共查询到20条相似文献,搜索用时 109 毫秒
1.
精神专科医院门诊抑郁症患者就诊影响因素分析 总被引:5,自引:0,他引:5
目的 调查精神专科医院门诊抑郁症患者的就诊特点,探讨影响抑郁症患者及时就诊和选择首次就诊(首诊)医疗机构的因素.方法 选择北京市2所精神专科医院的156例抑郁症患者,采用自编调查表对患者的一般情况、患病及就诊情况进行调查.结果 (1)及时就诊组(发病≤3个月到精神科就诊,61例)与非及时就诊组(发病>3个月到精神科就诊,95例)在对疾病性质的认识、第一主诉、病耻感、首诊医疗机构、就诊途径、花费的医疗费用及抑郁症阳性家族史等的差异有统计学意义(经x<'2>检验,P<0.05或P<0.01);(2)精神专科组(首诊医疗机构选择精神专科,52例)与非精神专科组(首诊医疗机构选择非精神专科,104例)在对疾病性质的认识、第一主诉、抑郁症阳性家族史、花费的医疗费用、婚姻状况、受教育程度等的差异有统计学意义(经X<'2>检验,P<0.05或P<0.01);(3)以患者首诊医疗机构作为因变量,将以上项目作为自变量进行Logistic回归,第一主诉、疾病性质的认识进入回归方程,各变量比值比分别为6.379和2.714.结论 (1)对疾病性质的认识、第一主诉、病耻感、就诊途径、首诊医疗机构的选择、受教育程度、抑郁症阳性家族史等因素,对抑郁症患者能否及时就诊有较大影响;(2)对疾病性质的认识、第一主诉、抑郁症阳性家族史、受教育程度、婚姻状况等因素可影响抑郁症患者对首诊医疗机构的选择. 相似文献
2.
为进一步深化医药卫生体制改革,提高基层精神卫生服务能力,朝阳区充分整合北京市
三级精神专科医院、区域内三级综合医院精神心理科及区域内精神专科医疗机构等市区两级精神卫生
资源,成立区域内精神卫生医联体。凝聚北京市内的优质专家资源,成立朝阳区精神医学联络会诊中心,
提供高水平的专业技术支撑。在辖区内所有社区医疗机构设置精神科,为患者提供方便可及的精神科
专业诊疗服务,同时带动社区精神卫生专业人才队伍培养。 相似文献
3.
4.
在我国,精神卫生社会工作随着精神疾病的演变而需求量增多,部分精神卫生医疗机构
设置了社工部并配置专业人员,而明确社会工作者在精神卫生医疗机构中的职能十分必要。现对国内
外精神卫生医疗机构社会工作者职能的研究进行综述,总结出主要职能有疾病预防、心理社会评估、心理
支持、危机干预、寻找社会资源等,为我国精神卫生领域社会工作管理人员和临床社会工作者提供参考。 相似文献
5.
目的 了解城区一级医疗机构(社区卫生服务中心)中医务人员的精神卫生知识水平,为在一级医疗机构中设置心理咨询专科作可行性的研究。方法 选取三所社区卫生服务中心(其中A院已经设立心理咨询专科6年;B、C院未设,但B院曾协助市精神卫生中心进行专项调研)在岗医务人员进行随机独立问卷调查,内容主要以患者向医务人员提出需了解的精神卫生知识,常见精神疾病的诊断和处理原则。以多选题和是非题的形式解答,解答对象不记名,但记录从医年限、职称、专业科室、精神卫生知识是接受培训还是自学获得。对问卷按掌握、基本掌握、熟悉、了解、基本不了解分成五类。结果A院中医务人员掌握、基本掌握和熟悉精神卫生知识的占81.39%,了解占9.30%,基本不了解仅2.33%。B院中掌握、基本掌握和熟悉精神卫生知识的占32.00%,了解占38.00%,基本不了解30.00%。C院掌握、基本掌握和熟悉精神卫生知识的占8.89%,了解占44.44%,基本不了解46.67%;但已经开设心理咨询专科门诊A院的高、中级人员都达到基本掌握和熟悉程度。工作年限、专业与掌握和了解精神卫生知识无显著关系。结论 在社区卫生服务中心设置心理咨询专科门诊服务是切实可行的,对充实一级医疗机构中医务人员的业务知识结构,完善社区卫生服务中心的功能有明显作用 相似文献
6.
