冠心病与抑郁症共患者情绪Stroop效应任务研究

目的 探讨冠心病（CHD）与抑郁症共患者对负性信息是否存在注意偏向。方法 选取2013年5月-2014年8月在潍坊医学院附属医院心内科住院的CHD患者44例,按照Zung氏抑郁自评量表（SDS）评分和临床精神科医生的诊断,将其分为CHD与抑郁症共患组和单纯CHD组。患者均参加情绪Stroop效应任务,记录其正确率、反应时和干扰效应。结果 排除试验时身体不适、操作不当未完成试验者,CHD与抑郁症共患组13例,单纯CHD组27例。对正确率进行重复测量方差分析,结果显示：阈限类型主效应显著（F=16.08,P＜0.001）,阈上呈现的正确率高于阈下呈现;组别主效应显著（F=6.48,P＜0.001）,CHD与抑郁症共患组的正确率低于单纯CHD组。对反应时进行重复测量方差分析,结果显示：组别主效应显著（F=21.68,P＜0.001）,CHD与抑郁症共患组反应时长于单纯CHD组;词汇类型主效应显著（F=83.61,P＜0.001）,负性词反应时长于正性词和中性词;阈限类型×组别交互作用显著（F=4.34,P=0.004）;组别×词汇类型交互作用显著（F=4.01,P=0.005）,简单效应分析发现：CHD与抑郁症共患组正性词和负性词反应时均长于单纯CHD组（F=16.14,P＜0.001;F=17.11,P＜0.001）;且CHD与抑郁症共患组负性词反应时长于正性词和中性词（F=10.09,P＜0.001）。对干扰效应进行重复测量方差分析,结果显示：词汇类型主效应显著（F=43.61,P＜0.001）,负性词的干扰效应大于正性词;组别×词汇类型×阈限类型交互作用显著（F=5.73,P=0.001）。以阈限类型为参照的进一步分析发现：阈上呈现时,词汇类型主效应显著（F=5.97,P=0.001）;组别×词汇类型交互作用显著（F=6.49,P＜0.001）,简单效应分析发现：两组正性词干扰效应比较,差异无统计学意义（F=1.08,P=0.07）;CHD与抑郁症共患组负性词干扰效应大于单纯CHD组（F=6.24,P＜0.001）;CHD与抑郁症共患组和单纯CHD组负性词干扰效应均大于正性词（F=4.40,P=0.04;F=5.45,P=0.02）。结论 CHD与抑郁症共患者对阈上负性词存在干扰抑制功能障碍,存在明显的负性注意偏向。     

改良电休克治疗对抑郁症患者延迟回忆能力的影响及相关因素分析

目的探索改良电休克治疗(modified electraconvulsive therapy,MECT)前后抑郁症患者延迟记忆能力变化情况及影响因素。方法对11例抑郁症患者分别在治疗前、治疗后48小时内进行测验,以中文听觉词汇学习测试(Chinese auditory learning test,CAVLT)分钟延迟回忆分数为终点指标,同时评定治疗前后患者汉密尔顿抑郁量表(Hamilton depressive scale,HAMD)分值。结果MECT治疗后患者延迟回忆分数降低,差异有统计学意义(t=4.190,P=0.002);MECT治疗后患者HAMD分值降低,差异有统计学意义(t=15.493,P0.001);延迟回忆能力改变值与治疗前延迟回忆分数相关(r=0.801,P=0.003)。结论 MECT治疗降低抑郁症患者延迟回忆能力,延迟回忆能力损害程度与治疗前延迟回忆能力有关。     

