Serum protein and red cell enzyme polymorphisms in affective disorders

Frequencies of serum groups (Hp and Gc) and red cell enzyme types (PGM1, 6-PGD and ES D) were studied in 195 patients with affective disorders. The patients were classified into four groups: (1) bipolar (manic-depressive) psychosis; (2) unipolar, recurrent, depressive psychosis; (3) non-psychotic reactive depression, and (4) unclassifiable. The Hp2 gene was increased in reactive and unclassifiable patients, the PGM1 1 gene was increased in bipolar patients and the ES D1 gene in reactive patients. No associations were found between affective disorders and the Gc and 6-PGD systems.     

双相障碍抑郁发作及单相抑郁症患者血清T3、T4、TSH和BDNF水平的相关性分析

目的:分析双相障碍抑郁发作及单相抑郁症患者与血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、甲状腺激素(TSH)和脑源性神经营养因子(BDNF)水平的相关性。方法:选取2017年12月～2019年12月我院收治的120例抑郁症患者为研究对象,按照病情不同分为双相障碍抑郁发作组(n=50)、单相抑郁症组(n=70),同时选取同期于本院进行体检的30例健康者作为对照组,检测血清T3、T4、TSH和BDNF水平,并进行汉密尔顿抑郁(HAMD)量表评分,分析血清T3、T4、TSH和BDNF水平的相关性。结果:双相障碍抑郁发作组起病年龄低于单相抑郁症组(P0.05);治疗前双相障碍抑郁发作组和单相抑郁症组血清T3水平高于对照组,TSH、BDNF水平低于对照组(P0.05),双相障碍抑郁发作组血清T4水平高于对照组,单相抑郁症组和对照组血清T4水平比较差异无统计学意义(P0.05),双相障碍抑郁发作组血清T4水平高于单相抑郁症组,TSH、BDNF水平低于单相抑郁症组(P0.05);治疗后双相障碍抑郁发作组和单相抑郁症组血清T4水平低于对照组,双相障碍抑郁发作组血清T4水平低于单相抑郁症组(P0.05),且三组血清T3、TSH、BDNF水平比较差异无统计学意义(P0.05);治疗后双相障碍抑郁发作组认知障碍因子评分低于单相抑郁症组(P0.05);Spearman相关分析显示,血清T3、T4、TSH水平和HAMD评分与BDNF呈负相关,TSH水平与BDNF呈正相关(P0.05)。结论:抑郁症患者血清T3、T4、TSH和BDNF水平存在异常,可作为判断双相障碍抑郁发作及单相抑郁症的指标。     

Red cell adenylate kinase phenotypes in the affective disorders

Summary The red cell adenylate kinase (AK) phenotype was determined by starch gel electrophoresis in 96 adult Caucasian subjects with affective disorders (24 with bipolar illness and 72 with unipolar illness). The phenotype frequencies and the gene frequencies of the bipolar group closely resembled that of the control subjects (180 subjects drawn from the population of a large institution for the mentally retarded), the unipolar group however, showed a significant increase in the frequency of the AK² allele.The significance of these results have been discussed in relation to the known genetic and biochemical findings in the affective disorders. It is suggested that the mechanism involved may be a reduction of the enzyme activity in the tissues of subjects with the AK 2:1 phenotype. This may present a selective disadvantage in the form of a decrease in control of energy metabolism in general, and control of adenine nucleotide levels in nervous tissue in particular.     

No association of red cell adenylate kinase phenotypes with affective disorders

Summary Red cell adenylate kinase (AK) phenotypes were studied in 195 patients with affective disorders (41 with the bipolar and 81 with the unipolar form of the disease) and 418 controls. No significant differences were found between patients and controls and between patients with different types of affective disorders. Thus the previous observation by Rundle et al. (1977) showing an increased frequency of the AK² allele in the unipolar group was not confirmed.     

