- P209
General Report on Nicotine Dependence and Smoking Cessation in China
Hongqiang Sun 1 , Song Guo 2 , Dafang Chen 3 , Zuoning Jiang 2 , Guangsheng Niu 2 , Junyu Gao 4 , Xiaohui Yang 5 , Dongfeng Zhou 6
1 Beijing Huilongguan Hospital, Teaching hospital of Peking University, Beijing, Chinese Mainland, 2 National Drug Dependence Treatment Center, Beijing Anding Hospital Affiliated Capital University of Medical Sciences, Beijing, Chinese Mainland, 3 Department of Epidemiology and Statistics, Peking University School of Public Health, Beijing, Chinese Mainland, 4 No.307 Hospital,PLA,China, Beijing, Chinese Mainland, 5 Beijing Anzhen Hospital Affiliated Capital University of Medical Sciences, Beijing, Chinese Mainland, 6 Institute of Mental Health ， Peking University, Beijing, Chinese Mainland
Objective: 1.To investigate whether demographic Factors in tobacco smoker affect nicotine craving intensity or not and the clinical significance of expired carbon monoxide(CO) and urine cotinine as means of detecting smoking intensity. 2. To Evaluate the effect of nicotine sublingual tablet on smoking cessation.3.To Explore whether CYP1A1 gene ， NQO1 gene and EPHX113 gene polymorphisms affect nicotine dependence and smoking cessation outcome.
Methods: 230 eligible Chinese participants were divided into treatment and placebo groups randomly in a double-blind status with a 3-month follow-up period. Participants provided smoking history and other demographic information after giving informed consent. A 5 ml blood sample provided for genomic DNA extraction. PCR － RFLP was used to genotype for the presence of gene polymorphism.
Results: The rates for complete abstinence and the rates of reduction (reduce 50% of smoking) at the end of treatment(3 months) for active drug vs. placebo were 52.2 % vs.19.1% and 42.6% vs.14.8% respectively （ P ＝ 0.000 ） .
In multiple linear regression models, nicotine craving of female smokers was less than those of male smokers （ P ＝ 0.045 ） ;Age≥50a （ P ＝ 0.034 ） and Body mass index(BMI) ＞ 25.4 kg ／ m2 （ P ＝ 0.002 ） as well.
The factor associated with CO and urine cotinine was daily cigarettes =26-60/day （ P ＝ 0.00;0.04 ） ; The factor associated with urine cotinine was BMI ＞ 25.4 kg ／ m2 （ P ＝ 0.04 ） . Factors associated with smoking reduction were married and office worker have positive influence on the smoking reduction （ OR ＝ 2.59 ， P ＝ 0.002 ； OR ＝ 2.24 ， P ＝ 0.041 ） . Both NQO1 heterozygous (Pro/Ser187) and homozygous (Ser/Ser187) variant types increase the risk to nicotine dependence. CYP1A1 homozygous variant type(Val/Val) , NQO1 heterozygous and homozygous variant types decreased significantly the efficacy of smoking reduction at the end of 2nd month treatment, and EPHX113 homozygous (His/His) variant type and NQO1 homozygous variant type （ Ser /Ser ） decreased significantly the rate of smoking reduction at the end of 3rd month of treatment.
Conclusions: The nicotine sublingual tables were effective on smoking cessation for Chinese smokers.
Age, sex, daily cigarettes, and BMI were associated with differences in nicotine craving. The daily cigarettes and BMI were associated with differences in CO and urine cotinine. Married and office worker were socio-demographic factors associated with the differences in outcome of smoking cessation attempts. Polymorphism of CYP1A1 gene ， NQO1 gene and EPHX113 gene alter enzyme activity, and subsequently alter individual nicotine metabolic activity, which finally determine the individual differences in smoking cessation and nicotine dependence among the subjects.
Keywords: nicotine dependence, smoking cessation, craving ， administration, sublingual, gene, polymorphism
- P210
男性酒精依 赖患者认知损害的质子波谱研究 - Study of Proton Magnetic Spectroscopy in Cognitive Impairment of Alcohol-dependent Patient
刚 刘 1 , 世平 谢 1 , 俭雄 范 1
1 南京医科大学附属 脑科医院 , 精神科 , 南京 , Chinese Mainland
目的 : 通 过无创性在体研究技术磁共振质子波谱 （ 1H-MRS ）， 检测受试者额叶代谢物质的变化 ， 探讨酒精性认知损害的神经生物学基础。
方法 : 应用 1H-MRS 技 术对 10 例男性酒精依 赖患者 （ 病例组 ） 和 10 例男性正常健康者 （ 对照组 ） 检测额叶氮 - 乙 酰天门冬氨酸 （ NAA ） 、胆碱 复合物 （ CHO ） 、肌酸 / 磷酸肌酸 （ Cr ） 。病例 组入组后进行戒酒，在戒断症状消失后，即最后一次酒精摄入 3 － 7 天内行首次 1H-MRS 扫描；在戒酒 1 月后， 对病例组额叶重复 1H-MRS 。在 每次 进行 1H-MRS 扫描的当天，利用威斯康星卡片分类测试（ WCST ） 对患者组的认知功能进行评定。对照组仅进行一次额叶 1H-MRS 扫描和 WCST 评定。
结果 : 患者 组急性戒酒期额叶 NAA/Cr 与 对照组的差异有统计学意义 (P <0.05) ，而 CHO/Cr 的差异无 统计学意义 (P>0.05); 急性戒酒 组和戒酒一月组前额叶 NAA/Cr 与 对照组的差异有统计学意义 (P <0.05) ，而 CHO/Cr 的差异无 统计学意义 (P>0.05); 急性戒酒 组和戒酒一月组 WCST 评估中完成分类数，错误应答数，持续性错误，概念化水平具有统计学差异 （ P 均 <0.05 ） ; 另外 , 对急性戒 酒 组和戒酒一月后 NAA/Cr 的 变化和 WCST 各指 标变化进行 Spearman 相 关分析，发现右侧灰质 NAA/Cr 的 变化与完成分类数的变化有统计学差异 （ r ＝ 0.7002 ， P<0.05 ）。
结论 : 长期饮酒可改变患者额叶代谢物浓度 ， 并影响其功能 ； 维持戒酒可使前额的神经损伤得到部分恢复 ， 同时额叶执行功能亦得到改善。
关键词 ： 酒精依 赖 认知损害 质子波谱
Background: Proton magnetic resonance spectroscopy may elucidate the molecular underpinnings of alcoholism-associated brain metabolites changes and the progression of alcohol dependence.
Methods: Using proton magnetic resonance spectroscopy, we determined absolute concentrations of N-acetylaspartate (NAA), creatine/phosphocreatine (Cr), and choline (Cho)-containing compounds in the frontal lobe white and grey matter in 10 alcoholics and 10 normal controls. All patients were examined within 3 to 7 days of their last drink. Patients who did not relapse were again studied after 1 months of abstinence.
Result: The NAA/Cr ratio at baseline was significantly lower in patient than in controls (left white matter: 1.45±0.38vs2.16±0.40; left grey matter: 1.17±0.11vs1.67±0.33; right white matter: 1.59±0.25vs2.09±0.41; right grey matter: 1.44±0.40 vs 1.56±0.30; all P < 0.05). There were also significantly differences in NAA/Cr ratio between alcoholics underwent short-term sobriety (1-7days) and continuing abstinence (30 days). After abstinence, the changes of NAA/Cr ratio in right grey matter were significantly correlated to the neuropsychological improvement.
Conclusions: Sobriety has marked and early, globally averaged and regionally specific metabolicchanges as well as functional benefits for convalescent alcoholics.
Key words: alcohol dependence ； proton magnetic spectroscopy ；
- P211
海洛因依 赖者 HPA 轴神经内分泌变化 - Dysfunction of the Hypothalamo-Pituitary-Adrenocortical Axis among Heroin Dependent Subjects: Effects of Acute and Protracted Abstinence
Xiaonian Luo 1
1 Beijing Anding Hospital , Beijing , Chinese Mainland
方法 : 采集 强制 与自愿戒毒海洛因依 赖者的血样 ， 经离心后提取血浆或血清用于检测 ： CRH （ corticotrophin-releasing hormone 促 肾上腺皮质激素释放激素 ） 、 ACTH （ adrenocorticotrophic hormone 促 肾上腺皮质激素 ） 和 COR （ cortisol 可的松 ） 。其中 CRH 与 ACTH 采用 RIA (radioimmunity 放射免疫 ) 法 测定， COR 采用 CLIA (chemiluminescent immunoassay 化学 发光免疫 ) 法 测定。强制戒毒组于 急性戒断期，戒断后第 30 与 90 天共 测量三次激素浓度；自愿戒毒组于入院第二天取血；正常对照组亦仅进行一次激素测查。通过问卷评估强制戒毒组的急性戒断症状。
结果 : 1. 共收集 强制戒毒的海洛因依 赖者 30 例（男 23 ，女 7 ），自愿戒毒的海洛因依 赖者 30 例（男 25 ，女 5 ），正常 对照 30 例（男 23 ，女 7 ）。 2. 三 组性别、年龄、文化程度无统计学差异（ p ﹥ 0.05 ）。两 组海洛因依赖者吸毒时间和吸毒量无统计学差异（ p ﹥ 0.05 ）。 3. 强制 组急性戒断期 CRH 低于 对照， COR 相反， ACTH 、与 对照无统计学差异；戒断后第 30 天 CRH 和 COR 恢 复至对照水平， ACTH 无 变化；戒断后第 90 天 CRH 、 ACTH 和 COR 均与 对照无统计学差异。自愿戒毒组 CRH 和 COR 低于 对照， ACTH 与 对照组无统计学差异。
结论 : HPA 轴相关激素的分泌与调节在海洛因依赖及戒断期处于紊乱状态，。虽然上述变化可能并非海洛因依赖所特有 ， 但临床工作者仍需对此提高重视程度。
Aims: Endocrine abnormalities of hypothalamo-pituitary-adrenocortical (HPA) have long been reported in animals and humans, but little is known about the range of hormones affected and findings are inconsistent. This study was to investigate the function of HPA axis in patients with opioid dependence receiving non-opiate treatment (NOT) or methadone treatment (MT) respectively and compare the results with the level in healthy controls (CON).
Methods: Sixty opioid-dependent subjects, half of them received non-opiate treatment, others received methadone treatment. The healthy volunteer was thirty also. The plasma concentration of corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH) and serum concentration of cortisol (COR) of NOT group were measured at acute withdrawal, after 30 days and 90 days. The measures of MT and CON were only one time.
Results: Compared with CON, CRH was lower while COR was higher of acute withdrawal of NOT group. After 30 days of abstinence, plasma concentration of CRH and COR restored to control level. While there was no significant difference of ACTH between these two groups. CRH and COR decreased while ACTH was comparable with control of the MT group.
Conclusions: Chronic opioid dependence induced decrease of the function of HPA axis. These changes returned to normal in 30 days. The data highlight the importance to screen the HPA axis function in clinical practice for individuals with chronic opioid dependence.
Keywords: opioid dependence, HPA axis, CRH, ACTH, cortisol.
- P212
海洛因依 赖者垂体 - 甲状腺 轴变化 - Alteration in Pituitary-thyroid Axis Function among Opioid Dependent Subjects
Xiaonian Luo 1 , Guofu Zhang 1 , Lixia Sheng 1 , Yong Chi 1 , Wanjiu Du 1 , Zuoning Jiang 1 , Yilang Tang 1 , Yanping Ren 1 , Song Guo 1 , Le Xiao 1
1 Beijing Anding Hospital, Beijing, Chinese Mainland
目的 : 通 过对海洛因依赖者及正常对照者的比较 ， 观察海洛因依赖者 PTA (pituitary-thyroid axis 垂体 - 甲状腺 轴 ) 的神 经内分泌变化 ， 发掘能够指导临床实践的线索。
方法 : 采集 强制 与自愿戒毒的海洛因依 赖者的血样 ， 经离心后提取血浆或血清用于检测 ： TSH （ thyroid-stimulating hormone 促甲状腺素 ） 、 FT3 （ free triiodoythyroxine 游离三碘甲状腺原氨酸 ） 和 FT4 （ free thyroxine 游离甲状腺素 ） 。采用 CLIA (chemiluminescent immunoassay 化学 发光免疫 ) 法 测定。强制戒毒组于急性戒断期，戒断后第 30 与 90 天共 测量三次激素浓度；自愿戒毒组于入院第二天取血，这是最接近阿片依赖的状态；正常对照组亦仅进行一次激素测查。通过问卷评估强制戒毒组的戒断症状及社会心理状态。问卷包括：戒断症状量表、可视渴求量表、汉密尔顿焦虑量表（ HAMA-14 项）、生活事件量表、应对方式量表和社会支持量表。
结果 : 1. 共收集 强制戒毒的海洛因依 赖者 30 例（男 23 ，女 7 ），自愿戒毒的海洛因依 赖者 30 例（男 25 ，女 5 ），正常 对照 30 例（男 23 ，女 7 ）。 2. 三 组性别、年龄、文化程度无统计学差异（ p ﹥ 0.05 ）。两 组海洛因依赖者吸毒时间和吸毒量无统计学差异（ p ﹥ 0.05 ）。 3. 强制 组急性戒断期 TSH 低于 对照， FT3 和 FT4 与 对照无统计学差异；戒断后第 30 天 TSH 仍低于 对照，而 FT3 升高， FT4 降低；戒断后第 90 天 TSH 与 对照无统计学差异， FT3 与 FT4 仍分 别处于升高与降低状态。自愿戒毒组 TSH 低于 对照， FT3 和 FT4 与 对照组无统计学差异。
结论 : HPA 轴及 PTA 相 关激素的分泌与调节在海洛因依赖及戒断期处于紊乱状态 ，某些激素恢 复较为缓慢。虽然上述变化可能并非海洛因依赖所特有 ， 但临床工作者仍需对此提高重视程度。
Aims: Endocrine abnormalities of pituitary-thyroid axis (PTA) have long been reported in animals and humans, but little is known about the range of hormones affected and findings are inconsistent. This study was to investigate the change of PTA and the time course of the hormonal alterations in subjects with opioid dependence after abstinence.
Methods: Blood samples from inpatients receiving non-opiate treatment NOT) or methadone treatment (MT) and healthy controls were collected and thyroid hormones were measured using chemiluminescent immunoassay. Hormones NOT group were measured at acute withdrawal, after 30 days and 90 days. The measures of MT and CON were only one time.
Results: (1) In both NOT group (N=30) and MT group (N=26), various numbers of subjects showed abnormal (mostly decreased) hormonal levels; (2) compared with controls (N=30), TSH levels in NOT group decreased significantly in acute withdrawal and this decrease continued up to the 30th day after abstinence; (3) NOT-FT4 also significantly decreased after abstinence, but this only occurred in day 30 and 90, not in acute withdrawal phase; (4) Contrarily, FT3-NOT significantly increased after abstinence, at least for one time-point (day 90), but no change observed in day 2 or day 30; (4) No significant correlations observed between the hormonal levels and the severity of opiate addiction, opioid withdrawal or anxiety symptoms.
Conclusions: PTA function is altered in opioid dependent subjects, and some alterations could last up to three months after abstinence. The data highlight the importance to screen the thyroid function in clinical practice for individuals with chronic opioid dependence.
Keywords: Opioid dependence, withdrawal, thyroid-stimulating hormone, free triiodothyronine, free thyroxine.
- P213
The Effects of Enriched Environment on Morphine Induced CPP and the Levels of D2 m RNA in Specific Brain Regions of High Responsive and Low Responsive Rats
卫萍 夏 1 , 刘 铁 桥 1 , 郝 伟 1 , 向 小 军 1 , 王 绪 轶 1
1 中南大学 , 湘雅二医院精神 卫生研究所 , 长沙 , Chinese Mainland
Early age living in enriched environment can influence the sensitivity of rats to several effects of drugs of abuse. The present study investigated the influence of early age housing conditions on the sensitivity of rats to the rewarding effects of morphine using a conditioned place preference procedure and the changing of gene expression of D2 receptor in specific brain regions.
Male rats were screened for locomotor activity in a novel environment and divided into high (HR) and low (LR) responders based on whether their locomotor activity score for the first 10 minutes was on the top third or the bottom third of the locomotor activity for the subject sample. The rats were then housed for 42 days in either an enriched or isolated conditions and in the last 12 days of housing in the different environments, half of them were tested in a morphine induced CPP procedure, then all of them were sacrificed and their brain sections were used for the ISH analysis of D2R mRNA levels in specific brain regions.
These results suggest that rearing rats in enriched conditions induces an attenuation in sensitivity to the rewarding effects of morphine. Associated with behavioral alternations, the expression of the D2R mRNA in the AcbSH and PFC were down regulated in the rats housed in the isolated rats. We found that this long term environmental manipulation exert significant effects on animals' reaction to rewarding effects and this behavioral difference is accompanied by the differential D2 activation in the mesolimbic dopamine system.
