Intramuscular Diffusion Status of Risperidone and Aripiprazole Long Acting Injectable (LAI) by Ultrasonography

The aim of this study was to consider the characteristics of intramuscular diffusion status of risperidone and aripiprazole long acting injectable (LAI) by ultrasonography. Subjects were 40 adult subjects diagnosed with schizophrenia and treated with LAI [32 patients were risperidone LAI (RLAI) and 8 patients were aripiprazole LAI (ALAI)]. However, in this paper, only three cases (one RLAI case and 2 ALAI cases) were selected to illustrate the diffusion effects of both LAI. Dorsogluteal intramuscular (IM) injection sites were measured at prone position using the “double cross” method. Before LAI injection, the distance from the epidermis to the under-fascia (DEUF), and distance from the epidermis to the iliac bone (DEI) at the IM injection site were assessed by using ultrasonography: 1) the injection needle was inserted to the gluteus medius, and 2) observed the diffusion status within the muscle injected RLAI and ALAI were confirmed using the B-mode ultrasonography. Both RLAI and ALAI were depicted as high echogenicity with acoustic shadowing. It was considered that the diffusion states of LAIs by ultrasonography were important time course evaluations providing objective evidence.

Optimal needle insertion length for intramuscular injection of risperidone long-acting injectable (RLAI)

Risperidone long-acting injectable (RLAI) is approved for the treatment of schizophrenia in many countries. The suggested site is the gluteal muscle with a needle length of two inches (50 mm) in Japan, which is longer than the ordinarily used needle for intramuscular injections. The aim of this study was to determine the optimal needle insertion length for accurate delivery of RLAI procedure among subjects who have normal body mass index (BMI: 18 to 25) and high BMI (>25). Thirty-seven patients with schizophrenia were administered RLAI intramuscularly into the dorsogluteal muscle. The standard procedure required inserting 80% of the two inch needle. By using data collected by ultrasonography, the findings confirmed that the median needle insertion lengths for subjects with normal and high BMI were 39.0 and 45.5 mm, respectively. To deliver RLAI effectively and safely, the authors strongly recommend that a specialized needle be used that is “marked” at the 40 mm point from the tip of the needle to the base. In this way regardless of subcutaneous fat content, the RLAI can be safely delivered into the muscle without causing untoward or side effects.

Effects of Depth of Needle Insertion with Risperidone Long-Acting Injectable in Persons with Schizophrenia: A Randomized Double-Blind Study

In some cases, if the insertion depth is shallower than expected, intramuscular (IM) injection of risperidone long-acting injectable (RLAI) may not penetrate the muscle fascia. However, if needle insertion depth is deeper than anticipated, needle penetration may cause damage to nerves, arteries and veins. Few clinical studies were done to evaluate the depth of needle length insertion reaching the intended gluteal muscle. The aim of this study was to evaluate the suitable depth of injecting RLAI. Twenty-six patients with schizophrenia were treated with RLAI, and randomly divided into two groups: 50 mm needle inserted group (Group-D, deep insertion, n = 13) and 20 mm needle insertion group (Group-S, shallow insertion, n = 13). For Group-S, the needle length was marked with a spacer at exactly 20 mm. Injections were performed by the psychiatrist or nurse, alternating between the two gluteal sites by double-cross method every two weeks. Clinical psychotic symptoms and injection site reactions were recorded throughout the study period. Experienced psychologists who were blinded from the needle-length experimental variable evaluated patients’ psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS) every two weeks. The plasma 9-hydroxyrisperidone (9-OH-RIS) concentrations were measured every two weeks;comparison data were determined on the 8th week and the 14th week. No significant difference was observed in 9-OH-RIS concentrations, psychotic symptoms, injection site skin reactions of subjects in both groups. However, in Group-D, injection site adverse reactions were confirmed in two subjects (15%). In Group-S, injection site reactions were confirmed in six subjects (46%). Although effective 9-OH-RIS concentrations were obtained with the insertion using both depth, it was concluded that the 50 mm insertion length was more suitable for dorsogluteal IM injections in adult patients with schizophrenia as demonstrated by the incidence of local adverse skin reactions.

