合理情绪行为疗法治疗偏头痛的临床研究

目的 探讨合理情绪行为疗法(REBT)对偏头痛的近远期疗效.方法 86例偏头痛患者随机分为REBT组、药物组各43例,REBT组:采用REBT治疗,2次/周;药物组:阿米替林50～100mg/天、尼莫地平60mg/天,均治疗12周,并设30例健康对照组.于治疗前、治疗12周后、停止治疗后第12周分别行SCL-90、偏头痛疗效评分(TSSM)及P300检测.结果 两组患者SCL-90总均分明显高于对照组;经治12周,两组患者TSSM、SCL-90总均分及主要因子分均显著降低,两组间无显著差异;停止治疗后第12周,REBT组SCL-90总均分及主要因子分、TSSM、P300潜伏期与其治疗时相比基本相同,P300波幅亦显著增高,而药物组SCL-90总均分及主要因子分、TSSM与其治疗时相比显著增高,两组同期相比差异显著.结论 REBT能改善患者认知功能障碍,REBT与阿米替林对偏头痛近期疗效相似,但远期疗效REBT优于药物治疗.     

百优解与阿米替林治疗抑郁症的比较研究

目的：比较百优解与阿米替林治疗抑郁症的疗效。方法：78例抑郁症患者随机分配到百优解和阿米替林组。经1周清洗后分别以这两种药物治疗进行对照。研究组用百优解20mg／d，对照组用阿米替林平均剂量为150mg／d。治疗4周后以Hamilton抑郁量表（HAMD）及现行四级标准评定疗效，以Asberg抗抑郁剂副反应量表评定不良反应。结果：百优解组总有效率为87．1％，阿米替林组为84．6％，HAMD总分及各因子分的减分两组间无显著差异（P〉0．05）。两组的不良反应百优解为镇静，阿米替林为抗胆碱能症状，对心血管的影响百优解明显较阿米替林为轻。结论：百优解是一种快速、强效而安全的抗抑郁药。     

小剂量阿米替林防治偏头痛的临床观察

目的观察西比灵防治偏头痛无效后,运用小剂量阿米替林的防治效果,以便一种药物无效后可选用另一种药物。方法将常规剂量西比灵防治偏头痛效果不佳的患者改为阿米替林治疗,并与西比灵比较,疗程12周。对所有防治患者进行头痛发作期症状控制率及发作频率、总有效率和远期疗效观察比较,并记录不良反应。结果阿米替林组（治疗组）和西比灵组（对照组）对比,阿米替林组对偏头痛发作控制率为25.93%,总有效率为81.49%,均较对照组疗效好,差异有非常显著性（P〈0.001）,不良反应轻微。结论小剂量阿米替林对西比灵防治偏头痛无效的患者,仍有较好的疗效,显效率高,远期治疗效果好。西比灵无效的患者,可改用阿米替林,其安全、廉价、无依赖性,可以改善睡眠、调节情绪。     

利培酮治疗咽异感症30例

目的：评价利培酮治疗咽异感症的临床效果。方法：将60例在耳鼻喉科门诊常规治疗无效的咽异感症患者随机分为观察组及对照组，两组分别用利培酮和安慰剂的治疗，疗程6周，采用症状自评量表（SCL－90）评定疗效和副反应，结果：观察组和对照组治疗前后SCL－90总分及因子分差异均有显著性，其副反应的发生率低和严重程度轻。结论：利培酮治疗咽异感症安全有效。     

西酞普兰与阿米替林治疗老年期抑郁症对照研究

目的：评价西酞普兰对老年期抑郁症的疗效和安全性。方法：将60例老年期抑郁症患者随机分为西酞普兰组和阿米替林组。采用汉密尔顿抑郁量表（HAMD）、副反应量表（TESS），在治疗前和治疗后第1、2、4、6周末评定其疗效和不良反应。结果：西酞普兰组与阿米替林组HAMD评分下降比较于疗后1周有显著差异（P〈0．05），西酞普兰组低于阿米替林组。HAMD总分及各因子分从疗后2周至6周均较治疗前显著降低。显效时间以西酞普兰组显著较短；西酞普兰组的胆碱能不良反应也明显低于阿米替林组（P〈0．01），且较轻微。结论：西酞普兰疗效与阿米替林相当。而西酞普兰具有起效快，耐受性好，不良反应小的特点。     

