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1.
目的 观察干扰素α-2b与聚乙二醇干扰素α-2a(PEG-IFNα-2a)治疗慢性乙型肝炎(CHB)患者的临床疗效。方法 将116例CHB患者分成两组,每组58例。给予对照组普通干扰素α-2b治疗,给予观察组PEG-IFNα-2a,疗程均为48 w。检测血清层黏连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原肽(PⅢP)及血清白介素4(IL-4)、白介素6(IL-6)、白介素10(IL-10)和干扰素γ(IFN-γ)变化。结果 在治疗结束时,观察组HBV DNA转阴率、HBeAg转阴率、HBeAg血清转换率和ALT复常率分别为75.9%、29.3%、22.4%和70.7%,显著高于对照组的51.7%、19.0%、10.3%和55.2%(P<0.05);观察组血清LN为(148.5±46.0) μg/L,显著低于对照组【(162.6±26.7) μg/L,P<0.05】,血清HA为(158.7±67.9)μg/L,显著低于对照组【(201.4±55.1) μg/L,P<0.05】,血清Ⅳ-C为(108.3±33.4) μg/L,显著低于对照组【(119.2±62.4) μg/L,P<0.05】,血清PⅢP为(145.8±47.2) μg/L,显著低于对照组【(155.3±36.7)μg/L,P<0.05】;观察组血清IL-4水平为(1.5±0.6) pg/ml,显著低于对照组【(3.9±1.6) pg/ml,P<0.05】,而IL-6水平为(6.9±1.3) pg/ml,显著高于对照组【(3.6±0.9) pg/ml,P<0.05】,IL-10水平为(22.6±13.4) pg/ml,显著低于对照组【(17.3±11.4) pg/ml,P<0.05】,IFN-γ水平为(37.2±10.2) pg/ml,显著高于对照组【(28.3±10.5) pg/ml,P<0.05】;观察组血小板计数减少发生率为51.7%,显著高于对照组的12.1%(P<0.05)。结论 PEG-IFNα-2a治疗CHB患者临床疗效优于普通干扰素α-2b,能持久有效地抑制HBV复制,改善血清肝纤维化指标,但不良反应较大,应及时处理。  相似文献   

2.
目的观察聚乙二醇干扰素α-2a联合阿德福韦酯治疗HBeAg阳性的慢性乙型肝炎(CHB)患者的疗效及其对血清T淋巴细胞因子和肝纤维化指标的影响。方法144例CHB患者依纳入顺序单双号被随机分为观察组和对照组,每组72例。给予对照组患者阿德福韦酯,观察组在对照组的基础上给予聚乙二醇干扰素α-2a,治疗24 w,观察两组抗病毒疗效以及血清T淋巴细胞因子白介素(IL)-2、IL-6、IL-10、γ-干扰素(INF-γ)以及血清肝纤维化指标Ⅲ型前胶原肽(PⅢP)、层粘连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)的变化。结果在治疗24 w末,观察组患者血清HBV 转阴率、HBeAg转阴率、HBeAg血清转换率分别为72.22%、58.33%和41.67%,显著高于对照组(分别为55.56%、22.22%和20.83%,P<0.05);观察组血清IL-2和INF-γ水平分别为(2.18±1.26) pg/ml和(99.65±11.03) pg/ml,较对照组显著升高【(1.71±1.05) pg/ml和(85.70±11.82) pg/ml,P<0.05】,而IL-6和IL-10分别为(4.53±2.15) pg/ml和(15.42±9.39) pg/ml,较对照组显著降低【(5.47±2.25) pg/ml和(20.07±13.08)pg/ml,P<0.05】;观察组HA、LN、Ⅳ-C、PⅢP分别为(127.28±59.60) μg/L、(110.52±37.39) μg/L、(116.56±28.61) μg/L和(163.65±64.38) μg/L,均较对照组显著降低【(261.35±81.46) μg/L、(162.32±38.82)μg/L、(174.13±43.05) μg/L和(212.43±64.25) μg/L,P<0.05】。结论聚乙二醇干扰素α-2a联合阿德福韦酯抗病毒疗效及改善HBeAg阳性CHB患者血清T淋巴细胞因子失衡,降低肝纤维化指标的作用优于单用阿德福韦酯者。  相似文献   