首发与复发抑郁症患者的过度概括化自传体记忆比较

目的探索复发性抑郁症与首发抑郁症患者过度概括化自传体记忆（OGM）的差异,以及过度概括化自传体记忆对抑郁症状的影响。方法对34例首发性抑郁症患者以及31例复发性抑郁症患者,采用自传体记忆测评（autobiographicalmemorytest,AMT）评定过度概括化自传体记忆水平、汉密尔顿抑郁量表测评（HAMD-17）及贝克抑郁量表（BDI）评定抑郁严重程度。结果①复发性抑郁症组OGM总分显著高于首发抑郁症组[分别为（3．90±1．65）分,（3．10±1．57）分,t=2．035,P〈O．05];②复发性抑郁症组积极线索词诱导的OGM总分显著高于首发抑郁症组[分别为（2．40±1．36）分,（1．70±1．08）分,t=2．308,P〈0．05];③OGM与BDI总分、HAMD总分以及认知障碍因子、迟缓因子呈高度的正相关性（r=0．497,P〈0．05;r=0．552,P〈0．05;r=0．631,P〈0．05;r=0．553,P〈O．05）。结论与首发性抑郁症患者相比,复发性抑郁症患者的OGM更为严重,抑郁症患者的OGM亦能够增加抑郁症的复发频率,加重认知障碍、迟缓症状。     

无抽搐电休克治疗后持续吸氧对精神分裂症患者记忆及认知功能的影响

目的探讨无抽搐电休克治疗(MECT)后持续吸氧对精神分裂症患者记忆及认知功能的影响。方法选择住院行MECT治疗的精神分裂症患者60例,随机分为研究组(MECT治疗后吸氧)及对照组(MECT治疗后未吸氧),各30例。分别在MECT治疗前、MECT疗程后次日、MECT疗程后第4周后采用阳性及阴性症状量表(PANSS)、韦氏记忆测验(WMS)、中国简版精神间分裂症患者认知量表(B-CATS)评估患者精神症状、记忆及认知功能变化。结果两组在MECT疗程结束后次日的PANSS减分均明显(均P<0.05)。研究组WMS在治疗结束后4周恢复至基线水平,而对照组在治疗结束后4周仍低于基线水平(P<0.05)。连线测验A、连线测验B在MECT疗程结束后(次日及4周后)均较基线期减少,两组间差异亦有统计学意义(均P<0.05);数字符号替换测验在MECT疗程结束后(次日及4周后)均较基线期增加,两组间差异亦有统计学意义(均P<0.05);研究组动物流畅命名在MECT疗程结束后(次日及4周后)较基线期增加,差异均有统计学意义(均P<0.05),而对照组在MECT疗程结束后(次日及4周后)与基线期相比加分不明显(P>0.05)。结论持续吸氧可以改善MECT治疗精神分裂症所致的记忆减退及认知功能障碍。     

阿立哌唑治疗利培酮所致男性性功能障碍研究

目的:探讨阿立哌唑治疗利培酮所致男性性功能障碍的疗效。方法:将66例因服用利培酮导致性功能障碍的男性精神分裂症患者随机分为两组,分别用阿立哌唑(35例)和安慰剂(31例)治疗8周。分别于治疗前、治疗后第4周、第8周采用勃起功能国际问卷(IIEF)自评,同时评定简明精神病评定量表(BPRS)及治疗中出现的症状量表(TESS)。结果:阿立哌唑组随着治疗时间的延长勃起功能得到改善(P<0.001)。安慰剂组IIEF评分基线与第4周末(t=-8.396,P<0.001)、基线与第8周末(t=-5.881,P<0.001)差异具有统计学意义。第4周末与第8周末IIEF评分差异无统计学意义(t=0.613,P=0.545)。两组间基线及第4周末IIEF评分差异无统计学意义,第8周末差异有统计学意义。两组间BPRS、TESS评分差异无统计学意义(P>0.01)。结论:阿立哌唑可有效治疗利培酮所致的男性性功能障碍,且不良反应较少。     