HLA antigens and affective disorders

A total of 168 patients with different types of affective disorders were examined with respect to their HLA antigens. The frequency of the A10 antigen was found to be increased in the patients particularly in those with the unipolar type of disease. The frequency of the A1 antigen was decreased among unipolar patients. A decreased frequency of the B7 antigen was found in the total material of patients, and in particular in those with a bipolar type of disease. Our results were in disagreement with findings by other investigators. So far there is no conclusive evidence for association between any HLA antigen and affective disorders.     

Level of Thyroid-Stimulating Hormone (TSH) in Patients with Acute Schizophrenia,Unipolar Depression or Bipolar Disorder

The aim of this study is to investigate differences in thyroid-stimulating hormone (TSH) level in patients with acute schizophrenia, unipolar depression, bipolar depression and bipolar mania. Serum level of TSH was measured in 1,685 Caucasian patients (1,064 women, 63.1 %; mean age 46.4). Mean serum TSH concentration was: schizophrenia (n = 769) 1.71 μIU/mL, unipolar depression (n = 651) 1.63 μIU/mL, bipolar disorder (n = 264) 1.86 μIU/mL, bipolar depression (n = 203) 2.00 μIU/mL, bipolar mania (n = 61) 1.38 μIU/mL (H = 11.58, p = 0.009). Depending on the normal range used, the overall rate of being above or below the normal range was 7.9–22.3 % for schizophrenia, 13.9–26.0 % for unipolar depression, 10.8–27.6 % for bipolar disorder, 12.2–28.5 % for bipolar depression, and 11.4–24.5 % for bipolar mania. We have also found differences in TSH levels between the age groups (≤20, >20 years and ≤40, >40 years and ≤60 years and >60 years). TSH level was negatively correlated with age (r = ? 0.23, p < 0.001). Weak correlations with age have been found in the schizophrenia (r = ? 0.21, p < 0.001), unipolar depression (r = ? 0.23, p < 0.001), bipolar depression (r = ? 0.25, p = 0.002) and bipolar disorder (r = ? 0.21, p = 0.005) groups. Our results confirm that there may be a higher prevalence of thyroid dysfunctions in patients with mood disorders (both unipolar and bipolar) and that these two diagnostic groups differ in terms of direction and frequency of thyroid dysfunctions.     

Affective Disorders among Patients with Borderline Personality Disorder

Background

The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders.

Methods

In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773), we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043) had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636). Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice.

Results

More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders.

Conclusions

The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than disorders in the unipolar spectrum. This association may reflect an etiological relationship or diagnostic overlapping criteria.     

黔南布依族、苗族和水族人群ABO血型分布及基因频率

本文对黔南州布依族、苗族、水族人群ABO血型的表现型及基因型频率进行检测。结果显示:黔南布依族ABO血型分布为O>B>A>AB;苗族、水族为O>A>B>AB。3个民族ABO血型基因频率相接近;经吻合度检测,符合Hardy-Weinberg平衡定律。黔南与黔东南、黔西南布依族和苗族群体间以及黔南水族男女群体间ABO血型分布差异均具有显著性(P<0.05或P<0.01),结果提示ABO血型分布存在民族、地区和性别差异。     

Increased sensitivity of dopamine receptors and recurrence of affective psychosis after childbirth.

