女性抗精神病药物源性内分泌紊乱的中药治疗

目的:观察中药二陈汤加减对女性患者抗精神病药物(AP)源性脂质代谢及内分泌紊乱的疗效及安全性,并探讨女性抗精神病药物源性内分泌紊乱的机制。方法:对44例符合入组标准的女性精神分裂症患者进行治疗,总疗程30天。所有患者在服用中药治疗前后检测血清催乳素(PRL)、雌二醇(E2)、睾酮(T)。并于治疗前后分别做心电图、血常规及尿常规检查。结果:治疗后患者血清催乳素、睾酮水平均下降,且与治疗前有显著性差异(P<0.01);雌二醇水平较治疗前显著上升(P<0.01)。治疗前后的心电图及血、尿常规检查亦未发现明显改变。结论:中药二陈汤加减有显著降低血清催乳素及睾酮水平以及提高血清雌二醇水平的作用,改善AP源性内分泌紊乱;且安全性较好,是一种治疗抗精神病药物源性内分泌紊乱的较为理想的方药。     

Efficacy of HuaDan Anshen Mistura for treating insomnia: a randomized,double-blind,placebo-controlled,multi-center clinical trial

Objective

To evaluate the effect of HuaDan Anshen Mistura (mistura) in clinical treatment of Chinese patients with insomnia.

Methods

In this randomized, double-blind, placebo-controlled, multi-center study, 244 patients with insomnia were randomly assigned to a placebo group, a low-dose (10 mL/day), or a high-dose (20 mL/day) mistura group. Efficacy was assessed by using the sleep dysfunction rating scale (SDRS) and Clinical Global Impression-Improvement (CGI-I) scores. Safety and tolerability assessments included emergent adverse events, laboratory tests, and electrocardiograms.

Results

Total SDRS scores decreased in all three groups, and there were significant differences between the placebo group and the low- and high-dose mistura groups (P=0.000). CGI-I ratings in the low- and high-dose mistura groups were significantly better than that of the placebo group (P=0.000). Incidences of rebound insomnia were similar in all three groups (placebo group: 6.94%, low-dose mistura group: 12.99%, and high-dose mistura group: 10.96%; P=0.475). The efficacy of HuaDan Anshen Mistura in the low- or high-dose group was significantly better than that of the placebo group (P=0.000), but with no significant difference found between the low- and high-dose mistura groups (P=0.887). The rates of adverse events were similar in the three groups (placebo 2.44%, low-dose mistura 0%, and high-dose mistura 5%; P=0.088).

Conclusion

HuaDan Anshen Mistura is an effective and generally well-tolerated hypnotic medicine for the treatment of Chinese patients with insomnia.     

电针治疗鼻咽癌放疗后吞咽障碍疗效观察

目的观察电针治疗鼻咽癌放疗后吞咽障碍的临床疗效。方法将40例鼻咽癌放疗后出现吞咽障碍的患者随机分为治疗组和对照组,每组20例。对照组给予营养神经、改善微循环、神经生长因子、康复理疗等基础治疗,治疗组在对照组治疗基础上采用电针治疗。采用洼田饮水试验评定两组治疗前后吞咽功能,并比较两组临床疗效。结果治疗组治疗后吞咽功能评分与对照组比较,差异无统计学意义(P>0.05)。治疗组总有效率为80.0%,对照组为50.0%,两组比较差异具有统计学意义(P<0.05)。结论电针是一种治疗鼻咽癌放疗后吞咽障碍的有效方法。     

Risk/benefit ratio of long-term treatment withβ 2-adrenoceptor agonists

Optimal control of chronic obstructive airway disorders is usually achieved with therapy based onβ ₂-adrenoceptor agonist administration. Aerosols are highly effective, have few side effects, allow for fine adjustment of dosage to titrate symptoms, and result in reduction in hyperreactivity. Equivalent bronchodilating doses of oral agents cause side effects that limit acceptability. With oral agents, cardiohemodynamic disturbances are usually minor, while tremor and restlessness diminish with continued drug use. In chronic regimens, an aerosolβ ₂-adrenergic agent should be chosen whose overall incidence of side effects is less than 5%, and an oral agent that produces no more than a 10% incidence of tremor. Suboptimal oral dosages in combination with maximal dosages ofβ ₂-agonist aerosol, with or without other bronchodilator drugs, are advisable for chronic therapy. An optimal risk/benefit ratio with broxaterol therapy will probably be achieved by using an aerosol-oral combination. Thus, broxaterol, a newβ ₂-agent, should be studied further to determine its value in chronic bronchospastic disorders.     

