门冬氨酸鸟氨酸联合纳洛酮治疗急性肝性脑病的临床疗效观察

目的观察门冬氨酸鸟氨酸联合纳洛酮治疗急性肝性脑病的临床疗效。方法选取北京市第六医院2010年-2012年诊治的60例急性肝性脑病患者,随机分为门冬氨酸鸟氨酸治疗组(对照A组)15例、纳洛酮治疗组(对照B组)15例和门冬氨酸鸟氨酸联合纳洛酮治疗组(实验组)30例。各组均治疗7 d,对其治疗前后血氨浓度、肝功能(AST、TBIL)水平进行评价和比较,同时比较各组患者的临床疗效。结果治疗后对照A组和对照B组患者与实验组患者相比,其血氨及AST、TBIL水平差异均有统计学意义(P0.05),且实验组显效率及总有效率(63.33%,90.00%)明显高于对照组(33.33%,63.33%),差异具有统计学意义(P0.05)。结论门冬氨酸鸟氨酸联合纳洛酮治疗急性肝性脑病可以有效改善患者临床症状,提高临床疗效。     

中西医结合治疗酒精性肝硬化并发肝性脑病25例临床观察

目的:探讨门冬氨酸鸟氨酸、纳洛酮联合醒脑静注射液对酒精性肝硬化并发肝性脑病的治疗作用.方法:酒精性肝硬化并发肝性脑病患者47例,分为治疗组25例,对照组22例.在常规综合治疗的基础上,对照组加用精氨酸、谷氨酸盐;治疗组加用门冬氨酸鸟氨酸、纳洛酮和醒脑静注射液.观察治疗组及对照组治疗前后的症状改善、血氨和肝功能指标,评价临床疗效.结果:治疗组血氨下降明显,治疗组总有效率高于对照组(88.00％ vs 63.64％,P＜0.05).2组患者治疗后血AST、ALT、GGT、TBIL均有不同程度的恢复,但均无统计学意义(P＞0.05).结论:门冬氨酸鸟氨酸、纳洛酮联合醒脑静注射液治疗酒精性肝硬化并发肝性脑病,能有效降低血氨,提高疗效.     

门冬氨酸鸟氨酸联合乳果糖治疗肝性脑病疗效观察

目的探讨门冬氨酸鸟氨酸联合乳果糖治疗肝性脑病患者的临床疗效。方法将80例重型肝炎或肝炎肝硬化并发肝性脑病患者随机分为治疗组40例和对照组40例,分别给予门冬氨酸鸟氨酸和乳果糖或支链氨基酸和精氨酸治疗,观察患者病情的变化。结果经过10天治疗,治疗组患者神志转清35例（87.5%）,无效5例（12.5%）;对照组有效20例（50.0%,x2=7.29,P〈0.01）;治疗组患者谷丙转氨酶、谷草转氨酶和总胆红素下降比对照组明显。结论门冬氨酸鸟氨酸联合乳果糖对改善肝功能,纠正肝性脑病有较好的治疗效果。     

门冬氨酸鸟氨酸治疗肝性脑病的临床研究

目的观察门冬氨酸鸟氨酸、乳果糖、氧氟沙星联合治疗肝性脑病的疗效。方法 23例肝性脑病患者在应用支链氨基酸的基础上,给予门冬氨酸鸟氨酸、乳果糖、氧氟沙星联合治疗,另23例接受精氨酸治疗。结果治疗14天后,治疗组22例（95.7%）神志转清,1例死亡;对照组15例（65.2%）神志转清,8例死亡;治疗组患者血氨的降低较对照组明显（P〈0.05）。结论门冬氨酸鸟氨酸、乳果糖、氧氟沙星联合应用是治疗肝性脑病的有效方法。     

