胸腺肽α_1联合抗结核药物治疗肺结核合并糖尿病患者的疗效观察

目的观察胸腺肽α1联合抗结核药物治疗肺结核合并糖尿病患者的临床效果。方法 76例肺结核合并糖尿病患者随机分为2组,对照组(n=38例)给予正规抗结核方案治疗并用胰岛素有效控制血糖,观察组(n=38例)在对照组治疗基础上加用胸腺肽α1注射剂1.6 mg,皮下注射,2次/周。观察两组患者痰菌阴转、病灶吸收、空洞闭合情况以及外周血T淋巴细胞亚群:CD4+、CD8+细胞的变化情况。结果观察组痰菌阴转率、病灶吸收率和空洞闭合率明显高于对照组(P0.05);观察组治疗后CD8+细胞明显下降(P0.05),而CD4+细胞和CD4+/CD8+明显上升(P0.05)。结论胸腺肽α1联合抗结核药物治疗肺结核合并糖尿病患者疗效显著,可明显提高痰菌阴转率、病灶吸收率、空洞闭合率及细胞免疫功能。     

胸腺肽 α1联合抗结核药物治疗肺结核合并糖尿病患者的疗效观察简

目的 观察胸腺肽α1联合抗结核药物治疗肺结核合并糖尿病患者的临床效果.方法 76例肺结核合并糖尿病患者随机分为2组,对照组（n=38例）给予正规抗结核方案治疗并用胰岛素有效控制血糖,观察组（n=38例）在对照组治疗基础上加用胸腺肽α1注射剂1.6 mg,皮下注射,2次/周.观察两组患者痰菌阴转、病灶吸收、空洞闭合情况以及外周血T淋巴细胞亚群：CD4＋、CD8＋细胞的变化情况.结果 观察组痰菌阴转率、病灶吸收率和空洞闭合率明显高于对照组（P〈0.05）;观察组治疗后CD8＋细胞明显下降（P〈0.05）,而CD4＋细胞和CD4＋/CD8＋明显上升（P〈0.05）.结论 胸腺肽α1联合抗结核药物治疗肺结核合并糖尿病患者疗效显著,可明显提高痰菌阴转率、病灶吸收率、空洞闭合率及细胞免疫功能.     

参附注射液辅助GP方案对非小细胞肺癌患者T淋巴细胞亚群及血清血管内皮生长因子水平的影响研究

目的探究参附注射液辅助GP方案对非小细胞肺癌患者T淋巴细胞亚群及血清血管内皮生长因子(VEGF)水平的影响。方法选择2013年1月—2015年3月在常熟市第一人民医院肿瘤科接受治疗的非小细胞肺癌患者128例,随机分成对照组和观察组,各64例。对照组患者采用常规GP方案治疗,包括顺铂和吉西他滨;观察组患者在常规GP方案基础上联合参附注射液治疗。28 d为1个化疗周期,两组患者均治疗4个化疗周期。比较两组患者的临床疗效,治疗前后T淋巴细胞亚群(CD+3细胞分数、CD+4细胞分数、CD+8细胞分数以及CD+4/CD+8细胞比值)、血清VEGF水平、血小板计数(PLT)、白细胞计数(WBC)。结果观察组患者临床疗效优于对照组(u=2.402,P=0.016)。治疗前两组患者CD+3细胞分数、CD+4细胞分数、CD+8细胞分数及CD+4/CD+8细胞比值比较,差异无统计学意义(P>0.05);治疗后观察组患者CD+3细胞分数、CD+4细胞分数、CD+4/CD+8细胞比值高于对照组(P<0.05);治疗后两组患者CD+8细胞分数比较,差异无统计学意义(P>0.05)。治疗前两组患者血清VEGF水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清VEGF水平低于对照组(P<0.01)。治疗前两组患者PLT、WBC比较,差异无统计学意义(P>0.05);治疗后观察组患者PLT、WBC高于对照组(P<0.01)。结论参附注射液辅助GP方案能有效调节非小细胞肺癌患者的T淋巴细胞亚群,降低血清VEGF水平,减轻化疗药物对骨髓的抑制作用。     

