目的 探讨适合用于氯氮平(CZP)、去甲氯氮平(N-CZP)血药浓度快速测定的样本处理方式.方法 选择临床服用CZP治疗的住院患者,使用含有肝素钠抗凝剂、促凝剂和普通的真空采血系统分别采集患者的血液样本,在HP-1100高效液相色谱仪上测定CZP、N-CZP的浓度,比较结果的不同.结果 经过促凝剂、肝素钠抗凝处理的样本,与普通管血清相比,相互间CZP、N-CZP浓度比较,差异无统计学意义(P>0.05).经含有促凝剂、肝素钠抗凝后处理样本,在不分离凝块条件下,无论是4℃,还是室温环境,放置24 h后较放置前CZP、N-CZP浓度结果比较,差异无统计学意义(P>0.05).分离血清后,含促凝剂的样本,4℃放置24 h较放置前,CZP、N-CZP浓度有降低趋势(P<0.05);使用肝素抗凝的血浆,放置前后无变化(P>0.05).结论 使用含有促凝剂和肝素钠抗凝剂的真空采样,适合用于CZP的快速测定.

目的 探究不同病情程度系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血清泌乳素(PRL)、生长激素(GH)水平变化及临床意义.方法 选取2015年5月-2018年3月新乡医学院第二附属医院收治的SLE患者95例作为SLE组,另选同期健康体检者50例作为对照组.采集两组晨起空腹肘静脉血5 mL,采用酶联免疫吸附法(ELISA)测定血清PRL、GH水平,比较SLE组与对照组、SLE组不同病情程度血清PRL、GH水平.结果 SLE组血清PRL、GH水平高于对照组(P＜0.05);SLE组中无活动患者血清PRL、GH水平最低,重度活动患者血清PRL、GH水平最高,随着SLE病情程度增加,血清PRL、GH水平呈升高趋势,轻度活动患者血清PRL、GH水平与无活动患者之间无明显差异(P＞0.05),重度活动患者、中度活动患者血清PRL、GH水平高于无活动患者(P＜0.05).结论 SLE患者血清PRL、GH水平明显高于健康人群,随着病情程度加重,血清PRL、GH水平呈升高趋势,对其进行检测可为临床治疗SLE提供数据参考.

目的 探析中段尿细菌培养及药敏试验对复发性尿路感染(RUTI)患者抗生素合理使用的影响.方法 选取2016年9月-2018年6月新乡医学院第二附属医院RUTI患者226例作为研究对象,均留取中段尿,并进行细菌培养及药敏试验,分析临床治疗效果及抗生素使用效果,并统计细菌培养及药敏试验结果.结果 经细菌培养,226例患者中,阳性98例(43.36％),阴性128例(56.64％);98例阳性中共分离出116株菌,其中96株检出1种细菌(82.76％),20株检出2种细菌(17.24％);常见菌株103株,分别为奇异变形杆菌(31.03％)、草绿色链球菌(9.48％)、大肠埃希氏菌(33.62％)、肺炎克雷伯菌(6.90％)及粪肠球菌(7.76％);奇异变形杆菌、肺炎克雷伯菌、大肠埃希氏菌均对奎奴普丁无药物敏感性,对美罗培南、亚胺培南及头孢他啶药物敏感性较强,且粪球杆菌对奎奴普丁药物敏感性达88.89％;临床总有效率为95.58％.结论 对中段尿实施细菌培养及药敏试验,有助于了解RUTI患者尿路感染菌及其药敏情况,及时掌握感染菌对抗生素耐药性,为临床正确合理选择与合理使用抗生素提供参考依据.

目的:观察解郁通络法治疗卒中后抑郁(PSD)患者的临床疗效及对神经递质的调节作用.方法:共选择125例符合要求的PSD患者作为研究对象,采用SAS软件,按随机数字表法分为观察组63例和对照组62例.两组患者均口服盐酸舍曲林片,25～50 mg/次,2次/d.对照组口服舒肝解郁胶囊,2粒/次,2次/d;观察组内服解郁通络汤,1剂/d.两组疗程均为连续治疗6周.进行治疗前后汉密尔顿抑郁量表-17(HAMD-17),患者健康问卷-9项(PHQ-9),美国国立卫生研究院卒中量表(NHISS),中医证候评分和日常生活活动能力量表(ADL)评分,检测治疗前后5-羟色胺(5-HT),去甲肾上腺素(NE),多巴胺(DA)脑源性神经营养因子(BDNF),血清S100-β蛋白(S100-β)和神经元烯醇化酶(NSE)水平.结果:观察组临床疗效优于对照组(Z =2.384,P＜0.01);观察组患者HAMD-17和PHQ-9评分均低于对照组(P＜0.01);观察组HAMD-17评分情况轻于对照组(Z =2.266,P＜0.05),观察组PHQ-9评分情况轻于对照组(Z=2.817,P＜0.01);观察组患者的NHISS,中医证候评分均低于对照组(P＜0.01),ADL评分高于对照组(P＜0.01);观察组血清5-HT,DA和NE水平均高于对照组(P＜0.01);观察组血清S100-β和NSE水平均低于对照组(P＜0.01),BDNF水平高于对照组(P＜0.01).结论:在心理治疗和SSRI治疗的基础上,给予PSD患者服用解郁通络汤,可进一步的减轻患者抑郁程度,缓解抑郁症状,还能减轻神经功能缺损程度和提高日常生活活动能力,调节神经递质表达,促进了脑神经组织的修复,临床可取的一定疗效.

