支持性心理治疗结合草酸艾司西酞普兰治疗脑卒中后抑郁的临床研究

目的:研究支持性心理治疗结合草酸艾司西酞普兰治疗脑卒中后抑郁的临床疗效。方法:首先将确诊为脑卒中后抑郁的48例患者随机分为研究组24例,给予草酸艾司西酞普兰10mg/天,结合支持性心理治疗。对照组24例,给予单用草酸艾司西酞普兰10mg/天,治疗6周。用汉密尔顿抑郁量表(HAMD)在治疗前及治疗后2、4、6周末评定疗效,副反应量表(TESS)评定不良反应。结果:研究组与对照组均有良好的效果,但研究组起效快,疗效更好(P0.05)。两组药物不良反应发生率差异无统计学意义(P0.05)。结论:支持性心理治疗结合草酸艾司西酞普兰治疗脑卒中后抑郁效果更好。     

艾司西酞普兰联合小剂量喹硫平治疗难治性抑郁症患者的对照研究

目的探讨草酸艾司西酞普兰联合富马酸喹硫平在治疗难治性抑郁症方面的临床疗效和安全性。方法将70例在门诊和住院收集的符合要求的难治性抑郁症患者,随机分成两组,每组35例,研究组服用草酸艾司西酞普兰联合小剂量富马酸喹硫平,对照组单用草酸艾司西酞普兰,观察期共8周。并于治疗前和治疗后的第2、4、6、8周均采用17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)评价各组的疗效,同时使用副反应量表(TESS)评定治疗期间的不良反应。结果治疗后两组HAMD、HAMA的评分较治疗前均显著下降(P<0.01);同期研究组各项评分结果较对照组下降更显著(P<0.001),第8周研究组和对照组有效率分别是82.86%、60.0%,两组间疗效差异有统计学意义(P<0.01)。两组药物不良反应发生率差异无统计学意义(P>0.05)。结论对于难治性抑郁症,草酸艾司西酞普兰联合小剂量富马酸喹硫平与单用艾司西酞普兰相比,起效较快,并能改善夜眠和焦虑症状,且安全性较好。     

盐酸文拉法辛与草酸艾司西酞普兰对抑郁障碍患者快感缺失的疗效对比

目的:观察盐酸文拉法辛与草酸艾司西酞普兰对抑郁障碍患者快感缺失的疗效对比。方法:将入院患者根据随机数字表法分为盐酸文拉法辛组(26例,75~225 mg/d)和草酸艾司西酞普兰组(27例,10~20 mg/d),疗程均为8周。在入组时收集一般资料、Snaith快感缺失量表(SHAPS)、汉密尔顿抑郁量表24项(HAMD-24),并于治疗2、4、6、8周末评定HAMD-24,于2、8周末评定SHAPS,同时评定副反应量表(TESS)。结果:草酸艾司西酞普兰组和盐酸文拉法辛组相比,所有患者经治疗8周后,两种药物对HAMD评分改善均有显著作用(P<0.01),两种药物间对HAMD的改善差异无统计学意义(P>0.05);治疗8周后,研究组患者SHAPS评分有显著统计学意义(P<0.01)。结论:草酸艾司西酞普兰和盐酸文拉法辛对抑郁障碍患者疗效相似,对相应症状具有明显改善作用;但盐酸文拉法辛对快感缺失的疗效较草酸艾司西酞普兰好。     

草酸艾司西酞普兰和氟西汀治疗老年抑郁症的疗效和不良反应分析

目的:比较抗抑郁药氟西汀和草酸艾司西酞普兰治疗老年抑郁症后抑郁症状的改善以及不良反应的分析。方法:将64例符合中国精神障碍分类与诊断标准第三版诊断标准的老年期抑郁症患者随机平分为两组,分别给予氟西汀和草酸艾司西酞普兰治疗6周。治疗前和治疗后2、4、6、8周末分别采用汉密尔顿抑郁量表(HAMD)、副反应量表(TESS)评定疗效和不良反应。结果:1.第1周草酸艾司西酞普兰组的症状明显轻于氟西汀组(P<0.01),第2周末两组HAMD减分率无显著差异。2.经过6周治疗后,草酸艾司西酞普兰组和氟西汀组的有效率分别为85.58%、84.26%,治愈率分别为52.6%、49.8%,两组的有效率和治愈率差异不显著。3.两组不良反应比较,草酸艾司西酞普兰的不良反应更轻微。结论:草酸艾司西酞普兰与氟西汀对老年抑郁症患者有肯定疗效,不良反应小;草酸艾司西酞普兰起效更快,不良反应更轻微,老年患者对其的依从性更好。     

草酸艾司西酞普兰与盐酸文拉法辛治疗脑卒中后抑郁的临床对照研究

目的:探讨草酸艾司西酞普兰治疗脑卒中后抑郁的临床疗效及安全性.方法:对88例符合脑卒中后抑郁诊断标准的患者.随机分成两组,分别给予草酸艾司西酞普兰与盐酸文拉法辛进行为期8周的治疗.采用汉密尔顿抑郁表(HAMD)评价疾病的严重程度及评定临床疗效.副反应量表(TESS)评估药物的不良反应.结果:治疗后草酸艾司西酞普兰组与盐酸文拉法辛组在汉密尔顿抑郁量表(HAMD)减分率无明显差异.草酸艾司西酞普兰组有效率为75%,盐酸文拉法辛组有效率为77.3%.两组疗效比较无显著性差异(P>0.05).副反应量表(TESS):草酸艾司西酞普兰组不良反应少.结论:草酸艾司西酞普兰不仅能有效控制脑卒中后抑郁症状,而且不良反应少.对脑卒后抑郁患者是一种较为理想的抗抑郁药物.     

