保守治疗膝骨性关节炎64例

[目的]观察保守疗法治疗膝骨性关节炎的临床疗效。[方法]64例全部采用新止骨增生丸结合透明质酸钠治疗。[结果]治愈38例,好转20例,未愈6例,总有效率约为90%。[结论]保守疗法治疗膝骨性关节炎可以起到很好的治疗作用。     

良性前列腺增生症的药物治疗与评价

目的:伴随老龄社会深化和人数增加,属于老年医学范畴的一组泌尿系统疾病(良性前列腺增生症、前列腺癌、前列腺炎、勃起功能障碍、早泄和膀胱过度活动症)的治疗正日益受到关注,用药情况呈明显上升趋势,本文对抗前列腺增生药的临床应用进行分析评价。方法:采用国内外文献分析方法。结果与结论:抗良性前列腺增生症药的合理和安全应用尤为重要。     

急性缺血性卒中静脉溶栓治疗后大脑中动脉再通患者的临床预后研究

目的：探讨急性缺血性卒中接受重组组织型纤溶酶原激活剂（ Recombinant Tissue Plasminogen Activa-tor,rt-PA）静脉溶栓治疗后大脑中动脉再通患者的临床预后情况。方法回顾性分析2013年9月至2014年9月,于天津市环湖医院神经内科接受静脉溶栓治疗的急性缺血性卒中患者资料552例。入选患者按照0．9 mg／kg剂量标准,给予rt-PA静脉溶栓治疗。所有患者于溶栓前及溶栓后24 h进行头部MRA检查,采用TICI血管再通分级标准判断大脑中动脉的再通情况。其中根据溶栓后24 h MRA检查结果分为血管再通组（188例）,血管未通组（364例）。溶栓前及溶栓后24 h的神经功能缺损评分及疗效判定,采用美国国立卫生研究院卒中量表（ National Institute of Health Stroke Scale,NIHSS）。神经功能的预后评价,采用改良Rankin评分（ modified Rankin Scale,mRS）。对2组患者溶栓后颅内出血（ intracranial hemorrhage,ICH）、症状性颅内出血（ symptomatic intracranial hemorrhage,SICH）的发生率、死亡率、神经功能缺损恢复及预后情况进行统计对比分析。结果血管再通组患者的恢复良好率和预后良好率均高于血管未通组,差异有统计学意义（ P ＜0．05）。血管再通组患者未出现症状性颅内出血,有6例患者出现了非症状性颅内出血。血管再通组及血管未通组的颅内出血发生率、其他部位出血率和住院期间死亡率差异均无统计学意义（P＞0．05）。结论研究结果表明,急性缺血性卒中患者在接受静脉溶栓治疗后,大脑中动脉再通的患者较未通患者神经功能缺损症状改善明显。静脉溶栓后,血管再通的患者临床预后获益更大。     

向日葵胰蛋白酶抑制剂SFTI的合成及酶抑制动力学研究

目的 考察合成的向日葵胰蛋白酶抑制剂的抑制效果,计算其抑制常数Ki.方法 采用Fmoc固相化学合成方法,反相柱纯化后用CytofluorTM微孔板发光检测仪测定向日葵胰蛋白酶抑制剂的抑制常数.结果与结论 向日葵胰蛋白酶抑制剂的Ki值为2.2nM±0.5(n=8),抑制效果良好.     

肺炎清止咳祛痰平喘作用的实验研究

目的：通过肺炎清的动物实验研究,探讨其止咳祛痰平喘作用.方法：参考相关文献制备小鼠模型,观察不同剂量肺炎清(大剂量组：每20 g小鼠用0.500 mL；中剂量组：每20 g小鼠用0.250 mL；小剂量组：每20 g小鼠用0.125 mL)对小鼠止咳、祛痰、平喘等作用.结果：止咳作用表明：肺炎清大、中、小剂量组均能够明显延长咳嗽潜伏期,减少咳嗽次数,与对照组比较差异有极显著性(P＜0.01)；祛痰作用表明：肺炎清大剂量组有明显祛痰作用,与对照组比较差异有显著性(P＜0.05).平喘作用表明：肺炎清大、中、小剂量组均能够明显抑制哮喘反应,潜伏期明显延长,与对照组比较差异有极显著性(P＜0.01).结论：肺炎清具有明显的止咳、祛痰、平喘等作用.     

经导管主动脉瓣置换术后抗栓治疗策略

目前,经导管主动脉瓣置换术(TAVR)后抗栓治疗方案尚不统一,因此为TAVR术后患者选择最佳的抗栓策略,实现个体化的抗栓治疗就成为了当前TAVR术后患者管理的重要内容。术后选择双联抗血小板、单药抗血小板和(或)抗凝治疗是目前TAVR术后抗栓治疗的主要策略。一方面目前TAVR适应证人群常合并肝肾功能不全、冠状动脉粥样硬化性心脏病、糖尿病、肿瘤、心房颤动等出血或血栓形成的高危因素,另一方面以术后影像学表现为主导的亚临床血栓是否需要更安全积极的抗栓方案尚无明确临床研究证据。该文探讨并梳理了TAVR术后抗栓治疗的进展。     

Triple Therapy-Based on Tegoprazan,a New Potassium-Competitive Acid Blocker,for First-Line Treatment of Helicobacter pylori Infection: A Randomized,Double-Blind,Phase III,Clinical Trial

