穴位注药治疗精神分裂症的研究

目的　观察穴位注射丹参合并小剂量抗精神病药物与单用抗精神病药物治疗精神分裂症的疗效。方法16 0例患者随机分为治疗组 10 0例 ,对照组 6 0例 ;辨证分为 5型 ,用阴阳经相配取穴的方法 ,根据疾病的虚实 ,用迎随和徐疾补泻手法 ,治疗组每日注射 1次 ,10次为 1疗程 ,共治疗 3个疗程 ;用简明精神症状量表 (BPRS)和药物副反应量表 (TESS)评定疗效和副反应 ,治疗结束后随访两年。结果　治疗组痊愈率、显效率与对照组间差异有显著性意义 (P <0 0 5 )。BPRS和TESS量表于每疗程结束后两组评分比较差异均有显著性意义 (P <0 0 5 ) ;复发率与对照组间差异有显著性意义 (P <0 0 5 )。结论　穴位注射丹参具有见效快、副作用少、远期疗效好的特点。实施有效的护理 ,适时的健康教育是提高患者依从性 ,保证有效治疗、取得良好效果的重要手段。     

参麦注射液治疗心绞痛的临床观察

目的　探讨参麦注射液对冠心病 (CHD)心绞痛的治疗作用。方法　 80例患者分为两组 ,每组 4 0例 ,在常规治疗的基础上 ,对照组应用丹参注射液进行治疗 ,治疗组应用参麦注射液进行治疗。结果　治疗组有效 39例 (97.5 % ) ,心电图改善 38例 (95 .0 % ) ,对照组分别为 31例 (77.5 % )和 2 9例 (72 .5 % ) ,组间比较具有显著性差异 (P <0 .0 1)。结论　参麦注射液对冠心病心绞痛疗效显著 ,且安全、无明显副作用     

复方麝香注射液联合脑血肿引流术治疗中老年高血压脑出血疗效观察及费用对比

目的:探讨复方麝香注射液联合微创手术治疗中老年高血压脑出血的临床疗效.方法:将78例接受微创治疗的患者随机分组,两组均采用内科综合治疗.手术对照组在综合治疗基础上加用微创手术进行脑血肿引流;中西医结合组在微创手术治疗后加用复方麝香注射液(10～20 ml/d)静脉滴注1周.结果:中西医结合组显效率(66.67%)、有效率(82.05%)均明显高于手术对照组(46.15%和69.23%,P均<0.05),存活患者日常生活能力也明显优于手术对照组(P<0.05),意识恢复时间明显短于手术对照组(P<0.05),并发症的发生率(15.38%)明显低于手术对照组(38.46%,P<0.01),病死率(5.13%)明显低于手术对照组(10.26%,P<0.01),平均住院天数[(18.29±4.93)d]明显少于手术对照组[(26.23±5.82)d,P<0.05],平均住院费用[(5 916.23±826.39)元]明显少于手术对照组[(8 168.35±1 021.21)元,P<0.05].结论:脑血肿引流术后加用复方麝香注射液治疗中老年高血压脑出血,可降低病死率,减少并发症,降低病残程度,提高生存患者的生活质量,缩短住院时间,降低治疗费用.     

Epidural block for obstetrics: Comparison of bolus injection of local anesthetic with gravity flow technique

Study Objective: To test the hypothesis that slow administration of local anesthetic into the epidural space by gravity flow reduces the incidence of signs and symptoms of unintended injection.

Design: Prospective, randomized study.

Setting: Teaching hospital.

Patients: 600 ASA physical status I and II parturients scheduled for labor and delivery or elective cesarean section.

Interventions: After identification of the epidural space with pulsations of an air-fluid column, parturients for vaginal delivery (n = 380) were randomized to receive a test dose of 3 ml 3% 2-chloroprocaine with epinephrine 20 μg, two doses of 7 ml bupivacaine 0.03 % with sufentanil 1 μg/ml and epinephrine 2 μg/ml by either gravity flow (Group 1) given over 30 seconds or by bolus injection (Group 2) given over 5 seconds through the epidural needle; parturients for Cesarean delivery (n = 220) were randomized to receive a test dose and two doses of 6 ml lidocaine 2 % with sufentanil 1 μg/ml and epinephrine 2 μg/ml by either gravity flow or by bolus injection through the epidural needle. Changes in maternal heart rate (HR) and blood pressure, signs of intravascular injection, and adverse effects of epidural bupivacaine-sufentanil were recorded after each dose.

Measurements and Main Results: Gravity flow administration (Group 1) was associated with a smaller increase in mean maternal HR (p < 0.001), less hypotension (p < 0.01), sedation (p < 0.01), nausea (p = 0.01), and segmental spread (p < 0.0001) than were corresponding doses given by traditional bolus injection (Group 1) for vaginal or Cesarean deliveries. The incidence of systemic toxicity was zero of 300 (0%) with gravity flow and 4 of 300 (1.3%) by bolus injection, p = 0.12, Fisher's exact test. No patient in either group had an accidental intrathecal injection.

Conclusion: Gravity flow administration of local anesthetic-opioid solution during epidural block for obstetrics was associated with fewer signs of systemic drug absorption and cardiovascular perturbations than was the traditional bolus injection. This study supports the current opinion that slow administration of local anesthetic during epidural black contributes to fewer adverse events.     

