幽门螺杆菌感染根除与老年消化性溃疡发生、复发关系的研究

目的　探讨老年消化性溃疡发生、复发与幽门螺杆菌 (Hp)感染的关系。方法　应用 PCR法对 78例老年性消化性溃疡幽门螺杆菌感染及幽门螺杆菌感染根除治疗后半年、 1年幽门螺杆菌再感染者进行了测定。结果　幽门螺杆菌检出率老年组明显高于青年组 ,Hp根治率青年组明显高于老年组 ,经 Hp根除治疗组溃疡愈合率明显高于未根除治疗组。结论　老年消化性溃疡发生与幽门螺杆菌感染密切相关 ,在溃疡治疗中 ,根除 Hp感染对减少溃疡复发具有重要临床意义     

关于消化性溃疡的产生、复发与幽门螺杆菌感染关系的探讨

目的:探讨老年消化性溃疡发生、复发与幽门螺杆菌(Hp)感染的关系.方法:应用PCR法对68例老年消化性溃疡幽门螺杆菌感染及撤底治疗后6mo,1a对幽门螺杆菌再感染者进行测定.结果:老年组幽门螺杆菌感染率明显高于青年组,Hp治愈率明显低于青年组,Hp撤底根除治疗组溃疡愈合率明显高于未根除治疗组.结论:老年消化性溃疡发生与幽门螺杆菌感染密切相关,在溃疡治疗中,根除Hp感染对减少溃疡复发有密切关系.     

三联疗法治疗老年幽门螺杆菌阳性消化性溃疡患者的最佳时效

目的探讨三联疗法治疗老年幽门螺杆菌阳性消化性溃疡患者的最佳时效。方法选取100例老年幽门螺杆菌阳性消化性溃疡患者作为研究对象,采用随机数字表法将100例患者分为三组,患者均采用奥硝唑、雷贝拉唑和铝碳酸镁标准三联方案,每日用药两次。组1患者服药7 d,组2患者服药10 d,组3患者服药14 d。观察并比较三组患者的幽门螺杆菌根除率、溃疡愈合率以及不良反应发生情况。结果三组患者幽门螺杆菌根除率比较有统计学差异(均P0.05),组1显著低于组2和组3(均P0.05),组2和组3比较无统计学差异(P0.05)。三组患者的溃疡愈合率比较无统计学差异(P0.05)。组1、2不良反应发生率明显低于组3(均P0.05);组1和组2比较无统计学差异(P0.05)。结论三联疗法10 d疗程是治疗老年幽门螺杆菌阳性消化性溃疡的较好实验方案。     

幽门螺杆菌相关性胃癌患者局部Th1/Th2细胞免疫应答变化

背景:幽门螺杆菌(Hp)感染与胃癌发生相关,免疫应答可能是其主要致病机制之一。目的:探讨Hp相关性胃癌患者黏膜局部Th1/Th2细胞免疫应答变化。方法:选取2011年1～6月27例胃癌患者和28例对照者,采用14C-尿素呼气试验、Hp抗体检测Hp感染,免疫组化法检测胃黏膜局部干扰素(IFN)-γ和白细胞介素(IL)-4表达情况。结果:Hp总体感染率为61.8%。Hp阳性患者中,胃癌组IFN-γ表达明显低于对照组(P<0.05),IL-4表达明显高于对照组(P<0.05);Hp阴性患者中,胃癌组IFN-γ、IL-4表达与对照组均无明显差异(P>0.05)。Hp阳性胃癌患者IL-4表达明显高于Hp阴性胃癌患者(P<0.05),Hp阳性对照组IFN-γ表达明显高于Hp阴性对照组(P<0.05)。结论:Hp阳性对照者以Th1细胞介导的免疫应答为主,Hp阳性胃癌患者以Th2细胞为主。黏膜局部Th1/Th2细胞免疫应答变化可能与Hp感染相关疾病的进展,特别是胃癌的发生密切相关。     