Background/AimsWe examined the efficacy and safety of tegoprazan as a part of first-line triple therapy for Helicobacter pylori eradication.MethodsA randomized, double-blind, controlled, multicenter study was performed to evaluate whether tegoprazan (50 mg)-based triple therapy (TPZ) was noninferior to lansoprazole (30 mg)-based triple therapy (LPZ) (with amoxicillin 1 g and clarithromycin 500 mg; all administered twice daily for 7 days) for treating H. pylori. The primary endpoint was the H. pylori eradication rate. Subgroup analyses were performed according to the cytochrome P450 (CYP) 2C19 genotype, the minimum inhibitory concentration (MIC) of amoxicillin and clarithromycin, and underlying gastric diseases.ResultsIn total, 350 H. pylori-positive patients were randomly allocated to the TPZ or LPZ group. The H. pylori eradication rates in the TPZ and LPZ groups were 62.86% (110/175) and 60.57% (106/175) in an intention-to-treat analysis and 69.33% (104/150) and 67.33% (101/150) in a per-protocol analysis (non-inferiority test, p=0.009 and p=0.013), respectively. Subgroup analyses according to MICs or CYP2C19 did not show remarkable differences in eradication rate. Both first-line triple therapies were well-tolerated with no notable differences.ConclusionsTPZ is as effective as proton pump inhibitor-based triple therapy and is as safe as first-line H. pylori eradication therapy but does not overcome the clarithromycin resistance of H. pylori in Korea (ClinicalTrials.gov identifier {"type":"clinical-trial","attrs":{"text":"NCT03317223","term_id":"NCT03317223"}}NCT03317223).     

Recovery of complete left bundle branch block in a dilated cardiomyopathy patient after treatment with sacubitril/valsartan: A case report

Rationale:The treatment of dilated cardiomyopathy (DCM) has recently been greatly improved, especially with the widespread use of sacubitril/valsartan (ARNI) combination therapy. We know that ARNI-like drugs can significantly improve the symptoms of heart failure with reducing ejection fraction. However, clinical studies evaluating the safety and efficacy of ARNI in DCM-associated arrhythmia are limited, and whether individuals with arrhythmia would benefit from ARNI remains controversial. In this case, we report a patient with complete left bundle branch block (CLBBB) associated with DCM whose CLBBB returned to normal after treatment with ARNI.Patient concerns:A 38-year-old man was admitted to the hospital for 20 days for idiopathic paroxysmal dyspnea. He presented with exacerbated dyspnea symptoms at night, accompanied by cough and sputum.Diagnosis:Physical examination revealed a grade 4/6 systolic murmur could be heard in the apical area of the heart and mild edema was present in both lower limbs. Laboratory examination found that the B-type natriuretic peptide was significantly increased. Echocardiography indicated left atrial internal diameter, right ventricular internal diameter, and left ventricular diastolic diameter were enlarged and ejection fraction was significantly decreased. Besides, the pulsation of the wall was diffusely attenuated. Electrocardiogram was suggestive of tachycardia and CLBBB. A diagnosis of DCM with CLBBB was considered based on a comprehensive evaluation of the physical examination, laboratory examination, echocardiography and electrocardiogram.Interventions:The patient was treated with ARNI at a dose of 50 mg (twice a day) at first, gradually increasing to the target dose (200 mg, twice a day) in the following 9 months as shown in Table ​Table1,1, along with metoprolol 25 mg (once a day [qd]), diuretics 20 mg (qd), and aldosterone 20 mg (qd).Table 1Specific medications used in treatment.

血清β-人绒毛膜促性腺激素对甲氨蝶呤单次注射治疗异位妊娠结局的预测作用

目的 评估血清β-人绒毛膜促性腺激素(β-hCG)对甲氨蝶呤(MTX)单次肌内注射治疗异位妊娠疗效的预测价值.方法 回顾性分析2010年1月1日至2018年12月31日在海军军医大学(第二军医大学)长海医院接受MTX单次肌内注射治疗的96例异位妊娠患者的临床资料.患者均接受MTX 50 mg/m2单次肌内注射方案,定期...     

聚酰胺-胺型树枝状高聚合物介导survivin反义寡核苷酸抑制结直肠癌裸鼠皮下移植瘤生长的作用

目的 探讨聚酰胺-胺型树枝状高聚合物(PAMAM)介导survivin反义寡核苷酸(survivin-ASODN)对结直肠癌裸鼠移植瘤的抑制作用.方法 以人结直肠癌细胞SW620裸鼠皮下注射建立结直肠癌裸鼠皮下移植瘤模型.将PAMAM和阳离子脂质体分别与survivin-ASODN混合得到载反义基因转染复合物.透射电镜观察复合物的形态.激光散射粒径分析仪测定粒径,zeta电位分析仪测定复合物的zeta电位,离心法和紫外分光分度仪测定复合物的包封率和体外DNA释放速度.将两种反义基因复合物注射裸鼠移植瘤体内,观察两组移植瘤体积,Western bloting方法检测移植瘤组织中survivin基因的表达.结果 PAMAM-survivin-ASODN复合物的粒径小于脂质体-survivinASODN复合物的粒径(P〈0.01),而zeta电位高于PAMAM-survivin-ASODN复合物zeta电位(P<0.05),基因包封率两组无显著差异.PAMAM对DNA持续释放达14d.但脂质体复合物只持续5 d.PAMAM-survivin-ASODN复合物治疗组裸鼠移植瘤survivin蛋白表达低于脂质体-survivin-ASODN复合物组(P<0.05).PAMAM-survivin-ASODN复合物治疗组移植瘤体积低于脂质体-survivin-ASODN复合物组(P<0.05).结论 PAMAM能将survivin-ASODN高效递送到结直肠癌移植瘤细胞.降低survivin蛋白的表达,抑制移植瘤生长.