度普利尤单克隆抗体治疗儿童中重度特应性皮炎的疗效与安全性研究

目的:探讨度普利尤单克隆抗体（单抗）治疗儿童中重度特应性皮炎（AD）的疗效与安全性。方法:采用回顾性分析的方法，纳入2021年4月—2022年10月在天津医科大学第二医院儿科哮喘和过敏专病门诊接受度普利尤单抗治疗16周的中重度AD患儿17例。比较治疗前后各项AD相关临床评估量表及过敏性共病临床指标、外周血嗜酸性粒细胞计数（EOS）、血清总IgE（T-IgE）水平的变化，评估治疗期间达到湿疹面积及严重程度指数从基线到16周降低≥50%（EASI50）和湿疹面积及严重程度指数从基线到16周降低≥90%（EASI90）的患儿比例及研究者整体评估（IGA）评分达到0或1（皮疹清除或几乎清除）的比例，观察治疗期间不良反应与不良事件的发生情况。结果:与基线相比，AD相关评估量表在度普利尤单抗首次注射后2周即出现显著下降（均P<0.01）；治疗8周后，达到EASI50、EASI90（及IGA评分达到0或1的患者比例即明显增加。度普利尤单抗治疗16周后，患者EOS水平总体较基线上升，5例患者血清T-IgE水平较基线下降，但差异无统计学意义。合并哮喘或过敏性鼻炎（AR）患儿的儿童哮喘控制测试／哮喘控制测试（C-ACT/ACT）、哮喘控制问卷（ACQ）、鼻炎视觉模拟（VAS）评分均得到显著改善，呼出气一氧化氮（FeNO）水平及吸入性糖皮质激素（ICS）剂量均较基线显著下降，第1秒用力呼气容积（FEV1）较基线上升（均P<0.05）。合并食物过敏患儿2例，既往食用过敏食物诱发AD皮疹及瘙痒加重的症状得到改善。治疗期间3例出现结膜炎。结论:度普利尤单抗治疗可以显著改善中重度AD儿童及其过敏性共病临床症状，降低FeNO水平及ICS剂量，改善肺功能，并可能降低血清T-IgE水平。治疗期间不良反应少，主要表现为轻中度结膜炎，安全性良好。     

丹白涂膜剂对黄褐斑患者皮肤屏障功能修复的临床研究

目的 观察丹白涂膜剂治疗黄褐斑的临床疗效及对患者皮肤屏障功能的修复作用.方法 将100例患者随机分为治疗组和对照组各50例.治疗组患者涂抹丹白涂膜剂,每晚1次;对照组涂抹2％氢醌乳膏,每晚1次.治疗3个月后评定分析两组的临床疗效;观察两组患者治疗前、治疗1个月、治疗3个月后的面部皮肤角质层含水量、经皮失水值(TEWL)、黑色素量.结果 治疗3个月后,治疗组总显效率为68.0％,对照组为52.0％,两组差异有统计学意义(P<0.05).治疗1个月时,治疗组皮肤角质层含水量较治疗前显著增加、TEWL值显著下降(P<0.05),对照组皮肤角质层含水量较治疗前显著下降、TEWL值显著升高(P<0.05),且两组间比较差异有统计学意义(P<0.05);治疗3个月时,治疗组患者皮肤角质层含水量较治疗1个月时显著增加、TEWL值显著下降(P<0.05),对照组患者皮肤角质层含水量、TEWL值较治疗1个月时差异无统计学意义(P>0.05),且治疗组患者皮肤角质层含水量显著高于对照组(P<0.05),TEWL值显著低于对照组(P<0.05);两组皮肤黑色素量均较治疗前下降(P<0.05),两组间比较差异无统计学意义(P>0.05).结论 丹白涂膜剂治疗黄褐斑比2％氢醌乳膏疗效更优,且对患者皮损部位的皮肤屏障功能具有更好的修复作用.     

润肤保湿软膏对血虚风燥证银屑病皮肤屏障功能干预作用及机制的研究

目的：探寻润肤保湿软膏对银屑病血虚风燥型皮肤屏障功能的影响及作用机制。方法60例血虚风燥型银屑病患者随机分为两组,治疗组30例使用润肤保湿软膏治疗,对照组30例使用尿素软膏治疗,4周后依据 PASI 评分法判定疗效;使用Soft5.5皮肤六参数测试仪,对用药前后患者皮损角质层含水量、皮肤中油脂水平及 pH 值进行测定,通过薄层层析、BIO-RAD Ge1Doc 凝胶成像系统、Quantity One 软件分析及 RT-PCR、 Western blot 的方法检测分析治疗前、后皮损神经酰胺（ Cer ）、水通道蛋白（ AQP-3）的含量;比较分析两组间及组内的临床疗效及各项指标变化,探寻润肤保湿软膏对血虚风燥型银屑病皮肤屏障功能的干预作用及机制。结果两组治疗后均有一定临床疗效,治疗组明显优于对照组（P<0.05）;两组治疗后皮脂含量、角质层含水量均高于治疗前（P<0.05）,而 pH 值治疗组明显低于治疗前（P<0.05）,对照组 pH 值无明显改变（P>0.05）;治疗后两组水通道蛋白（AQP-3）、神经酰胺（Cer）的含量高于治疗前（P<0.05）;治疗组治疗后皮脂含量、pH 值、AQP-3、Cer 较对照组治疗后改善显著,差异有统计学意义（ P<0.05）。结论润肤保湿软膏对血虚风燥型银屑病患者皮肤的屏障功能有显著调节及修复作用,有可能是通过神经酰胺和水通道蛋白对皮肤屏障功能进行修复。     