- P214
服刑罪犯自 杀 （ 伤 ） 行为调查及其策应 - A Survey aboot Suicide Behavior among Criminals in their Sentence Service
成 荣 吕 1
1 江 苏省监狱管理局精神病院 , 南京 , Chinese Mainland
目的 ： 监狱是国家刑罚执行机构 ， 建立平安监狱是监狱工作的主要目标之一。罪犯自杀行为是严重影响监狱监管安全的行为，更是影响罪犯生命的行为。为进一步了解掌握服刑罪犯中的自杀（伤）行为情况，提出相应的预防、干预对策，降低自杀（伤）行为的发生，开展 相 关的调查研究。
方法： 采用一般情况 调查表及《服刑罪犯自杀（伤）行为调查表》，调查统计 2002 年 6 月 ——2004 年 7 月在押罪犯 145044 人中的自 杀自伤情况。
结果： 自 杀自伤率 0.20% ，其中自 杀死亡 8 例，自 杀死亡率为 5.52/10 万，占自 杀自伤行为的 2.70% ；自 杀未遂 193 例，占 65.52% ；准自 杀 25 例，占 8.45% ；自 伤 70 例，占 23.33% 。自 杀（伤）方式为吞食异物 62 例，占 20.95% ；自 缢 85 例， 28.72% ；割腕 94 例，占 31.76% ；跳楼 33 例，占 11.14% ；其它方式 22 例，占 7.43% 。自 杀（伤）原因：监管改造方面 96 例，占 32.43% ；人 际关系 61 例，占 20.61% ；家庭因素 58 例，占 19.59% ；情 绪方面 31 例，占 10.47% ；其它 50 例，占 16.90% 。自 杀（伤）史：既往有自杀（伤）史者 55 例，占 18.58% ；其中两次以上 15 例。曾有 过精神医学门诊且被诊断为精神障碍 45 例，占 15.20% 。
结论： 由于 监狱管制比较特殊，罪犯心理社会压力较大，人际关系复杂，同时可能缺乏即时的家庭、社会支持，相对来说，其发生自杀、自伤的可能性较大，本资料为 0.20% 。本 资料自杀死亡比例为 5.52/10 万， 显著低于中国总的自杀率为 23/10 万。其原因可能是由于 监管安全防范性能增强及群体生活、劳动，自杀者易被发现并得到及时的处理。
建立罪犯 预防自杀研究机构、建立罪犯自杀危险性评估体系、普及心理健康知识、普及预防自杀知识、减少自杀工具的获得性、监管特殊措施的采取等措施是建立罪犯自杀行为的评估模式以及自杀行为的预测及干预策略是目前亟待解决的问题之一。
- 215
中国第一 间精神病医院住院病人自杀 50 年分析：一 项病例对照研究 - A Case-Control Study of Suicide among Psychiatric Inpatients in the First Psychiatric Hospital in China
洁 李 1 , 敬 华 苏 2 , 扬波 郭 2 , 元涛 郝 3 , 振 环 赵 1 , 慧 贤 卢 4 , 茂盛 冉 5
1 广州市精神病医院 , 办公室 , 广州市 , Chinese Mainland, 2 广州市精神病医院 , 科教科 , 广州市 , Chinese Mainland, 3 中山大学公共 卫生学院 , 统计与流行病学系 , 广州市 , Chinese Mainland, 4 广州市精神病医院 , 睡眠障碍科 , 广州市 , Chinese Mainland, 5 美国 关岛大学 , 关岛 , United States
目的： 识别精神分裂症住院病人自杀的潜在危险因素，为探讨如何进一步预防住院精神病人的自杀提供依据。
方法： 对中国第一间精神病医院 1956-2005 年住院精神病人自 杀进行回顾性分析，并对其中的精神分裂症病人（自杀组）按同性别、同诊断、相同或相近年龄、住院（对照组）进行 1 ： 1 匹配的病例 对照研究。结果：共有 77 例住院精神病人 发生自杀，自杀发生率 133.1/10 万（ 95%CI103.4-162.85/10 万）。多数自 杀 者 为精神分裂症病人（ 64 例，占 83.1% ），多数自 杀者采取自缢的方式（ 59 例，占 76.6% ），多数病人的自 杀行为发生在病房内（ 52 例，占 67.5% ）； 结果还显示，自杀组的住院次数明显高于对照组（ P=0.001 ）；自 杀组本次住院前 1 月及住院期 间的自杀未遂次数明显高于对照组（ P=0.017 ， 0.003 ）。自 杀组的罪恶观念、心境抑郁明显高于对照组（ P=0.006 ， 0.004 ）；自 杀组本次住院前 1 月及住院期 间的自杀意念、自杀未遂明显均高于对照组（ P 均 < 0.01 ）。 单因素条件性 logistic 回 归分析显示，住院精神 分裂症病人的罪 恶观念、心境抑郁、自杀意念和自杀未遂是其自杀行为发生的危险因素。
结论 ： 在 开展精神病医院住院病人自杀干预时 ， 应考虑其自杀的危险因素。
Objective: To identify potential risk factors of suicide among schizophrenic inpatients, in order to provide basis of how to prevent suicide in psychiatric inpatients.
Method: A retrospective analysis among inpatients with mental disorders in Guangzhou psychiatric hospital from 1956 to 2005, the first psychiatric hospital, in China . Using a case-control design, sixty four schizophrenic inpatients (suicide group) who committed suicide in psychiatric hospital was the same number of randomly selected control subjects (control group) who had no incident of suicide with schizophrenic inpatients.
Results: The rate of suicide was 133.1 (95% CI 103.4 – 162.9) per 100 000 admissions. Sixty four cases (83.1%) were diagnosed as schizophrenia, fifty nine (76.6%) were hung by themselves, and fifty two (67.5%) happened in wards. The numbers of hospitalization and the suicide attempts before and during hospitalization were significantly higher in suicide group than that in control group (P=0.001, 0.017 ， 0.003), and guilty thoughts, depressive mood were significantly higher in suicide group than that in control group (P=0.006 ， 0.004), Both suicidal ideation and suicide attempts one month before and during hospitalization were significantly higher in suicide group than that in control group (P< 0.01).In conditional logistic regression analyses, guilty thoughts, depressive mood, suicidal ideation, and suicide attempts were identified as independent predictors of suicide with schizophrenic inpatients.
Conclusion: The findings of risk factors for suicide should be taken into account when developing interventions to improve outcomes among in-patients in psychiatric hospital.
Key words: schizophrenia inpatients suicide risk factors
- P216
南非川斯 凯亚区的自杀因素 - Factors of Suicide in the Sub-region of Transkei, South Africa
Banwari Lal Meel 1
1 Walter Sisulu University, Forensic Medicine, Mthatha, South Africa
目的 ： 确定南非川斯 凯亚区自杀的可能因素。
方法 ： 访问自杀受害者的亲属 ， 分析受害者的人口学资料、社会经济学和心理社会 学 资料。
结果 ： 农村人群 （ >90 ％） 自 杀的可能性比城市居民 （ <10 ％） 更大。 13 ％的人在自 杀时留有遗言。在自缢和枪击死亡的人中，男性在数量上远远超过女性（分别为 82 ％和 89 ％）。相反，女性在服毒死亡（ 75 ％）中占了很大比例。明 显的促发因素包括经济困难（ 10 ％）、酒精 滥用（ 23 ％）、与健康有 关的问题（ 17 ％）、婚姻 问题（ 13 ％）和社会中的争吵（ 10 ％）。未受教育者（ 70 ％）和无 业者（ 64 ％） 选择自缢。
结论： 经济困难是主要的根本因素，这在 87 ％的自 杀受害者中都能被发现。
Objective: To identify the possible factors of suicide in the subregion of Transkei , South Africa .
Methods: Interviews with relatives of suicide victims, and analysis of victims' demographic, socioeconomic, and psychosocial data.
Results: Rural people (>90%) were much more likely to commit suicide than urban dwellers (<10%). Suicide notes were left by 13%. Among those who died by hanging and by gunshot injuries, males far outnumbered the females (82% and 89%, respectively). BY contrast, females consituted the greater proportion of deaths by poisoning (75%). Apparent precipitating factors included economic hardship (87%), alcohol abuse (23%), health related issues (17%), marital problems (13%), and social disputes (10%). The uneducated (70%) and unemployed (64%) used hanging as the method of choice.
Conclusion: Fianacial hardhip was the main underlying factor, identified in 87% victims of suicide.
- P217
纳洛酮和舒必利对大鼠脑震荡后空间学习记忆及海马 CA3 区 锥体细胞影响的比较研究 - Comparison the Effects Between Naloxone and Sulpiride on Spatial Learning and Memory Deficits Following Concussive Brain Injury in Rats and their Pyramidal Cells in Hippocampus CA3 Area
新 段 1
1 广 东省佛山市顺德区伍仲珮纪念医院 , 佛山市 , Chinese Mainland
目的 ： 研究比 较纳洛酮和舒必利对大鼠脑震荡后空间学习记忆能力及海马 CA3 区 锥体细胞的影响。
方法 ： 用金属 单摆打击装置制作 SD 大鼠 脑震荡模型 , 随机分 为 4 组 : 假打 击组、脑震荡组、脑震荡 + 纳洛酮治疗组、脑震荡 + 纳洛酮治疗组。用Ｍ orris 水迷 宫评价动物的空间学习记忆能力 , Nissl 染色 对海马 CA3 区 锥体细胞计数，用激光共聚焦显微镜和钙荧光探针技术观察海马 CA3 区 锥体细胞内钙离子荧光量值。
结果： 行 为学观察：打击后 d8-d13 脑震荡模型组隐匿平台逃避潜伏期明显比其他三组长 ( Ｐ <0.01) ；穿越原平台位置水域的次数明 显比其他三组减少 ( Ｐ <0.01) 。 Nissl 染色 对海马 CA3 区 锥体细胞计数：其他三组 CA3 区 锥体细胞计数平均值明显比假打击组低（ P<0.01 ）； 纳洛酮和舒必利治疗组明显比脑震荡组高（ P<0.01 ）。激光共聚焦 显微镜观察：脑震荡组大鼠海马 CA3 区 锥体细胞内游离钙荧光量平均值较其他三组明显增高（Ｐ <0.01 ），其他三 组间差异无显著性。
结论： 脑震荡大鼠出现了类似人类脑震荡一周后长达 6 天的空 间学习记忆功能障碍。纳洛酮和舒必利均能明显阻止脑震荡大鼠海马 CA3 区 锥体细胞内游离钙积聚，减少海马 CA3 区 锥体细胞数的缺失，对大鼠脑震荡后空间学习记忆损害具有明显的保护作用。同时说明脑震荡后脑内内源性阿片肽和多巴胺的增多 ， 参与了学习记忆能力损害的病理过程。
Aim: to compare the effects of naloxone with sulpiride on spatial learning and memory deficits following concussive brain injury (CBI) in rats.
Methods: Rats were randomly divided into four groups: sham injury group, brain concussion group, naloxone treatment group and sulpiride treatment group.
Results: The escape latencies in brain concussion group were statistically longer than that in other three groups respectively ( Ｐ <0.01).
Conclusion: Both naloxone and sulpiride attenuate learning and memory deficits.
- P218
Lower Levels of Whole Blood Serotonin in Obsessive-compulsive Disorder and in Schizophrenia with Obsessive-compulsive Symptoms
立文 谭 1
1 中南大学湘雅二医院精神 卫生研究所 , 长沙 , Chinese Mainland
Objective: To explore whether differences would exist in the clinical symptomatology and the whole blood serotonin (5-HT) concentrations in patients with obsessive-compulsive disorder (OCD), schizophrenic patients with and without OCS (S+OCS, S ﹣ OCS), and clozapine-treated schizophrenic patients with and without clozapine-induced OCS (CLZ+OCS, CLZ ﹣ OCS).
Methods: Evaluate clinical symptoms and levels of 5-HT in whole blood in patients with OCD, S+OCS, S ﹣ OCS CLZ+OCS, CLZ ﹣ OCS patients and health controls.
Results: We found that S+OCS patients (n =15) showed significantly lower scores on the Hamilton Anxiety Scale (HAMA), but similar levels of compulsions and obsessions using Yale-Brown Obsessive-Compulsive Scale (YBOCS) as compared to the patients (n =35) with OCD. S+OCS patients scored significantly lower on the Positive and Negative Syndrome Scale (PANSS) but higher on the Hamilton Depression Scale (HAMD) compared with S ﹣ OCS patients (n =19). However, CLZ+OCS patients (n =15) suffered from dominant compulsions but fewer obsessions compared with the OCD and S+OCS patients. OCD, S+OCS and CLZ+OCS groups had significantly lower levels of whole blood 5-HT than did the healthy volunteers (n =15), S ﹣ OCS and CLZ ﹣ OCS groups.
Conclusion: It suggests that alterations in serotonin metabolism may be a common biological characteristic of OCS in OCD as well as in schizophrenia.
- P219
印度昌迪加 尔 区的自 杀谱 ： 一项历时 30 年的尸 检研究 - Spectrum of Suicides in Chandigarh Zone of India - A 30 Years Autopsy
Dalbir Singh 1 , Banwari Lal Meel 2
1 Institute Chandigarh, Forensic Medicine, Chandigarh, India, 2 Walter Sisulu University, Forensic Medicine, Mthatha, South Africa
一 项历时 30 年 （ 1974 － 2004 ） 的 对印度西北部的一家地区护理医院的 1298 例自 杀死亡者进行的尸检研究显示 ， 自 1989 年以来自 杀死亡急剧上升 ， 其中以男性更为突出 （ 男 : 女 ＝ 1.52:1 ）， 最多 发生于 15 － 25 岁年龄组 （ 49 ％） 。大多数 实施自杀的人为已婚人士（男性 71 ％，女性 69 ％）， 51 ％是城市居民。 69 ％的人服毒自尽， 24.5% 的人自焚（ self-immolation ）， 4 ％的人跳 轨自杀。继住处（ 68 ％）之后，工作 场所（ 17 ％）、野外 / 旅 馆（ 9 ％）是最常 发生自杀的地方。导致自杀最常见的事件，在儿童中为考试失利（男性 8 ％，女性 28 ％）、同胞 间的对抗（男性 15 ％，女性 22 ％）； 15 － 25 岁年龄组中，男性为失业（ 25 ％），女性 为夫妻争执（ 27 ％）； 26 － 35 岁年龄组中，男性为失业（ 25 ％），女性 为夫妻争执（ 41 ％），老年男性 为财产争夺（ 24 ％）和孤独（ 37 ％）。
A 30 years (1974-2004) autopsy study of 1298 of suicidal deaths from a territory care hospital of North-West India revealed an abrupt rise in suicidal deaths since 1989 with male preponderance (M:F ratio 1.52:1) involving the most productive age group of 15 to 25yrs ( 49%). Majority (71% males & 69% females) who accomplished suicide were married and 51% belonged to urban area. 69% victims consumed toxic substances, 24.5% had self-immolation and 4% perished their lives by jumping in front of moving trains. Dwelling units (68%) followed by workplace (17%), fields/hotels (9%) were the commonest place of occurrence. In children failure in examinations (8%males, 28% females), sibling rivalry (15% males, 22% females) and between the age of 15-25 years unemployment (25%) among males and Marital disputes (27% in females) in the age-group of 26-35 years unemployment (25%) in males and marital disputes (41%) in females and property disputes (24%) and loneliness (37%) in older males were the common circumstances leading to suicides.
- P220
The Relationship between Different Types of Internet Addiction and Life Events of Medical College Students
Qi Chen 1 , Xumei Wang 1
1 Shengjing Hospital of China Medical University, Department of Psychology, Shenyang, Chinese Mainland
Objective: To investigate internet use in medical college students and analyze the relationship between different types of internet addiction and life events of medical college students, so as to provide evidence for practical intervention of internet addiction in college students.
Methods: Randomly select 446 medical undergraduates from two different medical colleges as subjects. Use Internet Addiction scale and Adolescent Self—Rating Life Events Cheek List (ASLEC) to test different types of internet addiction in the subjects and the frequency and intensity of stressful life events they experienced in the past 12 months.
Results: There are respectively 7.39%, 8.30% and 4.71% students showing addiction to computer games, cyber-relationship and information collection. According to the statistic analysis to the data, high possibility of computer game addiction is positively relevant to the factors of interpersonal relationship, study pressure and punishment; that of cyber-relationship addiction is positively relevant to the factor of interpersonal relationship; no significant relationship has been found between information collection addiction and any factors of life events.
Conclusion: There is a certain rate of medical students who are highly inclined to internet addiction. Computer game addiction and cyber-relationship addiction are related to stressful life events. Internet addiction might be induced by stressful life events and then cause more life events. Therefore, break the vicious circle through a breakthrough point might be an effective intervention strategy for internet addiction.
