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Objective:To compare the effect and safety of continuous veno-venous hemofiltration (CVVH)+double plasma molecular absorption (DPMA)+hemoperfusion (HP), CVVH+HP, and CVVH+plasma exchange (PE) in treatment of patient with severe wasp stings injury.Methods:Multicenter, historical cohort study and superiority test were used. From July 2020 to October 2022, patients with wasp sting injury and multiple organ damage admitted to the intensive care units (ICU) of five hospitals were consecutively screened and recruited into the CVVH+DPMA+HP group (intervention group). Propensity score matching was used to establish historical cohorts. Patients with severe wasp sting injury who hospitalized from January 2016 to June 2020 in each ICU were collected and matched 1∶1 with the intervention group, and divided into CVVH+HP group and CVVH+PE group according to their actual hemopurification protocols (historical control groups). The primary outcome was the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score on days 3 and 7 after initiation of treatment. Secondary outcomes included complications, length of ICU and hospital stays, and all-cause mortality. Multivariate Cox proportional risk regression was used to analyze the prognosis of patients.Results:After propensity score matching, 56 patients in intervention group and each of the two historical control groups were matched successfully. There were no significant differences in age, gender, comorbidities, biochemical test indices and critical illness scores among the groups. After treatment, APACHE Ⅱ score markedly declined in all groups, and the decrease was faster in the intervention group; treatment with DPMA [hazard ratio ( HR) = 1.04, 95% confidence interval (95% CI) was 1.02-1.08, P = 0.00], the decreased levels of body temperature ( HR = 1.02, 95% CI was 1.00-1.03, P = 0.02), serum creatine kinase (CK; HR = 0.98, 95% CI was 0.96-1.00, P = 0.05) and myoglobin (MYO; HR = 2.88, 95% CI was 1.24-6.69, P = 0.01) were independent risk factors for APACHE Ⅱ score decline to the target value (15 scores). There were no significant differences in the incidence of bleeding complications, filter or perfusion thrombosis, blood pressure reduction, catheter-related infection and anaphylaxis among the groups. Conclusion:CVVH+DPMA+HP regimen can significantly reduce the APACHE Ⅱ score of patients with severe wasp sting injury, and the efficacy is superior to CVVH+HP and CVVH+PE regimens, with safety.
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Objective:To explore the efficacy and safety of amisulpiride at low dosage combined with clozapine in the treatment of refractory schizophrenia. Methods:Totally 160 patients with refractory schizophrenia were chosen from the psychiatric department of 4 hospitals during January to September in 2014 and randomly divided into the observation group and the control group with 80 cases in each. The patients were treated with clozapine plus amisupiride or clozapine plus placebo for 12 weeks. The positive and negative syn-drome scale ( PANSS) and treatment emergent side effect scale ( TESS) was used to respectively evaluate the efficacy and the adverse effects. Results:At the weekend of the 4th, 8th and 12th week after the treatment, the clinical efficacy in the observation group was sig-nificantly better than that in the control group (all P0. 05). Conclusion:Amisulpiride at low dosage combined with clozapine can significantly improve the effi-cacy in the treatment of refractory schizophrenia without added adverse effects.
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Objective To explore the clinical characteristics of the patients with schizophrenia to make troubles and accidents likely ,to provide scientific evidence for preventing and controlling these patients to make troubles and accidents effectively .Methods 100 patients with schizophrenia to make troubles and accidents likely were randomly extracted and assigned to the study group from psychiatric department of this hospital .100 ordinary patients were divided into control group .Their data on illness were sur-veyed and analyzed retrospectively .The difference of the general condition and illness data along with mental symptoms between the both group were compared .Results The proportion of patients to be man peasant ,in rural area ,no a spouse and medical insurance , to have a lower degree of culture and to be 20 - 39 years old in the study group was significantly higher than those in the control group(P< 0 .05) .The social support and economic conditions of family in the study group were significantly poorer than those in the control group(P< 0 .05) .The proportion of patients to be paranoid schizophrenia ,to have a complications and the positive score of the positive and negative syndrome scale (PANSS) in the study group were significant higher than those in the control group but the negative score of PANSS and the course of disease were significantly lower (P< 0 .05) .The proportion of patients to have posi-tive symptoms such as illusion and delusion in the study group were significantly higher than that in the control group (P< 0 .05) . But the proportion of patients to have negative symptoms such as avoid social and emotional dull in the study group were signifi -cantly lower than that in the control group(P< 0 .05) .Conclusion The positive symptoms contribute to making troubles and acci-dents in SP patients .The patients to be paranoid schizophrenia ,a man and peasant ,in prime of life ,in rural area ,no a spouse and to have a lower degree of culture maybe make troubles and accidents more likely .Having a poor social support and economic conditions of family and no medical insurance cause the probability of their making troubles and accidents increase .
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@#ObjectiveTo explore the influence of antipsychotics combined with skill traning on quality of life and social function of patients with schizophrenia at recovery.Methods80 patients with schizophrenia were randomly divided into study group (n=40, antipsychotics plus skill training)and control group (n﹦40, only antipsychotics) for 1-year treatment. At pre-treatment and end of treatment, both groups were assessed with Positiveand and Negative Symptom Scale (PANSS), Generic Quality Of Life Inventory-74 (GQOLI-74) and Social Disability Screening Schedue(SDSS) respectively to evaluate their effects, quality of life and social funtion.ResultsAfter 1-year treatment, the general scores of PANSS and each factors in both groups decreased significantly compared with the baseline(P<0.05～0.01), and the significant difference was found between two groups(P<0.01). Improvement of each factor score of FAD(except factor of the material life) and SDSS in study group were more better than those in control group(P<0.05～0.01).ConclusionTreatment with antipsychotics plus skill traning is helpful to release the mental syndrome, improve quality of life and social funtion, and facilitate the recovery of the patients with schizophrenia at recovery.