Explanatory Variables as Evidence for Precision in Intramuscular Long-Acting Injections of Patients with Schizophrenia

Intramuscular injections can cause damage to arteries, veins and nerves. Achieving maximum effects of medications through precise intramuscular (IM) injections must be assured and with certainty, particularly with long-acting injection drugs (LAI). The purpose of this study is to determine precision in IM LAIs of patients with schizophrenia. These evidences estimate “Distance from the Epidermis to the Under-Fascia” (DEUF) and “Distance from Epidermis to the Upper-Arm Bone” (DEB) of the deltoid muscle. Explanatory variables include body height, weight, body-mass index (BMI), deltoid-muscle circumference, fat percentage and muscle mass measured by body composition monitor. Sixty nine subjects are included based on the Diagnostic Statistical Manual of Mental Disorders (DSM-IV, 1994), and receive treatments of typical and atypical antipsychotic LAI. There are 46 males and 23 females with average age of 51.41 (Standard Deviation = 13.58) and ranging from 21 to 81 years who are all right-handed. Ultrasonographic data and those from explanatory variables are calculated using Spearman’s rank correlation coefficients. Multiple regression analysis (step-wise method/forced input method) is performed assuming DEUF or DEB as dependent variables. Significant correlations are found with highest adjusted R-square. Paired t-tests show differences in average values of actual ultrasonographic measurements assigned to DEUF or DEB, and the regression equations for accuracy. Ultrasonographic values are assigned multiple-regression equations as true values, and the calculated values are compared with those obtained by regression equations. There are no significant differences observed for either the right or left arm. The multiple regression equations for BMI and fat percentages (upper extremity estimation) of DEUF, and for BMI and injection site circumference of estimated DEB, successfully value the DEUF and DEB. By using these multiple regression equations for IM injection to the deltoid-muscle, DEUF can better ensure accurate LAI into the muscle through body monitor, DEB, and measured values of the deltoid-muscle injection site circumference.

H_(2)O_(2)-Responsive Injectable Polymer Dots Hydrogel for Long-term Photodynamic Therapy of Tumors

Photodynamic therapy(PDT)has been emerged as a promising modality for cancer treatment.However,the development of drug delivery system enabling continuous release of photosensitizers(PSs)for long-term PDT treatment still remains challenges.Herein,a H_(2)O_(2)-responsive injectable hydrogel,covalently crosslinked by N^(1)-(4-boronobenzyl)-N^(3)-(4-boronophenyl)-N^(1),N^(1),N^(3),N^(3)-tetramethylpropane-1,3-diaminium(TSPBA)with PVA containing polythiophene quaternary ammonium salt(PT2)polymer dots(PDots)as a photosensitizer was fabricated.Under the stimulation of H_(2)O_(2),the obtained injectable hydrogel gradually degrades and releases PDots.In vitro experiments suggested that the released PDots could realize efficient tumor cells inhibition through its robust singlet oxygen generation capability upon 577 nm laser irradiation.In vivo studies demonstrated a sustained retention of PDots for at least 7 days following single-dose administration,facilitating efficient tumor inhibition with light treatments for 3 times without apparent biotoxicity.This work presents an innovative polymer dots-based composite local drug delivery system for long-term PDT in cancer treatment.

Geothermal extraction performance in fractured granite from Gonghe Basin,Qinghai province,China:Long-term injection and production experiment

The efficient exploitation of geothermal energy through enhanced geothermal systems(EGS)has been a relevant topic for hot dry rock(HDR)geothermal resources.When cryogenic fluid is injected into a thermal reservoir,improving heat exchange efficiency is key to achieving the optimal exploitation of HDR.In this paper,granite outcrops from Gonghe Basin were used as the testing sample.The natural fractures in the granite samples were relatively well developed.To simulate long-term injection and production from multi-wells in situ,physical ex-periments were performed in a newly-developed,in-house large-scale true triaxial experimental system.Geothermal extraction performance of an HDR was simulated for long-term injection and production operations.Simultaneously,the mode of one-injection and multiple-production wells was represented.In the paper,the ef-fects of the production-injection well spacing,the number of production wells and the injection rate on the production temperature and flow rate are discussed.The results show that,during long-term injection and pro-duction,there are two stages of production temperature variation,namely stabilization and attenuation.When the number of the production wells is increased,the heat extraction efficiency is accelerated.Moreover,competitive diversion of fluid among fractures occurred due to different conductivities.Furthermore,under different pro-duction modes,the production flow rate contributed differently to the heat extraction.Finally,the effect of the production-injection wells spacing on the heat exchange performance was analyzed;this is mainly reflected in the change of the effective heat exchange area between the rock and the injected fluid.The results emphasize the importance of designing an appropriate production mode and optimizing the injection-production parameters to ensure efficient HDR exploitation.

