米非司酮联合GnRH-a对子宫内膜异位症患者血清IGF-1、HMGB1水平的影响

目的探讨米非司酮联合GnRH-a治疗子宫内膜异位症患者对其血清IGF-1、HMGB1水平的影响。方法选取2015年9月-2017年11月该院收治的子宫内膜异位症患者120例作为研究对象,将所有患者随机分为两组,每组各60例,对照组患者使用米非司酮进行治疗,研究组在对照组的基础上联合GnRH-a进行治疗。对比两组患者的治疗效果、不良反应症状以及对血清IGF-1、HMGB1水平的影响。结果研究组患者的治疗有效率为80. 0%,显著高于对照组的71. 7%(P<0. 05);研究组患者不良反应发生率为3. 4%,明显低于对照组的16. 7%(P<0. 05);治疗前,两组患者的血清IGF-1、HMGB1状况比较差异无统计学意义(P>0. 05),治疗后,两组患者的血清IGF-1、HMGB1水平均有所改善,并且研究组患者改善程度明显优于对照组(P<0. 05)。结论子宫内膜异位症的治疗过程当中,采用米非司酮联合GnRH-a对其进行治疗,能够大大降低不良反应的发生率,减少复发率,增加妊娠率,使血清IGF-1、HMGB1水平得以改善,控制异位子宫内膜的增生,效果理想。     

祛风宣肺汤联合西药治疗咳嗽变异性哮喘(风邪犯肺)随机平行对照研究

[目的]观察祛风宣肺汤联合西药治疗咳嗽变异性哮喘(风邪犯肺)疗效。[方法]使用随机平行对照方法,将104例门诊患者按随机数字表法随机分为两组。对照组52例沙美特罗替卡松粉吸入剂,1吸/次,2次/d;多索茶碱,400mg/次,2次/d。治疗组52例祛风宣肺汤(麻黄、蜜枇杷叶、炒紫苏子各15g,蝉蜕、前胡、荆芥、炒牛蒡子、浙贝母、五味子、桔梗各10g,甘草8g,鱼腥草30g),水煎400mL,早晚温服,兼夹风寒者,加防风、紫菀、百部;兼夹风热者,加桑叶、菊花、薄荷、连翘;兼夹风燥者,加桑叶、杏仁、沙参;西药治疗同对照组。连续治疗3周为1疗程。观测临床表现、FEV_1、FEV_1%、用力肺活量(FVC)、最大呼气流量(PEF)、中医证候积分、不良反应。连续治疗2疗程(6周),判定疗效。[结果]治疗组痊愈26例,显效16例,有效7例,无效3例,总有效率94. 23%;对照组痊愈20例,显效13例,有效9例,无效10例,总有效率80. 77%;治疗组疗效优于对照组(P 0. 05)。FEV_1、FEV_1%、FVC、PEF、中医证候积分两组均有改善(P 0. 01),治疗组改善优于对照组(P 0. 05,P 0. 01)。[结论]祛风宣肺汤联合西药治疗咳嗽变异性哮喘(风邪犯肺),疗效满意,无严重不良反应,值得推广。     

鼻内镜术后鱼腥草滴鼻液与糠酸莫米松鼻喷雾剂联合局部应用对鼻黏膜组织重塑的影响研究

目的　探讨鼻内镜术后鱼腥草滴鼻液与糠酸莫米松鼻喷雾剂联合局部应用对黏膜组织修复与重塑的影响。方法　将46例行鼻内镜手术的慢性鼻-鼻窦炎伴和不伴鼻息肉患者，通过随机数表随机分为3组，分别为鱼腥草滴鼻液+糠酸莫米松鼻喷联合治疗组（16例）、单用糠酸莫米松鼻喷雾剂组（15例）及单用鱼腥草滴鼻液组（15例），在鼻内镜术后给予相应治疗，3个月后评估患者术后治疗有效率情况。采用免疫组化法评估鼻黏膜上皮细胞损伤分级，并分别计数鼻黏膜上皮细胞中转化生长因子β1（transforming growth factor-β1，TGF-β1）、成纤维细胞生长因子-2（fibroblast growth factor-2，FGF-2）、基质金属蛋白酶-9（matrix metalloproteinase-9，MMP-9）阳性细胞数。结果　治疗3个月后，联合治疗组患者治疗后的病情完全控制率优于单药治疗组（P 均<0.05），联合治疗组患者中无鼻黏膜损伤比例显著高于单药治疗组，且基底膜厚度较单药治疗组薄，TGF-β1阳性细胞数较单药治疗组少（P 均<0.05）。治疗后联合治疗组鼻黏膜上皮细胞中FGF-2阳性细胞数和MMP-9阳性细胞数较单药治疗组明显减少（P 均<0.05）。结论　鼻内镜术后鱼腥草滴鼻液与糠酸莫米松鼻喷雾剂联合局部应用，较局部单用以上两种药物有更好疗效，可促进黏膜上皮化，能明显减缓鼻黏膜重塑过程的发生与发展，促进鼻黏膜功能恢复，对鼻内镜术后鼻黏膜修复及预后具有积极意义。     

