神经节苷脂联合依达拉奉治疗急性脑梗死的效果观察及对炎症因子的影响

目的观察神经节苷脂联合依达拉奉治疗急性脑梗死的疗效及对炎症因子的影响。方法 2009年8月～2011年8月,156例急性脑梗死患者随机分为两组,观察组78例给予神经节苷脂联合依达拉奉治疗,对照组78例给予血栓通治疗,对比观察两组的临床疗效以及TNF-α、IL-6和CRP水平的变化。结果观察组的总有效率为88.5%,明显高于对照组的69.2%(P﹤0.05)。与治疗前比较,两组治疗后TNF-α、IL-6和CRP水平明显降低,差异均有统计学意义(P﹤0.05)。观察组治疗后TNF-α、IL-6和CRP水平明显低于同期对照组,两组比较差异有统计学意义(P﹤0.05)。结论神经节苷脂联合依达拉奉对急性脑梗死患者进行治疗,能够明显提高临床疗效,降低TNF-α、IL-6和CRP水平,值得临床推广应用。     

前列地尔治疗老年急性脑梗死的疗效及其血清IL-6和TNF-α的影响

目的观察前列地尔治疗老年急性脑梗死的临床疗效及对血清IL-6和TNF-α的影响。方法 2009年9月～2011年8月,192例急性脑梗死患者随机分为两组,观察组96例,采用前列地尔治疗;对照组96例采用复方丹参注射液治疗,对比观察治疗前后两组的临床疗效、血清IL-6和TNF-α的变化。结果观察组的显效率明显高于对照组(P﹤0.05),而两组总有效率比较,差异无统计学意义(P﹥0.05)。观察组治疗后血清IL-6和TNF-α水平明显下降(P﹤0.05);并且,观察组治疗后血清IL-6和TNF-α水平明显低于同期对照组水平(P﹤0.05),而对照组治疗前后血清IL-6和TNF-α水平比较变化不大(P﹥0.05)。结论前列地尔对老年急性脑梗死患者进行治疗,能够明显提高临床疗效,降低血清IL-6和TNF-α水平,值得临床推广应用。     

阿德夫韦酯联合扶正祛淤对慢性乙型肝炎患者肝纤维化指标的影响

[目的]观察阿德夫韦酯(ADV)联合扶正祛淤治疗慢性乙肝(CHB)的临床疗效及对肝纤维化指标的影响。[方法]100例CHB患者随机分为治疗组和对照组。对照组给予ADV治疗,治疗组给予ADV联合扶正化瘀治疗,疗程为1年。疗程结束后评价临床疗效。治疗前和疗程结束后测定血清肝纤维化(PCⅢ、Ⅳ-C、LN、HA)水平。[结果]治疗组临床疗效总有效率为94.0%,显著高于对照组(76.0%),相比较差异有统计学意义(P﹤0.05)。治疗后,两组患者血清肝纤维化4项(PC-Ⅲ、IV-C、LN、HA)水平显著下降(P﹤0.05),与治疗前比较差异有统计学意义(P﹤0.05),且治疗组与对照组比较差异有统计学意义(P﹤0.05)。两组均无不良反应。[结论]ADV联合扶正化瘀治疗CHB能够阻止或改善肝纤维化,临床疗效明显,值得临床推广应用。     

血清CRP、IL-6、TNF-α、TK、EAI在老年脑梗死患者诊断中的价值分析

目的探讨监测老年脑梗死患者血清CRP、IL-6、TNF-α、TK、EAI的临床价值。方法选取老年脑梗死患者作为观察组,选取同期有可比性的老年健康体检者56例作为对照组,分别抽取前者治疗前后及后者肘静脉血,检测血清CRP、IL-6、TNF-α、TK、EAI,并进行比较分析。结果观察组患者入院早期CRP、IL-6、TNF-α、TK、EAI均明显高于对照组,两组患者比较差异有统计学意义,有可比性(P﹤0.05);经过治疗3个月后,观察组患者CRP、IL-6、TNF-α、TK、EAI略高于对照组,但比较差异无统计学意义,没有可比性(P﹥0.05);随着梗死面积及轻度神经功能缺损的加重,脑梗死患者血清CRP、IL-6、TNF-α含量明显提高,相同评价指标内,不同程度脑梗之间差异明显,差异有统计学意义(P﹤0.05)。结论通过监测血清CRP、IL-6、TNF-α、TK、EAI,对老年脑梗死患者的临床诊断有着积极意义,值得临床推广。     