布比卡因脂质体注射液研究进展

布比卡因是临床上广泛使用的长效局部麻醉药,但是,对于手术后需要数天镇痛的患者,其6~8 h的作用时效尚不能满足临床需求。设计药物剂型可以延长局部麻醉药的作用时效或减小其毒性。将局部麻醉药包封在药物输送系统中可以为手术患者提供长效镇痛。2011年,美国食品药品管理局(FDA)批准了一种基于DepoFoam TM技术的多泡布比卡因脂质体注射液,该制剂时效可达72 h以上。该文综述了布比卡因脂质体注射液的临床安全性研究和应用于手术后镇痛的研究进展。

棕榈酸帕利哌酮注射液对比其他抗精神病药长效针剂治疗精神分裂症有效性和安全性的Meta分析

目的系统评价棕榈酸帕利哌酮注射液与其他抗精神病药长效针剂比较治疗精神分裂症的有效性和安全性。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、PsycINFO、CNKI、SinoMed、VIP、WanFang Data数据库,搜集关于棕榈酸帕利哌酮注射液对比其他抗精神病药长效针剂治疗精神分裂症的随机对照试验(RCT),检索时限均从建库至2023年4月30日。由2名研究者独立筛选、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入12个RCT,包括4368例患者。Meta分析结果显示,棕榈酸帕利哌酮注射液组与利培酮长效针剂组的临床有效率差异无统计学意义(P>0.05),与其他抗精神病药长效针剂组的阳性和阴性症状量表(PANSS)总体评分改变值差异也无统计学意义(P>0.05)。与其他抗精神病药长效针剂组相比,棕榈酸帕利哌酮注射液组总退出率[RR=1.14,95%CI(1.06,1.24),P<0.01]和肌注部位异常的不良反应发生率[RR=2.08,95%CI(1.03,4.22),P=0.04]均显著增加。结论当前证据表明,与其他抗精神病药长效针剂相比,棕榈酸帕利哌酮注射液治疗精神分裂症的有效性并无明显差异,但部分不良反应发生率稍有增加。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

精神分裂症的社区治疗获益:基于长效注射用抗精神病药物

精神分裂症会长期影响患者的社会和职业功能,以社区为基础的精神卫生服务和管理模式通过提高可及性、可接受性、可负担性、实用性和可扩展性来促进患者心理健康。在社区管理模式中,长效注射用抗精神病药物是目前治疗精神分裂症的主要策略之一,但目前缺少相关的证据梳理。本文系统全面地探讨了长效注射用抗精神病药物对精神分裂症患者的获益情况,包括有效性和安全性、依从性、使用态度、社会功能恢复及社区康复等。本文研究结果表明在不同的社区管理模式下,长效注射用抗精神病药物在精神分裂症患者的社区康复中可发挥比口服药物更卓越的疗效,不仅体现在能降低疾病复发率和再住院率,也在患者社会功能恢复、降低肇事率等方面有优秀的表现。但我国依然存在长效注射用抗精神病药物整体处方率低的问题,主要原因包括医疗机构与基层社区信息共享不足,社区医疗服务治疗率较低,患者随访率低,社区精神康复开展较少等。本文可为我国精神分裂症患者的社区治疗提供一定的参考,以探索更多的社区治疗方案,提高精神分裂症患者治疗效果及生活质量。

注射用原位凝胶的分类与基质材料

注射用原位凝胶作为一种较新的剂型,具有能够长效释放、病灶局部给药、防止药物滥用和误用等优势,具有广阔的应用前景。注射用原位凝胶在注射前具有较低黏度,易通过注射器,并在注射后由于体内环境因素影响在注射部位形成药物贮库。本文综述了注射用原位凝胶的4种主要类型,并对其基质材料方面的进展进行了总结,旨在为此类制剂的设计和优化提供参考。

