益赛普联合甲氨蝶呤对老年类风湿关节炎患者血清 CRP、IL-1及TNF-α水平的影响

目的:分析益赛普联合甲氨蝶呤对老年类风湿关节炎(RA)患者的疗效及对血清C反应蛋白(CRP)、白介素(IL-1)、肿瘤坏死因子(TNF)-α水平的影响。方法:将93例老年RA患者随机分成两组,对照组46例采用口服甲氨蝶呤治疗,观察组47例在对照组治疗上给予益赛普皮下注射,治疗后对比两组临床疗效及治疗前后血清CRP、IL-1、TNF-α水平。结果:观察组治疗后晨僵时间、疼痛指数、肿胀指数、VAS评分较治疗前显著降低,且低于对照组(P<0.05),且血清CRP、IL-1、TNF-α水平显著降低,其降低幅度大于对照组(P<0.05)。结论:益赛普联合甲氨蝶呤可显著改善临床症状,降低血清CRP、IL-1及TNF-α水平,疗效显著,值得推广应用。     

双歧三联活菌胶囊对溃疡性结肠炎患者炎性因子的影响研究

目的 观察双歧三联活菌胶囊对溃疡性结肠炎患者炎性因子的影响. 方法 75例确诊为溃疡性结肠炎患者随机分为观察组和对照组,其中观察组给予常规治疗结合双歧三联活菌胶囊,对照组按常规方法处理.观察用药2月后的临床症状评分、炎性因子TNF-α与炎性抑制因子IL-8、IL-10的含量水平.结果 治疗后,两组临床症状总评分均显著下降(P<0.01),且观察组下降程度明显大于对照组(P<0.01);两组患者IL-8显著下降(P<0.01),且观察组下降值大于对照组(P<0.01);而IL-10显著升高(P<0.01),且观察组大于对照组(P<0.05);两组患者TNF-α显著下降(P<0.01),且观察组下降值大于对照组(P<0.01).结论 双歧三联活菌胶囊能影响溃疡性结肠炎体内炎性因子水平.     

腹腔镜与开腹手术治疗早期宫颈癌对机体应激反应的影响

目的:探讨腹腔镜和开腹手术对早期宫颈癌患者应激反应的影响。方法:60例早期宫颈癌患者随机分为开腹组30例,腹腔镜组30例,比较两组患者术前术后白细胞总数、中性粒细胞数、白细胞介素-6(IL-6)、肿瘤坏死因子#(TNF-#)及C-反应蛋白(CRP)的变化。结果 :腹腔镜组与开腹组相比,术前白细胞总数、中性粒细胞计数、IL-6、TNF-#及CRP的差异无统计学意义(P>0.05)。两组术后1天白细胞总数、中性粒细胞计数、IL-6、TNF-#及CRP均较术前明显升高(P<0.05),术后3天IL-6、TNF-#及CRP均较术后1天有所回落,仍高于术前(P<0.05);术后1天、术后3天IL-6、TNF-#及CRP值腹腔镜组均低于开腹组(P<0.05)。结论:腹腔镜广泛全子宫切除术+盆腔淋巴结清扫术治疗早期宫颈癌对患者术后应激反应轻。     

早期肠内免疫营养对重症急性胰腺炎患者肠道屏障功能的影响

目的探讨早期肠内免疫营养(EIN)对重症急性胰腺炎(SAP)患者肠道屏障功能的影响。方法选择2011年1月至2013年12月铜川矿务局中心医院收治的SAP患者76例,其中36例患者给予早期常规肠内要素营养(对照组),40例患者给予早期EIN(观察组),比较2组患者急性生理与慢性健康(APACHEⅡ)评分、Ranson评分及血清内毒素、二胺氧化酶(DAO)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平。结果治疗前2组患者APACHEⅡ评分和Ranson评分比较差异均无统计学意义(P>0.05)。2组患者治疗后APACHEⅡ评分和Ranson评分均显著低于治疗前(P<0.05);治疗后观察组患者APACHEⅡ评分和Ranson评分均显著低于对照组(P<0.05)。治疗前2组患者血清内毒素及DAO水平比较差异均无统计学意义(P>0.05)。2组患者治疗后血清内毒素及DAO水平均显著低于治疗前(P<0.05);治疗后观察组患者血清内毒素及DAO水平均显著低于对照组(P<0.05)。治疗前2组患者血清TNF-α、IL-6、CRP水平比较差异均无统计学意义(P>0.05)。对照组患者治疗后血清TNF-α、CRP水平显著低于治疗前(P<0.05),但对照组患者治疗后血清IL-6水平与治疗前比较差异无统计学意义(P>0.05);观察组患者治疗后血清TNF-α、IL-6、CRP水平均显著低于治疗前(P<0.05);治疗后观察组患者血清TNF-α、IL-6水平显著低于对照组(P<0.05),但2组患者血清CRP水平比较差异无统计学意义(P>0.05)。结论早期EIN可有效改善SAP患者肠道屏障功能,减轻炎症反应,改善病情。     