艾迪注射液对晚期非小细胞肺癌化疗疗效及免疫功能的影响

目的研究艾迪注射液对晚期非小细胞肺癌GP方案化疗疗效及免疫功能的影响。方法选取非小细胞肺癌患者72例随机分为观察组和对照组。对照组患者给予GP方案化疗治疗。观察组患者给予艾迪注射液联合GP方案治疗。结果观察组近期总有效率与对照组比较无统计学差异(P0.05)。治疗后,观察组患者整体生活质量、躯体功能、情绪功能、角色功能、认知功能、社会功能都高于对照组(均P0.01),乏力、咳嗽、呼吸困难、胸痛都低于对照组(P0.01或P0.05)。治疗后,两组非小细胞肺癌患者免疫功能指标CD3+、CD3+CD4+、CD16+CD56+及CD4+/CD8+水平与治疗前相比均有所降低,但观察组患者均高于对照组(P均0.01)。两组患者不良反应比较无统计学差异(P0.05)。结论艾迪注射液联合GP方案治疗晚期非小细胞肺癌,能够促进化疗药物发挥良好抗癌功效,减轻化疗对患者生活质量及免疫功能损伤程度,且不增加化疗不良反应发生率。     

胸腺肽联合化疗对胃癌患者血清Th1和Th2类细胞因子的影响

目的观察胸腺肽联合化疗对胃癌患者血清Th1和Th2类细胞因子的影响。方法 68例胃癌患者分为两组,对照组(n=34)仅采用草酸铂+5-氟尿嘧啶(5-Fu)和亚叶酸钙(LV)治疗,观察组(n=34)在对照组治疗基础上加用胸腺肽治疗。观察两组临床疗效及治疗前后血清Th1和Th2类细胞因子表达水平。结果观察组治疗总有效率(70.6%)明显高于对照组(55.9%,P<0.05);观察组治疗后Th1类细胞因子表达水平明显高于治疗前和对照组治疗后(P<0.05);观察组治疗后Th2类细胞因子表达水平明显低于治疗前和对照组治疗后(P<0.05)。结论胸腺肽联合化疗可明显改善胃癌患者的细胞免疫功能,疗效显著,值得临床推广应用。     

益肺清化颗粒联合NP化疗方案对非小细胞肺癌患者免疫功能的影响

目的探讨益肺清化颗粒联合NP化疗方案对非小细胞肺癌患者免疫功能的影响。方法选取2012年1月—2014年1月聊城市中医医院收治的非小细胞肺癌患者80例,随机分为治疗组和对照组,各40例。两组患者均给予NP化疗方案,治疗组患者在NP化疗方案基础上加用益肺清化颗粒治疗,两组患者均以21 d为1个周期,治疗2个周期后观察临床疗效。观察两组患者近期临床疗效,治疗前后中医临床证候、免疫功能〔T淋巴细胞亚群:CD+3细胞分数、CD+4细胞分数、CD+8细胞分数及CD+4/CD+8细胞比值〕变化及化疗期间毒副作用。结果两组患者近期临床疗效比较,差异无统计学意义(u=3.077,P=0.058)。治疗组患者中医临床证候改善情况优于对照组(u=-0.716,P=0.043)。治疗前两组患者CD+3细胞分数、CD+4细胞分数、CD+8细胞分数及CD+4/CD+8细胞比值比较,差异均无统计学意义(P0.05);治疗后治疗组患者CD+3细胞分数、CD+4细胞分数、CD+8细胞分数及CD+4/CD+8细胞比值高于对照组(P0.05)。治疗组患者白细胞计数下降发生率、血小板计数减少发生率及恶心、呕吐发生率均低于对照组(P0.05)。结论益肺清化颗粒能有效提高行NP化疗方案的非小细胞肺癌患者的免疫功能,降低毒副作用,从而提高患者生活质量。     

胸腺肽α1对非小细胞肺癌患者化疗期间细胞免疫功能的影响

目的 观察胸腺肽仅。对恶性肿瘤患者化疗期间细胞免疫功能的影响。方法 将同期行吉西他滨＋卡铂化疗的68例非小细胞肺癌（NSCLC）患者随机分为观察组和对照组各34例,观察组在化疗期间同时予胸腺肽α1皮下注射。21d化疗结束后测定两组T细胞亚群、NK细胞活性、IL-2和CD25变化。结果 观察组治疗后CD3^＋、CD4^＋、CD4^＋／CD8^＋、NK细胞活性、IL-2水平明显高于治疗前,CD8^＋明显低于治疗前（P〈0．05）;而对照组变化趋势则与之相反（P〈0．05）。结论 胸腺肽α1可显著改善NSCLC患者化疗期间的细胞免疫功能,有利于增强机体的抗肿瘤效应。     

