首发抑郁症患者糖代谢的研究

目的:探讨首发抑郁症患者的糖代谢情况。方法:对100例首发抑郁症患者及50名健康人进行糖耐量试验(OGTT),并检测其空腹血浆胰岛素的浓度。结果:餐后0 h、餐后1 h、餐后3h血糖值,两组间差异均无统计学意义(P>0.05);抑郁症组空腹血糖值、餐后2 h的血糖值、OGTT血糖曲线下面积,两组比较均有显著性统计学差异(P<0.01);两组糖耐量减退的发生率有显著性统计学差异(P<0.01),抑郁症组糖耐量减退发生率较对照组高。结论:首发抑郁症患者存在一定的糖代谢异常,临床医师应该对抑郁症患者的血糖进行随访监测,以便早期发现、干预、治疗糖代谢性疾病。     

氯氮平对中年精神分裂症患者血糖血脂的影响

目的探讨氯氮平对中年精神分裂症患者血糖、血脂的影响。方法将接受氯氮平治疗的45例<40岁(对照组)和45例≥40岁(研究组)的精神分裂症患者,分别在治疗前和治疗8周末检测血糖和血脂水平,并进行比较。结果经氯氮平治疗8周后血糖、血脂水平显著上升,研究组上升更明显,血糖异常率为24.4%,对照组的血糖异常率为8.8%,两组差异有显著性(2=4.37,P<0.05);研究组的甘油三脂异常率为53.3%,对照组的甘油三脂异常率为24.4%,两组差异有显著性(2=7.9,P<0.01);两组血浆胆固醇异常率差异无显著性(2=2.5,P>0.05)。结论氯氮平容易引起中年精神分裂症患者血糖、血脂代谢紊乱。     

有氧运动对高脂膳食金黄地鼠糖脂代谢及肝脏过氧化物酶增殖体受体的影响

目的探讨有氧运动对高脂膳食金黄地鼠糖脂代谢及过氧化物酶增殖体受体(PPARs)的影响。方法将健康雄性清洁级金黄地鼠20只随机分为对照组和运动组,每组10只。2组金黄地鼠均给予质量分数10%高脂膳食。运动组金黄地鼠做跑台运动10周,对照组未做跑台运动。10周后检测金黄地鼠生物化学指标及肝脏组织中PPARs的基因表达。结果有氧运动10周后,2组金黄地鼠血清三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇比较差异无统计学意义(P>0.05);运动组金黄地鼠空腹血糖、胰岛素水平明显低于对照组,差异有统计学意义(P<0.05,P<0.01);有氧运动可以金黄地鼠提高肝脏总胆固醇、肝脂酶、脂蛋白脂酶(LPL)水平(P<0.05);2组金黄地鼠血清、肝脏、肌肉及肾周脂肪中游离脂肪酸比较差异无统计学意义(P>0.05);有氧运动升高金黄地鼠肝脏PPARs不明显(P>0.05)。结论有氧运动对高脂膳食金黄地鼠肝脏PPARs影响不明显,但可以调节糖脂代谢,降低血糖及胰岛素水平,改善胰岛素抵抗。     

