利培酮口服液合并丙戊酸钠缓释片治疗老年躁狂症疗效观察

目的:观察利培酮口服液合并丙戊酸钠缓释片治疗老年躁狂症的临床疗效及安全性.方法:采取随机入组,将70例老年躁狂症患者分为2组,观察组采用利培酮口服液合并丙戊酸缓释片治疗,对照组采用单一丙戊酸钠缓释片治疗,观察治疗6周,用躁狂量表(BRMS)评定疗效,不良反应量表(TESS)评定不良反应,并进行对比分析.结果:2组BRMS评分治疗前后差异无统计学意义(P>0.05),观察组治疗后1~6周末BRMS评分均下降,明显优于对照组(P<0.01);观察组6周末总有效率88.57%,对照组80.00%,差异无统计学意义(P>0.05).结论:利培酮口服液合并丙戊酸钠缓释片治疗老年躁狂症起效快,疗效肯定,不良反应少,药物依从性好,适合于老年人群.     

丙戊酸镁联合氯硝西泮和碳酸锂治疗躁狂症患者的临床效果

目的:观察丙戊酸镁联合氯硝西泮和碳酸锂治疗躁狂症患者的临床效果。方法:选取收治的84例躁狂症患者为研究对象,以治疗方法的不同分为对照组和观察组,每组42例,对照组予氯硝西泮和碳酸锂治疗,观察组在对照组基础上联合丙戊酸镁治疗,比较两组临床疗效,治疗前后贝克-拉范森躁狂量表(BRMS)评分及不同时间点不良反应量表(TESS)评分。结果:治疗前两组BRMS评分比较,差异无统计学意义(P>0.05);治疗后两组BRMS评分均较治疗前下降,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后临床总有效率为92.86%,高于对照组的71.43%,差异有统计学意义(P<0.05)。两组治疗2周、4周、6周后TESS评分比较,差异均无统计学意义(P>0.05)。结论:采用丙戊酸镁联合氯硝西泮和碳酸锂治疗躁狂症效果较好,且安全性较高,值得推荐。     

博思清联合丙戊酸钠治疗急性躁狂症效果分析

目的探究博思清联合丙戊酸钠在急性躁狂症患者治疗的临床疗效和安全性。方法选取2018年2月至2019年2月该院收治60例急性躁狂症患者,随机分为两组,对照组给予丙戊酸钠治疗,观察组给予思清联合丙戊酸钠治疗,对比两组的临床治疗效果,分别于治疗后1周、4周和治疗后8周采用躁狂量表(BRMS)对两组的临床症状进行评价,并记录两组治疗期间不良反应的发生情况。结果观察组治疗总有效率为93.33%,明显高于对照组(P<0.05);两组的BRMS评分均明显低于治疗前,治疗后4周、治疗后8周观察组的BRMS评分均明显低于对照组(P<0.05)。结论在急性躁狂症患者的治疗中联合博思清与丙戊酸钠,能够明显提高临床疗效,改善患者临床症状,而且不会增加不良反应发生风险,值得推广应用。     

丙戊酸镁缓释片合并奎硫平治疗40例有精神病性症状的躁狂症临床研究

目的:研究丙戊酸镁缓释片合并奎硫平治疗有精神病性症状的躁狂症疗效和安全性.方法:80例有精神病性症状的躁狂症随机分为丙戊酸镁缓释片合并奎硫平组(研究组)和利培酮口崩片合并碳酸锂组(对照组),观察8周,用Bech-Rafacelsen躁狂量表( BRMS)、简明精神病症状量表(BPRS)减分率评定疗效,用副反应量表(TESS)评定不良反应.结果:治疗8周,两组BRMS、BPRS评分较治疗前均显著下降(P均＜0.05),各时点评分两组间差异无统计学意义.但不良反应研究组明显小于对照组.结论:丙戊酸镁缓释片合并奎硫平治疗有精神病性症状的躁狂症疗效好,安全性高.     

