Effects of different methods of treatment of primary enuresis on psychologic functioning in children.

Sixty-two children with primary nocturnal enuresis were assigned randomly to one of two groups. Group 1 was treated with imipramine hydrochloride, and group 2 received a course of treatment with the Mozes Detector. Seventeen children from group 1 and 18 from group 2 were tested with the age-appropriate form of the Cattell personality questionnaire on three occasions: at the time of entry into the study, 2 months later and at follow-up, an average of 16 months later. The patients in group 2, who were older, had a higher rate of cure than did the patients in group 1. They also had significantly higher levels of extroversion and significantly lower levels of neuroticism at follow-up than did those in group 1. These findings indicate that better results are seen with the Mozes Detector than with imipramine in older children with primary nocturnal enuresis.     

Nocturnal Enuresis: Comparison of the Effect of Imipramine and Dietary Restriction on Bladder Capacity

Fifty children with nocturnal enuresis have been studied with a view to determining maximum bladder capacities and frequency of micturition, and the changes induced by dietary treatment and imipramine. Of 50 children treated with imipramine, 31 were symptomatically cured. Fifteen of the 48 children treated by dietary measures were also symptomatically cured, but as nine had already been cured by imipramine the correct cure rate for dietary treatment, for reasons indicated in the text, may have been no more than seven of the 48 cases. Treatment on the above lines, in those who responded, led to an increase in bladder capacity and a fall in diurnal frequency of micturition.Because the bladder can enlarge under the above conditions it is concluded that the bladder in the average enuretic is functionally but not structurally small, and that when dietary manipulation helps, it does so by eliminating factors from the diet to which the bladder is sensitive. Imipramine, by contrast, is effective because it blocks peripherally this effect.     

复方利多海浮膏对混合痔患者外剥内扎术后肛缘疼痛的临床效果

目的：探讨复方利多海浮膏用于治疗混合痔外剥内扎术后肛缘疼痛和水肿的临床疗效。方法：选择2012 年7月-2014 年12 月在我院接受混合痔外剥内扎术治疗的患者70 例,随机分为治疗组和对照组,每组各35 例。治疗组采用复方利多海浮膏外敷换 药治疗,对照组采用黄连膏换药治疗。观察并比较两组患者治疗前后肛缘疼痛和水肿的变化情况。结果：两组患者术前疼痛评分 及肛缘水肿得分差异无统计学意义（P＞0.05）;治疗组患者治疗后1 天、2 天、3 天、5 天的疼痛评分和肛缘水肿得分均显著低于对 照组,差异有统计学意义（P＜0.05）;治疗组患者治疗总有效率显著优于对照组,差异有统计学意义（P＜0.05）。结论：复方利多海 浮膏外敷换药用于治疗混合痔外剥内扎术后肛缘疼痛和水肿方面的疗效更好。     

Imipramine‐Induced c‐Fos Expression in the Medial Prefrontal Cortex is Decreased in the ACTH‐Treated Rats

Previous studies have shown that the antidepressive‐like effect of tricyclic antidepressants is blocked by repeated treatments with adrenocorticotropic hormone (ACTH). However, little is known about the neuroanatomy underlying the mechanism of the imipramine treatment‐resistant depression model. In the present study, first experimental evidence showed no significant difference of the serum imipramine concentrations between the saline and ACTH‐treated rats. In further study, imipramine produced significant increases in the c‐Fos expression in the medial prefrontal cortex (mPFC), the dentate gyrus of the hippocampus (DGH), and the central nucleus of the amygdala (CeA), in rats repeatedly treated with saline. The imipramine‐increased c‐Fos immunoreactivity was suppressed in the mPFC of rats repeatedly treated with ACTH. However, there was no significant difference in c‐Fos expression in the DGH and CeA between ACTH‐ and saline‐treated rats. These results suggest that the mPFC is maybe involved in effects of the imipramine in the ACTH‐treated rats. © 2013 Wiley Periodicals, Inc. J BiochemMol Toxicol 27:486‐491, 2013; View this article online at wileyonlinelibrary.com . DOI 10.1002/jbt.21510     

