西酞普兰合并奋乃静对精神分裂症患者认知功能的影响

目的观察西酞普兰合并奋乃静对精神分裂症患者认知功能的影响.方法采用入院顺序分层随机法,将120例慢性精神分裂症患者平均分为研究组(西酞普兰+奋乃静)和对照组(奋乃静+安慰剂).在治疗前、治疗后4,8,12周末分别以阳性症状、阴性症状量表和副反应量表评定疗效和副作用,用韦氏成人智力量表、韦氏记忆量表和威斯康星卡片分类测验评定治疗前后患者认知功能的改变.结果治疗12周后,研究组的言语量表、操作量表、全量表和记忆量表分分别为(84.97±3.73)分、(80.41±5.93)分、(83.37±5.81)分、(77.26±13.31)分;对照组分别为(75.41±3.95)分、(72.43±5.56)分、(75.87±5.34)分、(72.15±13.19)分,两组差异有显著性(P＜0.01).PANSS总分、阴性因子分比治疗前明显降低,治疗后4,8,12周末TESS评分,研究组均低于对照组,且治疗后低于治疗前,均差异有显著性(P＜0.05).结论西酞普兰合并奋乃静治疗对精神分裂症患者认知功能有明显改善.     

苯二氮卓类药物依赖失眠症患者睡眠质量应付方式及人格特征的研究

目的 探讨失眠症患者苯二氮卓类(BZD)药物依赖的人格特征和应付方式.方法 采用多导睡眠图、明尼苏达多相人格问卷(MMPI)、应付方式问卷对符合CCMD-3诊断标准的20例失眠症药物依赖组和20例非药物依赖组进行测评,并与20名正常人比较.结果 (1)失眠症组睡眠效率则明显低于对照组[(66.5±7.34)min,(86.45±6.58)min,P＜0.01],药物依赖组REM睡眠时间明显低于非依赖组[(27.40±7.67)min,(44.30±12.91)min,P＜0.05].(2)失眠症组MMPI量表评定,2组在Hs、D、Hy、Pd、Pa、Pt的T分显著高于正常对照组(P＜0.01),但2组比较差异无显著性(P＞0.05).(3)应付方式中失眠症组不成熟应付方式高于对照组、成熟应付方式低于对照组低于(P＜0.01).依赖组和非依赖组比较,解决问题[(0.51±0.13)分,(0.63±0.14)分]、求助低于非依赖组,自责、幻想、退避评分高于非依赖组(P＜0.05～0.01).结论 失眠与患者人格特征关系密切,不成熟的应付方式与BZD药物依赖的形成有关.     

综合心理治疗对精神分裂症患者认知功能影响的对照研究

目的 观察综合心理干预与单纯认知治疗对精神分裂症认知功能的影响.方法 将80例精神分裂症的患者以抛币法随机分成2组,其中一组(A组,n=40)给予综合心理干预;另一组(B组,n=40)给予认知治疗,治疗8周.在入组前、治疗8周末分别进行韦氏成人智力量表(WAIS-RC)、韦氏记忆量表(WMS)、威斯康星卡片分类测验(WCST)及副反应量表(TESS)评分,比较2组对精神分裂症患者认知功能产生的影响.结果 治疗8周后,A组记忆商、智商、持续操作错误数和随机操作错误数[分别为(110.52±18.03)分,(110.78±15.42)分,(15.48±9.82)分,(17.46±13.28)分],高于B组[分别为(96.64±18.26)分,(102.23±13.4)分,(20.35±11.47)分,(24.92±13.71)分],差异有显著性(P＜0.05).结论 认知治疗能改善精神分裂症患者的认知功能,而综合心理干预效果更显著.     

