重组人干扰素α-2b凝胶治疗手足口病的疗效观察

120例患儿均为住院确诊手足口病病例,随机分两组进行治疗,在常规抗病毒及支持治疗法基础上,治疗组61例,采用重组人干扰素α-2b凝胶治疗;对照组59例,采用阿昔洛韦软膏治疗。观察两组治疗前后病情的变化。结果治疗组使用重组人干扰素α-2b凝胶治疗有效率明显高于对照组,P<0.05为差异有统计学意义。重组人干扰素α-2b凝胶治疗手足口病疗效好,均未见不良反应,值得推广及应用。     

聚乙二醇干扰素α-2a和重组人干扰素α-2b治疗慢性丙肝临床疗效观察

慢性丙型肝炎(CHC)是肝硬化及肝癌的高危因素.目前认为干扰素是治疗丙型肝炎有效的药物.本文通过对湖南省株洲市一医院75例丙型肝炎患者临床治疗观察分析,对比不同类型干扰素对慢性丙型肝炎的临床疗效,报告如下.     

聚乙二醇干扰素α-2a和重组人干扰素α-2b治疗慢性丙肝临床疗效观察

慢性丙型肝炎（CHC）是肝硬化及肝癌的高危因素。目前认为干扰素是治疗丙型肝炎有效的药物。本文通过对湖南省株洲市一医院75例丙型肝炎患者临床治疗观察分析,对比不同类型干扰素对慢性丙型肝炎的临床疗效,报告如下。     

α-2b干扰素治疗丙型肝炎疗效观察

本文作者应用α-2b干扰素（IFN）治疗20例急、慢性丙型肝炎（丙肝）患者，以同期收治而未用IFN治疗的病例作对照观察，考核了IFN对丙肝的临床疗效和远期疗效。现报告如下：     

干扰素α-2b联合利巴韦林颗粒及山宝皮宁治疗扁平疣68例疗效观察

目的观察干扰素α-2b联合利巴韦林颗粒及山宝皮宁治疗扁平疣的疗效。方法治疗组68例，肌注干扰素100万单位，口服利巴韦林颗粒，外用山宝皮宁。对照组65例，肌注聚肌胞2mg，外用酞丁胺搽剂。结果治疗组有效率为88．24％，对照组有效率为43．08％，两组治愈率比较差异有显著性（P〈0．01）。结论干扰素α-2b联合利巴韦林颗粒及山宝皮宁治疗扁平疣取得较好疗效，可供临床应用。     

重组人干扰素α-2b喷雾剂和注射液治疗带状疱疹

目的 对比观察重组人干扰素α-2b喷雾剂和注射液分别治疗带状疱疹的疗效、安全性和费用.方法 75例患者按就诊顺序随机分为重组人干扰素α-2b喷雾剂组(A组)、重组人干扰素α-2b注射液组(B组)和vitB1 、vitB12组(C组),用χ2检验比较有效率,并观察不良反应和统计治疗费用.结果 治疗组( A、B两组)疗效优于对照组(C组),差异有统计学意义(P＜0.05),A、B两组有效率比较差异无统计学意义(P＞0.05).A组治疗费用明显低于B组且不良反应小.结论 重组人干扰素α-2b喷雾剂和注射液治疗带状疱疹疗效均显著,但喷雾剂使用方便,是治疗带状疱疹经济、安全、有效的药物.     

异维A酸联合重组人干扰素a-2b软膏治疗扁平疣疗效观察

扁平疣是临床常见的病毒性皮肤病,治疗比较棘手,因其有碍美容,常对患者的心理和社会交往产生一定负面影响.我院2007年1月～12月采用异维A酸胶丸联合干扰素软膏治疗扁平疣30例,取得满意效果,现报告如下.     