3.
目的 探讨应用熊去氧胆酸(UDCA)治疗妊娠期肝内胆汁淤积症(ICP)患者的疗效及其安全性。方法 2015年3月~2018年4月我院收治的ICP患者70例,被随机分为观察组35例和对照组35例,分别给予常规治疗和UDCA治疗4周。采用高效液相色谱串联质谱法检测血清胆汁酸谱,包括石胆酸(LCA)、UDCA、鹅去氧胆酸(CDCA)、胆酸(CA)、甘氨胆酸(GCA)、牛磺石胆酸(TLCA)和总胆酸(TCA)。结果 在治疗结束时,观察组和对照组瘙痒评分分别为(1.1±0.3)对(2.3±0.8),差异显著(P<0.05);血清ALT水平分别为(25.7±10.0) U/L对(85.1±24.3) U/L,AST分别为(22.6±10.3) U/L对(84.3±11.3) U/L,TBIL分别为(21.6±3.8) μmol/L对(30.5±5.4)μmol/L,差异显著(P<0.05);血清UDCA分别为(3.2±0.1) μmol/L对(2.5±0.2) μmol/L,CA水平分别为(1.2±0.1) μmol/L对(2.4±0.2) μmol/L,GCA分别为(1.6±0.2) μmol/L对(2.8±0.5) μmol/L,TCA分别为(1.2±0.3) μmol/L对(4.2±0.9) μmol/L,差异显著(P<0.05);观察组早产、产后出血和新生儿窒息等不良结局发生率显著低于对照组(17.1%对51.4%,P<0.05)。结论 应用UDCA治疗ICP患者能显著减轻症状,改善肝功能指标,且无明显的不良后果。  相似文献   

4.
目的 探讨应用腺苷蛋氨酸联合熊去氧胆酸治疗巨细胞病毒感染所致肝炎综合征患儿的疗效。方法 2013年2月~2016年3月收治的60例巨细胞病毒感染所致肝炎综合征患儿,采用随机数字表法将其分成对照组30例和观察组30例,分别给予门冬氨酸钾镁或腺苷蛋氨酸联合熊去氧胆酸治疗2~3 w,观察疗效情况。结果 两组患儿治疗前各项肝功能指标水平比较无明显差异;治疗后,观察组患儿血清ALT、AST和TBIL水平分别为(36.8±12.6) U/L、(44.2±10.5) U/L和(15.4±3.3)μmol/L,均显著低于对照组的【(77.4±15.8) U/L、(81.9±13.7) U/L和(68.5±16.9)μmol/L,P<0.05);观察组疾病恢复时间为(2.2±0.4)w,显著短于对照组的(3.9±0.7) w(P<0.05);两组不良反应发生率无显著性相差(P>0.05)。结论 应用腺苷蛋氨酸联合熊去氧胆酸治疗巨细胞病毒感染所致肝炎综合征患儿效果显著,能缩短病程,加速康复。  相似文献   

