Essential Oil from Citrus aurantium Alleviates Anxiety of Patients Undergoing Coronary Angiography: A Single-Blind, Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To determine the effectiveness and safety of essential oil from Citrus aurantium on anxiety in patients undergoing coronary angiography.@*METHODS@#A single-blind, randomized controlled trial was conducted in 80 patients experiencing coronary angiography in Imam Ali Hospital in Kermanshah, Iran from April to November in 2016. All patients were randomly divided into intervention and control groups by a random number table, 40 cases in each group. The patients in the intervention group inhaled Citrus aurantium essential oil for 15-20 min about 60 min before angiography. Following the same procedure, distilled water was used instead of Citrus aurantium in the control group. Spielbergers State-Trait Anxiety Inventory (STAI) was filled in and vital signs including systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory and pulse rate were recorded before and 20 min after the intervention. Adverse reactions after intervention were observed.@*RESULTS@#In the intervention group, the mean scores of STAI, SBP, DBP, respiratory and pulse rate were 53.30 ± 10.13, 134.82 ± 11.75 mm Hg, 84.49 ± 6.99 mm Hg, 17.87 ± 1.73 times/min, and 76.48 ± 12.55 beats/min at baseline and significantly decreased to 42.37 ± 10.15, 124.49 ± 10.48 mm Hg, 79.23 ± 6.62 mm Hg, 14.54 ± 1.43 times/min, and 70.03 ± 13.66 beats/min respectively 20 min after intervention (all P0.05). All subjects reported no adverse reactions.@*CONCLUSION@#Inhalation of the essential oil from Citrus aurantium was effective in reducing anxiety and stress levels in patients undergoing coronary angiography.@*TRIAL REGISTRATION@#IRCT2016040816797N2 (retrospectively registered on 21 April 2016, https://en.irct.ir/trial/15600 ).

Effect of cognitive-behavior therapy combined with mirtazapine on clinical efficacy in patients with functional dyspepsia / 中华行为医学与脑科学杂志

Objective@#To evaluate the efficacy of cognitive-behavioral therapy (CBT) combined with mirtazapine for patients with functional dyspepsia (FD).@*Methods@#Totally 121 patients with FD who met Rome Ⅳ diagnostic criteria in clinic of clinical psychiatry of a general hospital were collected.They were randomly divided into combined treatment group(n=61) and single drug group(n=60). The treatment period was 8 weeks.All patients with FD were given mirtazapine.The combined treatment group received 8 times systemic CBT treatments at the same time.Symptom checklist-90 (SCL-90) and gastrointestinal integral scale (GIS) were evaluated in all patients before and after 8-week intervention.@*Results@#After 8 weeks of intervention, the total score of SCL-90 scale, somatization, compulsion, depression, paranoia and other factors in the combined treatment group were lower than those in the single group(130.26±36.18 vs 147.95±45.55, 1.34±0.44 vs 1.51±0.5, 1.66±0.50 vs 1.90±0.66, 1.47±0.52 vs 1.69±0.63, 1.48±0.49 vs 1.70±0.61, 1.47±0.50 vs 1.73±0.68, respectively)(all P<0.05). After 8 weeks of intervention, the total score of the GIS scale in the combined treatment group (6.77±5.05 vs 9.49±5.24), vomiting (0.57±0.77 vs 0.88±0.91), spastic upper abdominal pain (0.43±0.74 vs 0.90±1.08) and post-sternal discomfort (0.57±0.89 vs 1.05±1.19) were significantly lower than that of the simple drug group after intervention(6.77±5.05 vs 9.49±5.24, 0.57±0.77 vs 0.88 ±0.91, 0.43±0.74 vs 0.90±1.08 and 0.57±0.89 vs 1.05±1.19, respectively), and the differences were statistically significant (all P<0.05).@*Conclusion@#CBT combined with mirtazapine in the treatment of FD is superior to drug therapy alone.CBT combined with mirtazapine can improve the emotional problems in the treatment of FD and further improving the digestive function.

