氨磺必利联合丙戊酸钠治疗酒精所致精神障碍的临床效果及预后分析

目的评价氨磺必利联合丙戊酸钠治疗酒精所致精神障碍(mental disorder induced by alcohol,MDIA)的临床疗效与安全性。方法选择2015年6月～2017年5月66例男性MDIA患者,根据随机数字表法分为研究组和对照组,研究组予氨磺必利联合丙戊酸钠治疗,对照组予氨磺必利治疗,应用阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、不良反应症状量表(Treatment Emergent Symptom Scale,TESS)评价临床治疗效果和用药安全性。结果研究组总有效率96.97%,高于对照组的81.82%,差异有统计学意义(P0.05);研究组患者治疗后PANSS评分逐渐降低,两组比较,差异有统计学意义(F=6.937,P0.05);研究组不良反应率9.09%,对照组6.06%,两组比较,差异无统计学意义(χ~2=0.926,P0.05);两组TESS评分比较,差异无统计学意义(F=0.234,P0.05)。结论氨磺必利联合丙戊酸钠可提高治疗MDIA效果,安全性高。     

氨磺必利与丙戊酸镁缓释片治疗酒精性精神障碍的临床观察

目的探讨分别采用氨磺必利与丙戊酸镁缓释片治疗由酒精性所致的精神障碍（MDIA）患者,观察并比较两组用药的临床疗效与安全性。方法选取我院2011年至2013年接收的酒精性精神障碍患者80例,以中国精神障碍分类与诊断标准（CCMD）中有关酒精所致精神障碍的诊断标准,按就诊先后顺序平均分为两组,即观察组与对照组,每组各40例。观察组给予氨磺必利进行治疗,对照组给予丙戊酸镁缓释片进行治疗。连续治疗观察8周,在第2周和第8周末分别用阳性与阴性综合征量表（PANSS）来评定其临床治疗效果,用症状量表（TETT）评定其不良反应。观察并比较两组PANSS及TETT得分,对比两组治疗有效率。结果治疗2周末两组PANSS和TETT得分以及治疗有效率并无明显差异（P〉0．05）。治疗第8周末,观察组PANSS评分比对照组下降明显（P〈0．05）;观察组TETT评分与对照组相比无明显差异（P〉0．05）;观察组总有效人数38例（95％）,对照组总有效人数31例（77．5％）,两组相比差异具有统计学意义（P〈0．05）。结论氨磺必利与治丙戊酸镁缓释片疗酒精性精神障碍（MDIA）患者均有效,且治疗效果安全确切,但氨磺必利总有效率高于丙戊酸镁缓释片。     

氨磺必利与奋乃静治疗精神分裂症的疗效研究

目的：比较氨磺必利和奋乃静两种药物治疗精神分裂症的安全性和疗效。方法选择符合ICD-10诊断标准的精神分裂症患者60例,随机分为研究组和对照组,各30例。择取阳性与阴性症状量表,即PANSS,对2组患者的临床治疗效果进行评定,并通过不良反应量表,即TESS,对基线和治疗12周末的安全性进行评估。结果治疗12周末,研究组PANSS阴性评分及TESS量表评分低于对照组,差异有统计学意义（P＜0.05）,而2组患者治疗后的PANSS阳性评分、病理性症状评分以及总分数据对比,组间差异无统计学意义;2组总有效率分别为83.3%和86.7%,2组间差异无统计学意义。结论氨磺必利与奋乃静治疗精神分裂症疗效相当,但氨磺必利对阴性症状疗效更好,且氨磺必利不良反应小。     

氨磺必利与利培酮治疗首发精神分裂症疗效和安全性对照研究

目的：分析比较氨磺必利和利培酮治疗首发精神分裂症的疗效和安全性。方法选取精神分裂症患者86例,将其按照年龄、性别、病情等情况随机均分为对照组和试验组（n=43）。试验组患者采用氨磺必利治疗,对照组患者采用利培酮治疗。对2组患者分别治疗8周。利用阳性和阴性症状量表（PANSS）、卡尔加精神分裂症抑郁量表（CDSS）评定患者治疗前和治疗8周后的反应,用症状量表（TESS）评定不良反应。结果治疗8周后,试验组患者的PANSS量表减分以及CDSS减分均显著高于对照组患者,2组比较差异具有统计学意义（P<0.05）。试验组患者的不良反应率与对照组患者基本相似,差异无统计学意义。讨论氨磺必利和利培酮疗效基本相似,但氨磺必利能较好改善患者的阴性症状以及情感症状,发生的不良反应少,对患者体重以及泌乳素影响较小。     