普拉提运动对慢性下腰痛患者的疼痛和腰椎功能的影响

为了揭示普拉提运动对慢性下腰痛患者的疼痛和腰椎功能的影响,本研究选择2017年1月至2018年6月在医院确诊并接受治疗的64例慢性下腰痛患者作为研究对象,根据运动疗法分为对照组(悬吊训练法)和观察组(悬吊训练法结合普拉提运动),采用视觉模拟评分(VAS)评价患者的疼痛程度,采用Oswestry功能障碍指数(ODI)评价患者的腰椎功能障碍情况,采用运动情境动机量表(SSIMS)评价患者的运动参与动机。研究显示,治疗后观察组的VAS评分显著低于对照组(p=0.043)。观察组治疗后的ODI总评分显著低于对照组(p=0.026),观察组患者治疗后的疼痛、生活自理、提物、行走和站立5个维度评分显著低于对照组(p<0.05)。SSIMS量表的4个维度中,鉴别原则得分最高,其次为内部动机,然后是外部调节,最后为缺乏动机。本研究结果提示,普拉提运动可显著降低下腰痛患者的疼痛程度,并改善腰椎功能。此外,普拉提运动具有较好的患者认可度和喜爱度,值得在临床和运动康复训练中应用。     

Children with Recurrent Abdominal Pain: How Do They Grow Up?

The results of treatment by reassurance and explanation of 30 children with recurrent abdominal pain have been compared with those in a group of 30 children seen earlier and given no such treatment. Most of the 19 treated children who responded to treatment did so more quickly than the untreated ones, and relapse did not occur in the treated group.     

稳定溶解臭氧水对皮肤创面炎症的治疗效果

目的:探讨浓度为1.8-3.2 mg/L溶解臭氧水冲洗控制皮肤创口炎症引发的红肿痛的临床效果。方法:将40例接受激光皮肤除斑治疗的患者分为两组,其中实验组20例患者采用浓度为1.8-3.2 mg/L溶解臭氧水冲洗皮肤创面,而对照组20例患者采用冰袋冷敷的方式处理创面。观察并比较两组患者皮肤创面红肿的改善情况以及两种治疗方法的临床效果。结果:1疼痛症状改善情况:实验组显效20例,对照组显效0例,实验组患者显效率明显高于对照组,差异具有统计学意义(P0.01)。2临床体征改善情况:实验组显效20例,对照组显效0例,实验组患者显效率明显高于对照组,差异具有统计学意义(P0.01)。结论:浓度1.8-3.2mg/L溶解臭氧水对于炎症引发的皮肤创面红肿症状具有显著的疗效,不仅能够抑制炎症发展,而且有利于促进创面愈合,值得在临床广泛推广应用。     

布比卡因局部阻滞治疗输尿管结石所致肾绞痛60 例的临床观察

目的:比较药物治疗与布比卡因局部阻滞治疗输尿管上段结石所致的肾绞痛的临床疗效。方法:选择输尿管结石患者共120例。随机分成药物治疗组(M组)与局部阻滞组(B组)各60例,其中药物治疗组采用杜冷丁加阿托品治疗,局部阻滞组采用布比卡因行痛区局部阻滞,两组年龄、性别均无统计学差异,比较两组患者治疗的总有效率、不良反应、镇痛起效时间、缓解时间等疗效指标。结果:局部阻滞组治疗的总有效率大于药物治疗组,不良反应也比药物治疗组少。疼痛起效时间及缓解时间,局部阻滞组均明显短于药物治疗组。结论:布比卡因局部阻滞治疗输尿管上段结石所致的肾绞痛临床疗效明显优于以杜冷丁加阿托品为代表的药物治疗。     

