盐酸帕罗西汀治疗躯体疾病伴发焦虑的疗效观察

目的：评价盐酸帕罗西汀治疗躯体疾病伴发焦虑的疗效。方法：对我院2002年1月-2003年．3月内外科躯体疾患伴发焦虑患者进行开放性平行对照研究，对照组用多虑平治疗，为期六周，采用HAMA、CGI量表评定临床效果，以TESS评定不良反应。结果：共65例(帕罗西汀31例，多虑平组34例)，临床判断帕罗西汀与多虑平的显效率分别为66．7％和69．4％，无显著差异，治疗后一周，多虑平组HAMA减分率优于帕罗西汀组，治疗二周后无显著差异。副反应的发生率，帕罗西汀组为17．6％，远低于多虑平组的34．6％。结论：帕罗西汀是一种疗效好，安全性高的治疗躯体疾病伴发焦虑的首选药物。     

体重对腰椎后路开窗减压手术疗效的影响

目的对不同体重老年腰椎管狭窄患者行单纯腰椎后路开窗减压手术,并评价其治疗效果。方法回顾性分析1996年12月～2002年12月间145例因老年腰椎管狭窄而采用单纯腰椎后路开窗减压手术治疗患者的病例资料,结合问卷调查患者对手术的满意程度,比较不同体重患者住院期间及术后症状改善情况,评估手术疗效。结果不同体重患者术后腰腿疼痛明显缓解、日常生活质量改善,患者对手术的满意率达67.59%。而且患者的各种统计数据表明,不同体重组之间差异无显著性意义(P>0.05)。结论体重在一定程度上影响老年腰椎管狭窄患者的手术治疗结果。单纯腰椎后路开窗减压手术,可以达到较为理想的治疗效果。     

Correlations between bone mineral density and demographic, lifestyle, and biochemical variables in community-dwelling Japanese women 69 years of age and over

Introduction A few epidemiologic studies have comprehensively attempted to identify risk factors for low bone mineral density (BMD) in elderly Asian women. The purpose of this study was to identify demographic, lifestyle, and biochemical factors correlated with BMD in elderly Japanese women 69 years of age and over.Methods The study design was cross-sectional. The subjects were 583 ambulatory women aged 69 years and over, and their average age was 74.3 (SD 4.4) years. Predictor variables were age, reproductive history, anthropometric indices, grip strength, calcium intake, lifestyle information, and serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D (1,25(OH)₂D), osteocalcin (OC), and undercarboxylated osteocalcin (ucOC) values. The outcome variable was forearm BMD measured with a DTX-200 osteometer.Results Simple linear regression analyses showed that BMD was significantly positively associated with body height, weight, body mass index, grip strength, serum albumin concentration, and “housework,” and negatively associated with age, years since menopause, age at menarche, number of children, serum 1,25(OH)₂D concentration, serum OC concentration, and ucOC concentration. The stepwise multiple regression analysis showed that weight (β=0.00316, SE=0.00028, R²=0.180), age (β=−0.00321, SE=0.00050, R²=0.108), log-transformed serum OC (β=−0.0445, SE=0.0064, R²=0.053), log-transformed serum 1,25(OH)₂D (β=−0.0401, SE=0.0074, R²=0.050), “farmwork” (β=0.00904, SE=0.00426, R²=0.005), and serum 25(OH)D concentration (β=0.000281, SE=0.000120, R²=0.003) were significantly associated with BMD.Conclusion It was concluded that body weight is a major predictor of forearm BMD among the factors measured in this study in independent Japanese women 69 years of age and over and that serum 1,25(OH)₂D concentration may be associated with cortical BMD. Maintenance of body weight is very important for maintaining BMD in this population, unless a large weight aggravates obesity-related diseases. A follow-up study is needed to confirm these findings.     

Lähmung des N. hypoglossus nach operativem Eingriff – Behandlung mit Akupunktur

Acupuncture is able to accelerate the process of healing significantly when employed in cases of nerve paresis as shown in the following analysis. The patient's constant condition of speech and swallowing impediment before treatment changed relatively fast after starting acupuncture treatment. It is self evident that we took into account the primary disease (AIDS) and its problems. The simplicity of a complementary treatment with acupuncture according to the possible results should make us consider the use of acupuncture as an important way to treat paresis in the early subacute phase and if possible during clinical stay.     

