饮酒与消化性溃疡及胃炎的关系

饮酒与消化性溃疡及胃炎的关系姚沛张冠卿赵桂芬郭德民Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓａｌｃｏｈｏｌｄｒｉｎｋｉｎｇ／ａｄｖｅｒｓｅｅｆｅｃｔｓ；ｐｅｐｔｉｃｕｌｃｅｒ／ｅｔｉｏｌｏｇｙ；ｇａｓｔｒｉｔｉｓ／ｅｔｉｏｌｏｇｙ主题词饮酒／副作用；消化性溃疡...     

高血压病伴消化性溃疡132例

高血压病伴消化性溃疡１３２例朱琼祥刘养娣Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｈｙｐｅｒｔｅｎｓｉｏｎ／ｃｏｍｐｌｉｃａｔｉｏｎｓ；ｐｅｐｔｉｃｕｌｃｅｒ／ｃｏｍｐｌｉｃａｔｉｏｎｓ；ｐｅｐｔｉｃｕｌｃｅｒ／ｔｈｅｒａｐｙ主题词高血压／并发症；消化性溃疡...     

消化性溃疡的复发因素与对策

消化性溃疡的复发因素与对策阴光耀肖军Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｐｅｐｔｉｃｕｌｃｅｒ／ｅｔｉｏｌｏｇｙ；ｐｅｐｔｉｃｕｌｃｅｒ／ｔｈｅｒａｐｙ；ｐｅｐｔｉｃｕｌｃｅｒ／ｐｒｅｖｅｔｉｏｎａｎｄｃｏｎｔｒｏｌ；Ｈｅｌｉｃｏｂａｃｔｅｒｉｎｆｅｃ...     

青少年消化性溃疡322例

目的探讨青少年消化性溃疡（APU）的临床特点．方法收集1987／199610a间13岁～20岁消化性溃疡（PU）患者322例，以同期20岁以上PU患者300例为对照组，进行临床分析，包括同期PU住院人数构成比、主要症状、首发症状、并发症、治疗效果等．结果APU占同期PU住院人数构成比由1987年的6.20％升至1996年的12．00％，其中DU占8．30％，GU占3．70％．上腹痛、节律性腹痛、反酸症状发生率依次为59．32％，17．08％，13．97％，而对照组依次为88．33％，40．33％，31．67％，两组有明显差异性．首发症状中上腹痛、出血的发生率依次为49．38％和38．20％，而对照组依次为65．00％和13．00％，两组差别具有非常显著的意义．APU组并发症发生率为42．23％，而对照组为49．33％，两组无显著差异，但溃疡出血的发生率分别为38．82％和24．33％，两者差异具有显著意义．APU组除5例因穿孔行手术治疗外，其余均经内科治疗后痊愈．结论APU有以下特点：住院人数构成比逐年上升，提示其发病率似乎有明显上升趋势，且DU发生率较成人组更高；症状不典型，在首发症状中，上消化道出血率高；并发症中，出血发生率高，而穿孔和幽门梗阻发生率低；病情易控制，预后良好．     

老年人消化性溃疡并出血93例临床分析

目的探讨老年人≥60岁消化性溃疡（PU）并出血的临床、内镜特点及转归．方法查找资料完整的老年患者93例并随机与同期≤45岁中青年患者79例进行对比，分析其临床特点，出血诱因、伴发病、病死率及内镜溃疡、伴发癌变（GCa）、萎缩性胃炎（CAG），胃粘膜肠腺化生（IM）情况．统计学资料采用X2检验．结果临床特点：出血量＞1000mL，老年组38例，占40．9％，中青年组17例，占21．5％（P＜0．01）．出现休克，老年组20例，占21．5％，中青年组3例，占3．7％（P＜0．001）．大便潜血阳性超过1wk，老年组44例，占47．3％，中青年组5例，占6．3％（P＜0．001）．内科保守治疗无效需手术，老年组16例，占17．2％，中青年组3例，占3．7％（P＜0．01）．伴发病，老年组76例，占81．7％，中青年组15例，占19．0％（P＜0．01）．病死率，老年组10例，占10．8％，中青年组2例，占2.5％（P＜0．05）．溃疡特点：胃溃疡（GU），老年组63例，占67．7％，中青年组16例，占20．3％（P＜0．001）．十二指肠溃疡（DU），老年组30例，占32．3％，中青年组63例，占79．8％（P＜0.001）．伴发CAG，老年组76例，占75．3％，中青年组20例，占25．3％（P＜0．01）．IM：老年组60例，占64．5％，中青年组18例，占22．8％（P＜0．001     

