目的 探讨加味涤痰汤辅助治疗对缺血性脑卒中后认知功能障碍患者神经功能及中医辨证量表评分的影响.方法 回顾性分析2019年11月至2021年11月于长安医院治疗的117例缺血性脑卒中后认知功能障碍患者的临床资料.根据治疗方案不同分为对照组(常规治疗+盐酸多奈哌齐治疗)57例和研究组(常规治疗+盐酸多奈哌齐治疗+加味涤痰汤治疗)60例.比较两组患者治疗前后的神经功能、日常生活能力和中医辨证量表评分,以及治疗后的临床疗效和不良反应发生情况.结果 治疗后,研究组患者的美国国立卫生研究院卒中量表(NIHSS)评分为(6.87±3.34)分,明显低于对照组的(8.69±1.95)分,日常生活能力评定量表(ADL)评分为(53.25±12.36)分,明显高于对照组的(47.68±11.58)分,血管性痴呆中医辨证量表(SDSVD)评分为(10.49±2.64)分,明显高于对照组的(12.96±2.85)分,差异均有统计学意义(P<0.05);研究组患者的临床治疗总有效率为95.00％,明显高于对照组的82.46％,差异有统计学意义(P<0.05);两组患者治疗期间均未发生明显不良反应.结论 加味涤痰汤辅助治疗缺血性脑卒中后认知功能障碍可有效改善患者的神经功能、日常生活能力以及中医症状,临床疗效显著.

Objective To investigate the expression and significance of S100P,CD147 and OCT4 in different stages of TNM of gastric cancer. Methods The expression levels of S100P,CD147 and OCT4 were detected by immunohistochemistry in 54 cases of gastric cancer,40 cases of chronic gastritis and 20 cases of normal gastric tissues,and the expression levels in different stages of TNM of gastric cancer were observed and compared. Results The positive expression rate(18. 52℅ )of S100P in gastric cancer tissues was significantly lower than that in normal gastric tissues and chronic gastritis tissues( P ﹤ 0. 05),however,the positive expression rates(100℅ )of CD147 and OCT4(77. 38℅ )were significantly higher than those in normal tissues and chronic gastritis tissues( P ﹤ 0. 05). The positive rate(0)of S100P in stage Ⅴ was significantly lower than that in stage I(37. 50℅ )and in stage Ⅱ(35. 71℅ )( P ﹤ 0. 05). The positive rates of CD147 in different stages of TNM were all 100℅ ,in which the strong positive rate was significantly higher than weak positive rate and moderate positive rate( P ﹤ 0. 05). The positive rate of OCT4 in stage Ⅲ and in stage Ⅴ was significantly higher than that in stageⅠ( P ﹤ 0. 05). The positive expression rate of S100P in patients with distant metastasis was significantly lower than that of patients without distant metastasis( P ﹤ 0. 05),however,the positive expression rate of OCT4 in patients with distant metastasis was significantly higher than that of patients without distant metastasis( P ﹤ 0. 05). There were no significant differences in positive expression rates of S100P,CD147,OCT4 in patients with different differentiation degrees (P ﹥ 0. 05). Conclusion The expression levels of S100P in gastric tissues are significantly decreased,however,the expression levels of OCT4 and CD147 are significantly increased,which is closely correlated to TNM staging and distant metastasis of patients with gastric cancer,but which is not related with tumor’s differentiation degree.

Objective To observe the clinical effect of Bailemian Capsules combined with fluoxetine and risperidone in treatment of depression. Methods Patients (84 cases) with depression in Changan Hospital of Xi’an from May 2015 to March 2016 were enrolled in this study and divided into control (42 cases) and treatment (42 cases) groups according to different treatments. The patients in the control group were po administered with Fluoxetine Hydrochloride Dispersible Tablets, 20 mg/time, once daily. At the same time, the patients were po administered with Risperidone Tablets, 2 mg/time, once daily. The patients in the treatment group were po administered with Bailemian Capsules on the basis of the control group, 4 grains/time, twice daily. The patients in two groups were treated for 4 weeks. After treatment, clinical efficacy was evaluated, and the changes of HAMD and WHOQOL-BREF scores in two groups were compared before and after treatment. Results After treatment, the clinical effect in the control and treatment groups were 80.95%and 95.24%, respectively, and there was difference between two groups (P<0.05). After treatment for 1, 2, and 4 weeks, HAMD scores of two groups were obviously decreased, and the difference was statistically significant in the same group (P<0.05);After treatment for 2 and 4 weeks, HAMD scores of the treatment group decreased more obviously than those of the control group with significant difference (P<0.05). After treatment, the WHOQOL-BREF scores of physical health, psychological status, social relations, and surrounding environment in two groups were increased (P<0.05);And WHOQOL-BREF scores in the treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Bailemian Capsules combined with fluoxetine and risperidone has a significant clinical effect in treatment of depression, can relieve the depression state, and improve the quality of life, which has a certain clinical application value.

目的观察柴胡疏肝散合温胆汤加减能否改善心脏神经症患者的临床症状及焦虑状态。方法将80例心脏神经症的患者随机分为治疗组(50例)和对照组(30例)。治疗组给予柴胡疏肝散合温胆汤加减治疗,每日1剂,每周6剂,连续治疗4周。对照组口服谷维素20 mg,每日3次。失眠者加安定2.5~5mg,每晚1次,连续治疗4周。两组均随访1个月。于治疗前后及1个月随访时分别进行焦虑自评量表(SAS)评分。结果治疗组治疗4周后总有效率90%,对照组总有效率73.33%。两组比较有统计学意义(P<0.01)。治疗组治疗后及1个月随访时SAS评分与治疗前及对照组比较均明显降低(P<0.05)。结论柴胡疏肝散合温胆汤加减治疗心脏神经症可改善患者症状,改善其焦虑状态。

目的 探讨十二指肠损伤的诊断及治疗.方法 对两家医院笔者参与治疗的16例十二指肠损伤病例的回顾性分析.结果 术前确诊5例(31.25%),漏诊1例(6.25%),治愈15例(93.75%),死亡1例(6.25%);发生并发症3例(18.75%).结论 简单而合理的手术方式是治疗十二指肠损伤的重要措施.

患者,男性,20岁,大学一年级学生.自感上牙前凸而被议论2年,辍学1周入院.2年前出现自己上牙前凸感,为此寝食不安,留恋往返于镜前.导致学习成绩下降.此后渐发展认为上牙前凸明显,相貌丑陋,整日沉湎于此想象中,感周围同学在议论、讥讽他的相貌.