目的:观察舒肝颗粒治疗围绝经期抑郁(肝郁气滞证)的临床疗效及对性激素和炎症因子的影响.方法:将120例患者随机按数字表法分为对照组和观察组各60例.两组患者均口服替勃龙片,2.5 mg/次,1次/d;对照组口服氟哌噻吨美利曲辛片,1片/次,早晨及中午各1次.观察组在对照组治疗的基础上口服舒肝颗粒,1袋/次,2次/d.两组疗程均为连续治疗8周.主要疗效指标采用汉密尔顿抑郁量表17项(HAMD-17),抑郁自评量表(SDS)和艾森克人格问卷(EPQ);次要疗效指标采用焦虑自评量表(SAS),肝郁气滞证评分、改良Kupperman(KI)评分,并检测促卵泡刺激素(FSH),促黄体生成素(LH),雌二醇(E2),5-羟色胺(5-HT),脑源性神经营养因子(BDNF),白细胞介素-1β(IL-1β),IL-6和肿瘤坏死因子-α(TNF-α)水平.于治疗前后各评价1次.结果:治疗后观察组临床抑郁疗效优于对照组(Z =2.038,P＜0.05);观察组患者围绝经期综合征疗效优于对照组(Z=2.316,P＜0.05);观察组患者HAMD-17,SDS和EPQ-N评分均低于对照组(P＜0.01),EPQ-E评分高于对照组(P＜0.01);观察组患者的SAS,KI和肝郁气滞证评分均低于对照组(P＜0.01);观察组患者FSH和LH水平均低于对照组,E2和BDNF水平均高于对照组(P＜0.01);观察组患者血清5-HT水平高于对照组,IL-1β,IL-6和TNF-α水平均低于对照组(P＜0.01).结论:舒肝颗粒可减轻围绝经期抑郁肝郁气滞证患者的、焦虑及围绝经期症状,并具有调节性激素、减轻炎症反应和调节5-HT和BDNF作用,临床疗效优于单纯的西医治疗.

Objective:To investigate efficacy of Jieyu Tongluo decoction in treating depression after ischemic stroke and its influence on neuroimmune inflammatory markers.Method:One hundred and twelve cases with depression after ischemic stroke were elected and randomly divided into observation group (56 cases) and control group (56 cases) by referring to random number table.Both groups received conventional intervention by referring to ‘ Chinese stroke rehabilitation treatment guidelines' Cases of control group were orally given with paroxetine hydrochloride,20 mg/day at beginning,l0 mg increasing per week,and maximum dose ≤ 40 mg/day.On basis of control group,observation group was given with Jieyu Tongluo decoction,1 dose/day.Two groups were observed for 6 weeks.Scores of depression self rating scale (SDS),HAMD factors,and efficacy were compared in both groups.Serum levels of interleukin (IL)-1β,IL-2,IL-6 and tumor necrosis factor (TNF)-α,plasma levels of corticosteroid release hormone (CRH),corticosteroid (ACTH) and cortisol (Cor) and levels of CD3 +,CD4+,CD8 + were detected in two groups.Result:After 3 weeks and 6 weeks treatment,SDS score of observation group was lower than that of control group (P ＜ 0.01).HAMD factors scores of observation group were lower than those of control group after treatment (P ＜ 0.01).Total effective of observation group was 88.89％,which was evidently higher than 71.7％ of control group (P ＜ 0.05).After treatment,serum levels of IL-1β,IL-2,IL-6 and TNF-α and plasma levels of CRH,ACTH and Cor of control group were remarkably lower than those of control group (P ＜ 0.01).After treatment CD3 + and CD4 + of observation group were obviously higher,while CD8 + was lower,than control group (P ＜ 0.01).Conclusion:Efficacy of Jieyu Tongluo decoction in treating depression after ischemic stroke is significant and may improve depression after ischemic stroke through inhibiting inflammatory factor index level,regulation of hypothalamicpituitary-adrenal axis (HPA) function,and increase cellular immune function.

为探讨血尿酸(Serum uric acid,SUA)与高血压病的关系,本文对127例高血压病患者血尿酸水平进行检测,并与108例健康体检者进行对照分析,报道如下. 对象与方法 1 对象高血压病组:2007年10月至2008年10月新乡医学院第二附属医院内科门诊及住院患者,共127例,男68例,女59例,平均年龄50.9±11.4岁;其中1级高血压39例,2级高血压41例,3级高血压47例.