焦虑症患者认知功能损害的比较研究

目的：探讨首发焦虑症的认知功能损害特点。方法：对114例首发焦虑症患者（焦虑症组）和正常对照组47例采用韦氏成人智力量表、韦氏记忆量表、威斯康星卡片分类测量（WCST）进行检测。采用汉密尔顿焦虑量表（HAMA）对焦虑症患者进行焦虑状态评估。结果：焦虑症组的心智、图片、再认、再生、联想、理解、背数、记忆商数、言语智商数、智商数均明显低于对照组（P〈0．05）。焦虑症组的WCST完成分类数明显低于对照组,总检测数明显高于对照组,差异均有统计学意义（P〈0．05）。相关分析显示,HAMA总分和心智、图片、再认、再生、联想、触觉、理解、背数、记忆商数、言语智商、操作智商、智商和完成分类数呈负相关（P〈0．05）;焦虑／身区体化因子和图片、再生、联想、理解、背数、完成分类数璺负相关（P〈0．05）;阻滞因子和心智、图片、再认、再生、联想、触觉、理解、背数、记忆商数、言语智商、操作智商、智商和完成分类数、概念化水平呈负相关（P〈0．05）。结论：首发焦虑症患者可能存在比较严重的全面认知功能损害,范围比较广,且焦虑症症状能够影响患者的认知能力。     

难治性抑郁症与首发抑郁症患者认知功能比较

目的探讨难治性抑郁症与首发抑郁症患者认知功能的差异。方法选择2008年1月～2018年3月在我院诊断治疗的难治性抑郁症患者25例为难治组,首发抑郁症患者30例为首发组,另选择健康志愿者30例为对照组。采用HAMD-17量表对两组患者临床严重程度进行评价。采用WAIS(韦氏成人智力量表)、WMS(韦氏记忆量表)对三组认知功能进行评价。结果难治组焦虑/躯体化评分显著高于首发组,差异有统计学意义(P0.05)。难治组WAIS总分、言语智商总分、图形拼凑评分显著低于首发组与对照组,差异有统计学意义(P0.05);难治组与首发组数字符号、图片排列、操作智商总分显著低于对照组,差异有统计学意义(P0.05)。难治组与首发组记忆商数、累加评分、图片回忆、触觉显著低于对照组,差异有统计学意义(P0.05);难治组时空定向、视觉再生显著低于首发组与对照组,差异有统计学意义(P0.05)。结论难治性抑郁症患者在时空定向、视觉再生、图形拼凑等方面与首发患者存在显著差异。     

单相抑郁与双相抑郁记忆功能的对照研究

目的了解单相抑郁、双相抑郁患者治疗前后的记忆功能障碍特点及其影响因素。方法对27例单相抑郁和30例双相抑郁患者予以3月药物治疗,治疗前和治疗后分别评定24项汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、功能大体评定量表(GAF)、韦氏记忆量表(WMS-RC),与26名正常对照进行比较。结果单、双相抑郁组治疗前后的心智(1-100)和(100-1)、图片、再认、再生、触觉、理解记忆、记忆商数以及单相抑郁的联想和背数、双相抑郁的心智(积累)治疗前后之间的差异有统计学意义,都是治疗后较优;治疗前单、双相抑郁组的心智(1-100)、(100-1)和(积累)、图片、再认、联想、触觉、理解记忆、背数、记忆商数都差于正常对照;治疗后心智(1-100)和背数是双相差于正常对照,心智(积累)是单相差于正常对照,心智(100-1)、图片、联想、记忆商数是单、双相差于正常对照;治疗前单相抑郁的心智(100-1)和(积累)、再认、再生、联想、记忆商数得分与阻滞因子呈负相关,理解记忆、背数得分与认识障碍因子得分呈负相关,心智(1-100)、触觉得分与体质因子得分呈正相关;双相抑郁的心智(积累)、联想、背数得分与认识障碍因子得分呈负相关。结论单双相抑郁都存在记忆功能障碍,但损害存在差异。单双相抑郁的记忆功能障碍都是特质性和状态性并存,均受临床症状严重程度的影响。     

