外周血淋巴细胞亚群在慢性HBV感染过程中表达的变化分析

目的探讨HBV感染患者外周血淋巴细胞亚群在疾病进展过程中的表达变化。方法选取2018年1月-2019年4月在天津市第二人民医院住院的慢性HBV感染患者共132例,其中慢性乙型肝炎患者47例,乙型肝炎肝硬化患者44例,乙型肝炎肝硬化相关原发性肝癌患者41例。另选取同期健康体检者42例作为对照组。采用流式细胞术检测4组外周血淋巴细胞亚群精准计数,比较4组外周血淋巴细胞亚群的表达水平。正态分布的计量资料,组间方差不齐采用Welch方差分析,两两比较采用GamesHowell检验。非正态分布的计量资料多组间及进一步两两比较采用Kruskal-Wallis H检验。计数资料组间比较采用χ2检验。相关性分析采用Spearman检验。结果与对照组和慢性乙型肝炎组相比,肝硬化组和肝癌组CD3^+、CD4^+T淋巴细胞数量明显减少,差异均有统计学意义(P值均<0.05)。与对照组相比,肝癌组CD8^+T淋巴细胞数量明显减少,差异有统计学意义(P<0.05);与慢性乙型肝炎组相比,肝硬化组和肝癌组CD8^+T淋巴细胞数量明显减少,差异均有统计学意义(P值均<0.05)。与对照组和慢性乙型肝炎组相比,肝硬化组和肝癌组CD19^+B淋巴细胞数量明显减少,差异均有统计学意义(P值均<0.05)。与对照组相比,肝硬化组和肝癌组CD16^+CD56^+NK细胞数量明显减少,差异均有统计学意义(P值均<0.05);与慢性乙型肝炎组比较,肝癌组CD16^+CD56^+NK细胞数量明显减少,差异有统计学意义(P<0.05)。4组疾病进展与外周血CD3^+T淋巴细胞、CD4^+T淋巴细胞、CD8^+T淋巴细胞、CD19^+B淋巴细胞、CD16^+CD56^+NK细胞呈明显负相关(r值分别为-0.414、-0.503、-0.269、-0.435、-0.402,P值均<0.01)。结论随着疾病的进展,慢性HBV感染患者免疫状态发生变化。外周血淋巴细胞亚群精准计数能够反应机体的免疫状态,可作为慢性HBV感染临床病情演变、治疗效果及疾病预后的参考依据。     

Effect of low-frequency electroacupuncture on pancreatic endocrine system in patients with simple obesity

Objective

To observe different efficacies of low-frequency electroacupuncture (EA) on pancreatic endocrine system in male and female patients with simple obesity due to spleen deficiency-related dampness.

Methods

A total of 80 simple obesity patients were assigned to a male group (n=37) and a female group (n=43). Both groups received a 30-minute low-frequency EA at Yinlingquan (SP 9), Sanyinjiao (SP 6), Zusanli (ST 36), Fenglong (ST 40), Quchi (LI 11), Tianshu (ST 25), Zhongwan (CV 12), Shuifen (CV 9), Qihai (CV 6) and Guanyuan (CV 4). The treatment was done once a day, and 10 times made up a course of treatment. Patients in both groups were treated for 2 courses. Then the changes in body mass index (BMI), serum insulin, insulin antibodies and leptin level in the two groups were observed and analyzed.

Results

After treatment, the BMI, serum insulin, insulin antibodies and leptin levels were significantly reduced in both groups (P<0.01 or P<0.05); the BMI and serum insulin concentration were more significantly reduced in the male group than those in the female group (both P<0.01); and the leptin level was more significantly reduced in the female group than that in the male group (P<0.01).

Conclusion

EA can significantly regulate BMI and pancreatic endocrine system in both men and women with simple obesity; however, there is a gender difference: better effect for men in reducing BMI and serum insulin and better effect for women in reducing serum leptin level.

     

贾建伟教授从正气理论调节慢性乙型肝炎患者免疫状态验案

据世界卫生组织报道,全世界约20亿人感染乙型肝炎病毒(HBV),其中2.4亿人为慢性HBV感染者[1]。HBV和宿主免疫系统是驱动疾病进展的两大因素,其中机体免疫功能紊乱是导致HBV感染慢性化的一个重要原因[2]。抗病毒是治疗慢性乙型肝炎(CHB)的关键,免疫调节有望成为未来更重要的治疗手段[3]。     

