喹硫平与奥氮平治疗酒精所致精神障碍的临床应用价值

目的 探讨喹硫平治疗酒精所致精神障碍的临床应用价值,并与奥氮平比较阳性和阴性症状量表变化情况及治疗不良反应.方法 选择酒精所致精神障碍患者80例,随机分为观察组和对照组,各40例,针对酒精所致精神障碍患者焦虑紧张和失眠症状,用抗焦虑药,如果患者出现抽搐,可肌肉注射安定,在以上治疗基础上,观察组使用喹硫平治疗,第一周为剂量递增期,根据病人的临床反应和耐受性调整剂量,剂量调整的范围在每日150～750 mg之间,对照组则使用奥氮平治疗,起始剂量为每日10 mg,饭前或饭后服均可,剂量范围为每日5～20 mg.在治疗后2周通过阳性和阴性症状量表（PANSS量表）对患者的阳性、阴性症状进行评分并比较两组的不良反应.结果 治疗后观察组PANSS量表阳性、阴性症状评分均显著低于对照组（P＜0.01）,观察组发生锥体外系反应、嗜睡及体重增加的比例均少于对照组（P＜0.05或0.01）.结论 喹硫平治疗酒精所致精神障碍相对于奥氮平其安全性更高,临床效果更确切,值得临床推广.     

超声引导下经皮肝穿刺无水乙醇注射治疗肝囊肿18例临床研究

目的研究超声引导下经皮肝穿刺置管引流后无水乙醇注射治疗肝囊肿临床应用价值。方法 18例肝囊肿患者,分别在超声引导下经皮肝穿刺无水乙醇注射治疗,囊肿直径3～5cm,采取直接经穿刺针抽吸囊液而后注射无水乙醇治疗的方法,囊肿直径≥5cm,采取经皮肝穿刺置管引流,待囊液明显减少后,经引流管分次注射无水乙醇的方法,无水乙醇注射剂量为囊液引流量的1/5～1/4,术后分别于1个月、3个月、6个月经腹部CT检查判定疗效,囊腔消失为临床治愈,囊腔直径缩小〉50%为临床有效,囊腔直径缩小〈50%为无效。结果超声引导下经皮肝穿刺无水乙醇注射治疗肝囊肿手术成功率100%,单发肝囊肿临床疗效优于多发肝囊肿,经皮肝穿刺置管而后经引流管分次注射无水乙醇的方法优于经皮肝穿刺直接注射无水乙醇的方法。结论超声引导下经皮肝穿刺置管引流后无水乙醇注射治疗肝囊肿具有定位准确、操作简单、创伤小、疗效确切、费用低等优点,值得临床推广。     

饮食饮酒及肥胖对无症状高尿酸血症发生痛风的影响

目的 调查我院体检人群中痛风及无症状高尿酸血症的基本情况,分析饮食、饮酒、肥胖等因素对其的影响,从而筛选无症状高尿酸血症人群发生痛风的危险因素.方法 对2010年5-8月在我院体检的1 209例人员进行调查,其中34例确诊的痛风患者为痛风组,63例无症状高尿酸血症者为高尿酸组,血尿酸正常人群中抽取118例为对照组,探讨饮食、饮酒、肥胖等方面的危险性.结果 蔬菜、奶类、酒精摄人量和腰围在痛风组、高尿酸组和对照组间比较差异有统计学意义(P＜0.05);痛风组和高尿酸组在酒精摄入量、腰围比较差异有统计学意义(P＜0.05).对酒精摄入量、腰围进行回归分析腰围OR为0.090,P为0.022＜0.05;酒精摄人量OR为0.646,P为0.019＜0.05.结论 中心性肥胖、酒精摄入量是高尿酸血症人群发生痛风的危险因素.     

