3-MHPG as a non-predictor of antidepressant response to imipramine and electroconvulsive therapy

The urinary excretion of 3-methoxy, 4-hydroxyphenyl-glycol, (3-MHPG) was measured in 20 unipolar depressed patients before treatment with imipramine and electroconvulsive therapy (ECT) to investigate the relationship between pretreatment urinary excretion of 3-MHPG and clinical response. There was no difference in 3-MHPG excretion for depressed patients and controls. There was no significant difference between the mean percentage reduction of Hamilton Depression Rating Scale Scores in "low" and "high" excretors of 3-MHPG in the imipramine and ECT group of patients after four weeks of treatment.     

18F-FDG PET显像在鼻咽癌诊断治疗中的价值

目的:探讨18F-FDG PET显像在鼻咽癌诊断治疗中的价值.方法:35例鼻咽癌PET与同期CT、MRI、骨ECT诊断结果比较分析,全部经病理组织学证实.结果:35例鼻咽癌PET与临床和CT、MRI、骨ECT诊断相符31例(88.6%),诊断不符4例(11.4%),其中真阴性2例和假阴性2例,1例ECT疑为多处骨转移,PET未发现核素浓聚改变,随访排除了骨转移;1例MRI疑为复发,PET未发现核素浓聚改变,病理及随访排除了复发;1例CT诊断肝转移,1例MRI诊断桥脑转移,PET均未发现核素浓聚改变.PET检测出CT、MRI和ECT未发现的转移灶6例(17.1%).结论:18F-FDG PET对鼻咽癌定性诊断具有较高的准确性和特异性,在诊断淋巴结和远处转移方面优于CT和MRI;诊断肝、脑转移有假阴性表现,提示PET应结合CT、MRI进行综合分析,才能作出正确的诊断.     

电化学治疗对肿瘤病人免疫功能的影响

20例晚期癌症病人接受电化学治疗（ECT），治疗后所有病例的肿物均有不同程度缩小，其中4例出现ECT后的远隔效应，即运高电化学治疗电极的转移灶减小。免疫参数（OKT3，OKT4／OKT8，自然杀伤细胞活动度NKA，淋巴细胞转化实验LTT）在ECT前后发生明显改变。所有这些均提示ECT能增强人体免疫功能。     

多发性骨髓瘤的临床及影像学分析

目的：探讨多发性骨髓瘤的临床表现特征与影像学的诊断价值．方法：回顾性分析32例经骨髓穿刺或手术病理证实的MM患者的影像学资料，对其临床特征和影像学表现特点进行综合分析．结果：多发性骨髓瘤最常见的临床表现有全身性疼痛、贫血、出血、肾功能损害、发热、肺部感染和全身乏力等．32例患者不同部位X线摄片的阳性率分别为颅骨85％、肋骨56％、脊椎53％、肩胛骨46．1％、骨盆43％、股骨37．5％、胫骨33．3％。15例脊椎CT均显示明显骨质破坏。12例脊椎MRI中有10例示明显信号改变。18例ECT全身骨扫描全部出现多骨的浓聚灶．结论：多发性骨髓瘤起病隐匿。临床表现多样化且缺乏特征性。典型影像学表现为多发穿凿状或虫蚀状骨质破坏及广泛的骨质疏松；X线平片检查尤其是头颅、骨盆、腰椎、肋骨及骨痛部位。应作为多发性骨髓瘤初诊的常规筛查，CT、MRI及ECT检查对早期和不典型多发骨髓瘤病变的显示明显优于X线平片检查．     

电休克治疗导致认知功能损害的研究进展

电休克治疗是以一定量电流通过患者头部,导致全身抽搐,从而达到治疗疾病的目的。其治疗作用已经得到广泛认可,但同时也引起了一定的不良反应,其中最常见的是认知功能损害,该不良反应的程度和持续时间与电休克所应用的参数和患者个体差异有关,所致认知功能损害主要表现为短期定向力障碍和记忆障碍,另外对智力也有不同程度的影响。     