体重指数对全膝关节置换术后功能的影响

目的回顾性分析体重指数(BMI)对骨关节炎(OA)患者全膝关节置换术(TKA)后功能的影响.方法由同一组医生使用同一种假体对320例(520膝)骨关节炎患者行全膝关节置换.按体重指数分为4组非肥胖组(BMI＜25.0 kg/m2)、超重组(BMI 25.1～27.0 kg/m2)、肥胖组(BMI 27.1～30.0kg/m2)和病理性肥胖组(BMI＞30.0 kg/m2),分别记录术前及随访时HSS膝评分、功能评分、膝关节最大屈曲、伸直度数和并发症.结果术前超重组、肥胖组和病理性肥胖组功能评分较非肥胖组低(P＜0.05),但膝评分差异无显著性.通过平均28.3个月的随访,无论膝评分和功能评分各组术后均明显提高,各组提高的幅度比较差异无显著性.虽然超重组、肥胖组和病理性肥胖组术后最大屈曲、伸直度数较非肥胖组小,但是改善幅度仍相当,差异无显著性(P＞0.05).肥胖组和病理性肥胖组围手术期并发症明显增高(P＜0.05),在总共93例(181膝)中,有14膝(9.2%)出现伤口并发症,其中1膝(0.5%)感染,感染发生于术后10周内,与伤口并发症有关;2膝(1.3%)内侧副韧带损伤.超重组166例(258膝)中有6膝(2.3%)出现伤口并发症,无感染及内侧副韧带损伤病例.非肥胖组61例(81膝)中有1膝(1%)出现伤口并发症,无感染及内侧副韧带损伤病例.结论TKR是进展期OA患者有效的治疗措施,肥胖并不是膝关节置换手术的障碍.但围手术期并发症增多,包括伤口愈合、感染、内侧副韧带损伤,应注意伤口缝合技术和保护内侧副韧带.     

针刺配合中药治疗24例小儿高热惊厥临床观察

针药并用，针刺人中、百合、涌泉、合谷，中药内服疏风情热，表里双解，止痉退烧，双管齐下治疗２４例小儿高热惊厥，经治疗均获痊愈。     

针刺对海洛因依赖的脱毒疗效及其防复吸潜力的临床研究

目的 比较针刺、针刺加阿片、阿片加丁丙诺啡及阿片加韩氏戒毒仪4种方法的脱毒疗效及其对脱毒末期稽延性戒断症状和心理渴求的影响。方法 应用戒断症状量表观察脱毒疗效，应用视觉类比量表(VAS)研究心理渴求程度。结果 针刺改善海洛困依赖者戒断症状的优势主要表现在治疗的第6天以后，改善渴求心理的优势表现在第8天以后，且无明显副作用。结论 针刺具有防复吸潜力。可作为解决稽延性戒断症状和消除心理依赖的治疗方法。     

不同频率电针刺激对大鼠髌腱血流量变化的影响

目的:探讨分析不同频率电针治疗时肌腱血流的变化及其变化机制。方法:将40只Wistar大鼠分为2Hz组、10Hz组、100Hz组和针刺(10Hz)+阿托品组、针刺(10Hz)+酚妥拉明组。手术剥离出大鼠胫骨粗隆上缘的髌腱,利用超声测定技术,观察针刺足三里和梁丘穴前后髌腱血流量的变化。并采用静脉滴入阿托品和酚妥拉明的方法,对针刺作用机制进行分析。结果:(1)2Hz组和10Hz组在针刺过程中,髌骨腱血流量分别下降至针刺前的82.11±10.8%、49.17±11.63%,针刺停止后,两组血流量却逆转为高于针刺前的水平,以10Hz组上升幅度较为明显;(2)100Hz组针刺过程中,血流量下降至针刺前的37.54±12.79%,针刺停止后血流量未恢复到针刺前的水平;(3)针刺(10Hz)+阿托品组:针刺时血流量降低至44.61±12.01%,停针后血流量未出现增加现象;(4)针刺(10Hz)+酚妥拉明组:针刺时血流量增加至119.73±14.66%,针刺停止后血流量继续增加。结论:(1)电针刺激期间髌腱血流下降,刺激停止后血流量明显增加;(2)中、低频率刺激对血流量增加效果优于高频刺激;(3)针刺对血流量的影响与舒血管神经和缩血管神经的调节有关。     

Care of the child in a body cast

Caring for a child in a body cast is a stressful situation for most families and many families state they do not receive adequate information on how to care for their child. This paper presents a comprehensive guide on caring for a child in a body cast. It examines the physical care issues, transportation and cast care. An instrument for assessing the family’s ability to cope with caring for a child in a body cast is described, and further resources for parents and nurses are presented.     

成都市中老年健身女性体成分指标与骨密度和骨代谢指标的相关性研究

目的探讨体重、体重指数(BMI)等体成分指标对中老年健身运动女性骨密度的影响及体成分指标与骨代谢指标、骨密度指标的关系。方法94例成都市城区健身运动女性根据BMI不同分为三组:低体重组(BMI≤20kg/m2)、正常体重组(20kg/m225kg/m2),采用Osteospace超声骨密度仪测定跟骨的BUA、SOS、STI骨密度指标;全自动生化分析仪测定血清AKP含量;应用放射免疫法测定血清hCT、BGP、IL-6、E2、TNF含量。应用方差分析和偏相关方法进行统计学处理。结果不同BMI组的体重、体重指数、瘦体重和体脂百分比差异显著,低体重组T-score与正常体重组、超重组比较有极显著差异;低体重组SOS、STI骨密度指标显著低于正常体重组;BUA、SOS、STI骨密度指标与体重、体重指数、瘦体重和体脂百分比呈正相关,与hCT、IL-6、TNF、BGP、AKP呈正相关,与E2呈负相关。低体重组骨量减少、骨质疏松发生率最高。结论体重、体重指数等体成分指标是影响中老年健身运动女性BMD的重要因素,保持体重有利于防止骨丢失和预防骨质疏松发生。