易善复与游泳运动对高脂饮食小鼠脂肪肝的预防作用比较

 目的 分别观察保肝药易善复和游泳运动对于高脂饮食小鼠脂肪肝的预防作用,通过细胞超微结构和显微结构的比较,为临床脂肪肝的预防提供依据。方法 高脂饮食性脂肪肝模型通过小鼠进食高脂饲料来诱导。将15只正常小鼠随机分为5组,即正常饮食对照组(N)、高脂饮食模型组(HF)、高脂饮食加药物组(HF+D)、高脂饮食加游泳组(HF+S)和正常饮食加药物组(N+D)。皮下注射易善复0.5 mL(3.32 mg/mL),游泳运动为小鼠每天25℃水温游泳20 min。连续实验4周后,测定小鼠体重并观察肝细胞组织切片和超微结构形态变化,以体重变化、肝细胞中脂滴的大小和多少、肝细胞超微结构的变化为主要衡量指标,比较保肝药易善复和游泳运动对于脂肪肝的预防效果。结果 HF组小鼠肝脏内出现了明显的脂肪变性,胞质内出现大量脂滴和胆固醇结晶,体重明显高于对照组;HF+S组小鼠肝脏的显微结构和超微结构无显著变化,体重增加;HF+D组小鼠体重有明显下降,同时肝脏出现了相对较为明显的脂肪变性;N+D组小鼠在肝脏形态结构无明显变化的前提下,体重有明显降低。 结论 4周的高脂饮食成功建立了小鼠脂肪肝模型;游泳运动和易善复对于抑制脂肪肝的形成有一定积极作用,游泳运动的保护作用优于易善复;易善复对于正常肝脏影响较小,可以用于脂肪肝的预防性治疗。     

益气活血方联合易善复胶囊治疗非酒精性脂肪性肝炎50例

目的观察益气活血方联合易善复胶囊治疗非酒精性脂肪肝的临床疗效。方法将非酒精性脂肪性肝炎80例按就诊时间先后随机分为治疗组50例和对照组30例,治疗组用益气活血方加易善复胶囊治疗,对照组单用易善复胶囊治疗,疗程均为3个月。结果治疗组证候、肝功能、血脂、B超检查结果改善均优于对照组,两组疗效比较差异有显著性（P〈0．01）。结论益气活血方联合易善复胶囊治疗非酒精性脂肪性肝炎疗效较好。     

对比异甘草酸镁与多烯磷脂酰胆碱治疗脂肪肝的临床疗效

目的：观察异甘草酸镁与多烯磷脂酰胆碱单独使用治疗脂肪肝的临床疗效对比。方法：选取我单位2013年1月～2014年4月期间因患有脂肪肝被收治的患者76例。其中37例使用多烯磷脂酰胆碱进行治疗,作为对照组。39例使用异甘草酸镁进行治疗,作为观察组。对两组的治疗效果及实验室指标进行对比分析。结果：观察组在治疗后显效的27例,有效的11例,总有效率为97.44%,对照组显效的17例,有效的13例,总有效率为81.08%,观察组的治疗总有效率明显高于对照组,差异具备统计学意义。观察组治疗1周后的肝功能指标明显低于对照组,观察组治疗3周后的肝功能指标明显低于对照组,差异具备统计学意义。结论：异甘草酸镁治疗脂肪肝有很好的疗效,丰富了临床治疗的手段,应当在临床中普及使用。     

药物性肝损伤针对性治疗的回顾性分析

目的：比较不同类型药物性肝损伤使用不同保肝药物进行针对性治疗的效果。方法：回顾性分析某院2013年1月-2017年12月诊断为药物性肝损伤的病历,收集病历信息,统计不同保肝药物治疗不同类型药物性肝损伤的疗程、费用及疗效。结果：对于肝细胞损伤型肝损伤的治疗,异甘草酸镁注射液治疗疗程最短[（5.47±1.94）d,P<0.05],总有效率最高（95.5%,P<0.05）,多烯磷脂酰胆碱注射液治疗费用最低[（664.62±273.05）元,P<0.05];对于胆汁淤积型肝损伤,注射用丁二磺酸腺苷蛋氨酸治疗疗程最短[（5.38±2.02）d,P<0.05],费用最低[（575.70±215.56）元,P<0.05],总有效率最高（91.1%,P<0.05）;对于混合型肝损伤,3种保肝药物治疗疗程及总有效率均无显著性差异（P>0.05）,但多烯磷脂酰胆碱注射液治疗费用较低[611.35±206.47）元,P<0.05]。结论：对于不同类型的肝损伤,针对性的治疗能缩短治疗疗程,降低平均治疗费用,提高保肝药物的治疗效果。     

熊去氧胆酸联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝炎疗效观察

[目的]观察熊去氧胆酸(UDCA)联合多烯磷脂酰胆碱(PPC)治疗非酒精性脂肪性肝炎(NASH)的临床疗效。[方法]85例NASH患者被随机分为2组,观察组(45例)给予口服UDCA胶囊250mg和PPC片465mg,3次/d;对照组(40例)给予口服PPC片465mg,3次/d;2组疗程均为3个月。观察2组治疗前后肝功能、血脂及B超下脂肪肝影像变化。[结果]观察组总有效率为75.6%,明显高于对照组的52.5%(P<0.05);治疗后观察组谷草转氨酶、谷丙转氨酶、总胆红素和谷氨酰转肽酶分别为(36.0±15.2)U/L、(32.5±14.5)U/L、(15.6±6.0)!mol/L和(67.5±23.5)U/L,明显低于对照组的(45.6±20.5)U/L、(42.0±17.5)U/L、(21.5±7.2)!mol/L、(90.3±35.2)U/L(P<0.05或P<0.01);观察组总胆固醇、三酰甘油分别为(1.7±0.9)mmol/L、(4.0±0.6)mmol/L,明显低于对照组的(2.1±1.0)mmol/L、(4.4±0.7)mmol/L(P<0.05或P<0.01),2组高密度脂蛋白胆固醇、低密度脂蛋白胆固醇比较差异无统计学意义(P>0.05);观察组和对照组治疗后脂肪肝程度均较治疗前有显著改善(P<0.01或P<0.05),但2组间比较差异无统计学意义(P>0.05)。[结论]UDCA联合PPC治疗NASH有较好的疗效。     

