200例抗精神病药物使用临床观察

目的 探讨老年精神病患者药物使用的临床价值.方法 回顾性分析该院住院治疗2周以上的老年精神病患者200例的临床资料.结果 器质性精神障碍使用剂量最小,其次为酒精所致精神障碍、情感障碍,使用剂量最高为精神分裂症患者.共患躯体疾病者使用抗精神病药剂量较小.结论 对老年精神病患者遵循个体化、小剂量和单一用药进行治疗.     

老年精神障碍患者的临床特点及治疗体会

目的对老年精神障碍患者的临床特点和相关治疗体会进行分析研究。方法将本院在2017年8月至2018年5月收治的老年精神障碍患者共计140例作为研究对象,用限定日剂量(DDD)和药物利用指数(DUI)分析老年精神障碍患者精神药物应用情况。结果经过对全部患者的分析,排在前3位的疾病为阿尔茨海默病、谵妄状态、抑郁焦虑。15种常用抗精神类药物中,除了舒必利和石杉碱甲之外,其他的抗精神病药物的DUI值均≤1.0。结论临床上对于老年精神障碍患者应用精神药物情况比较合理,要积极控制舒必利和石杉碱甲的处方使用,使整体药物使用情况更加合理。     

抗精神病药物所致药源性精神障碍30例分析

目的：对抗精神药物所导致药源性精神障碍病例进行临床分析。方法：对我院抗精神病药物所致药源性精神障碍30例所使用的药物进行研究结合临床经验得出结论。结果：服药1－2个月后是大部分患者药源性精神障碍高发期,药物大部分含氟,持续服药后立即停药致病情况较多。结论：对抗精神病药物所致药源性精神障碍的发生时间、临床特点、用药品种得到初步结论。     

抗精神病药物所致药源性精神障碍30例分析

目的:对抗精神药物所导致药源性精神障碍病例进行临床分析。方法:对我院抗精神病药物所致药源性精神障碍30例所使用的药物进行研究结合临床经验得出结论。结果:服药1-2个月后是大部分患者药源性精神障碍高发期,药物大部分含氟,持续服药后立即停药致病情况较多。结论:对抗精神病药物所致药源性精神障碍的发生时间、临床特点、用药品种得到初步结论。     

非典型抗精神病药物治疗儿童青少年精神障碍的临床应用

目的：了解非典型抗精神病药物在儿童、青少年精神障碍中的应用。方法：对广州白云心理医院住院的使用非典型抗精神病药物的106例精神障碍患者进行分析。结果：非典型抗精神药物已广泛应用于儿童、青少年精神障碍。结论：非典型抗精神病药物对儿童、青少年精神障碍的疗效是肯定的，副反应小，安全性高。     

非典型抗精神病药物治疗儿童青少年精神障碍的临床应用

目的:了解非典型抗精神病药物在儿童、青少年精神障碍中的应用.方法:对广州白云心理医院住院的使用非典型抗精神病药物的106例精神障碍患者进行分析.结果:非典型抗精神药物已广泛应用于儿童、青少年精神障碍.结论:非典型抗精神病药物对儿童、青少年精神障碍的疗效是肯定的,副反应小,安全性高.     

256例住院流浪精神障碍患者抗精神病药物使用情况调查

目的：了解我市民政系统医院住院流浪精神障碍患者精神药物的使用情况。方法：采用一日法,以2012年12月20日为时间点,用自制调查表,对我院全部在院的256例流浪精神障碍患者进行调查。结果：住院流浪精神障碍患者精神药物的使用频度以氯氮平居首位（38.29%）,其次为氯丙嗪（27.03%）,舒必利（16.66%）。以单一用药为主,日均剂量偏低。结论：由于经费及受济困药品目录的影响,新型抗精神病药物使用有限。     

老年精神障碍临床特点与治疗分析

老年精神障碍患者的治疗不仅要针对精神障碍的特点,还要注意药物使用的安全性,对于高龄精神障碍患者的治疗更应如此,因为这些患者不仅存在精神障碍,绝大多数同时存在各种各样的躯体疾病,尤其心、脑血管疾病为著[1].     

门诊精神病患者药物应用调查分析

目的：了解门诊精神病患者使用抗精神障碍药物现状。方法：根据我院门诊登记本记录的数据,按一般方法进行统计。结果：单一用药为81.23%,两药合用为17.08%,三药合用为1.69%。单一用药中利培酮比例最高,达26.14%,两药联用中氯氮平37.64%居首,三药联用中,仍为氯氮平,比例达57.69%。抗抑郁药氟西汀13.38%的总处方量排在第一位。结论：新型、不良反应小的抗精神障碍药物,正为广大患者所接受,但临床医生选用氯氮平的比例仍相当高,说明临床医生对于用药原则和躯体情况缺乏足够认识。     

门诊精神病患者药物应用调查分析

目的了解门诊精神病患者使用抗精神障碍药物现状.方法根据我院门诊登记本记录的数据,按一般方法进行统计.结果单一用药为81.23%,两药合用为17.08%,三药合用为1.69%.单一用药中利培酮比例最高,达26.14%,两药联用中氯氮平37.64%居首,三药联用中,仍为氯氮平,比例达57.69%.抗抑郁药氟西汀13.38%的总处方量排在第一位.结论新型、不良反应小的抗精神障碍药物,正为广大患者所接受,但临床医生选用氯氮平的比例仍相当高,说明临床医生对于用药原则和躯体情况缺乏足够认识.     

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.