复方甘草甜素治疗乙、戊型肝炎32例

目的观察复方甘草甜素注射液治疗乙、戊型肝炎的降酶、退黄疗效。方法急性黄疸型肝炎20例(戊型肝炎8例、乙型肝炎12例),慢性肝炎重度12例均为乙型肝炎,重型肝炎28例(乙型肝炎24例、戊型肝炎4例)。将60例患者随机分成对照组28例,常规应用门冬氨酸钾镁、维生素C,重型肝炎给予白蛋白等基础护肝治疗;治疗组32例,在以上护肝治疗基础上应用复方甘草甜素注射液100ml～120ml,每日一次静脉滴注,疗程4周。观察治疗前后肝功能变化情况。结果治疗后治疗组总胆红素和谷丙酶下降水平与对照组比较差异有显著性(P<0.05)。结论复方甘草甜素注射液治疗32例乙、戊型黄疸型肝炎,其降酶、退黄疗效明显优于对照组,特别是治疗慢性肝炎及重型肝炎。     

炎琥宁注射液治疗病毒性脑炎临床观察

将286例病毒性脑炎患儿随机分为治疗组和对照组各143例,在常规治疗基础上,治疗组将炎琥宁注射液200—600ml加入液体内静滴,对照组将病毒唑0．6～1．0g加入液体内静滴,均每日1次,连用1周。结果治疗组总有效率优于对照组（P〈0．05）,且各项辅助检查结果复常时间提前。提示炎琥宁注射液治疗病毒性脑炎值得临床应用。     

恩替卡韦联合复方甘草甜素治疗慢性乙型肝炎疗效观察

目的观察恩替卡韦联合复方甘草甜素治疗慢性乙型肝炎的临床疗效。方法将24例慢性乙型肝炎随机分成两组:治疗组接受恩替卡韦联合复方甘草甜素治疗;对照组单纯接受恩替卡韦治疗。疗程均为6个月。观察治疗前后血生化、HBeAg、HBV DNA等指标的变化情况。结果治疗6个月后治疗组肝功能指标复常率明显高于对照组。治疗组ALT25.60±35.82U/L,TBIL18.82±9.76μmol/L;对照组ALT45.57±44.42U/L,TBIL24.33±12.14μmol/L,两组相比,P<0.05。结论恩替卡韦联合复方甘草甜素治疗慢性乙型肝炎的疗效优于恩替卡韦单一用药。     

复方甘草甜素治疗慢性乙型肝炎的疗效观察

目的　观察复方甘草甜素治疗慢性乙型肝炎的临床疗效及安全性。方法　选择 168例慢性乙型肝炎患者 ,随机分为两组。治疗组 84例接受复方甘草甜素治疗 ;对照组 84例接受门冬氨酸钾镁治疗。疗程均为 4周。观察治疗前后患者乏力、食欲不振、腹胀等改善情况 ,肝功能、乙型肝炎病毒血清标志物、HBVDNA定量变化情况。结果　观察结束时 ,两组在症状改善恢复方面 ,治疗组明显优于对照组 (P <0 .0 1)。在肝功能恢复方面 ,治疗组在TBIL、ALT、AST等改善方面优于对照组 (P <0 .0 5 )。结论　复方甘草甜素能够较好地改善患者的临床症状 ,促进肝功能恢复。     

新通注射液治疗冠心病心绞痛的临床观察

目的观察新通注射液治疗冠心病心绞痛的临床疗效。方法108例冠心病患者，双盲随机分为新通治疗组（73例）和对照组（35例），以新通注射液12ml加入5％葡萄糖液500ml静滴治疗为治疗组，以复方丹参针12ml加入5％葡萄糖液250ml静滴治疗为治疗组（有糖尿病者改用生理盐水稀释）。平均每日1次，连续治疗2周，观察前后心绞痛症状、心电图的变化。结果心绞痛症状疗效：治疗组总有效率94．4％，对照组总有效率80．0％，两组比较差异有非常显著性（P〈0．01）；心电图疗效：治疗组总有效率69．9％，对照组总有效率37．1％，两组比较差异有非常显著性（P〈0．01）。结论新通注射液治疗冠心病心绞痛安全有效。     

