卵巢低反应辅助治疗的研究进展

改善卵巢低反应患者体外受精-胚胎移植(IVF-ET)的妊娠结局对生殖医生来说是巨大的挑战.虽然随着辅助生殖技术(ART)水平的不断提高,人们对卵巢低反应的认识不断增加,但到目前为止,其发病的具体机制仍未明了,且缺乏统一的诊断标准.同时,在改善卵巢低反应患者的IVF-ET周期结局的策略方面存在很大的争议.阐述了改善卵巢低反应者的周期结局的辅助治疗及其新观点,即在不改变控制性促排卵方案的前提下,在促排卵周期或前期添加辅助治疗药物,以改善卵巢低反应患者的IVF-ET的周期结局,如添加生长激素、睾酮、脱氢表雄酮、黄体生成激素、口服避孕药或雌二醇.     

Chemopreventive Potential of Natural Compounds in Head and Neck Cancer

Head and neck squamous cell carcinoma (HNSCC) is one of the most fatal cancers worldwide. Despite advances in the management of HNSCC, the overall survival for patients has not improved significantly due to advanced stages at diagnosis, high recurrence rate after surgical removal, and second primary tumor development, which underscore the importance of novel strategies for cancer prevention. Cancer chemoprevention, the use of natural or synthetic compounds to prevent, arrest, or reverse the process of carcinogenesis at its earliest stages, aims to reverse premalignancies and prevent second primary tumors. Genomics and proteomics information including initial mutation, cancer promotion, progression, and susceptibility has brought molecularly targeted therapies for drug development. The development of preventive approaches using specific natural or synthetic compounds, or both, requires a depth of understanding of the cross-talk between cancer signaling pathways and networks to retain or enhance chemopreventive activity while reducing known toxic effects. Many natural dietary compounds have been identified with multiple molecular targets, effective in the prevention and treatment of cancer. This review describes recent advances in the understanding of the complex signaling networks driving cancer progression and of molecularly targeted natural compounds under preclinical and clinical investigation.     

Vitamin C—An Adjunctive Therapy for Respiratory Infection,Sepsis and COVID-19

There are limited proven therapies for COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19. This literature review focuses on vitamin C deficiency in respiratory infections, including COVID-19, and the mechanisms of action in infectious disease, including support of the stress response, its role in preventing and treating colds and pneumonia, and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2–8 g/day) may reduce the incidence and duration of respiratory infections and intravenous vitamin C (6–24 g/day) has been shown to reduce mortality, intensive care unit (ICU) and hospital stays, and time on mechanical ventilation for severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and the frequency of vitamin C deficiency in respiratory infections, it may be worthwhile testing patients’ vitamin C status and treating them accordingly with intravenous administration within ICUs and oral administration in hospitalised persons with COVID-19.     

慢性阻塞性肺疾病的治疗

慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）是以慢性气流受限不完全可逆并呈进行性发展为特点的一种慢性呼吸系统疾病。我国不少学者将慢性支气管炎、支气管哮喘和肺气肿列于COPD范围。2003年慢性阻塞性肺疾病全球倡议（GOLD）推荐对急性患者在使用支气管舒张剂的基础上,吸入糖皮质激素。各国对其的研究治疗也日益重视。笔者拟对国内外COPD治疗研究现状作一综述。     

Colostrum Therapy for Human Gastrointestinal Health and Disease

There is increasing awareness that a broad range of gastrointestinal diseases, and some systemic diseases, are characterized by failure of the mucosal barrier. Bovine colostrum is a complex biological fluid replete with growth factors, nutrients, hormones, and paracrine factors which have a range of properties likely to contribute to mucosal healing in a wide range of infective, inflammatory, and injury conditions. In this review, we describe the anatomy and physiology of the intestinal barrier and how it may fail. We survey selected diseases in which disordered barrier function contributes to disease pathogenesis or progression, and review the evidence for or against efficacy of bovine colostrum in management. These disorders include enteropathy due to non-steroidal anti-inflammatory drugs (NSAIDs), inflammatory bowel disease (IBD), necrotizing enterocolitis, infectious diarrhea, intestinal failure, and damage due to cancer therapy. In animal models, bovine colostrum benefits NSAID enteropathy, IBD, and intestinal failure. In human trials, there is substantial evidence of efficacy of bovine colostrum in inflammatory bowel disease and in infectious diarrhea. Given the robust scientific rationale for using bovine colostrum as a promoter of mucosal healing, further work is needed to define its role in therapy.     

