目的 比较老年精神分裂症患者采用氯氮平与喹硫平治疗对精神行为症状、认知功能、血清泌乳素(PRL)水平及体重指数(BMI)的影响.方法 选取2020年5月至2022年3月新乡医学院第二附属医院收治的共计76例老年精神分裂症患者,以随机数字表法分成研究组(38例)与对照组(38例),对照组接受氯氮平治疗,研究组接受喹硫平治疗,比较两组精神行为症状、认知功能、血清泌乳素水平及BMI.结果 治疗后两组阳性与阴性症状量表(PANSS)评分均降低,研究组评分较对照组更低(P＜0.05);两组蒙特利尔认知评估量表(MoCA)、简易精神状态检查(MMSE)评分均提高,研究组评分较对照组更高(P＜0.05);两组PRL水平均提高,但研究组水平较对照组低(P＜0.05);对照组治疗后BMI提高(P＜0.05),但研究组治疗前后BMI差异无统计学意义(P＞0.05),治疗后研究组BMI较对照组低(P＜0.05).结论 相较于氯氮平,喹硫平应用于老年精神分裂症患者治疗中,能够更好地改善精神行为症状与认知功能,降低对PRL水平及BMI的影响.

Objective:To explore the effect of moderate intensity physical exercise on depression, anxiety and cognitive function of schizophrenic patients and its possible biochemical mechanism.Methods:Totally 148 patients with schizophrenia who were hospitalized in hospital from March 2019 to March 2021 were randomly divided into control group ( n=75) and exercise group ( n=73). The patients of the two groups were given drug treatment and routine exercise according to clinical practice, and the patients in exercise group were given additional medium-intensity physical exercise.Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the poor mental state of the subjects.The verbal fluency task(VFT), digital span test(DST), trail making test-A(TMT-A) and the positive and negative symptom scale (PANSS) were used to evaluate cognitive function.The levels of endocannabinoids (eCBs) receptors were detected by high performance liquid chromatography, and the levels of monoamine neurotransmitters and eCBs in the patients' serum were determined by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 software was used for statistical analysis.The measurement data between the two groups were compared by t-test and the counting data between the two groups were compared by χ2 test. Results:(1) After effective intervention, the scores of SAS, SDS, TMT-A and PANSS of the two groups were significantly lower than those before intervention, and the difference before and after intervention between the two groups was statistically significant( t=6.00, 6.52, 25.79, 17.03, all P<0.01). The scores of SAS, SDS, TMT-A and PANSS after intervention in the exercise group were significantly lower than those in the control group( t=4.66, 20.88, 6.61, 8.95; all P<0.01). The number of VFT and DST in the two groups after intervention were significantly higher than those before intervention, and the differences before and after intervention between the two groups were statistically significant( t=13.78, 22.76, both P<0.01). After effective intervention, the number of VFT and DST in exercise group were significantly higher than those in the control group( t=5.02, 5.15, both P<0.01). (2) After effective intervention, the contents of monoamine neurotransmitters and eCBs in serum of the two groups were significantly higher than those before intervention, and HVA level ((63.68±6.99) pg/mL), MHPG level ((175.90±16.22) pg/mL), 5-HIAA level ((29.94±4.19) pg/mL) and CBR1 level ((6.70±1.40)μg/L), 2-AG level ((61.90±5.73)pmol/g) and AEA level ((76.48±6.59) pmol/g) in exercise group were significantly higher than those in the control group ((52.97±5.37)pg/mL, (138.50±11.52)pg/mL, (23.87±3.15)pg/mL, (5.71±1.29)μg/L, (52.13±5.14)pmol/g, (67.66±5.88)pmol/g)( t=10.43, 16.21, 10.91, 8.65, all P<0.01). Conclusion:Moderate intensity physical exercise can significantly improve their depression, anxiety and cognitive function, which may be related to regulating the levels of ECBS and their receptors in patients with chronic schizophrenia to increase monoamine neurotransmitters.

