落率最高。而单纯药物组未脱落患者的治疗疗效优于脱落患者(P0.05),OR值为5.82(95%CI:1.44～23.63)。结论:认知行为治疗联合药物治疗广泛性焦虑障碍的疗效优于单独药物治疗,单纯药物组患者脱落与疗效欠佳有关,而联合治疗组脱落与维持期中CBT治疗间隔时间较长有关。     

认知行为治疗对社区精神分裂症患者的疗效

目的:探讨认知行为治疗对社区精神分裂症患者的短期和长期疗效。方法:本研究为一项随机对照临床试验,纳入符合ICD-10精神分裂症诊断标准的患者32例,随机分成两组,分别接受常规治疗(TAU组,n=16)和常规治疗联合认知行为治疗(CBT组,n=16)。采用阳性与阴性症状量表(PANSS)和临床大体印象量表(CGI)于基线和治疗结束时分别对两组患者进行评定,并随访评估其半年和一年疗效。结果:112周、38周和64周时,CBT组PANSS总分显著低于TAU组(t=-2.174,-2.187,-3.256;P0.05);2在38周和64周时,CBT组阳性症状量表得分显著低于TAU组(t=-2.564,-2.146;P0.05);3在38周和64周时,CBT组一般精神病理症状量表分显著低于TAU组(P0.05);4CBT组的1年随访复发率显著低于TAU组(P0.025),而有效率显著高于TAU组(60.0%VS.20.0%,P=0.039)。结论:认知行为治疗可改善社区精神分裂症患者的症状及病情严重程度,尤其是阳性症状与焦虑抑郁等一般精神病理症状,降低复发率。     

帕罗西汀联合催眠疗法治疗强迫症

目的:探讨帕罗西汀联合催眠疗法治疗强迫症的临床可行性。方法:2014年1月-2016年4月门诊就诊强迫症20例患者,在自愿选择方案的情况下分成2组,帕罗西汀联合丁螺环酮组(11例)及帕罗西汀联合催眠疗法组(9例),治疗4周。在治疗前、1周末、4周末予以强迫量表(Y-BOCS)及汉密尔顿焦虑量表测定。结果:两组治疗前后Y-BOCS及HAMA评分均有非常显著差异(t=4.92,7.10,8.31,8.80;P0.01)。治疗第1周及4周末HAMA:催眠组较丁螺环酮组改善显著(t=2.47,2.55,P0.05)。治疗4周末Y-BOCS:催眠组较丁螺环酮组改善显著(t=2.24,P0.05);药物不良反应:丁螺环酮组头昏7例,催眠组1例,(Fisher确切概率法P=0.028),有统计学差异。结论:帕罗西汀联合催眠疗效好,药物不良反应少,临床安全性较高,有利于提高患者的治疗依从性。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.     

A comparative study of the effects of dimebon,obsidan, finoptin,and cordaron on the functional state of ischemic focus and size of necrotic zone in experimental myocardial infarction

Dimebon, an antihistamine agent, exerts a moderate antianginal effect, improving the function of ischemic focus in the myocardium and decreasing the necrotic zone in experimental myocardial infarction. Dimebon is less active than obsidan, finoptin (except for the size of the necrotic zone), and cordaron. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 12, pp. 642–644, December, 1996     

Effects of sex steroid hormones on lipid peroxidation and glutathione antioxidant system in rat skin

Effects of estradiol and testosterone on the intensity of lipid peroxidation and contents of glutathione redox system components in the dermis and epidermis of rat skin were studied. Only estradiol induced considerable dose-dependent and tissue-specific biphasic antioxidant effects on the skin. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 12, pp. 663–666, December, 1999     

Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata

A series of surface-functionalized poly(ether ether ketone) (PEEK) films has been prepared by selective wet-chemistry; they are hydroxylated polymer (PEEK-OH) obtained by reduction, aminated polymer (PEEK-[]-NH2) prepared by coupling a diisocyanate reagent to PEEKOH (PEEK-[]-NCO) followed by hydrolysis, and carboxylated and aminocarboxylated polymers (PEEK-[]-GABA and PEEK-Lysine) resulting from the coupling of aminoacids to PEEK-[]-NCO. The aminated and carboxylated substrata promoted the adhesion and growth of CaCo2 cells in the presence of serum. Fibronectin (FN), an extra-cellular matrix protein, has been covalently fixed and/or adsorbed on various PEEK substrata, in the presence or not of a polymeric surfactant (Pluronic F68). The performances of the FN-grafted substrata (PEEK-[]-FN(1) and PEEK-[]-FN(2)) were significantly higher than those of reference substrata simply coated with FN (PEEK-OH(+FN)(1) and (2), PEEK-[]-NH2(+FN)(1) and (2)), considering the adhesion and spreading of CaCo2 cells in the absence of serum. Moreover, the stability of the adherent cells on the FN-adsorbed substrata dramatically depended on the experimental conditions applied during the PEEK coating with FN.