Factors associated with severe maternal outcomes in patients with eclampsia in an obstetric intensive care unit: A cohort study

To describe the clinical profile, management, maternal outcomes and factors associated with severe maternal outcome (SMO) in patients admitted for eclampsia.A retrospective cohort study was carried out. All women admitted to the Obstetric Intensive Care Unit (ICU) at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Northeast of Brazil, from April 2012 to December 2019 were considered for inclusion and patients with the diagnosis of eclampsia were selected. Patients who, after reviewing their medical records, did not present a diagnosis of eclampsia were excluded from the study. Severe maternal outcome (SMO) was defined as all cases of near miss maternal mortality (MNM) plus all maternal deaths during the study period. The Risk Ratio (RR) and its 95% confidence interval (95% CI) were calculated as a measure of the relative risk. Multiple logistic regression analysis was performed to control confounding variables. The institute''s internal review board and the board waived the need of the informed consent.Among 284 patients with eclampsia admitted during the study period, 67 were classified as SMO (23.6%), 63 of whom had MNM (22.2%) and 5 died (1.8%). In the bivariate analysis, the following factors were associated with SMO: age 19 years or less (RR = 0.57 95% CI 0.37–0.89, P = .012), age 35 years or more (RR = 199 95% CI 1.18–3.34, P = .019), the presence of associated complications such as acute kidney injury (RR = 3.85 95% CI 2.69–5.51, P < .001), HELLP syndrome (RR = 1.81 95% CI 1.20–2.75, P = .005), puerperal hemorrhage (PPH) (RR = 2.15 95% CI 1.36–3.40, P = .003) and acute pulmonary edema (RR = 2.78 95% CI 1.55–4.96, P = .008). After hierarchical multiple logistic regression analysis, the factors that persisted associated with SMO were age less than or equal to 19 years (ORa = 0.46) and having had PPH (ORa = 3.33).Younger age was a protective factor for developing SMO, while those with PPH are more likely to have SMO.     

贵州儿童甲状腺肿消长情况追踪调查与分析

目的 探讨实施全民食盐加碘(USI)措施后，贵州省儿童甲状腺肿(甲肿)及其消长规律。方法 2001年4月采用点面结合的“典型调查”方法调查贵州省儿童的甲状腺肿情况，2003年10月采用群体追踪调查的方法，对2001年调查的同一人群开展甲肿消长情况的流行病学现况追踪调查。结果 2003年共有效追踪调查了1702名学生。其中在240例原检出Ⅰ度甲肿的学生中，139例转变为正常，转变率57．92％。15例转变Ⅱ度，转变率为6．25％。86例未改变，占35．83％。在28例原检出Ⅱ度甲肿的学生中，7例转为正常，2例转为I度，总体转变率42．86％。在追踪调查的1434名正常学生中，新发甲肿率为6．69％。结论 贵州省8～10岁儿童甲肿率逐年下降，但降幅非常缓慢，儿童甲肿多数会随时间推移自行减轻或恢复正常，只有少数会加重。     

Analysis of JAK2(V617F) mutation in Chinese patients with myeloproliferative disorders

It is now well-recognized that the activating JAK2(V617F) mutation occurs in the majority of patients with polycythemia vera (PV) and approximately half of those with either essential thrombocythemia (ET) or myelofibrosis with myeloid metaplasia (MMM). Here we analyzed JAK2(V617F) mutation in 137 Chinese patients with myeloproliferative disorders by allele-specific polymerase chain reaction (PCR). DNA was extracted from methanol/acetic acid-fixed cells that had been routinely prepared for cytogenetic analysis. A single point mutation (Val617Phe) was identified in JAK2 in 42 (73.7%) of 57 patients with PV, 40 (58.8%) of 68 with ET, and eight (66.7%) of 12 with MMM.