Objective To survey the changes of gonadal hormone levels of male alcohol dependence (AD) patients to provide basis for clinical diagnosis and treatment. Methods Fifty-eight male AD patients were assigned to dependence group and 58 normal healthy people to control group,serum pituitary prolactin (PRL),testosterone (T) ,progesterone (PROG),follicle stimulating hormone (FSH),luteinizing hormone (LH) and estradiol (E2) levels detected using electrochemiluminescence,and detection results of 2 groups contrastively analyzed. Results Serum PRL,FSH,LH and E2 levels were significantly higher (P<0.05 or 0.01) and RROG lower (P<0.01) in dependency than in control group,group difference in T wasn't significant (P>0.05). Serum PRL,FSH,LH and E2 levels were positively related to ages in dependence group,but which had no statistical significance (P>0.05);PROG level was negatively related to ages,but which had no statistical significance (P>0.05);T level was positively related to ages,which had statistical significance (P<0.05). Conclusion Gonad hormone levels of male AD patients are abnormal,gonad axis functions imbalance,and the detection of gonadal hormone and treatment should be clinically enhanced.

Objective To study the drug resistance of Acinetobacter baumanii in lower respiratory tract infection,and to provide reference for the clinical resisting infection.Methods Drug susceptibility results of 104 strains of Acinetobacter baumanii separated from the lower respiratory tract infection in 2010 were analyzed retrospectively and K-B method was applied for the drug susceptibility test.Results The antibiotic susceptibility test in vitro showed:the resistant rate of Acinetobacter baumanii to polymyxin was lowest(7.7%),followed by meropenem(21.2%),imipenem(24.0%),cefoperazone/sulbactam(28.8%).Acinetobacter baumanii had higher resistance rates to the other antibaeterials.Conclusion Resistance of Acinetobacter baumanii is quite serious.Clinician should base on drug susceptibility test to choose antibiotics reasonably and controlling the infection effectually and delaying the occurrence of bacteria resistance.

Objective:To investigate bacteriology, pH value and the change of cocci and bacilli of infant with intestinal flora maladjustment's fresh lax sample for searching fast diagnostic method.Methods:The investigative object were 118 lax infants for flora maladjustment (approving by bacteriology cultivating) from this hospital's outpatients and inpatients since January 2004 to December 2005.Control group were 80 health infants from health care section office.The pathogenic bacteria were cultivated to examine pH value and account the proportion of cocci and bacilli with patients' fresh dejecta in 10 minutes.Results:①In 118 flora maladjustment infant samples, 42 cases (35.6%) Escherichia coli vanishing or reducing, 49 cases(35.6%)enteric conditional pathogenic germs preponderant developed and 27 strains (22.9%) epiphytes. ②The dejecta pH value of enteric flora maladjustment infants were 6~8, 92 cases were larger than or equal to 7 (78.0%); Control group dejecta pH value were 5～6.5, 68 cases were smaller or equal to 5.5(85.0%). There was a significant diference between them(χ2=116.52,P<0.005).③The proportion of cocci and bacilli was determined by smearing and microscope examining, flora maladjustment teams were 3/7~8/2, 106 cases cocci were larger than or equal to 40% (89.8%); The proportion of cocci and bacilli of control group samples was 1/9~3/7, none sample cocci was larger than or equal to 40%. There was a significant dieference between them(χ2=154.68,P<0.005).Conclusion:It is beneficial to the diagnosis of intestinal flora maladjustment by measuring the bacteriology, pH value and the change of cocci and bacilli of lax infant's fresh dejecta by pH value larger than or equal to 7 and the proportion of cocci and bacilli larger than 4/6. It is simple, quickly, exact and cheap, fits to grass roots laboratory.

Objective To investigate the changes of some immune indices in schizophreniac (SP) patients before and after chozapine treatment.Methods The serum IgG,IgM,IgA,C 3 and C 4 were measured with immunoturbidimetry in 83 SP patients before and after the treatment of clozapine,and were compared with 92 healthy subjects of control group.Results Before treatment,the levels of IgG,IgM,C 3 were significantly higher than that of control group (P0.05,P0.01,P0.01,respectively).Compared with the control group,the levels of IgG, IgM and C 3 in treatment group began to descent after 3 days of clozapine treatment.The IgG level was recorved normal after 7 days of clozapine treatment, After one month,there was no significant difference in C 3 level between the patients and the controls(P0.05), and there was significant difference before and after treatment in levels of IgG and C 3 (P0.05,P0.05),while the IgM level had downward trends but there was no significant difference before and after treatment (P0.05).There was no significant difference in comparison of levels of the IgA and C 4 between pretreatment and post-treatmwent and between both groups.Conclusion The antipsychotic clozapine can improve the immunological function for SP patients.