应用创造酶切位点PCR-RFLP检测乙醇脱氢酶2基因多态性

目的建立简便易行经济适用的乙醇脱氢酶2(ADH2)基因单核苷酸多态性检测方法。方法根据单碱基突变位点的碱基替代情况设计引物,其中一条引物根据突变位点邻近序列设计,人为引入错配碱基,使引物3′端和单碱基突变的一种突变型在PCR扩增后形成一个酶切位点,并应用相应内切酶进行酶切鉴定,通过PCR-RFLP技术判断ADH2基因SNP位点多态性。结果设计一对特异引物并PCR扩增含ADH2多态位点的DNA片段,使用限制性内切酶Bsh1236I酶切判断ADH2位点多态性,PCR和酶切效果均较好。结论应用创造酶切位点PCR-RFLP原理建立的ADH2多态位点检测方法具备简便、经济、快速的特点。     

不同大小聚乙烯醇颗粒在子宫腺肌症介入治疗中的临床疗效

目的评价不同大小聚乙烯醇(PVA)颗粒在子宫腺肌症介入治疗中的临床疗效。方法回顾性分析152例经子宫动脉栓塞术治疗的子宫腺肌症患者,根据PVA颗粒的大小随机分为A(350⁵00μm)、B(500500μm)、B(500⁷10μm)两组,每组病例76例,比较两组病例经子宫动脉栓塞术治疗后临床症状缓解程度及术后不良反应的差异。结果在痛经减轻、子宫体积变化方面两组比较,术后3个月差异有统计学意义(P<0.05),术后6个月两组比较无统计学差异(P>0.05),术后1年两组痛经减轻程度有统计学差异(P<0.05),而子宫体积方面两组比较无统计学差异(P>0.05),1年后两组病例完全缓解率均达到80%以上,无统计学差异,术后不良反应两组比较有统计学差异(P<0.05),A组不良反应更为显著,而两组在月经期及月经量改变、总有效率比较无统计学差异(P>0.05)。结论虽然两组临床效果半年后即达到相似,但A组术后不良反应疼痛更为严重,故从中长期效果及安全性来看,B组似乎更占优势。     

中药预知子乙醇提取物抗抑郁作用的实验研究

目的：N-究预知子乙醇提取物的抗抑郁作用,并初步探讨其作用机制。方法：采用小鼠悬尾实验、强迫游泳实验,抑制单胺重摄取作用实验等动物模型来考察预知子乙醇提取物抗抑郁作用及其作用机制。结果：预知子乙醇提取物能够显著缩短小鼠悬尾及强迫游泳不动时间;显著增加多巴胺（DA）致小鼠死亡作用和阿朴吗啡致小鼠刻板运动作用;增加5-羟色胺酸（5-HTP）致甩头作用,但对去甲肾上腺素（NE）重摄取抑制作用不明显。结论：预知子乙醇提取物有抗抑郁活性,与其增强5-HT、DA神经系统作用有关。     

超声引导下注射无水酒精治疗肾囊肿的疗效分析

目的探讨超声引导下肾穿刺注射无水酒精治疗肾囊肿的临床疗效。方法本组肾囊肿患者共118例,采取卧位,局麻,在彩色多普勒超声引导下经皮穿刺肾囊肿抽液后向肾囊肿内注射无水酒精,保留5分钟后抽出,观察其临床效果及并发症发生情况。结果118例共137个肾囊肿,经无水酒精治疗后复查发现总治愈率为84％,总显效率为98％,其中,9例患者在治疗后,出现不程度的头晕,恶心等,13例患者注入无水酒精后或拔出针后出现腰部胀痛或不同程序腹痛,休息后均可缓解,无出血、感染、剧痛等严重并发症。结论彩色多普勒超声导向能成功避开肾大血管,该方法具有疗效好、穿刺准确、方法简便、经济、安全等优点。     