固本益气方辅助同步放化疗治疗脑额叶胶质瘤术后患者疗效及对炎性细胞因子、细胞生长因子水平的影响

目的观察固本益气方辅助同步放化疗治疗脑额叶胶质瘤术后患者疗效及对炎性细胞因子、细胞生长因子(HGF)水平的影响。方法将116例脑额叶胶质瘤术后患者随机分为2组,对照组58例给予同步放化疗治疗,观察组58例在此基础上加用固本益气方治疗,2组疗程均为6个月。统计2组临床疗效、随访生存率及不良反应发生情况,观察2组治疗前后T淋巴细胞亚群、白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)、HGF水平及卡洛夫斯基功能状态评分(KPS)变化情况。结果观察组近期治疗总有效率、KPS评分和术后6个月、12个月生存率均显著高于对照组(P均0.05),各种不良反应发生率显著低于对照组(P均0.05);观察组治疗后CD4~+、CD4~+/CD8~+均显著高于治疗前及对照组(P均0.05),CD8~+及IL-17、TNF-α、HGF水平显著低于治疗前及对照组(P均0.05)。结论固本益气方辅助同步放化疗用于脑额叶胶质瘤术后患者可有效促进残存肿瘤缩小,改善细胞免疫功能,提高生存质量,下调IL-17、TNF-α及HGF水平,延长生存时间,并有助于降低药物毒副作用。     

Effect of stromal cell-derived factor-1/CXCR4 axis in neural stem cell transplantation for Parkinson’s disease

Previous studies have shown that neural stem cell transplantation has the potential to treat Parkinson’s disease,but its specific mechanism of action is still unclear.Stromal cell-derived factor-1 and its receptor,chemokine receptor 4(CXCR4),are important regulators of cell migration.We speculated that the CXCR4/stromal cell-derived factor 1 axis may be involved in the therapeutic effect of neural stem cell transplantation in the treatment of Parkinson’s disease.A Parkinson’s disease rat model was injected with 6-hydroxydopamine via the right ascending nigrostriatal dopaminergic pathway,and then treated with 5μL of neural stem cell suspension(1.5×104/L)in the right substantia nigra.Rats were intraperitoneally injected once daily for 3 days with 1.25 mL/kg of the CXCR4 antagonist AMD3100 to observe changes after neural stem cell transplantation.Parkinson-like behavior in rats was detected using apomorphine-induced rotation.Immunofluorescence staining was used to determine the immunoreactivity of tyrosine hydroxylase,CXCR4,and stromal cell-derived factor-1 in the brain.Using quantitative real-time polymerase chain reaction,the mRNA expression of stromal cell-derived factor-1 and CXCR4 in the right substantia nigra were measured.In addition,western blot assays were performed to analyze the protein expression of stromal cell-derived factor-1 and CXCR4.Our results demonstrated that neural stem cell transplantation noticeably reduced apomorphine-induced rotation,increased the mRNA and protein expression of stromal cell-derived factor-1 and CXCR4 in the right substantia nigra,and enhanced the immunoreactivity of tyrosine hydroxylase,CXCR4,and stromal cell-derived factor-1 in the brain.Injection of AMD3100 inhibited the aforementioned effects.These findings suggest that the stromal cell-derived factor-1/CXCR4 axis may play a significant role in the therapeutic effect of neural stem cell transplantation in a rat model of Parkinson’s disease.This study was approved by the Animal Care and Use Committee of Kunming Medical University,China(approval No.SYXKK2015-0002)on April 1,2014.