汶川地震救援人员创伤后应激反应特征的初步研究

目的:探讨5.12汶川地震军队救援人员创伤后应激损伤状况。方法:采用创伤后压力诊断量表、焦虑自评量表、抑郁自评量表和匹兹堡睡眠质量问卷,在地震爆发后65天左右,对107名执行运输遗体任务的官兵进行了测量。结果:PTSD症状轻度的占84%,中重度的占15%。其中症状在1个月内消失的占63%。从症状的分布来看,闯入性回忆占36.4%,回避29.9%,过度警觉29.9%,焦躁不安或易怒37.4%,入睡困难、睡眠易醒或早醒43.9%,难以集中注意力45.8%,对重要的活动兴趣下降32.7%。救援人员抑郁症状得分低于全国常模水平;焦虑自评量表得分与全国常模差异不显著。睡眠质量差的占72%,以入睡时间长和日间功能降低为主。结论:担任遗体运输的救援官兵在救援早期普遍存在创伤后应激反症状,症状程度较轻,多数在1个月内消失,焦虑和抑郁症状水平的总体状况也比较低,但普遍存在睡眠质量差的问题,并且直接影响到日间功能。     

Japan’s Hidden Youths: Mainstreaming the Emotionally Distressed in Japan

One of the most talked-about social issues in Japan in recent years has been the problem of the nation's purportedly one million "hidden" youths, known as hikikomori (literally, "the withdrawn"). Most observers agree that the category of hikikomori encompasses a wide range of problems and provocations. The fact that these various dilemmas lead to the shared outcome of shutting oneself away at home is the point of departure here. The article explores the spheres of mental health care, education and family, focusing on the reluctance to highlight underlying psychological dimensions of hikikomori and the desire on the part of schools and families to "mainstream" Japanese children, accommodating as many as possible within standardized public education. Hikikomori can perhaps be seen as a manifestation of Japanese democracy, in which the good society is imagined as cohesive, protective and secure, rather than one in which the individual can freely exercise the right to be different. Schools, families and the sphere of mental health care have focused on producing social inclusion but have discouraged citizens from being labeled as "different" -- even when such a distinction might help them. The dearth of facilities and discourse for caring for the mentally ill or learning disabled is, in many respects, the darker side of Japan's successes. Those who cannot adjust are cared for through the institutions of families, companies and various other spheres that offer spaces to rest and to temporarily "drop out"; however, the expectation is that rest will eventually lead to a re-entry into mainstream society. Often the psychological problem or disability that led to the problem goes unnamed and untreated (hikikomori, psychiatry, special education, youth, family, Japan).     

苏北盆地高邮凹陷D1井白垩纪-古近纪微体古生物地层及沉积环境

高邮凹陷D1井富含介形虫、轮藻和孢粉等化石。通过系统的微体古生物分析,首次对该地区白垩纪一古近纪微体古生物地层进行了精确划分,从下到上共建立11个化石组合：其中介形虫4个,轮藻4个,孢粉3个。文中还简要探讨了沉积环境演变,为该地区油气勘探提供有力的生物地层依据。     

Endogenous opiates: 2000

This paper is the twenty-third installment of the annual review of research concerning the opiate system. It summarizes papers published during 2000 that studied the behavioral effects of the opiate peptides and antagonists, excluding the purely analgesic effects, although stress-induced analgesia is included. The specific topics covered this year include stress; tolerance and dependence; learning, memory, and reward; eating and drinking; alcohol and other drugs of abuse; sexual activity, pregnancy, and development; mental illness and mood; seizures and other neurological disorders; electrical-related activity; general activity and locomotion; gastrointestinal, renal, and hepatic function; cardiovascular responses; respiration and thermoregulation; and immunological responses.     

PATHOPHYSIOLOGY OF DEPRESSION: DO WE HAVE ANY SOLID EVIDENCE OF INTEREST TO CLINICIANS?

Due to the clinical and etiological heterogeneity of major depressive disorder, it has been difficult to elucidate its pathophysiology. Current neurobiological theories with the most valid empirical foundation and the highest clinical relevance are reviewed with respect to their strengths and weaknesses. The selected theories are based on studies investigating psychosocial stress and stress hormones, neurotransmitters such as serotonin, norepinephrine, dopamine, glutamate and gamma-aminobutyric acid (GABA), neurocircuitry, neurotrophic factors, and circadian rhythms. Because all theories of depression apply to only some types of depressed patients but not others, and because depressive pathophysiology may vary considerably across the course of illness, the current extant knowledge argues against a unified hypothesis of depression. As a consequence, antidepressant treatments, including psychological and biological approaches, should be tailored for individual patients and disease states. Individual depression hypotheses based on neurobiological knowledge are discussed in terms of their interest to both clinicians in daily practice and clinical researchers developing novel therapies.     

Improving psychometric assessment of the Beck Depression Inventory using Multidimensional Item Response Theory

We studied the latent factor structure of the Beck Depression Inventory (BDI) under the light of Multidimensional Item Response Theory models. Under a Bayesian Markov chain Monte Carlo setting, we chose the most adequate model, estimated its parameters and verified its fit to the data. An evaluation of the inventory in terms of the assumed dimensions seems to agree with previous investigations in the factor structure of the BDI present in the literature. Cognitive and somatic‐affective latent traits were identified in the analysis making possible the interpretation of symptom evolution along these dimensions, in terms of probability of their appearance.     