温胆汤联合氨磺必利治疗难治性精神分裂症的对照研究

目的观察温胆汤联合氨磺必利治疗难治性精神分裂症的疗效和安全性。方法将72例难治性精神分裂症患者随机分为研究组和对照组,研究组口服温胆汤联合氨磺必利治疗,对照组单独口服氨磺必利治疗,观察12周。于治疗前、治疗后4、8、12周末观察阳性与阴性症状量表(PANSS)评分,观察两组治疗后临床疗效及不良反应情况。结果研究组治疗后有效率为72. 73%,对照组为51. 61%,两组比较差异有统计学意义(P 0. 05)。两组患者治疗12周后PANSS评分与本组治疗前比较均有降低,差异具有统计学意义(P 0. 01);两组患者治疗后各时间段评分比较,差异无统计学意义(P 0. 05)。研究组锥外系反应震颤、静坐不能的发生率明显低于对照组(P 0. 05)。结论温胆汤联合氨磺必利治疗难治性精神分裂症疗效好,安全性高,是治疗难治性精神分裂症的一个新途径、新方法。     

氨磺必利与喹硫平治疗老年精神分裂症对照研究

目的：比较氨磺必利与喹硫平治疗老年精神分裂症的疗效与安全性。方法将2013年10月—2014年6月该院收治的80例老年精神分裂症患者随机分为氨磺必利组和喹硫平组各40例,分别给予氨磺必利和喹硫平治疗,疗程10周。采取阳性和阴性症状量表（PANSS）、临床疗效总评量表（CGI）评定临床疗效;不良反应量表（TESS）评定不良反应。结果两组治疗后各时点PANSS总分、各因子分及CGI评分均显著降低（P<0.05）。组间比较,氨磺必利组阴性症状分在治疗6周(t=2.3065,P<0.01)、10周(t=2.2677,P<0.01)明显优于喹硫平组。两组显效率（χ2=0.050,P>0.05）和有效率（χ2=2.005,P>0.05）差异无统计学意义。两组不良反应较少。结论氨磺必利治疗老年精神分裂症安全有效。     

氨磺必利与奥氮平治疗女性精神分裂症患者的对照研究

目的 比较氨磺必利与奥氮平治疗女性精神分裂症患者的疗效及安全性.方法 采用随机、单盲对照的方法,将100例女性精神分裂症患者随机均分为2组(n=50),分别使用氨磺必利(氨磺必利组)和奥氮平(奥氮平组)治疗8周,采用阳性症状与阴性症状(PANSS)量表评定疗效,采用副反应(TESS)量表评定不良反应.结果 经过8周治疗,氨磺必利组和奥氮平组显效率分别为76.6%和72.9%,2组疗效差异无统计学意义(U=0.167,P>0.05);但治疗4周末氨磺必利组阴性症状分较奥氮平组减少更显著(P<0.05).而氨磺必利和奥氮平组的不良反应发生率分别为38.3%和45.8%,差异无统计学意义,但奥氮平组嗜睡和体质量增加指标显著高于氨磺必利组,差异具有统计学意义(P<0.05),其他不良反应发生率差异无统计学意义.结论 氨磺必利是一种安全有效的抗精神病药,较适合女性精神分裂症患者的临床治疗.     

氨磺必利、利培酮治疗初治精神分裂症患者的效果比较

目的:比较氨磺必利、利培酮治疗初治精神分裂症患者的效果。方法:选择88例精神分裂症患者作为本次研究对象,按照随机数字表法将患者分为研究组和对照组各44例。研究组行氨磺必利治疗,对照组行利培酮治疗,两组均连续治疗8周。结果:治疗前,两组PANSS量表评分比较,差异无统计学意义(P>0.05);治疗后,两组PANSS量表评分明显低于治疗前,且研究组明显低于对照组,不良反应发生率明显低于对照组,差异有统计学意义(P<0.05);研究组治疗依从性优率为84.09%,明显高于对照组的47.73%,差异有统计学意义(P<0.05)。结论:氨磺必利治疗初治精神分裂症患者的效果优于利培酮,且不良反应发生率较低。     

齐拉西酮联合丙戊酸钠治疗难治性精神分裂症的效果分析

目的探讨齐拉西酮联合丙戊酸钠对难治性精神分裂症的治疗效果与不良反应。方法分析78例难治性精神分裂症住院患者资料。其中口服齐拉西酮联合丙戊酸钠40例、齐拉西酮38例。以阳性和阴性症状评定量表（PANSS）和不良反应症状量表（TESS）进行评定。结果第8周末,联合治疗组和齐拉西酮组的有效率分别为75.0%、52.8%,二者差异有统计学意义（P〈0.01）;两组治疗第8周各项评分均较治疗前下降（P〈0.01）,治疗后联合治疗组较齐拉西酮组PANSS评分下降明显（P〈0.01）,两组不良反应差异无统计学意义（P〉0.05）。结论齐拉西酮联合丙戊酸钠治疗难治性精神分裂症疗效较佳,安全性高。     

氨磺必利与利培酮治疗首发精神分裂症疗效对比

目的对比分析氨磺必利与利培酮治疗首发精神分裂症的临床疗效。方法选取研究对象随机分为两组,研究组和对照组分别使用氨磺必利和利培酮;对比两组的疗效。结果两组患者的治疗有效率没有明显差异(P 0.05);对照组的PANSS阳性减分、PANSS阴性减分、PANSS总减分以及CDSS减分均明显低于研究组,两组间的差异具有统计学意义(P0.05)。结论氨磺必利与利培酮治疗首发精神分裂症都有效,但是氨磺必利对阴性症状以及抑郁的治疗更好。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.