阿立哌唑与溴隐亭治疗抗精神病药物所致高催乳素血症的对照研究

目的：比较小剂量阿立哌唑与溴隐亭治疗抗精神病药物（APS）所致高催乳素血症（HPRL）的疗效及安全性。方法：将120例APS所致高催乳素血症患者随机分为阿立哌唑组和溴隐亭组各60例,在维持原APS治疗方案的基础上,阿立哌唑组合并使用阿立哌唑,嗅隐亭组合并使用溴隐亭,疗程4周。于治疗前、治疗第4周末检测血清催乳素水平。以简明精神病量表（BPRS）及副反应量表（TESS）于治疗前及治疗第1、2、4周末评定原APS治疗疗效及其他不良反应。结果：研究结束时两组血清催乳素水平较治疗前相比差异有显著意义（P〈0.01）;同期两组间比较差异无显著性意义（P〉0.05）;两组BPRS评分治疗前后差异无显著性意义（P〉0.05）;TESS量表显示阿立哌唑组的副反应发生率明显低于溴隐亭组。结论：小剂量阿立哌唑及溴隐亭均能显著改善抗精神病药物所致的HPRL,疗效相当,但阿立哌唑的安全性明显高于溴隐亭。     

阿立哌唑治疗经典与非经典抗精神病药物所致高泌乳素血症的随机对照研究

目的探讨阿立哌唑治疗经典与非经典抗精神病药物所致高泌乳素血症的疗效及安全性。方法采取前瞻性开放性标签、随机、对照的研究设计,将120例服用经典（氯丙嗪）和非经典（利培酮）抗精神病药物后出现高泌乳素血症的精神分裂症病人,随机分为氯丙嗪合并阿立哌唑5 mg和阿立哌唑10 mg组（各30例）,利培酮合并阿立哌唑5 mg和阿立哌唑10 mg组（各30例）,总疗程12周。于治疗前、治疗后第4、8、12周分别检测催乳素;以阳性和阴性症状量表（PANSS）、副反应量表（TESS）评定对抗精神病药物疗效的影响及不良反应。结果4组干预前后血清泌乳素水平和PANSS总分评分比较,差异有统计学意义（P < 0.05）,各时间点组间比较差异无统计学意义（P>0.05）。4组不良反应发生率比较差异无统计学意义（χ2=1.11,P>0.05）。结论小剂量（5 mg/d）阿立哌唑可以逆转经典和非经典抗精神病药物所致高催乳素血症,能辅助改善精神症状且不增加不良反应。     

齐拉西酮与阿立哌唑治疗女性精神分裂症临床研究

目的探讨非典型抗精神病药齐拉西酮与阿立哌唑治疗女性精神分裂症患者的疗效与不良反应。方法将60例符合CCMD-3精神分裂症诊断标准的女性患者随机分为两组,分别给予齐拉西酮与阿立哌唑治疗8周,用阳性与阴性症状量表（PANSS）评定疗效,副反应量表（TESS）评定不良反应。结果齐拉西酮组与阿立哌唑组两组间疗效比较差异无统计学意义（P〉0.05）,齐拉西酮组不良反应发生率高于阿立哌唑组,但差异无统计学意义（P〉0.05）,两组治疗前后血清催乳素比较差异无统计学意义（P〉0.05）。结论齐拉西酮与阿立哌唑对女性精神分裂症患者疗效相当,较为安全。     

阿立哌唑治疗利培酮所致男性高催乳素血症68例疗效分析

目的:探讨联合使用小剂量阿立哌唑治疗利培酮所致男性高催乳素血症的有效性及安全性。方法:将68例利培酮所致的高催乳素血症的男性患者,在维持原治疗的同时随机分为两组,分别加用阿立哌唑5 mg(34例)及安慰剂(34例)对照治疗,疗程均为6周。于治疗前、治疗后检测血清催乳素(PRL);观察血清催乳素的浓度变化及临床表现,以简明精神病评定量表(BPRS)及不良反应量表(TESS)评定其对原治疗疗效的影响及不良反应。结果:治疗第6周末,治疗组血清催乳素[(24.6±7.6)μg/L]较治疗前(92.3±30,7)μg/L]下降,差异有统计学意义(P<0.001);对照组催乳素[(93.5±41.2)μg/L]与治疗前[(95.2±28.2)μg/L]比较,差异无统计学意义(P>0.05);治疗6周末,两组BPRS评分均较治疗前无显著差异,两组不良反应发生率均低。结论:阿立哌唑治疗利培酮所致的血高催乳症安全有效,且不良反应少。     

小剂量阿立哌唑治疗利培酮所致女性高催乳素血症的临床研究

目的:探讨阿立哌唑治疗利培酮所致女性高催乳素血症的疗效及安全性。方法:将34例利培酮所致高催乳素血症的女性精神分裂症患者,随机分为两组,研究组在维持原利培酮治疗的同时,合并阿立哌唑5 mg/d。对照组维持原治疗。疗程6周分别于治疗前、治疗6周末检测血清催乳素(PRL)水平。在治疗前、治疗6周评定简明精神病量表(BPRS)及副反应量表(TESS),同时观察高催乳素血症临床症状变化情况。结果:①治疗6周末,研究组PRL(35.26±7.65)ug/较治疗前(121.30±31.40)ug/L明显下降,有显著差异(P<0.001)。对照组6周末PRL(125.30±35.20)ug/L与治疗前(129.60±35.30)ug/L无显著性差异(P>0.05);②两组不良反应总体发生率均低,对原利培酮治疗的疗效均无不良影响。结论:阿立哌唑治疗利培酮所致的女性高催乳素血症较安全、有效。     

