缺氧对肺动脉内皮细胞和平滑肌细胞分泌血管活性肽的影响

用放射免疫测定和免疫组化法缺氧对培养的小牛肺动脉内皮细胞（ＰＡＥＣ）和肺动脉平滑肌细胞（ＰＡＳＭ）自分泌心钠素（ＡＮＰ）、血管紧张素Ⅱ（ＡＴⅡ）和内源性洋地黄因子（ＥＤＬＦ）的影响。无氧培养２４ｈ末，ＰＡＥＣ分泌ＡＮＰ减少４３．５％（Ｐ〈０．００１），ＡＴⅡ和ＥＤＬＦ呈明显负相关（ｒ为－０．８８和－０．７８６，Ｐ〈０．０１），细胞内ＡＮＰ阳性颗粒也显著减少（Ｐ〈０．００１）；ＰＡＳＭ分泌ＡＮＰ无显     

肾移植后血中内皮素和一氧化氮检测的临床意义

探讨肾脏移植后测定内皮素－１（ＥＴ－１）和一氧化氮（ＮＯ）的临床意义。对４７例肾脏移植病人进行外周血中ＥＴ－１和ＮＯ动态检测,将检测结果以移植肾善和血压值分别分组进行比较。移植后与尿毒症组相比较,ＥＴ－１值明显下降（Ｐ〈０．０１）,ＮＯ值明显升高（Ｐ〈０．０１）,急性排斥发生时ＮＯ值升高（Ｐ〈０．０５）,慢性排斥时ＥＴ－１值较肾功能稳定时明显升高（Ｐ〈０．０１）。高血压组的ＥＴ－１值较高而ＮＯ水平     

22例高原脑水肿患者血流动力学的观察

本文对喀喇昆仑山发病的２２例高原脑水肿患者血流动力学进行了检测。结果：Ｐ、ＴＰＲ、ＡＬＴ、ＡＲ、ＳＩ、ＶＰＥ、ＥＷＫ、ＨＯＩ、ｍＡＰ、Ｋ、ＰＡＷＰ、ＣＣＰ明显 高原健康对照组，ＢＶ、ＥＶＲ、ＡＣ明显低于对照组，差异非常显著（Ｐ〈０．００１或Ｐ〈０．０１）；η、ＳＶ高于对照组，ＥＴＫ低于对照组，差异显著（Ｐ〈０．０５）。高原脑水肿的血流动力学为高排主阻性病理性改变。     

阿立哌唑与利培酮治疗首发精神分裂症的对照研究

目的：比较阿立哌唑与利培酮治疗精神分裂症的疗效和安全性。方法：分别以阿立哌唑或利培酮治疗首发精神分裂症各34例，采用阳性症状与阴性症状量表（PANSS）、不良反应量表（TESS）在治疗前和治疗后1、2、4、6、8周末分别评定疗效及不良反应。结果：阿立哌唑组有效率94．1％，显效率67．6％；利培酮组有效率97．1％，显效率61．8．％。治疗8周后与治疗前PANSS评分有显著差异。组问比较：第二周末，阿立哌唑阴性症状减分率大于利培酮组，差异有显著性，其它组间比较差异无显著性。总体不良反应发生率两组相似，但锥体外系不良反应（EPS）阿立哌唑组6例（17．6％），利培酮组14例（41．2%），两组比较有显著差异（P〈0．05），同时，利培酮组体重增加、内分泌异常和性欲改变发生率高于阿立哌唑组（P〈0．05）。结论：阿立哌唑和利培酮对精神分裂症均有较好疗效，不良反应发生率低，但在改善阴性症状方面阿立哌唑快于利培酮；在EPS和体重增加方面，阿立哌唑也优于利培酮。     

川芎嗪对烫伤豚鼠血管内皮细胞保护作用的实验研究

目的：探讨川芎嗪对烧伤早期血管内皮细胞的保护作用。方法：用豚鼠３０％ＴＢＳＡⅢ度烫伤为模型,分为复苏组（ｎ＝４８）、治疗组（ｎ＝４８）和伤前对照（ｎ＝８）。复苏组在烧伤后立即给予平衡液复苏,治疗组在复苏同时给予川芎嗪。分别在伤前、伤后２、４、８、１２、２４和４８小时,测定血浆内皮素（ＥＴ）、一氧化氮（ＮＯ）;在伤后４和８小时取回结肠动脉中段作透射电镜观察。结果：治疗组各时相点ＥＴ水平较复苏组低（Ｐ〈０．０５,Ｐ〈０．０１）,ＮＯ水平无显著性差异,两组ＥＴ／ＮＯ比值比较,有显著性差异（Ｐ〈０．０５）。病理显示,治疗因管内皮细胞损害明显轻于复苏组。结论：川芎嗪对烧伤早期血管内皮细胞有保护作用。     