冷冻联合α-2b干扰素凝胶治疗肛周尖锐湿疣的疗效观察Efficacy

目的观察冷冻联合α-2b干扰素凝胶治疗肛周尖锐湿疣的疗效。方法选取60例肛周尖锐湿疣患者,随机分为A、B、C三组,A组采用激光去疣后给予α-2b干扰素凝胶外用;B组患者先外涂派特灵液去疣后给予α-2b干扰素凝胶外用;C组采用冷冻联合α-2b干扰素凝胶外用。结果三组患者分别给予不同方案治疗后,A组和C组、B组和C组对比差异均具备统计学意义((P<0.05),A组和B组对比无显著差异,不具备统计学意义(P>0.05)。结论肛周尖锐湿疣采用冷冻联合α-2b干扰素凝胶治疗疗效显著。     

保妇康栓与重组人干扰素α-2b凝胶治疗慢性宫颈炎伴HPV感染的临床疗效

探讨保妇康栓与重组人干扰素α-2b凝胶对慢性宫颈炎伴HPV感染治疗的临床效果,为慢性宫颈炎伴HPV感染的治疗提供依据。选取2014年12月~2015年12月宫颈HPV感染的患者98例进行研究,按照临床试验数字随机的方法将患者分为两组,每组49例,对照组采用重组人干扰素α-2b凝胶进行治疗,观察组在此基础上联合保妇康栓进行治疗,观察两组治疗后有效率、治疗前后宫颈糜烂面以及随访6个月后复发情况、检测HPV-DNA情况。观察组有效率为95.92%,显著高于对照组的71.43%,差异有统计学意义(P0.05);3、6个月后观察组宫颈糜烂改善情况显著优于对照组(P0.05);观察组6个月随访HPV转阴率及复发率分别为95.92%和6.12%,显著优于对照组的71.43%和32.65%(P0.05)。保妇康栓联合重组人干扰素α-2b凝胶治疗宫颈HPV感染疗效显著,不仅提高了HPV转阴率,而且大大降低宫颈HPV感染的复发率,值得临床推广使用。     

α-2b干扰素治疗HBeAg阳性慢性乙型肝炎临床分析

目的 观察普通α-2b干扰素（IFN）和聚乙二醇干扰素（PEG IFN）α-2b治疗HBeAg阳性慢性乙型肝炎抗病毒的临床疗效.方法 HBeAg阳性慢性乙型肝炎患者64例,36例给予普通α-2b干扰素抗病毒治疗,每次500万U,皮下注射,每周3次; 28例给予聚乙二醇干扰素α-2b 1.0 μg/kg皮下注射,每周1次.疗程均为52周.结果 治疗结束时,普通干扰素组与PEG IFN组的完全应答率分别为52.8%、60.7%;部分应答率分别为27.8%、21.4%;无应答率分别为19.4%、17.9%,两组比较差异无统计学意义（P〉0.05）.治疗结束时普通干扰素α-2b组,PEG-IFN α-2b组丙氨酸氨基转移酶（ALT）复常率分别是81.7%、85.9%,二者比较差异无统计学意义（P〉0.05）.普通干扰素α-2b组与PEG-IFN α-2b组在52周治疗结束时HBV DNA阴转率分别为49.3%、57.6%,二者比较差异无统计学意义（P〉0.05）.结论 两种不同剂型的α-2b干扰素治疗HBeAg阳性慢性乙型肝炎的应答率相似,普通干扰素具有更好的成本效益.     

Advances in the treatment of hepatitis C: combination antiviral therapy with interferon alfa-2b and ribavirin

PURPOSE: To provide nurse practitioners with the information to manage patients with chronic hepatitis C (HCV) receiving a new combination drug therapy containing ribavirin and interferon alfa-2b. DATA SOURCES: Reviews of clinical trial results including large multicenter trials, Centers for Disease Control and Prevention documents, data from the drug manufacturer. CONCLUSION: This new therapy offers the potential for HCV remission or complete cure of the HCV infection. Although virologic responses are markedly improved with combination therapy, the side effects associated with combination therapy warrant regular patient monitoring, management, and medical intervention when clinically indicated. IMPLICATIONS FOR PRACTICE: Combination therapy does not significantly worsen the side effects associated with mono-therapy, which are predictable, manageable, and reversible. However, proper patient education, symptom management, vigilance for serious side effects, and monitoring of hematologic parameters are critical to patient outcome.     