- P221
Research on Psychological Characteristics of Internet Overuse Youngsters
亚松 杜 1 , 莉莉 黄 2 , 文 庆 江 1
1 上海市精神 卫生中心 , 上海 , Chinese Mainland, 2 上海 师范大学教育学院心理系 , 上海 , Chinese Mainland
Objective ： To investigate Psychological Characteristics of Internet Overuse Youngsters by the Strengths and Difficulties Questionnaire (SDQ).
Methods ： We administered the Diagnostic Questionnaire for Internet Addictiona to 2602 youngsters in Shanghai to identify Internet Overusers ， whose psychological characteristics were studied according to the Strengths and Difficulties Questionnaire.
Results ： a) 65 students were identified as Internet Overusers including 16 girls.b). The SDQ showed that the Internet Overuse Youngsters, when compared with the Internet Normal Users in this study ， reported remarkable differences on emotional symptoms ， conduct problems ， hyperactivity -inattention ， peer problems and total difficulties as well as prosocial behaviour （ p<0.001 ） .c)The Internet Overuse Youngsters only reported remarkable differences on hyperactivity-inattention between sex (p<0.05).d)No remarkable psychological characteristic differences were found among Internet Overuse youngsters in Junior High School ， Senior High School and Vocational Technical School.
Conclusion ： When compared with the Internet Normal Users ， the Psychological Characteristics of the Internet Overuse Youngsters in school were more serious but far from abnormity ， who showed emotional symptoms ， conduct problems ， hyperactivity -inattention ， peer problems and total difficulties as well as poor prosocial behaviour.
- P222
四次甲基二 砜四胺与癫痫所致精神障碍的临床对照研究 A Comparative Clinical Study on Mental Disorder Caused by TETS Poisoning and Epilepsy Respectively
Guangxin Lan 1
1 Ganzhou No.3 Hospital, Department of Psychiatry, Ganzhou Jiangxi , Chinese Mainland
目的 : 探 讨四次甲基二砜四胺 （ TETS ） 所致精神障碍的 临床特征 , 提高 临床诊断水平 ， 进而探讨 TETS 所致精神障碍的 发生机制。
方法 : 采用自 编临床调查表 ， 对 28 例 TETS 中毒所致精神障碍 （ 研究 组 ） 和 28 例 癫痫所致精神障碍 （ 对照组 ） 进行临床对照研究。
结果 : 两 组间出现幻听、幻视、感知综合障碍、被害妄想、夸大妄想、情感迟钝、阵发性兴奋和冲动、睡眠障碍、自知力缺乏、脑电图异常等症状发生率的差异无统计学意义 （ P ＞ 0.05 ）； 两 组患者均在抽搐减少或抽搐停止后出现精神症状 ； 研究组以急性起病为主 ， 对照组以慢性起病为主 ， 两组间差异有非常显著的统计学意义 （ P ＜ 0.01 ）； 恐惧 12 例和 顺行性遗忘 13 例 仅出现在研究组及思维松弛 11 例 仅出现在对照组 ， 两组间差异均有非常显著的统计学意义 （ P ＜ 0.01 ）； 研究 组误诊 5 例。 结论 : 两 组病例的主要精神症状表现相同 ， 但在起病形式及部分精神症状表现具有各自的特点 ； TETS 所致精神障碍的 发生机制与 γ - 氨基丁酸 （ GABA ） 有 关。
关键词 : 四次甲基二 砜四胺 ； 癫痫 ； 精神障碍 ； 中毒 ； γ - 氨基丁酸
Objective: To discuss the pathogenesis of mental disorder caused by TETS and improve the diagnostic precision by studying the clinical features of mental disorder caused by TETS.
Methods: 28 mental disorder inpatients caused by TETS poisoning (subject group) and 28 mental disorder cases caused by epilepsy (comparative group) were recruited in the study. The self-designed questionnaires were applied to investigate the clinical features of the two groups.
Results: The variations of symptom incidences of the two groups in the following symptoms such as auditory hallucination, heteroptics, comprehensive perception disorder, murdered deliria, exaggeration deliria, emotional inaction, spelled excitement and impulsion, sleep disorder, lack of self-knowledge ability and abnormal electroencephalogram, etc., have no statistical significance(P>0.05). Psychiatry symptoms occurred after the reduction and termination of tics in both groups. While acute attacks appear in the subject group, the comparative group has chronic attacks. The discrepancies of the two groups enjoy great statistical significance (P ＜ 0.01). 12 phobia cases and 13 direct amnesia cases occurred only in the subject group, while 11 cases of slackening thinking only in the comparative group. The distinctions of the two groups enjoy striking statistical significance (P ＜ 0.01). There are 5 erroneous diagnoses in the subject group.
Conclusion: The two groups have identical major psychiatry symptoms, but their pathogenic forms and minor psychiatry symptoms show different features. The pathogenesis of mental disorder caused by TETS relates GABA.
Key words: Tetramethylenedisulphotetramine (TETS) ； Epilepsy ； Mental disorder ； Poisoning ； Gamma-aminobutyric acid (GABA).
- P223
强迫症患者 探究性眼球 轨迹运动分析 - Analysis of Exploratory Eye Tracking Movement Tested on 103 Obessive-Compulsive Disorders
秀霞 郑 1
1 福建省 闽清精神病院 , 福州 , Chinese Mainland
目的 ： 对 103 例 强迫症患者 （ Obessive-Compulsive Disorder,OCD ） 进行探究性眼球轨迹运动检查 ， 并结合临床症状特点进行分析。
方法 ： 应用探究性眼球轨迹运动标记记录仪 （ Type IV, 日本提供 ） 检查 103 例 强迫症患者及 81 例正常人 ， 对照研究探究性眼球轨迹运动 （ Exploratory Eye Tracking Movement,EETM ） 与 临床特征的关系。
结果 ： 探究性眼球 轨迹运动对强迫症患者特异性为 49.5 ％， 正常人 为 91.4 ％， 强迫症探究性眼球 轨迹运动的各项指标除眼动平均距离 （ Mean Eye Scanning Length,MESL ） 外与正常人比 较其差异均有非常显著性 （ P<0.01 ） 。
结论 ： 强迫症 D 分 值、 EETM 各 项指标与正常对照比较其差异有显著性。强迫症患者的临床表现与正常人比较有区别 ， 反映某 些患者 强迫症可能存在 认知功能障碍。
Objective: To test 103 Obessive-Compulsive Disorders by Exploratory Eye Tracking Movement,then to analyze the results associated with the clinical symptoms trait.
Methods: 103 Obessive-Compulsive Disorders and 81 normals were tested by tracking of exploratory eye movement (Type IV),and the relationship between the results of Exploratory Eye Tracking Movement and the clinical trait were control studied.
Results: The speciality of Exploratory Eye Tracking Movement to Obessive-Compulsive Disorders is 49.5 ％ , and the speciality of Exploratory Eye Tracking Movement to normals is 91.4 ％ Significant differences were noted in all indexes except Mean Eye Scanning Length between Obessive-Compulsive Disorders and normals （ P<0.01 ） .
Conclusion: Significant differences were noted in D value 、 all EETM indexes between Obessive-Compulsive Disorders and normals.Our data suggests: Obessive-Compulsive Disorders are clinically distinctive and differ from normals;it was reflected that some Obessive-Compulsive Disorders may have cognitive disfunctions.
- P224
苯海 对性交后腹泻的疗效 - Response of Post-coital Diarrhea to Trihexphenidyl
Pramod Kumar Singh 1 , Abhay Kumar 1
1 Patna Medical College , Department of Psychiatry, Patna , Bihar , India
在我 们的临床实践中 ， 经常会遇到新的问题 ， 没有既定的解决方案可供选用。 一个病人 经历了一个简单的药物干预后就出现了极不寻常的症状表现。这就是做现在这个病例报告的原因。 病例 为：患者，男性， 30 岁，高中学历，中等收入的商店经营者，结婚 6 年。 1 年半前来印度巴特那医学院精神科就 诊，有 4-5 年的抑郁症史，并伴有躯体症状主要是 GIT ？。他曾 经接受过内科医生的检查治疗但没有得到缓解。精神科门诊医生给予他抗抑郁剂和抗焦虑剂治疗，症状得到明显改善。随访中，患者报告可能是由于信任感和自信心的提高，他在每次性生活之后变得放纵，频繁性冲动可持续达 12 小 时。进一步的调查显示患者在婚前手淫时也会有类似的 症状表 现，这种情况在 10 年前就已 开始。为减少胆碱能样副反应如男性性行为发动和肠蠕动增加，常规使用抗胆碱药苯海索 (Pacitane) 。最初几周内 这一干预就取得了满意的疗效，性交后腹泻症状在接下来的几个月中消失。此结果及其他性生活后现象的意义解释将在今后进一步讨论。
We are often confronted with novel problems in our clinical practice for which no readymade solution is available. A very uncommon symptom was presented by a patient, which responded very definitely to a very simple intervention. That is the rationale for presenting the present case.
A thirty year old, High School educated, middle income group shopkeeper, married for six years, presented to Psychiatry services of Patna Medical College, Patna, India about one and half year back with 4-5 years history of depressive symptoms along with somatic symptoms focused around GIT. He had been examined, investigated and treated by Physicians without relief. At Psychiatry OPD, he was put on antidepressants along with anxiolytics, to which he showed significant improvement. During follow up, probably because of increasing trust and confidence, he reported that he develops loose and frequent motions lasting for about 12 hours, every time after he indulges in sexual intercourse. A little probe further revealed that he had similar symptoms after masturbation also during pre-marital period, which he had started about 10 years back. A routinely used anticholinergic, Trihexyphenidyl (Pacitane) was added to the drug regimen, because of the assumption that initiations of male sexual act as well as increased bowel frequency are predominantly cholinergic events. A very satisfactory response to this simple intervention was observed within first few weeks, leading to disappearance of post-coital diarrhea over next few months period.
The significance of this observation along with other post-coital phenomena will be discussed.
- P225
糖皮 质激素致精神障碍被误诊为 “ 双相情感障碍 ”1 例 - A Mental Disorder Caused by Glucocorticoid Misdiagnosed to "Bipolar Disorder", A Case Report
小 东 周 1 , 美 韦 1
1 解放 军白求恩国际和平医院 256, 临床部精神科 , 正定 , Chinese Mainland
患者 ： 李 ×× ， 女 ， 35 岁 ， 离异 ， 自由职业。
住院号 ： 217880 。因 “ 情 绪高涨与低落交替发作 20 天 ” ， 门诊以 “ 双相情感障碍 ， 抑郁相 ” 收入院。
患者 8 年前 开始罹患 “ 牛皮 癣 ” 、 “ 多 发性皮肤白化病 ” ， 曾多 处多次就医多年 ， 效果均不理想。入院前 20 天在听旁人介 绍后前往一私人诊所 ， “ 专治 ” 上述疾病。采取分批次、多个病灶 处皮下注射疗法，注射成多个皮丘为限，最大者达 3×4 厘米，最小者也 为 2×1 厘米。所用 药物名称该诊所拒绝透露。经连续治疗 5 天后，患者出 现注射处皮肤疼痛，但尚能忍受。夜里不眠，在家里来回走动，逐渐出现话多，不听劝告，反复出入高级商店，挥霍性购物；反复纠缠其舅舅为其购买高级轿车，非 20 万元以上 车不要；吹嘘和夸大自己的能力，逢人变讲自己的身上刺有 “ 迎刃而解 ” 四个字，表示自己的能力非凡无比，常高歌不休，影响他人休息， 劝告后与人发脾气，家人难以管理。上述现象持续约 10 天左右自行消失，但同 时患者和家人均发现患者的颜面部及双下肢出现浮肿，皮肤变薄，面色潮红，食欲亢进。为此曾去某省医院就诊，查血糖浓度为： 13.26mmol/L ；血常 规：中性白细胞 12.7×109/L 。入院前 1 周患者出 现少语少动、兴趣爱好下降、情绪低落，阵阵哀叹自己的命运，不思饮食，反复出现自杀的念头；对自己颜面部及躯体体形的改变觉得无奈；症状逐渐加重，并出现自语，但听不清内容。为求进一步诊治，入本院精神科。
入院 时查体： 意 识清，定向力正常，注意力集中，问答切题。患者呈典型的满月样面容，面部皮肤变薄，面潮红；躯干部脂肪集中较肢体明显；全身可见有多处皮肤色素脱落区。辅助性检查：血糖浓度为： 12.11mmol/L ；血常 规：中性白细胞 11.7×109/L 。精神 检查呈典型的抑郁综合征伴有与心境相协调的命令性听幻觉。
根据患者的既往病史、治 疗过程分析、典型的躯体变化以及精神障碍特点，修改诊断为：糖皮质激素所致精神障碍。经过小剂量抗抑郁药、抗焦虑药等对症处理 1 月后痊愈出院。随 访半年未复发。后经查询证实患者在个体诊所治疗为地塞 米松与 氢化可的松联合用药。
2 讨论： 该案例有如下特点： ①入院前曾有大 剂量的皮下注药治疗史，精神症状出现在治疗的过程之中； ②体格 检查发现患者呈典型的柯兴综合征表现； ③ 辅助性检查：血糖升高、白细胞总数升高； ④精神症状 为类躁狂样和类抑郁样表现； ⑤后 经查证患者在院外大量运用了糖皮质类激素； ⑥ 经过对症处理，精神症状缓解，随访未复发。故诊断考虑为糖皮质激素所致精神障碍。近些年来，我国一些个体诊所为追求短期利益，在糖皮质激素的使用方面有滥用趋势 [1] 。但是，就此引起精神障碍而入院接受治 疗的案例不多，原因在于尽管糖皮质 激素造成精神异常的比例可高达 70% ，但多数在大型 综合科医院被发现从而得到合理的治疗 [2] 。在 专科医院以精神障碍为主诉住院治疗者多被误诊所致，精神科医生对相关基础知识的掌握不熟练是原因之一。糖皮质激素对中枢神经系统的影响，又以地塞米松为甚，临床上合并出现的躯体症状及辅助检测结果在鉴别诊断上意义重大；精神障碍以抑郁综合症最常见，个别患者可以出现临床上 “ 典型 ” 的双相情感障碍的病情演 变过程，故容易造成误诊。
- P226
住院老年精神疾病患者合并躯体疾病 调查 - Survey of Senil Inpatients with Mental Disorder Combined with Somatic Disease
Ke Chen 1 , Xin-geng Pan 1 , Xing Pan 1
1 Huzhou Disan Hospital, Huzhou, Chinese Mainland
目的： 了解老年精神疾病患者合并躯体疾病的 种类和频度。 方法： 收集男、女老年精神疾病患者共 635 例，了解合并躯体疾病情况。
结果： 患者合并躯体疾病常 见疾病：高血压、糖尿病、呼吸系统疾病、心脏病。
结论 ： 老年精神疾病患者躯体疾病 种类多见常见 ， 必须加以重视。
关键词 : 精神疾病 躯体疾病
Objective: To understand the kinds and frquency of somatic diseases of senil psychiatric inpatients.
Method: To collect 635 senil inpatients in senil psychiatric, their somatic diseases were understand.
Results: 93.6% of senil inpatients were combined with somatic disease. Hypertension, diabetes, respiratory system diseases, cardiopathy.
Conclusion: There are many kinds of somaticl diseases in senil psychiatric inpatients. It is necessary to pay more attention.
- P227
奎硫平、氟 哌啶醇对青年精神分裂症患者血清生长激素水平的影响 - Effect of Quetiapine versus Haloperdol for Serum Levels of Growth Hormone in younger Schizophrenia
明廉 张 1 , 国 桢 袁 1 , 德祥 周 1 , 云彪 张 1
1 无 锡精神卫生中心 , 精神科 , 无 锡市 , Chinese Mainland
目 标 ： 探 讨青年精神分裂症患者血清生长激素 （ GH ） 基 础水平与正常青年人的差异 ， 及奎硫平和氟哌啶醇对 GH 水平的影响。
素材和方法 ： 用 酶 联免疫法测定 94 例青年精神分裂症患者奎硫平与氟 哌啶醇治疗前后的 GH 水平 ， 与 45 名健康者 对照 ， 并将药物分为奎硫平组 46 例和氟 哌啶醇组 48 例。
结果 ： 青年精神分裂症患者的基 础 GH 水平与健康 对照组差异无显著性 （ P>0.05 ）， 治 疗 8 周后 ， 奎硫平 组 GH 水平与治 疗前无明显变化 ， 氟哌啶醇组治疗 8 周后 GH 值为 （ 1.34±0.78 ） μ g/L ， 较治疗前 （ 2.38±0.98 ） μ g/L 显著降低 ， 差异有显著性 （ P<0.01 ） 。
结论 ： 氟 哌啶醇能使青年精神分裂症患者 GH 水平 显著降低 ， 奎硫平对青年精神分裂症患者 GH 水平无明 显影 响 ， 治 疗安全性好。
Objective: To find out if there was any difference of growth hormone level between younger schizophrenics and normal younger control,to observe the change after treatment of antipsychotics, and compare the hormone change after quetiapine and haloperidol treatment.