四君子汤治疗精神分裂症记忆损害的临床观察

目的研究四君子汤治疗精神分裂症记忆损害的疗效。方法将60例精神分裂症记忆损害患者用数字表法随机配对分为中药治疗组和安慰剂组。另选30例正常人为正常对照组。中药治疗组患者在服用氯丙嗪的同时服用四君子汤,安慰剂组患者在服用氯丙嗪的同时服用安慰剂。正常对照组不用任何治疗方法。中药治疗组和安慰剂组受试者分别在入组前和研究结束时做韦氏记忆量表检测,正常对照组受试者在入组时做韦氏记忆量表测查。结果治疗组和安慰剂组受试者治疗前各记忆项目分数与正常对照组相比差异有统计学意义(P<0.01),顺数、倒数、背数、记图、再认、再生、联想、理解和MQ值治疗组治疗前后比较和与安慰剂组比较差异有统计学意义(P<0.05);积累分项目检测结果显示,治疗组治疗前后比较和与安慰剂组比较差异无统计学意义(P>0.05)。安慰剂组各记忆项目检测分数治疗前后比较差异无统计学意义(P>0.05)。结论四君子汤对精神分裂症记忆损害有一定改善作用。     

创伤后应激障碍的记忆损害与脑结构磁共振特点探讨

目的探讨创伤后应激障碍（PTSD）的记忆损害与脑结构磁共振特点。方法选取研究组和对照组患者各16例,进行记忆功能评估,并给予磁共振医学影像检查,记录两组患者记忆功能评估结果、磁共振检查结果。结果研究组患者创伤后应激障碍患者理解记忆、延迟理解记忆、视觉再生、延迟视觉再生评分均显著低于对照组健康人群,差异有统计学意义;研究组脑部额叶与颞叶脑区灰质体积显著小于对照组。结论对PTSD患者行脑部MRI检查,可准确判断其是否出现记忆障碍。     

不同部位脑出血恢复期记忆损害特点的临床研究

目的：探讨基底节出血及丘脑出血患者出血恢复期的记忆损害特点。方法整群选取内蒙古国际蒙医医院2014年3月＿2016年3月收治的脑出血患者78例(观察组),根据出血部位分为基底节出血41例,丘脑出血37例,另选取同期健康体检者40名作为对照组。采用韦氏记忆量表(WMS)、韦氏成人智力量表(WAIS)、Rey听觉词语学习测验(AVMT)来评价两组患者记忆成分的差异。结果患者在1-100、100-1、累加、视觉再生、视觉再认、图片回忆、触觉记忆、联想学习、词汇测试、倒背、短延迟回忆、长延迟回忆等记得分较正常对照组明显下降。提示基底节出血及丘脑出血恢复期患者均存在记忆受损;基底节出血组患者与丘脑出血组患者在记忆成分中长延迟回忆(2.36±0.95﹚ vs (1.21±0.14﹚方面比较差异有统计学意义(P<0.05﹚。结论脑出血患者因出血部位不同,记忆成分受到不同程度损伤,针对不同部位脑出血及时干预可降低血管性痴呆的发生几率。     

创伤后应激障碍患者的心理护理

目的探讨创伤后应激障碍(PTSD)的心理护理及心理干预的临床应用。方法选取我院2013年6月至2014年6月收治的创伤后应激障碍(PTSD)患者40例,按照随机分组的方法,分为观察组20例和对照组20例。观察组患者在对照组常规护理的基础上,实施心理护理干预,比较两组患者的护理有效率和对护理工作的满意度。结果观察组护理有效率高于对照组,差异有统计学意义(P<0.05);观察组患者对护理工作的满意度高于对照组,差异有统计学意义(P<0.05)。结论加强心理护理与心理干预对创伤后应激障碍(PTSD)患者有积极意义,能有效提高患者的护理满意度,护理效果较好,值得推广应用。     

认知行为疗法联合超低频经颅磁刺激治疗抑郁症患者的效果

目的:观察认知行为疗法联合超低频经颅磁刺激治疗抑郁症患者的效果。方法:选取120例抑郁症患者为研究对象,按照随机数字表法分为观察组与对照组各60例。对照组采用超低频经颅磁刺激治疗,观察组在对照组基础上联合认知行为疗法治疗,比较两组临床疗效、汉密尔顿抑郁量表(HAMD)评分、杨氏狂躁评定量表(YMRS)评分、一般自我效能感量表(GSES)评分和韦氏记忆量表评分。结果:观察组治疗总有效率为95.00%,明显高于对照组的75.00%,差异有统计学意义(P<0.05);治疗后,两组HAMD、YMRS评分均低于治疗前,且观察组低于对照组,两组GSES评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组韦氏记忆量表中再认、图片、联想及背数等维度评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:认知行为疗法联合超低频经颅磁刺激治疗抑郁症患者可提高治疗总有效率和GSES评分,降低HAMD、YMRS评分,以及改善记忆功能,效果优于单纯超低频经颅磁刺激。     