四联疗法与常规三联疗法对幽门螺杆菌首次根除失败患者炎症因子的影响以及疗效对比

[目的]考察四联疗法与常规三联疗法对幽门螺杆菌(Hp)感染首次根除失败胃溃疡患者炎症因子的影响以及临床疗效分析。[方法]将Hp感染首次根除失败患者100例随机分为研究组和对照组,每组50例。对照组患者给予莫西沙星+雷贝拉唑+阿莫西林三联方案治疗,研究组患者给予莫西沙星+雷贝拉唑+阿莫西林+果胶铋四联方案治疗。IL-10和IL-6炎症因子采用酶联免疫检测法检测。对比2组患者的Hp根除率、溃疡愈合率以及不良反应。[结果]治疗前2组患者炎症因子差异无统计学意义(P0.05),治疗后2组IL-10和IL-6表达水平均与治疗前存在统计学差异(P0.05和P0.01),治疗后研究组IL-10显著高于对照组(P0.05),治疗后研究组IL-6显著低于对照组(P0.01)。研究组和对照组Hp根除率分别为90.0%(45/50)和74.0%(37/50),溃疡愈合率分别为92.0%(46/50)和78.0%(39/50)。研究组Hp根除率及溃疡愈合率均显著高于对照组(P0.05)。2组患者治疗后不良反应发生率研究组为16.0%,对照组为14.0%,2组间差异无统计学意义(P0.05)。[结论]四联疗法比常规三联疗法治疗幽门螺杆菌感染首次根除失败胃溃疡患者更有利于炎症状态改善,临床效果更优,患者安全可靠具有临床应用价值。     

微生态制剂在根除幽门螺杆菌治疗中的价值

[目的]探讨微生态制剂在根除幽门螺杆菌治疗中的价值。[方法]选取初次就诊仅十二指肠球部活动期溃疡且幽门螺杆菌阳性,并能积极配合完成治疗的患者84例,将其随机分为A组、B组、C组。A组:常规四联疗法(泮托拉唑+胶体果胶铋+阿莫西林+呋喃唑酮),B组:常规四联疗法+双歧三联活菌胶囊,C组:常规四联疗法+乳酸菌素片;3组疗程均为6个月。于治疗后2周、4周,分别检测各组患者的溃疡愈合情况和小肠细菌生长情况,于治疗6个月时检查幽门螺杆菌根除情况,并进行组间两两比较。[结果]1溃疡愈合情况:治疗2周时,愈合总有效率:C组(96.43%)B组(85.71%)A组(78.57%),治疗4周时,愈合总有效率:C组(100%)B组(89.29%)A组(82.14%),C组与B组、A组比较差异有统计学意义(P0.05),但B组与A组比较差异无统计学意义(P0.05)。2小肠细菌生长情况:治疗2周时,3组两两间比较差异有统计学意义(P0.01);治疗4周时,A组与B组、C组比较差异均有统计学意义(P0.05),但B组与C组比较差异无统计学意义(P0.05)。3幽门螺杆菌根除情况:治疗6个月时,幽门螺杆菌根除率C组(92.86%)B组(82.14%)A组(57.14%),组间比较差异有统计学意义(P0.01)。[结论]在根除幽门螺杆菌治疗中,应用微生态制剂能快速、稳定地促进溃疡愈合,并能有效降低肠道菌群失调,显著提高幽门螺杆菌的根除率,应用死菌制剂(乳酸菌素片)效果更明显,值得临床推广。     

老年消化性溃疡患者血清Ⅰ型胶原氨基端前肽、胃泌素水平及其与幽门螺杆菌感染的关系

目的探讨老年消化性溃疡患者血清Ⅰ型胶原氨基端前肽(PINP)、胃泌素水平及其与幽门螺杆菌(Hp)感染的关系。方法选取该院老年消化性溃疡患者89例作为研究组,同期选取健康体检者87例作为对照组,采用竞争放射免疫分析法测定血清胃泌素水平,采用双抗体酶联免疫吸附(ELISA)法测定血清PINP水平。结果研究组血清PINP水平明显低于对照组,血清胃泌素水平明显高于对照组(P0.05)。老年消化性溃疡患者Hp阳性率为73.03%(65/89),其中Hp阳性组血清PINP水平明显低于Hp阴性组,血清胃泌素水平明显高于Hp阴性组(P0.05)。胃溃疡患者Hp根除率为81.25%,十二指肠溃疡患者Hp根除率为90.91%,比较无统计学差异(P0.05),根除Hp治疗后,血清PINP水平明显高于根除Hp治疗前,胃泌素水平明显低于根除Hp治疗前(P0.05)。经Pearson相关性分析显示,血清PINP与Hp感染呈负相关(r=-0.521,P0.05),血清胃泌素水平与Hp感染呈正相关(r=0.613,P0.05)。结论老年消化性溃疡患者血清PINP明显降低,胃泌素水平明显升高,其中合并Hp感染PINP水平降低幅度更明显,胃泌素水平升高幅度更明显,两者水平与Hp感染具有紧密的关系。     

幽门螺杆菌感染对肝硬化患者高氨血症的影响

目的观察肝硬化患者合并幽门螺杆菌(Hp)感染与高氨血症的关系。方法采用尿素酶快速试验(RUT),14C-尿素呼气试验(14C-UBT)和血清抗Hp抗体测定,对64例肝硬化患者行幽门螺杆菌检测和血氨测定。对Hp阳性者给予根除治疗后复查血氨,比较根除治疗前后血氨浓度。结果肝硬化患者Hp感染率为67.2%,在根除Hp治疗后血氨浓度明显下降,与根除前相比差异有显著性(P<0.05);Hp阳性者与Hp阴性者血氨浓度比较差异有显著性(P<0.05)。结论Hp感染可导致肝硬化患者血氨升高,根除Hp后可使血氨水平明显下降。     