Mehods: RIA were used to examine serum level of growth hormone in 94 younger schizophrenics before and after treatment. The 94 patients were randomly assigned to quetiapine （ 46 case ） and haloperidol (48 cases). The results before treatment were compared with those of 45 normal control.
Results: There was no difference of serum growth hormone level between younger schizophrenics before treatment and normal control (P>0.05). After 8 weeks' treatment of quetiapine, the growth hormone level of patients was no significantly difference (P>0.05). After 8 weeks'treatment of haloperidol, the growth hormone level of patients was 1.34±0.78 μ g/L, Significantly lower than 2.38±0.98 μ g/L before trenatment (P>0.01).
Conclusion: Growth hormone level decreased after haloperidol treatment.The affect of quetiapine on growth hormone level were smaller than that of haloperidol.
- P228
ω -3 多不 饱和脂肪酸对 CMS 抑郁症大鼠模型作用的行 为学及神经生化研究 - The Influence of ω -3 PUFA (Polyunsaturated Fatty Acid) on the Behavior and Neurochemical Substrate of Rats in CMS Model of Depression
郭 晓云 1 , 江 开达 1 , 李 晓白 2 , 俞 瑾 3 , 崔 东红 1 , 吴 根 诚 3
1 上海市精神 卫生中心 , 上海 , Chinese Mainland, 2 中国医科大学第一 临床学院 , 沈阳 , Chinese Mainland, 3 复旦大学中西医结合系 ， 针刺原理研究所 , 上海 , Chinese Mainland
近年来 关于 ω -3 多不 饱和脂肪酸 （ polyunsaturated fatty acids, PUFA ） 和抑郁症的研究不断有文献 报道 ， 这些研究均提示 ω -3 PUFA （ 主要来自 鱼油和海洋食物 ） 可能参与了抑郁症发生 ， 并对抑郁症具有潜在的治疗作用。本研究通过进行 ω-3 PUFA 对慢性轻度应激（ chronic mild stress, CMS ）抑郁症大鼠模型的作用研究， 试图进一步阐明 ω-3 PUFA 的抗抑郁作用，并从神 经生化角度进行可能的机制探讨。
成年雄性 Sprague-Dawley 大鼠 43 只，随机分 为正常组和模型组。模型组大鼠接受 CMS 刺激 4 周后，再随机分 为 5 组，分别接受文拉法辛（ 2.5 mg·kg-1·d-1 ）、橄 榄油（ 3.1ml·kg-1·d-1 ）、 鱼油（ 3.1ml·kg-1·d-1, 含 ω-3 PUFA0.72g·kg-1·d-1 ）、生理 盐水（ 4 mg·kg-1·d-1 ）、 氯米帕明（ 10mg·kg-1·d-1 ）治 疗 4 周，期 间同时接受 CMS 刺激。行 为学指标（糖水消耗量与糖水偏爱百分比）测定每周 1 次。最末次行 为学测定结束后次日断头取脑冻存备用，采用高效液相色谱法测定海马与前额叶单胺类递质及代谢产物的浓度。
（ 1 ） ω-3 PUFA 、文拉法辛和 氯米帕明均能有效逆转 CMS 应激所导致的糖水摄入量和糖水偏爱百分比的降低，橄榄油和生理盐水则 无效；（ 2 ） CMS 应激导致大鼠前额叶 5-HT 、 5-HIAA 、 NE 水平升高， DA 降低，差异均有 统计学意义（ P<0.05 ），海 马单胺类递质也有相应的改变趋势，但未达到统计学意义（ P ＞ 0.05 ）。 ω-3 PUFA 能逆 转应激所致海马和前额叶 5-HT 及 DA ，以及海 马 5-HIAA 水平的异常（ P<0.05 ）。文拉法辛能逆 转应激所致海马 5-HIAA 及前 额叶 5-HT 水平的异常（ P<0.05 ）。 氯米帕明能逆转应激所致海马 5-HIAA 及前 额叶 5-HT 、 5-HIAA 、 NE 、 DA 的异常（ P<0.05 ）。各 药物对其他递质的浓度均没有影 响（ P ＞ 0.05 ）。
（ 1 ） ω-3 PUFA 、文拉法辛和 氯米帕明均对 CMS 模型所致 类抑郁行为具有逆转作用；（ 2 ） ω-3 PUFA 对脑 5-HT 与 DA 功能的 调节可能参与了上述现象的作用机制，对 5-HT 功能的 调节可能与文拉法辛的抗抑郁作用相关，氯米帕明作用的递质谱最为广泛， 5-HT 、 DA 和 NE 可能均参与了其抗抑郁作用机制。
- P229
首 发精神分裂症患者奥氮平治疗前后血浆瘦 . 素和脂 联素的研究 - A Study on Plasma Leptin and Adiponectin Levels before and after Treatment with Olanzapine in the Schizophrenia
毅君 刘 1 , 李 乐华 吴任容
1 中南大学湘雅附二医院精神 卫生研究所 , 长沙 , Chinese Mainland
目的 : 探 讨精神分裂症患者奥氮平治疗前后血浆瘦素和脂联素水平的变化及意义。
方法 : 患者 为 92 例首 发的精神分裂症患者 , 在研究四周前没有服 过任何药物。病人服用奥氮平的 剂量为平均 14.5 mg/d 。治 疗前和治疗 8 周后分 别测量身高、体重以计算体质量指数 , 用放射免疫方法 检测其空腹血浆瘦 素和脂 联素。结果 治疗后患者组体质量指数、血浆瘦素水平均明显上升 , 与治 疗前比较差异有显著性 ( P 均小于 0.05) ; 患者 组血浆脂联素水平在治疗后明显下降 , 与治 疗前比较差异有显著性 ( P 均小于 0.05) ; 治 疗前后血浆瘦素的差值和脂联素的差值呈负相关 ( r =- 01358, P < 0.05) 。 结论 首发精神分裂症患者服用奥氮平治疗容易出现药源性肥胖 , 应用奥氮平治疗后 , 瘦素水平随体重的增加而增高 ,Adi 随体重的增加而降低。
关键词 : 精神分裂症 瘦素 脂 联素 奥氮平
- P230
抑郁症患者的 APOE 基因多 态性及血脂水平的研究 - Apolipoprotein E Gene Polymorphisms and Serum Lipid Characteristics in Depressive Patients
玉梅 焦 1 , 立升 宋 2 , 立 伟 王 3 , 栋祥 汪 2 , 顺英 禹 2 , 慎 逊 施 3
1 上海市精神 卫生中心 & 复旦大学华山医院精神医学科 , 上海 , Chinese Mainland, 2 上海市精神 卫生中心 , 上海 , Chinese Mainland, 3 复旦大学华山医院精神医学科 , 上海 , Chinese Mainland
目的： 探索 APOE 基因多 态性与抑郁症间的关系及其对患者脂代谢、症状的影响。
法： 对 92 例符合 CCMD-3 抑郁 发作的患者和 60 例正常 对照进行 APOE 基因分型、 测量其体质参数、血脂。以 HAMD17 和 HAMA 评定患者症状。
结果： APOE 基因型及等位基因 频率，抑郁症与对照组间无显著差异。抑郁症组中，携带 APOEε4 等位基因的患者平均 TC 、 APOB 水平、 HAMD17 阻滞 项评分显著高于不携带 APOEε4 等位基因的患者，差异均有 统计学意义。携带和不携带 APOEε4 等位基因的抑郁症患者 TG 值 均分 别高于、 HDL 值分别低于携带和不携带 APOEε4 等位基因的 对照组，以上差异均有统计学意义。
结论： 抑郁症与 APOE 基因多 态性无明显关联。抑郁症患者存在一定的血脂紊乱，尤其是携带 APOEε4 等位基因的抑郁症患者可能有更多的血脂代 谢问题，而且携带 APOEε4 等位基因的抑郁症患者 HAMD17 阻滞 项评分较高。
Objective: To investigate the association of apolipoprotein E (APOE) gene polymorphisms with major depression ， and the influence of APOE gene to fasting serum lipid and the symptoms in major depressive patients.
Methods ： The genotypes and alleles of APOE gene polymorphisms in 92 major depressive patients and 60 healthy controls were examined and compared. The height, body weight, waist circumference ， hip circumference ， total cholesterol(TC), triglyceride(TG) ， high density lipoprotein cholesterol(HDL) ， low density lipoprotein cholesterol(LDL), apolipoprotein A1(APOA1), and apolipoprotein B(APOB) were measured; HAMD17 、 HAMA were used to assess the symptoms.
Results: The polymorphisms of APOE gene were not associated with depression. The depressive patients with APOE ε 4 allele had significantly higher level of TC and APOB 、 higher retardation scores of HAMD17 compared with those of patients without it. Compared with the controls who carried APOE ε 4 allele and not carried, the depression patients had significantly higher TG and lower HDL levels respectively.
Conclusion: The polymorphisms of APOE gene were not associated with major depression. Major depressive patients, especially the patients who carried the APOE ε 4 allele, had more disturbances in lipid metabolism and higher retardation scores of HAMD17.
- P231
去甲 肾上腺素转运体基因 G1287A 多 态性与重性抑郁症严重程度及自杀观念的关联性研究 - Study on Relationship between NETG1287A and Severity and Suicidal idea of Mmajor Depression
丽 晋 刘 1 , 妮 小 关 2 , 姗 王 2 , 芬 志 刘 2 , 红 杨 2 , 意 菊 彭 2 , 让 克 张 2
1 山西医科大学附属第一医院 , 精神 卫生科 , 山西省太原市 , Chinese Mainland, 2 山西医科大学第一附属医院 , 精神 卫生科 , 山西省太原市 , Chinese Mainland
目的 ： 控制社会心理因素下 ， 探 讨中国汉族人群 NET 基因 G1287A 多 态性与重性抑郁症严重程度及有无自杀观念的关联性。
方法 ： 严格按照 DSM-IV 入 组排除标准 ， 收集山西医科大学第一医院门诊 2005 年 4 月 -2007 年 3 月的重性抑郁症患者 299 例 ， 使用 HAMD 、 EPQ 、 LES 、 SSS 、 CSQ 等分 别对疾病严重程度以及人格、生活事件、社会支持、应对方式等社会心理因素进行评估 ， 采用 PCR 和基因 测序方法对 G1287A 基因多 态性进行检测 ， 统计分析使用 SPSS13.0 软件进行。以 24 分 为界将 HAMD 分 值分为轻中度和重度两个等级，基因型及等位基因分布比较用 χ2 检验，均数比较用 ANOVA ，社会心理因素的控制及相 应 OR 值的计算用多元 Logistic 回 归实现。
结果： 1.Hardy-Weinberg 遗传平衡检验：结果发现 MD 轻中度组、重度组及有自杀观念组、无自杀观念组中 NETG1287A 多 态性的基因型分布均符合 Hardy-Weinberg 遗传平衡定律（ P ＞ 0.05 ） , 说明群体基因遗传平衡。
2. NETG1287A 不同基因型及等位基因 间 HAMD 均数比 较无统计学差异（ P=0.115 ； P=0.593 ）。
3. 不同 HAMD 分 级间 NETG1287A 基因型及等位基因 频率分布均无统计学意义 (P=0.119 ； P=0.592) ，以 GG 基因型作参照， GA 基因型 (OR=0.505 ； OR95%CI=0.170,1.497 ； P=0.218) ； AA 基因型 (OR=1.259 ； OR95%CI=0.186,8.543 ； P=0.813 ）无 统计学意义。以 G 等位基因作参照， A 等位基因 (OR= 0.770 ； OR95%CI=0.352,1.687 ； P=0.514) 也无 统计学意义。
4. 有无自 杀观念组间 NETG1287A 基因型及等位基因分布均无 统计学意义（ P=0.246 ； P=0.118 ）。 控制心理因素后以 GG 基因型作参照， GA 基因型（ OR=0.408 ； OR95%CI=0.185,0.900 ； P=0.026 ）有明 显的统计学意义， AA 基因型 (OR=0.971 ； OR95%CI=0.223,4.219 ； P=0.968 ）无 统计学意义。以 G 等位基因作参照， A 等位基因 (OR= 0.671 ； OR95%CI=0.382,1.177 ； P=0.164) 无 统计学意义。
结论： 控制社会心理因素的情况下， NETG1287A 可能与抑郁症患者出 现自杀观念有关联， GA 基因型可能是其危 险因素；未发现 NETG1287A 与重性抑郁症 严重程度有关联。
Objective: To analyse the relationship between NETG1287A and severity and suicide idea of major depression under control the effect of social-psychic factor.
Method: Choose 299 MD patient according to DSM-IV, multivariate logistic regression were used to control social-phychic factors and compute odds ratio.
Result:
1. Hardy-Weinberg equilibrium analysis: gene polymorphism NETG1287A achieve genetic balance (P ＞ 0.05), the sample can represent the group.
2.There was no significant difference of genotype frequency and alleles frequency of NETG1287A betweene Two HAMD grades.
3. Taking social-phychic factors as covariant, there were significant difference of distribution of GA genotypes between suicidal idea group and non-suicidal idea group （ OR=0.408 ； OR95%CI=0.185,0.900 ； P=0.026 ） , but the OR values were not get statistical significance , while there were no significant difference of distribution of genotypes and alleles between two HAMD grades, and the OR values were not get statistical significance yet.
Conclusion: Taking social-phychic factors as covariant, the GA genotype maybe a risk factor of suicidal idea of MD , while NETG1287A may not correlate with the severity of MD.
- P232
Positive Association between the GABAA Receptor Gamma 1 Subunit Gene (GABRG1) and Paranoid Schizophrenia in Northern Chinese Population
Ning Sun 1 , Kerang Zhang 1 , Qi Xu 1 , Yong Xu 1 , Shan Wang 1 , Xiaoni Guan 1 , Juyi Peng 1 , Yan Shen 1
1 First Hospital of Shanxi Medical University, Psychiatry Department, Taiyuan, Chinese Mainland
Objective: Schizophrenia is one of the most serious psychiatric illnesses affecting approximately 1% of the worlds population. Several investigations suggest that abnormalities in γ -amino butyric acid (GABA) neurotransmission systems may be related to the pathophysiology of schizophrenia. GABAA receptors are associated ligand-gated chloride channels that mediate fast synaptic inhibition in the mammalian brain. In the present study we e performed a systematic polymorphism search to analyze the association between GABAA receptor genes and the paranoid schizophrenia.
Methods: The sample consisted of 80 unrelated patients with paranoid schizophrenia (36 males and 44 females; mean age, 24.9 ± 5.8 years, range 16-37 years) and 108 matched normal controls (56 males and 52 females, mean age 25.8 ± 5.8 years, range 18-40 years). All patients were diagnosed as having a schizophrenic illness using ICD-10 criteria, and interviewed by the consensus of at least two experienced psychiatrists and diagnosed according to the Schedules for Clinical Assessment in Neuropsychiatry (SCAN).52 reported single nucleotide polymorphisms (SNPs) in the coding or untranslated regions of the GABAA receptor genes were genotyped by polymerase chain reaction (PCR) and direct sequencing of PCR products. Hardy–Weinberg equilibrium for SNPs were evaluated using the χ 2 test. Statistical differences in genotypic and allelic frequencies between patients and controls using the UNPHASED program.
Results: (1) No significant differences were observed in genotypic or allelic frequencies of these SNPs between the patients and controls. (2) We found a positive association between rs976156(A)-rs1497568(C) haplotype and paranoid schizophrenia ( χ 2=8.951, P =0.008), the permutation test showed a strong association (global P=0.012 for 10000 permutations). The rs976156(A)-rs1497568(C) haplotype frequency in cases is higher than controls.
Conclusion: Our study may suggest that the GABRG1 gene is one possible suspected gene for paranoid schizophrenia in the northern Chinese population. Large studies need to be considered preliminary until they can be replicated in other populations.