慢性酒依赖者认知功能的对照研究

目的评估慢性酒依赖者的认知功能状况.方法分别应用韦氏成人智力量表(WAIS)和韦氏记忆量表(WMS),对30例男性酒依赖者和30例匹配的正常对照者进行智能和记忆功能的评定,比较两组之间的差异,并对酒依赖者认知功能损害的危险因素进行相关分析.结果慢性酒依赖者的智商(FIQ)为86.03±9.87,记忆商(MQ)为61.07±10.13,均显著低于正常对照组(P <0.05),智能和记忆量表的各因子分也表现出较为普遍的差异.相关分析表明,慢性酒依赖者的智商和记忆商数与饮酒时间呈显著负相关(r>0.4, P <0.01),与教育程度及习惯性饮酒开始年龄呈正相关(r>0.2, P <0.05).结论慢性酒依赖者存在显著的认知功能障碍.     

伴与不伴躯体化症状中青年首发抑郁症患者认知功能的对照研究

目的 比较伴与不伴躯体化症状的首发中青年抑郁症患者认知功能的差异.方法 对61例伴有躯体化症状的抑郁症患者(研究组)和58例不伴有躯体化症状的抑郁症患者(对照组)进行认知功能的对照性评估,用韦氏成人智力量表、韦氏记忆量表、威斯康星卡片分类测验评估其认知功能.结果 研究组的词汇、图画填空、再认、理解和持续错误数[分别为(9.74±2.40)分,(5.54±1.65)分,(7.07±2.35)分,(6.41±2.57)分,(69.02±11.49)分]与对照组[分别为(10.74±2.91)分,(6.30±1.91)分,(8.28±2.76)分,(8.28±2.23)分,(53.11±12.92)分]差异有显著性(P＜0.05).结论 伴有躯体化症状的首发中青年抑郁症患者较不伴有躯体化症状的首发中青年抑郁症患者认知功能受损更为严重.     

喹硫平合并5-羟色胺再摄取抑制剂对难治性强迫症疗效及认知功能的影响

目的 观察喹硫平合并5-羟色胺再摄取抑制剂治疗难治性强迫症的疗效及对认知功能的影响.方法 58名难治性强迫症患者,随机分为喹硫平合并治疗组(n=29)和安慰剂合并治疗组(n=29).在基线和治疗8周结束时进行Yale-Brown量表和认知功能评定,认知功能评定包括威斯康星卡片分类测验,Stroop测验,持续操作试验,韦氏记忆量表,以评估患者的注意、记忆和执行功能.比较2组治疗前后Yale-Brown量表和认知功能评分.结果 喹硫平合并治疗组和安慰剂组治疗前Yale-Brown量表总分分别为(28.5±4.4)分,(26.3±6.5)分;治疗后分别为(18.5±6.4)分,(25.7±5.4)分,差异有显著性(P=0.01).治疗前后威斯康星卡片分类测验中维持不能数增加,治疗前分别为(1.2±1.1)分,(1.3±1.4)分;治疗后分别为(1.6±1.0)分,(1.5±1.2)分,差异有显著性(P=0.03),其余认知功能测验指标治疗前后差异无显著性.结论 喹硫平合并治疗对难治性强迫症有效,对认知功能无明显影响.     

慢性酒依赖者认知功能的对照研究

目的评估慢性酒依赖者的认知功能状况。方法分别应用韦氏成人智力量表(WAIS)和韦氏记忆量表(WMS),对30例男性酒依赖者和30例匹配的正常对照者进行智能和记忆功能的评定,比较两组之间的差异,并对酒依赖者认知功能损害的危险因素进行相关分析。结果慢性酒依赖者的智商(FIQ)为86. 03±9. 87,记忆商(MQ)为61. 07±10. 13,均显著低于正常对照组(P<0. 05),智能和记忆量表的各因子分也表现出较为普遍的差异。相关分析表明,慢性酒依赖者的智商和记忆商数与饮酒时间呈显著负相关(r>0. 4,P<0. 01),与教育程度及习惯性饮酒开始年龄呈正相关(r>0. 2, P<0. 05 )。结论慢性酒依赖者存在显著的认知功能障碍。     