国产胸腺肽α1联合化疗在治疗晚期非小细胞肺癌的作用

目的本文观察国产胸腺肽α1（迈普新）联合诺维苯（NVB）加顺铂（DDP）在治疗中晚期（Ⅲ、Ⅳ期）非小细胞肺癌（NSCLC）的近期疗效及作用。方法将57例经病理证实的Ⅲ、Ⅳ期非小细胞肺癌患者随机分为A、B两组,A组（28例）采用胸腺肽α1加化疗,B组（29例）采用单纯化疗,两组化疗方案均采用NP（NVB、DDP）方案。两个疗程后评价疗效.观察两组患者肿瘤缓解率,毒副反应及治疗前后周血T细胞亚群的变化并进行评价。结果治疗后A、B两组的有效率分别为46.4%和37.9%,两者比较无显著性差异;治疗组治疗后T细胞亚群中CD3,CD4,CD4/CD8有明显提高（P〈0.05）,对照组前后无明显变化。结论胸腺肽α1联合化疗治疗Ⅲ、Ⅳ期非小细胞肺癌可提高机体免疫功能,且没有发现明显的毒副作用,是一较理想的免疫增强剂。     

胸腺肽联合GP方案治疗晚期非小细胞肺癌的临床疗效和安全性及对免疫功能的影响

目的观察胸腺肽联合GP方案治疗晚期非小细胞肺癌的临床疗效、安全性及对免疫功能的影响。方法将114例晚期非小细胞肺癌的患者分为对照组61例和观察组53例。对照组予吉西他滨1 000 mg·m~(-2)静滴,D1、D8联合顺铂75 mg·m~(-2)静滴,21 d为1个周期。观察组在对照组基础上,予胸腺肽注射液20 mg,皮下注射,隔日一次随化疗连续应用2个周期。观察两个周期化疗结束后患者的近期临床疗效、不良反应及T淋巴细胞亚群的变化。结果观察组临床获益率(86. 79%)高于对照组(80. 32%)(P 0. 05)。观察组客观有效率(37. 73%)略高于对照组(32. 79%),但差异无统计学意义(P 0. 05)。观察组血清T淋巴细胞亚群CD3~+、CD4~+、CD8~+和NK细胞计数值明显升高,CD4~+/CD8~+明显降低(P 0. 05)。其临床主要不良反应为血液学毒性和胃肠道反应,观察组化疗后Ⅲ~+Ⅳ°白细胞计数、血小板计数减少发生率明显低于对照组(P 0. 05),胃肠道反应、肝肾功能等其他不良反应两组间差异无统计学意义(P 0. 05)。结论胸腺肽联合GP方案治疗晚期非小细胞肺癌临床疗效良好,能有效提高患者T淋巴细胞亚群水平,降低化疗相关不良反应发生率,提高患者耐受性,临床可进一步研究推广。     

康艾注射液辅助化疗对老年中晚期非小细胞肺癌患者免疫功能及肿瘤标志物的影响

目的探讨康艾注射液辅助化疗对老年中晚期非小细胞肺癌患者免疫功能及肿瘤标志物的影响。方法老年中晚期非小细胞肺癌患者112例,根据入院时间单双号随机分为观察组和对照组各56例,对照组采用顺铂联合吉西他滨化疗方案,观察组联合应用康艾注射液,连续治疗4个周期,比较两组免疫功能、肿瘤标志物、近期疗效。结果观察组缓解率58. 93%明显高于对照组(37. 50%;χ~2=5. 149,P<0. 05); T淋巴细胞亚群CD3~+、CD4~+、CD4~+/CD8~+等明显高于对照组,CD8~+明显低于对照组(t=6. 952,7. 602,8. 429,8. 392,P<0. 05);血管内皮生长因子(VEGF)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)含量明显低于对照组(t=6. 451,8. 555,8. 498,P<0. 05)。结论康艾注射液辅助治疗有助于提高老年中晚期非小细胞肺癌临床疗效,可能改善患者细胞免疫功能、减少血清肿瘤标志物含量等因素有关。     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.