基底节缺血性卒中对认知功能的影响

目的 探讨基底节缺血性卒中导致的认知功能损害特点.方法 基底节缺血性卒中住院患者46例为观察组,所有病例均符1995年10月中华医学会第四届脑血管病学术研讨会通过的脑卒中诊断标准;对照组为性别、年龄和教育程度与观察组相匹配的健康人46例.认知评价采用一般问卷、韦氏成人智力量表的词汇及数字符号测试、韦氏记忆量表、工作记忆课题及威斯康星卡片等,共收集了20项认知功能相关指标.结果 观察组的连线作业A[(54.04±5.66)分]、执行完成分类数[(3.56±0.12)分]、执行错误应答数[(16.17±0.58)分]、执行非持续性错误数[(10.17±0.58)分]的得分显著高于对照组(t=4.67,5.03,9.45,9.5;P<0.01),而词汇测试{(54.21±2.73)分]、经历[(4.52±0.12)分]、定向[(4.65±0.11)分]、视觉再认[(8.34±0.62)分]、图片回忆[(8.13±0.43)分]、视觉再生[(6.957±0.48)分]、触觉记忆[(61.06±9.09)分]、联想学习[(7.39±0.51)分]、顺背[(6.17±0.31)分]、倒背[(3.13±0.14)分]和连线作业B[(122.39±8.28)分]的得分显著低于对照组(P<0.01);左右侧基底节缺血性卒中的认知指标显示:在数字符号、定向、执行正确应答数、错误应答数、持续性错误、非持续性错误数6个项目上的差异具有统计学意义(P<0.05或0.01);卒中体积与认知功能相关分析:两侧基底节缺血性卒中体积与完成分类数呈正相关(r>0,P<0.05),与顺背与倒背呈负相关(r=-0.857,-0.811;P=0.014,0.027);左侧基底节缺血性卒中体积与词汇测试、经历、视觉再认呈负相关(r=-0.764,-0.907,-0.747;P=0.027,0.002,0.033);右侧基底节缺血性卒中体积与词汇测试、数字符号、视觉再生、执行完成分类数呈负相关(r=-0.747,-0.770,-0.798;P=0.033,0.026,0.011).结论 基底节缺血性卒中可以引起言语智能、执行功能及记忆等认知功能改变,两侧基底节在操作智能、长时记忆及执行功能方面发挥作用不同,基底节卒中体积越大,认知功能损害越明显.     

5-羟色胺转运体基因多态性与不同民族创伤后应激障碍患者的关联性研究

目的 探讨5-羟色胺转运体(5-HTTLPR)基因多态性与海南省黎、汉民族创伤后应激障碍(PTSD)患者的相关性。方法 选取2017年10月至2018年7月在海南省人民医院就诊的308例PTSD患者作为研究组，其中黎族167例，汉族141例；另选2017年10月至2018年7月间未经受创伤性事件并在我院健康体检中心体检的158例健康志愿者作为对照组。收集研究对象的一般资料，采用PTSD临床评定量表、埃森创伤问卷(ETI)评定入组患者PTSD严重程度，另采用汉诺塔(TOH)、威斯康星卡片分类测试(WCST)、连线测验(TMT)与韦氏成人智力量表(WAIS)对评定入组对象认知功能，应用多聚酶链式反应(PCR)方法检测研究对象5-HTTLPR基因多态性。结果 三组被试者的平均年龄、性别构成、婚姻状况和受教育程度比较差异均无统计学意义(P>0.05)；黎族PTSD患者和汉族PTSD患者的各ETI评分与PTSD总分、TMT时间、TOH计划时间和执行时间、WCST的错误数明显高于对照组，而WAIS-RC中领悟、相似、木块图、物体拼凑及操作智商和TOH总分明显低于对照组，差异均有统计学意义(P...     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.