OBJECTIVE--To test the hypothesis that affective psychosis after childbirth is associated with an altered sensitivity to dopaminergic stimulation. DESIGN--Prospective study of pregnant women at high risk of developing an affective psychosis after childbirth. Clinical assessments in pregnancy and after delivery were made by using a semistructured interview (schedule for affective disorders and schizophrenia) and psychiatric illnesses were categorised according to operational criteria (research diagnostic criteria). SETTING--Obstetric and psychiatric departments in and around Greater London. SUBJECTS--29 pregnant women with a history of bipolar or schizoaffective psychosis and 47 control pregnant women. Of these, 16 from each group participated in a growth hormone challenge test and the results for 15 women in each group were analysed. INTERVENTIONS--On the fourth day postpartum women participating in the hormone challenge test were given a subcutaneous injection of a small dose (0.005 mg/kg) of the dopamine agonist apomorphine. MAIN OUTCOME MEASURES--Growth hormone secretion in response to apomorphine as an index of the functional state of hypothalamic dopamine receptors. RESULTS--Eight of the 15 women at risk of psychosis subsequently had a recurrence of illness (five bipolar, one schizomanic, and two major depressive illnesses); these women had significantly greater growth hormone responses to apomorphine than the seven at risk women who remained well and the 15 controls, and there were no significant differences between groups in average baseline growth hormone concentrations. The mean (SD) concentrations for women with recurrence, women at risk who remained well, and control women respectively were: average baseline concentrations 1.06 (1.14), 1.44 (1.39), and 0.90 (1.34) mU/l; peak increase in concentrations 13.68 (12.95), 3.46 (4.68), and 3.40 (3.83) mU/l (between group difference p less than 0.05); average increase in concentrations 6.74 (7.01), 1.78 (3.39), and 1.40 (2.05) mU/l (p less than 0.05). CONCLUSIONS--The onset of affective psychosis after childbirth was associated with increased sensitivity of dopamine receptors in the hypothalamus and possibly elsewhere in the brain. Such changes may be triggered by the sharp fall in circulating oestrogen concentrations after delivery.     

Allele polymorphism of the dopamine transporter gene in patients with endogenous psychoses: Association with pathological syndromes

A study was made of the association of the allele polymorphism of the 3′VNTR locus of the dopamine transporter (DAT) gene with schizophrenia, schizo-affective psychosis, and affective disorders. Three alleles (440, 480, and 520 nt) were found and the allele and genotype frequencies estimated in all groups. The allele and genotype frequencies in patients with depression significantly differed from those in controls and in patients with bipolar affective psychosis and schizophrenia. The results were correlated with the averaged MMPI profiles of controls and affective patients. In the latter group, 480/480 homozygotes significantly differed from patients with the other genotypes in the mean score on Hypochondria and Hysteria scales. The possible association of the DAT-3′VNTR polymorphism and individual syndromes, which are related to different mechanisms of psychological defense, is discussed.     

载脂蛋白E基因多态性检测对ACS患者降脂疗效的影响

目的:探究载脂蛋白E(ApoE)基因多态性检测在急性冠脉综合征(ACS)患者降脂治疗的中应用价值。方法:选取2019年2月~2020年6月180例ACS患者,采用随机数字表法分为A、B、C共3组各60例,各组患者均接受ApoE基因多态性检测,并根据Sanger法测序判断ApoE基因表型(E2、E3、E4表型),A组予以瑞舒伐他汀口服(10 mg/d),B组予以瑞舒伐他汀强化治疗(20 mg/d),C组予以瑞舒伐他汀(10 mg/d)+依折麦布(10 mg/d)口服,连续治疗1个月,评价3组各基因表型血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)]改善情况、LDL-C达标率,记录药物副反应,所有患者随访1个月,统计心血管不良事件(MACE)发生情况。结果:3组ApoE基因E2、E3、E4表型构成比无显著差异(P>0.05)。治疗后,各组不同ApoE基因表型TC、TG、LDL-C水平均较治疗前下降,且变化率比较差异有统计学意义(P<0.05),表现为E2型>E3型>E4型;其中,3组E2表型TC、TG、LDL-C水平变化率无显著差异(P>0.05);B组、C组E3表型TC、TG、LDL-C水平变化率均显著高于A组(P<0.05),但B组、C组各指标变化率比较差异无统计学意义(P>0.05);3组E4表型TC、TG、LDL-C水平变化率比较差异有统计学意义(P<0.05),且表现为C组>B组>A组。治疗后,A组LDL-C达标率为61.67%,显著低于B组的85.00%、C组的90.00%(P<0.05);其中,3组E2表型LDL-C达标率比较无显著差异(P>0.05),A组E3表型LDL-C达标率显著低于B组、C组(P<0.05),A组、B组E4表型LDL-C达标率低于C组(P<0.05)。治疗期间,仅B组出现1例ALT超出正常上限3倍,停药后可恢复正常。3组MACE发生率比较差异有统计学意义(P<0.05),表现为A组发生率18.33%明显高于B组5.00%、C组3.33%(P<0.05),但3组E2、E4型MACE发生率均无明显差异(P>0.05),而A组E3型MACE发生率高于B组、C组(P<0.05)。结论:ACS患者降脂疗效与ApoE基因表型有关,对E2表型单用瑞舒伐他汀即可取得良好降脂效果,对E3表型强化瑞舒伐他汀或联合依折麦布治疗较单用瑞舒伐他汀均能提高降脂效果,而对E4表型联合依折麦布降脂效果优于单用瑞舒伐他汀或强化治疗。     

