酒精所致精神障碍52例临床分析

对2054例住院病人进行回顾性临床分析中,发现有52例诊断为酒精所致精神障碍,发生率为2.53%,均为男性,平均年龄44.2±9.0岁,发生率呈逐年增加趋势。嗜酒的原因与遗传、职业、文化水平、民族风俗有关,黎族患者占27例(51.92%)。临床以幻觉、被害妄想、妒嫉妄想、行为障碍为多见。治疗:使用奋乃静23例(44.23%)的频率较高,显效率88.46%。长期大量酗酒,可致躯体损害,复发达11例(21.15%)。早期限制及戒酒可减少躯体的损害。     

A preliminary study of serotonergic antidepressants in treatment of dysthymia

Rosenthal, Jesse et al. A Preliminary Study of Serotonergic Antidepressants in the Treatment of Dysthymia. Prog. Neuro-Psychopharmacol. & Biol. Psychiat. 1992, 16(6): 933–941.

1. 1. There is increasing evidence that antidepressants may alleviate symptoms of dysthymia, but few prior studies on selective serotonergic agents.

2. 2. Twenty patients meeting criteria for dysthymia, but not meeting criteria for major depression, received open label trials of a serotonergic antidepressant, either fluoxetine or trazodone.

3. 3. Seventeen (85%) completed three-month medication trials, and of these, twelve (70.6% of completers) responded to treatment. Seven (41.2% of completers) were still in remission on followup at five months.

4. 4. Both fluoxetine and trazodone were well tolerated in dysthymics, and showed similar short-term effectiveness in treating dysthymic symptoms.

α-L-岩藻糖苷酶测定的临床应用

研究结果表明AFU测定对肝癌的诊断具有较高的敏感性和特异性，其价值优于AFP，两项指标联合检测可提高阳性检出率。动态监测有利于肝癌的早期诊断、鉴别诊断，并可作为转移、复发的指标，也可用于白血病及卵巢癌的诊断。     

Systematic Reviews on the Basis of Methodological Criteria

This paper describes a method of systematic reviewing. This method puts much emphasis on the methodological quality of the randomised clinical trials involved. Various items concerning the internal validity, precision and relevance of the studies are scored in such a way that next to the methodological quality the amount of uncertainty about it also becomes visible. These quality assessments are not only useful for systematic reviews, but also have an educational function for researchers with respect to the design and publication of a clinical trial.     

Pattern of renal dysfunction in analgesic nephropathy--comparison with glomerulonephritis.

Comprehensive renal function tests were performed in 84 patients with analgesic nephropathy, 33 glomerulonephritis patients matched for creatinine clearance, and 30 control subjects. A system of 1-day renal function tests including urine microscopy, creatinine clearance, phenolsulphonphthalein excretion, urine concentration and acidification, and electrolyte excretion, was used. Patients with analgesic nephropathy were found to have significant sterile pyuria and haematuria, even those with mild renal insufficiency, significantly reduced concentrating ability and a distal acidifying defect, and a tendency to impaired sodium conservation. These function defects are consistent with the primary lesion of renal papillary necrosis in analgesic nephropathy; the detection of these defects have implications in patient management.     

胃复春片对慢性胃病患者窦D细胞的影响

目的：探讨胃复春片治疗慢性胃病患者前后生长抑素内分泌细胞(D细胞)数量变化。方法：用免疫组化酶链亲合素过氧化酶复合技术(SABC)对患者治疗前后胃粘膜组织的D细胞染色，观察治疗前后D细胞的形态和数量变化。结果：经胃复春片治疗后，患者胃窦粘膜D细胞阳性数及强阳性率均明显下降，有显著意义。结论：胃复春片对慢性胃病患者生长抑素D细胞有调整作用。     

中药饮片加工炮炙在临床中的意义

本文简述了中药炮炙的根据、原理、方法以及各种不同辅料和炮炙方法对饮片药性与作用的影响。说明不同的炮炙方法可以直接影响和改变中药的药性和作用,影响到临床疗效,因此,必须重视中药饮片的炮炙工作。以确保临床安全有效的用药。     

A Comparative Study of the Percutaneous versus Intraoral Technique for Mental Nerve Block

Objective: Mental nerve block is frequently used to aid repair of facial lacerations; both percutaneous and intraoral approaches to blocking this nerve are used, but have never been compared. The authors compared the two techniques for pain of administration and effectiveness of anesthesia. Methods: A prospective, randomized, single-blind, crossover study was conducted using ten healthy volunteers aged 22 to 33 years. Patients having prior experience with mental nerve blocks, lidocaine allergy, active oral/facial infection, or previous facial fractures were excluded. Bilateral mental nerve blocks were done using intraoral technique on one side and percutaneous technique on the other. Both techniques were used by the same investigator and were carried out with 27-gauge needles and 2.5 mL of 2% buffered lidocaine at room temperature injected over 20 seconds. The oral mucosa was topically anesthetized with viscous lidocaine for 1 minute prior to intraoral injection. The orders of the blocks and sides of the face anesthetized were randomized. Subjective and objective pain (visual-analog scale), efficacy (anesthesia of lower lip), time to onset, and duration of anesthesia were evaluated. Results: The intraoral technique was subjectively less painful than the percutaneous approach in nine of ten subjects (p = 0.02). Scores on the visual-analog pain scale were significantly lower for the intraoral technique (p = 0.03). Intraoral injection produced lower-lip anesthesia in 10/10 subjects versus 7/10 for percutaneous (p = 0.25). Times to onset (approximately 1–2 minutes) and durations of anesthesia (approximately one hour) were similar for the two techniques. Conclusion: The intraoral approach to the mental nerve block with adjunctive topical anesthesia was subjectively and objectively less painful than the percutaneous approach without adjunctive anesthesia. While the intraoral approach had a greater efficacy of lower-lip anesthesia and a longer duration of action, these differences were not statistically significant.