急诊应用VSD与延期内固定治疗胫骨远端骨折的对比分析

目的：探讨严重胫骨远端骨折的临床治疗方案。方法：2008年2月至2011年2月我科治疗的106例严重胫骨远端骨折患者,84例急诊应用封闭负压引流术（vacuum sealing drainage,VSD）联合内固定治疗胫骨远端骨折（观察组）,22例延期应用内固定治疗胫骨远端骨折（对照组）,比较两组的住院天数、住院费用、术后并发症、术后疼痛程度评分。结果：两组在住院天数、住院费用的比较差异无统计学意义（P〉0.05）。观察组术后出现2例伤口裂开,疼痛程度评分为：（2.31±1.37）分,对照组出现3例伤口感染并裂开,疼痛程度评分为：（4.09±2.34）分。术后并发症、术后疼痛程度评分的比较差异有统计学意义（P〈0.05）。结论：急诊应用VSD联合内固定治疗胫骨远端骨折不增加患者的治疗费用,减少患者的痛苦,在临床上值得推广应用。     

蛇伤清毒合剂治疗蝮蛇咬伤临床观察

目的观察蛇伤清毒合剂治疗蝮蛇咬伤的临床疗效。方法将82例蝮蛇咬伤患者随机分为对照组和治疗组,对照组给予常规治疗,治疗组在常规治疗的基础上加服蛇伤清毒合剂。观察比较两组止痛时间、肿胀消退时间、疗程时间及两组患者局部坏死发生率、呼吸肌麻痹、急性肾功能衰竭发生率。蛄果蛇伤清毒合剂治疗组能缩短止痛时间、肿胀消退时间-减少局部坏死发生率、呼吸肌麻痹、急性肾功能衰竭发生率,与对照组比较差异显著（P〈0．05）。蛄论蛇伤清毒合剂能显著提高蝮蛇咬伤的疗效。     

Effect of combined treatment with imipramine and metyrapone on the immobility time, the activity of hypothalamo-pituitary-adrenocortical axis and immunological parameters in the forced swimming test in the rat.

Major depression is frequently associated with the hyperactivity of the hypothalamic-pituitary-adrenocortical axis, and glucocorticoid synthesis inhibitors have been shown to exert antidepressant action. The aim of the present study was to examine the effect of joint administration of metyrapone (50 mg/kg) and imipramine (5 and/or 10 mg/kg) on immobility time, plasma corticosterone concentration, the weight of spleens and thymuses and the proliferative activity of splenocytes in rats subjected to the forced swimming test--an animal model of depression. Metyrapone alone (50 mg/kg) reduced the immobility time of rats in the forced swimming test and decreased plasma corticosterone level, but did not change immunological parameters. Joint administration of metyrapone and imipramine (5 and 10 mg/kg) produced a more pronounced antidepressant-like effect than either of the drugs given alone. The forced swimming procedure significantly increased the proliferative activity of splenocytes, that parameter being reduced only by co-administration of metyrapone and imipramine. Joint administration of metyrapone and imipramine inhibited to a similar extend the corticosterone level as did treatment with metyrapone alone (about twofold); however, the plasma corticosterone level in animals treated with metyrapone and the higher dose of imipramine did not differ from the concentration of this steroid in control, not-stressed rats. The obtained results indicate that metyrapone potentiates the antidepressant-like activity of imipramine and exerts a beneficial effect on the stress-induced increase in plasma corticosterone concentration and the proliferative activity of splenocytes. These finding suggest that a combination of metyrapone and an antidepressant drug may be useful for the treatment drug-resistant depression and/or depression associated with a high cortisol level.     

臭氧痛点阻滞联合玻璃酸钠治疗肩周炎的临床疗效及对肩关节活动度的影响

目的:研究臭氧痛点阻滞联合玻璃酸钠治疗肩周炎的临床疗效及对肩关节活动度的影响。方法:选取2014年1月到2015年1月我院收治的肩周炎患者110例,按照随机数字表法将患者分为I组和II组,每组55例。I组给予臭氧痛点阻滞治疗,II组给予臭氧痛点阻滞联合玻璃酸钠治疗。应用视觉模拟量表(VAS)评价疼痛情况,应用量角器测量患者肩关节活动度,并比较两组临床疗效和不良反应。结果:I组总有效率83.6%显著低于II组的94.5%,比较差异具有统计学意义(P0.05);两组治疗后VAS评分、外展、内旋以及外旋活动度均显著优于治疗前,且II组显著优于I组,比较差异具有统计学意义(P0.05);两组不良反应发生率比较无统计学意义(P0.05)。结论:臭氧痛点阻滞联合玻璃酸钠治疗肩周炎具有较好的临床疗效,能显著改善患者肩关节活动度。     