康复新液治疗胃溃疡60例临床研究

目的分析探讨康复新液治疗幽门螺杆菌阳性的胃溃疡的作用。方法选取州市富阳区第二人民医院2013年5月至2014年6月收治的胃溃疡患者120例作为临床研究对象,随机分为观察组和对照组,每组各60例。对照组患者给予埃索美拉唑、阿莫西林、克拉霉素进行治疗,观察组患者在对照组的基础上加用康复新液。比较两组患者的临床症状改善情况、溃疡病灶愈合情况、幽门螺杆菌根除率以及用药不良反应率。结果根据统计结果,观察组患者的临床症状改善总有效率为95.00%,明显高于对照组患者的83.33%(P0.05);观察组患者的溃疡病灶愈合总有效率为90.00%,明显高于对照组患者的80.00%(P0.05);观察组患者的用药不良反应率和幽门螺杆菌根除率比较结果无明显差异性(P0.05)。结论康复新液对幽门螺杆菌感染导致的胃溃疡具有良好的临床治疗效果,值得推广使用。     

肝炎患者血清IL-12、IFN-γ和IL-10检测的意义

目的:探讨检测IL-12、IFN-γ和IL-10对病毒性肝炎患者的临床意义。方法:利用ELISA法检测97例病毒性肝炎患者血清IL-12、IFN-γ和IL-10水平,动态观察45例接受免疫增强剂治疗的慢性肝炎患者上述细胞因子的变化。结果:急性肝炎患者血清IL-12及IFN-γ水平均明显升高(P<0.01);慢性肝炎、肝硬化患者血清中IL-10明显高于正常对照组(P<0.01)。免疫增强剂治疗获得完全应答反应的患者治疗期间血清IL-12、IFN-γ水平明显上升(P<0.01),IL-10水平下降(P<0.05),无应答者治疗过程中上述细胞因子无明显变化。结论:Thl型免疫应答对机体清除病毒起关键作用;Th2型免疫应答与感染慢性化及疾病持续发展有关;免疫治疗可使部分Th2型免疫应答占优势的慢性肝炎患者转化为Th1型占优势。     

青少年高血压的研究进展

随着人们生活和行为方式的改变,高血压发病明显呈年轻化趋势。在青少年时期识别高血压病高危人群有助于早期进行有效干预和治疗,降低未来高血压的发生率及其严重性。现试从青少年高血压的诊断、发病因素、特点、治疗策略等方面的研究进展作一综述。     

Morbidity in cardiovascular diseases in immigrants in Sweden

INTRODUCTION: Although immigration to Sweden has increased in the last few decades, the incidence rates of cardiovascular disease and coronary heart disease in immigrants are unknown. The aim of the present study is to estimate whether place of birth affects the incidence rates of cardiovascular disease and coronary heart disease. MATERIAL AND METHODS: The study was designed as a follow-up study on morbidity in cardiovascular disease and coronary heart disease between 1 January 1997 and 31 December 1998, including three and a half million persons with age range 35-64 years, of whom 550 000 were born abroad, from the database MigMed consisting of the whole Swedish population. Incidence rates and relative risks were estimated by indirect standardization and a proportional hazard model. RESULTS: The age-adjusted risk of coronary heart disease was higher in most foreign-born groups than in Swedes. For example, in nine of 12 male groups, the relative risks varied between 1.1 and 2.2, and in seven of 12 female groups, the relative risks varied between 1.4 and 2.5. When also adjusting for level of education and employment status, the risks were still high, but on a lower level. CONCLUSIONS: Foreign-born people possess an over-risk of cardiovascular or coronary heart disease(CVD/CHD) compared with Swedish-born persons, also when level of education and employment status are taken into account.     

C·肉毒杀鼠素(冻干剂)应用研究

目的为研究C·肉毒杀鼠索对杀灭达乌尔黄鼠(简称黄鼠)的大面积应用情况和对家畜、家禽的毒害作用,进行了C·肉毒杀鼠素的应用研究.方法大面积投毒采用ES-2药饵撒播机[1],间隔约80m进行条投.羊、鸡采用直接灌胃.结果大面积应用的灭鼠率为83.72%.对羊、鸡最高剂量分别为500万MLD、150万MLD,均未出现中毒现象.结论 C·肉毒杀鼠素是较为理想的草原大面积杀灭黄鼠的理想、首选药物.     