普恩复胶囊治疗缺血性脑血管病66例

目的：比较普恩复胶囊与复方丹参注射液治疗缺血性脑血管病的疗效,方法：缺血性脑血管病66例,给予普恩复胶囊400mg,1次／日,28日为1疗程,对照组60例,静滴复方丹参16ml 5%葡萄糖500ml中静脉点滴,1次／日,21日为1疗程,结果：普恩复胶囊基本治愈率27％,显效率50％,总有效率94％,对照组基本治愈率17％。显效率27％,总有效率74％,两组有效率比较差异有显性（P＜0．05）,结论：普恩复胶囊治疗缺血性脑血管病优于复方丹参,是一种安全,无毒,口服方便的药物。     

慢性肝炎

复方甘草甜素等治疗慢性肝炎86例——沈效军（江苏东台市人民医院、南通医学院附属东台医院感染科224200）；《现代医药卫生》，2005，21（16）：2166[目的：观察复方甘草甜素注射液对慢性肝炎的疗效。方法：将172例慢性肝炎随机分为两组。治疗组使用复方甘草甜素注射液、胆维他、茵栀黄注射液治疗。对照组使用促肝细胞生长素、胆维他、茵栀黄注射液治疗，疗程均为八周。结果：治疗组对慢性肝炎疗效优于对照组。结论：复方甘草甜素对慢性肝炎有较好的疗效。]     

复方甘草酸苷联合门冬氨酸-鸟氨酸治疗慢性乙型肝炎高胆红素血症48例临床观察

目的 观察复方甘草酸苷联合门冬氨酸-鸟氨酸治疗慢性乙型肝炎高胆红素血症的临床疗效.方法 治疗组:复方甘草酸苷注射液60～80 ml加入10%葡萄糖注射液250 ml静脉点滴(静滴),门冬氨酸-鸟氨酸5～10 g加入10%葡萄糖注射液250 ml,均1/d,4周为1个疗程.对照组:甘草酸二铵注射液150 mg,门冬氨酸钾镁30 ml加入10%葡萄糖注射液250 ml静滴;1/d,4周为1个疗程.均用2个疗程.结果 本组资料结果显示,治疗组的总有效率为89.58%,明显优于对照组(P＜0.05).结论 门冬氨酸-鸟氨酸与复方甘草酸苷联用在改善临床症状和肝功能等方面具有良好的作用.     

654-2联合安定治疗重度眩晕60例疗效观察

目的观察654-2合安定治疗眩晕的疗效。方法将120例眩晕患者随机分为两组，治疗组60例予654-2注射液加入5％葡萄糖注射液250ml静滴以及安定注射液加入5％葡萄糖注射液250ml缓慢静滴；对照组60例，采用低分子右旋糖酐500ml加复方丹参注射液10～20ml静滴。结果治疗组疗效明显优于对照组（P〈0．01）。结论654-2联合安定治疗眩晕安全有效。     

酒精性肝病

复方甘草甜素联合还原型谷胱甘肽治疗酒精性肝病疗效观察——李宝山等（山西大同市第五人民医院消化内科037006）；《山西医科大学学报》，2006，37（3）：282-283[目的：观察复方甘草甜素联合还原型谷胱甘肽治疗酒精性肝病的疗效。方法：将72例酒精性肝病患者随机分为治疗组和对照组，前者给予复方甘草甜紊联合还原型谷胱甘肽治疗，后者单用复方甘草甜素治疗，疗程均为6周。结果：治疗组和对照组的显效率分别为33．33％、19．44％（P〈0．05），治疗后总胆红素分别为（21．55&#177;10．63）、（39．72&#177;10．68）mmol／L（P〈0．01）。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.