- P233
5-HTTLPR 和 C(-1019)G 基因多 态性联合作用 . 与重性抑郁症的 关联性研究 - Association between the Joint Action of 5-HTTLPR and C(-1019)G Gene Polymorphism and Major Depression
小妮 关 1 , 张克让 徐勇 杨红 孙宁 李忻蓉
1 山西医科大学第一医院 , 太原 , Chinese Mainland
目的 ： 探 讨 5-HTTLPR 和 C(-1019)G 基因多 态性联合作用与重性抑郁症发病的关系。
方法 ： 采用病例 对照研究 ， 严格按照入组排除标准 ， 选取病例组 197 例 ， 均来自山西医科大学第一医院精神 卫生科门诊 ， 男性 101 例 ， 女性 96 例 ， 年 龄范围 18~63 岁 ， 平均年龄 29.95±9.183 岁 ； 对照组 197 例 ， 男性 91 例 ， 女性 106 例 ， 年 龄范围 18~67 岁 ， 平均年龄 29.64±9.581 岁。采用 PCR 对 5-HTTLPR 及 C(-1019)G 基因多 态性进行检测。应用 UNPHASED 软件进行数据分析。
结果： 1.Hardy-Weinberg 遗传平衡检验： 应用拟合优度 χ2 检验分别分析病例组和正常对照组，结果发现在两个群体中 5-HTTLPR 和 C(-1019)G 多 态性均符合 H-W 平衡（ P ＞ 0.05 ） , 说明群体基因遗传平衡。
2.5-HTTLPR 及 C(-1019)G 单个基因多态性与重性抑郁症发病的关系：
病例 组和对照组间 5-HTTLPR 各基因型和等位基因分布 频率均无统计学差异（ P ＞ 0.05 ）。
病例 组和对照组间 C(-1019)G 各基因型和等位基因分布 频率均无统计学差异（ P ＞ 0.05 ）。
3.5-HTTLPR 和 C(-1019)G 基因多 态性的联合作用与重性抑郁症发病的关系：
5-HTTLPR 和 C(-1019)G 基因多 态性的等位基因组合 分布 频率在病例组和对照组间有统计学差异（ P ＜ 0.05 ），病例 组 G-S 等位基因 组合的频率 (21.4%) 明 显高于对照组 (12.4%) 。
结论： 在中国 汉族人群中， 5-HTTLPR 和 C(-1019)G 有 联合作用， G-S 等位基因 组合会增加重性抑郁症发病的危险性。
Objective ： To investigate the relationship between 5-HTTLPR and C(-1019)G gene polymorphism and morbidity of MD.
Methods ： A case-control sample, including 197 patients and 197 controls, was recruited in our study with strict selected standards. The cases consist of 101 males and 96 females (age range, 18-63 years ;mean age, 29.95 ± 9.183 years) who come from the outpatients in Department of psychiatry , First Affiliated Hospital , Shanxi Medical University. The controls consist of 91 males and 106 females(age range, 18-67years ;mean age, 29.64± 9.581 years). PCR was used to detect the polymorphism of 5-HTTLPR and C(-1019)G. The UNPHASED software was used for data analysis.
Result ： 1. Hardy-Weinberg equilibrium: The goodness-of-fit χ 2 test for Hardy-Weinberg equilibrium in the Case and control shows 5-HTTLPR and C(-1019)G gene polymorphism corresponding with the H-W equilibrium （ P ＞ 0.05 ） in the two groups. 2. Results of revelence between 5-HTTLPR, C(-1019)G single gene polymorphism and MD There were no significant differences of the distribution of 5-HTTLPR, C(-1019)G genotypes and alleles between patients and controls （ P ＞ 0.05 ） . 3. Results of revelence between joint action of 5-HTTLPR, C (-1019)G gene polymorphism and MD There was a significant difference of allele combination frequency of C(-1019)G and 5-HTTLPR between patients and controls (P ＜ 0.05). The frequency of G-S allele Combination in MD group （ 21.4% ） was higher than control （ 12.4% ). .
Conclusions ： There exists combined effects between C(-1019)G and 5-HTTLPR in Chinese Han. TheG-S allele combination may raise the risk of morbidity of MD.
- P234
Behavioral and Neurochemical Changes Induced by N-3 Polyunsaturated Fatty Acids in Chronic Mild Stress Rats
Yun Xiao Guo 1 , Da Kai Jiang 1 , Bai Xiao Li 2 , Jin Yu 3 , Hong Dong Cui 1 , Cheng Gen Wu 3
1 Shanghai Mental Health Center, Psychiatry Department, Shanghai, Chinese Mainland, 2 No. Inical College, China Medical University, Shenyang, Chinese Mainland, 3 Institute of Acupuncture Research, Department of Integrative Medicine, Shanghai, Chinese Mainland
Objective: The purpose of the present study was to examine if Omega-3 polyunsaturated fatty acids(PUFA) would produce antidepressant-like effects on chronic mild stress(CMS) model of depression and on monoaminergic neurotransmitters in brain tissue.
Methods: Forty-three male Sprague-Dawley rats, weighing100-120g, were used in the experiments. All rats were randomly divided into two groups, the CMS group and control. The CMS group were subjected to stress for 4 weeks and then subdivided into 5 groups, which were administered with(2.5 mg·kg-1·d-1), olive oil (3.1ml·kg-1·d-1), fish oil （ 3.1ml·kg-1·d-1, which contains omega-3 PUFA 0.72 g·kg-1·d-1 ） , clomipramine(10mg·kg-1·d-1) and saline （ 4 mg·kg-1·d-1 ） respectively for another 4 weeks. During the period of drug administration the CMS was not discontinued. Behavioral responses (sucrose intake and sucrose preference) were observed every week. After the last fluid intake test, all rats were killed by decapitation next day. The concentration of 5-HT, NE, DA and their metabolites of the hippocampus and frontal cortex were analyzed.
Results: (1) There was a significant up-regulation effect of omega-3 PUFA, venlafaxine, and clomipramine on both sucrose intake and sucrose preference in the CMS rats at the week 4. At week 1-3 there was no difference in behavioral parameters between groups. (2) The omega-3 fatty acids up-regulated the levels of DA and down-regulated that of 5-HT in both hippocampus and frontal cortex, down-regulated that of 5-HIAA in hippocampus induced by CMS. Venlafaxine reversed the abnormality of 5-HIAA hyper-function in hippocampus 5-HT in frontal cortex in the CMS rats. Clomipramine reversed the hyper-function of 5-HIAA in hippocampus, the hyper-function of 5-HT, 5-HIAA, NE, and the hypo-function of DA in frontal cortex in CMS exposed rats.
Conclusions: (1)Our data suggests that omega-3 fatty acids have a helpful effect on reversing the depression-like behaviors in rats in CMS, which is consistent with that of venlafaxine and clomipramine. (2) 5-HT and DA system are linked with the mechanism of antidepressant effects of omega-3 fatty acids.
- P235
Fluoxetine Drug Treatments Induce Glial Cell Line-derived Neurotrophic Factor (GDNF) Synthesis and Release in Rat Astrocytes
Zhang Xiao Bin 1
1 Southeast University, The Department of Neurology, Affiliated ZhongDa Hospital, Nanjing, Chinese Mainland
Objective: Astrocytes are dynamic regulators of synaptogenesis and synaptic strength and control neuronal production in the adult dentate gyrus which maybe the basis of antidepressant action and pathophysiology of depression. We research effect of fluoxetine on secretary of GDNF (glia derived neurotrophic factor) in the astrocyte from rat hippocampus
Methods: Cell viability were decided by MTT assayin the different level of fluoxetine. The concentration of GDNF in medium of cell culture were determined by ELISA. The RNA expression levels of GDNF were detected in fluoxetine-treated astrocytes by real-time RT-PCR.
Results: The 10 μ M of fluoxetine was choosed to treat astrocytes as optimal drug level by MTT assay. The cells were treated with the indicated concentrations of fluoxetine （ 0 μ M 、 1 μ M 、 5 μ M 、 10 μ M ） for 48 h. The level of GDNF concentration (pg/mL) in the conditioned medium in the 10 μ M fluoxetine group was significantly higher than the 0 μ M 、 1 μ M fluoxetine groups(P<0.05). A significant increase of GDNF release was detected following treatment with 10 μ M fluoxetine （ P<0.01 ） , after a long incubation period (48 h). Astrocytes were treated at a range of concentrations of fluoxetine for 48 h, Augmented GDNF release induced by fluoxetine treatment continued for 24 h when fluoxetine was withdrawn. The level of GDNF were significantly higher in 10 μ M 、 15 μ M 、 20 μ M groups than in 0 μ M group （ P<0.05 ） . The expression level of GDNF mRNA in 10 μ M and 20 μ M fluoxetine group was 2.0 and 1.8 times than that in 0 μ M fluoxetine group respectively.
Conclusions: Fuoxetine can promoted the secretion of GDNF and the express of mRNAGDNF. Fluoxetine -induced GDNF release was increased in a time- and concentration-dependent manner following 48 h incubation in astrocytes.
- P236
重性抑郁症 5-HTTLPR 和 5-HTTVNTR 与疾病 严重程度、自杀观念 的 关联性研究 - Association Study of Serotonin Transporter Gene Polymorphism and Major Depression
莉 张 1 , 孙宁 李忻蓉 彭菊意 张克让
1 山西医科大学 , 太原 , Chinese Mainland
目的 ： 探 讨重性抑郁症患者 5- 羟色胺转运体 （ 5-HTT ） 基因多 态性 (5-HTTLPR 、 VNTR) 与疾病 严重程度、自杀观念的关系。
方法 ： 选取重性抑郁症 (MD) 患者 239 例 ， 均 为汉族。采用 HAMD （ 17 项 ） 进行评定并计算总分 ， 以 24 分 为界将抑郁严重程度分为轻中度和重度两个等级。据 HAMD 第三 项条目 “ 自 杀 ” 的有无，分 为有自杀观念组和无自杀观念组。运用 PCR 检测 5-HTTLPR 和 VNTR 基因多 态性。应用 SPSS11.5 软件，采用方差分析、 χ2 检验以及多元 Logistic 回 归模型进行统计。
结果： 1 ． 5-HTTLPR 、 5-HTTVNTR 与疾病 严重程度的关联性分析： 不同基因型及等位基因 间 HAMD 总分值均数的比较均无统计学差异（ P>0.05 ）；以 24 分 为界将抑郁严重程度分为轻中度和重度两个等级间基因型与等位基因频率分布亦均无统计学差异（ P>0.05 ）。
2 ． 5-HTTLPR 、 5-HTTVNTR 与自 杀观念的关联性分析： ① MD 有无自 杀观 念 组间 5-HTTLPR 等位基因（ L 和 S ） 频率分布的比较有统计学差异（ x2=8.820 ， P=0.003 ）。以 S 等位基因 为参照， L 等位基因的 OR 值为 2.029 (95%CI=1.265-3.255,P=0.003) ， 说明 L 等位基因出 现自杀观念的风险为 S 等位基因的 2.029 倍。
MD 有无自 杀观念组间 5-HTTLPR 三 种基因型（ LL 、 LS 、 SS ） 频率分布的比较有统计学差异（ x2=8.358 ， P=0.015 ）。以 SS 基因型 为参照， LS 基因型的 OR 值为 1.982(95%CI =1.093- 3.596,P=0.024) ， LL 基因型的 OR 值为 3.802 ( 95%CI = 1.062 - 13.615,P=0.040) 。
② MD 有无自 杀观念组间 5-HTTVNTR 基因型（ Stin12/Stin12 、 Stin12/Stin10 ） 频率分布的比较无统计学差异（ x2=0.001 ， P=0.977 ），等位基因（ L 和 S ） 频率分布的比较亦无统计学差异（ x2=0.001 ， P=0.978 ）。
结论： 在 汉族人群中：
1. 5-HTTLPR 与 MD 疾病 严重程度无关联，与自杀观念可能有关联， L 等位基因可能是出 现自杀观念的危险等位基因， LL 基因型和 LS 基因型可能是出 现自杀观念的危险基因型。
2. 5-HTTVNTR 与 MD 疾病 严重程度无关联 ， 与自杀观念亦无关联。
Objective: To explore the association between 5-HTT gene polymorphism (5-HTTLPR and 5-HTTVNTR) and severity, suicidal idea of MD.
Methods: We selected 239 han patients with major depression as subjects.The depression states were assessed with Hamilton Depression Rating Scale(HAMD). The genotypes of two polymorphism (5-HTTLPR and 5-HTTVNTR) in 5-HTT gene were determined by using polymerase chain reaction.Using SPSS11.5 software analyses the results of χ 2 analysis, ANCOVA and multivariate logistic regression.
Results:
1. Results of revelence between 5-HTTLP, 5-HTTVNTR and severity of MD The comparison of HAMD score between genotypes and alleles had no significant difference. And the distribution of genotypes and alleles between two HAMD grades were not get statistical significance yet.
2. Results of revelence between 5-HTTLP, 5-HTTVNTR and suicidal idea of MD ① There were significant differences of the distribution of 5-HTTLPR alleles (L and S) between suicidal idea group and non-suicidal idea group ( χ 2=8.820, P=0.003). Comparing with the OR values of S,the OR values of L were 2.029 (95%CI=1.265-3.255, P=0.003).
There were significant differences of the distribution of 5-HTTLPR genotypes (LL,LS and SS) between suicidal idea group and non-suicidal idea group ( χ 2=8.358, P=0.015).Comparing with the OR values of SS,the OR values of LS were 1.982(95%CI=1.093-3.596, P=0.024)and the OR values of SS were 3.802 (95%CI=1.062-13.615, P=0.040). ② There were no significant differences of the distribution of 5-HTTVNTR genotypes (Stin12/Stin12 and Stin12/Stin10) between suicidal idea group and non-suicidal idea group ( χ 2=0.001,P=0.977)and the distribution of 5-HTTLPR alleles (L and S) were not get statistical significance yet( χ 2=0.001,P=0.978).
Conclusions:
1. 5-HTTLPR is associated with the suicidal idea of MD and L alleles, LL genotype and LS genotype can raise risk of its suicidal idea. But 5-HTTLPR may not corelate with severity of MD.
2. 5-HTTLPR may not corelate with severity and suicidal idea of MD.
- P237
5- 羟色胺转运体基因多态性与人格特征的关联性研究 - Association between the Serotonin Transporter Gene Polymorphism and Personality Traits
燕 任 1 , 杨红 徐勇 崔 晓红 孙宁 李忻蓉 彭菊意 张克让
1 山西医科大学 , 太原 , Chinese Mainland
目的 ： 分析 5- 羟色胺转运体基因 （ 5-HTT ） Stin2 及 LPR 多 态性与 中国 汉族健康人艾森克人格的关联性。
方法 ： 严格按入组标准收集 305 例中国 汉族健康人 ， 收集其一般人口学资料 ， 采用艾森克人格问卷 (EPQ) 测量人格 N 、 E 、 P 三个 维度 ， 计算各维度标准分 （ T ）， 并以 T50 分 为界 ， 将各维度分为两个等级 ： 神经质和非神经质人格 ， 内倾和外倾人格 ， 精神质和非精神质人格 ； 采用 PCR 对基因多态性进行检测。使用 SPSS13.0 统计软件包及 UNPHASED 软件进行统计分析。
结果：
1.Hardy-Weinberg 遗传平衡检验： 5-HTTLPR 、 Stin2 多 态性达到遗传平衡（ P>0.05 ），所 选样 本具有群体代表性。
2. 不同年 龄、性别、婚姻状况在人格各维度分级间分布均无明显差异（ P>0.05 ）。 3. Stin2 与人格的 关联分析：按性别分层进行研究：结果显示在男性或女性人群中， Stin2 不同基因型、等位基因 间 N 、 E 、 P 各人格 T 分均数比 较差异无统计学意义（ P>0.05 ）， N 、 E 、 P 不同人格 维度间 Stin2 基因型、等位基因 频率分布差异无统计学意义（ P>0.05 ） 4.5-HTTLPR 与人格的 关联分析：结果显示在男性或女性人群中， 5-HTTLPR 不同基因型、等位基因 间 N 、 E 、 P 各人格 T 分均数比 较差异无统计学意义（ P>0.05 ）， N 、 E 、 P 不同人格 维度间 5-HTTLPR 基因型、等位基因 频率分布差异无统计学意义（ P>0.05 ）。
结论： 当 样本例数为 305 例 时，未显示 Stin2 及 5-HTTLPR 与中国 汉族健康人群神经质、内外向、精神质人格存在关联。
Objective ： To assess the association between serotonin transporter (5-HTT) gene polymorphism (including Stin2 and 5-HTTLPR) and the Eysenck personality Questionnaire (EPQ) personality dimensions in Chinese Han normal population.
Methods ： 305 unrelated Chinese Han normal individuals were selected in our study with strict standards, general demography data were collected, three personality dimensions (Neuroticism, Extraversion and Psychoticism) were assessed with EPQ, calculate the standard scores (T) of three dimensions, and then divide the personality into two levels by the T50: Neuroticism and Non-neuroticism, Introversion and Extraversion, Psychoticism and Non-psychoticism; the polymorphism of Stin2 and 5-HTTLPR were detected by polymerase chain reaction (PCR). SPSS13.0 and UNPHASED software were used for single polymorphism association analysis.
Results ：
1.Hardy-Weinberg equilibrium test: Stin2 and 5-HTTLPR were obtained Hardy-Weinberg equilibrium (P>0.05), which indicated that the sample can represent the population.
