精神科专家门诊初诊病人1531例临床诊断统计分析

目的：了解北京大学精神卫生研究所专家门诊初诊病人的病种分析。方法：对2000年1月-6月专家门诊初诊病人进行统计分析，并将确诊病例按CCMD-2-R疾病学分类标准进行分类。结果：共调查病人1531例，发现各病种在门诊病人中的分布，以神经症最高，占总病例数的15.22%；重性精神病中情感性精神障碍占13.13%，高于精神分裂症及其他精神障碍。结论：门诊初诊病人的分布与精神疾病的患病率、医院特殊情况及疾病诊断标准的修订等诸多因素有关。     

部队多次住院精神障碍患者的住院特征分析

目的:了解部队多次(2次及2次以上)住院精神障碍患者的住院情况.方法:随机从2001-01/2005-12部队多次住院精神障碍患者中抽取1000名,以CCMD-3为诊断标准,进行回顾性病例分析.结果:部队多次住院精神障碍患者以士兵(60.2%)为主,男性(93.3%)占绝大多数,精神分裂症(80.5%)和情感性精神障碍(9.3%)是最常见的二种疾病诊断类型,癔症和神经症所占比例分别为2.9%和2.5%.在多次住院患者中,精神分裂症所占的比例(80.5%),高于它在全体住院患者中所占的比例(72.8%).多次住院患者的平均住院次数为3.8次,平均每次住院时间为(73.8±70.7) d.结论:精神分裂症、情感性精神障碍、癔症和神经症是部队精神障碍预防和诊治的主要病种.     

酒精中毒性精神障碍十二年住院病例临床报告

兹将我院自1981年至1992年的酒精中毒性精神障碍住院病例中以DSM—Ⅲ—R及中国精神疾病诊断标准(CCMD—Ⅱ)1989有关酒精中毒的诊断标准进行复核后资料比较完整,确诊为酒精中毒性精神障碍66例临床资料报告如下: 一般资料住院构成比变化,酒精中毒性精神障碍病种年住院构成比。1981年占同期住院病例数0.14％,到1992年上升为1.82％。住院全部病例均为男性,未见有女性病     

某县医院眼科1个月门诊病人分布情况

为了解西部山区县级医院眼科门诊病人疾病分布情况,加强防治的针对性,我们对泾源县医院(对口支援单位)有关病人情况进行了调查,旨在探讨其眼科疾病的分布和防治。现报告如下。1临床资料选择2004年8～9月在宁夏泾源县医院眼科门诊初诊病人共328例的病历资料,对其眼科疾病分布进行回顾性统计、分析。2结果2.1基本情况泾源县医院2004年8～9月眼科门诊初诊病人共328例,其中男性145例,女性183例;年龄最小1个月,最大80岁,平均(44.06±18.84)岁。2.2疾病分布按照解剖部位的不同,将病种进行分类统计,发现结膜疾病127例,占总数的38.72%,处于所有眼科…     

综合医院精神医学会诊138例临床分析

目的 对138例临床会诊进行分析，探讨综合医院会诊联络精神医学，有效提高非精神科医生对精神疾病的识别率。方法 收集会诊病例138例，采用回顾性分析将所有会诊病例以《中国精神障碍分类及诊断标准—3》(CCMD—3)诊断，并对各科室会诊分布及精神障碍诊断、治疗、转归采用SPSS做统计学分析。结果 神经症发病率最高，女性发病率高于男性，中青年与中等文化程度者占多数。结论 综合医院中非精神科医生对精神障碍认识不足，研究表明综合医院住院患者中各种心理问题占20％～70％，其中只有44％的病人得到精神科治疗。     

综合医院住院患者1500例精神科会诊结果与相关因素探究

目的研究探讨综合医院住院患者1 500例精神科联络会诊结果与相关因素。方法选取该院2012年5月‐2015年5月内向精神科要求会诊服务的1 500例患者,对患者的一般资料、精神障碍病种分类和内外科分布等情况进行统计分析。结果在参加本研究的所有患者中,年龄中位数52.5岁;女性患者占52.00%高于男性患者的48.00%;最常见的精神障碍是情绪障碍、神经症、器质性精神障碍和睡眠障碍等;除睡眠障碍和精神分裂症外,其他病种在内外科的分布情况比较差异均有统计学意义(P0.05);内科中最常见精神障碍是情绪障碍和神经症,外科中最为常见精神障碍是器质性精神障碍。结论综合医院各临床科室的精神科会诊服务需求较大,然而某些非精神科相关医师其对精神障碍的识别、处理等各方面能力均需要进一步得到提高。     

精神障碍住院患者的流行病学特征及相关危险因素分析

目的:探讨精神障碍住院患者病种构成及精神分裂症、心境障碍和癔症3种主要精神疾病的流行病学特征,并分析其相关危险因素.方法:采用自行设计的调查问卷,以中国精神障碍分类诊断标准第2版修订本为标准,对2008-2010年烟台地区住院精神障碍患者的2 453份病历进行统计分析.结果:住院患者女性多于男性,男女比为0.74∶1,...     

综合医院精神科联络会诊277例临床分析

目的了解综合医院精神科会诊的临床特点.方法广州医学院第二附属医院8个月的277例精神科会诊病例进行统计分析.结果内科会诊率最高(62.5%),诊断最多的精神障碍是器质性精神障碍(45.8%),随后是神经症(21.3%)和心境障碍(15.2%).结论综合医院精神科联络会诊具有患者的平均年龄较大、与脑功能密切相关的神经科病人最多、以器质性精神障碍为主要病种和新一代精神病药物的使用较多等四大临床特点.     

临床医生对社会医疗保险病种分类的分析

目的调查临床医生对社会医疗保险(简称医保)病人病种分类的准确性,为社会医疗保险的良好运作、维护医院和医保机构双方的合法权益提供参考依据。方法抽取某院2个月的医保住院病例,对临床医生分类的普通病种和特殊病种进行一一核查,记录分类错误的病例。结果在1151个医保病例当中,共有32个特殊病种的病例被错分为普通病种,错误率为3.4%,有7个普通病种的病例被错分为特殊病种,错误率为3.2%。结论临床医生应当熟练区分普通病种和特殊病种,加强国际疾病分类知识的学习,避免分错病种,并建议在上报病种分类前,增加病案管理人员的审核,以减少差错,维护医院和医保机构双方的合法权益。     

老年术后精神障碍的临床观察与分析

目的对1240例老年手术病人进行的术后精神状况进行了评价和分析.方法对1240例老年全麻手术病人进行术后连续7 d的床边认识评分.结果200例病人发生术后精神障碍,占总数的16.1%,精神障碍发生率为术后4天内较高,以后逐渐下降.根据病人临床症状不同,200例老年术后精神障碍病人分为三类临床亚型,焦虑型:占发病人数39.0%;安静型:占发病人数43.0%;混合型:占发病人数18.0%;死亡人数占发病人数的4.0%.结论老年术后精神障碍发病率较高,应当重视预防.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.