活动平板运动试验多项指标分析在冠心病诊断中的意义

目的：通过对活动平板运动试验（ＴＥＴ）多项指标进行分析，旨在评价ＴＥＴ在冠心病诊断中的价值。方法：对２４５例患者按Ｂｒｕｃｅ方案进行了ＴＥＴ检查，把阳性患者分为疼痛组（Ａ组）和无症状组（Ｂ组），两者进行比较，并与试验阴性组（Ｃ组）比较。结果：运动时间，最大心率Ａ组＜Ｂ组＜Ｃ组（Ｐ＜０．０５～０．０１）。运动血压Ｃ组＞Ａ组（Ｐ＜０．０１）。Ａ组与Ｂ组、Ｂ组与Ｃ组比较无差异（Ｐ＞０．０５）。ＳＴ段下移级别Ｂ组＞Ａ组（Ｐ＜０．０１），下移深度Ａ组＞Ｂ组（Ｐ＜０．０１）。结论：ＴＥＴ多项指标判断冠心病的准确性明显提高。     

高原肺水肿治疗前后血浆一氧化氮和心钠素含量的变化

目的：研究高原肺水肿的发生与血浆一氧化氮（ Ｎ Ｏ） 、一氧化氮合成酶（ Ｎ Ｏ Ｓ） 和心钠素（ Ａ Ｎ Ｐ） 的关系。方法：在海拔３ ７００ｍ 对１１ 例高原肺水肿患者在治疗前和治愈后分别检测其血浆 Ｎ Ｏ、 Ｎ Ｏ Ｓ和 Ａ Ｎ Ｐ含量，并与初入海拔３ ７００ ｍ 的１０ 名健康青年作对照。结果：高原肺水肿组 Ｎ Ｏ 治愈后较治疗前增高非常显著（ Ｐ＜ ０ ．０１） ， Ａ Ｎ Ｐ 降低非常显著（ Ｐ＜ ０ ．０１） ， Ｎ Ｏ Ｓ 无显著性差异（ Ｐ＞ ０ ．０５） ；治愈后 Ｎ Ｏ 和 Ａ Ｎ Ｐ显著低于健康青年组（ Ｐ＜ ０ ．０５） ，治疗前较健康青年 Ｎ Ｏ、 Ｎ Ｏ Ｓ降低非常显著（ Ｐ＜ ０ ．０１） ， Ａ Ｎ Ｐ 增高显著（ Ｐ＜ ０ ．０５） 。治疗前血浆 Ｎ Ｏ 含量与 Ｎ Ｏ Ｓ 活性呈高度正相关（ｒ＝ ０ ．８６４６ ， Ｐ＜ ０ ．０１） 。结论：血浆 Ｎ Ｏ、 Ｎ Ｏ Ｓ和 Ａ Ｎ Ｐ均参与了高原肺水肿的病理生理过程，血浆 Ａ Ｎ Ｐ含量升高可能是机体的一种保护性代偿机制。     

高原老年人右心室舒张功能的脉冲多普勒超声研究

海拔２２６０ｍ老年１３例（Ａ组），海拔３５００～４２００ｍ老年１２例（Ｂ组），年龄６０～７４岁。ＥＣＧ、ＵＣＧ、心三位片和肺功能无右室肥大和器质性心脏病及慢阻肺。脉冲多普勤测定三尖瓣口Ｅ＿ｖ、Ａ＿ｖ、Ｅ＿Ｉ、Ａ＿Ｉ、Ａ＿ｖ／Ｅ＿Ｉ、ＥＤＴ、ＡＴ。结果发现Ｂ组的Ａ＿ｖ／Ｅ＿ｖ增大（Ｐ＜０．００１）；ＥＤＴ及ＡＴ缩短（分别Ｐ＜０．００１）；ＡＴ与ＥＤＴ呈高度正相关（ｒ＝０．９３５、Ｐ＜０．０１）；ＡＴ与Ａ＿ｖ／Ｅ＿ｖ呈高度负相关（ｒ＝－０．９１６、Ｐ＜０．０１）；且ＥＤＴ与Ａ＿ｖ／Ｅ＿ｖ亦呈高度负相关（ｒ＝－０．９０７、Ｐ＜０．０１）；表明尚无高原心脏病的海拔３５００ｍ以上高原老年人，右室舒张功能减低，右室后负荷已有一定程度增加，两者间呈高度正相关关系。     

