肝硬化患者的心理状态分析

目的:分析肝硬化患者的心理状态.方法:对40 例肝硬化患者(研究组)及40 例健康志愿者(正常对照组)采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)进行问卷调查及对比研究.结果:肝硬化患者的焦虑发生率为27.5%,抑郁发生率为42.5%,焦虑合并抑郁的发生率为27.5%,与正常对照组相比,肝硬化患者的焦虑抑郁不良情绪的发生率升高(P＜0.05),其中家庭月收入少于1 000元、有并发症的肝硬化患者的抑郁积分较高(P＜0.01).结论:肝硬化患者的焦虑、抑郁情绪发生率显著高于正常人群,且受家庭经济状况和有无并发症的影响.     

住院糖尿病病人病情分析

目的:通过对近年来我院住院糖尿病病人的资料分析,观察糖尿病转归、并发症的发生率及死亡原因.方法:查阅全院住院糖尿病病人病历,对患者的相关临床资料登记.结果:糖尿病患病率呈逐年增加的趋势,与1993年相比,1997年患病率增加0.5倍,1998年患病率增加1倍,2001年前半年增加2倍.2001年上半年住院糖尿病病人高血压、冠心病和心梗的患病率分别为39.1%,35.2%和6.7%,住院高血压病人糖尿病患病率由1998年的6%增至2001年的9%,住院冠心病病人糖尿病患病率增高约10%(P＜0.01).住院心梗病人糖尿病患病率增高约15%(P＜0.05).近3.5年,有2618例糖尿病病人住院(1.95%),与非糖尿病病人相比,病死率无显著性差异.糖尿病主要死亡原因为感染(41.2%),终末期肾病(39.2%)及癌症(31.4%).由于冠心病及脑血管意外死亡仅为15%及13%,而呼吸道感染(81%)及足感染(63%)为主要死因.结论:近8.5年中,在33 005病人中糖尿病病人逐年增多,特别是在近4年中,提高约2倍.高血压、冠心病及心梗病人糖尿病患病率逐年增高.近3.5年中住院糖尿病病人的死亡主要原因并非是心血管病变,而是感染.糖尿病病人癌症病死率有所增加.提倡早期诊断,早期预防,早期治疗糖尿病,采取健康的生活方式.     

血管内栓塞治疗颅内动脉瘤围手术期护理

我院2003年6月~2006年10月应用电解可脱式铂金微弹簧圈对65例颅内动脉瘤病人进行血管内栓塞,配合术前术后有效的护理,取得良好的治疗效果,现就护理体会报告如下。1材料与方法本组65例,男29例,女36例,年龄26~67岁,平均年龄45岁。以自发性蛛网膜下腔出血(SAH)为首发症状61例,头痛头晕3例、肢体麻木无力1例。本组65例中,45例在神经麻醉下,20例在气管插管全身麻醉下实施栓塞术。全身肝素化抗凝下,采用Seldinger’s技术经股动脉穿刺插管行全脑血管造影术(DSA),沿微导管放入直径与动脉瘤体匹配的电解可脱式微弹簧圈,电解解脱后,复查脑血管造影,…     

老年认知功能障碍与脑结构CT测量的相关性研究

目的探讨脑萎缩与老年认知功能障碍之间的相关性。方法对开滦集团公司1063名离退休职工进行健康查体,用简易精神状态量表(MMSE)评定认知功能,按分界值将本次研究对象分为认知功能障碍组和认知功能正常组,同时用CT线性测量脑的相关部位以诊断脑萎缩情况,并对各型脑萎缩与认知功能的相关系数及提示老年认知功能障碍的敏感度、特异度、准确度进行分析。结果1063名观察对象中符合入选标准并资料完整者共计511名,其中108名有认知功能障碍,髓质脑萎缩55名、皮质萎缩5名、混合型萎缩30名;认知功能正常者403名,髓质脑萎缩214名、皮质萎缩13名、混合型萎缩62名。认知功能障碍组脑萎缩的发病率高于认知功能正常组,差异具有统计学意义(P<0.005);2组间颞叶海马钩回间距(26.86mm±3.73mmvs25.95mm±3.80mm)及海马钩回间距/大脑左右径的比值(0.21±0.02vs0.20±0.02)差异具有统计学意义(P<0.05);海马钩回间距、皮质脑萎缩、混合型脑萎缩与认知功能障碍呈负相关(分别为r=-0.094,P=0.034,r=-0.156,P≈0.000,r=-0.147,P≈0.000),以海马钩回间距20mm提示老年认知功能障碍的敏感度最高(98.14%),混合型脑萎缩的特异度(84.86%)、准确度最高(72.80%)。结论CT测量相关脑结构,判断脑萎缩类型可以为老年认知功能障碍的诊断提供有价值的信息。     

浅谈胡澍手校本《素问》的文献版本价值

清末经学家和小学家胡澍把《素问》作为子书之一，博采众本，悉心校勘，以小学的方法进行专门研究，撰成《素问校义》，为研习《内经》不可不读之书。通过对天津中医药大学图书馆所藏胡澍手校本《重广补注黄帝内经素问》的考证，发现胡澍校勘所据底本一直被误作宋本，而实是明顾从德影宋刻本．校勘工作历时数年，手校本《素问》留有胡澍悉心对校后所做出的千余条校语，可惜草创未就，他便英年早逝。手校本这第一手资料，对研究胡澍的治学思想和《素问校义》的成书过程，学习和掌握知识，传承弘扬学术，都具有重女的文献参考价值。     

Neuroprotective effect of estrogen after chronic spinal cord injury in ovariectomized rats