Dietary Natural Products for Prevention and Treatment of Liver Cancer

Liver cancer is the most common malignancy of the digestive system with high death rate. Accumulating evidences suggests that many dietary natural products are potential sources for prevention and treatment of liver cancer, such as grapes, black currant, plum, pomegranate, cruciferous vegetables, French beans, tomatoes, asparagus, garlic, turmeric, ginger, soy, rice bran, and some edible macro-fungi. These dietary natural products and their active components could affect the development and progression of liver cancer in various ways, such as inhibiting tumor cell growth and metastasis, protecting against liver carcinogens, immunomodulating and enhancing effects of chemotherapeutic drugs. This review summarizes the potential prevention and treatment activities of dietary natural products and their major bioactive constituents on liver cancer, and discusses possible mechanisms of action.     

Fibrinolytic Therapy in Thromboembolic Disease

Lytic therapy has been shown to be effective for pulmonary embolism and deep-vein thrombosis and seems promising for acute myocardial infarction. Ongoing trials should help establish its place in the management of thromboembolic disease.     

阿立哌唑辅助氟伏沙明治疗强迫障碍的临床观察

目的：探讨阿立哌唑辅助氟伏沙明治疗强迫障碍的临床疗效及安全性。方法：将54例强迫障碍患者随机分为两组（各27例）：阿立哌唑（2．5—10mg／d）辅助氟伏沙明（250—300mg/d）组（研究组）、氟伏沙明（250～300mg／d）组（对照组）,治疗观察期均为8周。两组患者于基线及治疗2、4、6、8周末分别评定Yale—Brown强迫量表（Y—BOCS）,并采用副反应量表（TESS）评定治疗期间的不良反应。结果：研究组、对照组分别脱落1例、2例。研究组的强迫思维和强迫行为评分在基线及2、4、6、8周末时点间比较差异均有统计学意义（P〈0．05）;2周末时,两组间的强迫思维评分比较差异有统计学意义（P〈0．05）,而强迫行为评分比较差异无统计学意义（P〉0．05）;4周末时,两组间的强迫行为评分比较差异有统计学意义（P〈0．05）;8周末时,两组间强迫症状有效率比较差异有统计学意义（P〈0．05）,而不良反应发生率比较差异均无统计学意义（P〉0．05）。结论：阿立哌唑辅助氟伏沙明可有效、持续地改善强迫障碍患者的强迫症状,且不良反应发生率与单一氟伏沙明治疗相当。     

Natural Vitamin D Content in Animal Products

Humans derive most vitamin D from the action of sunlight in their skin. However, in view of the current Western lifestyle with most daily activities taking place indoors, sun exposure is often not sufficient for adequate vitamin D production. For this reason, dietary intake is also of great importance. Animal foodstuffs (e.g., fish, meat, offal, egg, dairy) are the main sources for naturally occurring cholecalciferol (vitamin D-3). This paper therefore aims to provide an up-to-date overview of vitamin D-3 content in various animal foods. The focus lies on the natural vitamin D-3 content because there are many countries in which foods are not regularly fortified with vitamin D. The published data show that the highest values of vitamin D are found in fish and especially in fish liver, but offal also provides considerable amounts of vitamin D. The content in muscle meat is generally much lower. Vitamin D concentrations in egg yolks range between the values for meat and offal. If milk and dairy products are not fortified, they are normally low in vitamin D, with the exception of butter because of its high fat content. However, as recommendations for vitamin D intake have recently been increased considerably, it is difficult to cover the requirements solely by foodstuffs.     