Trace elements in bipolar disorder

IntroductionTrace elements may play an important role in bipolar disorders. The objective of this study is to determine serum copper and zinc, blood lead and cadmium and urine lead, cadmium and thallium concentrations in patients diagnosed with bipolar disorders and to compare these levels with those of a healthy control group.Materials and methodsA total of 25 patients diagnosed with bipolar disorder and 29 healthy subjects participated in this study. Serum copper and zinc concentrations were measured using flame atomic absorption spectrometry; the blood lead and cadmium concentrations were measured by electrothermal atomization atomic absorption spectrometry with Zeeman background correction; urine lead, cadmium and thallium concentrations were measured by inductively coupled plasma mass spectrometry.ResultsMedian blood and urine lead and cadmium levels were significantly higher among the bipolar patients than among the control group: Blood lead (μg/dL): patient median: 3.00 (IQR: 1.40–4.20); control median (μg/dL): 2.20 (IQR: 0.90–3.00) p = 0.040. Blood cadmium (μg/L): patient median: 0.39 (IQR: 0.10–1.15); control median: 0.10 (IQR: 0.10–0.17) p < 0.001. The median of cadmium (μg/L) in patients who smoked (1.20 IQR: 0.44–2.30) was higher than that in non-smokers (0.12 IQR: 0.10–0.34) p < 0.001. There was a statistically significant increase (p = 0.001) in zinc levels among patients in the manic phase (mean 111.28, SD: 33.36 μg/dL) with respect to the control group (mean 86.07, SD: 12.39 μg/dL).ConclusionsThe results suggest that there could be higher levels of some toxic trace elements in the group of patients with bipolar disorder than in the healthy control group.     

Unipolar and bipolar electrogram characteristics of recurrent cases of idiopathic ventricular arrhythmias undergoing repeat catheter ablation

IntroductionActivation mapping guided catheter ablation (CA) of ventricular arrhythmias (VAs) is limited in some cases when it is only relied on bipolar electrogram (EGM). We hypothesized that activation mapping with use of combined bipolar and unipolar EGM facilitates to identify the focal origin of VAs and results in reduction of recurrence rate of CA of VAs.MethodsWe analyzed the data of patients undergoing repeat ablations for idiopathic out-flow tract VAs. The EGM of the 1 st and 2 nd ablations were compared for earliest local activation time (LAT), presence of discrete potentials, and polarity reversal, unipolar potential morphology (QS or non-QS), potential amplitude and activation slope.ResultsThirty-seven patients were included. The Local activation time was significantly earlier in the 2nd ablation as compared to the 1st procedure (36.90 msec vs 31.85 msec, P < 0.01). The incidence of discrete potentials and polarity reversal were similar in both procedures (51% vs 57%, P = 0.8 and 62% in both the occasions, respectively). The unipolar voltage was similar in both occasions (6.94 mV vs 7.22 mV in repeat ablations, P = 0.7). The recurrence rate (5.7%) was significantly lower with routine use of combined unipolar and bipolar EGMs, as compared to the use of bipolar EGM alone (16.7%)ConclusionsUse of both bipolar and unipolar electrograms helps in better delineation of the sites of earliest activation for effective ablation of VAs. Use of unipolar electrograms in addition to bipolar electrograms is associated with lower long term recurrence rate.     

