INTRAOPERATIVE BLEEDING IN ENDOSCOPIC SUBMUCOSAL DISSECTION IN THE STOMACH AND STRATEGY FOR PREVENTION AND TREATMENT

To control intraoperative bleeding is an important key to successful endoscopic submucosal dissection. The distribution of submucosal vessels encountered during the procedure differ in places in the stomach and are roughly categorized into three groups: those located in the antrum, those in the lesser curvature, and those on the anteroposterior corpus wall which consists of oblique muscle layers. Therefore, knowledge of a suitable setting of diathermy and adjusted depth of dissection in the submucosal layer for each site is imperative. The combination of utilizing the distal attachment forced or swift coagulation (trimming with coagulation mode) have enable the treatment with an insulation tipped knife safer.     

西酞普兰与氯丙咪嗪治疗颈椎间盘突出症术后抑郁焦虑症状的对照研究

目的比较西酞普兰与氯丙咪嗪治疗颈椎间盘突出症伴抑郁焦虑症状的疗效和不良反应。方法对200例颈椎间盘突出症伴抑郁焦虑症状患者分别以西酞普兰与氯丙咪嗪治疗,共治疗6周。采用汉密尔顿抑郁量表(HAMD)评定临床疗效,采用副反应量表(TESS)评定副反应。结果西酞普兰组有效率91%;氯丙咪嗪组有效率90%,2组疗效相当。但西酞普兰组起效时间平均(11.1±5.6)d,而氯丙咪嗪组平均(15.1±8.2)d,以西酞普兰组显著较快(P<0.01)。西酞普兰组不良反应发生率为13%,而氯丙咪嗪组发生率为50%,西酞普兰组不良反应发生率较低。结论西酞普兰治疗颈椎间盘突出症术后伴抑郁焦虑症状的疗效与氯丙咪嗪相当,副反应少,值得推广应用。     

肌电生物反馈疗法治疗不同类型神经症的报告

本文报告肌电生物反馈治疗60例不同类型神经症的疗效;其中神经衰弱14例,紧张性头痛19例、焦虑症14例、强迫症6例、癔症4例、恐怖症2例、疑病症1例。总有效率为86.7％。其中10例紧张性头痛和焦虑症患者配合心理治疗和语言暗示,其效果显著。     

乳腺癌伴发抑郁焦虑患者的中医证型分析

目的 调查乳腺癌患者伴发的抑郁焦虑与中医证型的关系.方法 对248例乳腺癌患者采用抑郁自评量表(SDS)及焦虑自评量表(SAS)评估,对其中符合抑郁焦虑诊断的157例患者进行中医辨证分型,研究不同年龄阶段、不同病程、不同疾病分期患者的中医证型特点.结果乳腺癌患者中伴有抑郁焦虑情绪占63.31%,其中抑郁患者以肝郁痰凝型最高(占46.94)%,焦虑患者以正虚毒炽型最高(占42.86%);不同年龄、不同病程、不同分期的患者伴发抑郁焦虑的证型构成比差异有统计学意义(P＜0.01).结论 乳腺癌患者存在较高的抑郁焦虑情绪,肝郁痰凝型和正虚毒炽型与抑郁焦虑发生关系密切.     

No difference in symptoms of irritable bowel syndrome between healthy subjects and patients with recurrent depression in remission

There is bidirectional comorbidity between anxiety/depression and irritable bowel syndrome (IBS). To investigate the prevalence of IBS symptoms, and factors associated with gastrointestinal symptoms in patients with recurrent depressive disorder. Patients (n = 95) with recurrent type of major depression according to DSM-IV criteria and sex- and age-matched controls (n = 190) were sent questionnaires investigating symptoms of IBS [Gastrointestinal Symptom Rating Scale (GSRS)-IBS] and symptoms of anxiety and depression [Hospital Anxiety and Depression Scale (HADS)]. Medical records were checked over a 10-year period for chronic somatic symptoms or diseases. Seventy-three patients with unipolar disorder (mean age 63.6 years SD 13.8; range 23-86 years) and 156 controls (mean age 59.2 years SD 11.6, range 21-85 years) responded. Patients with recurrent depression had higher GSRS-IBS scores and showed a strong correlation between symptoms of IBS and anxiety-depression (r(s) = 0.54; P < 0.001). IBS symptoms were also associated with multiple pain symptoms, higher health-seeking behaviour and selective-serotonin-reuptake inhibitor intake. However, patients with recurrent depression (n = 46) in remission (HADS-Depression score <8) did not have more symptoms of IBS than controls (GSRS-IBS median score 6.0 vs 6.5; P = 0.46). There is a strong association between symptoms of IBS and symptoms of anxiety and depression, whereas depressive patients in remission do not have more IBS symptoms than controls.     