5.
目的 分析乙型肝炎肝硬化患者血清血小板衍生生长因子(PDGF)和叶酸水平变化。方法 2015年1月~2016年12月期间我院收治的110例乙型肝炎肝硬化患者,常规行肝功能Child-Pugh分级,采用ELISA法检测血清PDGF水平,采用化学发光法检测血清叶酸水平,采用放射免疫法检测血清Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层粘连蛋白(LN)和透明质酸酶(HA)水平。结果 32例Child-Pugh C级患者血清PDGF水平为(190.7±11.4)pg/ml,显著高于42例B级或36例A级患者的(128.5±8.1) pg/ml或(79.5±4.9) pg/ml(P<0.05);Child-Pugh C级患者血清叶酸水平为(2.7±0.5) μg/L,显著低于B级或A级患者的(5.3±0.5) μg/L或(7.1±0.8) μg/L(P<0.05);Child-Pugh C级患者血清谷丙转氨酶(ALT)、总胆红素(TBIL)水平和INR水平分别为(102.4±6.9) U/L、(60.7±5.8) μmol/L和(1.9±0.2),均显著高于B级患者【分别为(78.9±4.5) U/L、(36.4±3.2) μmol/L和(1.5±0.2)】或A级患者[分别为(56.8±3.9) U/L、(26.8±2.8) μmol/L和(1.2±0.1),均P<0.05】;Child-Pugh C级患者血清白蛋白(ALB)为(23.9±2.4) g/L,显著低于B级患者的(30.8±2.7) g/L或A级患者的(41.0±3.3) g/L(均P<0.05);Child-Pugh C级患者血清PCⅢ、Ⅳ-C、LN和HA水平分别为(279.7±19.2) μg/L、(140.4±8.0) μg/L、(159.7±8.2) μg/L和(237.8±9.1) μg/L,均显著高于B级分别为【(238.5±17.8) μg/L、(94.8±6.2) μg/L、(129.5±7.3) μg/L和(174.1±8.6) μg/L或A级患者(分别为158.6±13.6)μg/L、(75.4±5.1) μg/L、(96.8±6.8) μg/L和(128.3±6.9)μg/L,均P<0.05】;肝硬化患者血清PDGF水平与ALT、TBIL、INR和肝纤维化指标均呈正相关,与ALB呈负相关(均P<0.05),叶酸水平与ALT、TBIL、INR和肝纤维化指标均呈负相关,与ALB呈正相关(均P<0.05)。结论 随着肝功能损害程度的加重,肝硬化患者血清PDGF水平逐渐升高,而叶酸水平逐渐降低,其临床意义还有待于进一步研究。  相似文献   

6.
目的 研究自拟中药联合恩替卡韦治疗慢性乙型肝炎患者的疗效以及不良反应发生情况。方法 2015年1月~2016年12月我科收治的69例慢性乙型肝炎患者,34例接受自拟中药(党参20 g,醋柴胡10 g,郁金10 g,鳖甲30 g,丹参20 g,龙葵10 g,白花蛇舌草15 g,绞股蓝15 g,三七10 g,片姜黄10 g,赤芍15 g,炙甘草6 g,水煎 400 ml,每日1剂,分早晚温服)联合恩替卡韦治疗,35例只接受恩替卡韦治疗。应用SPSS 19.0统计软件完成数据分析处理。结果 在治疗前和治疗24 w末,观察组与对照组血清ALB水平差别未见统计学意义(P> 0.05),但治疗后观察组血清TBIL水平为(20.1± 4.7) μmol/L,显著低于对照组的(28.7± 4.8)μmol/L (P<0.05);观察组血清ALT水平为(40.9± 6.8) U/L,显著低于对照组的(50.2± 6.7) U/L(P<0.05);观察组血清AST水平为(39.6± 8.4) U/L,显著低于对照组的(52.5± 8.1) U/L (P<0.05);治疗后,观察组和对照组血清透明质酸(HA)、层连蛋白(LN)、4型胶原(IV-C)和3型前胶原(PC-Ⅲ)水平均有所下降,其中观察组血清HA水平由[(256.3± 9.3)μg/L下降至(98.3± 9.1) μg/L,对照组血清HA水平由[(255.3± 9.8) μg/L下降至(140.3± 9.6) μg/L,观察组血清LN水平由[(241.3± 7.8) μg/L下降至(110.3± 7.7) μg/L,对照组血清LN水平由[(240.4± 7.8) μg/L下降至(170.5± 7.9) μg/L,观察组血清IV-C水平由[(98.4± 6.8) μg/L降至(53.6± 6.7) μg/L,对照组血清IV-C水平由[(98.00± 6.5) μg/L下降至(70.9± 6.6) μg/L,观察组血清PC-Ⅲ水平由[(193.6± 13.2) μg/L下降至(98.3± 9.9) μg/L,对照组血清PC-Ⅲ水平由[(193.5± 13.4) μg/L下降至(120.3± 9.7) μg/L,显示出治疗后观察组肝纤四项指标均显著低于对照组(P<0.05)。另外,治疗后观察组与对照组血清HBeAg转阴率和HBV DNA转阴率均未见统计学差异,而消化道症状,如腹泻、腹痛以及呕吐的发生率在观察组和对照组分别为2.9%和8.6%,差别也无统计学意义(P>0.05)。结论 自拟中药联合恩替卡韦联合治疗慢性乙型肝炎患者,两者结合一方面可以迅速抑制HBV复制,在另一方面可以发挥祖国医学治本的优势,扶正而固本,增强了疗效。  相似文献   

