阿立哌唑治疗64例精神分裂症门诊患者临床分析

目的 观察阿立哌唑治疗精神分裂症的疗效、副反应和安全性.方法 使用阿立哌唑治疗64例精神分裂症门诊患者,疗程8周;阿立哌唑治疗剂量为10～30mg/d,平均治疗剂量（14.6±2.2）mg/d;采用阳性和阴性症状量表（PANSS）评价临床疗效,用副反应量表记录药物副反应,治疗前和治疗后2、4、6、8周进行血常规、肝功能、心电图的监测.结果 治疗8周后阿立哌唑的显效率为71.9%,有效率为90.4%（60例）;PANSS总分、阳性量表分和一般精神病理量表分在治疗后2周下降显著,与治疗前相比差异均有显著性（P＜0.05）,在治疗后4、6、8周与治疗前相比差异均有极显著性（P＜0.01）;阴性量表分在治疗后4周下降显著,与治疗前相比差异有显著性（P＜0.05）,在治疗后6、8周与治疗前相比差异均有极显著性（P＜0.01）.阿立哌唑副反应大多出现在治疗后2周左右,症状轻微,能耐受,持续时间短;实验室检查除发现3例患者心电图T波改变、2例患者转氨酶轻度升高外,余未见异常.结论 阿立哌唑治疗精神分裂症疗效好,副反应少而小,服用方便安全,依从性高,可以作为一线抗精神病药物使用.     

阿立哌唑与氯氮平治疗首发精神分裂症对照性研究

目的探讨阿立哌唑对精神分裂症治疗的临床疗效和安全性。方法对83例首次住院的精神分裂症患者分别给予阿立哌唑、氯氮平治疗,其中阿立哌唑组42例,剂量为(18.7±4.3)mg/d;氯氮平组41例,剂量为(300±43)mg/d;疗程共8周。以阳性与阴性症状量表(PANSS)及副反应量表(TESS)在治疗前及治疗后1、2、4、8周末分别评定疗效和副反应。结果(1)两组治疗后第1、2、4、8周的PANSS分与治疗前比较,无显著性差异(P>0.01)(。2)阿立哌唑与氯氮平显效率分别为82.5%和85.7%,两者有效治疗剂量分别为10-30mg/d,250-400mg/d。(3)TESS评定阿立哌唑组副作用少于氯氮平组(P<0.01)。结论阿立哌唑治疗精神分裂症,是一种安全有效的新型抗精神病药。     

奥氮平治疗首发精神分裂症开放性研究

目的:评价奥氮平治疗首发精神分裂症的效果与安全性.方法:对30例住院首发精神分裂症患者给予奥氮平治疗,起始剂量5mg/d,1周内根据病情调整至治疗剂量10～25mg/d,平均剂量15.11±4.21mg/d,疗程8周.于治疗前和治疗第1、2、4、8周末采用阳性与阴性症状量表(PANSS)评定临床疗效,副反应量表(TESS)评定不良反应.结果:在治疗第1周末起PANSS总分及各分值与治疗前比较差异有统计学意义(P均<0.05).其中痊愈13例(43.33%),显著进步10例(33.33%),进步5例(16.67%),无效2例(6.66%),总有效率93.33%.不良反应轻微,无明显心血管系统不良反应.结论:奥氮平治疗首发精神分裂症疗效肯定,使用安全.     

阿立哌唑治疗47例首发精神分裂症的临床分析

目的了解阿立哌唑对首发精神分裂症的临床疗效和不良反应。方法对门诊和住院的47例精神分裂症患者给予阿立哌唑治疗,疗程12周,以阳性和阴性症状量表(PANSS)评定疗效,以副反应量表(TESS)评定不良反应。结果阿立哌唑对首发精神分裂症有肯定疗效,剂量在10～30 mg/d。PANSS总分和各量表分,在自疗2周后显著下降,常见不良反应为疲劳、头胀,但多较轻,患者能耐受,1周后缓解[1]。结论阿立哌唑,是一种安全、有效的新型抗精神病药。     

牛黄宁宫片合氯丙嗪治疗精神分裂症的疗效报告

目的探讨牛黄宁宫片合氯丙嗪治疗精神分裂症的疗效和副反应。方法将40例符合CCMD-3诊断 标准的精神分裂症病人,给予氯丙嗪同时加服牛黄宁宫片治疗8周,采用阳性和阴性症状量表(PANSS)评 定临床疗效,副反应量表(TESS)和维体外系不良反应量表(ESPS)评定不良反应。结果治疗8周PANSS 总分、PANSS(一般精神分裂症)分、PANSS-P(阳性症状)分、PANSS—N(阴性)分在治疗前后有显著 差异(p<0．05);氯丙嗪最小剂量200mg/日,最大剂量300mg／日,平均终末剂量250mg±50mg,痊愈16例 (35．9％),显著进步17例(45％),好转3例(7．5％),无效4例(10％),有效率90．0%。结论牛黄宁宫片 是中西医结合治疗精神分裂症的有效治疗,可以减少抗精神病药剂量,提高疗效,减轻不良反应。     