首次发病精神分裂症和抑郁症患者的血浆瘦素及总胆固醇水平的研究

目的 比较精神分裂症、抑郁症患者血浆瘦素及总胆固醇水平.方法 48例首发精神分裂症患者,用简明精神病评定量表(BPRS)、阳性和阴性症状量表(Positive and Negative Syndrome scale,PANSS)量表评定,45例首发抑郁症用汉密顿抑郁量表(HAMD-24)进行评定,32例体检职工为对照组,所有人组对象服药前测定体质量指数、血浆瘦素和总胆固醇.结果 (1)正常对照组[(4.8±0.9)mmol/L]总胆固醇均高于抑郁症组[(3.7±1.0)mmol/L]及精神分裂症组[(3.4±0.9)mmol/L;P＜0.05～0.01],而抑郁症组与精神分裂症组之间的差异无显著性(P＞0.05);正常对照组血浆瘦索[(13.4±6.7)g/L]高于抑郁症组[(9.6±4.2)g/L]及精神分裂症组[(5.8±3.4)g/L;P＜0.05～0.01],抑郁症组高于精神分裂症组(P＜0.05).(2)3组的血浆瘦素及总胆固醇均与BMI呈正相关(r=0.48～0.63;P＜0.01);精神分裂症组的血浆瘦素和总胆固醇与PANSS阳性分、BPRS分均呈显著负相关(r=-0.38～-0.50;均P＜0.01);抑郁症组的血浆瘦素、总胆固醇与HAMD分呈显著负相关(r=-0.37～-0.41;P＜0.05～0.01).结论 精神分裂症和抑郁症患者的血浆瘦素及总胆固醇水平的降低独立于药物治疗和BMI改变之外,其在精神障碍中的重要病理生理学机制值得进一步深入探讨.     

苍附苁仙汤对多囊卵巢综合征患者机体糖脂代谢的影响

目的:探讨苍附苁仙汤的作用机理,从治疗角度上证实多囊卵巢综合征与机体的糖脂代谢指标有密切关系。方法:将80例多囊卵巢综合征患者随机分为中药组和对照组,每组各40例。中药组患者给予苍附苁仙汤方+炔雌醇醋酸环丙孕酮治疗;对照组患者给予炔雌醇醋酸环丙孕酮治疗。观察两组患者的临床疗效,并测定治疗前后的变化。结果:治疗前后,中药组患者的空腹血糖、甘油三酯和总胆固醇明显降低,差异有统计学意义(P<0.05);而对照组患者治疗前后差异无显著性(P>0.05)。治疗后,中药组患者的高密度脂蛋白较治疗前明显增高,差异有显著统计学意义(P<0.01)。而治疗前后,对照组患者的高密度脂蛋白比较,差异无显著性(P>0.05)。治疗后,两组患者的体重指数均明显降低,差异有显著统计学意义(P<0.01);而且中药组患者明显低于对照组,差异有统计学意义(P<0.05)。治疗前后,两组患者的基础窦卵泡计数比较均明显降低,差异有统计学意义(P<0.05);而且中药组患者明显低于对照组,差异有显著统计学意义(P<0.01)。治疗前后,两组患者的LH、T水平比较均明显降低,差异有显著统计学意义(P<0.01)。治疗后,两组患者的疗效比较,差异无显著性(P>0.05)。结论:苍附苁仙汤通过调节多囊卵巢综合征患者机体的糖脂代谢,从而达到治疗多囊卵巢综合征的目的。     

首发抑郁症患者血糖、血脂的对照研究

目的:探讨首发抑郁症患者的糖脂代谢情况。方法:对符合入组标准的68例首发抑郁症患者及40例健康对照者测量人体学指标:身高、体重、腰围、臀围,计算体重指数及腰围/臀围比值(以下简称腰臀比),BMI=体重/身高2(kg/cm2),检测空腹及餐后血糖(FBS)、血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)。结果:(1)抑郁症组空腹TG及血糖值明显高于对照组(P<0.01);而HDL值抑郁症组明显低于对照组(P<0.01);(2)抑郁症组餐后TG及血糖值明显高于对照组(P<0.01)。结论:首发抑郁症患者存在有一定的糖脂代谢异常,临床医师应该对抑郁症患者的血糖、血脂进行随访监测,以便早期发现、治疗糖脂代谢性疾病。     

抑郁症和焦虑症患者血浆单胺类神经递质浓度对照研究

目的探讨血浆单胺类神经递质与抑郁症和焦虑症的关系.方法使用高效液相-电化学检测法测定55例抑郁症、20例焦虑症患者和21例正常人的血浆去甲肾上腺素(NE)和五羟色胺(5-HT)浓度,同时评定汉密尔顿抑郁量表(HAMD,24项)和汉密尔顿焦虑量表(HAMA,14项).结果 2组患者的血浆NE浓度均显著高于正常对照组(P<0.05),但2组之间无明显差异(P>0.05);抑郁症组的血浆5-HT浓度显著低于正常对照组(P<0.05),焦虑症组的血浆5-HT浓度与正常对照组差异无显著性(P>0.05),2组患者之间血浆5-HT浓度也差异无显著性(P>0.05). 结论抑郁症和焦虑症患者存在血浆单胺类神经递质异常,但这不能鉴别两者.     