阿立哌唑联合丙戊酸镁对精神分裂症冲动控制障碍的疗效观察

目的 观察用阿立哌唑联合丙戊酸镁治疗精神分裂症患者冲动控制障碍的疗效和药物不良反应.方法 将56例有冲动控制障碍的精神分裂症住院患者随机分为研究组(阿立哌唑联合丙戊酸镁治疗)28例,对照组(单用阿立哌唑治疗)28例.疗程4周.两组于治疗前及治疗第4周末采用简明精神病评定量表,治疗前及治疗第1、2、4周末采用外显冲动控制障碍量表,不良反应量表评定疗效与不良反应.结果 两组治疗前与治疗后简明精神病评定量表各因子分差异均有统计学意义(P<0.01).治疗后两组间比较差异无统计学意义(P>0.05).两组治疗前后外显冲动控制障碍量表评分差异有统计学意义(P<0.01).治疗第2、4周末两组间比较差异有统计学意义(P<0.01).研究组评分降低更为明显.结论 阿立哌唑联合丙戊酸镁治疗精神分裂症的冲动控制障碍疗效更佳.     

阿立哌唑对抗精神病药物所致高泌乳素血症的影响

目的:探讨阿立哌唑对抗精神病药物所引起的高泌乳素血症的影响。方法:将90例抗精神病药物所致高泌乳素血症患者随机分为3组,实验组一30例(阿立哌唑5 mg/d),实验组二30例(阿立哌唑10 mg/d),对照组30例未添加阿立哌唑治疗,治疗8周。分别于基线期、4周后、8周后监测血清泌乳素水平,于基线期及8周后采用PANSS量表评估疗效,TESS评估药物不良反应。结果:(1)实验组治疗前后泌乳素水平存在统计学差异(P<0.05);(2)实验组一和实验组二治疗后泌乳素水平无统计学差异(P>0.05),对照组治疗前后泌乳素水平无统计学差异(P>0.05);(3)实验组组间治疗后PANSS量表、TESS量表无统计学差异(P>0.05)。结论:阿立哌唑能够改善抗精神病药物所引起的高泌乳素血症,且不存在量效关系。     

阿立哌唑治疗精神分裂症28例

目的:观察阿立哌唑治疗精神分裂症的临床疗效与安全性.方法:58例精神分裂症患者随机分为两组,阿立哌唑组28例,利培酮组30例.分别服用阿立哌唑与利培酮,治疗12周.分别于治疗前、治疗4、8、12周末采用阳性与阴性症状量表(PANSS)评定疗效,副反应量表(TESS)评定不良反应.结果:两者疗效差异无统计学意义(P＞0.05),药物不良反应发生率相近(P＞0.05).结论:阿立哌唑是一种安全有效的抗精神病药.     

阿立哌唑治疗抗精神病药物所致高催乳素血症对照研究

目的 探讨阿立哌唑治疗抗精神病药物(APS)所致高催乳素血症的疗效及安全性.方法 60例APS所致高催乳素血症患者,维持原APS治疗方案.随机分组后,分别加用阿立哌唑5mg(30例)及安慰剂(30例)进行对照治疗,疗程6周.于治疗前、治疗后6周检测催乳素(PRL);观察高催乳素血症临床症状变化情况;以简明精神病量表(BPRS)及副反应量表(TESS)评定对原APS治疗疗效的影响及其他不良反应.结果 阿立哌唑组研究结束时PRL[(27.5±8.2)μg·L-1]较基线[(148.7±45.5)μg·L-1]下降,差异具有显著性(P＜0.001);安慰剂组研究结束时PRL[(122.4±72.2)μg·L-1]与基线[(134.4±58.8)μg·L-1]比较,差异无显著性(P＞0.05);阿立哌唑组月经恢复(27/28)、自发泌乳消失(16/16),安慰剂组则均无改善.2组不良反应均轻,总体发生率相当,对原APS治疗的疗效均无不良影响.结论 阿立哌唑治疗抗精神药物所致高泌乳血症有效、安全.     

阿立哌唑对女性精神分裂症生理影响的临床研究

目的 探索阿立哌唑对女性精神分裂症患者生理影响.方法 在我院住院患者中选择符合CCMD-3诊断标准的女性精神分裂症患者300例,随机分为阿立哌唑组(研究组)150例,利培酮组(对照组)150例.采用PANSS、TESS 评定疗效和不良反应.结果 治疗组显效73.3%,有效率86.7%,与对照组相比差异无统计学意义(P＞0.05),两组治疗女性分裂时不良反应,尤期对生理指标影响差异有非常显著统计学意义(P＜0.01).结论 阿立哌唑对女性精神分裂症患者疗效确切,不良反应发生率低,程度更轻微,尤其是极大地降低了女性患者因抗精神病治疗而发生月经紊乱、高催乳素血症、肥胖及常伴随的心血管等生理影响方面显著降低了风险.     

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.