飞扬肠胃炎片治疗肠易激综合征的疗效观察

目的：探讨飞扬肠胃炎片治疗肠易激综合征的疗效,为临床提供参考。方法：将本院收治的90例肠易激综合征患者随机分为治疗组与对照组,各45例,对照组给予中药汤剂进行治疗,治疗组在对照组的基础上给予飞扬肠胃炎片进行治疗,观察两组的临床疗效和不良反应,并进行统计学比较。结果：对照组临床总有效为38例,总有效率为84.4%,治疗组临床总有效为43例,总有效率为95.6%,两组间比较差异有统计学意义,P〈0.05。两组患者治疗过程中和治疗后心率、血压、肝功能等均未出现明显变化,亦无其他不良反应现象出现,两组间比较,差异无统计学意义,P〉0.05。结论：飞扬肠胃炎片辅助中药汤剂治疗肠易激综合征有明显的疗效,其疗效优于单纯应用中药汤剂组,且未见不良反应现象发生,值得临床推广应用。     

丙戊酸镁缓释片辅助治疗精神分裂症兴奋激越的效果观察

目的：评价丙戊酸镁缓释片辅助治疗伴有兴奋、激越等症状的精神分裂症患者合理性及安全性。方法：将120例伴有兴奋激越精神分裂症患者随机分为单用非典型抗精神病药物组（57例））和联用丙戊酸镁缓释片组（63例）,以阳性与阴性症状量表（PANSS）、临床疗效大体评定量表（CGI）评定疗效,副反应量表（TESS）为主评估不良反应。结果：1周后两组间PANSS（G分、S分、T分）比较有统计学意义（P〈0.05）,治疗前后均有统计学意义。6周后联用组总有效率为94．74％,单用组为87．3％（P〈0．05）。两组不良反应比较差异无统计学意义（P〉0．05）。结论：丙戊酸镁缓释片能辅助治疗精神分裂症患者的兴奋、激越等症状,起效迅速、安全。     

Changes in the relative reinforcing effects of cigarette smoking as a function of initial abstinence

Rationale  Experimental research is needed in investigating how early smoking abstinence affects relapse risk. Objective  The present study assessed the feasibility of promoting smoking abstinence using once- rather than thrice-daily abstinence monitoring and the relationship between different durations of initial abstinence and changes in smoking preference. Methods  Participants were 34 adult smokers randomized into one of two conditions: 14-day (14C) and 1-day (1C) contingent payment for smoking abstinence. Smoking status and participant ratings were assessed daily; a delay discounting task involving hypothetical money and an inter-temporal choice task involving hypothetical money and cigarettes were administered at baseline and days 7 and 14; a direct test of preference for smoking versus money was assessed on day 14. Results  Once-daily monitoring gained robust experimental control over smoking abstinence. No differences in delay discounting for hypothetical money were observed between the two conditions. Compared to the 1C condition, participants in the 14C condition (1) showed significant increases in the mean percent of delayed hypothetical money over cigarettes choices in the inter-temporal choice task, (2) were significantly less likely to ever choose the smoking option in the direct test of preference for smoking versus money, and (3) reported greater ease of abstaining from smoking and lower nicotine withdrawal and craving. Conclusions  These results offer a more efficient procedure for experimentally promoting smoking abstinence, while providing further evidence that an initial period of sustained abstinence produces a profile of changes consistent with an overall lowering of relapse risk.     

Whole-body 3D water/fat resolved continuously moving table imaging

PURPOSE: To study the feasibility of three-dimensional (3D) whole-body, head-to-toe, water/fat resolved MRI, using continuously moving table imaging technology. MATERIALS AND METHODS: Experiments were performed on nine healthy volunteers, acquiring 3D whole-body head-to-toe data under continuous motion of the patient table. Two different approaches for water/fat separation have been studied. Results of a three-point chemical shift encoding and a spectral presaturation technique were compared with respect to image quality and performance. Furthermore, fast, low-resolution, whole-body water/fat imaging was performed in two minutes total scan time to derive patient-specific parameters such as the total water/fat ratio, the intraperitoneal/extraperitoneal fat ratio, and the body mass index (BMI). RESULTS: Good water/fat separation with decent image quality was obtained in all cases. The three-point chemical shift encoding approach was found to be more efficient with respect to signal-to-noise ratio (SNR) and acquisition time. CONCLUSION: Whole-body water/fat sensitive MRI using continuous table motion is feasible and could be of interest for clinical practice. Some improvements of the method are desirable.     

A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder

There is currently controversy regarding the need for and the effectiveness of behavior modification for children with attention-deficit hyperactivity disorder (ADHD) despite years of study and multiple investigations reporting beneficial effects of the intervention. A meta-analysis was conducted by identifying relevant behavioral treatment studies in the literature. One-hundred seventy-four studies of behavioral treatment were identified from 114 individual papers that were appropriate for the meta-analysis. Effect sizes varied by study design but not generally by other study characteristics, such as the demographic variables of the participants in the studies. Overall unweighted effect sizes in between group studies (.83), pre-post studies (.70), within group studies (2.64), and single subject studies (3.78) indicated that behavioral treatments are highly effective. Based on these results, there is strong and consistent evidence that behavioral treatments are effective for treating ADHD.     