老年消化性溃疡72例

老年消化性溃疡（PUA）系指年龄在60岁（或65岁）以上老年人的消化性溃疡（PU），现总结我院1990／1997PUA发病情况及临床特点1临床资料1990／1997我院PU门诊及住院患者413例，其中PUA72例（17．4％），男59例，女13例，男女之比4．5：1，年龄60岁～78岁，平均67．9岁．全部病例均经内镜证实根据溃疡部位分为胃溃疡（＊U川7例，十二指肠球溃疡（DU）55例，随机取同期60岁以下PU30例（每年4～5例），其中GU和DU各15例，年龄2五岁～58岁，平均叩．五岁，男女之比3．9：互2结果ZI］仅床特点老年GU和DU人数构成比表IPUA组与对照组…     

消化性溃疡

叙述溃疡病的发病概况、病因和机制．深刻掌握溃疡病的病理变化和常见的并发症．十二指肠溃疡与胃溃疡的比例约3．1：1，男性高于女性为3．9～8．5：1．而十二指肠溃疡的发病年龄略轻于胃溃疡，并是多因素的常发病，笔者认为比较明显的是防御因素，至于病理变化有溃疡的大体形态学和显微组织学变化两部分，同时胃溃疡多发于胃小弯及胃窦与胃接触的部位，约占90％；其次是胃贲门部，胃后壁和胃大弯侧，十二指肠溃疡多发于球部，以球前壁为多，约占50％，起病缓慢或急袭，病程少则几年，多则十几年，甚至几十年，并有反复发作为特征和出现大量出血，穿孔，幽门梗阻，癌变的并发症．关于防治的问题，首先强调人的因素、精神因素避免过度疲劳，同时注意饮食卫生．治疗原则上要消除临床症状，促进溃疡愈合，预防复发和防止并发症的发生为主要目的药物是内科治疗的唯一方法，制酸药是内科治疗的基本药，年龄45岁以上的患者，伴有“A”硬化者，多次反复出血不止者，而输血后血压仍不稳定有持续出血情况及合并穿孔、幽门梗阻者均可外科手术治疗．     

Hp SG与消化性溃疡的关系

ＨｐＳＧ与消化性溃疡的关系陈登登林志辉彭孝伟潘秀珍Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｓｔｏｍａｃｈｕｌｃｅｒ／ｅｔｉｏｌｏｇｙ；ｄｕｏｄｅｎａｌｕｌｃｅｒ／ｅｔｉｏｌｏｇｙ；Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ；ｈｅｌｉｃｏｂａｃｔｅｒｉｎｆｅｃｔｉｏ...     

乙型肝炎患者血清中HBcAg与HBV复制指标的关系

目的探讨乙型肝炎患者血清ＨＢｃＡｇ与ＨＢＶ复制指标的关系及临床意义．方法对３１１例乙型肝炎患者进行了ＨＢｃＡｇ检测，并同时进行酶联法乙肝五项、地高辛法ＨＢＶＤＮＡ检测，其中２３７例进行乙肝ＤＮＡ聚合酶（ＤＮＡＰ）检测．结果ＨＢｃＡｇ阳性组的ＨＢＶＤＮＡ检出率（７７６％），明显高于ＨＢｃＡｇ阴性组（３５５％，Ｐ＜００１）；在ＨＢｃＡｇ阴性组中，抗ＨＢｅ阳性者仍能检出２９９％（４４／１４７）ＨＢＶＤＮＡ者阳性；ＨＢｅＡｇ，ＨＢｃＡｇ均阳性者其ＨＢＶＤＮＡ和ＤＮＡＰ的检出率高达８５９％；其他依次为ＨＢｅＡｇ、抗ＨＢｅ和ＨＢｃＡｇ均阳性者７１４％，抗ＨＢｅ，ＨＢｃＡｇ阳性者６９２％，ＨＢｅＡｇ阳性，ＨＢｃＡｇ阴性者６８４％，抗ＨＢｅ阳性，ＨＢｃＡｇ阴性者２７６％．结论血清ＨＢＶＤＮＡ，ＤＮＡＰ，ＨＢｅＡｇ和ＨＢｃＡｇ均是反映乙肝病毒复制的敏感指标，抗ＨＢｅ的出现并不表示病毒复制停止，应参考其他病毒复制指标情况．各种指标的不同组合可以清楚地反映出患者体内病毒复制状况．     

Relationship between cytokine gene polymorphisms and chronic hepatitis B virus infection

Hepatitis B virus (HBV) infection is still a public health problem worldwide, being endemic in some parts of the world. It can lead to serious liver diseases such as chronic hepatitis, cirrhosis, and hepatocellular cancer. The differences in host immune response can be one of the reasons for the various clinical presentations of HBV infection. Polymorphisms of genes encoding the proinflammatory and antiinflammatory cytokines, which are responsible for regulation of the immune response, can affect the clinical presentation of the infection. Particularly, the polymorphisms of the genes encoding cytokines such as interleukin (IL)-1, IL-6, IL-8, IL-10, IL-18, IL-28B, interferon-γ, tumor necrosis factor-α, tumor growth factor-β1, and regulatory molecules like vitamin D receptor and chemokine receptor 5 can be responsible for different clinical presentations of HBV infections. The genomic information about cytokines and other mediators can be important for determining high-risk people for developing chronic hepatitis or hepatocellular cancer and may be used to plan treatment and preventive approaches for these people. In this review, the current knowledge in the literature on the association between cytokine/regulatory molecule gene polymorphisms and clinical course of chronic HBV infection is summarized, and the clinical implementations and future prospects regarding this knowledge are discussed.     

