阿立哌唑与奥氮平治疗精神分裂症伴代谢综合征患者的效果比较

目的:比较阿立哌唑与奥氮平治疗精神分裂症伴代谢综合征患者的效果。方法:选取2015年6月至2021年1月该院收治的100例精神分裂症伴代谢综合征患者进行前瞻性研究,按随机数字表法分为观察组和对照组各50例。观察组采用阿立哌唑治疗,对照组采用奥氮平治疗,比较两组治疗前后血糖指标[空腹血糖(FBG)、空腹胰岛素(FINS)]水平、血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平、阳性和阴性症状量表(PANSS)评分、临床疗效及不良反应发生率。结果:治疗后,观察组FBG和FINS水平与治疗前比较,差异均无统计学意义(P>0.05);对照组FBG和FINS水平均高于治疗前,且观察组FBG和INS水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组TC、TG、LDL-C、HDL-C水平与治疗前比较,差异均无统计学意义(P>0.05);对照组TC、TG、LDL-C水平均高于治疗前,且观察组TC、TG、LDL-C水平均低于对照组,差异有统计学意义(P<0.05);但两组HDL-C水平比较,差异无统计学意义(P>0.05);治疗后,两组阳性症状、阴性症状、一般精神病理评分及PANSS总分均低于治疗前,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05);两组治疗总有效率比较,差异无统计学意义(P>0.05);观察组不良反应发生率为12.00%(6/50),低于对照组的30.00%(15/50),差异有统计学意义(P<0.05)。结论:阿立哌唑与奥氮平均可有效改善精神分裂症伴代谢综合征患者的临床症状,获得良好疗效,但阿立哌唑对糖脂代谢的影响较小,且药物不良反应发生率较低。     

精神分裂症住院期间实施整体护理干预对患者生活质量及体重的影响

目的:观察精神分裂症患者住院期间实施整体护理干预对其生活质量及体重的影响。方法:按随机数字表法将104例精神分裂症住院患者分为对照组和观察组,每组52例。对照组按精神科常规方法进行护理,观察组实施整体护理干预,比较两组患者的生活质量及体重变化情况。结果:经精神分裂症患者生活质量量表(SQLS)评估发现,两组患者干预前的SQLS评分比较差异无统计学意义(P>0.05),经干预后观察组的社会心理得分、动力和精力得分、症状和不良反应得分均明显低于对照组,比较差异均具有统计学意义(P<0.05)。两组患者护理干预前体重比较差异无统计学意义(P>0.05),经干预14周后对照组的体重明显重于观察组,比较差异具有统计学意义(P<0.05)。结论:在精神分裂症患者住院期间实施整体护理干预可改善其生活质量,有效缓解体重增加,值得推广。     

老年综合评估对老年代谢综合征患者营养状态的影响

目的:探讨老年综合评估对老年代谢综合征患者营养状态的影响.方法:以2015年2月~2016年2月本院收治的80例老年代谢综合征患者作为研究对象.随机分为对照组和干预组,每组40例.对照组给予常规治疗、营养宣教和指导,干预组在对照组基础上同时进行综合评估.比较治疗前后患者营养状态评分(MNA)得分、营养指标(前白蛋白、白蛋白、淋巴细胞数目和血红蛋白)和血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平的变化.结果:治疗前对照组和干预组MNA评分差异无统计学意义,治疗后1个月干预组MNA评分高于对照组,但差异无统计学意义;治疗后3个月,干预组MNA评分高于对照组,其差异具有统计学意义.对照组和干预组治疗后血浆前白蛋白、白蛋白、淋巴细胞数目和血红蛋白水平较治疗前均升高,其差异均具有统计学意义,治疗后1个月,干预组血浆前白蛋白、白蛋白、淋巴细胞数目和血红蛋白水平均高于对照组,其差异均具有统计学意义.治疗后3个月,对照组和干预组FBG、TC和TG水平均下降,HDL-C水平均升高,其差异均具有统计学意义;对照组和干预组治疗前后LDL-C水平差异无统计学意义;治疗后3个月,干预组TG水平低于对照组,其差异均具有统计学意义.结论:临床上对于老年代谢综合征患者实施老年综合评估,制定有效的干预计划,有助于改善患者的营养状态,更好地控制老年代谢综合征患者的血脂水平.     

系统性跟踪式护理方法对动脉粥样硬化患者血脂变化的影响分析

目的:探讨系统性跟踪式护理方法对动脉粥样硬化(AS)患者血脂变化的影响。方法:将80例AS患者按照奇偶数字法随机地分为对照组与观察组,每组40例。对照组采用常规护理干预,观察组在此基础上采用系统性跟踪式护理干预。比较两组护理干预前后血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)及高密度脂蛋白(HDL-C)水平变化情况。结果:两组护理干预前后TC、TG、LDL-C及HDL-C水平差异有统计学意义(P<0.05),且两组护理干预后上述指标差异有统计学意义(P<0.05)。结论:系统性跟踪式护理方法对AS患者的血脂水平趋于稳定具有积极的意义,应在临床护理中加以推广及普及。     

药物结合心理行为的综合干预对精神分裂症伴代谢综合征患者代谢指标影响的研究

目的:探讨药物结合心理行为治疗精神分裂症伴代谢综合征的临床效果。方法:将本院100例精神分裂症伴代谢综合征患者随机分为干预组和对照组,每组各50例,对照组给予常规药物治疗和护理,干预组在此基础上实施心理行为综合干预。观察患者的临床疗效,比较代谢综合征各指标的变化情况。结果:两组患者入组时PANSS总评分、代谢综合征各项指标水平比较,差异均无统计学意义(P0.05)。出院6个月后两组PANSS评分指标,空腹血糖、餐后2 h血糖、甘油三酯、总胆固醇均下降,干预组低于对照组,差异均有统计学意义(P0.05)。结论:药物结合心理行为综合干预治疗精神分裂症伴代谢综合征患者,可提高治疗效果,改善患者代谢紊乱的情况。     

