利培酮对人体姿态平衡的效应

目的探讨利培酮对人体姿态平衡的效应.方法对病例组(39例精神分裂症病人)用利培酮治疗,于治疗第3天和第28天分别进行人体平衡实验;对26例不服精神药物的对照组(正常人)进行人体姿态平衡实验.结果 (1)病例组第3天测定的路径总长(795.49±159.67)和Romberg路径比(1.14±0.18)较对照组(679.01±110.26;1.03±0.14)的明显为大;(2)病例组第3天的路径总长和Romberg路径比较第28天的明显为大;(3)病例组第28天的平衡实验所有参数与对照组的均无显著差异;(4)平衡实验参数与精神病症状均无明显相关性.结论 (1)利培酮1mg/d治疗第3天可抑制本体感觉反射性的微小姿势控制功能;(2)利培酮(3.6±0.9)mg/d治疗1个月时,平衡功能损害已完全耐受;(3)利培酮治疗之初的平衡功能损害与精神分裂症无关.     

氯氮平对人体姿态平衡的效应

目的探讨氯氮平对人体姿态平衡的效应.方法研究组(17例精神分裂症病人)用氯氮平治疗,入组时和治疗第28天时分别评定简明精神病量表,治疗第3天评定药物副反应量表,氯氮平治疗第3天(100mg/d)和第28天[(315±63)mg/d]分别检测人体姿态平衡试验;对照组不服精神药物的26例正常人检测人体姿态平衡试验.结果 (1)研究组第3天的路径总长比对照组的明显为长(P ＜ 0.01);研究组第3天的Romberg路径比较对照组明显为大(P ＜0.01).(2)研究组第28天的Romberg路径比较第3天的明显为小(P ＜0.05),其余的平衡试验参数在第28天与第3天之间无显著差异.结论 (1)氯氮平抑制了本体感觉反射性的微小姿势控制功能;(2)氯氮平引起的姿态平衡损害随时间推移而发生耐受,唯视觉代偿的平衡功能可能随氯氮平的增量而下降.     

氯氮平对人体姿态平衡的效应

目的 探讨氯氮平对人体姿态平衡的效应。方法 研究组 (17例精神分裂症病人 )用氯氮平治疗,入组时和治疗第 28天时分别评定简明精神病量表,治疗第 3天评定药物副反应量表,氯氮平治疗第 3天(100mg/d)和第 28天[ (315±63)mg/d]分别检测人体姿态平衡试验;对照组不服精神药物的 26例正常人检测人体姿态平衡试验。结果 (1)研究组第 3天的路径总长比对照组的明显为长 (P<0. 01);研究组第 3天的Romberg路径比较对照组明显为大(P<0. 01)。(2)研究组第 28天的Romberg路径比较第3天的明显为小(P<0. 05),其余的平衡试验参数在第 28天与第 3天之间无显著差异。结论 (1)氯氮平抑制了本体感觉反射性的微小姿势控制功能; (2)氯氮平引起的姿态平衡损害随时间推移而发生耐受,唯视觉代偿的平衡功能可能随氯氮平的增量而下降。     

利培酮氯丙嗪对首发精神分裂症患者认知功能及事件相关电位P300的影响

目的比较利培酮和氯丙嗪对首发精神分裂症患者认知功能的影响。方法采用随机对照研究连续观察12周,利培酮组33例,剂量范围为1 ~7mg/d;氯丙嗪组22例,剂量范围25 ~600mg/d。进行PANSS、韦氏记忆量表(WMS)和事件相关电位P300的测评。结果首发精神分裂症患者在长时记忆、短时记忆、瞬时记忆及记忆商数(MQ)受损较为明显,与对照组比较差异有显著性(P<0. 05)。P300电位成分中P2 [ (186. 1±22. 8)ms]、N2 [ (241. 0±24. 5)ms]及P3 [ (349. 1±28. 2)ms]潜伏期明显延长,P2 [ (3. 7±2. 1)μV]及P3 [ (4. 2±2. 5)μV]波幅明显降低,与对照组比差异均有显著性(P<0. 05)。经过12周治疗利培酮治疗后WMS的再认、联想、理解、背数及记忆商(MQ)明显高于氯丙嗪,两组在治疗前后P300各指标之间无显著差异。结论首发精神分裂症患者存在着认知功能障碍,利培酮对首发精神分裂症认知功能的影响明显好于氯丙嗪。     

氯氮平利培酮对首发精神分裂症患者糖代谢影响的研究

目的 :探讨氯氮平和利培酮对首发精神分裂症患者糖代谢的影响。方法 :将 68例首发精神分裂症患者分为两组 ,分别给予氯氮平治疗 3 4例 (氯氮平组 )和利培酮治疗 3 4例 (利培酮组 )。两组患者治疗前、后第 4周末做糖耐量试验 ,测定甘油三酯、胆固醇 ,并测量身高、体重 ,计算体重指数 [BMI ,体重 (kg) /身高 (m2 ) ]。结果 :治疗第 4周末 ,氯氮平组餐后 1h、2h的血糖值 [分别为 (8.6± 1.8)mmol/L和 (6.7± 1.1)mmol/L]比治疗前 [分别为 (7.4± 2 .2 )mmol/L和 (5 .8± 1.4)mmol/L]明显升高 (P <0 .0 5 ,P <0 .0 1)而利培酮组无明显变化。治疗后氯氮平组 7例 (2 0 % )患者糖耐量减低的发生率高于利培酮组 1例 (3 % ) ,差异有显著性 (χ2 =3 .972 ,P <0 .0 5 )。结论 :氯氮平对首发精神分裂症患者餐后血糖的影响大于利培酮。     

