针刺配合舍曲林对卒中后抑郁患者抑郁及神经功能恢复的疗效观察

目的观察针刺配合舍曲林对卒中后抑郁（post stroke depression,PSD）患者抑郁状态、日常生活能力和神经功能缺损程度的影响。方法对治疗组86例PSD患者进行针刺治疗,配合服用盐酸舍曲林片;对照组51例仅服用盐酸舍曲林片。采用汉密尔顿抑郁量表（Hamilton depression scale,HAMD）、日常生活活动量表Barthel指数（Barthel index,BI）、神经功能缺损程度评分表（CSS）评价两组治疗前后抑郁状态及神经功能恢复情况。结果治疗组总有效率88.37%,对照组总有效率72.54%,两组比较差异有统计学意义。与治疗前相比,治疗后两组HAMD、CSS评分明显下降,BI评分明显提高（P〈0.01）,且治疗组优于对照组。结论针刺配合舍曲林明显改善PSD患者抑郁状态及日常生活能力,促进神经功能的恢复。     

卒中后抑郁的特点及其相关因素的Logistic回归分析

目的研究卒中后抑郁（PSD）的特点和相关因素,为卒中后抑郁的干预提供依据。方法采用临床流行病学调查方法对门诊和住院的198例脑卒中患者进行卒中后抑郁及其相关因素的现状调查,运用抑郁自评量表（SDS）、汉密尔顿抑郁量表（HAMD）、简易智力状态检查（MMSE）、日常生活能力量表（ADL）、神经功能缺损量表（NFDS）和自制一般情况调查表对卒中患者进行评定,并用Logistic回归分析法对相关因素进行分析。结果卒中后抑郁的发生率为36．86％,其中轻度63．01％、中度26．03％、重度10．96％;卒中后抑郁的特点为睡眠障碍、绝望、运动阻滞和焦虑等为主要表现;经Logistic回归分析,卒中后抑郁发生的相关因素有负性生活事件、病灶数目、心血管病史、抑郁症史、病灶部位以及脑卒中史。结论卒中后抑郁发生率较高,以睡眠障碍、绝望、运动阻滞和焦虑等主要表现,其相关因素有负性生活事件、病灶数目、心血管病史、抑郁症史,它的发生可能是社会心理学因素和神经生物学因素共同作用的结果。     

轻度脑卒中急性期睡眠障碍影响因素和失眠者药物干预的疗效分析

目的分析初发、轻度脑卒中患者急性期睡眠障碍的临床特点及影响因素,并观察药物干预对卒中后失眠患者的疗效。方法纳入脑卒中患者226例,采用匹兹堡睡眠质量指数(PSQI)、神经功能缺损程度评分(NDS)、改良Barthel指数(MBI)、汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)进行测评,并以PSQI量表总分>7分作为判断睡眠障碍的标准。分析卒中患者睡眠障碍的发生类型及特点;分析睡眠障碍在不同类型的卒中患者中发生率的差异,筛选影响因素;分析睡眠障碍患者与非障碍患者各量表评分的差异;分别在治疗前(脑卒中发病后1周内)及治疗后2周对睡眠障碍患者中的57例失眠者(出血性卒中14例、缺血性卒中43例)进行量表评分,分析治疗前后的差异。结果在226例患者中,99例(43.81%)发生睡眠障碍:出血性卒中患者以睡眠过多为主,缺血性卒中患者以不同形式的失眠居多。轻度脑卒中患者急性期睡眠障碍的发生率与性别、年龄、卒中部位、临床神经功能缺损程度、日常生活能力、精神状态(有无焦虑或抑郁)关系密切。与非睡眠障碍患者比较,睡眠障碍患者的神经功能缺损程度以及焦虑、抑郁程度较高(P<0.05),日常生活能力较低(P<0.05)...     