心理护理对于精神分裂症患者临床康复的价值分析

目的 探讨心理护理对于精神分裂症患者临床康复的价值.方法 选取82例精神分裂症患者作为研究对象.按照入院顺序随机均分为试验组和对照组,对照组患者进行常规精神科护理.试验组患者在对照组护理的基础上,进行心理护理.观察患者护理干预前后BPRS评分、SANS评分;观察患者护理干预前后IRPOS评分、NOSIE评分;观察患者住院时间和1年复发情况.结果 2组患者护理干预前,BPRS评分、SANS评分差异无统计学意义;试验组患者护理干预后BPRS评分、SANS评分均低于对照组,差异有统计学意义(P<0.05),2组患者护理干预前,IRPOS评分、NOSIE评分差异无统计学意义;试验组患者护理干预后IRPOS评分、NOSIE评分均低于对照组,差异有统计学意义(P<0.05),试验组患者住院时间为(92.33±8.37)d,对照组患者住院时间为(137.88±9.24)d,试验组低于对照组,差异有统计学意义(P<0.05).试验组患者1年复发率为9.76%(4/41),对照组患者1年复发率为48.78%(20/41),试验组高于对照组,差异有统计学意义(P<0.05).结论 心理护理对于精神分裂症患者临床康复有积极作用,可以改善患者BPRS评分、SANS评分、IRPOS评分、NOSIE评分,缩短患者住院时间,降低1年复发率.     

代谢综合征高危人群心血管危险因素综合干预效果

目的评价综合干预对代谢综合征(MS)高危人群心血管危险因素的影响。方法对经常住院的100例MS高危人群(干预组)进行综合干预,随访2年。另选一般临床资料与干预组相匹配的60例由于工作繁忙无时间进行系统干预的MS高危人群作为对照组。观察两组患者干预前后的腰围、体质指数(BMI)、收缩压(SBP)和舒张压(DBP)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)和C-反应蛋白(CRP)的变化。结果干预前两组患者腰围、BMI、SBP、DBP、HDL-C、LDL-C、TG、FBG、FINS、HOMA-IR、CRP水平间差别无统计学意义(P>0.05)。干预后两组患者除LDL-C和TG外,其他各项检测指标间差别均有统计学意义(P<0.05)。结论综合干预可改善MS高危人群的肥胖,降低血压和血糖,增加HDL-C水平,降低胰岛素抵抗和CRP水平。     

中青年代谢综合征护理综合干预的临床价值

目的探讨中青年代谢综合征护理综合干预的临床价值。方法选取该院于2010年3月—2012年3月间收治的中青年代谢综合症患者200例,将其随机平均分为观察组和对照组,观察组的100例患者进行综合护理干预,对照组的100例患者进行常规的护理干预。比较两组患者在干预前后的空腹血糖、腰围、BMI、DBP、SBP、HDL-C、TG等指标的改善情况。结果观察组患者空腹血糖、腰围、BMI、DBP、SBP、HDL-C、TG等各项指标的改善情况明显优于对照组,其差异有统计学意义(P<0.05)。结论综合护理干预可以提高患者的依从性,对于代谢异常的患者具有显著的改善作用。     

中等强度运动护理对2型糖尿病患者的影响

目的:观察中等强度运动护理对2型糖尿病患者的影响。方法:选取70例2型糖尿病患者作为研究对象,按照随机数字表法分为对照组和观察组各35例。对照组给予常规护理,观察组在对照组的基础上给予中等强度运动护理。比较两组护理前后BMI、空腹血糖(FBG)、餐后2 h血糖(PBG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平和护理依从性。结果:护理后观察组BMI、FBG、PBG、HbAlc、TC、TG、HDL-C和LDL-C等指标水平均明显优于对照组,差异有统计学意义(P<0.05);观察组护理依从率为88.57%(32/35),明显高于对照组的60.0%(21/35),差异有统计学意义(P<0.05)。结论:在常规护理基础上,采用中等强度运动护理能够显著降低2型糖尿病患者的血糖和血脂水平,以及提高患者护理依从性,效果优于单纯常规护理。     

针对性护理对精神分裂症合并高血压患者的护理效果观察

目的:观察针对性护理对精神分裂症合并高血压患者的护理效果。方法:选取100例精神分裂症合并高血压患者作为研究对象,采用随机数字表法分为对照组与观察组各50例,对照组患者应用常规护理,观察组患者在对照组基础上应用针对性护理,比较两组患者的血压水平、心理状态、精神症状及睡眠质量。结果:护理后,观察组血压低于对照组,差异有统计学意义(P<0.05);护理后,观察组汉密尔顿焦虑(HAMA)量表、阴性和阳性症状(PANSS)量表评分下降幅度优于对照组,差异有统计学意义(P<0.05);护理后观察组匹兹堡睡眠质量指数(PSQI)低于对照组,差异有统计学意义(P<0.05)。结论:对精神分裂症合并高血压患者实施针对性护理干预措施,可有效改善患者的心理状态、血压水平、精神症状及睡眠质量,效果优于常规护理。     

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…     

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.     

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.