丙戊酸钠对精神分裂症行为紊乱的辅助治疗作用

目的:观察利培酮联合丙戊酸钠治疗精神分裂症行为紊乱的辅助治疗作用。方法:将56例具有冲动行为的精神分裂症住院患者随机分为研究组(利培酮联合丙戊酸钠治疗)28例,对照组(单用利培酮治疗)28例。疗程8周。两组患者于治疗前及治疗第1、3、5、8周末采用PANSS评定量表和TESS评定量表测定,并予以比较。结果:两组患者的总体疗效尤以研究组显著,对照组锥体外系反应(EPS)发生率高于研究组。结论:利培酮联合丙戊酸钠治疗精神分裂症患者的冲动行为疗效优于单纯利培酮治疗。     

利培酮氯丙嗪对首发精神分裂症患者认知功能及事件相关电位P300的影响

目的比较利培酮和氯丙嗪对首发精神分裂症患者认知功能的影响.方法采用随机对照研究连续观察12周,利培酮组33例,剂量范围为1～7mg/d;氯丙嗪组22例,剂量范围25～600mg/d.进行PANSS、韦氏记忆量表(WMS)和事件相关电位P300的测评.结果首发精神分裂症患者在长时记忆、短时记忆、瞬时记忆及记忆商数(MQ)受损较为明显,与对照组比较差异有显著性(P＜0.05).P300电位成分中P2[(186.1±22.8)ms]、N2[(241.0±24.5)ms]及P3[(349.1±28.2)ms]潜伏期明显延长,P2[(3.7±2.1)μV]及P3[(4.2±2.5)μV]波幅明显降低,与对照组比差异均有显著性(P＜0.05).经过12周治疗利培酮治疗后WMS的再认、联想、理解、背数及记忆商(MQ)明显高于氯丙嗪,两组在治疗前后P300各指标之间无显著差异.结论首发精神分裂症患者存在着认知功能障碍,利培酮对首发精神分裂症认知功能的影响明显好于氯丙嗪.     

注射用利培酮微球与非经典抗精神病药治疗精神分裂症的对照研究

目的 探讨注射用利培酮微球治疗精神分裂症的疗效和安全性.方法 符合诊断标准的82名精神分裂症患者分成2组,分别给予注射用利培酮微球和非经典抗精神病药物利培酮、喹硫平、奥氮平治疗24周.于治疗前及治疗后2,4,12,24周末分别采用阳性与阴性症状量表(PANSS)、个体和社会功能量表(PSP)和副反应量表(TESS)量表评定临床疗效和副反应.结果 2组药物对精神分裂症均有显著疗效,2组治疗后各时间PANSS评分显著低于治疗前[研究组:(44.26±11.41)分,(92.87±12.79)分;对照组:(44.11±10.92)分,(93.35±14.16)分,(P＜0.05)],显效率2组间差异无统计学意义(P＞0.05);注射用利培酮微球治疗组与非经典抗精神病药物治疗组PANSS评定在第4周末差异有统计学意义(P＜0.05),并且在第24周末注射用利培酮微球治疗组得到更好的社会功能恢复(P＜0.05).2组药物的副反应总体差异无统计学意义(P＞0.05);注射用利培酮微球治疗组的静坐不能发生率早期高于口服非经典抗精神病药物组,但差异无统计学意义(P＞0.05);而嗜睡的发生率显著低于口服非经典抗精神病药物(P＜0.05).结论 长效利培酮微球与口服非经典抗精神药物相比疗效相当,社会功能恢复好,副作用较少.     

利培酮与奋乃静治疗脑血管病所致精神障碍的对照研究

目的 比较利培酮与奋乃静治疗脑血管病所致精神障碍的有效性及安全性。方法 将 63例患者按治疗药物分为两组,利培酮组(33例)和奋乃静组 (30例 ),比较两组患者的疗效及副反应。结果在治疗前两组间性别、年龄、病程、BPRS、MMSE等均无统计学差异(P>0. 05),两组在治疗前后BPRS评分均具显著性差异(35. 6±7. 3, 27. 3±6. 1,P<0. 01) (34. 9±6. 5, 28. 1±5. 7,P<0. 01),利培酮组治疗前后MMSE有显著性差异(13. 7±9. 1, 19. 5±9. 4,P<0. 05),两组间在治疗后BPRS无显著性差异(27. 3±6. 1,28. 1±5. 7,P>0. 05),而MMSE和TESS有显著性差异。结论 利培酮治疗脑血管病所致精神障碍与奋乃静疗效相当,但利培酮对认知功能的影响和安全性方面优于奋乃静。     

利培酮治疗精神分裂症患者所致泌乳素升高与 骨密度下降的相关性研究

目的 探讨利培酮治疗精神分裂症患者所致泌乳素升高与骨密度下降的相关性.方法 选择住院的25~45岁年龄段的精神分裂症患者100例,首发病例50例为对照组,住院接受利培酮单药维持治疗的病例50例为实验组,给予对照组常规药物治疗,给予观察组利培酮药物治疗.结果 对照组治疗3周后的泌乳素为(25.31±14.52),实验组治疗3周后的泌乳素为(75.23±51.28),两组对比差异具有统计学意义(P<0.05).实验组治疗后腰椎1的骨密度为(0.95±0.16),对照组腰椎1的骨密度为(1.15±0.18),两组对比差异具有统计学意义(P<0.05).结论 利培酮治疗精神分裂症患者,随着剂量的增加,患者利培酮血药浓度升高,同时引起患者泌乳素升高和骨密度下降的现象,由此增加患者骨折的风险,因此要谨慎的使用抗精神病药物.     

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.     

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.     

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 clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.