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Objective:To observe the improvement effect of olanzapine combined with Xinnaoxin pill on cognitive function in patients with bipolar disorder manic episode, and its influence on serum levels of interleukin(IL)-1β, tumor necrosis factor(TNF)-α and IL-10.Methods:From January 2018 to December 2018, 88 patients with bipolar disorder manic episode admitted to Wenzhou Kangning Hospital were screened and divided into control group and observation group according to the random number table method, with 44 cases in each group.The control group was orally given olanzapine tablets, with the first dose of 5 mg/d, up to 20 mg/d, and kept taking.On the basis of the control group, the observation group orally received Xinnaoxin pills with 5 pills per time and 2 times/d.After treatment for 2 months, the scores of the Beck-lavenson manic scale(BRMS), quality of life health survey summary(SF-36), cognitive function, the efficacy, and serum levels of IL-1β, TNF-α, IL-10 were compared in the two groups.Results:After treatment, the BRMS score of the observation group[(9.18±1.31)points] was significantly lower than that of the control group[(13.51±2.08)points]( t=6.833, P=0.000), the SF-36 score of the observation group[(329.98±35.31)points] was significantly higher than that of the control group[(293.78±31.49)points]( t=56.778, P=0.000). The number of sustained responses (31.34±5.52), sustained errors (8.39±1.08), and false responses (43.31±6.03) in the observation group were significantly lower than those in the control group[(36.31±5.16), (10.61±1.75), (45.90±6.23)]( t=7.880, 5.533, 5.003, all P=0.000), and the number of completed classification of the observation group(4.14±0.51) was significantly higher than that in the control group(3.09±0.39)( t=5.541, P=0.000). The total effective rate in the observation group(95.35%) was significantly higher than that in the control group(75.61%)(χ 2=5.164, P=0.023). The serum levels of IL-1β[(2.56±0.34)ng/L] and TNF-α [(8.33±1.05) ng/L] in the observation group were significantly lower than those in the control group[(3.51±0.44)ng/L, (11.93±1.63)ng/L]( t=6.334, 7.003, all P=0.000), and the serum level of IL-10 in the observation group [(269.31±28.64)ng/L] was significantly higher than that in the control group [(251.89±27.46)ng/L]( t=11.351, P=0.000). Conclusion:Olanzapine combined with Xinnaoxin pill in the treatment of bipolar disorder manic episode can effectively improve symptoms and signs, quality of life, cognitive function, increase the efficacy, and regulation of serum levels of IL-1β, TNF-α and IL-10 may be related with the efficacy.
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OBJECTIVE： To analyze the development status of neuropsychotropic therapeutic drug monitoring （TDM）， and to provide reference for improving the quality of TDM in neuropsychiatry department. METHODS： The laboratory data of neuropsychotropic TDM external quality assessment （EQA） were collected from Website of Clinical Laboratory Center of Ministry of Health （http：//www.clinet.com.cn） during 2008-2017， and then analyzed statistically in respects of TDM project， the number of involved laboratory， monitoring method， etc. RESULTS： By the end of 2017， the Clinical Laboratory Center of the Ministry of Health had conducted 5 neuropsychiatric TDM projects involving 4 drugs， including 3 items of serum TDM （carbamazepine， valproic acid， phenytoin）， lithium ion monitoring （lithium carbonate） in biochemical routine and newly added pharmacokinetic laboratory biological sample monitoring （carbamazepine） in 2014. From 2008 to 2017， the number of involved laboratories increased from 209 to 603， with carbamazepine （serum， plasma） and valproic acid showing good annual growth trend， exceeding 200 and phenytoin 107， but only 27 in lithium carbonate until 2017. Among all monitoring methods of involved laboratories， the number of laboratories which adopted fluorescence polarization immunoassay （FPIA） decreased year by year. By the end of 2017， there were fewer than 10 laboratories. The number of laboratories using acridinium direct chemiluminescence， enzyme-multiplied immunoassay technique （EMIT）， and high performance liquid chromatography （HPLC） had steadily increased. By the end of 2017， acridinium direct chemiluminescence was the most used in laboratory， followed by EMIT and HPLC. CONCLUSIONS： Due to the increasing number of participating laboratories， it can be seen that the consciousness of quality control of laboratory personnel is increasing day by day； but the complexity of TDM monitoring methods limits the types of drugs used in external quality evaluation. It is suggested to formulate guidelines， quality control standards and operation rules as soon as possible， so as to ensure the accuracy of test results.
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Peutz-Jeghers syndrome (PJS) is an autosomal dominant inheritance disease with tumor susceptibility and characterized by skin mucosal pigmentation, multiple gastrointestinal polyps and positive family history, and its pathogenetic gene is the STK11 gene located at 19p. The disease is rare in China. This article reviewed the current status of research on pathogenesis, clinical features, diagnosis and treatment of PJS.
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Objective To investigate the combination of free bone flap segment slip clinical treatment of tibial os-teomyelitis in patients with bone defect. Methods A total of 80 cases of osteomyelitis in patients with tibial bone de-fects in our hospital data were analyzed according to the different treatment options to patients were divided into two groups, the control group was given the treatment of bone segments slip, the experimental group was given implement the free flap combined with bone segment slip technology treatment, clinical outcomes were compared. Results 95% of the experimental group therapy showed a significant effect, significantly better than that in the control group(efficacy rate 85%)(P<0.05); 95% of the experimental group showed satisfaction with program efficacy, significantly higher than that in the control group(satisfaction rate 65%)(P<0.05); ADL scores in the experimental group(96.2±3.7)points, physical function score was(89.6±7.5)points, psychological function score(95.8±9.2)points, social function score(97.2±6.5) points, significantly higher than that in the control group(P<0.05); sensory scores in the experimental group (2.58±0.53) points, emotional score(1.32±0.12) points to assess rated (0.45±0.16) points, the other score for(0.82±0.22), significantly more than the control group (P<0.05). Conclusion The combination of free flaps in the treatment of bone segments ideal slip tibia bone defect effect, can improve clinical outcomes and improve the quality of life of patients, relieve pain in patients, should be introduced.