新型免疫抑制剂霉酚酸酯治疗狼疮性肾炎

目的观察新型免疫抑制剂霉酚酸酯(M.MF)治疗狼疮性肾炎的临床疗效和安全性。方法经肾活检证实的20例狼疮性肾炎,给予糖皮质激素联合MMF治疗。MMF初始剂量1.0～1.5g/d,治疗时间321个月,平均(10.9±6.2)个月。结果MMF治疗后24h尿蛋白定量从治疗前的平均5.55g下降至1.54g;d清白蛋白治疗前平均26.87g升至39g;6/8例肾功能不全患者3个月内Scr恢复正常;d清自身抗体产生明显减少,补体上升,其中ANA转阴率3个月达63％,6个月达81％;抗ds-DNA由治疗前23.77IU／ml下降至9.19IU／ml;2例重复活检,肾小球活动性病变明显减轻。MMF治疗的不良反应较少,偶有白细胞减少、感染、带状疱疹等。结论MMF对于各型狼疮性肾炎,尤其是Ⅳ型重症狼疮,经传统治疗无效者均有较好疗效,且长期应用不良反应少。     

The association between caudal block and urethroplasty complications of distal tubularized incised plate repair: experience from a South China National Children’s Medical Center

BackgroundThe effect of caudal block (CB) on the incidence of urethroplasty complications in hypospadias repair remains controversial. The evidence is conflicting, and some confounding bias issues need to be addressed. We sought to study a more homogenous group of distal hypospadias patients undergoing primary tubularized incised plate (TIP) repair by a senior pediatric urology surgeon in the past 2 years to examine the relationship between urethroplasty complications and the use of CB.MethodsWe reviewed our database to identify consecutive patients who had undergone hypospadias repairs by a senior director surgeon at our Center between January 2018 and November 2020. To be eligible to participate in the study, patients had to meet the following inclusion criteria: (I) have distal hypospadias; (II) have undergone a primary TIP repair; and (III) have attended follow-up appointments for a minimum period of 6 months. The primary outcome was the development of urethroplasty complications during the follow-up period. The principal variable of interest was whether or not CB was used perioperatively. The patients were categorized into a CB group (general anesthesia combined with CB) or a control group (general anesthesia only). Other potential risk factors were analyzed, including patient age at operation, patient weight, glans width, and the length of the urethral plate defect.ResultsThirty (12.2%) of the distal patients developed postoperative surgical complications. The postoperative surgical complication rates were similar between the different anesthesia groups. Weight, the length of the urethral plate length, and glans width did not contribute to the risk. Age was the only independent risk factor for postoperative surgical complications, and the complication rates increased in older patients.ConclusionsOur data from consecutive TIP repairs in distal hypospadias patients indicated no association between the use of CB anesthesia and the postoperative urethroplasty complication rate. Patients who were older in age when they underwent surgery had a higher risk of complications.     

Efficacy and tolerability of anti-asthma herbal medicine intervention in adult patients with moderate-severe allergic asthma

BACKGROUND: Chinese herbal medicine has a long history of human use. A novel herbal formula, anti-asthma herbal medicine intervention (ASHMI), has been shown to be an effective therapy in a murine model of allergic asthma. OBJECTIVE: This study was undertaken to compare the efficacy, safety, and immunomodulatory effects of ASHMI treatment in patients with moderate-severe, persistent asthma with prednisone therapy. METHODS: In a double-blind trial, 91 subjects underwent randomization. Forty-five subjects received oral ASHMI capsules and prednisone placebo tablets (ASHMI group) and 46 subjects received oral prednisone tablets and ASHMI placebo capsules (prednisone group) for 4 weeks. Spirometry measurements; symptom scores; side effects; and serum cortisol, cytokine, and IgE levels were evaluated before and after treatment. RESULTS: Posttreatment lung function was significantly improved in both groups as shown by increased FEV(1) and peak expiratory flow findings (P<.001). The improvement was slightly but significantly greater in the prednisone group (P<.05). Clinical symptom scores, use of beta(2)-bronchodilators, and serum IgE levels were reduced significantly, and to a similar degree in both groups (P<.001). T(H)2 cytokine levels were significantly reduced in both treated groups (P<.001) and were lower in the prednisone-treated group (P<.05). Serum IFN-gamma and cortisol levels were significantly decreased in the prednisone group (P<.001) but significantly increased in the ASHMI group (P<.001). No severe side effects were observed in either group. CONCLUSION: Anti-asthma herbal medicine intervention appears to be a safe and effective alternative medicine for treating asthma. In contrast with prednisone, ASHMI had no adverse effect on adrenal function and had a beneficial effect on T(H)1 and T(H)2 balance.     