微创钻孔引流术与开窗血肿清除术治疗高血压脑出血临床疗效及安全性观察

目的:对比分析微创钻孔引流术与开窗血肿清除术治疗高血压脑出血临床疗效及安全性。方法:选取神经外科收治的78例高血压脑出血患者随机分为观察组和对照组,观察组给予微创钻孔引流术治疗,对照组给予开窗血肿清除术治疗,比较两组患者手术指标及住院时间,术前、术后NIHSS评分、ADL评分、CRP、TNF-α指标水平,预后情况,术后并发症发生情况。结果:观察组患者手术时间、住院时间较对照组显著缩短,术中出血量较对照组显著减少,差异均具有统计学意义(P<0.05),术前两组患者NIHSS评分、ADL评分、CRP、TNF-α指标水平比较,差异无统计学意义(P>0.05),术后两组患者NIHSS评分、CRP、TNF-α指标水平显著降低,ADL评分显著上升,且术后观察组患者NIHSS评分、CRP、TNF-α指标水平下降和ADL评分上升更显著,差异均具有统计学意义(P<0.05),观察组患者预后有效率为76.92%显著提高,术后并发症发生率为7.69%显著降低,差异均具有统计学意义(P<0.05)。结论:微创钻孔引流术治疗高血压脑出血可减少对患者的创伤,促进患者术后恢复,改善患者神经功能缺损,提高生活能力,降低术后并发症和CRP、TNF-α指标水平,有效控制炎性反应,提高手术的安全性。     

红霉素联合小剂量茶碱对重度稳定期慢性阻塞性肺疾病肺功能与炎症因子的影响探讨

目的:探讨重度稳定期慢性阻塞性肺疾病患者(COPD)应用红霉素联合小剂量茶碱治疗效果。方法:采用随机数字表法将我院109例重度稳定期COPD患者分组,对照组54例给予红霉素口服,观察组55例联合小剂量茶碱治疗,对比两组患者治疗后肺功能、炎症因子、安全性及生活质量改善效果。结果:观察组治疗后FEV_1占比、FEV_1/FVC均高于对照组(P<0.05),CRP、IL-8、TNF-α、中性粒细胞数量及中性粒细胞弹性蛋白酶水平均低于对照组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05),观察组治疗后CAT评分低于对照组(P<0.05)。结论:红霉素联合小剂量茶碱能够更为有效地改善重度稳定期COPD患者炎症因子水平,促进肺功能的恢复,生活质量改善明显,安全性高。     

升降散治疗脓毒症心肌损伤患者的临床疗效评价

目的:评价升降散结合西医常规疗法治疗脓毒症心肌损伤患者的临床疗效。方法:纳入脓毒症心肌损伤(毒热内盛证)患者62例,随机分为西医对照组(简称"对照组")31例和中西医结合治疗组(简称"治疗组")31例。对照组给予西医常规治疗,治疗组在西医常规治疗基础上加用升降散治疗,两组疗程均为7 d。于治疗前后观察并比较两组患者的急性生理学与慢性健康状况评分(APACHEⅡ),检测患者的血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)水平,评价两组患者的中医证候积分及中医证候疗效。结果:治疗后,两组患者的中医证候积分较治疗前均明显降低(P0.01),且治疗组患者的中医证候积分改善情况优于对照组(P0.01);对照组的中医证候总有效率为71.0%,治疗组为93.1%,治疗组疗效优于对照组(P0.05)。治疗后,两组患者的血清TNF-α、IL-6、CRP水平较治疗前均显著降低(P0.01),且治疗组患者的血清TNF-α、IL-6、CRP水平降低程度优于对照组(P0.01,P0.05);两组患者的APACHEⅡ评分较治疗前均显著降低(P0.01),且治疗组患者的APACHEⅡ评分降低程度优于对照组(P0.05)。结论:升降散结合西医常规疗法能有效改善脓毒症心肌损伤(毒热内盛证)患者的中医证候,减轻患者的心肌炎症反应。     