糠酸莫米松乳膏联合卡泊三醇软膏治疗慢性湿疹及神经性皮炎的效果

目的：探讨糠酸莫米松乳膏联合卡泊三醇软膏治疗慢性湿疹及神经性皮炎的效果。方法80例慢性湿疹或神经性皮炎患者随机分为两组。对照组予以单用糠酸莫米松乳膏,观察组联合应用糠酸莫米松乳膏和卡泊三醇软膏,对比两组患者治疗前和治疗14 d 后的靶皮损面积和皮损面积评分、皮损瘙痒评分和湿疹病情指数（EASI）、皮肤生理功能,包括经表皮水分流失（TEWL）、角质层含水量（WCSC）和皮肤油脂（SC）。比较两组患者治疗6周后的总有效率。结果两组患者治疗14 d 后的靶皮损面积、皮损面积评分、皮损瘙痒评分、EASI 评分和 TEWL 均显著低于治疗前,WCSC 和 SC 显著高于治疗前,观察组治疗14 d 后的靶皮损面积、皮损面积评分、皮损瘙痒评分、EASI 评分和 TEWL 显著低于对照组（P ＜0．01）,WCSC 和 SC 显著高于治疗前（P ＜0．01）。观察组治疗6周后总有效率92．85％,显著高于对照组的68．42％,差异有统计学意义（χ2＝5．2000,P ＝0．0226）。结论糠酸莫米松乳膏联合卡泊三醇软膏治疗慢性湿疹及神经性皮炎的效果显著优于单用糠酸莫米松乳膏,值得临床进一步推广应用。     

运动对皮肤屏障功能的影响

目的 探究运动是否对人皮肤屏障功能有影响。方法 将符合纳入排除标准的28名青少年长跑运动员和28名健康非运动员作为研究对象。对其额中部、胸部、肘窝及腹股沟的皮肤表面pH值、经皮水丢失（transepidermal water loss,TEWL）值、皮脂含量和角质层含水量进行检测,并分别根据是否为运动员、性别（男性组、女性组）、年龄（≥ 14岁组,<14岁组）进行分组比较。根据运动员是否有使用润肤剂的习惯进行分组,比较上述5项指标。结果 在所有5个分组中,运动员组的皮肤表面pH值显著高于对应的非运动员组（P<0.001）。运动员组在胸、肘窝、腹股沟的TEWL平均值显著高于健康非运动员组相应部位的TEWL平均值（P<0.05）。运动员组胸和肘窝的皮脂含量均显著低于非运动员组（P<0.05）。运动员组在额中部、胸、肘窝、腹股沟的角质层含水量平均值显著低于健康非运动员组相应部位的角质层含水量平均值（P ≤ 0.001）。使用润肤剂组肘窝皮脂含量较高,腹股沟TEWL值较低,角质层含水量较高（P<0.05）。结论 运动员的皮肤生理屏障功能较健康非运动员差,使用润肤剂对运动员的皮肤屏障功能有一定的修复作用。     

度普利尤单抗治疗中重度特应性皮炎的长期疗效及安全性

目的：探讨度普利尤单抗治疗中重度特应性皮炎的长期有效性及安全性。方法：选择我院2021年4—11月收治的60例中重度特应性皮炎患者为观察对象，给予度普利尤单抗治疗。首次治疗时600mg皮下注射，之后每2周300mg皮下注射，距首次注射16周后调整为每4周300mg皮下注射，持续到患者治疗的第36周。比较患者首次注射与第4、8、16、24、36周注射后的研究者整体评分(IGA)、湿疹面积和严重程度指数(EASI)、瘙痒数字评价量表(NRS)、皮肤生活质量指数(DLQI)、源自患者的湿疹评价(POEM)评分和医院焦虑和抑郁量表(HADS)评分，测定患者IgE与IL-2、IL-4与IL-5水平，并比较治疗过程中对患者的不良反应情况。结果：治疗36周，患者IGA、EASI、NRS、DLQI、POEM和HADS呈现下降趋势，差异有统计学意义(P<0.05);治疗后患者lgE与IL-4与IL-5水平呈下降趋势，IL-2呈上升趋势，差异有统计学意义(P<0.05);患者在治疗期间出现3例结膜炎症状，未出现其他与药物相关的严重不良反应。结论：度普利尤单抗治疗中重度特应性皮炎具有较好的长期疗...     