不同负荷离心运动对大鼠骨骼肌组织结构和血清中酶活性的影响及其意义

目的: 探讨不同负荷运动型大鼠血清肌酸激酶(CK)、乳酸脱氢酶(LDH)与骨骼肌损伤的关系,为科学、准确地判断运动性骨骼肌损伤的研究提供理论依据。方法：70只雄性Wistar大鼠随机分为非运动干预对照组（C）、1次离心运动组(AE)和连续7 d离心运动组(SE)。分别在一次运动和末次训练后即刻、24 h和48 h取腓肠肌和血清,观察腓肠肌的组织结构和血清CK、LDH、丙二醛（MDA）及超氧化物歧化酶（SOD）生物活性的变化。结果：AE组大鼠骨骼肌组织结构在运动后24 h受损严重,SE组在末次运动的即刻骨骼肌组织结构受损严重,光镜下呈现出肌纤维扭曲、皱缩及横纹消失等变化。AE组大鼠血清CK、LDH、MDA活性升高的峰值出现在运动后即刻,与对照组比较差异有统计学意义（P<0.001）;运动后24 h SOD升高显著,与对照组比较差异有统计学意义（P<0.001）;SE组大鼠在末次运动后即刻血清CK、LDH、MDA、SOD明显上升,与对照组比较差异有统计学意义（P<0.001）。结论：一次性离心运动大鼠血清CK、LDH和MAD活性升高的峰值与骨骼肌组织损伤的峰值不同步,骨骼肌组织损伤具有一定的延迟现象。连续7 d离心运动,大鼠血清CK、LDH、MAD和SOD活性升高的峰值与骨骼肌组织损伤的峰值相一致,LDH可作为评价骨骼肌损伤后恢复程度的一个间接指标。     

老年急性穿支动脉型脑梗死患者应用替罗非班治疗的效果观察

目的观察老年急性穿支动脉型脑梗死患者应用替罗非班治疗的效果。方法 80例老年急性穿支动脉型脑梗死患者,随机分为对照组与观察组,各40例。两组患者均接受常规的溶栓治疗,在此基础上,对照组未给予替罗非班治疗,观察组给予替罗非班治疗。比较两组治疗前后神经功能及日常生活能力、术后血栓及不良事件发生情况。结果治疗前,两组美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)评分比较,差异无统计学意义(P>0.05);治疗后,两组NIHSS、BI评分均优于治疗前,且观察组NIHSS、BI评分分别为(5.6±1.4)、(70.6±7.4)分,均优于对照组的(11.1±2.9)、(66.1±5.9)分,差异有统计学意义(P<0.05)。观察组术后血栓发生率5.00%低于对照组的22.50%,差异有统计学意义(χ^2=5.165, P<0.05)。两组均未出现出血等不良事件。结论老年急性穿支动脉型脑梗死患者应用替罗非班治疗,可以促进患者的神经功能恢复,提高患者的日常生活能力,减少术后血栓的发生,未出现颅内出血的不良事件,值得在临床上推荐应用。     

Effects of moxibustion at different times on prostaglandin and vasopressin levels in uterine tissues of rats with dysmenorrhea due to cold-dampness retention

Objective

To observe the effects of moxibustion at different times on prostaglandin E₂ (PGE₂), prostaglandin F_2α (PGF_2α) and arginine vasopressin (AVP), in the uterine tissues of rats with dysmenorrhea due to cold-dampness retention, and to explore the differences and possible mechanisms of moxibustion at different times in easing pain in dysmenorrhea due to cold-dampness retention.

Methods

Forty-three female Wistar rats were randomly divided into a blank control group (n=7), a model group (n=9), a pre-moxibustion group (n=9), an immediate-moxibustion group (n=9) and a pre-moxibustion plus immediatemoxibustion group (n=9). Rat models of primary dysmenorrhea due to cold-dampness retention were established using (0±1) °C ice water immersion method combined with injection of estradiol benzoate for 10 d, followed by injection of oxytocin on the 11th day. Rats in the 3 intervention groups received moxibustion to Shenque (CV 8) and Guanyuan (CV 4), 10 min for each acupoint, once a day. Rats in pre-moxibustion group were given mild moxibustion, beginning on the 8th day during modeling, for 3 continuous days; rats in immediate-moxibustion group were given one time mild moxibustion, immediately after injection of oxytocin on the 11th day during modeling; rats in pre-moxibustion plus immediate-moxibustion group were given mild moxibustion, beginning on the 8th day during modeling till immediately after injection of oxytocin on the 11th day during modeling, for 4 continuous days. The level of PGF_2α in the rat uterine tissues was measured by enzyme-linked immunosorbent assay (ELISA), and the levels of PGE₂ and AVP in rat uterine tissues were measured by radioimmunoassay.