针对性护理干预联合咪达唑仑静推对纤支镜治疗患者的疗效观察

目的观察针对性护理干预联合咪达唑仑静推对纤支镜治疗患者的疗效。方法选择肺结核、支气管结核患者160例,按照随机数表法分为研究组和对照组,各80例,对照组术前采用常规护理和常规麻醉,研究组患者给予针对性护理联合咪达唑仑静脉推注,麻醉后记录患者的血压(BP)、风险比(HR)、相对危险度(RR)、Sp O2波动情况;采用抑郁自评量表(SDS)和焦虑自评量表(SAS)对患者的抑郁和焦虑情绪进行评价,记录2组患者不良反应。结果麻醉后,研究组患者的BP、HR、RR、Sp O2波动值均较对照组小(P0.05);护理干预后,研究组患者焦虑评分显著低于对照组(P0.05);研究组患者总有效率为93.75%,对照组为70.00%,研究组有效率高于对照组(P0.05);研究组出现2例呛咳,1例中止检查,2例躁动;对照组出现10例呛咳,9例躁动,4例中止检查,研究组不良反应发生率较对照组小(P0.05)。结论针对性护理联合咪达唑仑静推能够显著提高纤支镜治疗的疗效,且安全有效,值得临床应用。     

Characterization of a novel HBB:c.194dup variant of the β-globin gene combined with six alpha genes

β-thalassemia (β-thal) is one of the most prevalent inherited blood disorders in Ganzhou, south China. Next-generation sequencing was used to screen for thalassemia carriers in the general population. During the screening, we identified a novel β-thal variant in a 46-year-old Chinese man, which was validated by Sanger sequencing. Based on the patient’s clinical data, this novel mutation was classified as severe β⁰. However, the patient was mildly anemic (hemoglobin, 89 g/L), which was inconsistent with typical β⁰ carrier characteristics. On further evaluation, quantitative PCR indicated the presence of six α genes, while molecular analysis and pedigree analysis revealed the coexistence of ααα^anti3.7 and ααα^anti4.2. Therefore, we report a novel β-thal variant combined with six α genes. We describe the patient’s clinical phenotype and the process of molecular diagnosis. This case extends the spectrum of thalassemia variants.     

依巴斯汀片联合重组牛碱性成纤维细胞生长因子凝胶及舒敏保湿特护霜治疗老年患者面部激素依赖性皮炎的临床效果

目的探讨依巴斯汀片联合重组牛碱性成纤维细胞生长因子凝胶及舒敏保湿特护霜治疗老年患者面部激素依赖性皮炎的临床效果。方法将60例老年面部激素依赖性皮炎患者随机分为对照组(外用生理盐水)、观察1组(外用重组牛碱性成纤维细胞生长因子凝胶)、观察2组(在观察1组基础上外用舒敏保湿特护霜),各20例,三组均口服盐酸依巴斯汀片。比较三组的治疗效果。结果观察2组的治疗起效时间短于对照组及观察1组(P<0.05)。治疗1周和1个月后,观察1组与观察2组的自觉症状和客观体征评分均低于对照组,且观察2组低于观察1组(P<0.05)。观察1组与观察2组的治疗总有效率无显著差异(P>0.05),但均高于对照组(P<0.05)。药物不良反应发生例数较少,为一过性,均不影响治疗。观察1组与观察2组的复发率无显著差异(P>0.05),但均低于对照组(P<0.05)。结论依巴斯汀片联合重组牛碱性成纤维细胞生长因子凝胶及舒敏保湿特护霜治疗老年患者面部激素依赖性皮炎安全有效,值得在临床推广。     

Clinical experience with nonstandard doses ofinterferon alfa-2b and ribavirin in the treatment of chronic hepatitis C infection: A retrospective analysis

Background:

Hepatitis C virus (HCV) infection is the most common blood-borne virus in the United States. Several mono- and combination therapies have been approved by the US Food and Drug Administration for the treatment of HCV, but their routes of administration, dosing approaches, eras of introduction, and actual use in clinical practice and resulting effectiveness have not yet been reported.