BACKGROUND: At present, there is still lack of effective drugs for chronic spinal cord injury, whereas it is found recently that estrogen has a neuroprotective effect on brain and spinal cord injuries. OBJECTIVE: To observe the effect of estrogen on the apoptosis of nerve cells after gradual chronic spinal cord injury in ovariectomized rats. DESIGN: A randomized controlled animal trial. SETTING: Institute of Orthopaedics, the Second Hospital of Lanzhou University. MATERIALS: Sixty-five female Wistar rats of common degree, weighing 220–250 g, were provided by the experimental animal center of Lanzhou University. The rats were randomly divided into sham-operated group (n =5), estrogen-treated group (n =30) and saline control group (n =30), and the latter two groups were observed at 1, 3, 7, 14, 28 and 60 days respectively, and 5 rats for each time point. METHODS: All the rats were treated with bilateral oophorectomy 2 weeks before the experiment. T10 vertebral lamina was revolved into using plastic screw. The spinal canal impingement was not induced initially. After that, the original incision was opened to expose the screw every 7–10 days. MAIN OUTCOME MEASURES: The apoptosis and Caspase-3 positive cells in the damaged spinal cord were detected using terminal deoxynucleotidal transferase-mediated dUTP-biotin nick end labeling (TUNEL) method and Caspase-3 immunohistochemical staining at 1, 3, 7, 14, 28 and 60 days after chronic spinal cord injury respectively. RESULTS: Totally 65 rats were used, and the deleted ones during the experiment were supplemented by others. Changes of Caspase-3 expression after spinal cord injury: In the sham-operated group, only a small amount of Caspase-3 proteins were observed in the rat spinal cord, mainly located in motor neurons of spinal cord anterior horn. In the estrogen-treated group and saline control group, positive cells expressed occasionally at 1 day postoperatively, began to increase obviously at 7 days after injury, strongly expressed at 14 and 28 days, but decreased at 60 days, mainly located in the neurons of spinal cord gray matter anterior horn, and they expressed fewer in the motor neurons and white matter of ventral horn, and there were obvious differences between the estrogen-treated group and saline control group at 7, 14, 28 and 60 days (P < 0.05). CONCLUSION: Estrogen can reduce the apoptosis of nerve cells and promote the recovery of neurological function following gradual chronic spinal cord injury.     

大白鼠肾上腺的血管构筑

本实验采用血管铸型扫描电镜,注射明胶卡红组织切片显微镜下观察和注射铅丹乳胶追踪血管来源三种方法对14只健康大白鼠肾上腺血管构筑进行了研究。大白鼠肾上腺动脉发自腹主动脉和肾动脉。它们在行程中发出分支至腺体表面,再次分支穿入囊内,逐级分支至毛细血管。皮质动脉发自囊内血管,它们在皮质中分支分布。球状带的毛细血管与囊的毛细血管相连,毛细血管在球状带围绕细胞团形成网眼状;在束状带呈放射状排列;在网状带吻合增多形成网状。髓质动脉亦发自囊的血管,它们在皮质中不发分支直抵髓质,在髓质分成毛细血管。网状带的毛细血管越向髓质口径越粗,它们在皮髓交界处互相吻合形成更粗的静脉,这些静脉逐级吻合,最后形成一主干——中央静脉,它穿出皮质出现于肾上腺门处。左侧的中央静脉注入在肾静脉,右侧的注入下腔静脉。     

Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease.

High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves the motor symptoms of Parkinson's disease (PD). Opposite changes in mood, such as mania or depression, have been reported after surgery, but it is not known whether these side effects are specifically related to STN DBS. To learn whether STN DBS also influences the limbic loop, we investigated acute subjective psychotropic effects related to levodopa or bilateral STN DBS. After a median postoperative follow-up of 12 months, 50 PD patients completed the Addiction Research Center Inventory (ARCI), assessing subjective psychotropic effects in four conditions: off-drug/on-stimulation; off-drug/off-stimulation; on-drug/off-stimulation; and on-drug/on-stimulation. Both levodopa and STN DBS improved all the ARCI subscales, indicating subjective feelings of well being, euphoria, increase in motivation, and decrease in fatigue, anxiety, and tension. A suprathreshold dose of levodopa was significantly more effective than STN DBS, using the same electrical parameters as for chronic stimulation, on four of the five ARCI subscales. We concluded that 1) both STN DBS and levodopa have synergistic acute beneficial psychotropic effects in PD, 2) the psychotropic effects of both treatments need to be considered in the long-term management of chronic STN DBS, and 3) the results indicate an involvement of the limbic STN in mood disorders of PD.     

湘西自治州1995～2002年男性劳教人员法定性病监测报告

目的 了解湘西自治州重点人群性病患消长趋势，为性病防治工作提供科学依据。方法 从1995年起，采用统一的表格，每年对湘西州劳教所新入教人员进行一次法定性病监测。结果 三种法定性病平均患病率为14．64％(4．96～26．7％)，以1995年最低，1997年最高，8年未发现HIV／AIDS，患病率以20～39岁的性跃期人群为最高，汉族患病率高于其它民族；化程度越高，患病率越低。结论 男性劳教人员作为性病患病的高危人群，是哨点监测理想的目标人群。     

Adrafinil-induced orofacial dyskinesia.

We describe the first case of orofacial abnormal movements induced by adrafinil, a vigilance promoting agent of the same pharmacological class as modafinil. The dyskinesias did not spontaneously recover despite adrafinil withdrawal for a 4-month period. They were secondly dramatically improved by tetrabenazine, a presynaptic dopaminergic depleting drug which was introduced after the 4-month adrafinil-free period.