Preliminary Effects of Oral Uridine on the Ocular Surface in Dry Eye Patients

We designed a randomized, double blinded, 3-months controlled prospective clinical study to investigate effects of oral uridine on the ocular surface in dry eye patients. Twenty-seven patients who diagnosed as dry eye with lower than 5 mm of wetting in the Schirmer strip, with corneal epithelial erosion and who completely followed-up till 3 months were enrolled. Corneal-conjunctival fluorescein staining, non-anesthetic Schirmer test, impression cytology, and Ocular Surface Disease Index (OSDI) were evaluated in the experimental and placebo groups at the baseline, 1 and 3 months after start of medication in a double blinded manner. Fluorescein stain score of the cornea was markedly decreased in oral uridine group compared to the placebo group at 3 months after medication (P=0.032, Mann-Whitney U test). The Schirmer wetting score for the oral uridine group was significantly increased (P=0.001, Wilcoxon signed rank test) at 3 months and its difference between two groups was statistically significant (P=0.030, Mann-Whitney U test). OSDI scores were significantly decreased at 1 and 3 months in treatment group. Oral uridine is effective in treatment of dry eyes.     

The effectiveness of ziprasidone in treating impaired quality of life in schizophrenia: a 12-month, open-label, flexible-dose, naturalistic observational study of patients undergoing usual care

OBJECTIVE: Health related quality of life (HRQL) has become an important outcome measure in the treatment of psychiatric disorders. This long-term observational study examined ziprasidone-induced improvement in satisfaction with HRQL in schizophrenia patients treated under real-world conditions. METHOD: Seventy schizophrenia patients with persistent symptoms or troublesome side effects were assigned to a 12-month, open-label, flexible-dose (40-160 mg/d), large-scale, naturalistic trial. Outcome measures were taken at baseline, 6, and 12 months, and included the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), severity of symptoms, distress, and side effects. RESULTS: Thirty-two patients fully completed the study protocol. Patients reported poorer general HRQL compared with healthy subjects. At the end of the study, significant improvement in general activity, and satisfaction with life was observed. The effect sizes for these changes were moderate (0.55, and 0.72, respectively). After Bonferroni correction for multiple comparisons improvement in satisfaction with general activity remained significant. No significant changes were noted in other Q-LES-Q dimensions. Improvement in general activity was associated with a reduction in the severity of symptoms and emotional distress, but was unrelated to the ziprasidone daily dose, side effect scores, and concomitantly prescribed antidepressants, anxiolytics, mood stabilizers, or antiparkinson drugs. CONCLUSION: This study indicates that ziprasidone treatment resulted in the improvement of the satisfaction with general activity that tended to increase over time, from month 6 onwards. This effect was associated with reduction in the severity of clinical symptoms, and emotional distress.     

糖尿病患者中医不同证型规律探讨

目的对糖尿病中医证型规范化进行研究。方法采用现代流行病学和医学统计学方法,将出现频率高于95％的症状、体征纳入,确定常见的中证型;同时观察各证型体重指数、空腹血糖、血脂、空腹胰岛素、肿瘤坏死因子、白细胞介素-6等指标。结果不同证型的各项检测指标存在显著性差异。结论糖尿病证型诊断可以规范化,从而为制定客观、统一、规范化的证型诊断标准提供参考依据,提高临床辨证论治水平。     

胃复安引起锥体外系症状的临床分析——附26例报导

本文分析2813例应用胃复安止吐的病例,出现锥体外系症状者26例,中毒出现率0.92％,其中痉挛性斜颈12例(46％),帕金森震颤6例(23％),伸舌假性球麻痹和强直性张口或牙关紧闭各4例(15.4％),停药和及时应用安定,可很快中止上述症状。本文还对其中毒的和解毒的机制进行讨论。     

证候名称及分类研究的回顾与假设的提出

辨证论治是中医临床医学的精髓 ,然而证候相关名称与分类亟待规范。我国证候研究起始于5 0年代 ,80年代又展开了中医证候规范化的研究工作。但至今证候分类、证候的命名、证候的诊断均尚未统一。根本原因在于中医的证候诊断系统是一个非线性的复杂巨系统。通过对此前已经进行的证候研究的大量文献学调研 ,吸收“中风病证候诊断标准”课题组的工作经验 ,提出如下假设 :将证候进行降维升阶的分解处理 ,根据“外感六淫”、“内生五气”、“气相关”、“血相关”、“阴阳相关”、“其他”等 6类提取出适当的证候因素共 2 9个 ,并对这些证候因素的诊断进行规范 ,然后将这些规范了的证候因素交给使用者 ,由他们在临床使用时进行自由的交叉组合。希望能以此为证候研究提供一种新方法。     