7.
精神分裂症患者家属普遍存在各种心理问题,从而不同程度地影响着他们的生活质量和社会功能,同时心理健康状况也影响到患者的康复。精神分裂症患者家属的心理问题及其干预对策己经引起了一些业内人士,尤其是精神专科医护人员的重视。 相似文献
8.
目的调查截止2013年底止,上海市24家精神卫生专业机构医生队伍现状及未来需求,以便为更好地实施精神科住院医师规范化培训项目提供科学依据。方法采用问卷调查方法,对上海市24家公立精神卫生专业机构进行问卷调查和个别深入访谈、核实,内容包括床位数量、医生数量、职称情况、需求情况等。结果 24家专科医院实际开放床位13159张,医生数为1046人,床位数与医生数之比为12.58:1;其中具有中、高级职称的医师609人;住院医师323人;各类其他医师114人。最近四年共招录住院医师规范化培训生171人,未来3年在不包括综合性医院的精神(心理)科及其他民营精神专科医疗机构的实际需求下,上海市各级精神卫生医疗机构精神科医师需求则为331人。结论上海市精神科医生供需矛盾突出,职称结构不合理。 相似文献
9.
目的 对比分析2012年及2017年成都市精神卫生资源,了解成都市精神卫生医疗机构建设发展的现状和问题,为制定下一步精神卫生体系、人力和服务发展规划提供参考。 方法 于2018年1月-3月,采用成都市精神卫生资源调查表对2017年成都市行政区域内精神卫生医疗机构的床位、人力资源、业务开展情况等进行调查。 结果 2017年成都市实有开设精神科并开展业务的医疗机构共60家,编制床位数4 503张,床位密度3.14张/万人,分别较2012年增长了43.73%、17.60%;实有床位数9 647张,床位密度为6.65张/万人,分别较2012年增长了82.09%、47.12%。2017年成都市精神卫生医疗机构有精神科医生677人(4.71人/每10万人)、精神科护士1 511人(10.53人/每10万人),分别较2012年增长了2.17%、5.94%。2017年成都市精神科共接收门诊患者792 874人次,住院患者43 981人次,分别较2012年增长了76.09%、78.08%。平均每名精神科医生年负担门诊患者1 171人次、住院患者65人次,分别较2012年增长了40.75%、41.30%。 结论 与2012年相比,2017年成都市的精神卫生医疗机构数量急增;精神科开放床位数量已可以满足中等需求,精神科医疗服务量明显增加,但精神科医护人员并无明显增长。 相似文献
10.
精神分裂症患者家属普遍存在各种心理问题,不同程度地影响着他们的生活质量和社会功能。患者家属的心理问题及其干预对策已经引起了一些业内人士,尤其是精神专科医护人员的重视。 相似文献
11.
Late-onset Alzheimer's disease (LOAD) is an age-related neurodegenerative disorder characterized by gradual loss of synapses and neurons, but its pathogenesis remains to be clarified. Neurons live in an environment constituted by neurons themselves and glial cells. In this review, we propose that the neuronal degeneration in the AD brain is partially caused by diverse environmental factors. We first discuss various environmental stresses and the corresponding responses at different levels. Then we propose some mechanisms underlying the specific pathological changes, in particular, hypothalamic-pituitary adrenal axis dysfunction at the systemic level; cerebrovascular dysfunction, metal toxicity, glial activation, and Aβ toxicity at the intercellular level; and kinase-phosphatase imbalance and epigenetic modification at the intracellular level. Finally, we discuss the possibility of developing new strategies for the prevention and treatment of LOAD from the perspective of environmental stress. We conclude that environmental factors play a significant role in the development of LOAD through multiple pathological mechanisms. 相似文献
12.