脂代谢紊乱与早发型妊娠期高血压疾病相关性分析

目的探讨分析脂代谢紊乱与早发型妊娠期高血压疾病相关性。方法选取2013年7月1日—2018年7月1日惠州市第三人民医院收治的80例早发型(发生于妊娠34周以前)妊娠期高血压疾病患者作为观察组,选取收治的80例健康妊娠孕妇作为对照组,比较两组血脂指标之间的差异。结果两组孕妇的高密度脂蛋白胆固醇(HDL-C)水平比较差异无统计学意义(P>0.05);观察组孕妇的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)水平明显高于对照组(P<0.05),载脂蛋白A1(ApoA1)水平明显低于对照组(P<0.05)。结论妊娠期高血压疾病与脂代谢紊乱有非常密切的关系,应对该类患者的血脂进行监测,及时干预治疗,纠正脂代谢紊乱,控制病情进展,改善母婴妊娠结局。     

二甲双胍对奥氮平致精神分裂症肥胖患者的影响

目的:观察二甲双胍对奥氮平致精神分裂症肥胖患者的影响。方法:将奥氮平所致精神分裂症肥胖患者按照随机数字表法分为研究组(n=36)和对照组(n=36);对照组接受单一生活方式干预,研究组在生活方式干预的基础上,加用二甲双胍(1 000 mg/d),时程24周。比较两组干预前后体质量指数(BMI)和CRP、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平。结果:(1)干预后研究组CRP、BMI、FPG、TG显著低于对照组(P<0.05或P<0.01);与干预前相比,干预后研究组CRP、BMI、FPG、TC、TG、LDL-C均有显著降低(P<0.01),HDL-C变化差异无统计学意义(P>0.05);对照组CRP、BMI及各项糖脂代谢指标干预前后差异无统计学意义(P>0.05)。(2)研究组干预前后CPR的变化值与BMI的变化值正相关(r=0.301,P<0.05)。结论:在单一生活方式干预基础上,二甲双胍不仅可降低奥氮平所致精神分裂症肥胖患者体质量、改善糖脂代谢指标,还可降低患者血清CRP水平。     

银屑病患者血小板参数、C反应蛋白与血脂及载脂蛋白检测分析

目的探讨银屑病患者血小板参数、C反应蛋白(CRP)与血脂及载脂蛋白水平变化在银屑病发病中的作用及临床应用价值。方法对96例寻常型银屑病患者血小板参数、CRP以及血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDH-C)和载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及脂蛋白a(LPa)进行检测,并与正常对照组进行综合对比分析。结果银屑病组与对照组比较:银屑病组血小板压积(PCT)、平均血小板体积(MPV)和血小板分布宽度(PDW)明显升高(P0.05),进行期银屑病组显著升高(P0.01);血清TC、TG、LDL-c及ApoB均明显升高(P0.01),apoAI、HDL-c下降(P0.01),LPa仅进行期银屑病组升高显著(P0.05),其他两组轻度升高但差异无显著性(P0.05)。进行期银屑病组CRP浓度与对照组比较差异有高度显著性(P0.001);静止期银屑病患者组CRP浓度与对照组比较差异有显著性(P0.05);消退期银屑病患者组与对照组比较差异无显著性(P0.05)。结论银屑病患者血小板参数、CRP与血脂及载脂蛋白水平均有明显变化,联合监测对于判断病情转归和指导临床治疗具有重要意义。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.