炎琥宁与利巴韦林联用治疗麻疹临床效果分析

目的：探讨针对麻疹患者，观察临床选择炎琥宁+利巴韦林完成治疗后获得的临床效果。方法选择我院2013年1月～2015年1月麻疹患者110例。通过随机数表法完成麻疹患者的随机分组。C2组（对照组55例）：临床选择利巴韦林进行治疗。C1组（观察组55例）：临床选择炎琥宁+利巴韦林进行治疗。对比两组麻疹患者在临床治愈率、患者退热时间以及皮疹消退时间等方面表现出的差异。结果两组麻疹患者分别完成临床治疗后，C1组患者疾病治愈率为81.82%，C2组为61.82%，C1组高于C2组麻疹患者（P＜0.05）结论针对麻疹患者，临床选择炎琥宁+利巴韦林进行治疗，最终显著提高麻疹患者的生活质量。     

VGKC complex antibodies in epilepsy: Diagnostic yield and therapeutic implications

PurposeIn a significant number of patients developing epilepsy in adult life, the aetiology of their seizures remains unclear. Antibodies directed against the voltage gated potassium channel complex (VGKC Ab) have been identified in various cohorts of patients with epilepsy, although the role of these antibodies in epilepsy pathogenesis is not fully known.MethodWe reviewed the notes of 144 patients with unexplained adult onset epilepsy who had been tested for VGKC Abs. We collected data on their clinical syndrome, investigation results and response to treatment.ResultsWe identified 6 (4.2%) patients who had titres of >400 pM. One of the six patients was positive for LGI1 and another for CASPR2 subunit antibodies. All patients were given immunotherapy and experienced improvement in seizure control. No patient had the clinical syndrome of limbic encephalitis.ConclusionPatients with otherwise unexplained epilepsy and positive VGKC Abs are a heterogeneous group. In our cohort there was an overall favourable response to immunotherapy but further prospective studies are needed to determine the significance of these antibodies and the optimum treatment regimen for patients.     

蓝芩口服液联合阿莫西林克拉维酸钾分散片治疗儿童急性扁桃体炎的效果及对细胞免疫因子的调控

目的探讨分析蓝芩口服液联合阿莫西林克拉维酸钾分散片治疗儿童急性扁桃体炎的疗效及对患儿血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、可溶性白细胞介素-2受体(sIL-2R)水平的影响。方法选择2017年1月—2018年7月北京市石景山区妇幼保健院收治的急性扁桃体炎患儿192例作为研究对象,将患儿随机分为对照1组(n=63)、对照2组(n=64)和观察组(n=65)。对照1组患儿给予阿莫西林克拉维酸钾分散片,3~7岁患儿1片/次;8~12岁患儿1.5片/次;>12岁患儿2片/次,3次/d。治疗7 d为1个疗程。对照2组患儿给予蓝芩口服液,3~7岁患儿1支/次;8~12岁患儿,1.5支/次;>12岁患儿2支/次,3次/d,治疗7 d为1个疗程。观察组患儿的治疗方案为蓝芩口服液联合阿莫西林克拉维酸钾分散片,服用方案与对照组相同。治疗7 d为1个疗程。观察3组患者的临床疗效、退热时间、症状改善时间及复发率,同时比较3组治疗前后的IL-2、IL-6及sIL-2R水平。结果治疗后,观察组患儿临床治疗总有效率为95.38%,明显高于对照1组的84.13%和对照2组的81.25%,差异有统计学意义(P<0.05)。治疗后,观察组患儿退热时间、症状改善时间及复发率均显著低于对照1组和对照2组,差异有统计学意义(P<0.05);对照1组与对照2组在症状改善时间方面具有显著性差异(P<0.05)。治疗后,3组患儿血清IL-2、IL-6以及sIL-2R水平均较治疗前显著降低(P<0.05);且治疗后观察组患儿血清IL-2、IL-6以及SIL-2水平显著低于对照1组和对照2组,差异均具有统计学意义(P<0.05)。结论蓝芩口服液联合芩口服液和阿莫西林克拉维酸钾治疗急性扁桃体炎可有效促进疾病恢复,改善机体免疫能力,值得临床推广。     

房颤中心房钾离子通道重构机制及相关药物的研究进展

心房颤动(简称房颤)是临床上最常见的持续性快速心律失常之一,可以引起心房内血栓、脑栓塞等严重并发症,是我国70岁以上老年人发病率较高、致死率较高的一种疾病。房颤的发生机制较为复杂,大量研究表明,心脏离子钾通道重构在房颤的发生和持续存在中发挥极其重要的作用。作用靶点位于钾离子通道的药物已应用于心房颤动,虽有一定的疗效但仍存在效果欠佳,并发症较多等缺点,现阶段关于心房钾离子通道重构及新型钾离子通道药物已经成为房颤研究中的热点之一。     

Potassium-rich diet and risk of stroke: Updated meta-analysis

Recently a few prospective population studies provided additional and heterogeneous information concerning the reported statistical associations between potassium (K) intake and stroke risk. Therefore, we updated our previous meta-analysis of K intake and risk of cerebrovascular events.Three studies were added to the previous analysis, and the results of the comparison between the event rate in the two extreme categories of K intake were used. Pooled analysis of 14 cohorts (overall 333,250 participants and 10,659 events) showed an inverse and significant association between K intake and risk of stroke (Relative Risk: 0.80; 95% CI: 0.72–0.90).Our results indicated a favorable effect of higher K intake on risk of stroke. These results confirm the appropriateness of worldwide recommendations for a population increased consumption of potassium-rich foods to prevent cardiovascular disease.     