7.
目的 研究应用门冬氨酸鸟氨酸注射液治疗对肝癌切除术患者肝脏缺血再灌注损伤的保护作用。方法 2015年8月~2017年3月我院行择期肝癌切除术患者101例,采用随机数字表法将患者分为对照组50例和试验组51例。术后,给予两组血制品和护肝治疗,另给试验组门冬氨酸鸟氨酸注射液静脉滴注治疗7 d。采用硫代巴比妥酸法测定丙二醛(MDA),采用黄嘌呤氧化酶法测定超氧化物歧化酶(SOD),采用酶联免疫法测定一氧化氮(NO)和内皮素-1(ET-1)。结果 治疗后,试验组血清MDA水平显著低于对照组[(5.4±0.6) μmol/L对(7.3±0.9)μmol/L],ET-1水平显著低于对照组[(115.2±14.3) pg/L 对(216.6±26.8) pg/L],而试验组血清SOD水平显著高于对照组[(18.6±2.3) U/mL 对(13.3±1.6) U/mL],NO水平也显著高于对照组[(37.9±5.7) μmol/L对(22.5±3.1)μmol/L],差异均有统计学意义(P<0.05);试验组血清胆红素水平为(23.4±7.7)μmol/L ,显著低于对照组的(31.3±7.8) μmol/L(P<0.05);观察组患者呼吸频次显著慢于对照组(P<0.05),而两组血常规变化无显著性差异(P>0.05)。结论 应用门冬氨酸鸟氨酸注射液能够减轻肝癌切除术患者肝脏缺血再灌注损伤,保护肝功能,可能与其能够提高机体对氧自由基的清除能力、抑制过氧化反应和恢复肝脏代谢有关。  相似文献   

8.
目的观察围手术期应用地塞米松对肝切除手术患者术后肝功能的影响。方法选择行肝切除手术的原发性肝癌患者160例,随机分为观察组80例和对照组80例。给予对照组患者常规药物治疗,术后给予观察组患者地塞米松治疗3 d,记录并分析术前和术后不同时间两组患者谷丙转氨酶(ALT)、谷草转氨酶(AST)、白蛋白(ALB)、总胆红素(TBIL)、炎症因子超敏C-反应蛋白(hs-CRP)、白细胞介素-8(IL-8)变化和术后并发症发生情况。结果观察组术后第3天和第7天血清ALT水平分别为(114.6±14.9) U/L和(50.2±6.7) U/L,均显著低于对照组【(279.2±21.2) U/L和(79.8±11.0) U/L,差异均有显著性(P<0.05);观察组术后第3天和第7天血清AST水平分别为(141.2±16.0) U/L和(59.8±7.1) U/L,均显著低于对照组【(299.3±20.4) U/L和(85.5±12.4) U/L,P<0.05);血清ALB水平分别为(34.8±1.6) g/L和(38.3±1.9) g/L,均显著高于对照组【(31.6±1.4) g/L和(35.0±1.8) g/L,P<0.05);血清TBIL水平分别为(32.2±2.7) μmol/L和(27.1±2.4) μmol/L,均显著低于对照组【(36.2±3.1) μmol/L和(31.2±2.6) μmol/L,P<0.05);观察组术后第1天和第7天血清hs-CRP水平分别为(25.0±3.1) mg/L和(17.8±2.1) mg/L,均显著低于对照组【(30.6±3.8) mg/L和(21.0±2.6) mg/L,P<0.05);血清IL-8水平分别为(24.0±3.0) pg/ml和(14.0±1.9) pg/ml,均显著低于对照组【(28.6±3.7) pg/ml和(18.5±2.1) pg/ml,P<0.05);术后两组并发症发生率为35.0%和23.8%,差异无统计学意义(P>0.05)。结论地塞米松可加强肝切除手术患者肝功能的保护作用,降低患者体内炎症反应水平,未增加并发症发生率。  相似文献   