Psykiatriska synspunkter på problemet dold kriminalitet och anonyma brottslingar,med särskild hänsyn till exhibitionism

Background: Electroconvulsive therapy, ECT, is an effective acute treatment for severe depression. Today ECT is usually discontinued when the patient's depressive symptoms abate, although relapse is common. Some studies suggest that continuation ECT (cECT) may prevent relapse of depression, but there are few studies available. Aims: The aim of this study was to describe the need for inpatient care before, during and after cECT. Methods: A retrospective chart review was conducted of all patients (n=27) treated with cECT between 2005 and 2007 at Örebro University Hospital, Sweden. All patients were severely depressed at the initiation of index ECT. The DSM-IV diagnoses were major depression (n=19), bipolar depression (n=5) or schizoaffective depression (n=3). Results: The hospital day quotient was lower (HDQ=15) during cECT (mean duration±standard deviation=104±74 days) than during the 3 years prior to cECT (HDQ=26). The rehospitalization rate was 43% within 6 months and 58% within 2 years after the initiation of cECT. Seven patients were rehospitalized while on cECT. Conclusion: The need for inpatient care was reduced during cECT. However, rehospitalization was common. At the initiation of the cECT, the patients were improved by the index ECT. Also cECT was often terminated after rehospitalization, which contributed to the lowered hospital day quotient during cECT. Randomized clinical trials are needed to establish the efficacy of cECT. Clinical implications: Relapses and recurrences in depressed patients are common after ECT treatment. The results indicate that continuation ECT combined with pharmacotherapy might be an alternative treatment strategy.     

丙泊酚与硫喷妥钠对电抽搐治疗时抽搐发作的影响比较

目的探讨丙泊酚与硫喷妥钠对电抽搐治疗时抽搐发作影响特点的差异性,为改良式电抽搐疗法中静脉用麻醉药物的选择提供依据。方法对2005年7月至2005年12月在攀枝花市第三人民医院接受电抽搐治疗的111例精神病患者(硫喷妥钠组62例,丙泊酚组49例)进行同顾性分析。两组患者分别在硫喷妥钠和丙泊酚复合琥珀胆碱静脉麻醉下实施电抽搐治疗。对两组患者在治疗中痉挛发作情况进行分析。结果两组患者的主要人口学资料、病种及电治疗参数的差异均无统计学意义(P>0．05),丙泊酚组患者的运动性发作时间和脑电发放时间均较硫喷妥钠组长,其差异有统计学意义(P<0．01)。结论硫喷妥钠可上调大脑皮质神经元的兴奋阈值,降低电抽搐治疗时的痉挛发作程度。丙泊酚可能会使兴奋阈值下调,相同治疗参数引起的痉挛发作较好,但丙泊酚有诱发癫痫样发作的可能。     

术前肝胆囊静态显像胆囊未显影行微创保胆取石术33例临床分析

目的 评价术前肝胆囊静态显像(ECT)胆囊未显影患者行保胆取石术的成功原因及概率.方法 2006年8月～2009年4月在该院行微创保胆手术的患者术前常规行肝胆囊静态显像(ECT)检查.将胆囊未显影的患者纳入研究组,统计成功完成微创保胆手术例数并分析原因.结果 术前有80例患者肝脏显影良好.但胆囊未显影,均为胆囊结石患者,其中有33例患者成功地完成微创保胆取石术,占40.1%,成功原因主要是结石能全部取出等.结论 术前肝胆囊静态显像(ECT)胆囊显影表明胆囊有功能,是微创保胆术的适应证,未显影表明胆囊功能不良,均为胆囊结石患者,在术中若发现胆囊无萎缩,无明显积脓或急性炎症水肿.结石无严重嵌顿且能全部取出者可行微创保胆取石术,丰富了微创保胆手术的适应证.