消化性溃疡患者Hp感染与粘膜血流量

目的研究幽门螺杆菌（Ｈｐ）感染与消化性溃疡（ＰＵ）胃肠粘膜血流量（ＧＤＭＢＦ）的关系．福建省立医院消化内科福建省福州市３５０００１方法采用多普勒激光血流仪测定内镜检查患者的非病灶区贲门、胃体、胃窦部及溃疡或胃炎病灶区的ＧＤＭＢＦ．结果非病灶区ＧＤＭＢＦ以贲门部最高，胃体部次之，胃窦部较低，分别为１．６８±０５５Ｖ，１７０±０４２Ｖ和１３５±０３７Ｖ，均明显高于ＰＵ病灶区０８９±０３３Ｖ（Ｐ＜００１）；伴有Ｈｐ感染的ＰＵ患者病灶区及其它非病灶区ＧＤＭＢＦ均显著低于不伴Ｈｐ感染者．结论Ｈｐ感染可造成胃肠粘膜血流量降低，可能是溃疡病灶难愈或复发的原因之一．     

MiR-122 in hepatitis B virus and hepatitis C virus dual infection

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the most common causes of chronic liver diseases and hepatocelluar carcinomas. Over the past few years, the liver-enriched microRNA-122 (miR-122) has been shown to differentially regulate viral replication of HBV and HCV. It is notable that the level of miR-122 is positively and negatively regulated by HCV and HBV, respectively. Consistent with the well-documented phenomenon that miR-122 promotes HCV accumulation, inhibition of miR-122 has been shown as an effective therapy for the treatment of HCV infection in both chimpanzees and humans. On the other hand, miR-122 is also known to block HBV replication, and HBV has recently been shown to inhibit miR-122 expression; such a reciprocal inhibition between miR-122 and HBV suggests an intriguing possibility that miR-122 replacement may represent a potential therapy for treatment of HBV infection. As HBV and HCV have shared transmission routes, dual infection is not an uncommon scenario, which is associated with more advanced liver disease than either HBV or HCV mono-infection. Thus, there is a clear need to further understand the interaction between HBV and HCV and to delineate the role of miR-122 in HBV/HCV dual infection in order to devise effective therapy. This review summarizes the current understanding of HBV/HCV dual infection, focusing on the pathobiological role and therapeutic potential of miR-122.     

乙型肝炎病毒感染时的骨髓造血干细胞

目的研究乙型肝炎患者骨髓造血干细胞中HBV的感染、复制及对造血干细胞增殖的影响。方法收集乙型肝炎患者9例,健康者7例骨髓液,磁珠分离仪分离纯化骨髓液CD34＋细胞,取部分干细胞进行免疫组化和原位杂交,以感染HBV的干细胞（2.2.15细胞）为阳性对照,并设健康人骨髓干细胞为阴性对照。余两组干细胞分别分为两组,一组在含有干细胞生长因子（SCF）、酪氨酸激酶受体家族Ⅲ的配体（FLT3）、促血小板生成素（TPO）、白介素-3（IL-3）和10%FBS的IMDM培养基中孵育,另一组在无细胞因子的同样培养基中孵育。第0、1、6、12d进行PCR病毒载量检测并做细胞计数。结果患者组骨髓干细胞经免疫组化染色后为变为棕黄色与阳性对照组一致,经原位杂交后细胞染色为蓝紫色与阳性对照组一致,而阴性对照组均未染色。对患者组骨髓干细胞加细胞因子和无细胞因子第1、6、12d细胞计数分别比较,均明显少于正常对照组（t=0.818,P〈0.05;t=3.599,P〈0.05;t=2.967,P〈0.05）。加细胞因子患者组第6、12d细胞内病毒载量明显高于不加细胞因子患者组（t=3.36,P〈0.05;t=5.71,P〈0.01）。结论 HBV可以感染骨髓造血干细胞并且可随干细胞的增殖不断复制。感染了HBV的干细胞增殖能力减弱。     

Relationship between hepatitis B virus DNA levels and liver histology in patients with chronic hepatitis B