门冬氨酸鸟氨酸治疗肝硬化伴发肝性脑病68例疗效观察

目的评价门冬氨酸鸟氨酸（瑞甘）在治疗肝硬化伴发肝性脑病中的临床疗效。方法将2004年3月至2012年8月我院消化内科收治的肝硬化并发肝性脑病患者132例,按随机分配的方法分为观察组、对照组。对照组64例给予常规抗肝昏迷治疗,观察组68例在对照组治疗的基础上给予门冬氨酸鸟氨酸（瑞甘）静脉滴注,对比两组患者治疗前及治疗后血清转氨酶、血氨、总胆红素水平及两组的治疗总有效率。结果两组患者血清转氨酶、血氨、总胆红素治疗后与治疗前比较均有明显好转（P〈0．05）,观察组比对照组改善更显著（P〈0．05）;观察组的治疗总有效率明显高于对照组（P〈0．05）。结论门冬氨酸鸟氨酸可显著改善肝硬化伴发肝性脑病患者的生化指标,疗效确切,值得在肝硬化伴发肝性脑病患者的治疗中推广应用。     

左旋门冬氨酸鸟氨酸联合乳果糖治疗肝性脑病的临床疗效观察

目的探讨肝性脑病患者应用左旋门冬氨酸鸟氨酸联合乳果糖治疗的临床疗效。方法选取我院收治的63例肝性脑病患者,随机分为对照组31例和治疗组32例,对照组采取左旋门冬氨酸鸟氨酸治疗,治疗组在对照组的基础上采取联合乳果糖治疗。比较两组的临床治疗疗效、AST、ALT及血氨水平、用药后的不良反应。结果对照组的治疗总有效率为67.7%,明显低于治疗组的96.9%(P0.05);两组在治疗后ALT、AST及血氨水平均有下降,治疗前后具有统计学差异(P0.05),两组的ALT、AST之间差异不明显(P0.05),但两组血氨水平差异显著(P0.05);对照组的不良反应发生率为16.1%,治疗组的不良反应发生率为12.5%,两组之间差异不明显(P0.05)。结论对肝性脑病患者应用左旋门冬氨酸鸟氨酸联合乳果糖治疗,无严重不良反应,比单独采取左旋门冬氨酸鸟氨酸治疗安全性更高,且能显著提高临床疗效,降低血氨水平,可在临床上推广。     

门冬氨酸鸟氨酸联合纳洛酮治疗急性酒精中毒患者的疗效分析

目的探讨门冬氨酸鸟氨酸联合纳洛酮治疗急性酒精中毒患者的疗效。方法选取我院2016年3月至2017年9月诊治的急性酒精中毒患者96例为研究对象,按随机数字表法分成对照组和研究组,每组48例。两组患者均给予吸氧、输液、保暖、外伤处理等基础治疗。在基础治疗上,对照组患者给予纳洛酮0.4~0.6 mg静脉滴注治疗;研究组患者在对照组患者治疗的基础上给予门冬氨酸鸟氨酸5~10 g静脉滴注治疗。比较两组患者的临床疗效,两组患者兴奋期、共济失调期、昏迷期症状消失时间及意识完全恢复时间,检测比较两组患者血清中谷丙转氨酶(ALT)和谷草转氨酶(AST)水平,观察比较两组患者呼吸抑制加重、呕吐、心动过快、嗜睡、烦躁不安等不良反应发生情况。结果研究组患者的治疗总有效率为95.83%,对照组为77.08%;研究组患者的临床疗效优于对照组,差异有统计学意义(P0.01)。研究组患者兴奋期、共济失调期、昏迷期症状消失时间及意识完全恢复时间均显著短于对照组(P0.01)。治疗后,研究组患者血清ALT、AST水平均明显降低,且显著低于对照组(P0.01)。研究组患者不良反应发生率(4.16%)显著低于对照组为(20.83%),差异有统计学意义(P0.01)。结论门冬氨酸鸟氨酸联合纳洛酮治疗急性酒精中毒患者能促进患者意识恢复,有效减轻肝损伤,临床疗效显著,治疗安全性高。     