加强营养支持对改善高原地区肺心病营养不良患者呼吸和免疫功能的作用

目的：为探讨加强营养支持对高原地区肺心病缓解期营养不良患者呼吸和免疫功能的作用；方法：对３０例高原（海拔２２６０～３２００ｍ）慢性肺心病缓解期营养不良（ＮＤ）患者在加强营养支持前后作了肺功能、吸气肌功能、动脉血气、血清免疫球蛋白和补体测定，并与本地肺心病营养正常（ＮＮ）患者对比；结果：ＮＤ组三头肌皮肤皱褶厚度（ＴＳＦ）、上臂中部周径（ＭＡＭＣ）、口腔最大吸气压（ＰＩｍａｘ）、最大跨膈压（Ｐｄｉｍａｘ）、ＰａＯ２、ＩｇＡ、Ｃ３、Ｃ４均明显低于ＮＮ组（Ｐ均＜０．０１），膈肌张力—时间指数（ＴＴｄｉ）和ＰａＣＯ２明显高于ＮＮ组（Ｐ均＜０．０１），两组ＦＥＶ１．０、ＩｇＧ、ＩｇＭ无差异性。ＮＤ组加强营养支持６周后，体重明显增加，ＴＳＦ、ＭＡＭＣ、ＰＩｍａｘ、Ｐｄｉｍａｘ、ＰａＯ２、ＩｇＡ、Ｃ３、Ｃ４明显提高（Ｐ＜０．０１或＜０．０５），ＴＴｄｉ，ＰａＣＯ２明显下降（Ｐ＜０．０１）；结论：加强营养支持治疗能明显改善高原地区肺心病营养不良患者的呼吸功能和增强其免疫功能。     

肾上腺髓质素与肾上腺紧张素在维持性血透中的变化

本文应用放免法测定了３２例维持性血透患者透析前后血浆肾上腺髓质素（ＡＤＭ１３－３２）及前体肾上腺素紧张素（ＡＤＭ１５３－１８５）水平，发现ＡＤＭ较正常人明显增高，Ｐ〈０．００１，而ＡＤＭ１５３－１８５明显下降，Ｐ〈０．０１，前者与ＡＭＰ，血浆ＢＵＮ，ＥＴ有明显相关性，ｒ值分别为０．４９２，０．７４３，０．４９２，而后者与ＭＡＰ，ＢＵＮ，ＥＴ无关，血液透析后，ＡＤＭ１３－５２与ＡＤＭ１５３－１８５这     

阿立哌唑与利培酮疗效及安全性评价

目的 探讨阿立哌唑与利培酮治疗精神分裂症的疗效及安全性。方法 将84例精神分裂症患者随机分为两组,分别给予阿立哌唑与利培酮,治疗8周。采用阳性、阴性症状量表（PANSS）评定疗效,用不良反应量表（TESS）评定不良反应。结果 阿立哌唑组和利培酮组显效率分别为78.6%和76.2%,利培酮组体重增加、内分泌紊乱副作用高于阿立哌唑组。结论 阿立哌唑与利培酮治疗精神分裂症的疗效相仿,锥体外系反应比利培酮少,是一种有效、相对安全的抗精神病药物,尤其适合女性患者。     

In vivo effects of olanzapine on striatal dopamine D(2)/D(3) receptor binding in schizophrenic patients: an iodine-123 iodobenzamide single-photon emission tomography study.

Olanzapine is a new atypical antipsychotic agent that belongs to the same chemical class as clozapine. The pharmacological efficacy of olanzapine (in contrast to that of risperidone) has been shown to be comparable to that of clozapine, but olanzapine has the advantage of producing a less pronounced bone marrow depressing effect than clozapine. The specific aims of this study were (a) to assess dopamine D(2)/D(3) receptor availability in patients treated with olanzapine by means of iodine-123 iodobenzamide [(123)I]IBZM single-photon emission tomography (SPET), (b) to compare the results with findings of [(123)I]IBZM SPET in patients under treatment with risperidone and (c) to correlate the results with the occurrence of extrapyramidal side-effects (EPMS). Brain SPET scans were performed in 20 schizophrenic patients (DSM III R) at 2 h after i.v. administration of 185 MBq [(123)I]IBZM. Images were acquired using a triple-head gamma camera (Picker Prism 3000 XP). For semiquantitative evaluation of D(2)/D(3) receptor binding, transverse slices corrected for attenuation were used to calculate specific uptake values [STR-BKG]/BKG (STR=striatum; BKG=background). The mean daily dose of olanzapine ranged from 0.05 to 0.6 mg/kg body weight. The dopamine D(2)/D(3) receptor binding was reduced in all patients treated with olanzapine. Specific IBZM binding [STR-BKG]/BKG ranged from 0.13 to 0.61 (normal controls >0.95). The decreased D(2)/D(3) receptor availability revealed an exponential dose-response relationship (r=-0.85, P<0.001). The slope of the curve was similar to that of risperidone and considerably higher than that of clozapine as compared with the results of a previously published study. EPMS were observed in only one patient, presenting with the lowest D(2)/D(3) availability. The frequency of EPMS induced by olanzapine (5%) was considerably lower than the frequency under risperidone treatment (40%). Our findings suggest an exponential relationship between the daily dose of olanzapine striatal and decreased D(2)/D(3) striatal binding availability. The results are consistent with the findings of in vitro experiments reporting a higher D(2)/D(3) receptor affinity and a similar 5HT(2) receptor affinity of olanzapine as compared with clozapine. Thus, the decreased tendency to induce EPMS at therapeutic doses is not due to the limited occupancy of striatal D(2)/D(3) receptors in vivo. Patients are protected from EPMS by other intrinsic effects of the drug, i.e. the combination of both D(2)/D(3) and 5HT(2) receptor antagonism.     