百优解与阿米替林治疗抑郁症的比较研究

目的比较百优解与阿米替林治疗抑郁症的疗效.方法78例抑郁症患者随机分配到百优解和阿米替林组.经1周清洗后分别以这两种药物治疗进行对照.研究组用百优解20 mg/d,对照组用阿米替林平均剂量为150 mg/d.治疗4周后以Hamilton抑郁量表(HAMD)及现行四级标准评定疗效,以Asberg抗抑郁剂副反应量表评定不良反应. 结果百优解组总有效率为87.1%,阿米替林组为84.6%,HAMD总分及各因子分的减分两组间无显著差异(P＞0.05).两组的不良反应百优解为镇静,阿米替林为抗胆碱能症状,对心血管的影响百优解明显较阿米替林为轻.结论百优解是一种快速、强效而安全的抗抑郁药.     

舍曲林与阿米替林治疗81例创伤后应激障碍的疗效比较

目的：比较舍曲林与阿米替林治疗创伤后应激障碍的疗效和不良反应。方法：81例创伤后应激障碍患者随机分成两组,分别用舍曲林与阿米替林治疗12周。用症状自评量表（SCL-90）中的躯体化、抑郁和焦虑3个因子总分评定症状变化,用不同减分率评定疗效。用不良反应量表（TESS）评定药物不良反应。结果：舍曲林组痊愈率为61．90％,总有效率为90．48％;阿米替林的痊愈率为43．59％,总有效率为71．79％,两组疗效比较差异有统计学意义（P〈0．05）。两组TESS测评,各时点组间比较,差异有统计学或高度统计学意义（P〈0．05或P〈0．01）。结论：舍曲林治疗创伤后应激障碍疗效确切,不良反应较小。     

阿米替林与尼莫地平治疗偏头痛的效果对比分析

目的对比研究阿米替林与尼莫地平治疗偏头痛的效果。方法选取2015年8月至2018年7月我院收治的偏头痛患者68例,采用随机数字表法分为观察组与对照组,对照组采用尼莫地平治疗,观察组采用阿米替林治疗,对比2组患者临床疗效及1年内复发率。结果观察组治疗总有效率94.12%显著高于对照组70.59%,差异有统计学意义(P0.05);观察组复发率显著低于对照组,差异有统计学意义(P0.05)。结论阿米替林治疗偏头痛效果优于尼莫地平,复发率较低,值得临床推广应用。     

三个专业大专生SCL－90评定结果分析

目的：通过比较不同专业大专生的SCL－90评定结果，了解大专生的心理健康状况。方法：整群随机抽样的原则，抽取洛阳市3所院校3个专业的学生，填写SCL－90调查表，收回有效答卷338份。结果：3个专业学生在SCL－90总均分，阳性均分和阳性项目数存在一定差异；SCL－90各因子中强迫，人际关系敏感，抑郁，偏执等4项因子分在3个专业学生中均偏高，3个专业之间互相比较，有部分因子存在显著性差异。3个专业学生因子分≥3分比较以强迫、人际关系敏感，抑郁，敌对性，偏执等人数较大。结论：3个专业的大专生心理健康状况存在一定差异。     

西酞普兰与阿米替林治疗老年期抑郁症对照研究

目的:评价西酞普兰对老年期抑郁症的疗效和安全性。方法:将60例老年期抑郁症患者随机分为西酞普兰组和阿米替林组。采用汉密尔顿抑郁量表(HAMD)、副反应量表(TESS),在治疗前和治疗后第1、2、4、6周末评定其疗效和不良反应。结果:西酞普兰组与阿米替林组HAMD评分下降比较于疗后1周有显著差异(P<0.05),西酞普兰组低于阿米替林组。HAMD总分及各因子分从疗后2周至6周均较治疗前显著降低。显效时间以西酞普兰组显著较短;西酞普兰组的胆碱能不良反应也明显低于阿米替林组(P<0.01),且较轻微。结论:西酞普兰疗效与阿米替林相当,而西酞普兰具有起效快,耐受性好,不良反应小的特点。     

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.