Biobrane versus 1% silver sulfadiazine in second-degree pediatric burns

Partial-thickness burns in children have been treated for many years by daily, painful tubbing, washing, and cleansing of the burn wound, followed by topical application of antimicrobial creams. Pain and impaired wound healing are the main problems. We hypothesized that the treatment of second-degree burns with Biobrane is superior to topical treatment. Twenty pediatric patients were prospectively randomized in two groups to compare the efficacy of Biobrane versus 1% silver sulfadiazine. The rest of the routine clinical protocols were followed in both groups. Demographic data, wound healing time, length of hospital stay, pain assessments and pain medication requirements, and infection were analyzed and compared. Main outcome measures included pain, pain medication requirements, wound healing time, length of hospital stay, and infection. The application of Biobrane to partial-thickness burns proved to be superior to the topical treatment. Patients included in the biosynthetic temporary cover group presented with less pain and required less pain medication. Length of hospital stay and wound healing time were also significantly shorter in the Biobrane group. None of the patients in either group presented with wound infection or needed skin autografting. In conclusion, the treatment of partial-thickness burns with Biobrane is superior to topical therapy with 1% silver sulfadiazine. Pain, pain medication requirements, wound healing time, and length of hospital stay are significantly reduced.     

"Specific" Binding of [3H]Imipramine to Protease-Sensitive and Protease-Resistant Sites

A number of 5-hydroxytryptamine (5-HT) uptake inhibitors have been shown to displace the binding of [3H]imipramine to rat cortical membranes in a complex manner with Hill slopes less than unity. Norzimeldine displaced the binding of [3H]imipramine in a biphasic manner with IC50 values for the two components of about 30 nM and 30 microM. This latter site alone was found in tissues that had been treated with a protease. Binding to both of these sites was displaced by 10 microM desipramine. The protease-sensitive [3H]imipramine binding sites were found to be saturable, high-affinity binding sites with a KD of 8 nM. The number of these sites varied between brain regions and was positively correlated with the regional distribution of [14C]5-HT but not [3H]noradrenaline uptake. This was not the case however for the protease-resistant but desipramine-displaceable binding sites. Since most previous [3H]imipramine binding studies have been performed with high concentrations of desipramine (10 microM) to define "specific binding," these data would suggest that either protease-sensitivity or displacability by 1 microM norzimeldine would give more reliable estimates of the specific binding.     

Novel neurological and immunological targets for salicylate-based phytopharmaceuticals and for the anti-depressant imipramine

