慢性丙型肝炎病毒感染妇女经血中有HCV-RNA

本文旨在明确丙型肝炎病毒在两性间和家庭内传播的可能途径,作者检测了丙型肝炎病毒慢性感染妇女的经血。 14例绝经前妇女接受检测,其中10例经PCR法及第二代ELISA(Ⅱ)法检测为血清HCV阳性,1例经ELISA法检测为血清抗-HCV阳性但HCV-RNA阴性,3例无丙肝病     

血清风疹抗体测定与临床应用

血清风疹抗体测定与临床应用上海第二医科大学附属瑞金医院传染科（２０００２５）许蓓，蔡伊梅儿科实验室奚容平风疹是儿童时期由风疹病毒引起的急性呼吸道传染病，通常症状轻、预后好。近年来上海地区所发生的风疹其症状和体征呈不典型趋势，造成临床诊断有一定困难。本...     

Long term treatment of lamivudine in chronic hepatitis B patients with severe liver fibrosis——ten-year follow-up outcomes of NUCB 4006 trial

Objective To evaluate the clinical and histological outcomes in a cohort of chronic hepatitis B (CHB) patients who had histologically confirmed severe liver fibrosis and received lamivudine (LAM) therapy for up to 10 years. Methods Thirty-nine CHB patients with severe liver fibrosis (Ishak fibrosis score≥4) were treated with LAM for up to 10 years. Disease progression liver histological improvement, virological and biochemical responses were evaluated during follow-up. Data were analyzed using paired t test, Fisher exact test and Willcoxon test. Results Twenty-eight patients completed the 10-year follow-up. There were 5 (17.9% ) patients with disease progression.At the end of follow up, 16 patients received a second liver biopsy, which showed significant improvement of histological activity index (1.1 ± 1.4 vs 7. 1 ± 3.2, t =- 0.82, P＜0.01 ) and Ishak fibrosis score (3.6±2.2 vs 5.3±0.7, t= -2.89, P＜0.05) compared to baseline. There were 3 cases with Ishak fibrosis score improved from F5 to F0. Among 27 patients, 3(11% ) cases achieved hepatitis B surface antigen (HBsAg) loss and 2 (7 % ) achieved HBsAg seroconversion. At the end of follow-up, 19 out of 23 (83% ) hepatitis B e antigen (HBeAg) positive patients obtained HBeAg loss and 9 (39 % ) obtained HBeAg seroconversion. During LAM treatment, 11 patients experienced virological breakthrough or detected documented LAM-related resistance mutation. The viral loads of all patients were below 1 ×103 copy/mL at the end of follow-up after rescued by add-on or switch to another nucleotide analog.Conclusions Long-term LAM therapy can delay the disease progression in CHB patients with severe liver fibrosis, increase HBsAg and HBeAg loss rates, sustain suppression of HBV replication at a low level and even totally reverse the liver fibrosis in some patients. The effect of LAM resistance mutation on disease outcomes would be reduced by rescue therapy.     

自身免疫性肝炎的研究进展

自身免疫性肝炎(autoimmune hepatitis,AIH)是一种呈慢性炎症性坏死的肝脏疾病,其发病与HLA等位基因密切相关.近20年来,AIH的诊断与治疗取得了较多进展,发现了更多的AIH自身抗体、基因及新型治疗药物,建立了AIH的血清免疫学检查方法和遗传异质性研究;掌握了AIH临床表现、发生发展、疾病转归与种族、地域分布和遗传背景的关系.本文就AIH有关研究进展作一综述.     