Zhonghua Liu Shengliang Li Zibin Liang Yan Zhao Yulin Zhang Yaqi Yang Minjuan Wang FengLi 《中国神经再生研究》2013,(33):3095-3106
There are several major pathological changes in Alzheimer's disease, including apoptosis of cho- linergic neurons, overactivity or overexpression of 13-site amyloid precursor protein cleaving enzyme 1 (BACE1) and inflammation. In this study, we synthesized a 19-nt oligonucleotide targeting BACE1, the key enzyme in amyloid beta protein (AI3) production, and introduced it into the pSilenCircle vector to construct a short hairpin (shRNA) expression plasmid against the BACE1 gene. We transfected this vector into C17.2 neural stem cells and primary neural stem cells, resulting in downregulation of the BACE1 gene, which in turn induced a considerable reduction in reducing AI3 protein production. We anticipate that this technique combining cell transplantation and gene ther- apy will open up novel therapeutic avenues for Alzheimer's disease, particularly because it can be used to simultaneously target several pathogenetic changes in the disease. 相似文献
13.
朱逸溪 《神经疾病与精神卫生》2013,13(3):317-321
阿尔茨海默病(AD)是一种隐匿性起病,进行性恶化的神经退行性疾病,临床最初表现为认知功能障碍,并有可能在5~10年内完全衰退。患者往往伴随严重的记忆力丧失、精神行为异常、人格改变、言语功能障碍,无法独立生活,最终近乎于植物状态。Ferri等采用DISMOD软件在全球60岁以上人群中估计,全球的痴呆患者人数到2040年将达到8llO万左右。 相似文献
14.
BACKGROUND: Total saponins of Panax ginseng (TSPG) exhibits neuroprotection against Parkinson's disease in the substantia nigra. OBJECTIVE: To investigate the effects of TSPG on human embryonic neural stem cells (NSCs) proliferation and differentiation into dopaminergic neurons using in vitro studies, and to observe NSC differentiation in a mouse model of Parkinson's disease, as well as behavioral changes before and after transplantation. DESIGN, TIME AND SETTING: In vitro neural cell biology trial and in vivo randomized, controlled animal trial were performed at the Institute of Basic Medical Sciences, Chongqing Medical University between September 2004 and December 2007. MATERIALS: TSPG (purity 〉 95%) was isolated, extracted, and identified by Chongqing Academy of Chinese Materia Medica. Recombinant human basic fibroblast growth factor (bFGF) and recombinant human epidermal growth factor (EGF) were purchased from PeproTech, USA. A total of 25 C57/BL6J mice, aged 18-20 weeks were included. Twenty were used to establish a Parkinson's disease model with i.p. injection of MPTP (1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine) and TSPG alone or combined with interleukin-1 (IL-1)-treated NSCs prior to transplantation into the corpus striatum. The remaining five mice were pretreated for 3 days with TSPG prior to MPTP injection, serving as the TSPG prevention group. METHODS: Primary NSCs were isolated, cultured and purified from embryonic cerebral cortex. Immunocytochemistry was employed to detect specific antigen expression in the NSCs. In vitro experiment: (1) to induce proliferation, NSCs were treated with TSPG, EGF+bFGF, or TSPG+EGF+bFGF, respectively; (2) to induce dopaminergic neuronal differentiation, NSCs were treated with TSPG, IL-1, or TSPG+IL-1, respectively. MAIN OUTCOME MEASURES: In vitro experiment: the effects of TSPG on NSCs proliferation were evaluated with flow cytometry and MTT assay. Tyrosine hydroxylase expression was determined by immunocytochemistry assay to observe effects of TSPG on dopaminergic neuronal differentiation. In vivo experiment: differentiation of grafted NSCs in the mouse brain was determined by immunohistochemical staining. Behavioral changes were evaluated by spontaneous activity frequency, memory function, and score of paralysis agitans. RESULTS: (1) NSCs were cultured and passaged for more than three passages. Immunocytochemistry revealed positive nestin staining, as well as neurofilament protein and glial fibrillary acidic protein. (2) TSPG significantly increased NSC proliferation, in particular when combined with EGF and bFGF, which was twice as effective as FGF or bFGF alone. TSPG also induced dopaminergic differentiation in NSCs, in particular when TSPG was added together with IL-1, resulting in an effect five times greater than that of IL-1 alone. (3) At day 30 following transplantation, most NSCs in the TSPG prevention group differentiated into dopaminergic neurons, and the scores of paralysis agitans, spontaneous activity, and memory function were significantly increased compared with TSPG alone or TSPG+IL-1 groups (P 〈 0.05). CONCLUSION: TSPG stimulated NSC proliferation, in particular when combined with FGF and bFGF. TSPG significantly induced dopaminergic neuronal differentiation of NSCs, and the effect was greater when combined with IL-1. In addition, TSPG greatly improved behavior in the Parkinson's disease mouse model following NSC transplantation. Following NSC transplantation, TSPG pretreatment exhibited superior efficacy over either TSPG alone or TSPG in combination with IL-1, in terms of behavioral improvements in the Parkinson's disease mouse model. 相似文献
15.