Inflammatory processes are increasingly recognised to contribute to neurological and neuropsychatric disorders such as depression. Thus we investigated whether a standardized willow bark preparation (WB) which contains among other constituents salicin, the forerunner of non-steroidal antiphlogistic drugs, would have an effect in a standard model of depression, the forced swimming test (FST), compared to the antidepressant imipramine. Studies were accompanied by gene expression analyses. In order to allocate potential effects to the different constituents of WB, fractions of the extract with different compositions of salicyl alcohol derivative and polyphenols were also investigated. Male Sprague Dawley rats (n=12/group) were treated for 14 days (p.o.) with the WB preparation STW 33-I (group A) and its fractions (FR) (groups FR-B to E) in concentrations of 30 mg/kg. The FRs were characterized by a high content of flavone and chalcone glycosides (FR-B), flavonoid glycosides and salicyl alcohol derivatives (FR-C), salicin and related salicyl alcohol derivatives (FR-D) and proanthocyanidines (FR-E). The tricyclic antidepressant imipramine (20 mg/kg) (F) was used as positive control. The FST was performed on day 15. The cumulative immobility time was significantly (p<0.05) reduced in group A (36%), group FR-D (44%) and by imipramine (16%) compared to untreated controls. RNA was isolated from peripheral blood. RNA samples (group A, group FR-D, and imipramine) were further analysed by rat whole genome microarray (Agilent) in comparison to untreated controls. Quantitative PCR for selected genes was performed. Genes (>2 fold, p<0.01), affected by WB and/or FR-D and imipramine, included both inflammatory (e.g. IL-3, IL-10) and neurologically relevant targets. Common genes regulated by WB, FR-D and imipramine were GRIA 2 ↓, SRP54 ↓, CYP26B ↓, DNM1L ↑ and KITLG ↓. In addition, the hippocampus of rats treated (27 d) with WB (15-60 mg/kg WB) or imipramine (15 mg/kg bw) showed a slower serotonin turnover (5-hydroxyindol acetic acid/serotonin (p<0.05)) depending on the dosage. Thus WB (30 mg/kg), its ethanolic fraction rich in salicyl alcohol derivatives (FR-D) (30 mg/kg) and imipramine, by being effective in the FST, modulated known and new targets relevant for neuro- and immunofunctions in rats. These findings contribute to our understanding of the link between inflammation and neurological functions and may also support the scope for the development of co-medications from salicylate-containing phytopharmaceuticals as multicomponent mixtures with single component synthetic drugs.     

腹腔灌注化疗联合内生场热疗治疗胰腺癌恶性腹水的疗效

目的:探讨腹腔灌注化疗联合内生场热疗治疗胰腺癌恶性腹水的临床疗效。方法:将50例晚期胰腺癌合并恶性腹水患者随机分为实验组与对照组,每组25例。实验组行腹腔灌注化疗联合内生场热疗治疗,对照组单纯行腹腔灌注化疗。比较两组患者腹水控制疗效、生活质量改善、疼痛程度和不良反应情况。结果:实验组患者治疗后腹水控制总有效率为68.0%,明显高于对照组的36.0%(P0.05);实验组生活质量改善率达60.0%,远高于对照组的40.0%(P0.05);实验组患者疼痛水平明显好于对照组(P0.05);两组患者不良反应发生率无明显差异(P0.05)。结论:腹腔灌注化疗联合内生场热疗治疗胰腺癌恶性腹水效果显著,能明显改善患者生活质量、缓解疼痛,值得临床推广。     

复方嗜酸乳杆菌片对感染性腹泻患者胃肠道症状的影响

目的应用复方嗜酸乳杆菌片治疗感染性腹泻,观察微生态制剂对患者胃肠道症状的影响。方法选择100例感染性腹泻患者,均来自青岛大学附属中心医院,采用随机数字表法随机分为A、B组。其中A组患者(80例)单用复方嗜酸乳杆菌片(1.0g/次,3次/d,口服)治疗;B组患者(20例)单用利福昔明片(0.2g/次,4次/d,口服)治疗。两组患者均采用配对设计方法,治疗前进行胃肠道症状分级评分,包括单个症状(腹痛、腹胀、腹泻频率、大便性状)的评分和上述症状的总评分。治疗3d后门诊随访或电话随访,再次进行胃肠道症状分级评分,比较治疗前后患者的胃肠道症状评分改善情况并判断疗效以及治疗中的不良反应。结果两组患者的总有效率分别为78.75%和85.00%,差异无统计学意义(P0.05)。两组患者治疗过程中均未见不良反应。复方嗜酸乳杆菌片治疗后患者腹胀、腹泻频率、大便性状的症状评分和症状总评分较治疗前显著降低,差异有统计学意义(P0.01)。腹痛症状评分治疗前后差异无统计学意义(P0.05)。结论复方嗜酸乳杆菌片治疗感染性腹泻能达到满意的疗效,可改善患者腹胀、腹泻频率、大便性状等胃肠道症状。     

