苦碟子注射液辅助治疗慢性肺心病急性加重期临床观察

目的观察苦碟子注射液辅助治疗慢性肺心病急性加重期的临床疗效。方法把123例慢性肺心病急性加重期的患者随机分成苦碟子治疗组62例和常规治疗组61例。两组均给予常规治疗,苦碟子治疗组加用苦碟子注射液治疗,14天为一疗程,疗程结束后评价临床疗效。结果苦碟子治疗组:显效37例,有效22例,无效3例,总有效率95.16%;常规治疗组:显效25例,有效18例,无效18例,临床总有效率70.49%。比较两组临床疗效,χ2=13.43,P0.01,两组疗效差异有统计学意义。结论苦碟子注射液辅助治疗慢性肺心病急性加重期患者临床疗效显著,优于常规治疗组。     

丹参注射液治疗慢性肺心病心力衰竭84例疗效观察

目的观察丹参注射液对慢性肺心病心力衰竭的治疗效果，并与常规治疗的疗效进行对照。方法2004年1月～2006年9月收治慢性肺，12,病，12,力衰竭155例，对照组用持续低流量吸氧，改善通气功能、强心、利尿、纠正电解质及酸碱平衡等常规治疗，治疗组在上述综合治疗基础上用丹参注射液40ml＋5％葡萄糖液250ml静滴，每日1次，2周为1个疗程。结果治疗组84例，显效56例，有效22例，无效6例，总有效率92．9％；对照组71例，显效29例，有效24例，无效18例，总有效率74．6％。两组疗效差异有显著性（P〈0．05）。结论在常规治疗慢性肺心病心力衰竭的基础上辅以丹参注射液疗效满意。     

丹红注射液辅助治疗冠心病80例临床观察

目的 观察丹红注射液辅助治疗冠心病的临床疗效.方法 将150例患者随机分成治疗组(常规治疗加丹红注射液)与对照组(常规治疗),治疗2周后观察临床疗效及心电图变化.结果 观察组显效率为75.00％,总有效率为95.00％;对照组显效为50.00％,总有效率为72.86％.治疗组显效率、总有效率优于对照组,差异有统计学意义(P＜0.05).两组均未发现明显不良反应.结论 丹红注射液辅助治疗冠心病安全有效.     

中医辨证治疗慢性心力衰竭35例临床观察

目的观察中医辨证分型治疗慢性心力衰竭的临床疗效.方法将65例慢性心力衰竭病人随机分为两组,对照组30例,即单纯西医抗心力衰竭常规治疗.治疗组在上述治疗基础上经辨证分型以参附针、参麦注射液、黄芪注射液、香丹注射液、剌五加注射液、红花注射液治疗.两组治疗4周后判断疗效.结果治疗组显效率34.2%,总有效率分别为94.3%,对照组显效率30.0%,总有效率83.3%,两组比较有统计学意义(P＜0.01).结论中医辨证分型治疗慢性心力衰竭疗效明显优于单纯西医治疗.     

中西医结合治疗慢性肺源性心脏病合并心力衰竭的临床分析

目的分析丹参注射液联合多巴胺治疗慢性肺心病合并心力衰竭的临床疗效。方法选择我科2007年1月—2009年12月收住的慢性肺心病心力衰竭患者92例。对照组用吸氧、抗感染、祛痰、平喘、强心、利尿、纠正水电解质平衡失调等综合治疗。治疗组在上述基础上用丹参注射液联合多巴胺,1次/d,10d为1个疗程。结果治疗组46例,显效31例,有效12例,无效3例,总有效率93.5%;对照组46例,显效21例,有效14例,无效11例,总有效率76.1%。两组总有效率比较差异有统计学意义(P0.05)。结论在常规治疗肺心病心力衰竭的基础上,联合使用丹参注射液加多巴胺注射液可提高疗效。     