Mingshan Wang Lina Zhang Xiangyu Ji Yanwei Yin Hui Xu Hong Liu Nianguo Hou 《中国神经再生研究》2009,4(12):1013-1018
BACKGROUND: Previous studies of cerebral ischemia have used young animals, with an ischemic time greater than 5 minutes (safe time limit). Despite an increased understanding of neuronal apoptosis, it remains uncertain whether brief cerebral ischemic events of 5 minutes or less damage brain tissue in elderly rodents. OBJECTIVE: To investigate the effects of transient cerebral ischemia (5 minutes)/reperfusion injury on brain cortical and hippocampal edema, aquaporin-4 (AQP-4) expression, and neuronal apoptosis in aged rats, and to compare ischemic sensitivity between cortex and hippocampus. DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed at the Institute of Cerebrovascular Disease, Qingdao University Medical School from April 2008 to March 2009. MATERIALS: Rabbit anti-AQP-4 polyclonal antibody, TUNEL kit, and SABC immunohistochemistry kit were purchased from Wuhan Boster Bioengineering, China. METHODS: A total of 160 healthy, male, aged 19-21 months, Wistar rats were randomly assigned to 4 groups: sham-surgery, and ischemia 1-, 3-, and 5-minute groups, with 40 rats in each group. The global cerebral ischemia model was established using the Pusinelli four-vessel occlusion, and the three cerebral ischemia groups were subdivided into reperfusion 12-hour, 1-, 2-, 3-, and 7-day subgroups, with 8 rats in each subgroup. The sham-surgery group was subjected to exposure of the first cervical bilateral alar foramina and bilateral common carotid arteries. MAIN OUTCOME MEASURES: The dry-wet weight assay was used to measure brain water content and histopathology of the cortex and hippocampus was observed following hematoxylin-eosin staining. In addition, cortical and hippocampal AQP-4 expression was detected by streptavidin-biotin complex immunohistochemistry, and neuronal apoptosis was detected by the TUNEL method. RESULTS: There was no significant difference in brain water content or AQP-4 expression in the cortex and hippocampus between ischemia 1- and 3-minute groups and the sham-surgery group or brain water content or AQP-4 expression in the cortex between ischemia 5-minute group and sham-surgery group (P 〉 0.05). However, brain water content and AQP-4 expression in the hippocampus after 5 minutes of cerebral ischemia were significantly increased compared with the sham-surgery group (P 〈 0.05 or P 〈 0.01). Several TUNEL-positive cells were observed in the cortex and hippocampus of the sham-surgery group and ischemia 1-minute group, as well as in the cortex of the ischemia 3-minute group. In addition, the number of apoptotic neurons in the hippocampus of ischemia 3-minute group and in the cortex and hippocampus of ischemia 5-minute group was significantly increased (P 〈 0.05 or P 〈 0.01 ). Neuronal apoptosis was increased after 12 hours of ischemia/reperfusion, and it reached a peak by 2 days (P 〈 0.01). CONCLUSION: Transient cerebral ischemia (5 minutes) resulted in increased hippocampal edema, AQP-4 expression, and neuronal apoptosis. Moreover, cerebral ischemia had a greater effect on neuronal apoptosis than brain edema or AQP-4 expression, and the hippocampus was more sensitive than the cortex. 相似文献
16.