Lipid sensing in the brain and regulation of energy balance

Nutrient-sensitive neurons [to glucose and fatty acids (FAs)] are present at many sites throughout the brain, including the hypothalamus and brain stem, and play a key role in the neural control of energy and glucose homoeostasis. Through their neuronal output, FAs can modulate feeding behaviour as well as insulin secretion and activity. Central administration of oleate, for example, inhibits food intake and glucose production in rats. This suggests that daily variations in plasma FA concentrations could be detected by the central nervous system as a signal that contributes to regulation of energy balance. At the cellular level, subpopulations of neurons in the ventromedial and arcuate hypothalamic nuclei are selectively either inhibited or activated by FAs. Possible molecular effectors of these FA effects most likely include the chloride and potassium ion channels. While intracellular metabolism and activation of the ATP-sensitive K⁺ channels appear to be necessary for some signalling effects of FAs, at least half the FA responses in ventromedial hypothalamic neurons are mediated by interaction with fatty acid translocase (FAT)/CD36, an FA transporter/receptor that does not require intracellular metabolism to activate downstream signalling. Thus, FAs and their metabolites can modulate neuronal activity by directly monitoring the ongoing fuel availability for brain nutrient-sensing neurons involved in the regulation of energy and glucose homoeostasis. Besides these physiological effects, FA overload or metabolic dysfunction may also impair neural control of energy homoeostasis and contribute to obesity and/or type 2 diabetes in predisposed subjects.     

Brief Communication EFFECTS OF MELATONIN ON KCN-INDUCED NEURODEGENERATION IN MICE

Melatonin is known to have a neuroprotective effect by preventing epileptic seizures, which are normally induced by cyanide. To demonstrate the neuroprotective function of melatonin, we examined cell death and changes in plasma melatonin level in KCN-treated mice. Neuronal cell death is shown in substantial nigra of KCN-treated groups. In melatonin-treated groups, this cell death decreased in substantia nigra. Plasma melatonin level at 12:00 was significantly decreased to 52.6% after KCN injection as compared to the normal group. In contrast, melatonin level was significantly decreased (74.5%) in KCN + melatonin group. Melatonin level at 24:00 was significantly decreased to 57.0% after KCN injection and also significantly decreased to 81.0% in KCN-melatonin group as compared to the normal group. Results from the present study suggest that melatonin prevents neuronal cell death in KCN-induced brain.     

静脉补钾局部疼痛缓解方法的研究

目的 :寻找缓解静脉补钾局部疼痛的方法。方法 :连续入院病人 30 0例 ,入院后第 1、2、3天分别静脉输入 10 %葡萄糖溶液 5 0 0ml加入 10 %氯化钾 15ml(A组 )、5 %葡萄糖氯化钠溶液 5 0 0ml加入 10 %氯化钾 15ml (B组 )以及生理盐水 5 0 0ml加入 10 %氯化钾 15ml(C组 ) ,同时观察局部疼痛的发生情况。对A组中出现疼痛的病例立即在输液中加入 10 %氯化钠 10ml,观察对局部疼痛的影响。结果 :A组中疼痛发生率为 80 .33 % ,B、C组分别为 11.6 7%及 10 .0 0 % ,与A组相比 ,差异有统计学意义 (P≤0 .0 0 1) ,而B、C组之间差别无统计学意义 (P >0 .0 5 )。A组中疼痛病例加入 10 %氯化钠后 94.19%病人疼痛消失 ,与加入前相比 ,差异有统计学意义 (P <0 .0 1)。结论 :采用糖盐水或生理盐水做溶剂补钾可显著减少疼痛的发生 ,在 10 %葡萄糖溶液中加入适量氯化钠可消除或减轻补钾时的疼痛。     

中药熏洗配合红外线照射对痔术后患者创面影响的研究

目的探讨不同护理措施对痔术后创面的影响。方法将80例痔术后患者按入院顺序分为观察组和对照组各40例。观察组患者排便后创面用中药熏洗配合红外线照射每日2次，对照组患者用1：5000高锰酸钾溶液坐浴每日2次。4d为评估周期。1个周期后评估创面疼痛、水肿、出血、肉芽生长情况以及愈合时间。结果在创面疼痛、水肿、肉芽生长等方面，观察组显著优于对照组，x^2CMH分别为10．40、3．708、12．904，P均〈0．05；两组出血比较，x^2CMH=0．612，P〉0．05；观察组创面愈合时间缩短。结论痔术后患者宜采用中药熏洗配合红外线照射创面。