高剪切工艺制备阿立哌唑长效注射混悬剂

目的优化阿立哌唑长效注射混悬剂的制备工艺。方法采用高剪切工艺制备阿立哌唑长效注射混悬剂,考察定转子类型、线速度、定转子间距、助悬剂浓度、药物浓度、料液温度对药物粒径的影响,并与球磨法制备的样品对比颗粒形貌、体外释放、体内缓释效果。结果最优制备工艺为:以胶体磨模块作为剪切头,药物浓度为13%,羧甲基纤维素钠浓度为0.52%,辅料溶液pH为5.0~6.0,转子线速度为35 m·s^(-1),定转子间距为100μm,料液温度在48~65℃,得到阿立哌唑长效注射混悬剂的平均粒径为(3.83±0.05)μm。与球磨法制备的样品相比,具有更好的分散性,药物颗粒更为圆滑,以及具有更为优异的体内外缓释效果。结论通过高剪切工艺制备阿立哌唑长效注射混悬剂,制备工艺简便,易于放大生产,并实现了较好的缓释效果,对其他药物的开发具有一定的参考价值。

胰岛素注射在糖尿病患儿中的效果及对血糖水平的影响研究

目的探讨胰岛素注射在糖尿病患儿中的治疗效果及对血糖水平的影响。方法选取2021年8月—2023年5月潍城区人民医院收治的96例糖尿病患儿为研究对象,按照信封法分为两组,各48例。对照组采用短效胰岛素治疗,观察组在对照组治疗的基础上联合地特胰岛素注射液治疗,两组均进行3个月干预。比较两组血糖水平、血清Th1及Th2细胞因子水平及不良事件发生率。结果干预3个月后,两组血糖水平均降低,且观察组空腹血糖、餐后2 h血糖及糖化血红蛋白水平低于对照组,差异有统计学意义(P均<0.05)。干预3个月后,两组血清Th1及Th2细胞因子水平得到改善,且观察组白细胞介素-2、白细胞介素-4、白细胞介素-12及肿瘤坏死因子-α水平低于对照组,差异有统计学意义(P均<0.05)。观察组不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论地特胰岛素注射干预用于糖尿病患儿中,可降低其血糖水平,调节血清Th1及Th2细胞因子水平,有助于降低不良事件发生率。

米库氯铵注射液对比阿曲库铵作为短效肌松药在小儿斜视手术中的应用效果

目的分析米库氯铵注射液作为短效肌松药在小儿斜视手术中的应用效果。5方法选取2019年1月~2020年1月拟在我院行斜视矫正手术患儿1000例,将其采用数字随机表法随机分为对照组(500例)和观察组(500例),两组患儿均于全麻气管插管下实施斜视矫正手术,对照组患儿采用方案(依次静注咪唑安定2 mg,芬太尼2μg·kg^(-1),丙泊酚2 mg·kg^(-1),阿曲库铵0.5 mg·kg^(-1))诱导麻醉,观察组患儿采用(依次静推咪唑安定2 mg,芬太尼2μg·kg^(-1),米库氯铵注射液0.2 mg·kg^(-1),丙泊酚2 mg·kg^(-1))方案诱导麻醉。两组患儿均持续静脉泵入丙泊酚,瑞芬太尼维持麻醉。监测、收集两组患儿围麻醉期血流动力学指标(SBP、DBP、MAP和HR)、Ⅰ级插管条件率、拔管时间、术后不良事件。并对上述指标进行组间比较。结果①血流动力学稳定性比较:两组患儿T_(0)时SBP、DBP、MAP、HR组间差异无统计学意义(P>0.05);两组患儿T_(1)、T_(2)时SBP、DBP、MAP较T_(0)下降(Pkg^(-1)<0.05),T_(3)基本回升至T_(0)水平,其中观察组患儿T_(1)、T_(2)时SBP、DBP、MAP低于对照组患儿(P<0.05);两组患儿HR在T_(1)、T_(2)时略微下降,T_(3)则下升至T_(0)水平,组间差异无统计学意义(P>0.05)。②肌松效果比较:观察组患儿拔管时间明显较对照组患儿短,而Ⅰ级插管条件率均明显高于对照组患儿,组间差异有统计学意义(P<0.05);③不良事件率比较:两组患儿术后均未出现残余肌松及呼吸道事件,两组患儿术后恶心、呕吐率组间差异无统计学意义(P>0.05)。结论米库氯铵作为短效肌松药用于小儿斜视手术,可为手术提供良好肌松条件,促进手术顺利进行,且并未增加额外不良反应,对血流动力学指标影响时间短、波动范围小,对小儿斜视手术利大于弊。