2.There was no statistically significant difference of age, gender and marriage between different personality dimension levels (P>0.05).
3.Stin2 and personality: Study the association in male and female separately, the results showed that neither in male nor in female, there was no statistically significant difference of each personality means between different Stin2 genotype and allele frequency; there was no statistically significant difference of Stin2 genotype and allele frequency distribution between different personality dimension levels (P>0.05).
4.5-HTTLPR and personality: the results showed that neither in male nor in female, there was no statistically significant difference of each personality means among different 5-HTTLPR genotype and allele frequency;there was no statistically significant difference of 5-HTTLPR genotype and allele frequency distribution between different personality dimension levels(P>0.05).
Conclusions ： When the sample reaches 305, it didn't show that the Stin2 and 5-HTTLPR gene polymorphism have association with the Neuroticism, Extraversion and Psychoticism personality in Chinese Han normal individuals.
- P238
精神分裂症核心家系 MTHFR 基因多 态位点 HRR 和 TDT 分析 - Analysis of the Polymorphic Site HRR and TDT of MTHFR Gene in in Nuclear Family Member of Schizophrenia
万虎 亢 1 , 宁 师 1
1 西安交通大学医学院第一附属医院精神科 , 西安 , Chinese Mainland
目的 : 探 讨汉族精神分裂症与亚甲基四氢叶酸还原酶 (MTHFR) 基因多 态性的关系。
方法 : 应用聚合酶链反应和限制性片段长度多态性技术 , 检测 106 例精神分裂症患者及其父母的基因多 态性 , 采用 单倍体相对风险 （ HRR ） 和 传递不平衡检验 (TDT) 方法分析精神分裂症核心家系 MTHFR 基因与精神分裂症的 关系。结果 (1) 精神分裂症 组 MTHFRC677T 、 A1298C 基因型 频率分布均与父母组相接近，差异无统计学意义 (χ2=0.369, p>0.05 ； χ2=1.214 ， p>0.05) 。（ 2 ） HRR 分析 结果提示 MTHFRC677T 和 A1298C 两位点均与精神分裂症无 关联（ χ2=0.236 ， p>0.05 ； χ2=3.327 ， p>0.05 ）。（ 3 ） TDT 检验未发现精神分裂症与 MTHFR 基因相 连锁（ χ2=0.243,p>0.05; X2=2.123,p>0.05 ）。
结论 : MTHFR 基因 C677T 、 A1298C 多 态性均与精神分裂症无关联，未发现 MTHFR 基因与精神分裂症的 发病存在传递不平衡， MTHFR 基因可能不是中国 汉族精神分裂症的遗传易感因素。
- P239
雌激素 对妇女围绝经期与绝经期抑郁障碍的影响 - The Effect of Estrogen in Peri-menopausal and Menopausal Women with Depressive Disorders
学文 于 1 , 成 阁 高 2
1 西安交通大学医学院第一附属医院 妇幼保健中心 , 陕西西安 , Chinese Mainland, 2 西安交通大学医学院第一附属医院心理 卫生中心 , 陕西 , Chinese Mainland
探 讨了围绝经期与绝经期抑郁障碍妇女的雌激素水平以及用雌激素治疗妇女围绝经期与绝经期抑郁障碍的效果。
方法： 采用磁 酶 联免疫技术检测了 30 例 围绝经期和绝经期抑郁障碍妇女血清雌激素、卵泡刺激素、黄体生成素水平。并用雌激素（单用组）或联合应用抗抑郁药物（联合组）治疗围绝经期和绝经期抑郁障碍妇女，用 HAMD 量表 评估抑郁症状的治疗效 果；用 KMI 量表 评估围绝经期和绝经期症状的治疗效果。
结果： 围绝经期与绝经期抑郁障碍妇女血清雌激素水平明显低于正常围绝经期及绝经期妇女 (P<0.05) 。治 疗后两组 HAMD 总分均明显下降 (P<0.001) ； 联合组和单用组的减分率分别为 70.53% 和 58.24% ，两 组比较有显著性差异 (P<0.05) 。 联合组和单用组的总有效率分别为 93.33% 和 80% ， 联合组高于单用组，但无统计学意义（ P>0.05 ）。治 疗后两组 KMI 评分均明显下降，差异非常显著 (P<0.001) ； 联合组和单用组的减分率（ 73.99% 和 70.66% ）、 联合组和单用组的总有效率（ 96.67% 和 93.33% ）也无明 显差异 (P>0.05) 。
结论： 围绝经期与绝经期抑郁障碍的发生与雌激素水平的降低有关，因此采用雌激素治疗围绝经期与绝经期抑郁障碍可以取得良好的效果。受雌激素水平的影响，在原来抗抑郁药物的基础上，联合应用雌激素对提高疗效的作用更明显。
Objective: To investigate concentration of estrogen, FSH and LH in serum and the effects of estrogen therapy (ET) on antidepressant response in perimenopausal and postmenopausal women with depressive disorder.
Methods: Serum levels of estrogen, FSH and LH were measured by magnetism-ELISA. Thirty subjects received estrogen at 2.5mg/day for two week, with an decrease to 1.25mg/day at week 3 for a 8-week trial, and thirty-one subjects received the combination of estrogen and antidepressant at 20mg. The 17 item Hamilton Depression Rating Scale (HDRS) and Kupperman (KMI) were administered to all patients at baseline and 8-week thereafter.
Results: The serum level of estrogen was lower in women with depressive disorder than in the healthy women (p<0.05). No difference was found for FSH and LH between two groups. Both groups showed a significant reduction in HDRS and KMI scores at the end of the 8-week trial. The women receiving estrogen with antidepressant (70.53% for decreased HDRS score rate)showed significantly greater improvement compared to the women receiving estrogen only (58.24% for decreased HDRS score rate). There was no significant difference between the two treatment groups for total effective rate of improving depressive disorder and perimenopausal and postmenopausal symptoms.
Conclusion: Perimenopausal and postmenopausal depressive disorder is correlated with serum estrogen level. Estrogen may play a effective role in antidepressant for perimenopausal and postmenopausal women with depressive disorder. But the combination of antidepressant and estrogen is the best solution for the treatment of perimenopausal and postmenopausal depressive disorder, and the therapy must be individual.
- P240
Ghrelin 和 Leptin 基因多 态性与精神分裂症患者利培酮治疗前后血糖变化 - Ghrelin and Leptin Gene Polymorphism and Change of Serum Glucose before and after Risperidone Treatment in Patients with Schizophrenia
丽阳 郭 1 , 万虎 亢 1
1 西安交通大学医学院第一附属医院心理 卫生中心 , 陕西西安 , Chinese Mainland
目的 : 精神分裂症受 试经利培酮单药治疗后空腹血糖的变化 , 分析瘦素基因 － 2548G/A 多 态性 ， ghrelin( 生 长索 ） 基因 Leu72Met （ 亮氨酸 72 蛋氨酸 ） 多 态性分别和相互作用与血糖变化的联系。
方法 : 66 例受 试利培酮单药治疗 10 周 ， 治 疗前和治疗 4 周和 10 周 时测空腹血糖水平。聚合酶链式反应 － 限制性片段长度多态性 （ PCR-RFLP ） 技 术检测瘦素基因和 ghrelin 基因多 态性。结果 治 疗后受试血糖水平有显著性增加，（ 4.589±0.832 /4.994±0.808/5.211±0.655 ， F=13125.61, P ＜ 0.01 。男性瘦素 GG+GA 基因型携 带者治疗后血糖水平较高， p=0.018 。 ghrelin 基因 Leu72 等位基因携 带者空腹血糖水平较高（ 0.702±0.009/0.677±0.008 ， F=4.269, P =0.042 ）。两 种基因的联合作用和利培酮治疗后血糖变化有关， P ＜ 0.05 。
结论 : 利培 酮治疗可导致受试血糖水平升高。瘦素 G 等位基因是治 疗后男性发生空 腹血糖升高的危 险因素。携带 ghrelin 基因 Leu72 等位基因的患者易 发生高血糖。
Objects: To assess the change of fasting plasma glucose during resperidone treatment in patients with schizophrenia or schizophrenia-like psychosis. To analyse the relation between the each or combined action of polymorphism of the leptin -2548G/A and the ghrelin gene Leu72Met and the change of the fasting plasma glucose.
Methods: 66 patients with schizophrenia or schizophrenia-like psychosis were treated with risperidone during 10 week. Fasting plasma glucose was measured on admission, 4-week and 10-week treatment. The polymorphism of leptin and ghrelin gene were determined with PCR-RFLP technique.
Results: During risperidone treatment, fasting plasma glucose increase significantly on 4-week, 10-week (4.589±0.832/4.994± 0.808/5.211± 0.655 ， F=13125.61, P ＜ 0.01). The man with G allele has the higher lever of the fasting plasma glucose (F=6.528,P=0.016). The patient with Leu72 allele also has the higher glucose level (0.702±0.009/0.677±0.008 ， F=4.269, P =0.042). The combination action of the two gene polymorphism had relation with the change of serum glucose during treatment, P ＜ 0.05.
Conclusions: During the treatment of risperidone, patients have the increase of fasting plasma glucose. The –2548G allele of leptin gene may be a risky factor of the increase of the fasting plasma glucose caused by risperidone in man. The Leu72 allele in ghrelin gene may be also a risky factor of the increase of the fasting plasma glucose.
- P241
多巴胺 D2 受体基因多 态性与精神分裂症、药物疗效、锥体外系反应及治疗前后泌乳素水平变化 的 关联分析 - Association of Polymorphism of Dopamine D2 Receptor Gene and Schizophrenia, Medical Therapeutic Effect, Extracorticospinal Tract's Response and the Change of the Prolactin Level from Prior Treatment to Post-treatment
希 照 仲 1
1 新 乡医学院第二附属医院 , 新 乡 , Chinese Mainland
目的 : 探 讨多巴胺 D2 受体基因 Taq1A 多 态性与精神分裂症、药物疗效、锥体外系反应及治疗前后泌乳素水平变化的相关性 ； 方法 选择符合 CCMD-3 诊断标准的首发住院精神分裂症患者 198 例 ， 来自新 乡医学院第二附属医院在 2005 年 10 月至 2006 年 10 月首次住院的患者。 198 例健康人作 为对照。患者服药前和治疗第 8 周 进行 PANSS 量表 评定，并进行疗效评定和锥体外系评定；利用 PCR 技 术对精神分裂症患者 D2 受体基因型 测定，用酶联免疫法对患者治疗前后泌乳素水平测定； 结果 首 发精神分裂症患者治疗前后 血清泌乳素水平之 间有显著性差异；多巴胺 D2 受体 Taq1 基因型 A1A1 在精神分裂症 组和对照组有显著性差异，基因型和等位基因频率与药物疗效、锥体外系反应及治疗前后泌乳素水平的变化之间没有显著性差异 ; 结论 首 发精神分裂症患者服用抗精神病药物维思通后，血清泌乳素水平高于治疗前；多巴胺 D2 受体 Taq1 基因型 A1A1 可能是精神分裂症的危 险因素；精神分裂症患者基因型和等位基因频率与药物疗效、锥体外系反应及治疗前后泌乳素水平的变化没有联系。
Objective: The current study is to investigate the relationship of polymorphism of dopamine D2 receptor gene and schizophrenia, medical therapeutic effect, extracorticospinal tract's response and the change of the prolactin level from prior treatment to post-treatment.
Methods: 198 schizophrenics who were diagnosed according to CCMD-3 were the first time hospitalization in the Second Affiliated Hospital of XinXiang Medical College in the period of October in 2004 and June in 2005. 198 health adults were acted as control group. All patients were evaluated by PANSS scale before drug treatment and in the eighth week. In the period of treatment they were undertaken therapeutic effect and extracorticospinal tract evaluation. To survey schizophrenics' D2 acceptor genetype used by PCR, to survey the patients' prolactin level from prior treatment to post-treatment used by euzymelinked immunosorbent assay.
Results: There was significant difference in the prolactin level in serum of the first-episode schizophrenia patients from prior treatment to post-treatment; There was significant difference in dopamine D2 receptor Taq1 genetype A1A1 between the schizophrenia group and the normal contract ， but there was no significant difference between genetype, allele frequency and medical therapeutic effect, extracorticospinal tract's response and the change of the prolactin level from prior treatment to post-treatment.
Conclusions: The prolactin level in serum of first-episode schizophrenia are higher after they were treated with Risperdal; Probably dopamine D2 receptor Taq1 genetype A1A1 is a risk factor of schizophrenia. There is no relationship between genetype, allele frequency and medical therapeutic effect, extracorticospinal tract's response and the change of the prolactin level from prior treatment to post-treatment
- P242
使用 MK-801 建立精神分裂症 动物模型的研究 - Animal Model of Schizophrenia Built by MK-801
鸽 杨 1
1 河南省精神病医院 , 新 乡 , Chinese Mainland
目的 : 探 讨 MK-801 制作精神分裂症 动物模型的可行性。 [ 方法 ]1. 取健康雄性 Wistar 大鼠 64 只 ， 体重 350±20g ， 随机分 为 8 组 ， 每组 8 只 ， 设其中 1 组为对照组 ， 其它 7 组根据注射的 MK-801 剂量分别设为 0.06mg/kg ， 0.15mg/kg ， 0.3mg/kg ， 0.6mg/kg ， 1.2mg/kg ， 1.8mg/kg ， 2.4mg/kg 组。 2 实验组分别腹腔注射对应剂量的 MK-801 ， 对照组给予等体积生理盐水，均连续注射 3 天。 观察末次后大鼠的运动、刻板行为、共济失调及社会行为并进行评分，每 10min 评分一次，共 6 次。 3.1h 后将大鼠断 头取脑，脑组织 -70 ℃保存。 4. 根据 评分结果绘制运动、刻板行为、共济失调的时间－效应曲线和剂量－效应曲线图。
结果 : 0.06mg/kg 、 0.15mg/kg 剂量 MK-801 作用下大鼠行 为无明显改变； 0.3mg/kg 、 0.6mg/kg 、 1.2mg/kg 、 1.8mg/kg 、 2.4mg/kg 剂量的 MK-801 可 诱发大鼠出现类精神分裂症症状。根据运动、刻板行为、共济失调的时间－效应曲线和剂量－效应曲线优化建立精神分裂症动物模型的最佳剂量为 0.6mg/kg 。精神分裂症 动物模型的行为改变主要表现为运动明显增多、刻板行为、共济失调、社会退缩包括。 结论 : 使用 MK-801 建立精神分裂症 动物模型具有可靠性、可重复性和稳定性的优势。
Objective: Investigate the predominance of schizophrenia model built by MK-801.
Methods: 1 Experimental animals were 64 healthy male SD rats weighting 350±20g. Rats were randomly divided into 8 groups,one group with saline, the other groups with different doses of MK-801, 0.06mg/kg, 0.15mg/kg, 0.3mg/kg, 0.6mg/kg, 1.2mg/kg, 1.8mg/kg, 2.4mg/kg. 2 Expermental groups were injected daily with different doses of MK-801 （ ip ） and control group with an equal volume of 0.9% saline （ ip ） for 3 days. We observed locomotion of all animals before last administration with MK-801, and evaluated locomotion, stereotype, ataxia, social behaviour every 10 min for one hour after last injection. 3 All rats were killed 1h later. Brains were removed and immediately stored long term at -70 ℃ . 4 We drawed the dose-response maps on the basis of scores evaluated.
Results: At doses of 0.3mg/kg, 0.6mg/kg, 1.2mg/kg, 1.8mg/kg, 2.4mg/kg rats were induced schizophrenia-like symptoms, but at doses of 0.06mg/kg, 0.15mg/kg MK-801 had no effect on rats behaviour.According to the results of dose-response measurements of locomotion, stereotype, ataxia, 0.6mg/kg MK801 was determined as the optimum dosage for animal model of schizophrenia. The model existed schizophrenia-like sympyoms including hyperlocomotion,stereotype, ataxia and social withdrawal.
Conclusions: It is valid, repeatable and steady to build schizophrenia model with MK-801.
- P243
Effects of Urocortin3 on Anxiety-like Behavior of Rats and Serotonergic Neurons in Dorsal Raphe Nucleus and Hippocampal CA3
Fei Song 1 , Mei Xu Wang 2
1 Shenjing Hospital Affiliated China Medical University, Psychiatry Department, Shenyang, Chinese Mainland, 2 Shenjing Hospital Affiliated China Medical University, Shenyang, Chinese Mainland
Preface: With animal anxiety models developing, the studies become more in mechanism about animal anxiety-like behavior and stress behavior. Researches about CRF peptide family in anxiety models were keeping profound. CRF peptide family includes CRF, urocortin 1 (UCN1), urocortin 2(UCN 2), urocortin 3(UCN 3). UCN3 is a new member of CRF peptide family, and binds with high affinity to CRF2 receptor. There were not concordant conclusions about the effects and mechanism of UCN3 on stress-like behavior. Elevated plus maze is a classical animal anxiety model, and we used it to invest the effects of UCN3 on anxiety-like behavior. Some studies showed that CRF peptide family not only bind with self receptor, but also impacted with serotonergic system. The aim of this research was to study the effects of UCN3 on stress behavior and serotonergic neurons in both dorsal raphe nucleus and hippocampal CA3. The result would provide theory about the effects of UCN3, CRF2 receptor on stress behavior and exploitation of new anti-anxiety drugs.