9.
目的 研究视频化健康教育在乙型肝炎病毒相关肾炎(HBV-GN)患者中的应用效果。方法 2014年12月~2016年12月我院肾内科收治的HBV-GN患者61例,采用随机数字表法将患者分为对照组30例和观察组31例。给予对照组常规健康教育,在观察组,给予视频化健康教育,观察24 w。采用ELISA法检测血清γ干扰素(IFN-γ)和白细胞介素-4(1L-4)。采用Zung抑郁自评量表(SDS)和焦虑自评量表(SAS)进行焦虑和抑郁评分。结果 干预后,观察组患者血肌酐(sCr)水平为(214.6±111.2)μmol/L,明显低于对照组的[(365.4±103.9) μmol/L,P<0.01];24 h尿蛋白定量为(0.5±1.2) g/L,显著低于对照组的[(1.2±1.1)g/L,P<0.05];血清IL-4水平为(67.9±15.5) pg/L,显著低于对照组的 [(89.±29.7) pg/L,P<0.05],而IFN-γ水平为(49.6±12.1) pg/L,显著高于对照组的[(30.2±11.4) pg/L,P<0.05];观察组患者SAS和SDS评分分别为(35.6±4.2)和(40.3±3.2),显著低于对照组[分别为(43.6±4.7)和(47.9±5.8),P<0.05]。结论 视频化健康教育能够帮助改善HBV-GN患者肝肾功能,降低血清细胞因子水平,减轻患者焦虑和抑郁情绪。  相似文献   

10.
目的 探讨茵栀黄口服液对蛋氨酸胆碱缺乏(MCD)饮食诱导的非酒精性脂肪性肝炎(NASH)大鼠肝脂肪变的保护作用。方法 将30只大鼠随机均分为对照组、MCD组和茵栀黄灌胃组。给予对照组普通饮食,给予另两组动物MCD饮食,于第4周末开始分别给予生理盐水或茵栀黄口服液灌胃,第8 w末处死大鼠。取肝组织行病理学检查。取血,使用全自动生化分析仪检测大鼠血清谷丙转氨酶(ALT)、谷草转氨酶 (AST)、总胆红素(TBIL)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖(FBG)。结果 对照组和MCD组大鼠体质量分别为【(487.2±6.5)g和(155.8±3.1)g,P<0.05】,肝指数分别为【(2.92±0.06)%和(5.09±0.19)%,P<0.05】;MCD组大鼠肝组织出现明显的肝脏脂肪变、小叶炎症和气球样变,同时伴有轻度纤维化,茵栀黄处理组大鼠肝指数为(4.47±0.18)%,显著低于MCD组(P<0.05);茵栀黄组和MCD组大鼠肝组织NAFLD活动度积分(NAS)分别为【(5.9±0.2)分和(7.2±0.1)分,P<0.05】,肝纤维化积分为【(0.3±0.2)分和(0.8±0.2)分,P<0.05】;茵栀黄组和MCD组大鼠血清ALT水平分别为【(68.4±6.4) U/L和(111.9±5.5) U/L,P<0.05】,AST分别为【(110.5±7.9) U/L和(170.5±10.8) U/L,P<0.05】,但是茵栀黄口服液灌胃对MCD大鼠血脂和血糖无显著影响。结论 茵栀黄口服液可以改善MCD诱导的NASH大鼠肝脏脂肪变、肝细胞气球样变、小叶炎症和纤维化,降低NASH大鼠血清转氨酶水平,为应用茵栀黄口服液处理NAFLD提供了实验依据。  相似文献   

11.
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。  相似文献   

12.
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.  相似文献   

13.
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.  相似文献   

14.
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.  相似文献   

15.
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。  相似文献   

16.
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。  相似文献   

17.
氯硝柳胺悬浮剂的毒性评价   总被引:2,自引:2,他引:2  
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。  相似文献   

18.
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  相似文献   

19.

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.  相似文献   

20.
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.  相似文献   

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