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Objective:To explore the changes of cerebral blood flow (CBF) perfusion caused by N 2O (laughing gas) abuse. Methods:From December 2017 to October 2018, the CBF perfusion images of 24 patients with laughing gas abuse (9 males, 15 females; age: 18-32(24.0±8.9) years) from China-Japan Friendship Hospital were analyzed retrospectively. The region uptake statistics of different brain regions of interest (ROI) (basal ganglia, central region, cerebellum, cingulate gyrus, frontal lobe, medial temporal lobe, occipital lobe, parietal lobe, temporal lobe) between patients with laughing gas abuse and normal people of the same age group from background software database were calculated automatically. Statistic>1.68 indicated the increase of local CBF perfusion, while statistic < -1.68 indicated the decrease of local CBF perfusion. The correlation between the statistics of bilateral brain regions and the correlation between statistical values and clinical indicators were analyzed by Pearson and Spearman correlation analyses.Results:The correlation of the statistics between bilateral regions of each brain area was significant( r values: 0.503-0.892, all P<0.05). The decreased CBF proportions of frontal and temporal lobes were 62.5%(15/24) and 70.8%(17/24), respectively. The highest proportion of increased CBF was cingulate gyrus (33.3%, 8/24). There were significant correlations between frontal lobe, central brain area and duration of laughing gas abuse ( rs values: 0.375, 0.305, both P<0.05). Conclusion:CBF perfusion imaging is helpful for understanding the changes of CBF in patients with laughing gas abuse.
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Objective:To investigate the clinical, neuropsychological and regional cerebral blood flow (rCBF) characteristics in patients with psychiatric symptoms caused by nitrous oxide abuse.Methods:Twelve patients with psychiatric symptoms caused by nitrous oxide abuse were enrolled from February 2018 to February 2020 in the Department of Neurology, China-Japan Friendship Hospital and the First Hospital of Tsinghua University.All patients were scored with the brief psychiatric rating scale (BPRS), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). The SPECT/CT images were collected with low-energy and high-resolution collimator.After the pictures were reconstructed, 18 brain regions were automatically sketched and calculated by Database Comparison software.The statistical value of the difference between the general mean value of each brain region and that of the corresponding region of interest in the same age group was estimated.Results:(1)The clinical manifestations of 12 patients were anxiety, depression, hallucination, delusion, and 7 patients were accompanied by cognitive decline.(2)Neuropsychological examination: BPRS score was 57.83±11.15 (anxiety depression factor was 3.94±0.47; lacking active factor was 3.25±0.85; thinking disturbance factor was 3.21±1.27; activity factor was 2.28±0.56; hostility factor was 3.14±1.24). The score of self-knowledge impairment was 2.92±1.08, the score of inability to work was 4.50±1.17, the score of HAMD was 32.75±10.13, the score of HAMA was 18.67±5.80, the score of MMSE was 27.67±2.50, and the score of MoCA was 24.58±3.78.(3)SPECT showed that compared with the general mean value of the corresponding regions of interest of normal people, the patients showed hypoperfusion in the frontal lobe (7 patients, 58.30%) and the temporal lobe (8 patients, 66.70%).Conclusion:Nitrous oxide abuse has an obvious effect on rCBF.The psychiatric symptoms include anxiety, depression, hallucination, delusion and so on, which affect the ability to work and learn.SPECT has important value in the diagnosis of nitrous oxide abuse, and indicates changes in local brain functional activity.
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Objective To explore the problems that should be paid attention to during the process of the identification of the mental illness of the judiciary.Methods The process and conclusion of 22 cases of forensic psychiatric expertise were reviewed and analyzed in the Department of psychiatric disorders,Beijing Anding Hospital,Capital Medical University from August 1,1982 to July 31,2016.The analysis indexes mainly include:(1) the time of the implementation of the identification;(2) the matters entrusted by the Commission;(3) the identification materials provided by the client;(4) the conclusion of the appraisal.Results (1) from July 31,1999 to August 1,1982,7 cases were identified from to August 1,1999,and 15 cases were identified from to July 31,2016.(2) from August 1,1982 to July 1999 31 during the day mainly identification issues for 6 cases (85.7％,6/7) mental state and the ability of criminal responsibility and 1 cases (14.3％,1/7) mental state and sexual self defensive ability,from August 1,1999 to July 2016 31 during the day in 15 cases of all matters for identification of mental state and civil capacity.(3) including the authentication materials provided by a client:Previous expert opinions and description of mental state of medical records,effective during the testimony of witnesses and / or detention,public security organs information records,audio-visual materials.(4) most of the identified people can be identified in the clinical diagnosis of mental illness and to determine the legal capacity,individual identification can not come to the conclusion.Conclusion The identification number and the difficulty of life;for his identification of civil capacity increased;should focus on ensuring the identification data of the authenticity,integrity,adequacy and validity;"conclusion" is also a kind of expert conclusion,it is suggested to use three cent method civil capacity rating was identified.
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Objective To explore the value of the combination of personality responsibility theory and motivation theory in the evaluation of the ability of criminal responsibility of the patients with mental disorders. Methods A retrospective analysis of our hospital in 2013 and 2014 the implementation of identification of 101 cases of patients with mental disorders of the criminal responsibility, analysis indicators include: the reflection of the basic characteristics of personality; motive; identification of illegal behavior evaluation; the capacity of criminal responsibility. Results different symptoms reflects abnormal consistency and specificity of personality integrity; when the symptoms are not at the same time, with the implementation of the illegal behavior of the motivation also has realistic and non realistic differences; personality integrity can not damage the normal and correct evaluation of the illegal act, almost all favorable personality particularity of affected persons can recognize the illegality of the behavior; the integrality and consistency of the affected personality criminal responsibility were incomplete; special personality influence for full criminal responsibility. Conclusion The combination of personality responsibility theory and motivation theory is applied to the identification of the criminal responsibility ability of the patients with mental illness. To define the identity of the actor as the actor, to identify the patient's behavior is "not control" or "no control", it is worth promoting the application in the work of mental illness judicial identification.
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OBJECTIVE:To investigate the drug treatment of hospitalized patients with depression in our hospital during 2008. METHODS: In cross section study, the medical records which in accordance with ICD-10 diagnostic criteria for depression disorders in our hospital during 2008 were retrieved, then the utilization of psychotropic drugs was analyzed and summarized. RESULTS: The utilization rate of new antidepressants including selective serotonin reuptake inhibiter (SSRI), selective serotonin and noradrenaline reuptake inhibiter (SNRI), noradrenaline and specific serotonin antagon (NaSSA) reached 89.9%, among which sertraline accounted for the largest proportion (22.5%). New antidepressants combined with atypical antipsychotics took up a big proportion, particularly quetiapine (39.2%). CONCLUSION: New antidepressants become the mainstream drug in the treatment of depression. Drug combination occupies a big proportion, especially combining with atypical antipsychotics. The safety of drug combination need to be further explored.