拉米夫定与泛昔洛韦联合治疗乙型肝炎病毒慢性感染的临床研究

目的 观察拉米夫定与泛昔洛韦联合治疗乙型肝炎病毒(HBV)慢性感染的临床疗效。方法 慢性乙型肝炎患者90例。设联合治疗组28例，单用拉米夫定组30例，单用泛昔洛韦组32例。联合治疗组给予口服拉米夫定0．1g／d(PO)，泛昔洛韦1．5g／d(PO)，24周。拉米夫定、泛昔洛韦单用组剂量及疗程分别同联合治疗组。结果 3组均无明显副反应，丙氨酸转氨酶(ALT)复常率无差异。3组HBV DNA阴转率分别为89．3％、66．7％、40．6％，差异有显著性。乙型肝炎表面抗原(HBeAg)阴转率分别为28．6％、23．3％、21．9％，差异无显著性。结论 拉米夫定与泛昔洛韦联合用药安全、耐受性好，临床显示联合治疗对HBV DNA的抑制作用显著优于单用药。     

Evaluation of clinical benefit from treatment with mepolizumab for patients with eosinophilic granulomatosis with polyangiitis

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奎的平治疗精神分裂症76例临床观察

目的 评价奎的平治疗精神分裂症的疗效和副反应。方法 用奎的平治疗精神分裂症患者76例，疗程8周，采用PANSS、BPRS和TESS量表观察疗效和副反应。结果 奎的平治疗精神分裂症的总有效率达80．26％，PANSS评分和BPRS评分治疗前后相比有显著性差异，不良反应有口干、嗜睡、低血压、胃肠道反应等。结论 奎的平是一种安全有效的抗精神病药物，可作为第一线抗精神病药。     

未足月胎膜早破残余羊水量过少81例临床分析

目的探讨未足月胎膜早破（PPROM）残余羊水量过少病人的并发症、分娩方式及母婴结局。方法回顾性分析在我院分娩的220例PPROM的临床资料,分残余羊水量过少组与对照组,对两组并发症、分娩方式及母儿结局进行比较。结果残余羊水量过少组在脐带脱垂、1分钟低Apgar评分、死胎死产、新生儿死亡的发生率显著高于对照组,有统计学差异,P值均〈0.05。且剖宫产率明显高于对照组,P〈0.001。结论对PPROM残余羊水量过少者应严密监测,如并发非头先露、胎儿窘迫、脐带脱垂,剖宫产是较为安全的分娩方式。     

Successful treatment of a patient with mitochondrial myopathy with alirocumab

A 48-year-old man presented to our lipid clinic with statin intolerance and elevated serum creatine kinase levels, being affected by mitochondrial myopathy because of heteroplasmic mitochondrial DNA missense mutation in MTCO1 gene (m.7671T>A). He had just been treated with a coronary artery bypass 4 years before because of acute coronary syndrome, and he had consistently high levels of both low-density lipoprotein cholesterol and triglycerides. Dyslipidemia was successfully treated using 75 mg of alirocumab subcutaneously every 2 weeks, 10 mg of ezetimibe daily, 2 g of marine omega-3 fatty acids daily, and 145 mg of micronized fenofibrate every 2 days. Although muscle weakness persisted, myalgia did not reoccur and serum creatine kinase levels remained almost stable over the time.