Clinical correlates of chronotypes in young persons with mental disorders

While important changes in circadian rhythms take place during adolescence and young adulthood, it is unclear how circadian profiles during this period relate to emerging mental disorders. This study aimed to: (i) characterise morningness–eveningness preference in young people with primary anxiety, depression, bipolar or psychotic disorders as compared to healthy controls, and (ii) to investigate associations between morningness–eveningness preference and the severity of psychiatric symptoms. Four hundred and ninety-six males and females aged between 12 and 30 years were divided into five groups according to primary diagnosis. The Hamilton Depression Rating Scale and the Brief Psychiatric Rating Scale were administered by a research psychologist and participants completed the Kessler Psychological Distress Scale and the Horne–Östberg Morningness–Eveningness Questionnaire (ME). ME scores were significantly lower (i.e. higher levels of “eveningness”) in all patient diagnosis subgroups compared to the control group. The psychosis group had higher ME scores than the depression and anxiety groups. Compared to the control group, the anxiety, depression and bipolar subgroups had a significantly higher proportion of “moderate evening” types, with a similar trend for the psychosis group. The proportion of “extreme evening” types was significantly higher in the anxiety and depression subgroups than in the control group. Lower ME scores correlated with worse psychological distress in males from the bipolar group. Lower ME scores correlated with higher depression severity in females with depression and in males with bipolar disorder. These results suggest that young persons with various mental disorders, especially those with affective disorders, present with a stronger “eveningness” preference and higher rates of evening chronotypes than healthy controls from the same age group. Later chronotypes were generally associated with worse psychological distress and symptoms severity. These associations were modulated by sex and primary diagnosis.     

Resting-state EEG source localization and functional connectivity in schizophrenia-like psychosis of epilepsy

Background

It is unclear whether, like in schizophrenia, psychosis-related disruption in connectivity between certain regions, as an index of intrinsic functional disintegration, occurs in schizophrenia-like psychosis of epilepsy (SLPE). In this study, we sought to determine abnormal patterns of resting-state EEG oscillations and functional connectivity in patients with SLPE, compared with nonpsychotic epilepsy patients, and to assess correlations with psychopathological deficits.

Methodology/Principal Findings

Resting EEG was recorded in 21 patients with focal epilepsy and SLPE and in 21 clinically-matched non-psychotic epilepsy controls. Source current density and functional connectivity were determined using eLORETA software. For connectivity analysis, a novel nonlinear connectivity measure called “lagged phase synchronization” was used. We found increased theta oscillations in regions involved in the default mode network (DMN), namely the medial and lateral parietal cortex bilaterally in the psychotic patients relative to their nonpsychotic counterparts. In addition, patients with psychosis had increased beta temporo-prefrontal connectivity in the hemisphere with predominant seizure focus. This functional connectivity in temporo-prefrontal circuits correlated with positive symptoms. Additionally, there was increased interhemispheric phase synchronization between the auditory cortex of the affected temporal lobe and the Broca''s area correlating with auditory hallucination scores.

Conclusions/Significance

In addition to dysfunction of parietal regions that are part of the DMN, resting-state disrupted connectivity of the medial temporal cortex with prefrontal areas that are either involved in the DMN or implicated in psychopathological dysfunction may be critical to schizophrenia-like psychosis, especially in individuals with temporal lobe epilepsy. This suggests that DMN deficits might be a core neurobiological feature of the disorder, and that abnormalities in theta oscillations and beta phase synchronization represent the underlying neural activity.     

Identification of sialyltransferase 8B as a generalized susceptibility gene for psychotic and mood disorders on chromosome 15q25-26

