齐拉西酮与奋乃静治疗精神分裂症的临床疗效及安全性比较

目的:比较齐拉西酮与奋乃静治疗精神分裂症的疗效和安全性。方法:将60例住院患者随机分为齐拉西酮组与奋乃静组,各30例,2组平均剂量分别为(111.6±32.3)、(18.3±8.1)mg·d-1,po,疗程均为8周,以阳性和阴性症状量表评价疗效、副反应量表评定不良反应。结果:齐拉西酮与奋乃静的总体疗效相当(P>0.05),但不良反应明显低于奋乃静。结论:齐拉西酮是一种安全、有效的抗精神病药,其不良反应少于奋乃静。     

头孢哌酮与莫西沙星治疗肺部感染的疗效对比

目的：比较头孢哌酮与莫西沙星治疗肺部感染的疗效及其安全性。方法：共选入肺部感染住院患者120例,随机分为两组,其中应用头孢哌酮治疗60例、莫西沙星治疗60例。结果：头孢哌酮组有效率86.7%,莫西沙星组有效率93.3%;对致病菌株的清除率分别为83%和90.8%;不良反应发生率分别为5%与3.3%,两者临床疗效无明显差异（P〉0.05）。结论：头孢哌酮与莫西沙星都是安全有效治疗肺部感染的药物。     

A trial of "standard" outpatient alcoholism treatment vs. a minimal treatment control

This study sought to examine the effectiveness of a "standard" outpatient alcoholism treatment (ST) program. An outpatient alcoholism treatment as it is commonly practiced in the US (with group and individual therapy, and an emphasis on Alcoholics Anonymous [AA]), was compared with a minimal treatment (MT) approach (weekly alcohol education movies). At 6 months, ST patients surpassed those in MT in terms of complete abstinence, reduction in amount of alcohol consumed, length of sobriety at follow-up, improvement in employment status, number of AA meetings attended, and lower initial drop-out. It is concluded that a ST approach is more helpful than MT in treating severely alcohol-dependent individuals who have not been able to cut down drinking on their own. Those already drinking less appeared to be helped by MT.     

Restrictive dieting vs. "undieting" effects on eating regulation in obese clinic attenders

This study tested predictions from restraint theory [Herman & Polivy (1984). A boundary model for the regulation of eating. In: A. J. Stunkard, & E. Stellar (Eds.), Eating and its disorders (pp. 141-156) New York: Raven Press.] and the three-factor model of dieting [Psychol. Bull. 114 (1993) 100.] using an eating regulation paradigm. Participants were 42 obese, nonbinge eaters assigned to either a weight loss group (restrictive dieters or RDs) or a group designed to eliminate dieting ("undieters" or UDs). Participants took part in an ostensible ice cream taste test with or without a preload, both before and after the weight control intervention. At pretest, restraint theory's prediction that participants would engage in counter-regulatory eating was not supported. At posttest, after 8 weeks of the dieting interventions, RDs increased and UDs decreased their intake following a preload, a pattern most consistent with the predictions of restraint theory. This counter-regulatory trend was observed in spite of a significant decrease in RDs' Disinhibition scale scores following treatment. Implications of these findings for restraint theory, the three-factor model of dieting, and relapse in obesity treatment were discussed.     

他莫昔芬与托瑞米芬治疗乳腺癌的经济学分析

目的:评估2种内分泌治疗乳腺癌药的经济学价值。方法:130例乳腺癌患者按照不同的治疗方案分为他莫昔芬组(TAM组)80例,托瑞米芬组(TOR组)50例,观察2组治疗方案的疗效及安全性,运用药物经济学的成本-效果分析方法进行评价。结果:TAM、TOR组治疗药品成本分别为90.30、809.52元,有效率分别为88.75%、94%。结论:从药物经济学角度评估,TAM方案优于TOR方案。     

伊托必利对比多潘立酮治疗功能性消化不良的Meta分析

目的:系统评价伊托必利对比多潘立酮治疗功能性消化不良(FD)的疗效和安全性。方法:计算机检索PubMed、EMBASE、SCI、CBM、CNKI、VIP、万方数据库及Cochrane图书馆,补充手工检索,对纳入伊托必利对比多潘立酮治疗FD的随机对照试验(RCT)进行方法学质量评价和Meta分析。结果:共纳入18个RCT,B级文献11篇,C级文献7篇。总有效率及恶心、上腹胀、嗳气、呕吐、上腹疼痛、反酸的缓解率伊托必利组均高于多潘立酮组,但差异无统计学意义;不良反应发生率伊托必利组低于多潘立酮组,但差异无统计学意义;早饱、厌食的缓解率伊托必利组高于多潘立酮组,且差异有统计学意义。结论:基于当前证据,伊托必利治疗FD疗效优于多潘立酮,期待高质量研究证实。     