腹膜透析患者应对压力的方式与焦虑抑郁情绪的关系

目的：探讨应对压力的方式与腹膜透析患者的焦虑抑郁情绪的关系。方法：采用自填式结构问卷，对81例腹膜透析患者进行调查，了解患者的一般情况和患者应对措施，同时用综合性医院焦虑和抑郁情绪量表测量他们的焦虑与抑郁情绪。结果：控制年龄等因素后的等级回归分析表明：使用“面对”和“自我缓解”应对方式显著降低患者的焦虑情绪，采用“屈从”应对方式增加焦虑的发生；文化程度高的患者采用逃避应对方式则大大增加焦虑情绪的程度，女性和经济收入高者采用面对应对方式可以大大降低焦虑情绪的发生；“自我缓解”应对方式显著降低患者抑郁情绪发生的可能性。结论：不同的应对方式对腹膜透析患者的焦虑抑郁情绪存在差异。     

焦虑症患者的生命质量与焦虑症状的相关性研究

目的 探讨焦虑症患者的生命质量以及与焦虑症状的关系.方法 采用生命质量量表(LQS)及Hamilton焦虑量表(HAMA)对60例焦虑症患者进行了问卷调查,并与60例正常对照者比较.结果 焦虑症患者的生命质量总分及各因子评分均明显低于正常对照者(P＜0.01).焦虑症患者的生命质量总分及各因子评分与HAMA总分及因子分均呈显著性负相关(P＜0.01).结论 焦虑症患者的生命质量较差,且与焦虑症状有关,即焦虑症状越重,其生命质量越差.     

Similarities in Skeletal Muscle Strength and Exercise Capacity Between Renal Transplant and Hemodialysis Patients

Exercise intolerance is common in hemodialysis (HD) and renal transplant (RTx) patients. Aim of the study was to assess to what extent exercise capacity and skeletal muscle strength of RTx patients differ from HD patients and healthy controls and to elucidate potential determinants of exercise capacity in RTx patients. Exercise capacity, muscle strength, lean body mass (LBM) and physical activity level (PAL) were measured by cycle-ergometry, isokinetic dynamometry, DEXA and Baecke Questionnaire, respectively, in 35 RTx, 16 HD and 21 controls. VO2peak and muscle strength of the RTx patients were significantly lower compared to controls (p<0.01), but not different compared to HD patients. In RTx patients, strength (p<0.001), PAL (p=0.001) and age (p=0.045) were significant predictors of VO2peak. Muscle strength was related to LBM (p=0.001) and age (p=0.001), whereas gender (p<0.001) and renal function (p=0.01) turned out to be significant predictors of LBM. No effects of corticosteroids were observed. Exercise capacity and muscle strength seem equally reduced in RTx and HD patients compared to controls. In RTx patients, muscle strength and PAL are highly related to exercise capacity. Renal function appears to be a significant predictor of LBM, and through the LBM, of muscle strength and exercise capacity.     

联合抗焦虑治疗持续性胸背痛伴焦虑症状患者的疗效观察

目的 探讨氟哌噻吨＋美利曲辛（商品名，黛力新）等药物联合治疗胸背痛伴焦虑症状患者的临床疗效。方法 将符合胸背痛伴焦虑症状的56例患者，随机分为A、B两组，每组28人．A组予以黛力新＋多虑平抗焦虑治疗，同时予以西乐葆止痛治疗；B组予以西乐葆单纯止痛治疗。观察治疗4周后患者胸背痛的疼痛程度的视觉类比评分（VAS）和汉密尔顿焦虑量表评分（HAMA）的变化。结果 A组患者治疗后VAS评分由（8．56±1．43）分下降到（3．42±1．71）分，HAMA焦虑量表评分由（29．48±8．75）分下降到（12．73±7．29）分；B组患者治疗后VAS评分由（8．61±1．24）分下降到（6．57±2．16）分，HAMA焦虑量表评分由（29．33±8．91）分下降到（20．36±5．77）分。2组治疗后VAS评分、HAMA焦虑量表评分的差值比较有显著性意义俨〈0．05）。结论 黛力新＋多虑平等联合治疗能显著改善患者的胸背痛伴焦虑症状，而单纯西乐葆止痛治疗效果不佳。     

耐磷酸盐土霉素菌株选育和发酵的研究

以土霉素生产菌株138^#为出发菌株，经饥饿培养、5-FU、UV、咖啡因复合诱变处理，再用含高磷酸盐的培养基定向筛选，得到高产突变菌株100^#。该突变株遗传特性稳定，代谢特性优于出发菌株，经57m^3发酵罐生产验证，生产稳定，低效价罐批减少59．5％，在磷酸盐浓度提高到0.04％～0.05％时，统计一年的正常罐批平均发酵效价比对照菌株提高5．76％。