异甘草酸镁联合门冬氨酸鸟氨酸治疗重型肝炎疗效观察

目的观察异甘草酸镁联合门冬氨酸鸟氨酸治疗重型肝炎的疗效。方法将55例重型肝炎患者随机分为治疗组29例和对照组26例,治疗组予以异甘草酸镁加门冬氨酸鸟氨酸治疗,对照组予以甘草酸二胺加还原性谷胱甘肽治疗。结果治疗4周后,治疗组患者总胆红素、丙氨酸氨基转移酶、白蛋白和凝血酶原时间比对照组改善明显,差异有统计学意义(P0.05);治疗组发生肝性脑病4例(13.8%),而对照组为8例(30.8%,P0.05)。结论以异甘草酸镁联合门冬氨酸鸟氨酸为主要药物治疗重型肝炎患者有效。     

门冬氨酸鸟氨酸注射液抗肝性脑病的疗效观察

目的观察门冬氨酸鸟氨酸治疗肝性脑病的疗效。方法将60例肝性脑病患者随机分为治疗组30例和对照组30例，治疗组在常规综合治疗的基础上将门冬氨酸鸟氨酸10g～20g加入5％葡萄糖注射液250ml中静脉滴注1次／d，治疗7d。观察治疗前后患者的肝功能、静脉血氨浓度和数字连接试验的改善情况。结果门冬氨酸鸟氨酸治疗肝性脑病临床疗效显著优于对照组，治疗后静脉血氨浓度和数字连接试验的改善均有非常显著性差异（P〈0．05），并无明显毒副作用。结论门冬氨酸鸟氨酸治疗肝性脑病疗效确切，安全性好。     

左旋门冬氨酸鸟氨酸联合纳洛酮治疗肝性脑病患者疗效观察

目的 探讨左旋门冬氨酸鸟氨酸联合纳洛酮治疗肝性脑病患者的临床疗效。方法 将80例肝性脑病患者随机分为对照组和治疗组,对照组40例采用综合治疗加用左旋门冬氨酸鸟氨酸治疗,治疗组40例在对照组治疗的基础上加用纳洛酮治疗。两组患者均治疗10 d。结果 经过临床治疗后,对照组有13例（32.5%）患者在24 h内神志清醒,血氨恢复正常,16例（40%）患者在48 h内神志明显改善,血氨水平呈下降趋势,11例（27.5%）患者病情无明显改善;治疗组有21例（52.5%）患者在24 h内神志恢复,血氨恢复正常,15例（37.5%）患者在48 h内神志改善,血氨水平呈下降趋势,4例（10.0%）患者无明显改善。两组患者均未出现死亡病例。两组疗效比较,有显著性差异（P<0.05）;治疗组神志恢复时间为（36.5±6.4） h,明显短于对照组的（48.1±7.3）h,数字连接时间为（49.8±10.3）s,明显短于对照组的（61.6±11.9）s（P<0.05）;两组治疗前后肝功能指标变化无显著性差异（P>0.05）。结论 左旋门冬氨酸鸟氨酸联合纳洛酮治疗肝性脑病患者能够缩短患者神志恢复时间。     

Cardiovascular,diabetes, and cancer strips: evidences,mechanisms, and classifications

Objectives

To report and name firstly that there are cardiovascular disease (CVD), diabetes mellitus (DM) and cancers (CDC) strips; and disclose their mechanisms, classifications, and clinical significances.

Study design

Narrative and systematic review study and interpretive analysis.

Methods

Data sources and study selection: to collect and present related evidences on CDC strips from evidence-based, open-access, both Chinese- and English-language literatures in recent 10 years on clinical trials from PubMed according to keywords “CVD, DM and cancers” as well as authors’ extensive clinical experience with the treatment of more than fifty thousands of patients with CVD, diabetes and cancers over the past decades, and analyze their related mechanisms and categories which based on authors’ previous works. Data extraction: data were mainly extracted from 48 articles which are listed in the reference section of this review. Qualitative, quantitative and mixed data were included, narratively and systematically reviewed.