Effects of Insulin and Streptozotocin-Induced Diabetes on Brain Norepinephrine Metabolism in Rats

Administration of insulin (2 IU/kg, i.p.) produced a significant decrease (18%) in forebrain norepinephrine and a significant increase in the major metabolite of norepinephrine, 3-methoxy-4-hydroxyphenylglycol-sulfate (MOPEG-SO4, +19%) in rats. Streptozotocin-induced diabetes produced the opposite effects, resulting in an increase in forebrain norepinephrine (+17%) and a decrease in MOPEG-SO4 (-26%). In addition, insulin increased (+143%) and diabetes decreased (-41%) the turnover rate of norepinephrine, as measured by the rate of decrease of norepinephrine following inhibition of tyrosine hydroxylase by alpha-methyl-p-tyrosine. All of these effects in diabetic rats were reversed by insulin replacement therapy. These data are discussed within the context of mood disorders characteristic of diabetic patients.     

Ketamine modulates TRH and TRH-like peptide turnover in brain and peripheral tissues of male rats

Major depression is the largest single healthcare burden with treatments of slow onset and often limited efficacy. Ketamine, a NMDA antagonist used extensively as a pediatric and veterinary anesthetic, has recently been shown to be a rapid acting antidepressant, making it a potential lifesaver for suicidal patients. Side effects and risk of abuse limit the chronic use of ketamine. More complete understanding of the neurobiochemical mechanisms of ketamine should lead to safer alternatives. Some of the physiological and pharmacological actions of ketamine are consistent with increased synthesis and release of TRH (pGlu-His-Pro-NH₂), and TRH-like peptides (pGlu-X-Pro-NH₂) where “X” can be any amino acid residue. Moreover, TRH-like peptides are themselves potential therapeutic agents for the treatment of major depression, anxiety, bipolar disorder, epilepsy, Alzheimer's and Parkinson's diseases. For these reasons, male Sprague–Dawley rats were anesthetized with 162 mg/kg ip ketamine and then infused intranasally with 20 μl of sterile saline containing either 0 or 5 mg/ml Glu-TRH. One, 2 or 4 h later, the brain levels of TRH and TRH-like peptides were measured in various brain regions and peripheral tissues. At 1 h in brain following ketamine only, the levels of TRH and TRH-like peptides were significantly increased in 52 instances (due to increased biosynthesis and/or decreased release) or decreased in five instances. These changes, listed by brain region in order of decreasing number of significant increases (↑) and/or decreases (↓), were: hypothalamus (9↑); piriform cortex (8↑); entorhinal cortex (7↑); nucleus accumbens (7↑); posterior cingulate (5↑); striatum (4↑); frontal cortex (2↑,3↓); amygdala (3↑); medulla oblongata (1↑,2↓); cerebellum (2↑); hippocampus (2↑); anterior cingulate (2↑). The corresponding changes in peripheral tissues were: adrenals (8↑); epididymis (4↑); testis (1↑,3↓); pancreas (1↑); prostate (1↑). We conclude that TRH and TRH-like peptides may be downstream mediators of the rapid antidepressant actions of ketamine.     

Design,synthesis, and systematic evaluation of 4-arylpiperazine- and 4-benzylpiperidine napthyl ethers as inhibitors of monoamine neurotransmitters reuptake

Two series of 4-arylpiperazine- and 4-benzylpiperidine naphthyl ethers were designed based on structure-activity relationship (SAR) and docking model of reported monoamine neurotransmitters reuptake inhibitors. The compounds were synthesized in 3-simple steps and their biological activities were evaluated. Several compounds were proven to be potent inhibitors of serotonin and norepinephrine reuptake. Computer docking was performed to study the interaction of the most potent compound 35 with human serotonin transporter. The results of the analyses suggest that 4-arylpiperazine- and 4-benzylpiperidine naphthyl ethers might be promising antidepressants worthy of further studies.     

北京市2型糖尿病患者抑郁状况的横断面调查及其危险因素分析

目的:探讨北京市2型糖尿病(T2DM)患者抑郁症发病情况及其危险因素,为T2DM合并抑郁症的防治提供依据。方法:采取横断面调查的方法对2016年1月-2016年12月中国人民解放军总医院健康管理研究院体检中患T2DM的3000例患者随机抽取1200例进行调查,所有患者进行Zung抑郁自评量表(SDS)测评,根据SDS结果分为T2DM合并抑郁症组和T2DM非抑郁症组。应用单因素和多因素Logistic回归法分析T2DM合并抑郁症的危险因素。结果:北京市T2DM患者抑郁症患病率为21.93%,不同性别T2DM患者抑郁症患病率比较无统计学差异(P0.05)。单因素分析显示,北京市T2DM患者抑郁症发病与糖尿病病程、运动情况、胰岛素治疗、并发症情况、糖化血红蛋白有关(P0.05),与饮食控制、血糖监测情况、收缩压、舒张压、胆固醇、甘油三酯无关(P0.05)。多因素Logistic回归分析显示糖尿病病程≥10年、胰岛素治疗、并发症≥3个、糖化血红蛋白≥8.0%是北京市T2DM患者抑郁症发病的危险因素(P0.05),经常运动是北京市T2DM患者抑郁症发病的保护性因素(P0.05)。结论:北京市T2DM患者抑郁症患病率为21.93%,糖尿病病程≥10年、胰岛素治疗、并发症≥3个、糖化血红蛋白≥8.0%是北京市T2DM患者抑郁症发病的危险因素,经常运动是北京市T2DM患者抑郁症发病的保护性因素。