小剂量阿立哌唑片联合足量丙戊酸钠治疗躁狂症的临床效果

目的探讨小剂量阿立哌唑片联合足量丙戊酸钠治疗躁狂症的临床效果。方法选取2016年4月至2018年5月于驻马店市第二人民医院就诊的82例躁狂症患者,根据治疗方案分为两组,每组41例。对照组服用丙戊酸钠治疗,观察组在对照组基础上加服小剂量阿立哌唑片。对比两组疗效、治疗前及治疗2个月后狂躁量表(BRMS)评分及不良反应发生情况。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗2个月后观察组BRMS评分低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论小剂量阿立哌唑片联合足量丙戊酸钠治疗躁狂症患者,可有效提高疗效,改善患者临床症状。     

利培酮联合丙戊酸钠治疗急性躁狂症疗效及安全性

目的：探讨利培酮联合丙戊酸钠治疗急性躁狂症疗效及安全性。方法：将94例急性躁狂症患者随机分为2组;观察组48例,采用利培酮＋丙戊酸钠治疗;对照组46例,采用丙戊酸钠治疗。分别在治疗前及治疗后1、2、4周对两组患者的BRMS评分。结果：观察组有效率为83．3％,明显高于对照组的65．2％（P〈0．05）;观察组治疗后的BRMS评分明显优于对照组。结论：利培酮与丙戊酸钠联合治疗急性躁狂症安全有效,临床值得推广。     

富马酸喹硫平联合丙戊酸钠对双相障碍躁狂的治疗效果观察

目的 探讨双相障碍躁狂采用富马酸喹硫平联合丙戊酸钠治疗的临床疗效.方法 选取我院收治的56例双相障碍躁狂患者,随机数字表法分为对照组和观察组各28例,比较2组疗效.结果 观察组与对照组患者治疗总有效率比较有显著性差异(P＜0.05),且观察组患者BRMS评分与PANSS评分均明显低于对照组(P＜0.05).结论 双相障碍躁狂采用富马酸喹硫平联合丙戊酸钠治疗,治疗效果良好,值得临床推广应用.     

氯氮平辅助丙戊酸钠治疗急性躁狂症疗效观察

目的　观察氯氮平合并丙戊酸钠治疗急性躁狂症的疗效和安全性。方法　 80例患者随机分为观察组 (氯氮平 丙戊酸钠 )和对照组各 4 0例 ,2组均用丙戊酸钠 1.2g d ,观察组加用氯氮平15 0～ 4 5 0mg d ,治疗 6周。用躁狂量表 (BRMS)评定疗效 ,以副反应量表 (TESS)评定不良反应。结果　观察组比对照组早起效 1周 ,有效率高 (P <0 .0 5 )。结论　结论佐用氯氮平治疗急性躁狂可起效快 ,提高疗效     

丙戊酸钠治疗心境障碍-躁狂症的疗效观察

目的探讨丙戊酸钠治疗躁狂症的疗效.方法 随机选择22例躁狂症患者,给予丙戊酸钠治疗4周,治疗前后采用BRMS量表评分进行观察.结果经丙戊酸钠治疗前后BRMS总分有较大幅度下降,P<0.05.结论丙戊酸钠治疗心境障碍-躁狂症的疗效确切,无明显毒副作用.     

富马酸喹硫平联合丙戊酸钠治疗双相障碍躁狂的临床效果

目的观察富马酸喹硫平联合丙戊酸钠治疗双相障碍躁狂发作的临床效果和安全性。方法按就诊先后顺序将2013年9月~2014年9月在清远市人民医院精神科住院的120例双相障碍躁狂患者随机分为治疗组和对照组,各60例。治疗组给予富马酸喹硫平联合丙戊酸钠治疗,对照组给予富马酸喹硫平治疗,疗程均为8周,采用躁狂量表(BRMS)及阳性和阴性症状量表(PANSS)评分来评估临床效果,采用副反应量表(TESS)评定药物副作用。结果治疗8周后,两组患者BRMS及PANSS评分均显著降低(P<0.05),治疗组BRMS[(10.95±2.18)分]及PANSS[(38.64±4.32)分]评分均显著低于对照组[(16.17±2.35)分和(45.89±3.86)分](P<0.05),治疗组总有效率(80.0%)明显高于对照组(68.3%)(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论富马酸喹硫平联合丙戊酸钠治疗双相障碍躁狂效果显著,安全可靠,值得临床推广应用。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.