柴黄清胰活血颗粒对重症急性胰腺炎患者的临床疗效及相关细胞因子的影响

目的观察柴黄清胰活血颗粒对重症急性胰腺炎患者的临床疗效及对相关细胞因子的影响。方法 60例重症急性胰腺炎患者随机分为治疗组30例和对照组30例,对照组予以中、西医常规治疗,治疗组在常规治疗的基础上,加用柴黄清胰活血颗粒治疗。观察两组患者入院时,开始治疗后3天、7天的临床症状、体征以及白细胞计数以及血清TNF-α、IL-18、PAF水平,并进行量化对比。结果治疗组总体有效率优于对照组(P0.05);两组患者症状、体征评分在治疗3天后明显下降,在第7天治疗组下降更为显著(P0.05);两组患者白细胞计数在治疗3天、7天后明显下降,治疗组与对照组相比具有统计学意义(P0.05);治疗3天后,两组患者血清TNF-α、IL-18、PAF水平均显著下降(P0.05),治疗组下降更为明显,差异有统计学意义(P0.05),治疗7天后,两组血清TNF-α、IL-18、PAF水平较3天后明显降低,治疗组下降更为明显,差异有统计学意义(P0.05)。结论柴黄清胰活血颗粒可以通过抑制炎症因子的释放,控制SAP患者炎症反应,改善临床症状、体征,提高治疗有效率。     

慢性阻塞性肺疾病血清CRP与TNF-α水平对患者病情及生活质量的影响研究

目的:探讨慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)血清CRP和TNF-α水平与患者病情及生活质量的相关性。方法:随机收集了33例COPD急性加重期患者(A组)、29例COPD稳定期患者(B组)及31例健康对照组(C组),检测所有研究对象血清CRP及TNF-α水平,并进行日常生活质量(ADL)评分,分析COPD患者血清CRP与TNF-α水平对患者生活质量的影响。结果:A组患者血清CRP、TNF-α水平及ADL评分均显著高于B组和C组(P<0.05);B组血清TNF-α和ADL评分高于C组(P<0.05),但血清CRP与C组比较差异无统计学意义(P>0.05);A组患者血清CRP与TNF-α水平均与患者ADL评分正相关,但B组患者CRP与TNF-α与患者ADL评分无相关性(P>0.05)。结论:血清CRP与TNF-α水平是COPD炎性反应活动的标志性指标之一,且可能是患者日常生活质量下降的原因之一,检测该两项指标有助于判断病情和预后。     

中药保留灌肠联合清热消痈汤治疗急性单纯性阑尾炎临床疗效观察

目的:探讨中药保留灌肠联合清热消痈汤治疗急性单纯性阑尾炎的临床疗效观察。方法:收集我院收治的急性单纯性阑尾炎患者100例,随机分为对照组和治疗组,各50例,对照组予以甲硝唑注射液及氨苄西林注射液;治疗组在对照组的基础上给予中药灌肠联合清热消痈汤治疗,两组患者均治疗4周。比较4周后两组患者的临床疗效、血清C反应蛋白(CRP)及肿瘤坏死因子(TNF-α)水平、体温恢复正常时间、腹痛及压痛减轻时间、白细胞计数及中性粒细胞百分比。结果:治疗组临床总有效率为86.00%,对照组临床总有效率为50.00%,治疗组较对照组改善显著,两组结果具有显著差异(P0.05);治疗组治疗后血清C反应蛋白(CRP)及肿瘤坏死因子(TNF-α)水平较对照组降低明显,结果具有显著差异(P0.05);治疗组治疗后患者体温恢复正常时间、腹痛及压痛减轻时间均短于对照组,结果有显著差异(P0.05);治疗组患者白细胞计数及中性粒细胞百分比降低较对照组明显,结果具有显著差异(P0.05)。结论:中药保留灌肠联合清热消痈汤针对急性阑尾炎具有较好的治疗作用,可起到解热镇痛、通腑泻下、清热凉血的功效,值得临床推广应用。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…