Drug Therapy in Alcoholic Liver Disease

Drug therapy in patients with alcoholic liver disease may bedirected towards preventing the disease progessing, treatingcomplications such as ascites and hepatic encephalopathy, andtreating associated clinical problems such as the alcohol-withdrawalsyndrome. No drugs, with the possible exception of cortiscosteroids,modify the disease process significantly. Treatment of asciteshas improved in recent years with the use of aldosterone antagonistssuch as spironolactone, and lactulose has proved to be a usefuldrug in the management of hepatic encephalopathy. Sedativesand other drugs that depress central nervous system fuctionmust be used with great caution, particularly in patients whohave decompensated liver disease or who continue to drink heavily.The possibility of toxic side-effects must be considered beforeany drug is prescribed for a patient with alcoholic liver disease.     

葡萄糖酸钙锌口服溶液辅助治疗儿童轮状病毒肠炎疗效观察

目的评价葡萄糖酸钙锌口服溶液佐治轮状病毒性肠炎患儿的疗效。方法 150例轮状病毒性肠炎患儿分为对照组和观察组。对照组给予饮食疗法和液体疗法等对症治疗方式,观察组在对照组治疗方式的基础上,加用葡萄糖酸钙锌口服溶液治疗轮状病毒性肠炎患儿。结果观察组总有效率为97.33%高于对照组88.00%,差异显著(P<0.05)。结论葡萄糖酸钙锌口服溶液治疗轮状病毒性肠炎患儿疗效可靠。     

Iron Therapy in Inflammatory Bowel Disease

The most common complication seen in inflammatory bowel disease (IBD) patients is iron deficiency anaemia (IDA). Symptoms such as chronic fatigue can be as debilitating to IBD patients as pathological symptoms of abdominal pain and diarrhoea. Recognising and correcting anaemia may be as important as managing IBD symptoms and improving overall quality of life. Thus, iron replacement should be commenced the moment IDA is identified. Although intravenous iron is now considered standard treatment for IBD patients in Europe, oral iron still appears to be the preferred option. Advantages of oral iron include greater availability, lower costs and ease of applicability. However, its multitude of side effects, impact on the microbiome and further exacerbating IBD activity can have consequences on patient compliance. The newer oral iron formulations show promising safety and efficacy data with a good side effect profile. Intravenous iron formulations bypass the gastrointestinal tract absorption thereby leading to less side effects. Multiple studies have shown its superiority compared to oral formulations although its risk for hypersensitivity reactions continue to lead to clinician hesitancy in prescribing this formulation. This article provides an updated review on diagnosis and management of IDA in IBD patients, discussing the newer oral and intravenous formulations.     

雾化治疗在耳鼻喉科疾病治疗中的应用

雾化治疗,即以特定的方法将药物制成汽雾剂,用以防治疾病的方法。雾化治疗是人类防治疾病的方法之一,它为人类保健作出了应有的贡献。我国人民早在1400年前就已经掌握了它,并开始应用于临床。当今,雾化治疗有了长足发展,并广泛应用于临床各科室。笔者就雾化治疗在耳鼻喉科的应用综述如下。     

饮食疗法对高血压疾病患者预后的重要性

目的：分析饮食疗法对于治疗高血压患者的治疗效果,从而总结饮食疗法对高血压疾病患者预后的重要性。方法：回顾2010年1月-2012年11月在本院接受高血压治疗的50例患者的饮食治疗方法,并分析饮食疗法对于这些患者的治疗效果,进行总结。结果：50例患有高血压的患者在经过饮食疗法和药物治疗的双重治疗后,血压均得到了有效控制,病情基本好转,患者对于治疗效果非常满意。结论：饮食疗法能够有效地控制患者的血压,对于药物治疗起到了很好的辅助作用,对于高血压患者的治疗很有必要。