络病辨证浅析

络脉是微小层次的结构与功能的统一体 ,在结构上具有浅、深、末、网的四大特点。络脉有气络与血络之分 ,是气血运行的载体。络病辨证在临床辨证论治中占有重要地位。常见的络脉病证为 :络气病证包括络脉气虚证和络脉气滞证 ;络血病证包括络脉血虚证、络脉血瘀证、络脉血热证和络脉血寒证 ;络脉虚证包括络脉气虚证、络脉血虚证、络脉阴虚证和络脉阳虚证 ;络脉毒滞证等     

大剂量阿托伐他汀对急性冠状动脉综合征的调脂及抗炎作用

目的探讨40 mg/d阿托伐他汀对急性冠状动脉综合征行经皮冠状动脉介入治疗术后患者的调脂及抗炎作用。方法将92例急性冠状动脉综合征行经皮冠状动脉介入治疗术后患者随机均分为两组,对照组给予阿托伐他汀10 mg/d,试验组给予阿托伐他汀40 mg/d,用药后4、12、24周检测两组患者血脂、血清中超敏C反应蛋白和基质金属蛋白酶9浓度,对比两组调脂及抗炎作用差异。结果①用药后12周,试验组患者血清总胆固醇较对照组显著降低(P<0.05);用药后24周,试验组患者血清总胆固醇和低密度脂蛋白胆固醇均较对照组显著降低(P<0.01)。②用药后12周,试验组患者血清基质金属蛋白酶9较对照组显著降低(P<0.01);用药后24周,试验组患者血清超敏C反应蛋白较对照组显著降低(P<0.05)。③降脂强度与病人的血清超敏C反应蛋白和基质金属蛋白酶9的浓度下降趋势呈线性正相关。④随访期内两组心脏事件发生率无统计学差异(P>0.05)。结论①服用阿托伐他汀40 mg/d安全可靠。②服用阿托伐他汀40 mg/d可显著提高急性冠状动脉综合征患者行经皮冠状动脉介入治疗术后血脂达标率。③服用阿托伐他汀40 mg/d对炎症因子血清基质金属蛋白酶9和血清超敏C反应蛋白具有更强抑制作用。     

谈《伤寒论》中的欲愈候

欲愈候是预示疾病将愈的一类证候。文章列举《伤寒论》中6种典型欲愈候,并结合后世医家评述,分别探讨其临床指征、作解机理、现代临床意义,这对于临床把握疾病的发展规律以及指导临床用药等,均具有一定的积极意义。     

糖尿病肾病中医证型与甲状腺功能关系探讨

目的：探讨糖尿病肾病的中医证型分布特征与甲状腺功能的关系。方法：将315例糖尿病肾病患者分为阴虚燥热、气阴两虚、脾肾气虚（阳）、阴阳两虚4种本证组和兼湿证、兼瘀证、兼痰瘀证3种标证组,以化学发光免疫分析法测定T3、T4、FT3、FT4、TSH,分析中医证型与甲状腺功能关系。结果：随着糖尿病肾病中医本证证型从阴虚燥热型向脾肾气虚（阳）型、气阴两虚型、阴阳两虚型的逐渐发展,甲状腺功能减退的患病率有逐渐增高的趋势,甲状腺功能亢进的患病率有逐渐降低的趋势。组与组间存在着差异有统计学意义（P〈0.05）。甲状腺功能亢进者其主证以阴虚燥热型为主,标证以无兼证为主;甲状腺功能减退者主证以阴阳两虚型为主,标证以痰瘀证为主。结论：甲状腺功能与糖尿病肾病中医证型相关,在一定程度上为中医辨证分型提供客观依据。     

急性冠状动脉综合征患者血清基质金属蛋白酶2水平的检测

目的检测急性冠状动脉综合征患者血清基质金属蛋白酶2的水平,探讨其与不稳定性斑块及临床危险度的内在联系。方法应用十二烷基硫酸钠—聚丙烯酰胺凝胶电泳及Western免疫印迹法分别检测急性冠状动脉综合症患者血清基质金属蛋白酶2的水平。其中不稳定型心绞痛组28例,分属低、中、高危3个亚组,急性心肌梗死组50例,正常对照组50例,稳定型心绞痛组51例。结果对照组、稳定型心绞痛组、不稳定型心绞痛组和急性心肌梗死组基质金属蛋白酶2水平分别为236±33 INT.mm2、224±23 INT.mm2、455±51 INT.mm2和503±45 INT.mm2。急性心肌梗死组和不稳定型心绞痛组分别与稳定型心绞痛组和对照组之间比较,基质金属蛋白酶2水平差异有显著性,对照组与稳定型心绞痛组之间基质金属蛋白酶2水平无统计学差异。4组之间血清基质金属蛋白酶原水平无明显差别。Western免疫印迹法也显示了类似的结果。不稳定型心绞痛低危、中危、高危3个亚组间比较,无论是酶原还是活性酶的水平均未发现显著差别。结论血清基质金属蛋白酶2水平在急性冠状动脉综合征患者中明显升高,提示血清基质金属蛋白酶2增高可作为急性冠状动脉综合症的一个危险信号,但基质金属蛋白酶2与急性冠状动脉综合症危险度并无相关性。