血管紧张素Ⅱ受体AT1拮抗剂治疗原发性高血压的临床疗效及其对血清脂联素水平的影响

目的探讨血管紧张素Ⅱ受体AT1拮抗剂治疗原发性高血压的临床疗效及对血清脂联素水平的影响。方法 70例原发性高血压患者(观察组)给予血管紧张素Ⅱ受体AT1拮抗剂(缬沙坦)治疗,连续治疗30d后评价疗效,并选择30例健康者为对照组,测定观察组和对照组血清脂联素水平。结果观察组治疗后,临床疗效总有效率为97.1%;观察组治疗后血压明显改善,SBP、DBP水平与治疗前比较差异有统计学意义(t=3.782,3.723,P﹤0.05),血清ADP水平显著上升,与治疗前比较差异有统计学意义(t=4.891,P﹤0.05)。治疗前观察组SBP、DBP水平显著高于对照组,两组相比较差异有统计学意义(t=3.897,3.782;P﹤0.05);ADP水平显著低于对照组,两组相比较差异有统计学意义(t=5.330;P﹤0.05)。结论血管紧张素Ⅱ受体AT1拮抗剂能有效降压和升高原发性高血压患者血清ADP水平,是治疗原发性高血压有效方法,值得临床推广应用。     

依达拉奉联合低分子量肝素钙治疗急性脑梗死的疗效观察及对血清C反应蛋白的影响

目的 观察依达拉奉联合低分子量肝素钙治疗急性脑梗死的疗效及对血清C反应蛋白(CRP)的影响.方法 82例急性脑梗死患者按随机数字表法分为两组,每组41例,观察组采用依达拉奉联合低分子量肝素钙治疗;对照组仅采用低分子量肝素钙治疗,比较两组的临床疗效及治疗前后神经功能缺损程度评分及血清CRP的变化.结果 观察组的总有效率为90.2％(37/41),明显高于对照组的70.7％(29/41),差异有统计学意义(P＜0.05).两组治疗后神经功能缺损程度评分均明显下降(P＜0.05).并且,观察组治疗后神经功能缺损程度评分明显低于同期对照组[(9.86±3.41)分比( 13.62±4.23)分](P＜0.05).观察组治疗后血清CRP水平明显下降(P＜0.05),并且明显低于同期对照组[(14.79±3.02) mg/L比(17.38±3.89) mg/L](P＜ 0.05),而对照组治疗前后血清CRP水平比较差异无统计学意义(P＞ 0.05).结论 依达拉奉联合低分子量肝素钙治疗急性脑梗死能够明显提高临床疗效,改善神经功能,减少炎性反应的发生,值得临床推广应用.     

依达拉奉对急性脑梗死患者的临床疗效及C反应蛋白的影响

目的 探讨依达拉奉对急性脑梗死患者的临床疗效及其对血清高敏C反应蛋白(CRP)水平的影响.方法 急性脑梗死患者62例,其中男33例、女29例,将患者按治疗方法不同分为治疗组(33例)和对照组(29例),对照组采用常规治疗,脱水、降颅压、控制血压等,治疗组在常规治疗的基础上加用依达拉奉30mg静脉滴注,2次/d,共治疗10d.治疗前后测定两组血清CRP水平,并进行神经功能缺失和日常生活活动能力评定(ADL).结果 治疗组疗效明显优于对照组(P＜0.05);治疗组治疗后CRP明显降低,与对照组比较差异有统计学意义(P＜0.05).治疗组与对照组患者的神经功能缺失程度分别为(9.21±2.31)分,(14.24±6.32)分.两者比较差异有统计学意义(P＜0.05).ADL评分分别为(58.23±5.31)分,(43.42±11.25)分,两者比较差异有统计学意义(P＜0.05).结论 依达拉奉可改善急性脑梗死患者的病情,促进神经功能恢复,其机制可能与抗炎和抗动脉硬化有关.     

42例丁苯酞胶囊治疗急性脑梗死临床观察

[目的]探讨丁苯酞胶囊治疗急性脑梗死的疗效。[方法]将84例急性脑梗死患者随机分入治疗组和对照组各42例,对照组采用西医常规治疗,治疗组在西医常规治疗的基础上加用丁苯酞胶囊,治疗1个疗程后,观察两组的临床疗效。[结果]治疗组显效率(61.90%)明显高于对照组(38.10%),差异有统计学意义(P﹤0.05),每个组治疗后神经功能缺损程度评分均明显低于治疗前(P﹤0.05),治疗后,治疗组神经功能缺损程度评分(11.03±9.95)显著低于对照组(16.62±10.21)(P﹤0.05)。[结论]丁苯酞胶囊可提高急性脑梗死临床疗效。     