We previously identified a significant bipolar spectrum disorder linkage peak on 15q25-26 using 35 extended families with a broad clinical phenotype, including bipolar disorder (types I and II), recurrent unipolar depression and schizoaffective disorder. However, the specific gene(s) contributing to this signal had not been identified. By a fine mapping association study in an Australian case-control cohort (n?=?385), we find that the sialyltransferase 8B (ST8SIA2) gene, coding for an enzyme that glycosylates proteins involved in neuronal plasticity which has previously shown association to both schizophrenia and autism, is associated with increased risk to bipolar spectrum disorder. Nominal single point association was observed with SNPs in ST8SIA2 (rs4586379, P?=?0.0043; rs2168351, P?=?0.0045), and a specific risk haplotype was identified (frequency: bipolar vs controls?=?0.41 vs 0.31; χ(2)?=?6.46, P?=?0.011, OR?=?1.47). Over-representation of the specific risk haplotype was also observed in an Australian schizophrenia case-control cohort (n?=?256) (χ(2)?=?8.41, P?=?0.004, OR?=?1.82). Using GWAS data from the NIMH bipolar disorder (n?=?2055) and NIMH schizophrenia (n?=?2550) cohorts, the equivalent haplotype was significantly over-represented in bipolar disorder (χ(2)?=?5.91, P?=?0.015, OR?=?1.29), with the same direction of effect in schizophrenia, albeit non-significant (χ(2)?=?2.3, P?=?0.129, OR?=?1.09). We demonstrate marked down-regulation of ST8SIA2 gene expression across human brain development and show a significant haplotype×diagnosis effect on ST8SIA2 mRNA levels in adult cortex (ANOVA: F(1,87)?=?6.031, P?=?0.016). These findings suggest that variation the ST8SIA2 gene is associated with increased risk to mental illness, acting to restrict neuronal plasticity and disrupt early neuronal network formation, rendering the developing and adult brain more vulnerable to secondary genetic or environmental insults.     

Alterations in kynurenine precursor and product levels in schizophrenia and bipolar disorder

Increased concentrations of kynurenine pathway metabolites have been reported by several groups for disorders involving psychosis, including schizophrenia and bipolar disorder. To identify components of the pathway that may be relevant as biomarkers or may underlie the etiology of psychosis, it is essential to characterize the extent of kynurenine pathway activation and to investigate known regulators of one of the key kynurenine-producing enzymes, tryptophan 2,3-dioxygenase (TDO2), previously shown in this laboratory to be increased commensurate with kynurenine in postmortem anterior cingulate brain tissue from individuals with schizophrenia. Using this same anterior cingulate sample set from individuals with schizophrenia, bipolar disorder, depression and controls (N=12-14 per group), we measured the precursor of kynurenine and two downstream products. The precursor, tryptophan, was significantly increased only in the schizophrenia group (1.54-fold the mean control value, p=0.02), and through substrate-induced activation, may be one cause of the increased kynurenine and kynurenine metabolites. This finding for tryptophan differs from some, but not all, previous reports and methodological reasons for the discrepancies are discussed. A product of kynurenine metabolism, 3-OH-anthranilic acid was also significantly increased only in the schizophrenia group (1.68-fold the mean control value, p=0.03). 3-OH-anthranilic acid is a reactive species with cytotoxic properties, although the threshold for such effects is not known for neurons. Analysis of major pre- and post-mortem variables showed that none were confounding for these between-group experimental comparisons. Nicotinamide, a pathway end product, did not differ between groups but was associated with cause of death (suicide) within the bipolar group (p=0.03).     

全髋关节置换术与双极人工股骨头置换术治疗老年股骨颈骨折的临床疗效

目的：探讨全髋关节置换术（THA）与双极人工股骨头置换术（BHA）治疗老年股骨颈骨折的临床疗效。方法：选择2013 年7 月-2015 年3 月我院收治的老年股骨颈骨折患者90 例,根据手术方法不同将患者分为全髋关节置换组（THA 组）和双极人工股 骨头置换组（BHA 组）,每组45 例。观察并比较两组患者的手术时间、术中出血量、住院时间、术后并发症的发生率及手术效果。结 果：两组患者的手术时间、术中出血量及住院时间比较,差异无统计学意义（P>0.05）;THA 组并发症的发生率明显低于BHA 组, 差异具有统计学意义（P<0.05）;术后1 年,两组手术优良率比较,差异无统计学意义（P>0.05）;术后两年及三年,THA 组手术优良 率明显高于BHA 组,差异具有统计学意义（P<0.05）。结论：THA和BHA 治疗老年股骨颈骨折均具有良好的临床疗效,但THA具 有更好的远期疗效,而且术后并发症的发生率较低。