论利培酮联用舍曲林用于治疗阴性症状为主的精神分裂症的疗效分析

目的：研究利培酮联用舍曲林治疗以阴性症状为主的精神分裂症的临床效果。方法选取2009年～2012年收治的70例阴性症状为主的精神分裂症患者为研究对象,35例观察组采用利培酮联用舍曲林的药物治疗法,35例对照组采用利培酮单纯药物治疗法,观察两组患者临床反应。结果两组患者症状均有缓解,观察组治疗效果明显优于对照组。结论利培酮联用舍曲林对治疗以阴性症状为主的精神分裂症有很好的效果,值得临床大力推广。     

路优泰合并抗精神病药物治疗分裂症阴性症状

目的:研究在服用原抗精神病药物基础上合并路优泰对分裂症阴性症状的治疗效果。方法:以阴性症状为主型的分裂症患者60例,随机分为两组,实验组在服用原抗精神病药物基础上合并路优泰,以阴性症状评定量表(SANS)减分情况评定疗效,以副反应量表(TESS)得分情况评价治疗中出现的副反应。结果:结果:两组病人治疗第2周末始逐渐呈现差异SANS(P<0.05)直至研究结束。两组TESS(P>0.05)。结论:路优泰合并抗精神病药物治疗分裂症阴性症状相对单独抗精神病药物效果为佳,且未出现更多副反应。     

Clozapine treatment of schizophrenia: implications for forensic psychiatry

Clozapine, a new antipsychotic medication, is now the first-line treatment for neuroleptic refractory schizophrenia. Preliminary observations on its efficacy in treating schizophrenic patients with co-morbid substance abuse and, particularly, schizophrenic patients with persistent aggressive behaviour suggests that clozapine may provide a useful treatment option in forensic patient populations. Potential applications of clozapine and management considerations that are relevant to the forensic setting are discussed.     

奥氮平和利培酮治疗精神分裂症的疗效和安全性比较

 目的 比较奥氮平和利培酮治疗精神分裂症的疗效及安全性。方法 128例精神分裂症患者随机分为奥氮平组(64例)和利培酮组(64例),治疗时间为8周。应用阳性和阴性症状量表( PANSS) 和不良反应量表( TESS) 评定两种药物的临床疗效和不良反应。结果 奥氮平组在治疗2周末、4周末、8周末PANSS总分均小于利培酮组,差异有统计学意义(t=-2.223,-2.927,-2.339;P＜0.05)。在8周的治疗过程中,两组患者PANSS得分均随着时间的延长而呈下降趋势(P＜0.05)。奥氮平组有效率为95.31%,利培酮组有效率为89.06%,两组临床疗效差异无统计学意义(χ²=1.736;P＞0.05)。奥氮平组肝功能异常和体质量增加高于利培酮组,差异有统计学意义(χ²=4.571,4.827;P＜0.05)。利培酮组肌强直、震颤、静坐不能高于奥氮平组,差异有统计学意义(χ²=5.885;P＜0.05)。结论 奥氮平和利培酮对精神分裂症均具有较好的疗效,奥氮平较利培酮起效快;两药均较安全,但奥氮平可导致肝功能异常和体质量增加。     