复方甘草酸苷注射液联合多烯磷脂酰胆碱注射液治疗慢性乙型肝炎疗效观察

目的探讨复方甘草酸苷注射液联合多烯磷脂酰胆碱注射液治疗慢性乙型肝炎的临床疗效。方法 90例慢性乙型肝炎患者分为3组,每组30例。Ⅰ组患者给予复方甘草酸苷注射液治疗,Ⅱ组患者给予多烯磷脂酰胆碱注射液治疗,Ⅲ组患者给予复方甘草酸苷注射液和多烯磷脂酰胆碱注射液联合治疗,疗程均为30 d。治疗前后检测3组患者外周血肿瘤坏死因子-α(TNF-α)、丙氨酸氨基转移酶(ALT)和总胆红素(TB)水平及血浆白蛋白和球蛋白的比值(A/G),并进行比较。结果治疗前3组患者血清TNF-α水平比较差异无统计学意义(P>0.05);3组患者治疗后血清TNF-α水平显著低于治疗前(P<0.05);治疗后Ⅰ组与Ⅱ组患者血清TNF-α水平比较差异无统计学意义(P>0.05);治疗后Ⅲ组患者血清TNF-α水平显著低于Ⅰ组和Ⅱ组(P<0.05)。3组患者治疗前血清ALT和TB水平及A/G比较差异均无统计学意义(P>0.05);3组患者治疗后血清ALT和TB水平显著低于治疗前(P<0.05),3组患者治疗后A/G显著高于治疗前(P<0.05);治疗后Ⅰ组与Ⅱ组患者血清ALT和TB水平及A/G比较差异均无统计学意义(P>0.05);治疗后Ⅲ组患者血清ALT和TB水平显著低于Ⅰ组和Ⅱ组(P<0.05);治疗后Ⅲ组患者A/G显著高于Ⅰ组和Ⅱ组(P<0.05)。结论复方甘草酸苷注射液联合多烯磷脂酰胆碱注射液治疗慢性乙型肝炎可显著改善患者血清TNF-α水平和肝功能。     

Antifungal therapy for keratomycoses

Keratomycoses have recently emerged as an important cause of ocular morbidity, especially in third-world countries. Available antifungal agents are limited in their efficacy, due to limited penetration into the cornea, the fungistatic nature and the development of drug resistance. Effective usage of the available drugs is hampered by the inefficiency of currently available antibiotic sensitivity tests for fungal organisms. There is also limited knowledge regarding the ideal combination(s) of antifungal agents, including issues of synergism and antagonism. Despite these problems, recent publications indicate encouraging outcomes in the treatment of a large series of fungal keratitis. Advances include better drug formulations, new agents and novel methods of drug delivery into the eye. As our ability to deal with advanced fungal keratitis remains limited, the importance of early diagnosis has been stressed and molecular biological techniques may play an important role in the future. This article summarises the important new advances in these areas in the past 2 years and provides guidelines for the management of these serious corneal infections.     

Exploring the efficacy and safety of polyene phosphatidylcholine for treatment of drug-induced liver injury using the Roussel Uclaf causality assessment method: a propensity score matching comparison

Objective In China, polyene phosphatidylcholine (PPC) is widely used to treat alanine aminotransferase (ALT) elevation associated with various liver diseases. Here, we assessed the efficacy and safety of PPC in treating drug-induced liver injury (DILI).Methods Data from a multicenter retrospective cohort study (DILI-R) were analyzed to compare PPC and magnesium isoglycyrrhizinate (MgIG) for treatment of DILI. We used the Roussel Uclaf causality assessment method (RUCAM) to evaluate patients with DILI. Patients with RUCAM scores ≥6 were included in the study, while those with RUCAM scores <6 were further evaluated by a panel of hepatologists. The primary outcome was the proportion of patients with ALT normalization at discharge. Propensity score matching was used to identify 183 matched pairs of patients (366 patients in total) from 25,927 patients with DILI.Results Among the DILI patients, 64 of 183 (34.97%) achieved normal ALT levels after treatment in both the PPC and the MgIG groups.Conclusion There were no significant differences in safety biomarkers including serum creatinine, blood urea nitrogen, white blood cells, platelets, hemoglobin, and albumin between patients treated with PPC or MgIG. The safety and efficacy of these two agents for treatment of DILI were comparable.     

硫普罗宁联合多烯磷脂酰胆碱治疗酒精性肝病的护理83例

目的探讨硫普罗宁联合多烯磷脂酰胆碱治疗酒精性肝病的护理要点及方法。方法对用硫普罗宁联合多烯磷脂酰胆碱治疗的酒精性肝病患者83例进行心理、饮食及肝穿方面的护理,增加病人对治疗的配合及顺应性。结果全部接受治疗的83例酒精性肝病患者,有效率96．5％（80／83）。结论酒精性肝病采取硫普罗宁联合多烯磷脂酰胆碱治疗,具有显著的疗效,但必须进行深入的临床护理,对改善病人生活习惯,提高病人治疗、检查的依从性是非常重要的。