丹参酮ⅡA磺酸钠联合苦黄注射液治疗慢性乙型肝炎高胆红素血症34例

[目的]观察丹参酮ⅡA磺酸钠联合苦黄注射液治疗慢性乙型肝炎高胆红素血症的临床疗效。[方法]将2009年6月~2010年6月收治的慢性乙型肝炎高胆红素血症患者随机分为观察组34例和对照组33例,对照组予以苦黄注射液30 ml加入5%葡萄糖注射液250 ml中静脉滴注;观察组在对照组治疗基础上给予丹参酮ⅡA磺酸钠注射液40 mg加入10%葡萄糖注射液250 ml中静脉滴注,2组均给以常规护肝治疗,观察总胆红素（TB）、丙氨酸氨基转移酶（ALT）、天冬氨酸转氨酶（AST）变化情况。[结果]治疗4周后观察组显效13例,有效14例,无效7例,总有效率为79.4%;对照组显效9例,有效11例,无效13例,总有效率60.6%,2组总有效率比较差异有统计学意义（P〈0.05）,观察组TB明显下降,与对照组比较差异有统计学意义（P〈0.05）;2组间ALT、AST下降差异无统计学意义（P〉0.05）。[结论]丹参酮ⅡA磺酸钠联合苦黄注射液治疗慢性乙型肝炎高胆红素血症临床疗效良好。     

丹红注射液配合中药熏洗治疗糖尿病周围神经病变的疗效观察

目的 观察丹红注射液配合中药熏洗治疗糖尿病周围神经病变（DPN）的疗效.方法 将同期收集的54例DPN患者随机分为治疗组（30例）和对照组（24例）.两组基础治疗相同,治疗组在此基础上加丹红注射液静脉滴注,同时配合中药熏洗治疗.对照组加维生素B1肌肉注射,均1次/d,连续治疗4周比较疗效.结果 治疗组显效13例,有效15例,显效率44.33%,总有效率93.33%;对照组显效6例,有效13例,显效率25.00%,总有效率79.16%.两组疗效比较差异有统计学意义.结论 丹红注射液配合中药熏洗治疗DPN疗效确切.     

参麦注射液联合米力农治疗慢性肺心病心力衰竭的疗效观察

目的观察参麦注射液联合米力农治疗慢性肺心病心力衰竭的疗效。方法选择我院收治的慢性肺心病心力衰竭患者78例,随机分为观察组39例和对照组39例,对照组给予常规治疗及乳酸米力农注射液静脉滴注,观察组在对照组基础上再予参麦注射液静脉滴注,两组均治疗20天为1个疗程。结果经治疗1个疗程后,观察组显效16例,有效17例,无效6例,总有效率为84.62%,对照组显效11例,有效16例,无效12例,总有效率为69.23%,观察组疗效明显优于对照组(P0.05)。结论参麦注射液联合米力农治疗慢性肺心病心力衰竭疗效较好,故值得推广。     

凯西莱注射液治疗慢性乙型肝炎并脂肪肝36例

目的:观察凯西莱注射液治疗慢性乙型肝炎并脂肪肝的疗效。方法:采用凯西莱注射液300mg溶于5％葡萄糖注射液250ml中静脉滴注,1次/d,疗程4周,观察主要症状体征、肝功能、血脂、血常规、乙肝病毒指标、B超等的变化。结果:36例患者中显效16例(44.4％),有效11例(30.6％),无效9例(25％),治疗后患者ALT总有效率为77.8％,AST为44％,TBil为56％,甘油三酯治疗后较治疗前明显降低(P<0.0)。结论:凯西莱对慢性乙型肝炎并脂肪肝治疗疗效确切,临床使用安全,不良反应少,是新型代谢改善解毒剂,值得临床推广应用。     

利福平注射液治疗结核性胸膜炎104例疗效观察

目的探讨利福平注射液治疗结核性胸膜炎临床疗效及其不良反应。方法选择初治单侧结核性胸膜炎患者104例,应用利福平注射液后,进行疗效及不良反应观察,随机选择39例（治疗组）与口服利福平组（对照组）比较,分别观察半个月、1个月、2个月疗效,结果第一个月末两组显效率分别为76．99％、25．6％,有效率分别为92．3％、69．2％;第二月末两组显效率分别为84．6％、56．4％,有效率分别为94．8％、79．5％。治疗组胃肠道反应明显低于对照,其余肝功能、血常规等不良反应两组相近。结论利福平注射液治疗结核性胸膜炎有临床价值,疗效优于口服利福平胶囊。     

胰岛素瘤的解剖分布特点分析

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。     

Pathogenesis of carcinoma of the papilla of Vater

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.     

Demonstration of the mechanism of action of biguanides

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.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

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.     

血吸虫童虫生长发育及其机制的研究进展

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。     

124例耐多药结核分枝杆菌基因突变特征分析

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。     

氯硝柳胺悬浮剂的毒性评价

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。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

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     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

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.     

Study of constancy of hydrogen-consuming flora of human colon

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.