低强度He-Ne激光血管内照射治疗难治性精神分裂症的疗效分析

目的探讨低强度He-Ne激光血管内照射(ILLLI)对难治性精神分裂症的疗效。方法对60例符合入组条件的难治性精神分裂症病人随机分为研究组(ILLLI+氯氮平)和对照组(氯氮平),用BPRS及PANSS量表于治疗前及治疗后第2、4和8周各评定1次,对治疗后第4和8周的疗效进行评定,并使用TESS量表评定治疗4周后的副作用。结果BPRS量表中的焦虑、抑郁因子分及PANSS量表中的阴性症状评分在治疗后第4周,研究组与对照组比较,差异有显著意义(均P<0.05),治疗后第4和8周的有效率和显效率及治疗后第4周TESS量表的各项因子分,两组比较差异均无显著意义(P>0.05)。研究组嗜睡的副作用轻,但诱发心慌明显重于对照组。结论ILLLI能改善难治性精神分裂症病人的焦虑、抑郁情绪及阴性症状,减轻因氯氮平引起的某些副作用,可作为辅助治疗手段。     

In vivo effects of olanzapine on striatal dopamine D2/D3 receptor binding in schizophrenic patients: an iodine-123 iodobenzamide single-photon emission tomography study

Olanzapine is a new atypical antipsychotic agent that belongs to the same chemical class as clozapine. The pharmacological efficacy of olanzapine (in contrast to that of risperidone) has been shown to be comparable to that of clozapine, but olanzapine has the advantage of producing a less pronounced bone marrow depressing effect than clozapine. The specific aims of this study were (a) to assess dopamine D₂/D₃ receptor availability in patients treated with olanzapine by means of iodine-123 iodobenzamide [¹²³I]IBZM single-photon emission tomography (SPET), (b) to compare the results with findings of [¹²³I]IBZM SPET in patients under treatment with risperidone and (c) to correlate the results with the occurrance of extrapyramidal side-effects (EPMS). Brain SPET scans were performed in 20 schizophrenic patients (DSM III R) at 2 h after i.v. administration of 185 MBq [¹²³I]IBZM. Images were acquired using a triple-head gamma camera (Picker Prism 3000 XP). For semiquantitative evaluation of D₂/D₃ receptor binding, transverse slices corrected for attenuation were used to calculate specific uptake values [STR–BKG]/BKG (STR=striatum; BKG=background). The mean daily dose of olanzapine ranged from 0.05 to 0.6 mg/kg body weight. The dopamine D₂/D₃ receptor binding was reduced in all patients treated with olanzapine. Specific IBZM binding [STR–BKG]/BKG ranged from 0.13 to 0.61 (normal controls >0.95). The decreased D₂/D₃ receptor availability revealed an exponential dose-response relationship (r=–0.85, P<0.001). The slope of the curve was similar to that of risperidone and considerably higher than that of clozapine as compared with the results of a previously published study. EPMS were observed in only one patient, presenting with the lowest D₂/D₃ availability. The frequency of EPMS induced by olanzapine (5%) was considerably lower than the frequency under risperidone treatment (40%). Our findings suggest an exponential relationship between the daily dose of olanzapine striatal and decreased D₂/D₃ striatal binding availability. The results are consistent with the findings of in vitro experiments reporting a higher D₂/D₃ receptor affinity and a similar 5HT₂ receptor affinity of olanzapine as compared with clozapine. Thus, the decreased tendency to induce EPMS at therapeutic doses is not due to the limited occupancy of striatal D₂/D₃ receptors in vivo. Patients are protected from EPMS by other intrinsic effects of the drug, i.e. the combination of both D₂/D₃ and 5HT₂ receptor antagonism. Received 6 March 1999 / in revised form 11 April 1999     

齐拉西酮治疗首发精神分裂症临床研究

目的评价盐酸齐拉西酮（力复君安）治疗首发精神分裂症的疗效及安全性。方法将52例首发精神分裂症患者随机分为齐拉西酮组（27例）和利培酮组（25例），进行为期6周的双盲对照研究。采用阳性和阴性症状量表（PANSS）、临床总体印象量表（CGI）、不良反应量表（TESS）及有关实验室检查评价疗效和安全性。结果治疗结束时，两组PANSS评分较入组时均显著减低（P〈0．01）；PANSS减分率：齐拉西酮组为（70．10±23．19）％，利培酮组为（71．46±30．55）％；临床总有效率：齐拉西酮组为85．19％．利培酮组为84．00％；两组疗效差异无统计学意义。不良反应的发生率齐拉西酮组为48．28％。利培酮组为57．14％，利培酮组发生例次比齐拉西酮组要多。两组间比较差异无统计学意义。结论国产齐拉西酮治疗首发精神分裂症的疗效和不良反应与利培酮相似。是一种有效、安全的抗精神病药物。