Study on the quality control mode of inpatient medical records under two-level randomized blind method / 医学研究生学报

With the social development, the importance of medical records has become increasingly prominent.This paper analyzes the methods and shortcomings of the current medical record quality control and proposes a new mode under two-level randomized blind method combining with the experience of our own hospital.This new mode, through reconstructing the work team, adjusting work pattern and task allocation, supervising problems rectification, combining with experts′ supervising terminal record, inspecting link record randomly, handling dissent, evaluating connotation quality and assessing performance, effectively reduced the defect rate of medical records, improved the archiving rate and promoted the quality of medical records, which is worth promoting.

Comparison of escitalopram with citalopram in treatment of depression / 中国医师杂志

Objective To evaluate efficacy and safety of escitalopram in treating depression .Methods In this randomized , single-blind, citalopram parallel controlled, fixed dosage study, the study group was treated with escitalopram tablet 10mg/d and the control group with citalopram tablet 20mg/d.Observation duration was 6 weeks.Hamilton Rating Scale for Depression ( 17-item HAMD),Clinical Global Impression (CGI) and Hamilton Rating Scale for Anxiety (HAMA) were used to measure the efficacy.Items including Treatment Emergent Symptoms Scale (TESS), lab examination and vital signs for assessment of safety .Results Eighty-eight patients were randomly divided into study group (43 patients) and control group (45 patients).After 6 weeks treatment, a signif-icant greater reduction in HAMD 17 ,CGI-SI and HAMA total score was found for both study group and control group showing significant difference with their baseline ( P 0.05 ) .However , after 1 week treatment , the HAMD17 and CGI-SI score reductions between two groups were significant difference ( P 0.05 ) .In study group , the positive response rates was 81.4%,and in controls was 80.8%, there was no significant difference between two groups ( P >0.05 ) .There was no significant difference about the incidence of adverse reaction between two groups ( P >0.05 ) .Conclusions Escitalopram is a safe and effective antidepressant as citalopram , however , it has a more rapid reaction than the latter .

The Effect of Abdominal Respiration on the Emotion-related Biological Indicators in College Students / 中国运动医学杂志

Objective This study is to examine the effect of different breathing patterns (abdominal respiration,natural respiration)on skin temperature(TEMP),skin conductivity(SC) and heart rate variability (HRV) in college students.Methods We use single blind trial in the study,and randomly select thirty students,including fourteen male and sixteen female,aged 19.6±0.77 years,and then randomly divide them into two groups:the intervention group (abdominal respiration group,6 males and 9 females) and the control group(natural respiration group,8 males and 7 females).In the study three phases are included:baseline phase(five minutes),test phase(fifteen minutes),recovery phase(five minutes).Data of above indicators was collected at 3-5 min,14.5-19.5 min,and 23-25 min,respectively,during the study.Results (1) There are no significant difierences of all three indicators between the two groups in the baseline phase(P0.05).(3)There are no significant differences of TEMP and the HRV in the recovery phase between the two groups(P>0.05),except the SC (P<0.05).Conclusion No significant difference is observed between the influences of abdominal and natural respiration on the emotion-related biological indicators.

Estimulação magnética transcraniana de repetição: comparação da eficácia com a eletroconvulsoterapia / Repetitive transcranial magnetic stimulation: comparison of efficacy with electroconvulsive therapy