Objectives:

The aim of this article was to characterize clinical use and virologic response (VR) of the HCV treatments interferon alfa-2b plus ribavirin (IFN + RBV) and peginterferon alfa-2b plus ribavirin (peg-IFN + RBV).

Methods:

This retrospective chart review of office-based practices in theUnited States was conducted at 200 physicians' offices across the United States. We collected data concerning dosing patterns, VR (HCV RNA load, ≤1000 IU/mL or “negative” on polymerase chain reaction qualitative analysis), and adverse events (AEs) from the medical records of a geographically diverse sample of patients receiving treatment for chronic HCV infection in the United States from July 2001 to June 2002. For efficacy assessment, factors that were statistically different at baseline were adjusted using logistic regression. Providers also reviewed the medical records for symptoms or signs consistent with HCV treatment-related AEs.

Results:

Data from the records of 675 patients (423 men, 252 women; mean [SD] age of 45.5 [8.2] years; mean [SD] body weight, 80.8 [19.4] kg) were analyzed. At baseline, the IFN + RBV treatment group (330 patients) had significantly higher percentages of black patients (22.1% vs 15.7%; P = 0.032) and patients with hepatic disease based on clinician-reported cirrhosis and liver dysfunction (18.8% vs 9.9%; P < 0.001), and a significantly lower percentage of white patients (60.3% vs 69.6%; P = 0.012) compared with the peg-IFN + RBV treatment group (345 patients). The difference in log-transformed baseline HCV RNA loads between the 2 treatment groups in this study was <1 log unit. A significantly higher percentage of IFN + RBV-treated patients compared with peg-IFN + RBV-treated patients were prescribed HCV therapy on diagnosis (37.3% vs 29.9%; P = 0.041), and the mean (SD) duration of treatment was significantly different between the 2 treatment groups (52.5 [37.0] vs 27.5 [15.0] weeks; P < 0.001). Peg-IFN + RBV was associated with a higher rate of VR compared with IFN + RBV on univariate analysis (28.5% vs 17.5%; P = 0.018). Recommended doses of peg-IFN and higher-than-recommended doses of RBV were associated with an increased likelihood of VR. Higher-than-recommended doses of peg-IFN without a concomitant increase in RBV was not associated with an increased likelihood of VR. The incidences of the 3 most commonly reported AEs in the IFN + RSV group were significantly higher compared with those in the peg-IFN + RSV group: fatigue, 217 (65.8%) versus 185 (53.6%) patients (P = 0.001); depression, 147 (44.5%) versus 120 (34.8%) (P = 0.009); and anxiety, 87 (26.4%) versus 64 (18.6%) (P = 0.014). Nausea, however, was reported in a significantly higher number of patients in the peg-IFN group compared with the IFN + RBV group (74 [21.4%] vs 51 [15.5%]; P = 0.045). The frequencies of dose modification and treatment discontinuation due to AEs were similar between the 2 treatments and were similar to or less than those reported in other studies.

Conclusions:

In this retrospective data analysis of US office-based practicesconcerning HCV treatment, clinicians were observed to prescribe IFN + RBV at doses that differ from recommendations in the product information (PI), as well as prescribe the RBV component of peg-IFN + RBV at doses that differed from PI recommendations. Although patients treated with peg-IFN + RBV appeared to achieve higher VR compared with those treated with IFN + RBV in our analysis of data from clinical practice, peg-IFN + RBV was associated with lower VR rates compared with those reported in clinical studies.     