Insulinoma: Selective arterial calcium injection performed to confirm localization and complete resection

A case of insulinoma is reported in a patient in whom selective arterial calcium injection (SACI) tests were performed both to confirm tumor localization before surgery and to confirm complete tumor removal during surgery. An 18-year-old woman with hypoglycemic episodes was diagnosed with an insulinoma in the pancreatic body demonstrated by celiac arteriography. In a preoperative SACI test, calcium was injected into the splenic artery (SpA), gastroduodenal artery (GDA), and superior mesenteric artery (SMA). Serum immunoreactive insulin (IRI) and proinsulin levels were measured in hepatic venous samples. IRI was markedly increased after the injection of calcium into the GDA and SMA, while there was no response in IRI levels when calcium was injected into the SpA. Therefore, no occult insulinoma was revealed in the distal area fed by the SpA, although the presence of insulinoma was uncertain in the proximal pancreas. In the intraoperative SACI test, calcium was injected into the celiac artery. Insulin (determined by enzyme immunoassay) and proinsulin levels were measured in portal venous samples before and after resection of the tumor. After resection, these levels decreased in response to the calcium stimuli, confirming complete removal of the insulinoma. The SACI test was helpful to localize the insulinoma and was useful to confirm the complete removal of the tumor.     

Mechanisms underlying the antidopaminergic effect of clonazepam and melatonin in striatum

Intrastriatal injection of the GABA_A antagonist, bicuculline, caused about a 75% decrease in the inhibitory effect of the central-type benzodiazepine (BZ) agonist, clonazepam or the indoleamine hormone, melatonin, on apomorphine-induced rotation in a 6-hydroxydopamine model of dopaminergic supersensitivity. Pretreatment with the peripheral-type BZ antagonist, PK 11195 (intrastriatally or intraperitoneally), also attenuated the antidopaminergic effect of these drugs but with much less potency than bicuculline. However, the combination of both bicuculline and PK 11195, injected directly into the striatum, completely blocked the antidopaminergic action of clonazepam or melatonin. These results indicate that the antidopaminergic action of clonazepam and melatonin in the striatum involves two distinct mechanisms: (1) a predominant GABAergic activation via the BZ/GABA_A receptor complex, and (2) a secondary mechanism linked to a PK 11195- sensitive BZ receptor pathway. Recent studies indicate that PK 11195 blocks BZ-induced inhibition of the adenylyl cyclase-cyclic AMP pathway in the striatum. Since cyclic AMP has been implicated in the rotational behaviour of 6-hydroxydopamine-lesioned animals, it is possible that the antidopaminergic action of clonazepam and melatonin also involves suppression of this second messenger. All rights reserved.     

辽宁产东亚钳蝎毒镇痛作用与脑内中枢关系的研究

应用立体定位、核团内注射与电解损毁核团技术及微电极细胞外记录方法，以猫丘脑后核内脏大神经诱发单位放电为内脏痛指标，观察向尾状核、中脑导水管周围灰质及杏仁内侧核内注入东亚钳蝎毒及在电解损毁３个核团前后ＰＯ内脏大神经诱发单位放电的变化。在损毁诸核之前刺激内脏大神经引起单位诱发放电，损毁诸核之后诱发放电减弱或消失，这与辽宁产东亚钳蝎毒注入诸核团中的作用相一致。表明蝎毒的作用部位与上述核团有关，更进一步证明蝎毒作用部位     

葛根素冻干粉针治疗不稳定型心绞痛的短期疗效观察--附30例报告

目的观察葛根素冻干粉针(麦普宁)治疗不稳定型心绞痛(Unstable angina pectoris.UAP)的临床疗效.方法将60例UAP患者随机分为治疗组30例和对照组30例.对照组采用常规治疗.治疗组在常规治疗的基础上加用葛根素冻干粉针400mg加入5%葡萄糖液250ml中静脉滴注,疗程均为14d.结果治疗组的总有效率(93%)优于对照组(66%),差异有统计学意义(P＜0.05).治疗组治疗前后心电图12导联中ST段下降导联数(NST)及12导联中ST段压低数值总和(ΣST)均有明显改善(P＜0.05),随访心绞痛患者6～18个月,未发现明显不良反应.结论葛根素冻干粉针剂能有效减少心绞痛发作,应用简单、监测方便,可降低心肌梗死发生率.     

益肾化浊注射液对慢性肾功能衰竭大鼠残余肾中细胞因子含量的影响

通过观察益肾化浊注射液对5／6肾切除大鼠残余肾中细胞因子含量的影响，益肾化浊注射液延缓慢性肾功能衰竭（CRF）模型大鼠肾功能减退的作用机理。结果显示：益肾化浊注射液可以降低5／6肾切在鼠血清肌,尿素氮（P＜0．01），下调肾组织中白细胞介素－1（IL－1）（P＜0．05），白细胞介素－8（IL－8）（P＜0．05）及肿瘤坏死因子（TNF）（P＜0．05）的总体水平，说明益肾化浊注射液可以通过下调5／6肾切除大鼠残余肾中相关细胞因子含量，抑制促炎细胞因子对肾脏的损害，从而延缓CRF的进展。     

假腔内注射凝血酶治疗股动脉假性动脉瘤(附6例临床分析)

目的：探讨超声引导下假腔内注射凝血酶对股动脉假性动脉瘤的治疗效果。方法：对本科1999年9月－2002年8月行心脏介入诊疗后并发的6例右侧股动脉假性动脉瘤进行假腔内凝血酶注射治疗，并对其结果进行了分析。结果：6例患者均即刻治疗成功，未见明显并发症，随访30d无复，结论：假腔内注射血酶是一种安全，简便，快速，耐受性佳，经济和有效的治疗股动脉假性动脉瘤的方法。