五氟利多暗服药与氟哌啶醇治疗Tourette综合征对照研究

目的:对比研究五氟利多暗服药与氟哌啶醇治疗Tourette综合征的疗效和不良反应。方法:68例Tourette综合征患儿随机分为五氟利多组(34例)与氟哌啶醇组(34例),2组均治疗8wk。采用耶鲁抽动程度综合量表(YGTSS)评估治疗效果,采用不良反应症状量表(TESS)评估不良反应。结果:2组间治疗效果无显著性差异(P>0.05);五氟利多组的不良反应较氟哌啶醇组轻,2组间有显著性差异(P<0.01)。结论:五氟利多暗服药与氟哌啶醇治疗Tourette综合征均具有良好效果,但五氟利多暗服药服用方便,不良反应较少。     

美金刚与多奈哌齐随机对照治疗阿尔茨海默病的Meta分析

目的:系统评价美金刚治疗阿尔茨海默病(AD)的有效性和安全性。方法:按照系统评价的要求全面检索Medline、中国数字医院图书馆和中国生物医学文献光盘数据库,对符合纳入标准的文献进行分析。结果:共纳入42项研究,419例患者。美金刚(治疗组)与盐酸多奈哌齐(对照组)治疗AD的简易精神状态量表(MMSE)评分变化比较,合并比值比(OR)为0.09,经Z检验,P=0.85,治疗组与对照组的MMSE评分变化比较,差异无统计学意义;美金刚与盐酸多奈哌齐治疗AD的日常生活活动能力量表(ADL)评分变化比较,合并OR=-0.16,经Z检验,P=0.83,治疗组与对照组的ADL评分变化比较,差异无统计学意义;美金刚与盐酸多奈哌齐治疗AD的安全性比较,合并OR=0.28,经Z检验,P=0.009,治疗组与对照组在治疗AD的安全性方面比较,差异有统计学意义,美金刚较盐酸多奈哌齐不良反应发生率低。结论:美金刚治疗AD疗效确切、使用安全。     

脂必妥和辛伐他汀治疗高脂血症比较

目的比较脂必妥和辛伐他汀治疗高脂血症的疗效.方法158例高脂血症患者随机分为脂必妥组88例和辛伐他汀组70例,脂必妥组用脂必妥1 05 g,tid口服,辛伐他汀组用辛伐他汀10 mg qd,晚饭后口服,两组疗程均为8周.结果两药治疗8周后血清TC、TG水平均有显著降低(P＜0.01).但两组间比较差异无显著性.两药均有升高HDL-ch作用(P＜0.05).结论脂必妥治疗高脂血症安全有效.     

替硝唑与甲硝唑治疗滴虫性阴道炎的成本-效果分析

目的评价滴虫性阴道炎两种治疗方案,以指导临床合理用药.方法根据文献选择替硝唑与甲硝唑治疗滴虫性阴道炎的两种治疗方案,并应用药物经济学的成本-效果分析法对其进行分析.结果与结论替硝唑是治疗滴虫性阴道炎的较佳治疗方案.     

替硝唑与甲硝唑治疗滴虫性阴道炎的成本-效果分析

目的:评价滴虫性阴道炎两种治疗方案,以指导临床合理用药。方法:根据文献选择替硝唑与甲硝唑治疗滴虫性阴道炎的两种治疗方案,并应用药物经济学的成本-效果分析法对其进行分析。结果与结论:替硝唑是治疗滴虫性阴道炎的较佳治疗方案。     