硅凝胶联合超脉冲CO2点阵激光术对剖宫产术后皮肤瘢痕的预防及治疗效果

目的探讨硅凝胶联合超脉冲CO₂点阵激光术对剖宫产术后皮肤瘢痕的预防及治疗效果。方法前瞻性研究纳入2018年7~8月东莞市松山湖中心医院收治的100例剖宫产术后患者作为研究对象,分为观察组和对照组,各50例。对照组不予任何干预。观察组于手术伤口拆线后立即予硅凝胶涂抹,每日3次,3个月为1个疗程;观察组完成硅凝胶疗程后,有28例患者产生瘢痕,均立即采用超脉冲CO₂点阵激光术治疗,每3个月1次,共3次。2组患者于产后3、6、9、12及18个月时采用温哥华瘢痕评分量表(VSS)对瘢痕形态进行评分,采用视觉模拟评分法(VAS)对瘢痕疼痛及瘙痒情况进行评分。记录观察组的临床疗效和治疗过程中发生的不良反应。结果产后3、6、9、12及18个月,观察组VSS评分[(6.00±1.31)、(5.38±1.35)、(4.78±1.23)、(4.20±1.1)、(3.92±1.00)分]、疼痛[(2.84±1.02)、(2.40±0.93)、(2.06±0.62)、(1.20±0.67)、(1.04±0.60)分]及瘙痒[(3.00±1.05)、(2.50±0.86)、(2.12±0.67)、(1.34±0.59)、(1.12±0.59)分]评分均呈逐渐下降趋势,且明显低于同一时间段对照组VSS评分[(6.60±1.56)、(6.44±1.25)、(6.38±1.21)、(6.46±1.51)、(6.48±1.47)分]、疼痛[(3.94±0.87)、(3.82±0.83)、(3.76±0.72)、(3.72±0.81)、(3.66±0.87)分]及瘙痒[(4.08±0.99)、(3.98±0.89)、(4.00±0.90)、(4.04±0.92)、(3.96±0.95)分]评分,差异均有统计学意义(P<0.05);而对照组VSS评分、疼痛及瘙痒评分均未见明显变化(P>0.05)。观察组经超脉冲CO₂点阵激光术治疗后9个月(产后18个月),治疗的总有效率达92.9%,总显效率82.1%。观察组不良反应发生率低:轻度色素沉着14.29%,持续性红斑7.14%。结论硅凝胶联合超脉冲CO₂点阵激光术对剖宫产术后皮肤瘢痕的预防及治疗效果满意,不良反应轻微,值得临床推广应用。     

上海地区145例慢性乙型肝炎患者HBV基因型与α-2b干扰素疗效关系的初步探讨

目的调查上海地区慢性乙型肝炎患乙型肝炎病毒(HBV)基因型分布状况，研究α-2b干扰素疗效与患HBV基因型的关系。方法用特异性引物PCR的方法鉴定上海地区145例乙型肝炎患的HBV基因型。对其中符合抗病毒治疗标准的22例患以α-2b干扰素进行治疗并观察疗效，疗程24周。分别在治疗前、治疗后12、24周进行血清生化学和病毒学的检测。结果145例乙型肝炎患中HBV基因型B型占60％，C型占36．6％，B、C混合型仅占3．4％。接受α-2b干扰素治疗的22例患中，感染HBV基因型B型的患33％取得了治疗联合应答，而C型仅为7％。结论上海地区HBV基因型流行以B型为主，其次为C型，B、C混合型较少见。本研究发现B基因型接受α-2b干扰素的应答率比C型为高，与献报道相仿，但经统计学检验差异无显性，值得进一步加以研究证实。     

TE化疗联合黄芪多糖注射液治疗中晚期乳腺癌临床疗效及对患者血清HER2-ECD TAP水平的影响

目的 探讨多西紫杉醇+表柔比星新辅助化疗联合黄芪多糖注射液治疗中晚期乳腺癌临床疗效及对患者血清人表皮生长因子受体-2胞外段、肿瘤异常糖链糖蛋白水平的影响.方法 将60例中晚期乳腺癌患者按随机数字表法分为两组,各30例.对照组给予多西紫杉醇+表柔比星新辅助化疗,观察组在对照组基础上联合黄芪多糖注射液治疗.观察4个疗程.比...