Methods: All rats were anesthetized with hydral, mounted in a stereotaxic and unilaterally implanted with an indwelling cannula. Rats were allowed 1 week to recover prior to testing. Rats were randomly divided into 3 groups, UCN3 group(n=12), control group (n=12),blank control group(n=12). 10ug UCN3 was intracerebroventricularly (i.c.v) microinjected to UCN3 group. 5ul saline was microinjected i.c.v. to control group and blank control group. After microinjected i.c.v. 10 minutes, UCN3 group and control group were placed onto the center of elevated plus maze for 5 minutes. After 2 hours when UCN3 group and control group were tested behavior, all rats were anesthetized and perfused by paraformaldhyde. Middle brains were removed and made into frozen slices. Immunohistochemistry method was used to measure the expression of 5-HT in DRN and hippocampal CA3.
Results: Rats centrally injected with UCN3, displayed a significantly increased time spent in the open arms(t=2.45, P<0.05), higher percentage of time in the open time(t=2.75, P<0.05), higher open arm entries(t=0.78, P<0.05),compared to vehicle-treated rats. Compared with control grpup, OD scores and positive cell of DRN 5-HT in UCN3 group significantly increased (t=2.29, P<0.05),(t=2.23,P<0.05), and OD scores and positive cell of hippocampal CA3 of UCN3 group significantly increased(t=4.46, P<0.01),(t=16.97, P<0.01). Compared with blank control group, OD scores and positive cell of DRN 5-HT in control group decreased insignificantly(P>0.05).
Discussion: The principal of EPM is rodents are not only curious of new environment, but also afraid of high and open place. Open arm preference in EPM, as measured by preferential time and entries directed at the open arms, has been proposed to relate inversely to anxiety. After microinjected i.c.v. 10ug UCN3 10 minuets, the preferential time and entries of open arm are more than control group. This indicated an anxiolytic-like function for UCN3. Serotonergic neurons of the brainstem dorsal raphe nucleus are known to be important mediators of the endocrine and behavioral responses to exposure to stressors. Amydala and hippocampus is one of projections regions of 5-HT neurons. 5-HT is a significant neurotransmitter in mental disorders. The present experiment discover UCN3 increased 5-HT expression in DRN, which stimulated 5-HT neurons in DRN,and induced 5-HT expression increased in hippocampal CA3,suggesting that UCN3 increases 5-HT projection to hippocampus from DRN. The present experiment further supports that CRF2 receptor which UCN3 specially binds lead to anxiolytic-like effects in regulation of behavioral response to stress. It would provide a new way to study and cure anxiety disorders and stress related disorder.
Key words: Urocortin 3; anxiety-like behavior; serotonin; dorsal raphe nucleus; hippocampus
- P244
与未服 药首发精神分裂症患者错误监控过程相关的异常神经活动源 - Dysfunctional Neural Origins of Error Monitoring Process in First Episode and Drug-naive Schizophrenia
继军 王 1 , 云翔 唐 2 , 明 岛 张 2 , 伟君 苏 1 , 斌 谢 3 , 泽萍 肖 4
1 上海市精神 卫生中心脑电影像室 , 上海市 , Chinese Mainland, 2 上海交通大学医学院精神医学教研室 , 上海 , Chinese Mainland, 3 上海市精神 卫生中心 , 上海 , Chinese Mainland, 4 上海市精神 卫生中心 , 上海市 , Chinese Mainland
Aim: A failure of internal monitoring of errors contributes to the generation of schizophrenic symptoms. For instance, Frith and Done (1990) proposed that failure to monitor self-generated activity contributes to delusions of alien control. A distinct negative event-related potential (ERP) was detected when participants make errors of commission on a wide variety of experimental tasks, and has been termed as error-related negativity (ERN). The rostral anterior cingulate has been postulated as the neural origin of ERN. Although a decreased ERN has been reported in schizophrenia patients, whether this electrophysiological abnormality could be directly associated with the dysfunctional neural activity of anterior cingulate in schizophrenia remains unclear. The present study examined this association in first episode and drug-naive schizophrenia.
Methods: Subjects were 11 drug-naive patients with first episode schizophrenia. They were compared with 21 gender, age and education matched normal controls. ERN was elicited using a variation of the Eriksen Flanker Task, and was recorded with the 64 channel Neuroscan cap and BrainAmp 32*2. The neural generators of ERN were reconstructed using Low Resolution Brain Electromagnetic Tomography (LORETA). The difference of ERN neural current density was evaluated using LORETA built-in t test.
Results: A reduction in ERN amplitude was replicated in our schizophrenia patients. LORETA analysis revealed that the neural origins of ERN in normal controls included Superior Frontal Gyrus (BA 8, BA 6), Middle Frontal Gyrus (BA 9) and Middle Temporal Gyrus (BA 21). The main origins of ERN in schizophrenia patients included Middle Occipital Gyrus (BA 19, BA 18), Superior Frontal Gyrus (BA 8), Middle Frontal Gyrus (BA 9) and Inferior Temporal Gyrus (BA 37). However, the significant difference of ERN associated neural activity between 2 groups was found on Superior Frontal Gyrus (BA 9, BA 8) and anterior cingulate (BA 32, BA 24).
Conclusions: While schizophrenia patients might recruit a different neural circuit when they monitor their error responses, the abnormal ERN in schizophrenia patients at least partly derives from the dysfunctional neural activity of anterior cingulate.
- P245
应激适应中单胺类神经递质的作用及 5-HT 对海马 GR/MR 和 BDNF 表达的影响 - Role of Monoamine Neurotransmitter and the Effect of 5-HT to GR/MR and BDNF in Hippocampus in Adjustment to Stress
建松 周 1 , 凌江 李 1 , 卫晖 李 1
1 中南大学湘雅二医院精神 卫生研究所 , 长沙市 , Chinese Mainland
目的 : 研究 单次及重复限制应激大鼠额叶、海马、下 丘 脑等脑区单胺类递质变化 ； 5-HT 及其 1A 受体在慢性 应激中对大鼠情绪、认知等及对海马 GR/MR 受体、 BDNF mRNA 表达的影响 ， 探索 5-HT 在 应激适应中的作用机制。
实验一 ： 方法 24 只雄性 SD 大鼠随机分 为对照、单次应激和重复应激等 3 组。重复应激连续应激 10 天 ， 应激 24 小 时后进行行为学测试 ， 并断头取脑 ， 采用高效液相色谱分析法分析额叶、海马和下丘脑组织匀浆的单胺类递质及其代谢产物。 结果 单次应激组旷场实验中央格停留时间和高架十字迷宫中开臂停留时间明显低于对照组 （ P<0.01 ）， 而重 复应激组与对照组无显著性 差异 （ P>0.05 ） 。 单次应激组额叶、海马 5-HT 及 5-HIAA 的含量高于 对照组 （ P<0.01 ）， 额叶和下丘脑的 MHPG 水平、下丘 脑的 NE 水平高于 对照组 （ P<0.01 或 P<0.05 ）； 重 复应激组海马的 5-HT 及 5-HIAA 高于 对照组 （ P<0.01 ）； 单次应激组与重复应激组的海马儿茶酚胺类与对照组与均无显著性差异 （ P>0.05 ） 。
实验二 ： 方法 按体重匹配原 则将大鼠随机分为对照、应激、 5-HT 耗竭和 5-HT 耗竭 应激等 4 组 ， 以对氯苯丙胺耗竭 5-HT 。 应激连续 10 天。以 旷场实验、高架十字迷宫、糖水偏好实验、强迫游 泳 实验和水迷宫测试等进行行为学评估。以免疫组化方法比较各组海马 GR/MR 蛋白免疫反 应性；以原位杂交法比较各组海马各区 BDNF mRNA 的表达。 结果 5-HT 耗竭 应激组相对于应激组旷场实验中央格停留和高架十字迷宫开臂停留时间较少（ P<0.01 ）；糖水 实验消耗糖水较少、强迫游泳中不动时间较长（ P<0.01 ）。水迷 宫测试的第 3 、 4 天， 5-HT 耗竭 应激组平均逃离潜伏期明显增加，测试时在目标象限停留时间和穿越平台次数明显减少。应激组海马各区 GR 水平均高于 对照组，其余各组间无显著性差异；各组海马各区 MR 水平无 显著性差异 （ P>0.05 ）。 5-HT 耗竭 应激组 BDNF mRNA 在海 马各区的表达分别低于耗竭组（ P<0.01 ），其余各 组间无显著性差异（ P>0.05 ）。
实验三： 方法 给予对氯苯丙胺耗竭大鼠体内 5-HT ，再按体重匹配原 则随机分为：对照、应激、 DPAT 、 应激 +DPAT 、 WAY 、 应激 +WAY 、 应激 +WAY+DPAT 等 7 组。分别给予 5-HT1A 激 动剂 8-OH-DPAT 或拮抗 剂 WAY100635 皮下注射。 应激模式，行为学、免疫组化、原位杂交等同实验二。结果 8-OH-DPAT 能降低 5-HT 耗竭 组及 5-HT 耗竭 应激组旷场实验和 高架十字迷 宫实验中的焦虑水平，增加其糖水消耗量，减少其在强迫游泳中总不动时间，而该作用则被 WAY100635 阻断。各 组水迷宫实验平均逃离潜伏期、目标象限时间和穿越平台次数均无显著性差异（ P>0.05 ）。 应激 +DPAT 组海马 CA1 、 CA2 及 CA3 区的 GR 水平高于 应激组（ P<0.05 ）；其余各 组 GR 水平无 显著性差异（ P>0.05 ）；各 组海马各区 MR 水平无 显著性差异（ P>0.05 ）。 应激 +DPAT 组海马各区的 BDNF mRNA 水平高于 应激组（ P<0.05 ），其余各 组无显著性差异（ P>0.05 ）。 结论 ① 大鼠急性 应激焦虑水平增高，重复暴露则能够对该刺激适应。 ② 应激引起海马 5-HT 及其代 谢产物增加，促进个体对应激适应。 ③ 5-HT 低下使大鼠 对应激适应能力降低，产生抑郁、焦虑，且易导致学习记忆等认知功能受损。 ④重 复应激中， 5-HT 耗竭大鼠海 马 GR 功能受抑制、 BDNF mRNA 表达下 调。 ⑤突触后 5-HT1A 受体激活有利于保 护海马，促使其发挥正常功能，能够缓解应激引起的焦虑、抑郁行为，从而促进对应激的适应。
- P246
精神分裂症 动物模型不同脑区 IL-1β 和 TNFα 表达的研究 - The Expression Levels of IL-1β and TNFα in Different Brain Regions of Animal Model with Schizophrenia
燕 张 1
1 河南省精神病医院 , 新 乡 , Chinese Mainland
目的 : 验证精神分裂症模型存在免疫紊乱并探讨 MK-801 对 IL-1β 和 TNFα 表达的影响。
方法 : 1 实验动物选用健康的雄性 SD 大鼠 16 只，体重 350±20g ，将大鼠随机分 为 2 组，每组 8 只。 2 实验组腹腔注射 0.6mg/kg 剂量的 MK-801 ， 对照组给予等体积生 理 盐水，均连续注射 3 天。 对末次注射后大鼠的运动、刻板行为、共济失调及社会行为进行评分，每 10min 评分一次，共 6 次。 3 1h 后将大鼠断 头取脑， -70 ℃保存。 4 利用免疫 组化法检测大鼠前额皮质，齿状回和海马 CA1 区的 IL-1β 、 TNFα 表达水平；使用 图文分析系统分析 IL-1β 、 TNFα 表达的 积分光密度值。 5 统计方法采用独立样本 t 检验。
结果 : 1 精神分裂症 动物模型中 IL-1β 在 DG 区的表达水平 显著低于对照组；在 PFC 和 CA1 区的表达低于 对照组 , 差异无 显著性。 2 精神分裂症模型中 TNFα 在 DG 区和 CA1 区的表达水平 显著低于对照组；在 PFC 区的表达低于 对照组，差异无显著性。
结论 : 精神分裂症 动物模型存在由 IL-1β 和 TNFα 介 导的免疫紊乱， MK-801 对不同脑区 IL-1β 和 TNFα 的表达具有抑制作用。
Objective: Investigate the existence of immune disturbance in animal model with schizophrenia and the effect produced by MK-801 on the expression levels of IL-1 β and TNF α in different brain regions of rats.
Methods: 1.Experimental animals were 16 healthy male SD rats weighting 350±20g. Rats were randomly divided into 2 groups. 2.Experimental group was injected daily with 0.6mg/kg dose of MK-801 （ ip ） and control group with an equal volume of 0.9% saline （ ip ） for 3 days. We evaluated all rats locomotion,stereotype,ataxia,social behaviour every 10 min for one hour after last injection. 3.All rats were killed one hour later. Brains were removed and immediately stored at -70 ℃ .4.We measured the expression levels of IL-1 β 、 TNF α in the prefrontal cortex, dentate gyrus, CA1 regions of rats with immunohistochemical method, and analyzed integrated optical density with Image Analysis Syetem. 5.Adopted statistical method was Independent-Samples T Test.
Results: 1.Compared to control group, the expression levels of IL-1 β of schizophrenia model were decreased significantly in dentate gyrus and insignificantly in the prefrontal cortex and CA1 regions. 2.Compared to control group, the expression levels of TNF α of schizophrenia model were decreased significantly in dentate gyrus and CA1 regions and insignificantly in the prefrontal cortex.
Conclusions: There exists immune disturbance medicated by IL-1 β and TNF α in schizophrenia model, and MK-801 can inhibit the expression levels of IL-1 β and TNF α in different brain regions.
- P247
The Effect of Atypical Antipsychotics, Perospirone, Ziprasidone and Quetiapine on Microglial Activation Induced by Interferon-y
Qian Bian 1 , Takahiro Kato 2 , Akira Monji 2 , Sadayuki Hashioka 2 , Shigenobu Kanba 2
1 Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, Shanghai Mental Health Center, Shanghai Jiaotong University, Shanghai, Chinese Mainland, 2 Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
An accumulating body of evidences point to the significance of neuroinflammation and immunogenetics in schizophrenia, characterized by increased serum concentration of several pro-inflammatory cytokines. In the central nervous system (CNS) microglial cells are the major immunocompetent cells which release pro-inflammatory cytokines, nitric oxide (NO) and reactive oxygen species to mediate the inflammatory process. In the present study, we investigated whether or not atypical antipsychotics, namely perospirone, quetiapine and ziprasidone, would have anti-inflammatory effects on activated microglia which may potentiate neuroprotection. All three atypical antipsychotics significantly inhibibited NO generation from activated microglia while perospirone and quetiapine significantly inhibited TNF- α release from activated microglia. Antipsychotics, especially perospirone and quetiapine may have an anti-inflammatory effect via the inhibition of microglial activation, which is not only directly toxic to neurons but also has an inhibitory effect on neurogenesis and oligodendrogenesis, both of which have been reported to play a crucial role in the pathology of schizophrenia.
Key words: atypical antipsychotics, inflammation, microglia, nitric oxide, schizophrenia, TNF- α
- P248
Neurobiological Substrates of Aggression and Violence in Male Delinquents: A Neurophysiological and Executive Cognitive Function Study
Qian Bian 1 , Mingdao Zhang 1 , Bin Xie 1
1 Shanghai Mental Health Center, Shanghai Jiaotong University, Shanghai, Chinese Mainland
Objective: To explore the neurophysiological and neuropsychological bases underlying the aggression and violence in male delinquents.
Methods: 75 male delinquents with official records of aggressive and violent violation as a study group and 41 normal controls were determined by brain evoked potentials and Wisconsin Card Sorting Test （ WCST ） .
Results: Compared with the control group ， the male delinquents with aggressive and violent behavior display prolonged V latency in Auditory Brainstem Evoked Potential （ ABR ） reflecting more filtering out of peripheral auditory stimuli, shorter N1 latency and increased P2 amplitude in Somatosensory Evoked Potential （ SEP ） indicative of enhanced cortical response to somatosensory stimuli and prolonged P3 latency of target stimuli in auditory event-related potential （ P300 ） during a standard oddball task implicating less efficient cognitive functioning. The study group also scored higher in total response, preservative error and random error, but scored lower in hit rate of WCST than the control group, which demonstrate poor frontal executive cognitive functioning. Additionally, there were significant correlations between WCST and III amplitude in ABR, P2 amplitude in SEP, P3 latency of target stimuli in P300 respectively.