Os estudos publicados nos últimos anos sobre a utilização da estimulação magnética transcraniana de repetição (EMTr) têm sugerido significativas ações antidepressivas. Neste trabalho foi realizado um estudo comparativo da EMTr com a eletroconvulsoterapia (ECT) que é um método consagrado para o tratamento de transtornos depressivos. Foi feita, em primeiro lugar, uma extensa revisão a respeito destes dois métodos de tratamento não medicamentoso, expondo a sua história, a sua eficácia, as principais indicações, contra-indicações e efeitos colaterais, além dos possíveis mecanismos de ação, que ainda não estão completamente esclarecidos. A seguir foi realizado um ensaio clínico controlado, randomizado, simples-cego, comparando a eficácia de ambos para o tratamento da Depressão Maior unipolar refratária, sem sintomas psicóticos, com indicação de ECT. Também foi realizada uma avaliação dos efeitos cognitivos, especialmente da memória. Trinta e cinco pacientes foram incluídos. A eletroconvulsoterapia foi realizada com indução anestésica geral e relaxamento muscular. Foram feitas aplicações na posição unilateral direita com carga 4,5 vezes o limiar convulsígeno. A EMTr foi aplicada no córtex pré-frontal dorso-lateral esquerdo com intensidade de 100% do limiar motor. Os pacientes receberam 20 sessões (cinco dias por semana por quatro semanas), com 25 séries de estimulação por dia (com freqüência de 10 Hz por 10 segundos, com intervalos de 20 segundos). As escalas de avaliação foram aplicadas nos tempos basal, após duas semanas de tratamento e após quatro semanas de tratamento. Ambos os tratamentos tiveram eficácia equivalente, com uma taxa de redução média dos escores na escala de Hamilton para depressão de 42 %, uma resposta clínica de 46 % e uma taxa de remissão de 14%. A EMTr apresentou um perfil mais benigno de efeitos colaterais (cefaléia em 1 %). A ECT resultou em cefaléia (em 20 %) e náuseas (em 10%).Não houve diferença nos efeitos cognitivos...

Studies published over the past few years suggest that repetitive transcranial magnetic stimulation (rTMS) may have significant antidepressant actions. This work performs a comparison between rTMS and electroconvulsive therapy (ECT), an established method to treat depression disorders. First there was an extensive review on the knowledge of both non pharmacological treatments including their history, efficacy, main indications, contraindications and side effects, in addition to the possible mechanisms of action, not yet fully understood. After that, a controlled randomized, single-blind clinical trial was conducted, comparing the efficacy to treat unipolar resistant nonpsychotic major depression that were referred to receive ECT. An evaluation of cognitive effects was also performed, specially memory effects. Thirty five patients were included. Electroconvulsive therapy was performed with general anesthesia and muscular relaxation. Right unilateral electrodes positioning was used, with a charge 4.5 times the convulsive threshold. rTMS was performed over the left dorsolateral prefrontal cortex at 100% motor threshold. Patients were treated with 20 sessions (five times per week for four weeks) with 25 trains a day (frequency of 10 Hz, duration of 10 seconds with 20 seconds intertrain interval). Patients were evaluated at baseline, after two weeks and after four weeks of either treatment. Both groups were equivalent in efficacy, showing a means of reduction on Hamilton depression rating scale of 42%, an overall clinical response of 46% and a remission rate of 14%. rTMS showed a more benign profile regarding side effects (headache on 1%). ECT induced headache (20%) and nausea (10%). No cognitive effects were observed on either treatments. This study adds to the growing literature supporting an antidepressant effect for rTMS, similar to ECT on patients with unipolar nonpsychotic major depression.

Therapeutic Effect of Risperidone on the Refractory Schizophrenia: a Single-Blinded Comparison with Haloperidol / 신경정신의학

OBJECTIVES: We attempted to investigate clinical efficacy of risperidone a new antipsychotic agent with high safety and without life-threatening side effect such as agranulocytosis, in refractory schizophrenia compared with a haloperidol, well-known antipsychotic agent. METHODS: Thirty-four subjects(risperidone group 16, haloperidol group 18), who had been proved to be refractory schizophrenics with prospective antipsychotic treatment with at least 2 antipsychotic agents belonging to different chemical groups from each other, were examined with Clinical Global Impression(CGI) and 18-item Brief Psychiatric Rating Scale(BPRS) at 0, 2nd, 4th, 8th, and 12th week from start of drug administration. Those scales were rated in the single-blind manner. RESULTS: End-point response rate of risperidone was 25%(4 subjects), and that of haloperidol was zero. Difference of the response rates between risperidone and haloperidol was statistically significant. Broader spectrum of symptoms was improved with risperidone treatment than with haloperidol. CONCLUSION: Risperidone is an antipsychotic agent that clinicians can primarily and effectively try in the refractory schizophrenics with high safety.