Results

With several conceptual and technical breakthrough, authors present related evidences on CDC strips, these are, CVD and DM, DM and cancers, cancers and CVD linked, respectively; And “Bad SEED” +/– “bad soil” theory or doctrine may explain this phenomenon due to “internal environmental injure, abnormal or unbalance” in human body resulting from the role of risk factors (RFs) related multi-pathways and multi-targets, which including organ & tissue (e.g., vascular-specific), cell and gene-based mechanisms. Their classifications include main strips/type B, and Branches/type A as showed by tables and figures in this article.

Conclusions

There are CDC strips and related mechanisms and classifications. CDC strips may help us to understand, prevent, and control related common non-communicable diseases (NCDs) as well as these high risk strips.     

Trust,benefit, satisfaction,and burden

BACKGROUND: Community-based participatory research (CBPR) approaches that actively engage communities in a study are assumed to lead to relevant findings, trusting relationships, and greater satisfaction with the research process. OBJECTIVE: To examine community members' perceptions of trust, benefit, satisfaction, and burden associated with their participation. DESIGN, SETTING, AND PARTICIPANTS: A randomized controlled trial tested a cancer prevention intervention in members of African-American churches. Data were collected at baseline and 1-year follow-up. MEASUREMENTS: Subscales measured perception of trust in the research project and the project team, benefit from involvement with the project, satisfaction with the project and the team, and perception of burden associated with participation. MAIN RESULTS: Overall, we found high levels of trust, perceived benefit, and satisfaction, and low perceived burden among community members in Partnership to Reach African Americans to Increase Smart Eating. In bivariate analyses, participants in the intervention group reported more perceived benefit and trust (P <.05). Participants in smaller churches reported more benefit, satisfaction and trust, while participants from churches without recent health activities perceived greater benefit, greater satisfaction, and lower burden with the project and the team (P <.05). Participants whose pastors had less educational attainment noted higher benefit and satisfaction; those whose pastors were making personal lifestyle changes noted higher benefit and satisfaction, but also reported higher burden (P <.05). CONCLUSIONS: A randomized clinical trial designed with a CBPR approach was associated with high levels of trust and a perceived benefit of satisfaction with the research process. Understanding variations in responses to a research partnership will be helpful in guiding the design and implementation of future CBPR efforts.     

Hemagglutinin Stability and Its Impact on Influenza A Virus Infectivity,Pathogenicity, and Transmissibility in Avians,Mice, Swine,Seals, Ferrets,and Humans

Genetically diverse influenza A viruses (IAVs) circulate in wild aquatic birds. From this reservoir, IAVs sporadically cause outbreaks, epidemics, and pandemics in wild and domestic avians, wild land and sea mammals, horses, canines, felines, swine, humans, and other species. One molecular trait shown to modulate IAV host range is the stability of the hemagglutinin (HA) surface glycoprotein. The HA protein is the major antigen and during virus entry, this trimeric envelope glycoprotein binds sialic acid-containing receptors before being triggered by endosomal low pH to undergo irreversible structural changes that cause membrane fusion. The HA proteins from different IAV isolates can vary in the pH at which HA protein structural changes are triggered, the protein causes membrane fusion, or outside the cell the virion becomes inactivated. HA activation pH values generally range from pH 4.8 to 6.2. Human-adapted HA proteins tend to have relatively stable HA proteins activated at pH 5.5 or below. Here, studies are reviewed that report HA stability values and investigate the biological impact of variations in HA stability on replication, pathogenicity, and transmissibility in experimental animal models. Overall, a stabilized HA protein appears to be necessary for human pandemic potential and should be considered when assessing human pandemic risk.