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陈明 《北京中医药》2006,25(3):135-138
目的观察健脾清化汤结合西药治疗耐药幽门螺杆菌(HP)相关性溃疡的临床疗效.方法将68例耐药HP相关性消化性溃疡患者,随机分为治疗组和对照组,在分别给予抗HP标准三联7d后,治疗组改用中药健脾清化汤3周,对照组改用奥美拉唑3周.疗程结束后,观察主要症状改善、胃镜变化、耐药HP根除情况及不良反应.结果在主要症状改善、耐药HP根除方面,中药加西药组明显优于西药组(P《0.05).结论中药健脾清化汤结合西药对耐药HP相关性溃疡有较好的临床疗效.  相似文献   
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陈秀萍 《北京中医药》2006,25(6):357-358
喘证在临床上可出现于许多急、慢性疾病过程中,如西医的急、慢性支气管炎,肺部感染,肺气肿,慢性肺源性心脏病,心力衰竭以及肾功能衰竭等.中医辨证有虚实之分.笔者自2004年以来,用金匮肾气丸加味治疗阳虚喘证90例,获得了良好效果.现报道如下.  相似文献   
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Diethylstilbestrol (DES), a non‐steroidal estrogen, has been found to cause altered germ cell development and disordered ovarian development in fish females. However, the mechanisms that might be involved are poorly understood. In this study, female juveniles of yellow catfish (Pelteobagrus fulvidraco) (120 days post‐hatching) were exposed to two doses (10 and 100 ng l?1) of DES for 28 days. After the endpoint of exposure, decreased ovary weight and gonadosomatic index, as well as various ovarian impairments were observed in response to DES. Besides, DES elevated the mRNA levels of vitellogenin 1 (vtg 1) and estrogen receptor 1 (esr 1) in liver and decreased 17β‐estradiol level in plasma. Correspondingly, suppressed mRNA levels of the key genes in the hypothalamic–pituitary–gonadal axis (such as cyp19a1b, gnrh‐II, fshβ and lhβ in brain and fshr, lhr and cyp19a1a in ovary) after DES exposure were also observed. The declined level of plasma 17β‐estradiol and altered gene expressions of genes in the hypothalamic–pituitary–gonadal axis were thus supposed to be closely related to the disrupted oogenesis in DES‐treated fish. Analyses further demonstrated that, higher concentration of DES elevated the expression ratio of bax/bcl‐2, indicating the enhanced apoptosis occurred in ovary. Moreover, DES upregulated the expressions of genes involved in proliferation (cyclin d1 and pcna), meiotic entry (cyp26a1 and scp3) and meiotic maintenance (dmc1), resulting in arrested oogenesis in catfish. The present study greatly extended our understanding on the mechanisms underlying of reproductive toxicity of DES on fish oogenesis.  相似文献   
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Background

Unintentional underfeeding is common in patients receiving enteral nutrition (EN), and is associated with increased risk of malnutrition complications. Protocols for EN in critically ill patients have been shown to enhance adequacy, resulting in better clinical outcomes; however, outside of intensive care unit (ICU) settings, the influence of a protocol for EN is unknown.

Objective

To evaluate the efficacy and safety of implementing an EN protocol in a noncritical setting.

Design

Randomized controlled clinical trial.

Participants and settings

This trial was conducted from 2014 to 2016 in 90 adult hospitalized patients (non-ICU) receiving exclusively EN. Patients with carcinomatosis, ICU admission, or <72 hours of EN were excluded.

Intervention

The intervention group received EN according to a protocol, whereas the control group was fed according to standard practice.

Main outcome measures

The proportion of patients receiving ≥80% of their caloric target at Day 4 after EN initiation.

Statistical analyses performed

Student t test or Wilcoxon rank-sum test were used for continuous variables and the difference between the groups in the time to receipt of the optimal amount of nutrition was analyzed using Kaplan-Meier curves.

Results

Forty-five patients were randomized to each group. At Day 4 after EN initiation, 61% of patients in the intervention arm had achieved the primary end point compared with 23% in the control group (P=0.001). In malnourished patients, 63% achieved the primary end point in the intervention group compared with 16% in the control group (P=0.003). The cumulative deficit on Day 4 was lower in the intervention arm compared with the control arm: 2,507 kcal (interquartile range [IQR]=1,262 to 2,908 kcal) vs 3,844 kcal (IQR=2,620 to 4,808 kcal) (P<0.001) and 116 g (IQR=69 to 151 g) vs 191 g (IQR=147 to 244 g) protein (P<0.001), respectively. The rates of gastrointestinal complications were not significantly different between groups.

Conclusions

Implementation of an EN protocol outside the ICU significantly improved the delivery of calories and protein when compared with current standard practice without increasing gastrointestinal complications.  相似文献   
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In clinical therapy, the poor prognosis of hepatocellular carcinoma (HCC) is mainly attributed to the failure of chemotherapeutical agents to accumulate in tumor as well as lack of potency of tumor penetration. In this work, we developed actively tumor-targeting micelles with pH-sensitive linker as a novel nanocarrier for HCC therapy. These micelles comprised biodegradable poly(ethylene glycol)-poly(aspartate) polymers, in which paclitaxel can be covalently conjugated to pAsp via an acid-labile acetal bond to form pH-responsive structures. In vitro drug release studies showed that these structures were stable in physiological condition, whereas collapsed once internalized into cells due to the mildly acidic environment in endo/lysosomes, resulting in facilitated intracellular paclitaxel release. In addition, dehydroascorbic acid and guanidinopropyl methacrylamide polymers were decorated on the surface of micelles to achieve specific tumor accumulation and tumor penetration. Cellular uptake and in vivo imaging studies proved that these micelles had remarkable targeting property toward hepatocarcinoma cells and tumor. Enhanced anti-HCC efficacy of the micelles was also confirmed both in vitro and in vivo. Therefore, this micellar system may be a potential platform of chemotherapeutics delivery for HCC therapy.  相似文献   
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