α干扰素联合柴胡治疗慢性乙肝临床疗效观察

目的探讨α干扰素联合柴胡注射液抗病毒的可行性及其机制。方法用α干扰素联合柴胡注射液治疗慢性乙型肝炎34例并与单用干扰素组对照,观察2组在保肝、抗病毒、副作用上的差异。结果联合用药组明显减轻干扰素不良反应（P〈0.01）,降低ALT（P〈0.05）,提高HBeAg阴转率（47%）、HBV-DNA阴转率（35%）、抗-HBe阳转率（37%）,与干扰素组比较有显著性差异。结论干扰素联合柴胡注射液抗病毒,能改善肝功能,抑制病毒复制,减轻用药反应,提高治疗慢性乙型肝炎的整体疗效。     

干扰素α治疗慢性乙型肝炎——《慢性乙型肝炎防治指南》部分解读

1干扰素α治疗慢性乙型肝炎的作用机制 自1990年美国FDA正式批准干扰素α-2b治疗慢性乙型肝炎（慢乙肝）以来，干扰素α治疗慢性乙型肝炎已有近20年的历史，是最早用于抗病毒治疗的药物，目前认为干扰素α治疗慢性乙型肝炎的作用主要包括以下3个方面。①抗病毒作用：干扰素α的抗HBV作用是其治疗慢性乙型肝炎的最重要的作用，也是研究最多的一个作用；②减轻肝纤维化作用：临床中观察到干扰素α治疗的慢性乙型肝炎比没有经过抗病毒治疗的患者发生肝硬化和肝癌的相对少见，但一直没有很好的循证医学证据，最近澳大利亚一项大样本的临床试验显示无论是否能获得抗病毒应答，干扰素α确实具有减轻肝纤维化，降低肝硬化的发生率的作用；③调节免疫作用：干扰素α具有广泛的调节免疫作用，这也是抗乙肝病毒的作用机制之一。     

口含型干扰素治疗乙型肝炎50例并丙型肝炎重叠感染14例疗效分析

口含型干扰素治疗乙型肝炎５０例并丙型肝炎重叠感染１４例疗效分析广东省人民医院门诊内科（５１０１２０）唐光华，林业英干扰素是具有抗病毒和免疫调节作用的生物学物质。国内外文献报告应用ａ－干扰素治疗慢性乙型肝炎（ＣＨＢ）及慢性丙型肝炎（ＣＨＣ）取得一定效果...     

慢性病毒性肝炎抗病毒治疗的发展方向

慢性病毒性肝炎的抗病毒治疗是最根本的治疗.慢性乙型肝炎的抗病毒治疗,常规干扰素、聚乙二醇化干扰素、拉米夫定、阿德福韦酯、恩替卡韦等都已先后被批准上市,并得到了广泛的应用;慢性丙型肝炎的抗病毒治疗,常规干扰素、常规干扰素联合利巴韦林、聚乙二醇化干扰素联合利巴韦林等治疗的逐步发展,目前可以使得半数以上的患者取得持续性病毒学应答（SVR）.慢性病毒性肝炎的抗病毒治疗,不同的药物和不同的治疗方案进展很快.在不远的将来,慢性乙型肝炎的抗病毒治疗主要集中在新型核苷类似物的研发上,而慢性丙型肝炎的抗病毒治疗则主要集中在非结构蛋白NS3、NS5B的抑制剂方向上.     

阿德福韦酯联合α1b干扰素治疗慢性乙型肝炎疗效观察

目的：了解阿德福韦酯联合α1b干扰素对慢性乙型肝炎的抗病毒治疗效果。方法：选择52例慢性乙型肝炎患者（治疗组）采用阿德福韦酯和α1b干扰素联合治疗,26例慢性乙型肝炎患者（对照组）单用α1b干扰素治疗。结果：治疗组HBVDNA转阴率与HBeAg转换率较对照组均有明显提高,差异有统计学意义。结论：阿德福韦酯联合α1b干扰素抗乙型肝炎病毒疗效优于单一用药。     

胸腺肽、苦参碱联合干扰素治疗慢性乙型肝炎的临床观察

目的 探讨胸腺肽、苦参碱联合干扰素治疗慢性乙型肝炎的临床效果.方法 选取同期住院或门诊治疗的慢性乙型肝炎患者78例,分为干扰素组、胸腺肽加干扰素组、苦参碱加干扰素组.结果 胸腺肽、苦参碱联合干扰素治疗慢性乙型肝炎疗效显著.结论 胸腺肽、苦参碱联合干扰素治疗慢性乙型肝炎具有较好的降酶、退黄、改善肝功能作用,且有一定的抗病毒作用.     

拉米夫定与干扰素联合治疗慢性乙型肝炎68例临床观察

慢性乙型肝炎目前还缺乏可靠特效的治疗方法，单一用抗HBV药物疗效欠佳，因此选用2种具有抗病毒、免疫调节药物联合治疗慢性乙型肝炎具有协同增效的作用。我们采用拉米夫定（lamivudine，LAM）联合干扰素（interferon，IFN）治疗慢性乙型肝炎68例，现报告如下。     

浅谈对慢性乙型肝炎患者进行抗病毒治疗的研究进展

慢性乙型肝炎患者的乙肝病毒检测结果显示为阳性，其病程超过半年或发病日期不明确，患者的临床表现主要有乏力、恶心、腹胀、肝部疼痛等症状。到目前为止，慢性乙型肝炎仍然是威胁人类健康的主要慢性病之一。随着对慢性乙型肝炎研究的不断深入，在临床上主要使用干扰素和核苷（酸）类似物对此病患者进行抗病毒治疗，效果不错。本文结合临床实践，对慢性乙型肝炎患者进行抗病毒治疗的研究进展做简单的论述。     

聚乙二醇化干扰素a-2b治疗HBeAg阳性慢性乙型肝炎：HBsAg转阴与HBV基因型相关

HBsAg转阴是慢性乙型肝炎抗病毒治疗完全应答的纯正标志。方法为在一项多中心随机对照试验中，266例HBeAg阳性慢性乙型肝炎病人接受聚乙二醇化干扰素a-2b（100μg／d）联合拉米夫定（100mg／d）或安慰剂的治疗，疗程52wk；治疗结束后随访26wk。     

干扰素对各型慢性乙型肝炎的细胞免疫功能上调作用

目的 抗病毒药物干扰素和贺普丁与细胞免疫的关系。方法 用流式细胞仪检测慢性乙型肝炎外周血淋巴细胞方法，比较各型慢性乙型肝炎148例与正常对照组的关系，抗病毒药物干扰素20例和贺普丁49例治疗后细胞免疫的变化。结果 贺普丁治疗6mo后慢性乙型肝炎病人CD4^＋、CD8^＋绝对值、CD4^＋／CD8^＋比值均与未使用组相近，差异无显著性（P〉0．05）；干扰素治疗6mo后的CD4^＋、CD8^＋绝对值比未使用组高，差异有显著性（P〈0．05）。结论 各型慢性乙型肝炎存在细胞免疫的紊乱，干扰素有调节细胞免疫功能作用。     

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.