骨关节炎发病机制及治疗进展

骨关节炎（OA）是临床上常见的一种关节炎,多累及下肢负重关节与双手小关节,容易导致关节畸形,严重影响患者生活质量。OA并非单纯的关节退行性病变,而是与年龄、肥胖、炎症、免疫及遗传等因素相关。近年来关于OA的治疗有新的指南。本文就近年来OA的发病机制、治疗指南等方面的新进展加以总结,对于有争议的氨基葡萄糖,通过对其的疗效、安全性等进行综合分析,建议氨基葡萄糖继续用于治疗OA。     

婴幼儿腹泻时肠道蛋白质丢失的研究

作者研究了５５例急性，迁延性和慢性腹泻患儿的粪α１－抗胰蛋白酶含量，年龄１－２９个月。结果显示，迁延性腹泻及慢性腹泻组每克湿粪ａ１－ＡＴ含量分别为０．４９±０．２９ｍｇ、０．６８±０．３２ｍｇ均显著大于正常组０．２７±０．２５ｍｇ。     

中医护理及健康宣教对慢性盆腔炎的临床疗效观察

慢性盆腔炎是妇科常见病和多发病,病情顽固,缠绵难愈,严重者可影响工作和生活.西医治疗方法对控制急性期病情发展有确切疗效,但对其后遗症特别是反复发作和慢性盆腔炎的防治尚无理想疗法.中医药治疗有明显优势和特色.2010-05-2011-05,笔者对156例慢性盆腔炎患者进行中医护理及健康教育,结果如下.     

脂质体在脑靶向给药系统中的研究进展

血脑屏障是阻碍药物进入大脑的主要因素,血脑屏障上皮细胞间的紧密连接使药物很难渗透入脑,从而显著增加了临床药物治疗颅内疾病的难度。连接抗体的脂质体或免疫脂质体可作为特定的药物载体将药物分子包裹并靶向运输到相应组织或器官内。本文将总结如何应用这种技术将药物转运通过血脑屏障,及其临床应用前景。     

葛根素对缺氧缺血新生大鼠神经保护作用及其机制

目的：观察葛根素（Pue）对缺氧缺血性脑损伤（HIBD）新生大鼠脑源性神经生长因子（BDNF）,Bax,及半胱天冬酶-3表达及远期学习记忆能力的影响.方法：7d龄S D大鼠随机分为3组：葛根素组（Pue组）在缺氧缺血后注射葛根素50 mg/kg,1次/d,共7 d;对照组（Con组）给予同体积的的生理盐水;假手术组（Sham组）仅分离经总动脉,不给药.各组分别于1 wk后采用免疫组化方法检测各组BDNF,Bax,Caspase-3在海马区的表达,4 wk后水迷宫检测其远期学习记忆能力.结果：①术后1 wk海马区Pue组BDNF表达水平高于Con组（P〈0.05）,海马区Bax,Caspase-3表达水平低于Con组（P〈0.05,P〈0.01）.②术后4 wk Morris水迷宫Pue组逃避潜伏期缩短明显快于Con组（P〈0.05,P〈0.01）,穿过原平台次数及在目标象限游泳时间与总时间百分比Pue组明显多于Con组（P〈0.05,P〈0.01）.结论：葛根素能减轻新生大鼠缺氧缺血引起的脑组织损伤,提高新生大鼠年长后的学习记忆能力.这种保护作用可能和葛根素增加海马区BD-NF的表达、降低Bax,Caspase-3在海马区的表达抑制海马区神经细胞的凋亡有关.     

温经通络方穴位贴敷防治冬季奥沙利铂化疗致神经毒性的临床研究

目的 探讨冬季使用奥沙利铂(Oxaliplatin,L-OHP)化疗所致周围神经毒性的特点,分析使用温经通络、活血化瘀方进行穴位贴敷后的疗效.方法 将70例在冬季(每年12月～次年2月)期间使用L-OHP的患者,随机分为两组各35例,治疗组用温经通络方穴位贴敷,对照组使用热水袋加温以提高局部的温度,4个化疗周期后观察疗效.结果 治疗组周围神经毒性的总有效率为35％,对照组为9％,差异有显著意义(P＜0.05);两组患者在治疗后的机能状况(KPS)评分差异有显著意义(P=0.01).结论 使用温经通络、活血化瘀方穴位贴敷可预防和减轻在冬季使用L-OHP化疗所致的周围神经毒性.