Alzheimer's disease (AD) is the most common type of dementia, comprising an estimated 60-80% of all dementia cases. It is clinically characterized by impairments of memory and other cognitive functions. Previous studies have demonstrated that these impairments are associated with abnormal structural and functional connections among brain regions, leading to a disconnection concept of AD. With the advent of a combination of non-invasive neuroimaging (structural magnetic resonance imaging (MRI), diffusion MRI, and functional MRI) and neurophysiological techniques (electroencephalography and magnetoencephaJography) with graph theoretical analysis, recent studies have shown that patients with AD and mild cognitive impairment (MCI), the prodromal stage of AD, exhibit disrupted topological organization in large-scale brain networks (i.e., connectomics) and that this disruption is significantly correlated with the decline of cognitive functions. In this review, we summarize the recent progress of brain connectomics in AD and MCI, focusing on the changes in the topological organization of large-scale structural and functional brain networks using graph theoretical approaches. Based on the two different perspectives of information segregation and integration, the literature reviewed here suggests that AD and MCI are associated with disrupted segregation and integration in brain networks. Thus, these connectomics studies open up a new window for understanding the pathophysiological mechanisms of AD and demonstrate the potential to uncover imaging biomarkers for clinical diagnosis and treatment evaluation for this disease. 相似文献
17.
高血压脑出血(Hypertensive intrac-rebral hemorrhage,HICH)是具有高发病率、高病死率、高致残率的急性脑血管疾病,占所有脑卒中患者的10%-20%,早期病死率可高达49.4%。随着人口老龄化,其发病率逐年提高;而外科手术的干预,使其病死率有所下降,但致残率居高不下。如何提高手术疗效和患者生存质量,一直是神经外科医师努力的方向。微侵袭血肿清除术因其手术创伤小,恢复快,是目前国内治疗高血压脑出血的重要手段。 相似文献
18.
墨蝶呤还原酶(SPR)催化四氢生物蝶呤(BH4)从头合成途径的最后一步反应。SPR基因遗传缺陷或突变可导致BH。的合成紊乱,影响单胺类神经递质(如多巴胺、5-羟色胺及谷氨酸等)的合成或释放,进而参与包括精神分裂症在内的多种神经精神系统疾病的发生发展过程。此外,SPR基因敲除小鼠表现出持续增强的自主活动等类精神分裂症症状,说明该基因在精神分裂症的发病中扮演重要的角色。进一步研究SPR基因及其单核苷酸多态性的功能,可为阐明精神分裂症的发病机制提供重要的线索,也为新一代抗精神病药物的研制及开发开拓新的视野。现对SPR基因与精神分裂症的相关研究做一综述。 相似文献
19.
目的 探讨神经内镜联合亚低温在治疗高血压基底节区脑出血中的临床应用价值.方法 回顾性分析我院神经内镜治疗高血压基底节区脑出血患者40例的临床资料,并对治疗结果进行分析.结果 神经内镜治疗组22例(甲组),神经内镜联合亚低温治疗组18例(乙组),术后3个月根据GCS评分,甲组恢复良好1例,中残4例,重残6例,植物生存6例,死亡5例;乙组恢复良好4例,中残8例,重残3例,植物生存1例,死亡2例,两组比较差异有统计学意义(P<0.05).两组颅内压比较第1天两者差异不明显,但第2、3天亚低温组颅内压明显降低.结论 神经内镜是治疗高血压基底节区脑出血较为有效的手术方式,联合亚低温治疗能有效降低颅内压,改善术后神经功能恢复,具有较好的临床应用价值. 相似文献
20.
谷胱甘肽过氧化物酶(glutathione peroxidases,GPX)是在哺乳动物中发现的,可通过还原性谷胱甘肽催化还原过氧化物和有机过氧化氢物,从而保护细胞和其他如DNA、蛋白及脂质体等敏感生物分子免受氧自由基的损伤。血浆谷胱甘肽过氧化物酶(GPx-3)是1987年Takahashi等从人的血浆中纯化得到的,是目前已知的GPX家族8个成员中唯一的细胞外亚型。研究发现有多种因素影响GPx-3的表达,并参与了多种疾病的发生、发展,本文就GPx-3的结构、功能、基因表达及其与疾病的关系作一综述。 相似文献