无抽搐电休克对精神分裂症患者工作记忆的影响

目的探讨无抽搐电休克治疗（MECT）对精神分裂症患者工作记忆的影响。方法采用2-back-[作记忆测试作为工作记忆批评定工具,对30例精神分裂症患者在MECT治疗前后的试验的正确率和反应时进行比较,同时比较精神分裂症患者中MECT组与30例单纯药物治疗精神分裂症患者在试验结果差异。结果重复测量方差分析发现,MECT治疗前后3次试验正确率[（66．70±9．82）％,（67．614-6．83）％,（80．72±12．08）％]和反应时[（1415．69_＋258．51）ms,（1328．65＋236．08）ms,（1094．454±259．44）nlsJ差异具有统计学意义（F：19．163,P〈O．OOl;F=13．084,P〈0．001）;精神分裂症患者在2-Back任务的正确率和反应时在MECT疗程结束后2周[（80．72±12．08）％;（1094．454-259．44）ms]较MECT治疗前[（66．70±9．82）％;（1415．694-258．51）ms]均有提高,差异有统计学意义（￡=-4．369,P〈0．001;t---5．596,P〈O．001）;精神分裂症患者在MECT疗程结束后2周[（80．724-12．08）％;（1094．454_259．44）ms]较MECT疗程结束后1d[（67．614_6．83）％;（1328．654_236．081）ms]均有提高,差异有统计学意义（t一5．416,P〈0．000;f=3．824,P=0．001）;MECT组精神分裂症患者在疗程结束2周在试验正确率方面大于服药组[（73．67＋10．41）％],差异有统计学意义（卢2．424,P=0．018）。结论精神分裂症患者工作记忆功能经过MECT治疗可能会有不同程度的改善。     

舍曲林合并无抽搐电休克治疗老年抑郁症的临床研究

目的 了解舍曲林合并无抽搐电休克（MECT）治疗对老年抑郁症患者的疗效与不良反应.方法 对83例符合老年抑郁症的患者按随机数字表法分为研究组41例和对照组42例,研究组给予舍曲林合并MECT治疗,对照组单用舍曲林治疗,观察8周.分别于治疗前、治疗后第1、2、4和8周末时采用汉密尔顿抑郁量表（HAMD17）评定疗效,不良反应症状量表（TESS）评定不良反应.研究组治疗前后采用临床记忆量表甲套评定认知功能.结果 研究组脱落7例,对照组脱落5例.研究组治疗后第1、2、4、8周末时的HAMD17总分较治疗前显著下降（P＜0.05）,对照组治疗第2、4、8周末HAMD17总分较治疗前下降（P＜0.05）.两组间治疗后第2周末时HAMD17总分比较差异有统计学意义（P＜0.05）.研究组治疗后第1个24h临床记忆量表甲套中指向记忆、图像自由回忆项目分较治疗前下降（均P＜0.05）,治疗第2周末联想学习、无意义图形再认项目分及记忆商值较治疗前升高（均P＜0.05）,治疗第8周末除图像自由回忆项目外,其他项目分及记忆商值较治疗前升高（P＜0.05或0.01）.研究组HAMD减分率（76.23＆#177;21.41）％,临床总有效率85.29％,临床痊愈率47.06％;对照组HAMD减分率（51.26＆#177;18.13）％,临床总有效率64.86％,临床痊愈率21.62％,两组间差异均有统计学意义（均P＜0.05）.两组患者各时点的TESS评分比较差异无统计学意义（P＞0.05）.结论 舍曲林合并MECT治疗能提高老年抑郁症的疗效,无严重不良反应.     