生物制剂联合传统医药治疗中重度特应性皮炎的临床观察

目的 观察度普利尤单抗联合复方甘草酸苷片治疗中重度特应性皮炎的临床疗效及安全性。方法 将29例成人中重度特应性皮炎患者随机分为观察组14例和对照组15例,观察组给予度普利尤单抗联合复方甘草酸苷片治疗,对照组单用度普利尤单抗治疗,比较两组患者治疗后的临床疗效及不良反应情况。结果 治疗后第16周,观察组与对照组的平均EASI值变化百分比差异具有统计学意义(P＜0.05),表明随着疗程的延长,观察组的疗效优于对照组。两组均有2例患者发生结膜炎。结论 度普利尤单抗联合复方甘草酸苷片治疗中重度特应性皮炎较单用度普利尤单抗疗效更佳,且安全性好。     

健脾祛风方治疗特应性皮炎95例临床观察

目的：探讨健脾祛风方治疗脾虚型特应性皮炎的临床疗效及其对皮肤角质层含水量和pH值的影响。方法：将192例特应性皮炎患者随机分为治疗组（95例）和对照组（97例）。所有患者除给予尿素乳膏外用外,治疗组采用健脾祛风方口服,对照组采用西替利嗪口服,治疗疗程为4周。评价两组患者的临床疗效,检测治疗前后患者皮肤角质层含水量、皮肤pH值的变化。结果：治疗组的总有效率为82.11%,明显高于对照组的61.86%（P〈0.05）。治疗后,两组患者的SCORAD积分较治疗前均显著降低（P〈0.05）,且治疗组的SCORAD积分明显低于对照组（P〈0.05）。治疗后,两组患者的皮肤角质层含水量均显著增加（P〈0.05）,皮肤pH值显著降低（P〈0.05）;且治疗组患者的皮肤角质层含水量、皮肤pH值与对照组相比,差异亦有统计学意义（P〈0.05）。结论：健脾祛风方治疗脾虚型特应性皮炎具有较好的疗效。     

rhEGF 联合点阵激光对痤疮疤痕患者皮肤屏障功能及TLR2 水平的影响

目的 探讨基因重组人表皮生长因子（rhEGF）联合点阵激光对痤疮疤痕患者皮肤屏障功能及Toll 样受体2（TLR2）的影响。方法 选取2014 年1 月-2015 年12 月之间收入该院的60 例痤疮疤痕患者为研究对象,根据随机数字法分为对照组和研究组,每组各30例。对照组患者给予点阵超脉冲CO2 激光治疗,研究组患者在点阵超脉冲CO2 激光治疗后外用rhEGF 凝胶。比较两组患者的疗效、外周血CD14+ 单核细胞TLR2 表达率及皮肤屏障功能。结果 两组患者的治疗总有效率比较,差异有统计学意义（P <0.05）,研究组高于对照组（93.33 % vs 70.00 %）。治疗后,两组患者的经皮水份丢失（TEWL）、皮肤红斑情况（a 值）均较治疗前降低,差异有统计学意义（P <0.05）,研究组低于对照组;两组患者的pH 值较治疗前均降低,差异有统计学意义（P <0.05）,研究组低于对照组;两组患者的角质层含水量较治疗前均升高,差异有统计学意义（P <0.05）,研究组高于对照组。治疗后,两组患者的乳酸刺激实验总分、粘脱蛋白质含量较治疗前均降低,差异有统计学意义（P <0.05）,研究组低于对照组。治疗后,两组患者的TLR2 表达率较治疗前均降低,研究组患者低于对照组。研究组患者的瘢痕增生、色素沉着及持久性潮红的发生率低于对照组。结论 rhEGF 联合点阵激光对治疗痤疮疤痕具有良好的治疗效果,能够降低TLR2 表达水平,改善皮肤屏障功能,减少不良反应,值得临床推广应用。     

外用糖皮质激素对老年性干皮症患者皮肤屏障功能的影响

目的 评价外用糖皮质激素对老年性干皮症患者皮肤屏障的影响.方法 32例老年性干皮症患者一侧前臂外用0.1％氢化可的松乳膏(实验组),每日1次,持续8周,于第O、2、4、8周进行随访评价,并以用药前后另一侧手臂作为对照(对照组).皮肤屏障功能评价内容包括检测角质层含水量及经表皮水分丢失(TEWL)值.结果 实验后2周,实验组角质层含水量最高,而TEWL值最低.实验后8周,实验组角质层含水量高于对照组(P＜0.01),且TEWL值低于对照组(P＜0.01).结论 外用糖皮质激素对于老年性干皮症患者用药8周时,未观察到皮肤屏障功能破坏;用药2周时对皮肤屏障功能有暂时改善作用.     

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…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.