静脉滴注硫酸奈替米星致过敏性喉水肿1例

某例患者,女,25岁,因发热、尿频、尿痛在我院门诊就诊,检查尿常规提示：WBC3＋,诊断为“尿路感染”。用0．9％氯化钠250mL加硫酸奈替米星0．2g（商品名：益天星,0．2g·支,批号：070622,江苏四环生物服务有限公司）。当患者输注约10min后,患者感咽喉堵塞感,刺激性咳嗽,声音嘶哑,出现全身无力,胸闷,头晕,立刻停止输液,平卧,     

Maternal exposure to tobacco smoke, alcohol and caffeine, and risk of anorectal atresia: National Birth Defects Prevention Study 1997–2003

Anorectal atresia is a congenital anomaly with mostly unknown risk factors. Studies have provided evidence of teratogenic effects of alcohol and tobacco, and animal studies have suggested that caffeine may potentiate their teratogenicity. However, it is unclear how these factors affect the risk of anorectal atresia. We analysed data from maternal telephone interviews in a multistate case-control study with 464 infants with anorectal atresia and 4940 infants with no major birth defects. We used unconditional logistic regression to determine the association of exposure to smoking, environmental tobacco smoke (ETS), alcohol or caffeine with anorectal atresia. Effect modification by caffeine intake was assessed on additive and multiplicative scales.
There was no association with alcohol intake in this analysis. However, there was some evidence of an association between anorectal atresia and maternal exposure to tobacco smoke and caffeine. Compared with non-smokers not exposed to ETS, the crude odds ratio (OR) and 95% confidence interval [CI] for cigarette smoking was 1.2 [95% CI 1.0, 1.5]. The association with anorectal atresia for non-smokers exposed to ETS at home and work was OR = 2.3 [95% CI 1.2, 4.1]. Compared with the lowest level of caffeine intake (<10 mg/day), the association for the highest caffeine intake (≥300 mg/day) was OR = 1.5 [95% CI 1.0, 2.2]. Results did not change after adjustment for covariates. This study found evidence of associations between anorectal atresia and caffeine intake, cigarette smoking and exposure to ETS. Because there are currently few additional data to support these results, further study is needed.     

AMPAR-mediated synaptic transmission in the CA1 hippocampal region of neonatal rats: unexpected resistance to repeated ethanol exposure

α-Amino-3-hydroxyl-5-methyl-4-isoxazole-propionate glutamatergic receptors (AMPAR) mediate most of the fast excitatory synaptic transmission in mature neurons. In contrast, a number of developing synapses do not express AMPARs; these are gradually acquired in an activity-driven manner during the first week of life in rats, which is equivalent to the third trimester of human pregnancy. Neuronal stimulation has been shown to drive high conductance Ca²⁺-permeable AMPARs into the synapse, strengthening glutamatergic synaptic transmission. Alterations in this process could induce premature stabilization or inappropriate elimination of newly formed synapses and contribute to the hippocampal abnormalities associated with fetal alcohol spectrum disorder. Previous studies from our laboratory performed with hippocampal slices from neonatal rats showed that acute ethanol exposure exerts potent stimulant effects on CA1 and CA3 neuronal networks. However, the impact of these in vitro actions of acute ethanol exposure is unknown. Here, we tested the hypothesis that repeated in vivo exposure to ethanol strengthens AMPAR-mediated neurotransmission in the CA1 region by means of an increase in synaptic expression of Ca²⁺-permeable AMPARs. We exposed rats to ethanol vapor (serum ethanol concentration ∼40 mM) or air for 4 h/day from postnatal day (P) 2-6. In brain slices prepared at P4-6, we found no significant effect of ethanol exposure on input-output curves for AMPAR-mediated field excitatory postsynaptic potentials (fEPSPs), the contribution of Ca²⁺-permeable AMPARs to these fEPSPs, or the acute effect of ethanol on fEPSP amplitude. These results suggest that homeostatic plasticity mechanisms act to maintain glutamatergic synaptic strength and ethanol sensitivity in response to repeated developmental ethanol exposure.