Results

Compared with the blank control group, the levels of PGF_2α and AVP, the PGF_2α/PGE₂ ratio in the model group were significantly increased (P<0.01), and the PGE₂ level was significantly decreased (P<0.01) in the rat uterine tissues in the model group. Compared with the model group, the writhing latency was significantly prolonged, the writhing number and the total writhing score were all decreased in the pre-moxibustion group, the immediate-moxibustion group and the pre-moxibustion plus immediate-moxibustion group (all P<0.01); the levels of PGF_2α and AVP, and the PGF_2α/PGE₂ ratio were all significantly decreased (P<0.05, P<0.01), and the PGE₂ level was significantly increased (P<0.01) in the rat uterine tissues of the 3 treatment groups. Compared with the pre-moxibustion group, the writhing number and the total writhing score were all decreased in the immediate-moxibustion group and the pre-moxibustion plus immediate-moxibustion group (all P<0.01), the writhing latency was significantly prolonged in the pre-moxibustion plus immediate-moxibustion group(P<0.01); the levels of PGF_2α and PGF_2α/PGE₂ ratio were significantly decreased (P<0.05, P<0.01), and the PGE₂ level was significantly increased (P<0.01) in rat uterine tissues in the immediate-moxibustion group and the pre-moxibustion plus immediate-moxibustion group. Compared with the immediate-moxibustion group, the writhing latency was significantly prolonged and the writhing number was decreased (all P<0.05), and the total writhing score was decreased (P<0.01) in the pre-moxibustion plus immediatemoxibustion group; the PGF_2α level and the PGF_2α/PGE₂ ratio were significantly decreased (P<0.01), and the PGE₂ level was significantly increased (P<0.01) in rat uterine tissues in the pre-moxibustion plus immediate-moxibustion group.

Conclusion

Moxibustion at different times all can produce obvious analgesic effects on dysmenorrhea due to cold-dampness retention in rats, and pre-moxibustion plus immediate-moxibustion ranks the top. The mechanism of this analgesic effect may be via the regulation of abnormal PGF_2α, PGE₂ and AVP levels, to effectively inhibit the spastic contraction of uterine smooth muscle in dysmenorrhea rat, thereby improving the ischemia and hypoxia in uterus.

     

近十年针灸干预对原发性痛经动物模型影响的实验研究进展

原发性痛经是妇科常见病,其发病率较高,严重影响了人们的正常工作和日常生活。多年来,对于针灸治疗本病的临床研究颇多,但由于人体研究的局限性,如子宫组织病理生理学上的改变等情况则难以观察。故制备原发性痛经动物模型显得尤为重要。系统回顾近10年针灸对原发性痛经动物模型干预实验的研究进展,并对痛经不同证型模型建立的方法进行了收集、整理和分析,以期为针灸治疗原发性痛经提供科学的实验依据。     

静脉输液安全中的责任心探讨

本文通过对输液全过程加强责任心的培训,使输液护士提高认识,加强责任心,大大减少或杜绝了输液反应的发生,减轻了病人的痛苦,保证了医疗安全.     

七氟醚对脂多糖致热大鼠体温的影响

目的观察七氟醚短暂重复性麻醉脂多糖致热大鼠的体温变化,探讨七氟醚调节体温的可能作用机制。方法健康SD雄性大鼠24只,体重210～230 g,随机分为三组:空白对照组(C组)、模型组(M组)、模型+七氟醚组(S组),每组8只。C组腹腔注射0.9%氯化钠注射液(10 ml/kg),M组腹腔注射脂多糖(LPS)20μg/kg制备大鼠发热模型,S组腹腔注射LPS(20μg/kg)后,每隔1 h置入1.5%七氟醚麻醉罐中麻醉,每次吸入30 s～1 min。造模后每隔30 min平行监测三组大鼠体温1次,共监测10 h。记录三组大鼠的生理情况、体温、体温升高时点、体温峰值、体温峰值时点。记录体温升高持续时间10 h和≥10 h发生情况。结果 M组和S组注射LPS后都出现体温升高,有寒颤、竖毛、蜷缩精神萎靡等表现,个别出现轻微腹泻。M组和S组均表现为三相热,S组体温升高时点明显晚于M组(P0.05),S组体温峰值明显高于M组(P0.05),体温峰值时点明显晚于M组(P0.05)。M组和S组体温峰值明显高于C组(P0.05),体温峰值时点均明显晚于C组(P0.05)。M组和S组体温升高持续时间(≥10 h)的比例分别为37.5%、87.5%,两组差异无统计学意义。结论七氟醚短暂重复性麻醉脂多糖致热大鼠,可推迟大鼠体温升高和体温峰值时点且可升高体温峰值,机制有待于进一步研究。