利培酮口服液与氟哌啶醇治疗儿童抽动障碍的对照研究

目的:比较利培酮口服液与氟哌啶醇治疗儿童抽动障碍的疗效及不良反应。方法:对102例儿童抽动障碍分别给予利培酮口服液与氟哌啶醇治疗,其中利培酮口服液组51例,氟哌啶醇组51例。疗效评定采用耶鲁抽动症状严重程度量表(YGTSS),不良反应采用不良反应量表(TESS),观察8周。结果:利培酮口服液组显好率、好转率分别为58.82%、76.47%,氟哌啶醇组显好率、好转率分别为56.86%、72.55%,2组总有效率接近,氟哌啶醇组流涎、震颤、EKG异常多见。结论:利培酮口服液和氟哌啶醇同样能有效治疗儿童抽动障碍,利培酮口服液依从性较好。     

Outpatient vs. Inpatient Treatment for the Chronically Mentally Ill with Substance Use Disorders

Treatment decisions about complex patients with both substance use disorders and chronic mental illness cannot be reduced to an inpatient vs. outpatient dichotomy. Treatment progresses through a series of stages, in each of which we must make decisions about treatment settings and approaches. I discuss treatment decisions within the framework of a staged treatment model, reviewing decisions to be made during stabilization, engagement, persuasion, active (or primary) treatment, and relapse prevention (or aftercare).     

Treatment of oral mucosal manifestations of chronic graft-versus-host disease: dexamethasone vs. budesonide

Introduction: The oral mucosa is commonly involved in chronic graft-versus-host disease (cGVHD). Oral mucosal cGVHD markedly affect individual’s daily function and wellbeing. In some cases, it might become a life threating complication.

Areas covered: This article describes the rationale for treatment, method of topical application in the oral cavity, evidence supporting the topical administration of dexamethasone and budesonide for oral cGVHD, and their adverse effects.

Expert opinion: Evidence supports the use of topical dexamethasone and budesonide for treatment of oral cGVHD. Topical corticosteroid choice for oral cGVHD, takes into consideration the potency, bioavailability, preferred concentration, and possible adverse effects. Budesonide’s pharmacological characteristics mark it as a preferable topical agent for oral cGVHD.     

文拉法新与舍曲林治疗抑郁症疗效的Meta分析

目的：评价文拉法新与舍曲林治疗抑郁症疗效的差异。方法：对6项符合纳入标准的研究应用循证医学方法评价文拉法新与舍曲林治疗抑郁症疗效有效率、以及症状学变化的差异。结果：文拉法新组的有效率（122/177 vs 128/179,OR=1.22,95%CI：0.77~1.93,Z=0.86,P〉0.05）与曲林组相似,但是文拉法新组在第1周末（WMD：-1.57,95%CI：-2.98~-0.15,Z=2.17,P=0.03）和第2周末（WMD：-1.53,95%CI：-2.83~-0.23,Z=2.30,P=0.02）症状改善明显于舍曲林,而在第6周末相似（WMD：0.13,95%CI：-0.91~1.17,Z=0.25,P=0.81）。结论：文拉法新与舍曲林治疗抑郁症有效率相似,但前者症状改善前2周改善比较快。     

卷曲霉素对比链霉素治疗复治、耐药肺结核的系统评价

目的:采用循证医学的方法评价卷曲霉素对比链霉素治疗复治、耐药肺结核的有效性和安全性。方法:计算机检索Cochrane Library、PubMed、EMBASE、CBM、CNKI、VIP、万方数据库,按纳入与排除标准选择试验,并对其进行质量评价。用RevMan5.0软件对数据进行Meta分析。结果:共纳入8项研究,Meta分析结果显示,卷曲霉素组痰菌转阴率、病灶吸收率和空洞改变情况均优于链霉素组,差异具有统计学意义(P<0.05);尚不能认为2组不良反应发生率有差异。结论:现有证据表明,卷曲霉素与其他抗结核药联用治疗复治、耐药肺结核的疗效优于链霉素联用的方案;但由于纳入的文献数量有限、研究质量不高,上述结论还需大样本高质量的随机对照试验加以验证。     

The "vine of the soul" vs. the Controlled Substances Act: implications of the hoasca case

In 2006, the Supreme Court paved the way for the sacramental use of a hallucinogen, hoasca, to be imported, distributed and ingested by a religious group. This case has broad implications for religious freedom for using sacramental psychotropics and how such cases might be decided in the future. This article outlines the arguments used both by the church and by the government. It lists the facts of the cases, explains and analyzes the decision, evaluates the likelihood of expansions of religion-based exceptions for entheogen use in light of the Supreme Court's decision and offers a profile for those groups most likely to receive such an exemption.