行为干预对精神分裂症并发糖尿病患者生活质量的影响

目的:探讨行为干预对精神分裂症并发糖尿病患者生活质量的影响.方法:将68例精神分裂症并发糖尿病患者随机分为研究组和对照组各34例,两组在常规治疗基础上研究组给予行为干预,疗程12周,测空腹血糖(FPG)、餐后2小时血糖(2hPG),采用综合生活质量问卷(GQOLI-74)评定生活质量.结果:行为干预12周后,研究组FPG、2hPG显著低于对照组,血糖改善明显(P＜0.05).GQOLI-74各因子分显著提高,与对照组比较差异有显著性(P＜0.01).结论:行为干预可显著提高精神分裂症并发糖尿病患者生活质量.     

舒适护理对糖尿病并发脑梗死患者生活质量的影响

目的:探讨舒适护理对糖尿病并发脑梗死患者生活质量的影响,为临床护理糖尿病并发脑梗死患者提供一定指导。方法:回顾性分析60例糖尿病并发脑梗死患者临床资料,随机分成观察组与对照组,每组30例,观察组在常规药物治疗基础上采用舒适护理,对照组采用常规药物治疗和护理,观察两组血糖达标时间、脑梗死复发率以及护理前后SF-36评分、NIHSS评分和ADL评分上的不同。结果:观察组血糖达标时间和脑梗死复发率明显低于对照组,差异有统计学意义(P<0.05);护理前后两组SF-36评分、NIHSS评分和ADL评分均有明显改善,且观察组明显优于对照组,差异有统计学意义(P<0.05)。结论:对糖尿病并发脑梗死患者在常规药物治疗基础上采用舒适护理能够有效控制血糖水平,降低脑梗死复发率,提高患者的生活质量,是一种科学有效的护理方法,值得临床推广。     

儿童期与青少年期首发精神分裂症临床特征比较

目的比较分析儿童期以及青少年期首发精神分裂症的临床特征。方法在我院接受精神分裂症诊治的患者中随机抽取97例,根据患者发病年龄分为对比组(n=43)和探析组(n=54),回顾性分析患者临床资料,同时比较分析2组患者思维障碍、语言障碍、行为障碍、情感障碍以及认知障碍发生情况。结果儿童期患者与青少年期患者性别、家族史、诱因、病前个性、起病形式差异均不存在统计学意义(P0.05),2组患者行为障碍、情感障碍、语言障碍、思维障碍发生率差异存在统计学意义(P0.05),2组患者感知障碍发生率差异不存在统计学意义(P0.05)。结论儿童期以及青少年期首发精神分裂症发病形式以及临床症状具有较大差异,因此应根据患者年龄段及早进行识别并采取具有较强针对性的治疗措施以促进其病情好转。     

2型糖尿病150例慢性大血管与微血管并发症的临床分析

目的对比新疆维族和汉族早发和迟发2型糖尿病(Type2 diabetes mellitus,T2DM)患者并发糖尿病大血管与微血管病变(Diabetic microangiopathy,DMAP)的差异,探讨其临床特点。方法选择临床确诊的住院和门诊维族及汉族T2DM患者共150例,按照年龄、性别、民族分组,比较并发大血管病变和DMAP及生化项目的差异。结果维族和汉族间HDL-C、LDL-C、2h PG水平差异有统计学意义(P0.05);FPG、TC、TG水平差异无统计学意义(P0.05)。早发组T2DM患者并发DMAP阳性率显著高于迟发组T2DM患者(χ2=4.304,P0.05)。早发组Hb A1c、TG水平显著高于迟发组(P0.01);早发组LDL-C水平显著低于迟发组(P0.01)。早发组与迟发组相比FBG、2h PG、TC及LDL-C水平差异无统计学意义。性别间差异无统计学意义(P0.05)。结论早发T2DM患者较迟发者有更严重的代谢紊乱和易并发糖尿病微血管病变的临床特点;不同民族存在较大差异。     