帕罗西汀对卒中后抑郁总体康复的疗效分析

目的 探讨帕罗西汀对卒中后抑郁(PSD)总体康复的疗效。方法 将97例PSD患者随机分为帕罗西汀治疗组(50例)及对照组(47例)，两组均同时应用常规脑血管病治疗药物。采用汉密顿抑郁量表(HAMD)，汉密顿焦虑量表(HAAMA)，临床神经功能缺损程度评分(SSS)评定疗效和功能改善状况。结果 治疗后治疗组HAMD，HAMA，SSS评分较对照组低，差异有统计学意义。结论 帕罗西汀治疗卒中后抑郁有效，能改善患者情感状态及促进神经功能恢复。     

卒中后抑郁与血-脑脊液屏障病变研究进展

卒中后抑郁（Post stroke depression,PSD）,是指脑卒中后并发的抑郁症,是卒中后最常见的精神障碍,属于继发性抑郁症的一种,发生率占急性卒中患者30％以上。其临床表现主要为：情绪低落,可伴绝望感、乏力,缺乏主动性,失眠早醒,少数患者伴焦虑。卒中后抑郁不仅严重影响卒中患者的预后,延长患者的康复时间,降低患者的生活质量,     

高压氧治疗脑卒中后抑郁症的疗效

目的 探讨高压氧(HBO)治疗脑卒中后抑郁症(PSD)的效果及其对神经功能康复的影响.方法 将符合标准的脑卒中后抑郁症患者随机分为高压氧治疗组和对照组分别进行治疗,用汉密顿抑郁量表(HAMD)、中国卒中量表(CSS)和日常生活活动能力评分(ADL)对治疗前后的情况进行比较分析.结果 治疗1个月后,高压氧治疗组患者的HAMD、CSS、ADL评分均较治疗前有明显改善,与对照组比较亦有统计学差异.结论 高压氧是治疗脑卒中后抑郁症的有效方法,能够明显促进患者神经功能康复.     

高海拔地区脑卒中急性期情感障碍的临床分析

目的：探讨高海拔地区脑卒中急性期情感障碍的发生率及其相关因素,指导卒中患者的临床康复工作。方法：采用汉密顿抑郁量表、汉密顿焦虑量表、神经功能缺损程度评分及日常生活能力评定量表对522例脑卒中患者进行临床筛查。结果：522例卒中患者发生情感障碍282例（54.0%）,抑郁242例（46.4%）、焦虑192例（36.8%）、躁狂发作3例（0.6%）,均以轻度为主;从构成比看,女性高于男性,且年龄≥60岁较≤45岁情感障碍发生率明显为高（P〈0.05）;其发生与优势半球及基底节病灶、卒中后失语或言语困难、神经功能缺损程度及日常生活能力均有密切关系（P〈0.05）。结论：高海拔地区脑卒中后情感障碍发生率高,临床医生应予高度重视,早期识别、早期治疗,对提高脑卒中患者生存质量有重要意义。     

脑卒中患者抑郁情况及用药分析

目的了解卒中患者在卒中发生后抑郁症的发生及诊疗概况。方法对188例脑卒中后发生抑郁症的患者连续入组进行调查。筛查量表选用自评抑郁量表（SDS）。结果入院后,脑卒中患者发生抑郁表现的比例为50.0%,用药的构成比中,盐酸舍曲林使用频率最高。结论卒中后抑郁症状的发生率较高,但是经常被忽视或者治疗失当,耽误病情,严重影响患者的康复及生活质量,应引起临床医生的高度重视。     

舍曲林与氯丙咪嗪治疗强迫症的对照研究

目的 比较舍曲林与氯丙咪嗪治疗强迫症的临床疗效及不良反应.方法 将60例强迫症患者随机分为舍曲林组和氯丙咪嗪组,疗程均为8周.分别于治疗前和治疗后第2、4、6、8周未采用Yale-Brown强迫量表（Y-Bocs）、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评定疗效,采用副反应量表（TESS）评定不良反应.结果 舍曲林组和氯丙咪嗪组治疗后,Y-Bocs、HAMD、HAMA分值均显著下降,差异无统计学意义.舍曲林不良反应发生率明显少于氯丙咪嗪.结论 舍曲林治疗强迫症与氯丙咪嗪疗效相当,不良反应轻,值得推广.     

脑卒中后抑郁的研究现状

卒中后抑郁与卒中有着直接关系。近年来许多研究表明，卒中后抑郁与病灶部位、躯体功能障碍等因素有关，盐本氟西汀是治疗卒中后抑郁的首选用药。抗抑郁治疗不但能提高卒中患者的生活质量，而且有助于卒中后神经功能的康复。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.