强迫症含强迫思想和强迫行为者二重辨证施治在开放式心理病房的研究

目的 :探讨二重辨证施治对强迫症含强迫思想和强迫行为者的疗效 ,及其在开放式心理病房的适应情况。 方法:将 5 2例强迫症含强迫思想和强迫行为者按随机的原则在开放式心理病房分为研究组 (2 7例 )和对照组 (2 5例 )。研究组用二重辨证施治 ,对照组用认知疗法结合氯丙咪嗪、氟西汀等。研究时间共 5个月 ,头 2个月为积极治疗期 ,后 3个月为自由治疗期。采用临床疗效评定标准 ,耶鲁布朗强迫症量表 (Y -BOCS) ,x2 检验 ,t检验。 结果 :研究组和对照组 ,积极治疗期末痊愈差异有统计学意义 (x2 =19.94,P <0 .0 0 5 ) ,自由治疗期末痊愈差异有更大的统计学意义 (x2 =2 6.64 ,P <0 .0 0 5 )。耶鲁布朗强迫症量表 (Y -BOCS)总分 ,两组治疗前差异无统计学意义 (t =0 .75 6,P >0 .2 ) ;积极治疗期末 ,两组差异有统计学意义 (t=10 .3 2 4,P <0 .0 0 1) :自由治疗期末 ,两组差异有更大的统计学意义 (t=12 .66,P <0 .0 0 1)。 结论 :二重辨证施治对强迫症含强迫思想和强迫行为者有普遍卓越的痊愈功效和痊愈巩固功效 ,应积极推广。开放式心理病房可作为强迫症含强迫思想和强迫行为者二重辨证施治的医疗平台     

臀上皮神经临床意义

目的:阐明臀上皮神经临床意义。方法:解剖20具尸体(40侧)腰臀区,对臀上皮神经及相关结构进行解剖、观察、分析。结果:40侧腰臀区共发现138支臀上皮神经。在神经出胸腰筋膜后层处的卵圆形空隙有27个,其剩余空间周围见有脂肪组织。结论:臀上皮神经穿出胸腰筋膜后层处的卵圆形空隙为引起脂肪组织疝出、卡压神经引发腰痛的薄弱点。     

Dopamine transporters, D2 receptors, and glucose metabolism in corticobasal degeneration.

Alterations in presynaptic and postsynaptic dopaminergic system and cerebral glucose metabolism in corticobasal degeneration (CBD) were assessed to evaluate the potential usefulness of different imaging methods for CBD. (123)I-FP-CIT/(123)I-beta-CIT SPECT and (123)I-IBZM SPECT as well as (18)F-FDG PET were performed in eight CBD patients. Decreased presynaptic dopamine transporter binding was found in all CBD patients while D2 receptor binding was reduced in only one patient. (18)F-FDG PET displayed a contralateral hypometabolism in cortical and subcortical areas in seven out of eight patients. Our results demonstrate that glucose metabolism and DAT are reduced, while D2 receptors may be frequently preserved in CBD.     

腹腔室隔综合征的早期手术处理

目的 总结腹腔室隔综合征（abdominal compartment syndrome，ACS）的诊断和早期手术治疗经验。方法 13例ASC患者原发病为：重症急性胰隙炎（severe acute panereatitis，SAP）6例，腹部剜合性损伤内出血3例，腹部率中、肠扭转、急性胃穿孔伴腹腔严重感染及结肠癌晚期肠梗阻各1例，均以膀胱压力（urinary bladder pressure，UBP）俭测和临床特征得以确诊。其中UBP轻度升高3例，中度升高6例，重度升高4例。13例行早期剖腹、腹腔减压术、胃肠腔内减压引流术和其他综合处理措施。结果 确诊后12h内手术者7例，1例结肠癌患者术后伤口全层裂开，腹腔感染、感染性休克而残废；12～24h内手术者3例，1例SAP患者伴发席汉氏综合征术后死于成人呼吸窘迫综合征；超过24h手术者3例，2例SAP患行死于多器官功能障碍UBP中、高度升高者各死亡2例。病死率为30．8％（4／13）、结论 ACS一旦确诊，尤其是中、重度患者应早期开腹，充分减压引流，才可望改善预后。     

支气管扩张症辨证模式初探

目的:探讨支气管扩张症的中医辨证分型规律及证候特点.方法:通过对563例支气管扩张症的临床流行病学调查,采集以症状、体征、舌、脉及相关理化检测为变量的基本信息,以频数分析、聚类分析、方差分析等方法,提炼支气管扩张症的证候分布规律及证候特点.结果:临床上支气管扩张症多见4种证候类型,分别为痰热壅肺证(45.65%)、肝火犯肺证(24.51%)、肺脾气虚证(22.38%)、气阴两虚证(7.46%).结论:较大样本的临床流行病学调查为研究支气管扩张症辨证分型规律提供了科学依据,并可以通过主症判别分析法建立证候识别模式,为临床实践提供依据.     

外伤性脾切除术后中医证候及免疫功能的研究

目的:研究外伤性脾切除术后中医辨证与免疫功能变化的关系.方法:选择15例脾切除和15例非脾切除患者作为观察对象,以其症状、舌苔、脉象及免疫功能的测定作为观察指标,观察其中医辨证与免疫功能变化.结果:脾切除组在术后早期可出现脾胃虚弱的证候群,同时免疫功能测定补体C3、免疫球蛋白IgG、免疫球蛋白IgM的水平明显降低,与非脾切除组有显著性差异.结论:脾切除容易造成患者术后出现的脾胃虚弱症候群,并降低患者的免疫功能.     

对急性冠状动脉综合征的新认识和治疗对策

近几年来，由于基础实验研究的迅速发展，对急性冠状动脉综合征(ACS)的认识和治疗取得了重大进展。作者就ACS分子生物学和细胞学基础、不稳定斑块的治疗对策、ACS的危险分层及治疗方法作一综述。     

AAEM minimonograph #43: Neuromuscular problems in the performing arts

Over the past 10–15 years, there has been increasing interest in the health problems of performing artists. In this review, I will discuss the major playing-related disorders seen in instrumental musicians. Among the 672 instrumentalists evaluated, the major diagnoses identified included musculoskeletal disorders in 64%, peripheral nerve problems in 22.5%. and focal dystonia in 7%. Sixty percent of instrumentalists were female although males predominate in the group with focal dystonia. The average age of those evaluated was 32 years. Among musculoskeletal disorders overuse syndrome is the most common. Frequent peripheral nerve disorders include thoracic outlet syndrome, carpal tunnel syndrome, and ulnar neuropathy. A characteristic distribution of symptoms and signs is identified for each instrument group. Electrodiagnostic studies are an important part of the evaluation of these disorders. With carefully designed treatment, the majority of instrumental musicians can be returned to full and pain-free playing activities. The success rate is highest in some entrapment neuropathies but remains low in focal dystonia. © 1994 John Wiley & Sons, Inc.