五子衍宗汤治疗肾虚髓减型帕金森病轻度认知功能障碍临床研究

目的:观察五子衍宗汤治疗肾虚髓减型帕金森病轻度认知功能障碍(PD-MCI)对患者血清尿酸(UA)、同型半胱氨酸(Hcy)含量的影响。方法:选取符合纳入标准的PD-MCI肾虚髓减型患者91例,采用随机数字表法将所有研究对象分为2组。对照组45例给予盐酸多奈哌齐片治疗,观察组46例在对照组治疗方案的基础上给予五子衍宗汤治疗。观察2组治疗6周后、治疗12周后的临床疗效、中医证候积分、简易智力状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、血清UA以及血清Hcy的含量。结果:临床总有效率观察组93.48%,高于对照组71.11%,差异有统计学意义(P0.05)。治疗6周后、治疗12周后,2组中医证候积分、血清Hcy含量较治疗前明显降低,呈逐渐降低趋势,观察组中医证候积分、血清Hcy含量均显著低于同期对照组,差异均有统计学意义(P0.01);2组MMSE、MoCA评分及血清UA含量均较治疗前明显提高,呈逐渐升高趋势,观察组MMSE、MoCA评分及血清UA含量均显著高于同期对照组,差异均有统计学意义(P0.01)。治疗后,2组经血常规、肝功能、肾功能、心电图、血压、心率等检查,均未发现异常现象。结论:针对肾虚髓减型PD-MCI患者给予五子衍宗汤治疗可提高临床疗效,缓解患者临床症状,改善患者认知功能障碍及血清UA、Hcy含量,且安全性良好。     

亚急性联合变性病的病因护理6例

亚急性联合变性病(subacutecombineddegeneration,SCD)是维生素B12缺乏所引起的脊髓变性疾病。临床上以脊髓后索和侧索联合损害为特发性改变,表现为肢体深感觉障碍,感觉性共济失调,痉挛性截瘫及伴发周围神经病,巨幼红细胞贫血。在我国此病非常少见,近年有上升趋势。我院2003年7月～2004年9月共收治SCD病人6例,针对其发病原因,在护理过程中我们结合治疗对病人进行饮食、用药及心理护理,取得良好的效果,现将护理报告如下。临床资料1.一般资料。男4例,女2例,年龄21～71岁,平均年龄51岁。6例中素食者1例;家住偏远山区、经济条件差、饮食差2例…     

3例腕部头静脉输液致桡神经浅支卡压综合征原因探讨

Dellon[1]1986年首次报道了桡神经浅支卡压综合征,认为该病在临床上并不少见,是腕部疼痛的重要原因,常见病因为腕部反复活动或局部外伤、扭伤致长期频繁牵拉、摩擦桡神经浅支,造成该神经行程中卡压、粘连,病人出现腕部及手背桡侧半麻痛不适,以致影响患手用力活动.     

The Effectiveness of Cross-Tapering Switching to Ziprasidone in Patients with Schizophrenia or Schizoaffective Disorder

Objective

Switching antipsychotics is one useful therapeutic option when the treatment of schizophrenia encounters suboptimal efficacy and intolerability issues. This study aimed to investigate the efficacy and tolerability of cross-tapering switching to ziprasidone from other antipsychotics.

Methods

A total of 67 patients with schizophrenia or schizoaffective disorder were recruited in this 12-week, multicenter, non-comparative, open-label trial. Prior antipsychotics were allowed to be maintained for up to 4 weeks during the titration of ziprasidone. Efficacy was primarily measured using the 18-item Brief Psychotic Rating Scale (BPRS) at baseline, 4 weeks, 8 weeks, and 12 weeks. Efficacy was secondarily measured by the Clinical Global Impression-Severity (CGI-S) scale and the Global Assessment of Functioning (GAF) scale at each visit. Regarding the metabolic effects of switching to ziprasidone, weight, body mass index (BMI), waist-to-hip ratio (WHR), and lipid profile-including triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol levels-were measured at each follow-up visit.

Results

The BPRS scores were significantly improved at 12 weeks after switching to ziprasidone (F=5.96, df=2.11, p=0.003), whereas the CGI-S and GAF scores were not significantly changed. BMIs, WHRs, and TG levels were significantly decreased, with no significant changes in other lipid profiles.

Conclusion

Cross-tapering switching to ziprasidone is effective for patients with schizophrenia spectrum disorders. Beyond the efficacy of the procedure, favorable metabolic profiles show that switching to ziprasidone may be helpful for maintenance therapy over an extended period.     

Characterization of twenty-six microsatellite markers for the tropical pioneer tree species Cecropia insignis Liebm (Urticaceae)

Cecropia insignis is an ecologically important Neotropical pioneer tree and major vertebrate food source. Although this species is relatively common in faunally intact tropical rainforests, its population dynamics may be negatively impacted by hunting of seed-dispersing animals. To better understand gene flow and regeneration dynamics in C. insignis, we characterized 26 microsatellite markers in a population sampled from Barro Colorado Island, Panama. Eleven loci of ≥3 alleles were tested on 48 individuals, whereas the remaining 15 loci of two alleles were tested on 12 individuals. Allelic richness ranged from 2 to 9 per locus. Observed and expected heterozygosity averaged 0.478 and 0.440 respectively. Polymorphism information content was between 0.141 and 0.757. Only two loci exhibited deviation from Hardy–Weinberg proportions.     

体温测量时间的研究与护理对策

体温，也称体核温度，是指身体内部胸腔、腹腔和中枢神经的温度；其特点是相对稳定且较皮肤温度高。测量体温的目的是判断体温有无异常；动态监测体温变化，分析热型及相伴症状；协助诊断，为预防、治疗、康复、护理提供依据。目前，体温的测量部位主要有直肠、口腔和腋窝。测直肠温度时，将温度计插入直肠3cm以上，一般测量温度为3min。口腔（舌下部）是广泛采用的测温部位，其特点是所测温度值比较准确，测量也较为方便；但对不能配合的病人，如婴幼儿、精神异常、昏迷、口腔疾患等病人不宜测口温。腋窝皮肤表面温度较低，只有让被测者将上臂紧贴其胸廓，使腋窝紧闭形成人工体腔，机体内部的热量才能逐渐传导过来，使腋窝的温度逐渐升高至接近于体核的温度水平。因此测定腋窝温度时，时间至少需要10min左右。测量腋下体温操作方便，但存在的缺点是由于腋下测温是通过皮肤测量温度，故较其他两种方式所需的测量时间较长。