EFFECTS OF COMPREHENSIVE TREATMENT ON LIFE QUALITY OF FIRST-EPISODE SCHIZOPHRENIA PATIENTS

目的:探讨抗精神病药联合心理社会干预的综合治疗对对首发精神分裂症患者临床症状和生活质量的影响.方法:90例首发精神分裂症患者随机分为观察组和对照组,每组45例患者;两组患者均予以利培酮系统治疗,观察组在药物治疗的基础上给予8周的心理干预;两组患者均随访6个月.分别于入组时及随访结束时采用阴性与阳性症状量表(PANSS)、健康状况调查问卷(SF-36)对患者进行评估.结果:入组时,两组患者PANSS、SF-36评分比较差异无显著性(P＞0.05);随访结束时,观察组PANSS总分及各分量表评分明显低于对照组(P＜0.01),SF-36各分量表评分明显高于对照组(P＜0.01).结论:综合治疗对改善首发精神分裂症患者的精神症状和生活质量有积极作用.     

正念认知干预对双相情感障碍患者心理健康状况及生活质量的影响

目的探讨正念认知干预对双相情感障碍(BAD)患者心理健康状况及生活质量的影响。方法选择2016年1月～2017年12月该院精神科就诊的BAD患者共100例,随机分为干预组和对照组。两组均予以丙戊酸钠片治疗,起始剂量400 mg/d,逐渐加量增至800～1600 mg/d。对照组在药物治疗基础上采用常规干预措施,干预组再加正念认知干预,两组均干预12周。观察两组干预前后心理健康状况及生活质量变化,并评估其临床效果。结果干预12周后,两组患者SAS和SDS评分均较干预前明显下降(P0.05或P0.01),且干预组下降幅度较对照组更显著(P0.05);干预12周后,两组生活质量SF-36评分均较治疗前明显上升(P0.05或P0.01),且干预组上升幅度较对照组更显著(P0.05)。结论正念认知干预BAD患者能明显的改善患者的心理健康状况,提高患者的生活质量。     

临床药学服务干预对社区慢性病患者社会支持生活质量及治疗依从性的影响

目的 探讨临床药学服务干预对社区慢性病患者社会支持、生活质量、治疗依从性的影响.方法 对86 例2级甲等以上医院按照有关诊断标准确诊的相关慢性疾病患者进行临床药学服务干预,用社会支持评定量表、世界卫生组织生存质量测定量表简表及治疗依从性观察其效果.结果 研究组与对照组干预前社会支持各维度的评分均无差异(P＞0.05),而干预1周后观支持[(11.24±4.15)分;(9.02±3.25)分]、支持利用度维度[(8.05±2.40)分;(5.79±3.01)分]的评分差异即有显著性(P＜0.05或＜0.01).研究组从干预1周后,社会支持各维度的评分较干预前即有显著提高,差异有显著性(P＜0.05或＜0.01).研究组与对照组干预前生活质量各维度的评分均无差异(P＞0.05),而干预1周后生理领域、心理领域、社会领域、环境领域的评分差异即有显著性(P＜0.05或＜0.01).研究组从干预1周后,生活质量各维度的评分较干预前即有显著提高,差异有显著性(P＜0.05或＜0.01);干预前治疗依从性的评分无差异(P＞0.05),而干预1周后治疗依从性的评分差异即有显著性(P＜0.05或＜0.01).研究组从干预1周后,治疗依从性的评分较干预前即有显著提高,差异有显著性(P＜0.05或＜0.01).相关分析,显示社会支持各维度与治疗依从性均呈显著正相关,主观支持、客观支持、支持利用度的相关系数分别为0.41,0.39和0.44.结论 临床药学服务干预能提高社区慢性病患者的社会支持、生活质量、治疗依从性;并发现社会支持与治疗依从性具有显著正相关性.     

心理-认知-行为三联康复干预对创伤性颅脑损伤患者的神经功能、肢体运动与生活质量的影响

目的 探讨心理-认知-行为三联康复干预用于创伤性颅脑损伤(TBI)患者,对其神经功能、肢体运动及生活质量的影响。方法 选取2016年1月～2018年12月住院治疗TBI患者74例,随机分为干预组和对照组各37例。对照组给予常规干预,干预组在对照组上加以心理-认知-行为三联康复干预,两组干预8周。评估两组TBI患者干预前及干预8周后神经功能指标(CSS评分)、肢体运动(Fugl-Meyer评分)与生活质量(QOL评分)变化情况。结果 干预8周后,两组CSS评分与Fugl-Meyer评分均较前分别显著下降或显著上升(P0.05或P0.01),且干预组变化情况与对照组相比更显著(P0.05或P0.01);同时两组生活质量指标评分亦较前显著上升(P0.05或P0.01),且干预组上升情况与对照组相比更显著(P0.05或P0.01)。结论 心理-认知-行为三联康复干预用于TBI患者,能显著改善神经功能及肢体运动,降低致残率,提高其生活质量。     