超短效多次胰岛素皮下注射对2型糖尿病患者胰岛β细胞功能和血糖控制的影响

目的:探讨超短效多次胰岛素皮下注射对2型糖尿病(T2DM)患者胰岛β细胞功能和血糖控制的影响。方法:研究对象选取2022年6月至2023年12月门诊收治的60例T2DM患者为研究对象,均给予超短效多次胰岛素皮下注射治疗,观察治疗前后胰岛β细胞功能、血糖控制情况。同时,将60例T2DM患者按糖化血红蛋白(HbA1c)水平分为低HbA1c组32例和高HbA1c组28例,比较两组治疗前后胰岛β细胞功能、血糖变化差值。结果:治疗后,胰岛β细胞功能指数[HOMA-β(C-P)In]、空腹C肽(FC-P)相对于治疗前明显提升(P<0.05),胰岛素抵抗指数[HOMA-IR(C-P)In]、空腹血糖(FBG)相对于治疗前均明显降低(P<0.05);低HbA1c组患者治疗前后HOMA-β(C-P)In差值、HOMA-IR(C-P)In差值、FBG差值高于高HbA1c组(P<0.05),但两组FC-P差值无统计学意义(P>0.05)。结论:超短效多次胰岛素皮下注射治疗可改善T2DM患者胰岛β细胞,有效控制血糖,且低HbA1c患者治疗前后血糖、胰岛素β细胞功能改善相对更佳。

Efficacy and Safety in Intramuscular Injection Techniques Using Ultrasonographic Data

Delivered by intramuscular (IM) injections, Long Acting Injections (LAI), offering comparatively long term medicinal effects from several weeks to several months, are gaining much attention. The aim of this article was to indicate a safe and effective IM injection technique based on evidenced data derived from ultrasonographic data. Accurate anatomical knowledge is necessary in order to administer IM injections. It is possible to gain an adequate understanding of injection site anatomical structures by using ultrasound diagnostic devices. In particular, ultrasonography offers real-time diagnostic data allowing for observation of injection site, subcutaneous tissues, fat layers, muscle membrane, muscles and bones. To deliver the drug accurately into the muscle is essential, to achieve maximum drug efficacy and prevent injection site reactions. Therefore, when administering IM injections to the buttocks area, a suitable injection needle between 23G 25 mm to 21G or 22G 38 mm must be chosen depending on physique and drug characteristics. Needles determined as safe and effective through ultrasonographic evidence are needed such as in the case of a deltoid injection site, in which a 23G 25 mm injection needle is used in the absence of notable obesity. Not only the needle type is essential, but also the IM procedure itself. It is important to stretch the skin, inserting the needle at 90 degree angle to ensure depth of needle insertion to the muscle. Until new con-firmed evidence becomes available, it is necessary to increase the understanding of injection site selection methods, needle insertion depth, needle angle, and established IM injection techniques. The application of ultrasound devices in the development of next-generation techniques for IM injection is promising. Importantly, these techniques provide critical information from a risk management perspective.