高龄老年高血压的临床研究进展

随着社会老龄化进程的加快,80岁以上高龄老人的绝对数量以及占总人口的比例均在增加,如何提高高龄老年高血压的防治水平备受关注。现试从高龄老年高血压的临床特点、治疗策略等方面的临床研究进展作一综述。     

中国老年性耳聋的研究与干预进展

老年性耳聋已成为影响我国老年人生活质量的最主要的慢性病之一。助听器是目前帮助听力损失的老年人克服交流障碍的主要手段。在我国,数字助听器已逐渐取代模拟助听器并且体现出了更好的效果。但是老年听力损失患者中使用助听器的比例仍然很小。人工耳蜗植入也已被应用在老年患者中。我国针对老年人的听力康复服务还有较长的路要走。     

Sex Differences in Ethanol-induced Dopamine Release in Nucleus Accumbens and in Ethanol Consumption in Rats

In vivo microdialysis was used to examine changes in nucleus accumbens and striatal dopamine, dihydrophenylacetic acid (DO-PAC), and homovanillic acid (HVA) following acute administration of ethanol (0.0, 0.25, 0.5, 1.0, or 2.0 g/kg) in male and female Long-Evans rats. Following dialysis, rats were trained to bar-press for oral ethanol reinforcement. In nucleus accumbens, females showed significant increases in extracellular dopamine following 0.25 or 0.5 g/ kg ethanol, but did not show significant increases over baseline at the higher doses. Males showed slight increases in dopamine at the lower doses and decreased dopamine at 2.0 g/kg. In striatum, both sexes showed increased dopamine at the lower doses and decreased dopamine at 2.0 g/kg. There were slight increases in nucleus accumbens DOPAC and HVA at some doses in both sexes, but no changes in striatal metabolite levels. In addition to showing increased responsiveness to ethanol-induced mesolimbic dopamine stimulation, females consumed more ethanol than males during behavioral testing. The pattern of both greater ethanol-induced nucleus accumbens dopamine release and greater ethanol consumption in females supports the hypothesis that ethanol reward is mediated, at least in part, by the mesolimbic dopamine system.     

Epstein-Barr virus in malignancies in renal transplant recipients in Japan

A role for Epstein-Barr virus (EBV) in the development of malignancies including lymphomas, and carcinoma of the stomach, nasopharynx, thymus and salivary gland is suggested. It is indicated that EBV evokes polyclonal-B-cell-proliferative diseases in immunocompromised hosts, such as transplant patients, which results in monoclonal malignant lymphomas. The suppression of immune functions in these patients is thought to lead to incomplete elimination of the cells expressing EBV latent infection genes. To examine the etiological role of EBV in the development of malignancies following renal transplant in Japan, 42 malignancies in 1744 cases of renal transplant were studied for the presence and type of EBV. The polymerase chain reaction revealed that 5 malignancies were positive for EBV, all type A: 2 of 2 cases of non-Hodgkin's lymphoma (NHL), 2 of 8 cases of gastric adenocarcinoma of the common type, and 1 of 2 cases of gastric plasmacytoma. In situ hybridization revealed positive signals in the nucleus of tumor cells in 2 cases of NHL and 1 of plasmacytoma. Positive signals were found in the small lymphoid cells but not in the tumor cells in 2 cases of gastric carcinoma. On the basis of these findings, a role for EBV in the development of malignancies in renal transplant patients is unlikely except for lymphoid neoplasias.Abbreviations PCB polymerase chain reaction - EBV Epstein-Barr virus - NHL non-Hodgkin's lymphoma     

糖尿病大鼠心室肌细胞钾通道的改变

目的研究糖尿病大鼠心室肌细胞钾通道的改变及增加葡萄糖代谢对其的作用。方法取体重150～200g的雄性SpragueDawley大鼠,腹腔注射链脲菌素(STZ)建立糖尿病模型,采用酶解法获得单个心室肌细胞,应用膜片钳全细胞记录技术记录钾电流。结果糖尿病大鼠心室肌细胞瞬间外向性钾流(Ito)密度较对照组显著降低[ 60mV时,分别为(15.90±1.19)pA/pF(n=25)和(28.55±0.97)pA/pF(n=12),P<0.001];分别用100nmol/L胰岛素及1.5mmol/L二氯乙酸在体外预处理心室肌细胞4～5h和3～4h使Ito密度恢复至对照组水平[ 60mV时,分别为(29.40±0.38)pA/pF(n=20)和(27.35±0.97)pA/pF(n=12)]。结论糖尿病大鼠心室肌细胞钾通道功能发生改变,增加葡萄糖代谢可逆转这一改变,提示葡萄糖代谢与Ito功能间存在一定关系。