Conclusions: Decreased cortex arousal, frontal dysfunction and less functional integrity in cortex may partly underlie the neurobiological genesis of aggressive and violent behavior among male delinquents.
- P249
There are Not Only Hopes but also Effective Methods to Solve the Problem of Genetics in Psychiatry
Hong Chen 1 , Jie Ya Chen 2
1 World Federation of Chinese Medicine Societies, Beijing, Chinese Mainland, 2 Haidian Third Experimental Primary School, Beijing, Chinese Mainland
Objectives: (1) To change their thinking style.(2)To change their life style.(3)To make their new,formal styles as indestructible ones as we can until they are in place of their old,wrong styles.
Methods: Montessori--educational therapy, Stress Training, Environmental therapy, Morita therapy, Behavior therapy, TCM Psychoanalytic therapy,P sychotherapy, Cognitive therapy, Social practice, Structural family therapy.
Results: The principles are as follows: It is true that genetics in psychiatry exist but babies live with their mental-parents since born so they are affected by their parents wrong thinking style and life style naturally, this environment is terrible. Most mental patients have to eat pills for their whole life. They lose hope, they think they cannot be cured forever especially for those who have genetics in psychiatry. Bad circle, really. Their sad hearts would kill themselves. To survive, they must jump out of this environment, to rebuild themselves. And that is really works!
Conclusions: The patients family thinking style and life style could be changed into new, formal ones if psychiatrists gave their whole family enough correct training. Genetics just like enemies, we can win by improving our skills, overcoming all the difficulties!
- P250
儿茶酚氧位甲基 转移酶基因多态性与抑郁症认知功能的关联性研究 - An Association Study on Catechol-O-methyltransferase Gene Polymorphism and the Cognitive Function in Depression
璐璐 张 1 , 洪波 郑 1 , 河晃 邓 1 , 悦 邓 2 , 柱国 何 1 , 远光 黄 1 , 娟花 黎 1 , 雄 黄 1 , 琼 阳 1 , 燕 付 1
1 广州市精神病医院 , 广 东省广州市 , Chinese Mainland, 2 广州医学院第二附属医院 , 广 东省广州市 , Chinese Mainland
目的 ： 探 讨儿茶酚氧位甲基转移酶 （ COMT ） 基因多 态性与抑郁症认知功能及其严重程度的关系。
方法 ： 应用聚合酶链反应 （ PCR ） 及聚丙 烯酰胺凝胶电泳 (PAGE) 方法 ， 检测抑郁症患者和健康志愿者 COMT 基因多 态性分布。患者组评定 HAMD24 、 WCST 、 WMS-RC 和 连线 A 、 B 测验。
结果： （ 1 ） COMT 等位基因与基因型 频率在患者组和对照组内均有显著性差异，但在两组间无显著性差异。（ 2 ）患者 组 COMT 等位基因、基因型之 间在 WCST 、 WMS-RC 和 连线 A 、 B 测验无显著性差异，但在 HAMD24 认识障碍因子分上均有显著性差异。（ 3 ）基因型 A/A 与 认识障碍、绝望感均呈负相关；等位基因 A 与 绝望感呈负相关；等位基因 G 与 认识障碍、绝望感均呈正相关。在 WCST 测验中，等位基因 G 与持 续错误数呈正相关；在 WMS-RC 测验中，等位基因 G 与数字广度（倒背）呈 负相关。
结论 ： COMT 基因多 态性与抑郁症患者的疾病严重程度及认知功能的改变可能存在关联。
Objective: To investigate the relationship between COMT gene polymorphism and the cognitive function in depression.
Methods: PCR and PAGE techniques were used to detect COMT gene polymorphism in patients with depression, and 100 healthy people were involved as controls.The patients were assessed with HAMD24 、 WCST 、 WMS-RC and Connecting trial A 、 B.
Results: (1)significant differences in COMT genotype and allele frequencies were both found in study group and control group,but no significant differences between two groups. (2) no significant differences in the scores of neuropsychological tests were found between COMT genotype and allele frequencies in study group,but significant differences in the cognition item scores of HAMD24. (3) genotype A/A frequency was negatively correlated to the cognition and disappear items scores of HAMD24,allele G correlated to depressive symptoms was opposite to genotype A/A, and allele A negatively to the disappear symptoms. Allele G frequency was positively correlated to the persistent errors, and negatively to the number extent of neuropsychological tests.
Conclusion: It is suggested that COMT gene polymorphism is possibly associated with depression severity and change of cognitive function.
- P251
生物 钟基因隐花色素 -1 与精神分裂症核心家系的 单体型相对风险分析 - Haplotype-based Haplotype Relative Risk Analysis btween the Clock Gene Cryplochrome-1 and Schizophrenic Trios
子文 彭 1 , 晓岗 陈 2 , 劲松 唐 2
1 中南大学湘雅二医院精神 卫生研究所 , 广州 , Chinese Mainland, 2 中南大学湘雅二医院精神 卫生研究所 , 长沙 , Chinese Mainland
目的 : 探 讨精神分裂症与生物钟基因隐花色素 -1 （ Cryptochrome-1 ,Cry1 ） 的 关系。
方法 : 检测 100 个精神分裂症核心家系的 Cry1 基因上的 rs2300448 ﹑ rs1921135 和 rs1056560 三个多 态性位点 ， 并进行单体型相对风险分析 （ HHRR ） 。
结果 : HHRR 结果显示 ， rs2300448 多 态性由父母传递给患病子女的等位基因 （ G/A ） 频率差异有显著性 (P ＜ 0.05), 等位基因 G 优先传递给患病子女 ； 而 rs1056560 和 rs1921135 的等位基因 传递频率差异无显著性 (P ＞ 0.05) 。
结论 : Cry1 基因可能与中国 汉族精神分裂症相关联。
关键词 : 精神分裂症 ； 隐花色素 － 1 ； 基因 ； 单体型相对风险分析
Objective: To investigate the relationship between schizophrenia and Cryptochrome-1 in Chinese Han family trios.
Methods: One hundred schizophrenic trios were subjected to analysis of the polymorphic sites rs2300448 、 rs1921135 and rs1056560 in Cryptochrome-1 gene by Haplotype-based haplotype relative risk analysis (HHRR).
Results: Significantly preferntial transmission of the allele of rs2300448 (P=0.029) was detected by HHRR in this study and the allele G was found preferential transmission from parents to affected offsprings, while not found in rs1056560 and rs1921135.
Conclusion: Cry1 gene may be associated with schizophrenia in Chinese Han population.
Key words: schizophrenia; Cryptochrome-1; gene; HHRR
- P252
隐花色素 -1 基因与精神分裂症核心家系的 传递不平衡分析 - Transmission Disequilibrium Test of the Clock Gene Cryptochrome-1 and Schizophrenia Based on Family Trios
子文 彭 1 , 晓岗 陈 2 , 劲松 唐 2
1 中南大学湘雅二医院精神 卫生研究所 , 广州 , Chinese Mainland, 2 中南大学湘雅二医院精神 卫生研究所 , 长沙 , Chinese Mainland
目的 ： 探 讨精神分裂症与隐花色素 － 1 （ Cryptochrome-1 ,Cry1 ） 基因多 态性的关联关系。
方法 ： 对 100 个精神分裂症核心家系的 Cry1 基因上的多 态性位点 rs2300448 ﹑ rs1921135 和 rs1056560 进行多态性检测 ； 并进行传递不平衡分析 （ TDT ） 。
结果 ： (1)rs2300448 经过 TDT 分析 发现 , 等位基因 G 优先传递给患病子女 (P=0.027) ， 但 P 值经 Bonferroni 校正后 ， 差异无 显著性 （ Pc ＝ 0.054 ）； rs1056560 和 rs1921135 多 态性位点未发现传递不平衡现象。（ 2 ） 经 TDT 多点分析 发现单体型 rs2300448-rs1056560G-A; rs1921135-rs2300448-rs1056560T-G-C 和 C-G-A 存在 传递不平衡现象，但 P 值经 Bonferroni 校正后， T-G-C 和 C-G-A 差异无 显著性（ Pc ＞ 0.05 ） , 只有 G-A 差异有 显著性（ Pc ＝ 0.036 ）。
结论 ： Cry1 基因可能与中国 汉族人群精神分裂症相关联。
Objective: To investigate the relationship between schizophrenia and Cryptochrome-1 in the Han Chinese family trios.
Methods: One hundred schizophrenic trios were detected by PCR-RFLP and were subjected to analysis of the polymorphism sites rs2300448 、 rs1921135 and rs1056560 in Cryptochrome-1 gene by transmission disequilibrium test.
Results: (1) Significantly preferential transmission of the allele of rs2300448 was detected by TDT and the allele G was found preferential transmission from parents to affected offsprings (P=0.027), however, the value of P is not significant after Bonferroni correction （ Pc ＝ 0.054 ） . And preferential transmissions were not found in rs1056560 and rs1921135. (2)Three haplotypes showed significant transmission distortion, including rs2300448-rs1056560G-A; rs1921135-rs2300448-rs1056560T-G-C and C-G-A, but the values of P are not significant after Bonferroni correction （ Pc ＞ 0.05 ） in haplotypes T-G-C and C-G-A, and the value of P is still significant after Bonferroni correction in haptotype G-A （ Pc ＝ 0.036 ）
Conclusion: Cry1 gene may be related to schizophrenia in the Han Chinese population.
P253
在控制社会心理因素条件下探 讨去甲肾上腺素转运体基因 . T182C 多 态性与重性抑郁障碍的关联性 - Approach the Relevance between the Polymorphism of T182C (a Kind of Noradrenalin Transport Gene) and Major Depression Controlling for Social-psychological Factors
彦芳 王 1 , 徐勇 刘志芬 樊珍 张克让
1 山西医科大学第一医院精神科 , 太原 , Chinese Mainland
目的 ： 探 讨在控制社会心理因素条件下去甲肾上腺素转运体 （ NET ） 基因 T182C 多 态性与重性抑郁障碍 （ MD ） 的 关联性。
方法 ： 采用病例 对照研究设计 ， 对 152 例重性抑郁障碍患者及 152 例健康 对照 ， 运用焦磷酸测序仪检测两组人群的去甲肾上腺素转运体基因 T182C 多 态性 ， 并运用艾森克个性问卷、生活事件量表、社会支持量表、特质应对方式问卷进行有关社会心理因素的评定 ， 应用 SAS 软件采用 logistic 回 归模型 ， 统计分析在控制与不控制社会心理因素条件下两组人群的 T182C 基因型与等位基因的比 值比 （ OR ） 。
结果 ： 1 、在控制社会心理因素前 ： 以 TT 为参照 ， 基因型 TT 、 TC 和 CC 的比 值比 OR 分 别为 （ 1 ， 0.965 ， 2.231 ）， CC 基因型 （ OR=2.231 ； OR95%CI=0.946, 5.261 ； P=0.0667 ） 统计学差异不显著 ； 以 T 为参照 ， C 等位基因 （ OR=1.24 ； OR95%CI= （ 0.879 ， 1.751 ）； P=0.2202 ） 2 、在控制社会心理因素后 ： 以 TT 为参照 ， 基因型 TT 、 TC 和 CC 的比 值比 OR 分 别为 （ 1 ， 1.169 ， 6.232 ） 呈梯度升高的 现象 ， CC 基因型 （ OR=6.232 ； OR95%CI=1.346, 28.846 ； P=0.0193 ） 统计学差异显著 ； 以 TC 为参照 ， CC 基因型 （ OR=5.332 ； OR95%CI=1.175 ， 24.187 ； P=0.0301 ） 统计学差异显著 ； 以 T 为参照 ， C 等位基因 （ OR=1.692 ； OR95%CI=0.966 ， 2.965 ； P=0.0661 ）
结论 ： CC 基因型是罹患重型抑郁障碍的危 险因素 ， 其患病危险是 TT 基因型的 6.232 倍 ， 是 TC 基因型的 5.332 倍。
- P254
汉族健康人群去甲肾上腺素转运体 T182C 基因多 态性 . 与人格的 关联性研究 - Associations between Norepinephrine Transporter Gene Polymorphism T182C and Personality of Healthy Han People
珍 樊 1 , 杨红 任燕 崔 晓红 彭菊意 牛亮 张克让
1 山西医科大学第一医院精神科 , 太原 , Chinese Mainland
目的 ： 探 讨汉族健康人群去甲肾上腺素转运体 （ NET ） T182C 基因多 态性与人格的关联性。
方法 ： 按照入 组标准筛取中国汉族健康人群 322 例 ， 年 龄在 18~61 岁之间 ， 平均年龄 29.04±10.46 岁 ， 其中男性 146 人 ， 女性 176 人。收集一般人口学 资料，运用艾森克人格问卷 (EPQ) 测量人格的三个纬度，即神经质（ N ）、内外向（ E ）、精神 质（ P ）， 计算各纬度标准分（ T ），以 T50 分 为界，将各纬度分为两个等级。 PCR 法 检测 T182C 基因多 态性。使用 SPSS13.0 统计软件包进行统计分析。
结果： 1.Hardy-Weinberg 遗传平衡检验： T182C 基因多 态性达到遗传平衡（ P=0.66 ），所 选样本具有群体代表性。 2. 一般人口学 资料分析：不同年龄、性别、婚姻状况在人格各维度分级间分布差异无统计学意义（ P>0.05 ）； E 纬度 T 分在不同性 别间分布差异有统计学意义 (t=2.06,P=0.04) ，女性 E 纬度 T 分均数（ 58.49 ）明 显高于男性（ 56.18 ）。 3. 汉族健康男性人群中， NET T182C 不同基因型及等位基因 间， EPQ 各人格 T 分均数比 较差异无统计学意义（ P>0.05 ）； EPQ 不同人格 纬度分级间，基因型及等位基因频率分布差异无统计学意义（ P>0.05 ）。 4. 汉族健康女性人群中， ① NET T182C 不同基因型 间， P 、 N 人格 纬度均数比较差异无统计学意义， T/C 与 C/C 两 种基因型间 E 人格 纬度均数比较差异有统计学意义（ x2=6.549 ， P=0.038 ）， T/C 基因型（ 56.44 ） E 人格 纬度均数明显低于 C/C 基因型（ 63.49 ）。 NE 转运体 T182C 不同等位基因 间，各人格 T 分均数比 较差异无统计学意义（ P>0.05 ）。② P 、 N 不同人格 维度间基因型频率分布差异无统计学意义（ P>0.05 ） ,T/C 基因型在内 倾人格中出现的频率（ 13.6% ）明 显高于外倾人格（ 6.8% ），（ x2=11.83 ， P=0.001 ， OR=3.714 ）。 EPQ 不同人格 纬度分级间，等位基因频率分布差异无统计学意义（ P>0.05 ）。
结论： 1 、 NET T182C 基因多 态性与汉族健康男性 EPQ 人格特征无明 显关联。 2 、 NET T182C 基因多 态性与汉族健康女性 P 、 N 人格特征无 关联，与 E 人格特征有 关联， T/C 基因型是女性内 倾人格的可疑危险因素。
Objective: To assess the associations between Norepinephrine transporter gene polymorphism T182C and personality of healthy Han people.
Methods: Collected 322 China healthy Han people,the age is from 18 old to 61 old,the average age is 29.04±10.46 old.There are 146 men,176 women. To assess all the volunteers' demography data and EPQ personality include P,E,N latitude,to calculate standard score(T),divide each latitude into two grades.Using PCR to detect gene polymorphism T182C. Using SPSS13.0 to do statistical analysis.
Results:
1 、 Hardy-Weinberg equilibrium analysis: gene polymorphism T182C achieve genetic balance(P=0.66), the sample can represent the group.
2 、 Demography data analysis: the distribution variance of age 、 gender 、 marriage and educational level don't have statistical significance among every latitude(P>0.05); the distribution variance of T score don't have statistical significance among age 、 marriage and educational level(P>0.05),but the T score distribution of E latitude have in different gender(t=2.06,P=0.04) ， the mean scores(58.49) of feminine E latitude are obviously higher than masculine (56.18).
3 、 In healthy male Han people, the distribution variance of T score don't have statistical significance among different genetype and different allele(P>0.05); the distribution variance of genetype and allele don't have statistical significance among every latitude grades(P>0.05).
4 、 In healthy female Han people, ① the mean T scores of P 、 N latitude don't have statistical significance among different genetype,E latitude's have among T/C and C/C genetype （ X2=6.549,P=0.038 ） , E scores in T/C genetype are obviously lower than C/C genetype's. the mean scores of every latitude don't have statistical significance among different allele (P>0.05). ② The distribution variance of genetype don't have statistical significance among different grades in P 、 N latitude (P>0.05). The frequency of T/C genetype in introvert are obviously higher extroversi |