地震后医护人员心理卫生状况的调查分析

目的调查地震灾害一年后在都江堰市工作的医护人员心理卫生状况和相关因素,为以后开展心理咨询和治疗提供科学依据。方法采用症状自评量表（SCL-90）,对灾区都江堰市8家医院的220名医护人员（调查组）和非受灾区崇州市7家医院的213名医护人员（对照组）进行心理健康评定比较并同时与全国常模比较,对结果进行分析。结果SCL-90显示,都江堰市8家医院的220名医护人员除人际关系敏感外,其他相关因子分数均高于全国常模,P〈0．05。结论地震一年后,都江堰市基层工作的医护人员依然存在心理健康问题,心理健康情况总体低于全国常模水平。在帮助受灾病人的同时,他们也受到地震冲击,应给予他们心理支持,使他们尽早走出心理阴影。     

基于分布式哈希表的电子病历共享和存储网络

提出一种基于分布式哈希表的电子病历及其位置信息的存取模型,以此为基础建立了分层的病历共享网络架构,以及医疗机构间和区域间病历共享和数据同步的机制,讨论了网络拓扑参数的分析计算方法。该方案具有结构简单、伸缩性好、对服务器带宽和响应性能要求低、管理成本低、易于分析和优化的特点。     

The investigation of syncope

Patients with syncope are usually referred to either neurology or cardiology clinics, yet the facilities for detailed syncope investigation are mostly in cardiac units. The diagnosis rests principally upon the history, but investigations may be required to support the clinical diagnosis. Close collaboration between the epilepsy clinician and a cardiologist is essential for effective investigation and safe management of syncope. It is frequently misdiagnosed and often erroneously treated as epilepsy. Furthermore, it is potentially a marker of sudden death when associated with certain cardiac disorders. Here we review the main syncope types and explore diagnostic approaches.     

Tilt Training: A Treatment for Malignant and Recurrent Neurocardiogenic Syncope

The treatment of neurocardiogenic syncope is insufficient in many cases. We hypothesized that the repeated exposure of the cardiovascular system to orthostatic stress could have a therapeutic effect on the regulation of cardiovascular reflex mechanisms. We have started a program of tilt training for heavily symptomatic patients. After hospital admission, patients were tilted daily (60-degree inclination), until syncope, or until a maximum of 45–90 minutes. The patients were instructed to continue a program of daily tilt training at home: two 30-minute sessions of upright standing against a vertical wall. No medication was prescribed. A total of 260 tilt table sessions were performed in 42 patients. The first tilt test was positive after 21 ± 13 minutes. The syncope was cardioinhibitory in 14 cases, vasodepressor in 19, mixed in 9. At the time of hospital discharge, 41 patients could support 45 minutes of head-up tilting. After a mean follow-up time of 15.1 (SD 7.8) months, 36 patients remained completely free of syncope. Syncope still occurred in one patient and presyncope in four patients. One patient died from an extensive myocardial infarction. The abnormal autonomic reflex activity of neurocardiogenic syncope can be remedied by a program of continued tilt training without the administration of drugs. This new treatment has proven to be effective for the vasodepressor and the cardioinhibitory type of syncope.     

Determinants of a positive response to carotid sinus massage and head-up tilt testing

BackgroundOrthostatic hypotension (OH) and carotid sinus hypersensitivity (CSH) are common causes of syncope in older people. The aim of this study was to determine if patient's age, sex and presenting symptoms influence the result of carotid sinus massage and head-up tilt testing.MethodsRetrospective analysis of the database and reports was carried out between 1995 and 2006 at a tertiary referral centre. Patient's age, sex, presenting symptoms and test result were examined. Presenting symptoms were classified as syncope, falls or dizzy spells.ResultsOf the 1583 tests reported, OH was present in 402 patients (25.4%), of whom 175 (11.1%) were symptomatic. 188 of 1464 (12.8%) patients undergoing carotid sinus massage had evidence of CSH, of which 156 were symptomatic.Male patients were significantly more likely to have symptomatic CSH than female patients (odds ratio 2.28, 95% CI 1.54 to 3.04, p < 0.01).There were non-significant trends to increased diagnosis of symptomatic OH with increasing age, male sex and referral with syncope. There were non-significant trends to increased diagnosis of symptomatic CSH with increasing age and referral with syncope.ConclusionMale sex, increasing age and being referred with syncope were all associated with an increased likelihood of receiving a diagnosis of either OH or CSH. The overall prevalence of CSH was lower than in previous studies, which may reflect different patient populations.