糖尿病合并急性脑卒中并发医院获得性肺炎的临床特征和危险因素

目的探讨糖尿病合并急性脑卒中患者并发医院获得性肺炎(HAP)的临床特征和危险因素。方法选取2010年1月-2014年12月入住中山大学附属第一医院神经内科糖尿病合并急性脑卒中并发HAP患者59例为肺炎组,随机选择同期住院未并发肺炎的糖尿病合并急性脑卒中患者72例作为对照组。分析两组患者临床特征,统计临床检查结果,运用Logistic回归分析糖尿病合并急性脑卒中患者并发HAP的独立危险因素。结果与对照组相比,肺炎组的年龄、住院天数、吞咽困难、胃管进食、意识障碍、瘫痪发生率及房颤病史患病率水平升高,格拉斯哥(GCS)评分降低,两组间差异有统计学意义(P0.05);肺炎组白细胞总数、中性粒细胞百分比、血糖、尿素氮、纤维蛋白原(Fbg)水平高于非肺炎组,同型半胱氨酸水平低于非肺炎组,两组间差异有统计学意义(P0.05)。Logistic回归分析结果表明吞咽困难、意识障碍、房颤病史、白细胞总数、Fbg表达水平与糖尿病合并急性脑卒中患者并发HAP密切相关。结论吞咽苦难、意识障碍、白细胞总数及Fbg水平升高、房颤既往病史是糖尿病合并急性脑卒中患者并发HAP的独立危险因素。     

长期服药精神分裂症患者血浆瘦素胰岛素及胰岛素抵抗的相关性研究

目的研究长期服用抗精神病药物的慢性精神分裂症患者空腹血清瘦素、胰岛素水平和胰岛素抵抗及其之间的关系.方法 218例病程＞5年的慢性精神分裂症患者接受糖尿病流行病学调查,测定空腹血糖、餐后2h血糖、空腹瘦素(leptin)和空腹胰岛素(FINS)水平.根据血糖水平及糖尿病临床症状,分为糖尿病组(DM组)、血糖调节异常组(AGT组,包括IFG和IGT)和血糖正常组(NGT组,其中BMI＜26归为NGTa组;BMI≥26归为NGTb组).结果 DM组空腹瘦素[(30.05±10.76)ng/ml]、胰岛素[(13.35±4.99)pIu/ml]水平高于NGTa组[分别为(24.35±10.74)ng/ml、(10.86±3.30)μIu/ml;P＜0.05和P＜0.01];整体患者leptin与FINS呈显著正相关(r=0.210,P=0.005),进一步分组做相关分析,NGTa组、NGTb组leptin与FINS均呈显著正相关(r=0.277,P=0.014;r=0.457,P=0.017).整体患者leptin与HOMA胰岛素抵抗指数(HOMA-IR)呈显著正相关(r=0.231,P=0.002),分组后NGTa组leptin与HOMA-IR呈正相关(r=0.228,P=0.045).结论长期服用抗精神病药物(APS)可引起血leptin、FINS水平升高,当两者处于失平衡状态时,就会导致血糖调节异常及糖尿病,推测APS引起的瘦素水平增高可能参与了胰岛素抵抗,而导致糖尿病的发生.     

