肖相如治疗慢性肾功能衰竭经验

慢性肾功能衰竭的本质是气化功能减退,治疗应以恢复人体的气化功能为目的。肖相如教授认为慢性肾功能衰竭的患者多有水湿停留,凡见患者症状不太明显,或有轻度水肿者,其认为湿瘀互结可能是这一时期的主要问题,给予当归芍药散为主治疗;患者内生肌酐清除率下降、血肌酐上升、尿素氮上升者,不论患者有无脾虚的证候,都应在补肾的基础上积极健脾,尤其是在尚无脾虚表现时及时健脾,对保护肾功能具有积极的意义。此时可考虑加用半夏泻心汤、补脾胃泻阴火升阳汤、香砂六君子汤等加减治疗;患者秽浊之邪明显,舌苔厚如积粉,舌质紫绛者,其本质为湿郁化浊,浊郁化毒,毒入血分,给予达原饮合犀角地黄汤为主治疗。     

四逆散合小建中汤治疗小儿肠系膜淋巴结炎30例

目的:观察四逆散联合小建中汤治疗小儿肠系膜淋巴结炎的临床疗效。方法:选取80例肠系膜淋巴结炎患儿作为研究对象,按照随机平行分组法随机分为治疗组与对照组各40例,对照组给予常规西药治疗,治疗组给予四逆散合小建中汤治疗,两组均治疗7 d,7 d后比较两组患儿的临床疗效。结果:对照组愈显率为72.5%,治疗组愈显率为90.0%,治疗组愈显率明显高于对照组(χ2=16.024,P=0.007);治疗组腹痛、发热、呕吐泄泻及淋巴结肿大消失时间均明显短于对照组(P0.05)。结论:四逆散联合小建中汤治疗小儿肠系膜淋巴结炎效果理想,可显著改善临床症状体征、缩短病程。     

加味玉屏风散治疗慢性荨麻疹64例

目的:观察加味玉屏风散治疗慢性荨麻疹的临床疗效及对血清TNF-α、IL-8表达水平的影响。方法:将128例慢性荨麻疹患者随机分为观察组和对照组各64例,观察组给予加味玉屏风散治疗,对照组给予盐酸左西替利嗪片治疗。治疗4周后,观察两组临床疗效、起效时间、复发率并进行比较,检测两组患者血清中TNF-α、IL-8水平。结果:观察组有效率为98.43%,对照组有效率为93.75%,观察组优于对照组(P<0.05);观察组复发率低于对照组(P<0.05);观察组血清中TNF-α、IL-8水平显著低于对照组(P均<0.05)。结论:加味玉屏风散治疗慢性荨麻疹疗效显著,复发率低,且不良反应轻微,且可明显抑制血清中TNF-α与IL-8的表达。     

联合吸入噻托溴铵和沙美特罗/氟替卡松治疗慢性阻塞性肺疾病的疗效分析

目的探析噻托溴铵粉吸入剂联合美沙特罗/氟替卡松雾化吸入治疗慢性阻塞性肺疾病(COPD)的临床疗效。方法采用前瞻性平行试验法收集2011年6月至2013年6月期间接受雾化吸入治疗150例COPD患者,采用随机抽签法将其分为两组,每组75例。对照组雾化吸入沙美特罗替卡松粉吸入剂(50μg沙美特罗/250μg丙酸氟替卡松),试验组雾化吸入沙美特罗替卡松粉吸入剂+噻托溴铵粉吸入剂。对比分析两组患者肺功能、临床症状、临床疗效及预后。结果疗程结束后,试验组肺功能改善情况明显优于对照组(P0.05),临床症状改善情况明显优于对照组(P0.05),明显改善患者的身体状况(P0.05);试验组治疗总有效率明显高于对照组(P0.05),无严重不良反应发生,随访期间,试验组急性发作率低于对照组(P0.05)。结论联合吸入噻托溴铵和沙美特罗/氟替卡松治疗能改善COPD患者临床症状和体征,促进肺功能的恢复,降低对生活的影响程度,减少急性加重发作次数,疗效显著且安全性高,可作为临床治疗COPD的首选方案。     

Differences of cellular composition and adhesion molecule expression in “leukemic” as compared with “normal” human long-term bone marrow cultures

Summary Human long-term bone marrow cultures (HLTBMCs) were established with bone marrow samples collected from 15 patients with acute myeloid leukemia (AML) and compared with HLTBMCs from eight healthy volunteers. During 6 weeks of culture, the cellular composition of HLTBMCs was quantitatively studied. The cells of the HLTBMCs were divided into three main categories: fibroblasts, macrophages, and other cells (endothelial cells, hematopoietic cells and undefined cells). HLTBMCs derived from healthy volunteers demonstrated a very consistent development. The number of fibroblasts increased during culture and the number of macrophages decreased, resulting in a steady state after 3 weeks of culture. In contrast, HLTBMCs derived from patients with AML showed a strikingly different pattern of irregular development and a steady state was not reached under our conditions. The APAAP technique was used to demonstrate expression of adhesion molecules. VLA2, VLA5, VLA6, LFA1, Mac1, p150/95, ₂-chain, HCAM, ICAM1, NCAM, and VCAM1 were more expressed on normal as compared with leukemic bone marrow stromal cells, although this reached significance only for ₂-chain and NCAM. VLA1, 3, and 4 were expressed in a higher percentage on leukemic stroma (not significant). More expression was seen on normal as opposed to leukemic macrophages for the adhesion molecules tested, except for VLA5. The differences reached significance for the majority of molecules tested. It is concluded that striking differences exist in cellular composition and adhesion molecule expression between HLTBMCs from healthy individuals and those from patients with AML. This may have an impact on the pathogenesis of AML.     

