白癜风患者治疗前后抗黑素细胞IgG抗体水平的变化

目的 探讨白癜风的病因并为皮质类固醇激素及免疫调节剂治疗白癜风提供理论根据。方法 采用间接免疫荧光技术检测58例白癜风患者血清抗黑素细胞IgG抗体。选择17例抗黑素细胞IgG抗体阳性的进展期患者给予皮质类固醇激素及免疫调节剂治疗，然后再检测该抗体。结果 11例治疗有效的进展期白癜风患者抗体阳性率治疗后明显降低。结论 白癜风患者血清中抗黑素细胞IgG抗体水平随着治疗后病情的好转而降低。表明白癜风与自身免疫密切相关。且皮质类固醇激素及免疫调节剂治疗进展期白癜风有明显效果。     

他克莫司软膏促进儿童白癜风色素再生:57例回顾

白癜风是一种自身免疫性疾病,以色素丢失为特征。光疗和局部皮质类固醇激素应用是最常用的治疗方法,但这些治疗方法并不经常有效,且在面部应用皮质类固醇激素会引起皮肤萎缩、毛细血管扩张和眼部并发症。作者通过对57例儿童白癜风的回顾性调查,探讨了局部应用他克莫司软膏治疗的有效性,患者用他克莫司软膏治疗至少3个月。观察时记录他克莫司软膏应用前后光疗的临床反应,89%的头颈部患者、63%的四肢与躯干部患者应用他克莫司软膏后至少有局部反应。面部阶段性白癜风患者良好反应率最高。有2例应用之初有烧灼感。儿童白癜风,特别时头颈部者,局…     

白癜风的光化学疗法

白癜风的光化学疗法赵龙保句容市皮肤病防治所２１２４００余桂琳滁州市第二人民医院２３９００１白癜风是常见的皮肤病，如发生在面、颈等暴露部位时，严重影响美容。目前治疗白癜风的方法众多，但主要有补骨脂素类的光化学疗法（ＰＵＶＡ）和皮质类固醇激素两大类。现对...     

白癜风的治疗新进展

目的 探讨白癜风患者的治疗的最新进展.方法 采集本院2010年1月至2011年1月的50例白癜风临床资料合并参考文献法进行回顾性分析和研究.结果 传统治疗方法 有饮食疗法、心理治疗、局部外用皮质类固醇、PUVA疗法、中草药、外科表皮移植,或伪装、脱色等等;较新的治疗方法 有光化学疗法、细胞因子和生长因子、窄波UVB(311nm)疗法,单频准分子光疗法,局部皮质类固醇霜与UVA联合治疗,自体黑素细胞移植等方法.结论 对各种治疗白癜风的新旧方法 所作的相应评估,将为治疗白癜风的新进展提供一定的理论依据和临床实践指引价值.     

白癜风的发病机制与临床治疗

白癜风的发病机制目前仍未清楚 ,常见的有自身免疫学说、精神与神经化学学说、遗传学说、黑素细胞自身破坏学说及微量元素缺乏等 5种。治疗效果不佳 ,药物治疗可用皮质类固醇、免疫调节剂和免疫抑制剂、氮介、苯丙氨酸、钙泊三醇、性液素 -甲状腺素混合物及铜、锌制剂 ,还有光化学治疗 ,外科治疗及中医药物及其他治疗。     

白癜风的发病机制与临床治疗

白癜风的发病机制目前仍未清楚,常见的有自身免疫学说、精神与神经化学学说、遗传学说、黑素细胞自身破坏学说及微量元素缺乏等5种.治疗效果不佳,药物治疗可用皮质类固醇、免疫调节剂和免疫抑制剂、氮介、苯丙氨酸、钙泊三醇、性液素-甲状腺素混合物及铜、锌制剂,还有光化学治疗,外科治疗及中医药物及其他治疗.     

人工晶体植入术后迟发性葡萄膜炎临床分析

目的 探讨白内障人工晶体术后迟发性葡萄膜炎发生的原因及治疗方法。方法 对9例白内障囊外摘出联合人工晶体植入术后迟发性葡萄膜炎患者的发病时间，诱因，临床表现及治疗进行了回顾性分析。结果 一般在术后20d左右发病，男女发病率大致相同，并发糖尿病，关节炎的白内障患者发病率最高，对皮质类固醇治疗敏感。结论 白内障人工晶体术后迟发性葡萄膜炎可能由免疫复合物介导的变态反应引起。可早期应用皮质类固醇治疗以预防严重并发症的产生。     

比较定量吸入器和干粉吸入器在吸入皮质类固醇治疗支气管哮喘中的作用

比较定量吸入器和干粉吸入器在吸入皮质类固醇治疗支气管哮喘中的作用上海第二医科大学新华医院潘祝平，董利军综述瑞金医院邓伟吾审校哮喘是一种与气道炎症有关的疾病［１］．皮质类固醇因其可直接对抗哮喘的炎症成份而成为当今治疗哮喘最有效的药物［２～５］。但全身用...     

银屑病治疗的进展

银屑病是一种常见、易复发的慢性炎症性皮肤病 ,其病因和发病机制尚未完全明了 ,一般认为可能与遗传、感染、免疫功能失调、机体代谢、体内微量元素的增减及神经精神因素等有关 ,故治疗方法繁多。目前其新的治疗药物的前景应是临床效果最好的而副作用最小。现将本病近年来治疗上的进展介绍如下。1　原有治疗方法的新进展1.1　外用皮质类固醇激素　外用皮质类固醇激素治疗银屑病有效 ,自 80年代应用超强皮质类固醇激素 (如 0 .0 5 %丙酸氯倍他索 )治疗本病以来 ,对它的认识已不断提高 :1皮质类固醇激素治疗本病见效较快 ,但停药易致反跳或转…     

吸入或全身性类固醇治疗对重度哮喘同样有效

一项随机双盲试验表明,对住院的重度哮喘病人,类固醇类药物吸入治疗和全身性治疗同样有效,因此经过静脉注射类固醇类药物2天后即可停止继续使用全身性治疗。 纽约Beth Israel医学中心的Dr.Mary Lee-Wang指出,根据广泛采用的原则,对病情加重需要住院的重度哮喘病人的标准治疗方法是全身性给予皮质类固醇类药物。让需要住院的哮喘病人吸入皮质类固醇的作用尚不清楚。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.