注射用利培酮微球(Ⅱ)治疗急性期精神分裂症患者的疗效及安全性研究

背景长效抗精神病药是目前精神分裂症全病程治疗中的重要选择之一。注射用利培酮微球(Ⅱ)在剂型上进行了改良,治疗期间无需补充口服药物,能够快速起效,但目前尚缺少其临床疗效的相关研究。目的评估注射用利培酮微球(Ⅱ)治疗急性期精神分裂症患者的疗效及安全性。方法本研究为单臂多中心前瞻性研究,纳入2021年8月—2022年4月北京大学第六医院、河北省精神卫生中心、乌鲁木齐市第四人民医院、太原市精神病医院、天津市安定医院5个研究中心,18~55岁急性期精神分裂症患者为研究对象,给予25.0 mg/2周、37.5 mg/2周或50.0mg/2周可变剂量注射用利培酮微球(Ⅱ)治疗,随访8周。分别在基线和2、4、6、8周末进行阳性与阴性症状量表(PANSS)、临床总体印象量表(CGI)及精神科药物不良反应量表(UKU)评定。于基线及8周末进行个人和社会功能量表(PSP)评定,并采集患者实验室检查指标。结果研究共纳入58例患者。治疗2、4、6、8周末患者PANSS总分、阳性症状量表分、阴性症状量表分、一般精神病理量表分、CGI-疾病严重程度(CGI-S)评分均较基线降低(P<0.001);2、4、6周及8周末患者PANSS总分减分有效率分别为37.9%(22/58)、70.7%(41/58)、89.7%(52/58)和89.7%(52/58)。治疗8周末PSP评分[(71.00±14.99)分]高于基线[(46.28±15.43)分](P<0.001)。患者的平均血药浓度在1、2、4、6、8周末分别达到(12.94±8.47)、(13.23±10.86)、(21.09±13.04)、(23.64±14.23)、(29.08±19.51)μg/L。常见不良反应包括震颤、肌张力障碍、便秘等,均为轻度到中度,无严重不良反应及因无不良反应脱落者。治疗8周末泌乳素水平较基线升高(P<0.05)。结论注射用利培酮微球(Ⅱ)可在不补充口服抗精神病药的情况下快速起效,可有效改善精神分裂症急性期的多维度症状,且耐受性良好。

棕榈酸帕利哌酮长效针剂对精神分裂症患者认知和社会功能改善及内分泌代谢的影响

目的 探讨棕榈酸帕利哌酮长效针剂对精神分裂症患者认知和社会功能改善及内分泌代谢效果。方法 选择120例惠州市第二人民医院收治的精神分裂症患者为对象,研究开始、结束时间分别为2021年7月、2022年7月。随机分为对照组、试验组,各60例。对照组口服利培酮治疗,试验组采用棕榈酸帕利哌酮长效针剂治疗。分别在入组时、6、12个月评价各项指标并检测内分泌指标。结果 入组时,两组患者PANSS各症状评分差异无统计学意义,P> 0.05。入组6、12个月时,试验组患者阳性、阴性症状评分、一般精神病理评分和总分均低于对照组,差异有统计学意义,P <0.05。入组6个月、12个月时,两组TSEE评分比较差异有统计学意义,P <0.05。入组时,两组患者PSP、MoCA评分差异无统计学意义,P> 0.05。入组6、12个月时,试验组患者PSP、MoCA评分均高于对照组,差异有统计学意义,P <0.05。入组时两组患者血糖、血脂(总胆固醇、三酰甘油)、血清泌乳素差异无统计学意义,P> 0.05。入组6、12个月时,试验组患者血糖、血脂(总胆固醇、三酰甘油)、血清泌乳素均优于对照组,差异有统计学意义,P <0.05。结论 棕榈酸帕利哌酮长效针剂治疗精神分裂症患者的效果显著,能够有效改善患者的认知功能、社会功能,减轻其精神症状,同时改善患者的内分泌状态,不良反应发生风险低,安全可靠。

The Effect of a Psycho-Educational Program on Psychiatric Symptoms, Drug Attitude and Treatment Satisfaction of Patients with Schizophrenia