草酸艾司西酞普兰联合小剂量氨磺必利治疗以躯体症状为主老年抑郁症的疗性和安全性观察

目的:观察草酸艾司西酞普兰联合小剂量氨磺必利治疗以躯体症状为主老年抑郁症的疗效和安全性。方法:采用随机数字表法将符合《国际疾病分类(第10版)》(ICD-10)抑郁症诊断标准的85例老年抑郁症患者分为研究组43例(采用草酸艾司西酞普兰联合氨磺必利治疗)和对照组42例(采用草酸艾司西酞普兰组),疗程8周。于治疗前和治疗后第1、2、4、6、8周末采用汉密尔顿抑郁量表17项版(HAMD-17)及症状自评量表(SCL-90)躯体化因子分评定并比较两组疗效及采用不良反应量表(TESS)评定安全性和不良反应。结果:治疗1周末,研究组的HAMD-17总评分与治疗前比有统计学差异性(P<0.05),治疗2周后,两组HAMD-17总评分与治疗前比较差异均有统计学意义(P<0.05)。治疗4周末,研究组HAMD-17和SCL-90躯体化因子总评分均较对照组低,比较差异有统计学意义(P<0.05);两组痊愈率及总有效率差异均有统计学意义(P<0.05)。研究组与对照组总体的不良反应发生率差异无统计学意义(P>0.05)。结论:草酸艾司西酞普兰联合小剂量氨磺必利治疗以躯体症状为主的老年抑郁症的疗效优于单纯草酸艾司西酞普兰治疗疗效,但其安全性等同。     

奥替溴铵与匹维溴铵治疗腹泻型肠易激综合征的疗效及安全性探讨

目的 探讨奥替溴铵与匹维溴铵治疗腹泻型肠易激综合征的疗效及安全性.方法 选取2015年3月—2016年7月在我院就诊的腹泻型肠易激综合征(IBS)患者78例,依据就诊先后顺序随机分为研究组和对照组,每组各39例.研究组服用奥替溴铵治疗,对照组服用匹维溴铵治疗,比较2组的临床疗效以及不良反应.结果 2组患者在治疗4周后腹痛、腹胀、腹泻等临床症状缓解与治疗前比较差异显著(P>0.05),组间比较差异无明显区别(P>0.05).服用奥替溴铵患者总药物不良反应率为17.9%,服用匹维溴铵患者的总药物不良反应率为20.5%,对比无显著区别(P>0.05).结论 服用奥替溴铵和匹维溴铵后肠易激综合征的患者腹痛、腹部不适、腹泻等症状均明显改善,且两种药物的治疗效果相差无几,安全可靠,值得在临床中借鉴使用.     

艾司西酞普兰合并动力性分析治疗难治性抑郁症临床疗效观察

目的 探讨艾司西酞普兰合并动力性分析对难治性抑郁症的疗效.方法 将63例抑郁症患者利用随机数学表法随机分为研究组31例(艾司西酞普兰合并动力性分析)和对照组32例(单用艾司西酞普兰),疗程为12周,采用汉密尔顿抑郁量表(HAMD)评定疗效.结果 治疗后第8,12周末,研究组的HAMD评分[8周末(17.35±2.98)分;12周末(9.26±3.46)分]显著低于对照组的HAMD评分[8周末(21.97±3.26)分;12周末(15.28±3.18)分,(P＜0.05)].研究组不良反应发生率25.81%,对照组不良反应发生率25%,2组差异无显著性(P＞0.05).结论 艾司西酞普兰合并动力性分析治疗难治性抑郁症能明显提高疗效,缓解更彻底,并不增加药物不良反应.     

草酸艾司西酞普兰与盐酸舍曲林治疗脑卒中后抑郁的临床对照研究

目的：探讨草酸艾司西酞普兰治疗脑卒中后抑郁的临床疗效及安全性。方法：对112例符合脑卒中后抑郁诊断标准的患者。随机分成两组,分别给予草酸艾司西酞普兰与盐酸舍曲林进行为期12周的治疗。应用抑郁量表评价疾病的严重程度及评定临床疗效。副反应量表（TESS）评估药物的不良反应。结果：治疗后草酸艾司西酞普兰组与盐酸舍曲林组用抑郁量表评定其治疗效果相当。草酸艾司西酞普兰组有效率为78．6％,盐酸酸舍曲林组效率为76．8％,两组疗效比较无显著性差异（P ＞0．05）。副反应量表（TESS）：草酸艾司西酞普兰组不良反应少。结论：草酸艾司西酞普兰能改善脑卒中后抑郁症状,并且耐药性好,安全,不良反应少。     

两种草酸艾司西酞普兰治疗抑郁症的疗效及安全性分析

目的:对比分析国产草酸艾司西酞普兰和进口草酸艾司西酞普兰在抑郁症治疗中的应用效果和安全性。方法:将选取接诊的抑郁症患者60例按顺序编号并随机分组,得对照组(进口草酸艾司西酞普兰治疗)和观察组(国产草酸艾司西酞普兰片治疗)各30例,对比两组疗效。结果:治疗后观察组的HAMD评分与对照组比较,差异无统计学意义(t=0.57;P>0.05);观察组的治疗有效率和不良反应率和对照组比较,差异无统计学意义(χ~2=1.87,2.39;P>0.05);观察组的治疗成本为(2 562.17±134.28)元,显著低于对照组,差异有统计学意义(t=13.74,P<0.05)。结论:国产草酸艾司西酞普兰和进口药物治疗抑郁症的效果类似,且国产药物的治疗成本相对更低,具有更高的临床应用价值。     

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…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.