强化认知康复训练对糖尿病伴认知功能障碍患者认知功能和生活质量的影响

目的探讨强化认知康复训练对糖尿病伴认知功能障碍患者认知功能和生活质量的影响。方法选取80例糖尿病伴认知功能障碍患者,随机分为干预组和对照组各40例。两组均予以饮食调整、适当运动及药物降血糖等基础治疗。对照组加予常规康复干预,干预组在对照组基础上加用强化认知康复干预,两组均干预16周。评估两组干预前与干预16周后认知功能指标及生活质量变化。结果干预16周后,两组MOCA评分和MMSE评分较前不同幅度上升(P0.05或P0.01),且干预组较对照组上升幅度更明显(P0.05);同时两组躯体功能、心理情感、社会功能和物质生活等4项评分均较前明显上升(P0.05或P0.01),且干预组上升值较对照组更显著(P0.05)。结论强化认知康复训练用于糖尿病伴认知功能障碍患者的疗效确切,能明显改善其认知功能,提高生活质量,改善其预后。     

综合治疗对首发精神分裂症患者生活质量的影响

目的:探讨抗精神病药联合心理社会干预的综合治疗对对首发精神分裂症患者临床症状和生活质量的影响。方法:90例首发精神分裂症患者随机分为观察组和对照组,每组45例患者;两组患者均予以利培酮系统治疗,观察组在药物治疗的基础上给予8周的心理干预;两组患者均随访6个月。分别于入组时及随访结束时采用阴性与阳性症状量表(PANSS)、健康状况调查问卷(SF-36)对患者进行评估。结果:入组时,两组患者PANSS、SF-36评分比较差异无显著性(P0.05);随访结束时,观察组PANSS总分及各分量表评分明显低于对照组(P0.01),SF-36各分量表评分明显高于对照组(P0.01)。结论:综合治疗对改善首发精神分裂症患者的精神症状和生活质量有积极作用。     

中药穴位注射治疗2型糖尿病周围神经病变临床观察

目的 观察中药穴位注射治疗2型糖尿病周围神经病变的临床疗效。方法 将70例2型糖尿病周围神经病变（diabetic peripheral neuropathy,DPN）患者随机分为对照组和治疗组,每组35例。在糖尿病常规治疗基础上,对照组加用弥可保治疗,治疗组在对照组基础上加用红花注射液穴位注射。治疗前、治疗4周后分别进行密西根州糖尿病周围神经病评分（Michigan diabetic neuropathy score,MDNS）。结果 治疗4周后,治疗组临床疗效优于对照组,差异有统计学意义（P＜0.05）。两组患者治疗后MDNS评分和症状、体征评分均较治疗前明显减少（P＜0.05）;两组MDNS评分和症状、体征评分差值比较,差异均有统计学意义（P＜0.05）。结论 中药穴位注射可以显著减少DPN患者MDNS评分和症状、体征评分,提高生活质量。     

实施护理干预对焦虑症患者生活质量的影响

目的 探讨护理干预对焦虑症患者生活质量的影响.方法通过护理干预方法改变焦虑症患者的生活质量,并与对照组进行比较.结果 4周末实验组和对照组HAMA、HAMD评分明显降低(P＜0.01,P＜0.05);生活质量总指数实验组明显高于对照组,有统计学意义(P＜0.05).结论 通过护理干预可以提高焦虑症患者的生活质量.     

正念认知疗法联合药物对抑郁症患者残留症状疗效及生活质量影响

目的:探讨正念认知疗法(MBCT)联合药物对抑郁症残留症状患者的治疗效果及生活质量的影响。方法:选取2020年11月－2021年10月在乌鲁木齐市第四人民医院临床心理科门诊就诊和住院患者84例,经急性期抗抑郁药物治疗8周后,仍然存在残留症状的患者,采用随机对照研究方法分为对照组和干预组,每组各42例。对照组给予常规抗抑郁药物治疗,干预组在常规抗抑郁药基础上结合MBCT干预。观察两组入组时、4、8周末后的汉密尔顿抑郁量表17条目(HAMD-17)、贝克抑郁自评量表(BDI)、生活质量量表(WHOQOL-BREF)和五因素正念量表(FFMQ)自评和他评量表评分变化,经统计学分析抑郁症残留症状患者的治疗效果。结果:干预组4周干预后、8周末的总评分低于对照组(均P<0.05),干预组4周干预后、8周末的减分率高于对照组(均P<0.05);干预组4周末、8周末的WHOQOL-BREF量表评分均高于基线(均P<0.05);两组4周末、8周末的BDI量表评分较基线下降(P<0.05);治疗后FFMQ评分显著上升,干预组4周末、8周末的评分高于对照组。结论:MBCT联合药物可改善抑郁症患者的残留症状,提高其生活质量及正念水平。     

配偶同步心理干预对肺结核患者负性情绪和生活质量的影响

目的探讨配偶同步心理干预对肺结核患者负性情绪和生活质量的影响。方法选取2016年1月～2018年1月在该院治疗的肺结核患者共100例,随机分为观察组与对照组。两组患者均予以常规的治疗,对照组患者只对肺结核患者进行心理干预,观察组患者在对照组治疗基础上对患者与配偶进行同步心理干预。两组患者均干预3个月,分别在干预前后评估患者负性情绪及生活质量情况。结果干预3个月后,两组患者SAS、SDS评分均较干预前下降(P0.05或P0.01),且治疗后观察组下降幅度较对照组更显著(P0.05);干预3个月后,两组患者生活质量SF-36评分均较干预前明显上升(P0.05或P0.01),且治疗后观察组上升幅度较对照组更显著(P0.05)。结论对肺结核患者进行有效的配偶同步心理干预能改善患者的负性情绪,提高患者的生活质量。     

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.