巴曲酶及尤瑞克林治疗急性脑梗死的疗效观察

目的:观察联合应用巴曲酶及尤瑞克林治疗急性脑梗死的临床疗效、NIHSS评分和日常生活能力评分巴氏指数的情况,并对PLT、PT、APTT的影响。方法:选择50例急性脑梗死患者作为观察对象,随机分为对照组(男13例,女12例)和观察组(男14例,女11例),对照组给予急性脑梗死常规治疗2周,观察组在其基础上给予巴曲酶+尤瑞克林连续治疗5天。分析2组治疗前后NIHSS、巴氏指数、PLT、PT及APTT的影响。结果:与对照组相比,观察组NIHSS、巴氏指数及治疗有效率有显著改善,差异有统计学意义(P0.05);2组治疗前后比较及治疗后对比比较,PLT、PT及APTT变化不大,差异均无统计学意义(P0.05)。结论:巴曲酶联合尤瑞克林治疗急性脑梗死临床疗效显著,且安全可靠,值得在临床上推广。     

胰激肽原酶联合依那普利治疗早期糖尿病肾病临床观察

目的 观察胰激肽原酶联合依那普利治疗早期糖尿病肾病（DN）的疗效.方法 两组均给予血糖、血压控制,低蛋白饮食等基础治疗,将60例2型DN早期患者随机分为治疗组（胰激肽原酶＋依那普利）和对照组（依那普利）.治疗4周,比较两组治疗前、后尿白蛋白排泄率、血尿素氮、血肌酐、血清白蛋白的变化.结果 两组治疗前、后尿白蛋白排泄率有明显差异（P〈0.05）;血尿素氮、血肌酐均有所降低;血清白蛋白有所升高;但组间无显著差异（P〉0.05）.结论 胰激肽原酶联合依那普利治疗早期DN疗效显著,值得临床推广应用.     

Photoprotection: effects and side effects

Sunlight is required for life on Earth. Nevertheless it may also be hazardous and can lead to the development of skin cancer and photosensitivity diseases. After a short summary of current knowledge of photocarcinogenesis, the article emphasizes the role of topical sunscreens, their mode of action and potential side effects. The current recommendations for photoprotection for the general public are outlined.     

Rx exercise: effects and side effects

More than ever before, physicians and patients alike are aware of the benefits of regular exercise. The involved physician must be able to prescribe individualized programs (e. g., for the post-MI patient) and to recognize side effects that may arise. Exercise is rarely ineffective as therapy: however, the potential for noncompliance is great unless the patient is motivated to begin at an appropriate level.     

Deterministic effects

Deterministic effects are distinguished from stochastic effects for radiation protection purposes by the following characteristics: both incidence and severity increase as a function of dose after a threshold dose is reached. Cell killing is central to all deterministic effects with the exception of radiation-induced cataracts. The understanding of radiation-induced killing of cells has increased greatly in the last decade with an extraordinarily intense interest in apoptosis. Programmed cell death has long been known to developmental biologists and the importance of cell death has been recognized and quantified by tumor biologists and students of cell kinetics but the coining of a new name and the increase of understanding of the molecular aspects of cell death has stimulated interest. Some cells appear to be very sensitive to radiation and undergo apoptosis, whereas others such as fibroblasts do not with equal frequency. This characteristic, like many others, underlines the genetic differences among cell types. We are reaching a time that there are techniques and the knowledge to apply them to clinical and radiation protection problems. In radiotherapy, success depends on the differential effect between tumor and normal tissues that is obtained. To design the optimum therapy, a profile of both the tumor cells and the cells of the normal tissues that may be at risk would help. The profile would characterize the radiosensitivity and the underlying factors, which could help in the choice of adjunct therapy for tumor and normal tissue. Fibrosis, a common unwanted late effect, appears to be influenced by genetic factors, at least in experimental animals. Techniques are available for treating people as individuals more than ever before, and that must be a good thing to do. Protection against deterministic effects would seem an easy matter but we are uncomfortably ignorant of the precise effect of protracted low-dose irradiation on tissues, such as the bone marrow and the testis, important features of risk in space. Entering the new century, it may be timely to classify radiation effects, as Radiation Effects Research Foundation (RERF) has done, into cancer, genetic effects, and noncancer effects. The recognition in the atomic-bomb survivors of noncancer effects at doses on the order of 0.5 Sv (half the dose level considered a threshold in earlier studies) should stimulate interest in deterministic effects.     

Heterologous vaccine effects

The heterologous or non-specific effects (NSEs) of vaccines, at times defined as “off-target effects” suggest that they can affect the immune response to organisms other than their pathogen-specific intended purpose. These NSEs have been the subject of clinical, immunological and epidemiological studies and are increasingly recognized as an important biological process by a growing group of immunologists and epidemiologists. Much remain to be learned about the extent and underlying mechanisms for these effects.The conference “Off-target effects of vaccination” held in Annecy-France (June 8–10 2015) intended to take a holistic approach drawing from the fields of immunology, systems biology, epidemiology, bioinformatics, public health and regulatory science to address fundamental questions of immunological mechanisms, as well as translational questions about vaccines NSEs. NSE observations were examined using case-studies on live attenuated vaccines and non-live vaccines followed by discussion of studies of possible biological mechanisms. Some possible pathways forward in the study of vaccines NSE were identified and discussed by the expert group.