87例行为问题儿童认知功能的对照研究

目的 探讨行为问题儿童的认知功能特征,为行为问题儿童的心理干预提供科学依据.方法 87例符合Rutter儿童行为量表教师问卷行为问题诊断标准的行为问题儿童作为研究组,按1∶1比例,抽取相等数量的同性别同年龄组正常儿童作为对照组.采用龚耀先等修订的中国韦氏儿童智力量表(C-WISC)、许淑莲等编制临床记忆量表(CMS)、数字划销测验(NCT)、第四例外测验(FET)进行认知功能测试.结果 行为问题儿童与正常儿童在算术[(10.40±3.02)分,(12.13±3.26)分]、言语智商[(121.55±12.54)分,(129.40±13.98)分]、拼图[(9.98±2.79)分,(11.70±2.78)分]、操作智商[(97.40±10.84)分,(103.93±14.22)分]、总智商[(112.28±11.14)分,(119.03±12.57)分]、言语理解因子智商[(110.48±11.23)分,(115.80±12.31)分]、记忆不分心因子智商[(101.25±11.66)分,(109.40±15.45)分]、数字划销测验的净分值[(67.05±33.85)分,(88.72±22.51)分]、失误率[(32.27±35.77)%,(15.41±10.35)%]等方面差异具有统计学意义(P＜0.05).行为问题儿童的Rutter量表分值与记忆不分心因子智商、数字划销测验的净分值呈显著负相关(r=-0.335,-0.367,P＜0.05),与失误率呈显著正相关(r=0.333,P＜0.05).结论 行为问题儿童可能存在部分认知功能方面的缺陷.     

精神分裂症和抑郁症患者认知功能的对照研究

目的 研究精神分裂症和抑郁症患者的认知功能.方法 采用韦氏成人智力量表、韦氏记忆量表和威斯康星卡片分类测验评估34例精神分裂症、35例抑郁症和37例正常对照的认知功能.结果 1.精神分裂症和抑郁症患者的智商、记忆和威斯康星卡片分类测验成绩均差于对照组.2.抑郁症患者与精神分裂症患者的完成分类数[(4.09±1.27)个,(1.53±1.00)个]、错误应答数[(39.17±17.89)个,(50.41±26.44)个]、持续错误百分数[(20.86±11.29)%,(26.56±13.05)%]、随机错误百分数[(14.40±7.81)%,(24.67±14.50)%]和概念化水平[53.56±17.32)%,(31.30±16.21)%])差异有显著性.3.抑郁症患者和Ⅱ型精神分裂症患者在完成分类数[(4.09±1.27)个,(1.50±0.16)个]、随机错误百分数[(14.40±7.81)%,(27.87±16.39)%]和概念化水平[(53.56±17.32)%,(23.89±14.88)%]方面差异有显著性.结论 精神分裂症和抑郁症患者认知功能损害广泛而全面,精神分裂症执行功能损害比抑郁症更严重,阴性症状可能与精神分裂症的执行功能损害有关.     

脑动脉狭窄患者认知功能障碍的研究

目的 探讨脑动脉狭窄与认知功能障碍之间的关系.方法 采用成人韦氏记忆测验(WMS)、成人韦氏智力量表(WAIS-RC)对72例脑动脉狭窄患者及18例健康者进行认知功能评估.结果 记忆商(MQ):椎-基底动脉狭窄组[(73.29±26.77)分]较颈内动脉狭窄组[(86.38±21.96)分]减退明显(P＜0.05),智商(IQ):颈内动脉狭窄组[(72.25±23.46)分]较椎-基底动脉狭窄组[(80.65±25.22)分]减退明显(P＜0.05).动脉狭窄各组的记忆功能和认知功能均较对照组差(P＜0.05),其中颈动脉狭窄组以领悟、算术、相似性、数字符号、填图、木块图等检测减退为主,椎-基底动脉狭窄组以背数、词汇、图形拼凑等检测减退为主(P＜0.01),而全脑动脉狭窄组的记忆认知功能减退是全面的.结论 脑动脉狭窄与认知功能密切相关,动脉狭窄类型不同,引起的认知功能障碍类型不同.     

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…     

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.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.