Objective:To study the cognitive effects of ziprasidone with female schizophrenia.Methods:A total of 60 female patients with schizophrenia,who were up to standard of CCMD-3,were randomly assigned to ziprasidone group(n=60) for 8 weeks.The dosage of ziprasidone was 40mg/day to 160mg/day.To make positive and negative syndrome scale(PANSS),as well as exploratory eye movement(EEM),cancellation test(CT),wisconsin card sorting test(WCST),before and after the cure of 8 weeks.All the datum was put into spss17.0 to dispose.Results: After treatment eye fixations(NEF)increased but had no statistic meaning,RSS increased(P=0.01),D decreased(p=0.008);the total score of CT was increased(P=0.0001);in WCST,CC,RC,RCP increased(P0.05),RE decreased(P0.05),RFP increased(P0.01),RP,RPE,RPEP decreased(P0.01).After 8 weeks,PSP and PANSS score increased(P=0.000).Conclusions: ziprasidone is effective in the treatment of schizophrenia,and more effective with the cognitive of schizophrenia also.

[Objective]To explore the infectious situation of HBV and HCV for inpatients with psychosis and provide the data for prevention and control of heapititis B and C in hospital.[Methods]From June,2003 to June,2005,3 896 inpatients in Shandong Mental Health Center and 4 191 normal controls were involved in this study.ELISA was used to test HBsAg,anti-HBs,HBeAg,anti-HBe,anti-HBc,and anti-HCV for the subjects.The subjects whose anti-HCV was positive were retested for amount of virus.[Results]The infectious rate of HBV in 3 896 inpatients with psychosis was 60.99%,that of 4 191 normal persons was 44.35%(P0.01);The infectious rate of HCV in the inpatients with psychosis was 0.82%,that of the normal control group was 0.45%(P0.05);The infectious rate of 3 108 Schizophrena for HBV and HCV were 60.55% and 0.80% respectively,and those of patients with other mental disorders were 62.69% and 0.89%(P0.05).In 3 896 inpatients,the rate of the model with HBsAg,HBeAg and anti-HBc positive was 4.96%,the rate of the model with HBsAg,anti-HBe and anti-HBc positive was 4.70%,the rate of the model with HBsAg and anti-HBc positive was 3.99%,the positive rate of both anti-HBs and anti-HBc positive was 22.23%,the positive rate of anti-HBc positive was 12.73%,the rate of the model with anti-HBs,anti-HBe and anti-HBc positive was 9.03%,the positive rate of anti-HBe and anti-HBc was 3.31%,the positive rate of anti-HCV was 0.77%,the rates of anti-HBs and anti-HCV,anti-HBc and anti-HCV were all 0.03%.[Conclusion]The infection rate of HBV and HCV in the patients with psychosis were higher.

病理性半醒状态是一种特殊的睡眠后的觉醒障碍,是精神病司法鉴定中较为罕见的例外状态之一,多发生于过度疲劳、长期睡眠不足、大量饮酒、噩梦、激情状态、不愉快体验等情况下出现一种异常的深睡眠后的觉醒过程[1].均伴有意识障碍,有的出现幻觉、妄想、残留梦境以及强烈的惊恐反应而发生冲动伤人或凶杀行为,清醒后对其行为过程不能完整回忆.此病很少引起医务工作者的注意.作者遇到3例,现报道如下.

目的:探讨阿尔茨海默病与老年精神分裂症患者P300的差异及P300在阿尔茨海默病患者认知功能障碍严重程度判断中的价值.方法:采用电生理技术检测2000-12/2003-12山东省精神卫生中心住院及门诊阿尔茨海默病患者38例及老年精神分裂症患者40例的P300.应用简明精神状态量表评定阿尔茨海默病患者的认知功能.结果:阿尔茨海默病患者P300检测结果中在Fz[(402.50±3.77)ms]、Cz[(425 81±1.90)ms]和Pz[(366.31±1.61)ms]3点P300潜伏期与老年精神分裂症患者相比均明显延长,差异有显著性(t=4.23,2.79,4.56;P均＜0 01);在Fz[(5.05±0.65)μV]、Cz[(3.93±0.56 pV]和Pz[(7.97±0.73)μV] 3点波幅明显减低,与老年精神分裂症患者比较,差异有显著性(t=4.02,3.75,2.85;P均＜0.01).阿尔茨海默病患者P300在Fz,Cz及Pz3点潜伏期与简明精神状态量表分数显著负相关(r=-0.78,-0.76,-0.77,P均＜0.01);在Fz,Cz及Pz 3点波幅与简明精神状态量表分数显著正相关(r=0.77,0.78,0.75;P均＜0.01).结论:阿尔茨海默病患者P300在Fz、Cz与Pz3点潜伏期延长及波峰减低的现象与老年精神分裂症患者的差异以及与简明精神状态量表分数的关系,有助于对阿尔茨海默病患者认知功能受损程度的判断.

例1男性,65岁.以胸骨后闷压感、伴阵发性疼痛及上腹饱胀20余天于2002年3月就诊.心电图示慢性冠状动脉供血不足,以缺血性心脏病、不稳定心绞痛收住院.既往有糖尿病史.查体:老年男性,神志清,活动自如,两锁骨上未及淋巴结,血压130/80 mm Hg,心率74次/min,律整,心音低钝,各瓣膜区未闻及杂音,双肺呼吸音清.

我们在临床心电图工作多年中,遇到多例AMI患者的不典型心电图表现,由于诊断问题延误了最佳治疗时间.现结合临床表现复习文献将AMI的不典型心电图表现分述如下.

患者,男,48岁,既往体健.因精神失常二十余年,又兴奋话多、言语零乱二个月第二次入本院治疗,诊断躁狂症.