系统性红斑狼疮合并肝损害的临床分析

目的探讨系统性红斑狼疮患者肝脏损害的临床特点，加深对狼疮肝病的认识。方法回顾分析82例SLE有肝损害患者与无肝损害患者的临床资料，其中SLE合并肝损害42例，分为有肝损害组和无肝损害组。将有肝损害患者的临床表现、实验室检查结果与无肝损害的患者进行比较。同时，将系统性红斑狼疮患者肝纤维化4项指标和肝功能指标进行检测。结果系统性红斑狼疮组与对照组层粘连蛋白、血清Ⅲ型前胶原氨基端肽、丙氨酸氨基转移酶、天门冬酸氨基转移酶、碱性磷酸酶及总胆红素指标的比较差异有显著性（P〈0．05）；两组比较肝脏超声影像学特点有显著性差异（P〈0．05）；C反应蛋白、血沉、SLEDAI积分与对照组比较无统计学意义（P〉0．05）。结论系统性红斑狼疮肝损害，以肝细胞损害为主。系统性红斑狼疮患者的肝损害可能是多因素的，应明确病因，合理地使用激素和免疫抑制药物。     

血浆胆红素吸附联合双重血浆置换救治严重肝损害的护理体会

目的:研究分析血浆胆红素吸附联合双重血浆置换救治严重肝损害的护理体会。方法:选取我院38例严重肝损害患者为观察对象,对其临床资料进行分析,分析血浆胆红素吸附联合双重血浆置换救治严重肝损害的护理体会。结果:对比患者采用血浆胆红素吸附联合双重血浆置换治疗前后门冬氨酸氨基转移酶、总胆红素及直接胆红素指标变化状况,治疗后患者门冬氨酸氨基转移酶、总胆红素及直接胆红素指标显著低于治疗前的,有统计学意义(P0.05)。结论:血浆胆红素吸附联合双重血浆置换在治疗严重肝损害患者临床上具有显著效果,有效的护理措施可有效提高患者临床治疗效果。     

甲状腺功能亢进症合并肝损害45例临床分析

目的探讨甲状腺功能亢进症(甲亢)合并肝损害的特点及其防治。方法对2002-04～2012-09间在我院诊治的45例甲亢患者进行回顾性调查,观察甲亢合并肝损害的情况,分析甲亢患者治疗前后肝功能各项指标:丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)、胆红素(TBIL)的变化。结果 45例甲亢合并肝损伤的患者经过抗甲状腺药物治疗2个月后,复查甲状腺功能与肝功能各项指标均恢复正常。结论甲亢易合并肝损害,在应用抗甲状腺药物使甲亢控制后,肝功能可恢复正常。     

系统性红斑狼疮的肝组织学改变

系统性红斑狼疮的肝组织学改变华东医院竺越，朱毅，顾同进系统性红斑狼疮（ＳＬＥ）的发病原因尚未被完全阐明，因此对本病所引起的多系统损害的机理及特点也未肯定。到目前为止，ＳＬＥ的肾脏组织学改变已有了较明确的认识，即“狼疮肾”。对肝脏病变，大多认为ＳＬＥ不...     

甲亢危象合并严重肝损害

甲状腺机能亢进症合并肝损害（简称：甲亢合并肝损害）比较常见,其临床确诊包括3个重要条件：①患者通过放射线碘及血清甲功检查,诊断为甲状腺机能亢进症。②有肝功损害临床表现：肝功能血清胆红素、天冬氨酸氨基转移酶、丙氨酸氨基转移酶、碱性磷酸酶和r-谷氨酰转肽酶,至少有1项升高;腹部B超胆道无异常;心脏超声排除心功能衰竭;     

系统性红斑狼疮肝损害的临床分析

目的:探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者肝损害的临床特点。方法:对明确诊断为SLE的42例有肝损害患者的临床资料进行临床分析。结果:42例SLE患者中16例有肝脏损害,占36.7%,多为轻中度肝损害;其中ALT升高12例,AST升高8例,TBiL升高3例,ALP升高6例,γ-GT升高11例。结论:SLE肝损害并不少见,多发生在病情的活动期,以肝细胞损害为主。临床表现不特异,易发生误诊和漏诊。     

以肝损害为首发症状的系统性红斑狼疮1例

系统性红斑狼疮是一种累及多系统、多器官且具有多种自身抗体的自体免疫性疾病。多数患者有发热、皮疹、关节痛及浆膜炎、肾脏损害，少数可累及心脏、肺、消化道及中枢神经系统，肝损害多为治疗后发生，以肝损害为首发症状，较为少见。我院曾遇到1例，报告如下。     

慢性丙型肝炎患者体内肝脏海帕西啶mRNA与铁贮存相关,与炎症无关

目的:慢性丙型肝炎患者的肝脏铁含量常升高,这可能会导致肝脏损害。海帕西啶,肝脏内受炎症和铁贮存上调的基因,可能参与了这一现象的病理生理过程。病理性海帕西啶低表达是遗传性血色病发生的重要因素。但是,海帕西啶在丙型肝炎患者铁负荷中的作用还不明确。受试者和方法:为了明确丙肝患者肝脏海帕西啶m RNA与肝脏炎症指标和铁代谢的关系,本研究提取了慢性丙型肝炎患者肝活检标本的全部RN A,并对海帕西啶m RNA进行了定量。分析肝脏海帕西啶m RN A与天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、铁蛋白、病毒载量、纤维化、肝脏…     

甲亢性肝损害63例临床分析

目的　探讨甲亢性肝损害的发病机理及治疗方案。方法　对甲亢性肝损害患者与甲亢无肝损害患者的肝功能、游离T3 (FT3 )、游离T4 (FT4 )、体重指数 (BMI)及并发症进行对比分析。结果　甲亢性肝损害肝功能主要表现为丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶 (AST)及碱性磷酸酶 (ALP)的升高 ;甲亢性肝损害患者的FT3 、FT4 均高于甲亢无肝损害组 (P <0 .0 1) ,BMI低于无肝损害组 (P <0 .0 1) ;甲亢性肝损害患者并发周期性麻痹、甲亢性肌病、重症肌无力的发生率高于甲亢无肝损害组 (P <0 .0 1,P <0 .0 5)。结论　甲亢伴肝损害的程度与端正情严重程度及甲亢并发症有密切关系     

丙型肝炎病毒感染者的血清酶活性分析

目的分析丙型肝炎病毒感染者的6种血清酶活性,比较各种酶检测对丙型肝炎病毒感染者的临床意义。方法收集丙型肝炎病毒感染者107例,分成丙型肝炎病毒携带者、轻度慢性丙型肝炎患者和中度慢性丙型肝炎患者3组。使用自动生化分析仪以酶促动力法测定丙型肝炎病毒感染者的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、γ-谷氨酰转移酶、碱性磷酸酶、5’-核苷酸酶及腺苷酸脱氨酶活性。结果与正常对照相比,丙型肝炎病毒感染者血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、γ-谷氨酰转移酶及腺苷酸脱氨酶活性均升高;随肝功能损害程度加重,酶活性升高程度增大,其中腺苷酸脱氨酶灵敏度明显高于其它血清酶。结论血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、γ-谷氨酰转移酶及腺苷酸脱氨酶均可作为丙型肝炎病毒感染者的病情监测指标,以腺苷酸脱氨酶检测灵敏度最高;天门冬氨酸氨基转移酶和丙氨酸氨基转移酶的活性升高与患者的肝功能损害程度密切相关。     

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…