无抽搐电休克治疗重性抑郁障碍临床研究

目的观察无抽搐电休克治疗（MECT）重性抑郁障碍的疗效及安全性。方法将63例重性抑郁障碍患者随机分成两组,分别采用MECT和西肽普兰药物治疗,观察期为6周。以汉密尔顿抑郁量表（HAMD）总分及减分率为主要临床疗效评价指标;以抑郁自评量表（SDS）、焦虑自评量表（SAS）、汉密尔顿焦虑量表（HAMA）总分的差异为次要疗效评估指标;以治疗时出现的症状量表（TESS）观察治疗出现的不良反应;并采用临床记忆量表观察观察组患者的记忆变化。结果治疗第6周末,观察组的临床痊愈率和有效率明显高于对照组（P〈0.05或0．01）。观察组SAS总粗分、SDS总粗分、HAMA总分、HAMD总分治疗第1周末即较治疗前下降（P〈0.05或0．01）,而对照组于治疗第2周末才开始下降（P〈0．05）;观察期内,观察组除SAS总粗分仅于治疗后1周末、2周末显著低于对照组（均P〈0.01）外,上述其它量表分治疗后各时点均低于对照组（P〈0．05或0．01）。两组间治疗后各时点TESS总分比较无统计学意义。观察组临床记忆量表治疗后第一个24h时指向记忆、图象自由回忆、无意义图形再认分值较治疗前下降（均P〈0．05）,治疗后6周末各项量表分值及记忆商值较治疗前升高（P〈0．05或0.01）。结论MECT对重性抑郁障碍起效较迅速,疗效较显著,安全性较好。     

他汀类药物对奥氮平治疗精神分裂症患者所致血脂异常的影响

目的探讨他汀类药物对奥氮平治疗精神分裂症患者所致血脂异常的疗效及安全性。方法以两精神专科医院门诊及住院单用奥氮平治疗、符合《国际疾病与健康问题统计与分类-第10版》(International statistical classification of diseases and related health problems-10th revision,ICD-10)诊断标准的精神分裂症患者120例为研究对象。在奥氮平治疗前(基线时)、第4周末、第12周末分别测定患者总胆固醇(Total cholesterol,TC)、低密度脂蛋白-胆固醇(Low density lipoprotein cholesterol,LDL-C)浓度。治疗第4周末将其中符合奥氮平所致血脂异常患者72例,按奇偶数抽签法随机分成两组,各36例。研究组给予他汀类药物治疗血脂异常,对照组不用他汀类药物治疗。基线时及治疗第4周、第12周末对所有患者用阳性阴性症状量表(Positive and negative symptom scalez,PANSS)、不良反应症状量表(Treatment emergent symptom scale,TESS)分别评定疗效及安全性。并比较他汀类药物治疗血脂(TC、LDL-C)异常的疗效与奥氮平治疗精神症状的疗效(PANSS减分率)的相关性。结果 PANSS评分:12周末研究组低于对照组(P0.05);研究组、对照组12周末均低于4周末、低于基线时(F=4.82,P0.05;F=8.75,P0.05)。TESS评分:4周末两组无差异;研究组12周末低于4周末;对照组12周末高于4周末;12周末研究组低于对照组(P0.05)。TC、LDL-C浓度:基线时、4周末两组无差异;12周末研究组均低于对照组;研究组12周末低于4周末,4周末高于基线时,12周末低于基线时(F=16.65,P0.05);对照组12周末高于4周末,4周末高于基线时,12周末高于基线时(F=24.42,P0.05)。PANSS、TESS评分与TC、LDL-C浓度均呈正相关(P0.05)。结论他汀类药物治疗奥氮平所致血脂异常安全有效,并与奥氮平治疗精神分裂症的疗效密切相关。     

无抽搐电休克合并氯氮平治疗难治性精神分裂症的对比照研究

目的：了解无抽搐电休克治疗（MECT）对难治性精神分裂症的疗效与不良反应。方法：对100例难治性精神分裂症患者随机分为两组，其中，无抽搐电休克合并氯氮平治疗与单用氯氮平治疗各50例，使用简明精神病评定量表（BPRS）与不良反应量表（TESS）分别于入组前及治疗后1、2、4、8周末进行评定，评定两组治疗方法的疗效和不良反应。结果：合并MECT合并氯氮平治疗组BPRS评分明显降低（P〈0．01）与单用氯氮平治疗组有显著性差异；MECT合并氯氮平治疗组TESS评分在治疗结束后第2周末明显降低。结论：MECT对难治性精神分裂症有效，不良反应少。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.