Gastric carcinogenesis in rats given hypertonic salt at different times before a single dose ofN-methyl-N′-nitro-N-nitrosoguanidine

A 1-ml dose of 4.5 M NaCl was given intragastrically to male Wistar rats at 10 min, 1 h, 4 h, 12 h, 24 h or 48 h before a single intragastric dose of 250 mg/kgN-methyl-N-nitro-N-nitrosoguanidine (MNNG). After 52 weeks the incidence of forestomach squamous cell carcinoma was 21% in control animals receiving MNNG alone. The cancer incidence in the forestomach varied with the time elapsed between application of NaCl and MNNG, and was significantly increased in animals pretreated with NaCl 4 h (43%), 12 h (54%) and 24 h (41%) before MNNG. These results show that salt has a cocarcinogenic effect on initiation of forestomach carcinogenesis in rats, and that this effect depends on the time interval between pretreatment with NaCl and application of MNNG. Gastric adenocarcinomas occurred more frequently in the antrum (78%) than in the corpus (22%). The incidence of gastric adenocarcinoma in animals pretreated with salt before application of MNNG (11%–22%) was not significantly influenced by the time elapsed between pretreatment with salt and application of MNNG, and did not differ from animals receiving MNNG alone (18%). The lack of a cocarcinogenic effect of NaCl on glandular gastric carcinogenesis might be due to the use of dimethyl/sulfoxide as solvent for MNNG.Abbreviations MNNG N-methyl-N-nitro-N-nitrosoguanidine - DMSO dimethylsulfoxide This work was supported by grants from the Norwegian Cancer Society. Dr Sørbye is a Research Fellow of the Norwegian Cancer Society     

注射用丹参粉针剂治疗溃疡性结肠炎患者出凝血时影响

目地:观察注射用丹参对溃疡性结肠炎的疗效及对出凝血时的影响。方法:符合纳入标准的患者被随机分到注射用丹参治疗组和西药常规治疗组。治疗结束后,观察两组治疗效果,测定治疗前后患者出凝血时(PT、APTT、Fbg)及血小板(PLT)水平。结果:丹参治疗组有效率为95.69%,对照组为82.05%,两者比较差异具有统计学差异(P<0.05);两组治疗前后PT、APTT、Fbg、PLT水平差异均有统计学差异(P<0.05),并且丹参治疗组改善效果更明显(P<0.05)。结论:联合应用注射用丹参能提高溃疡性结肠炎疗效,并能改善患者高凝状态。     

平乐郭氏正骨伤科用药简析

目的：总结平乐郭氏正骨治疗骨伤病的经验。方法：从骨伤病的早、中、晚三期着手,辨证分型论治。早期：多为瘀血实证,治宜攻破,若为出血过多或亡血,则宜补而兼行。中期：肿痛减而未尽,瘀血尚有存留,新骨未长,应用“和”法,以调和气血,通经活络,去瘀生新,接骨续筋。后期：多为气血亏损,营卫不和,感受内因、外因而并病,故用药应以和营卫,补气血,健脾益肾,通利关节。结果：采用三期辨证分型内外治法相结合,效果显著。结论：平乐郭氏正骨治疗骨伤病疗效确切。     

香砂六君子汤合金沸草散治疗慢性咽炎50例

目的观察香砂六君子汤合金沸草散治疗慢性咽炎的临床疗效。方法将98例病例随机分为治疗组50例和对照组48例,分别采用香砂六君子汤合金沸草散加减和金荞麦片治疗。两组疗程均为2个月,观察临床疗效。结果治疗组、对照组总有效率分别为92.0%、72.9%;组间总有效率比较,差异有统计学意义（P〈0.05）。结论香砂六君子汤合金沸草散治疗慢性咽炎疗效良好。     

锡类散抗炎镇痛实验研究

目的观察锡类散抗炎镇痛效果。方法测定锡类散对大鼠血管通透性试验、小鼠耳肿胀试验、小鼠醋酸扭体试验、小鼠热板法致痛试验的影响。结果锡类散低、中、高剂量组及阳性对照组的大鼠血管通透性、小鼠耳肿胀度和醋酸所致小鼠扭体反应与阴性对照组比较,差异均有统计学意义（P〈0.05）。热板法致痛试验中,锡类散中、高剂量组在给药后30min-120min有明显的镇痛作用,与阴性对照组比较差异均有统计学意义（P〈0.05）。结论锡类散具有良好的止痛和抗炎药理作用,为扩大锡类散临床上用于痔瘘术后换药提供了科学依据。