Lidocaine patch (5%) is no more potent than placebo in treating chronic back pain when tested in a randomised double blind placebo controlled brain imaging study

ABSTRACT: The 5% Lidocaine patch is used for treating chronic neuropathic pain conditions such as chronic back pain (CBP), diabetic neuropathy and complex regional pain syndrome, but is effective in a variable proportion of patients. Our lab has reported that this treatment reduces CBP intensity and associated brain activations when tested in an open labelled preliminary study. Notably, effectiveness of the 5% Lidocaine patch has not been tested against placebo for treating CBP. In this study, effectiveness of the 5% Lidocaine patch was compared with placebo in 30 CBP patients in a randomised double-blind study where 15 patients received 5% Lidocaine patches and the remaining patients received placebo patches. Functional MRI was used to identify brain activity for fluctuations of spontaneous pain, at baseline and at two time points after start of treatment (6 hours and 2 weeks). There was no significant difference between the treatment groups in either pain intensity, sensory and affective qualities of pain or in pain related brain activation at any time point. However, 50% patients in both the Lidocaine and placebo arms reported a greater than 50% decrease in pain suggesting a marked placebo effect. When tested against an untreated CBP group at similar time points, the patch treated subjects showed significantly greater decrease in pain compared to the untreated group (n=15). These findings suggest that although the 5% Lidocaine is not better than placebo in its effectiveness for treating pain, the patch itself induces a potent placebo effect in a significant proportion of CBP patients.     

鼻渊汤辨证加减治疗对慢性鼻窦炎患者症状与疼痛的影响

目的:评价鼻渊汤辨证加减治疗慢性鼻窦炎的临床效果,观察其对患者症状与疼痛的影响。方法:选择我院门诊2016年6月～2018年6月收治的慢性鼻窦炎患者117例为本次研究对象,采取随机数字表法将其分为对照组与观察组。对照组58例采用西医常规疗法,观察组59例采用鼻渊汤辨证加减治疗。对比两组患者的临床治疗效果,治疗前后临床症状及疼痛的改善情况。结果:治疗后,观察组治疗有效率为89.83%,明显高于对照组(70.69%,P0.05),而观察组症状评分明显低于对照组(P0.05)。此外,观察组治疗后VAS评分为(0.74±0.13分),亦明显低于对照组(1.52±0.30分)(P0.05)。结论:鼻渊汤治疗慢性鼻窦炎能够显著改善患者临床症状,降低其疼痛感受,并提高临床疗效。     

吗啡皮下自控镇痛泵治疗难治性癌痛的前瞻性多中心随机对照研究

摘要 目的：观察吗啡皮下自控镇痛泵治疗难治性癌痛的临床疗效。方法：采用前瞻性多中心随机对照研究,应用治疗方法分为试验组和对照组,其中试验组使用皮下自控阵痛泵给药,对照组口服吗啡片剂,5 d为一疗程,共计观察3疗程。观察两组患者治疗后疼痛积分改善情况;每疗程吗啡日均用量;疼痛起效时间、最佳缓解时间;镇痛维持时间及剂量稳定天数、爆发痛情况;生活质量改善及不良反应发生率;疗程费用情况。结果：两组患者数字疼痛评分法(numerical rating scale,NRS)评分在治疗后均较镇痛前显著降低（P＜0.05）;在吗啡用量比较方面,试验组吗啡用量显著低于对照组同期用量;试验组在疼痛缓解时间、疼痛最佳缓解时间方面均显著优于对照组;治疗期间试验组平均镇痛维持时间明显长于对照组（P＜0.05）;两组患者治疗后体力状况分析标准(performance status,PS)评分较治疗前显著改善;试验组便秘、嗜睡不良反应发生率显著低于对照组（P＜0.05）。试验组每疗程费用明显低于对照组,具有明显经济优势。结论：吗啡皮下自控镇痛泵给药方式控制难治性癌痛临床疗效确切,止痛效果明显。与对照组比较,疼痛起效时间短,疗程较吗啡用量少,不良反应发生率低,改善了患者生活质量,且减轻了患者经济压力。