The purpose of this study was to determine the effect of a Comprehensive Psycho-Educational Approach and Scheme Set (COMPASS) for patients with schizophrenia who were treated with risperidone long-acting injectable (RLAI), on their psychiatric symptoms, drug attitudes, and treatment satisfaction levels. Participants were sixty-five patients at thirteen hospitals in Japan who met ICD-10 F2 criteria for schizophrenia or schizo-affective disorder and were treated with RLAI. A correlational study design was used to measure the effect of the COMPASS on the psychiatric symptoms, drug attitudes, and treatment satisfaction levels of patients treated with RLAI. Using the following evaluation indicators: The Subjective Satisfaction to Treatment Scale (SSTS), Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF), Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS), and Drug Attitude Inventory-10 (DAI-10), measurements were taken at the beginning of the program (baseline), at the end of the program, and six months after (endpoint). Data analysis included descriptive statistics, Mann-Whitney U test or Wilcoxon signed-rank test, and Spearman’s rank correlation coefficient. Significant differences were observed in BPRS total (p < 0.001), sub-scales of BPRS positive (p < 0.001), BPRS negative (p < 0.01), BPRS affective (p < 0.01), and GAF (p < 0.001). However, there was no significant change in subscale of BPRS manic, DAI-10, DIEPSS, or SSTS but significant positive correlations were found between SSTS and DAI-10 and GAF at baseline;a negative correlation was found between SSTS and BPRS. The findings of the study suggested the benefit of using the COMPASS in conjunction with RLAI to decrease patients’ psychiatric symptomatology and improve treatment satisfaction. In addition, patient satisfaction was found to be an important factor to be considered by the psychiatrist.

高血糖危象患者静脉输注胰岛素向皮下注射速效胰岛素类似物的转换时机研究

目的 分析高血糖危象患者静脉输注胰岛素向皮下注射速效胰岛素类似物的转换时机。方法 回顾性分析68例高血糖危象患者的临床资料,均予以胰岛素持续静脉泵入,依据速效胰岛素类似物皮下注射不同转换时机分为对照组(30例)和观察组(38例)。对照组在停止静脉输注胰岛素前的1 h予以胰岛素类似物皮下注射,观察组在停止静脉输注胰岛素同时开展速效胰岛素类似物皮下注射。比较两组患者停泵前1 h、停泵前0.5 h、停泵时、停泵后0.5 h、停泵后1 h、停泵后2 h的血糖水平以及血糖波动值,同时记录两组患者低血糖发生情况。结果 观察组患者停泵前1 h、停泵前0.5 h、停泵时、停泵后0.5 h、停泵后1 h、停泵后2 h血糖水平分别为(15.20±2.54)、(15.64±2.62)、(15.70±2.52)、(16.78±2.62)、(16.92±2.50)、(15.54±2.58)mmol/L,与对照组的(15.38±2.46)、(15.59±2.50)、(15.95±2.56)、(16.12±2.48)、(16.56±2.54)、(15.52±2.60)mmol/L比较,差异均无统计学意义(P>0.05)。观察组患者停泵前0.5 h、停泵时、停泵后0.5 h、停泵后1 h、停泵后2 h血糖波动值分别为(0.32±0.10)、(0.38±0.11)、(0.52±0.09)、(0.82±0.12)、(0.11±0.02)mmol/L,与对照组的(0.31±0.10)、(0.40±0.12)、(0.48±0.14)、(0.78±0.15)、(0.10±0.03)mmol/L比较,差异均无统计学意义(P>0.05)。两组于停泵24 h内均未观察到低血糖发生。结论 高血糖危象患者胰岛素静脉输注停止的同时开展速效胰岛素类似物皮下注射能达到胰岛素静脉输注向皮下注射的连续转换,同时将胰岛素水平维持在相对恒定状态,值得采用。

抗精神病长效针剂与长期口服抗精神病药物治疗慢性精神分裂症对照研究

观察抗精神病长效针剂与长期口服抗精神病药物治疗慢性精神分裂症的疗效。将70例慢性精神分裂症患者按本人及家属诉求分为长效针剂组和口服药物组,疗程16周,比较两组患者BPRS评分、不良反应发生情况、治疗依从性和治疗效果。结果显示,两组患者BPRS评分以及临床疗效差异无统计学意义(P>0.05),长效针剂组患者不良反应发生率更低(P<0.05),治疗依从性更高(P<0.05),但治疗费用高于口服药物组(P<0.05)。研究发现,简化给药方式,使用长效针剂,是改善慢性精神分裂症患者治疗依从性的重要方案。采用医保报销+社会救助+财政兜底方式,个人自费部分可结合辖区卫健、民政、残联等部门的救治救助对策进行补助申请,不足部分有各区财政兜底的方式,更有益于社区推广。