利培酮(卓菲)对传统抗精神病药治疗无效的精神分裂症患者的疗效

目的探讨国产利培酮在治疗使用传统抗精神病药无效的精神分裂症患者的疗效. 方法对比43例使用过3种和3种以上传统抗精神病药物治疗入组时阳性和阴性症状量表(PANSS)评分大于60分的精神分裂症患者换用利培酮治疗,观察6周,于换用前和换用后2、4、6周末进行PANSS和副反应量表TESS评定. 结果换药4周后PANSS减分率与换药前比较差异有显著性(t=3.12,P＜0.01),副反应量表(TESS)换药前后差异显著(t=2.50,P＜0.05),说明国产利培酮疗效优于传统抗精神病药,不良反应轻微.结论国产利培酮在治疗精神分裂症方面较传统抗精神病药有较好的疗效和安全性.     

47例精神分裂症阿立哌唑门诊治疗临床观察

目的观察阿立哌唑(商品名博思清)治疗精神分裂症病人的疗效和不良反应.方法47例门诊精神分裂症患者应用阿立哌唑治疗8周,以阳性与阴性症状量表(PANSS)评定疗效,以副反应量表(TESS)评定不良反应.结果阿立哌唑治疗门诊精神分裂症疗效是肯定的,剂量10～30 mg/d.PANSS量表总分及各量表分自治疗2周起显著下降,显效;2周44.6%;3周55.3%;4周70.2%.常见的不良反应为静坐不能、口干、视物模糊、恶心呕吐、失眠、头昏、嗜睡、心动过速.结论阿立哌唑治疗精神分裂症疗效肯定,安全性高,临床上值得推广.     

齐拉西酮治疗精神分裂症的临床疗效和安全性

目的 验证国产齐拉西酮治疗精神分裂症的疗效及副反应.方法 对30例精神分裂症患者使用齐拉西酮治疗,疗程6周,以阳性与阴性症状量表（PANSS）评定疗效,用副反应记录表评价副反应.结果 治疗后患者PANSS总分及各因子分均较治疗前明显下降.结论 齐拉西酮对精神分裂症的阳性症状、阴性症状等精神病性症状均有效,不良反应少,安全性好.     

不同剂量利培酮对精神分裂症各症状群的疗效比较

目的 :为了解不同剂量利培酮对精神分裂症不同症状群的疗效有无差异。方法 :将符合CCMD Ⅱ R精神分裂症诊断标准的患者随机分 4组 ,用 2 ,3,4 ,5mg固定剂量的利培酮治疗。于用药前、用药 1周末、2周末、4周末、6周末、8周末、12周末进行PANSS评分 ,对各组的PANSS总分及减分率、各症状群总分及减分率进行比较、分析。结果 :共有 173例入组 ,16 0例完成 12周观察。统计分析显示 12周末的PANSS总分 4组均较治疗前有显著降低 ,减分率、有效率、显效率 4组间均无显著性差异。阳性、阴性、一般精神病理 3个分量表分析 ,12周末各剂量组间减分率、有效率、显效率无显著差异。临床治愈率阴性症状各组间无显著差异 ,阳性症状 3,5mg显著高于 2 ,4mg组 ,一般精神病理症状 3mg显著高于 4mg组 ,显示 3mg对 3个症状群的改善都是最好的。反应缺乏、思维障碍、激活性、偏执、抑郁 5个症状群比较分析也显示 3mg对各症状群的疗效最好。结论 :不论是PANSS总分 ,还是不同的因子分析 ,3mg都是起效最早、疗效最好的 ,3mg利培酮是治疗精神分裂症的最佳剂量。当患者以思维障碍、阳性症状为主要表现时 ,利培酮用量以 35mg·d-1为宜 ;阴性症状为主时 2 4mg·d-1为宜 ;抑郁症状突出时 2 3mg·d-1为宜。     

47例精神分裂症阿立哌唑门诊治疗临床观察

目的:观察阿立哌唑(商品名:博思清)治疗精神分裂症病人的疗效和不良反应.方法:47例门诊精神分裂症患者应用阿立哌唑治疗8周,以阳性与阴性症状量表(PANSS)评定疗效,以副反应量表(TESS)评定不良反应.结果:阿立哌唑治疗门诊精神分裂症疗效是肯定的,剂量10～30 mg/d.PANSS量表总分及各量表分自治疗2周起显著下降,显效;2周:44.6%;3周:55.3%;4周:70.2%.常见的不良反应为静坐不能、口干、视物模糊、恶心呕吐、失眠、头昏、嗜睡、心动过速.结论:阿立哌唑治疗精神分裂症疗效肯定,安全性高,临床上值得推广.     

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.