膝骨关节病的关节镜诊断治疗

目的 通过对79例84膝骨关节病的关节镜诊断治疗回顾性总结,探讨高效率、创伤小、疗效佳的方法。方法 采用关节镜微创技术,结合术前检查对膝骨关节病分为：软骨破坏型,滑膜类型,游离体型及半月板型,依此施行有针对性,局限化手术治疗。结果 69膝得到6mo-3a的随访,按膝关节综合评分表评分,优20％,良59％,可和差21％。结论 该方法具有创伤小、康复快、并发症少等优点,在病损严重的病例,全膝置换或截骨术是进一步提高总体疗效的适宜选择。     

三味中药配伍应用对改善烫伤小鼠受损免疫功能的作用

目的　观察对烫伤小鼠受损免疫功能具有调理作用的单味中草药 ,经过配伍应用后的协同作用。方法　采用 1 .0 3 4× 1 0 5 Pa的蒸气烫伤 1 0s ,烫伤面积 1 6% ,深度为Ⅲ度的致伤模型烫伤动物。通过观察MΦ的吞噬功能、枯否细胞清除能力、MΦ抗原提呈功能、血清TNF量、淋巴细胞增殖反应及IL 2产生能力、小鼠抗体产生能力、PMNH2 O2 释放量及PMN溶菌酶释放量、血清补体的趋化作用和聚集作用等指标 ,籍以了解单味中药与配伍中药对烧 (烫 )伤小鼠受损免疫功能的调理作用。结果　单味中药三七(PP) ,金银花 (LJ)和虎杖 (PC)对小鼠受损免疫功能有一定的改善作用。PC +LJ、PP +PC、PP +LJ等二味配伍的中药 ,除少数指标外 ,均比单味药的作用好。而PP +LJ+PC三味配伍药的调理作用 ,比单味药和二味配伍药的调理作用更佳。结论　单味中药经配伍应用后对烧 (烫 )伤小鼠严重受损的免疫系统功能 ,具有比单味药更好的协同调理作用。     

睾丸原发性恶性淋巴瘤——附10例报道

目的报道10例睾丸原发性恶性淋巴瘤,并分析其临床表现、形态学牲及免疫表型。方法 采用HE及免疫组织化学方法,对标本切片进行染色,显微镜观察分析。结果患年龄为38～76岁,中位年龄56．25岁。临床表现主要为睾丸无痛性弥漫性肿大。病变部位：右侧5例,左侧4例,双侧1例。组织学形态均为恶性弥漫性非霍奇金淋巴瘤,免疫表型B细胞来源9例,T细胞来源1例。结论睾丸弥漫性无痛性肿大在中老年患应考虑睾丸原发性恶性淋巴瘤的可能,最后确诊要依靠病理形态学及免疫组织化学来证实。     

电化学聚合漆酚-锌金属螯合物合成及性质研究

以电化学方法合成了聚合漆酚（ＥＰＵ）,并用ＥＰＵ与二异丙氧基锌作用生成漆酚金属螯合物「ＥＰＵ－Ｚｎ（Ⅱ）」,采用原子发射光谱（ＡＥＳ）、ＦＴ－ＩＲ、ＤＭＴＡ、ＴＧ－ＤＴＡ和ＸＰＳ等对其进行表征,探讨其结构与性质。证明了螯合物中存在着因Ｚｎ（Ⅱ）和ＥＰＵ配位作用而引起的交联,故难溶于绝大多数的有机溶剂,玻璃化转变温度和耐热性能的提高。     

脑梗死患者急性期血小板膜糖蛋白表达的研究

目的　探讨脑硬死患者急性期血小板膜P -选择素 (CD6 2p)的表达及其与临床神经功能缺损程度的关系。方法　用流式细胞术测定 41例急性期脑梗死患者血小板膜CD6 2 p的表达。 结果　轻、中、重型脑梗死患者CD6 2 p的表达分别为 (1.38± 0 .2 9) %、(3.15± 1.5 8) %、(10 .46± 5 .0 7) % ,与正常对照组 (1.5 6± 0 .17) %比 ,轻型脑梗死患者CD6 2p的表达无显著性差异 (P >0 .0 5 ) ,中、重型脑梗死患者CD6 2 p的表达显著升高 (P <0 .0 5和0 .0 1)。结论　脑梗死患者急性期血小板膜CD6 2 p的表达与临床神经功能缺损程度有关。     

硫脲、硅酸盐对碳钢钝化作用的影响

本文利用化学方法,通过碳钢在含有ZnSO4,Na2HPO4与（NH2）2CS或Na2SiO3三者复配得4mol/L的（NH4）2CO3溶液中的阳极极化曲线的测定,分析得出：在特定的环境中,ZnSO4,Na2HPO4与9NH2）2CS或Na2SiO3三者复配物对碳钢都有较理想的钝化使用。