长期服药精神分裂症患者血浆瘦素胰岛素及胰岛素抵抗的相关性研究

目的研究长期服用抗精神病药物的慢性精神分裂症患者空腹血清瘦素、胰岛素水平和胰岛素抵抗及其之间的关系。方法218例病程>5年的慢性精神分裂症患者接受糖尿病流行病学调查,测定空腹血糖、餐后2h血糖、空腹瘦素(leptin)和空腹胰岛素(FINS)水平。根据血糖水平及糖尿病临床症状,分为糖尿病组(DM组)、血糖调节异常组(AGT组,包括IFG和IGT)和血糖正常组(NGT组,其中BMI<26归为NGTa组;BMI≥26归为NGTb组)。结果DM组空腹瘦素[(30.05±10.76)ng/ml]、胰岛素[(13.35±4.99)μIu/ml]水平高于NGTa组[分别为(24.35±10.74)ng/ml、(10.86±3.30)μIu/ml;P<0.05和P<0.01];整体患者leptin与FINS呈显著正相关(r=0.210,P=0.005),进一步分组做相关分析,NGTa组、NGTb组leptin与FINS均呈显著正相关(r=0.277,P=0.014;r=0.457,P=0.017)。整体患者leptin与HOMA胰岛素抵抗指数(HOMA-IR)呈显著正相关(r=0.231,P=0.002),分组后NGTa组leptin与HOMA-IR呈正相关(r=0.228,P=0.045)。结论长期服用抗精神病药物(APS)可引起血leptin、FINS水平升高,当两者处于失平衡状态时,就会导致血糖调节异常及糖尿病,推测APS引起的瘦素水平增高可能参与了胰岛素抵抗,而导致糖尿病的发生。     

老年糖尿病患者的血糖检验研究

目的:探析血糖检验在老年糖尿病患者中的临床运用价值。方法:选择2013年2月-2015年2月期间我干休所170例老年糖尿病患者为研究对象,运用随机数字表法将其分为两组,其中对照组接受日常锻炼和药物治疗,而观察组在此基础上,再每周检验1次血糖,每3个月检验1次糖化血红蛋白,比较两组检验结果。结果:检验前,两组的糖化血红蛋白、餐后2h血糖以及空腹血糖比较无明显差异(P0.05);检验后,与对照组比较,观察组的糖化血红蛋白和空腹血糖明显下降,组间比较差异显著(P0.05);两组的血糖控制效果比较差异有统计学意义(P0.05)。结论:临床上定期检验老年糖尿病患者的血糖水平,可以根据患者的实际情况,及时调整治疗方案,对控制患者的血糖水平有着极其重要的意义。     

精神分裂症并发糖尿病相关因素分析

目的:分析精神分裂症并发糖尿病的相关影响因素。方法:在2017年6月—2018年11月抽取我院住院治疗的精神分裂症89例患者为观察对象,分析其中并发糖尿病的发生率,总结精神分裂症并发糖尿病的相关影响因素。结果:本组89例精神分裂症患者中糖尿病并发率为15.73%。影响精神分裂症患者并发糖尿病的因素包括体质量指数高、体重高、病程长、使用氯氮平这一抗精神病药物治疗(P<0.05),精神分裂症并发糖尿病未显示和年龄、性别存在相关性(P>0.05)。结论:精神分裂症并发糖尿病的可能性较高,其中体质量指数、病程、治疗药物是重要影响因素,临床应该加强重视与干预,最大程度降低精神分裂症患者糖尿病并发率,减低精神分裂症的临床治疗难度。     

精神分裂症合并糖尿病患者综合护理干预的探讨

目的探讨精神分裂症合并糖尿病患者综合护理干预的临床效果。方法选取2014年10月-2015年5月本院收治的18例精神分裂症合并糖尿病患者作为对照组,给予常规护理;选取2015年6月-12月本院收治的12例同类型患者作为观察组,给予综合护理干预,比较两组患者的护理效果。结果观察组空腹血糖、餐后2小时血糖改善水平优于对照组,组间差异显著(P0.05);观察组服药依从性、定期复诊率、复发率、再住院率与对照组相比,差异具有统计学意义(P0.05);两组简明精神病量表总分及各因子分进行比较,观察组均低于对照组,组间差异有统计学意义(P0.05)。结论给予精神分裂症合并糖尿病患者综合护理干预可显著改善患者临床症状,提高其治疗依从性,有效控制复发率和再住院率,值得临床选择和积极推广。     

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.     

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.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…