AIM： To study the relationship between hepatitis B virus （HBV） DNA levels and liver histology in patients with chronic hepatitis B （CHB） and to determine the prevalence and characteristics of hepatitis B e antigen （HBeAg） negative patients.
METHODS： A total of 213 patients with CHB were studied, and serum HBV DNA levels were measured by the COBAS Amplicor HBV Monitor test. All patients were divided into two groups according to the HBeAg status.The correlation between serum HBV DNA levels and liver damage （liver histology and biochemistry） was explored.
RESULTS： Of the 213 patients with serum HBV DNA levels higher than 10^5 copies/mL, 178 （83.6%） were HBeAg positive, 35 （16.4%） were HBeAg negative. The serum HBV DNA levels were not correlated to the age,history of CHB, histological grade and stage of liver disease in either HBeAg negative or HBeAg positive patients. There was no correlation between serum levels of HBV DNA and alanine aminotransferanse （ALT）,aspartate aminotrans-ferase （AST） in HBeAg positive patients. In HBeAg negative patients, there was no correlation between serum levels of HBV DNA and AST,while serum DNA levels correlated with ALT （r = 0.351, P = 0.042）. The grade （G） of liver disease correlated with ALT and AST （P 〈 0.05, r = 0.205, 0.327 respectively）in HBeAg positive patients. In HBeAg negative patients,correlations were shown between ALT, AST and the G （P 〈 0.01, and r = 0.862, 0.802 respectively）. HBeAg negative patients were older （35 ± 9 years vs 30 ±9 years, P 〈 0.05 ） and had a longer history of HBV infection （8 ± 4 years vs 6 ± 4 years, P 〈 0.05） and a lower HBV DNA level than HBeAg positive patients （8.4± 1.7 Log HBV DNA vs 9.8 ± 1.3 Log HBV DNA, P 〈0.001）. There were no significant differences in sex ratio,ALT and AST levels and liver histology between the two groups.
CONCLUSION： Serum HBV DNA level is not correlated to histological grade or stage of liver disease in CHB patients with HBV DNA mor     

乙型肝炎病毒感染的流行现状

乙型肝炎病毒(HBV)感染是一个重要的公共卫生问题,据世界卫生组织(WHO)公布的数据,全球20亿人已感染HBV,其中3.5～4亿人为慢性HBV携带者[1]。HBV感染可以引起急性和慢性肝脏疾病,包括肝硬化和肝癌[1]。乙型肝炎引起的与HBV相关的肝衰竭、肝硬化、肝癌,每年会导致100万人死亡。中国是HBV感染的高发区,2006年进行的HBV感染的血清流行病学调查结果显示,HBsAg携带率为总人口的7.18%。因此,     

Clinical and experimental research on weile jiaonang for peptic ulcer

AIM To observe the therapeutic effect of weile jiaonang (WLJN) for peptic ulcer (PU) and its toxicity toanimals, and to find out the nontoxic Chinese medicines in replacing those chemical medicines with sideeffect.METHODS Five hundred and forty patients with PU were divided into three groups, therapeutic group byWLJN, control group taking famotidine and combined group with WLJN and famotidine. One hundred andeighty patients in each group were studied. The diagnosis of 540 patients with PU is in accordance with thebasis provided by the National Scientific Congress of Digestive System Disease convened in Hangzhou, 1978.The study followed the criterion provided by this Congress.RESULTS Total effective rate in therapeutic group was 93.3%, and 93.3% in control group. Combinedgroup achieved a total effective rate of 100%. For all three groups, there was no significant differencestatistically, but the control group appeared obvious side effects. The result of acute toxic experiments onwhite mice showed that there no death and toxic side effect even the highest dosage was given, which wasequivalant to 120 times to the dosage of patients. The result of chronic toxic experiment showed there was noobvious pathologic change in three dosed groups. The tails of mice in dosed groups were more smooth delicateand cleaner than those in control group.CONCLUSION Through observation in clinic and exprimental animal, it is proved that weilejiaonang isparticularly effective and safe Chinese patent drug against PU.     

Hepatitis B virus and hepatitis C virus dual infection

Hepatitis B virus (HBV) and hepatitis C virus (HCV) share common mode of transmission and both are able to induce a chronic infection. Dual HBV/HCV chronic coinfection is a fairly frequent occurrence, especially in high endemic areas and among individuals at high risk of parenterally transmitted infections. The intracellular interplay between HBV and HCV has not yet been sufficiently clarified, also due to the lack of a proper in vitro cellular model. Longitudinal evaluation of serum HBV DNA and HCV RNA amounts has revealed that complex virological profiles may be present in coinfected patients. Dual HBV/HCV infection has been associated to a severe course of the liver disease and to a high risk of developing hepatocellular carcinoma. Despite the clinical importance, solid evidence and clear guidelines for treatment of this special population are still lacking. This review summarizes the available data on the virological and clinical features as well as the therapeutic options of the dual HBV/HCV infection, and highlights the aspects that need to be better clarified.