从血流动力学探讨活血化瘀治疗肝炎,肝硬化和肝癌

通过对肝炎、肝硬化和肝癌患者肝内微循环血流动力学的检测,发现肝内微循环血流动力学的病变贯穿其发病过程。血流动力学病变严重的病例预后较差。故治疗肝炎、肝硬化、肝癌时应重视活血化瘀和使用促进微循环开放的中药。为了使肝内微循环灌流量增加还应考虑使用能增加心脏排出量的中药。     

微创跖骨近端截骨联合Akin截骨术治疗重度 外翻

目的:探讨微创跖骨近端闭合楔形截骨术（proximal closing wedge osteotomy,PCWO）联合Akin截骨术治疗重度 外翻的临床疗效。 方法:选取2016年8月至2018年8月重度 外翻患者45例（50足）,其中男14例,女31例;年龄（40.1±13.0）岁（...     

CD4+CD25+调节性T细胞在慢性乙型肝炎患者免疫发病机制中的作用

目的:探探讨CD4~ CD25~ 调节性T细胞(regulatory T Cell,Treg)在慢性乙型肝炎(chronic hepatitis B,CHB)患者免疫发病机制中的作用以及其可能在治疗中的应用前景.方法:收集未经抗病毒治疗的CHB患者34例和健康对照18例外周血单个核细胞(peripheral blood mononuclear cell,PBMC)标本,以三色/四色流式分析法对PBMC中CD4~ CD25~ Treg的频率及表面分子表达进行分析,并同时通过磁珠分选去除CHB患者PBMC中的CD4~ CD25~ Treg,分别以MHC-肽-五聚体法和酶联斑点计数法(enzyme-linked immunospot assay,Elispot)检测HBV core18-27抗原肽刺激的对HBV特异性的CTL(cytotoxic T lymphocyte)频率的升高以及IFN-γ的分泌.结果:CHB患者外周血中CD4~ CD25~ CD45RO~ CTLA4~ T细胞群以及CD4~ CD127~(lo)CD25~(hi-int)T细胞群所占CD4~ T细胞群的比例与健康对照相比均明显上升(3.78%±1.87%.4.40%±2.11%vs 1.58%±0.76%,2.11%±1.26%;t=4.86,t=5.96;P<0.01)去除CHB患者中CD4~ CD25~ Treg后,特异性CTL的频率以及其分泌IFN-γ的频数与未去除组比出现显著上调(0.94%±0.38%,26±13 vs 0.20%±0.18%,119±30;t=5.25,t= 9.886;P<0.01).结论:CHB患者循环中增多的Treg可能参与抑制抗HBV的免疫应答抑制,去除Treg以及联合病毒抗原肽刺激的进一步研究可能为CHB的免疫治疗提供新的思路.     

Identification of differentially expressed genes in normal mucosa, adenoma and adenocarcinoma of colon by SSH

Abbreviation CRC colorectal cancer.SSHsuppression subtrsctive hybridization.LD PCR longdistance polymerase chain reaction.HLA human leukocyteantigen.IGRBP insulin-like growth factor binding protein.GN guanylin,EF1 elongation factor 1AIM To construct subtracted cDNA libraries and furtheridentify differentially expressed genes that are related tothe development of colorectal carcinoma(CRC).METHODS Suppression subtractive hybridization(SSH)was done on cDNAs of normal mucosa,adenoma andadenocarcinoma tissues from the same patient.Threesubtracted cDNA libraries were constructed and thenhybridized with forward and backward subtracted probesfor differential screening.Positive clones from eachsubtracted cDNA library were selected for sequencing andBLAST analysis.Finally,virtual Northern Blot confirmedsuch differential expression.RESULTS By this way,there were about 3-4×10~2clones identified in each subtracted cDNA library,inwhich about 85% positive clones were differentiallyscreened.Sequencing and BLAST homology searchrevealed some clones containing sequences of knowngene fragments and several possibly novel genes showingfew or no sequence homologies with any knownsequences in the database.CONCLUSION All results confirmed the effectiveness andsensitivity of SSH.The differentially expressed genesduring the development of CRC can be used to shed lighton the pathogenesis of CRC and be useful genetic markersfor early diagnosis and therapy.     

Epidemiologic and virologic characteristics of hepatitis B virus genotype B having the recombination with genotype C

BACKGROUND & AIMS: Hepatitis B virus (HBV) isolates of genotype B (HBV/B) with or without the recombination with genotype C over the precore region plus core gene have been reported. METHODS: All the 41 HBV/B isolates having the recombination with genotype C (HBV/Ba) possessed the nucleotide 1838 of A in contrast to that of G in all 29 of those without the recombination (HBV/Bj). Taking advantage of this single nucleotide polymorphism, a restriction fragment length polymorphism method was developed that distinguished HBV/Ba from HBV/Bj. RESULTS: HBV/Bj was detected in 90 of the 97 (93%) carriers of HBV/B from Japan, whereas HBV/Ba occurred in all 177 carriers of HBV/B from other countries (China, 20; Hong Kong, 45; Taiwan, 32; Thailand, 30; Vietnam, 30; and the United States, 20 [all of an Asian ethnicity]). In a case-control study, hepatitis B e antigen (HBeAg) and the double mutation in the core promoter (T1762/A1764) were significantly more frequent in 80 carriers each of HBV/Ba than HBV/Bj (35% vs. 18%, P < 0.05 and 33% vs. 15%, P < 0.05, respectively). Differences in the prevalence of HBeAg were more conspicuous between the carriers of HBV/Bj and HBV/Ba older than 30 years (5 of 66 or 8% vs. 16 of 62 or 26%, P < 0.01). CONCLUSIONS: HBV/B having the recombination with genotype C is frequent in Asia, except in Japan, and HBeAg is more prevalent in carriers of HBV/Ba than HBV/Bj.     

运动性心律失常

运动性心律失常是指发生于机体剧烈运动期间或之后的心律失常。临床表现不一,从心悸、头晕、晕厥、心绞痛、急性心肌梗死和充血性心力衰竭,甚至到心脏性猝死。运动性心律失常可见于心肌缺血,如患有动脉粥样硬化性心脏病以及患有原发性或继发性心肌病的患者。然而,也可能发生在似乎健康的个体。在后一组人群中,运动性心律失常可以是良性的,但也可以是获得性(如药物诱发)或先天性(如先天性长QT综合征或致心律失常性右室发育不良)心电活动或结构的异常而呈恶性。这种潜在病理生理学机制的复杂性,使运动性心律失常的诊断和治疗成为临床医学上的…     

不同方法治疗围绝经期及绝经后妇女抑郁症的疗效分析

目的 探讨抗抑郁药物及性激素治疗围绝经期及绝经后妇女抑郁症的临床效果.方法 采用汉米尔顿抑郁量表(HRSD)及自评抑郁量表(SDS)对86例围绝经期及绝经后抑郁症妇女进行抑郁症程度评价,然后随机分为2组,每组43例.对照组应用抗抑郁药物,其中轻、中度(29例)患者应用氟哌噻吨美利曲辛(其他名称:黛力新)1～2片/d;重度患者(14例)应用盐酸氟西汀(其他名称:百忧解)20 mg/d;性激素治疗(HRT)组(轻、中度31例,重度12例)应用替勃龙1.25 mg/d.入选者每4周随访1次,共计12周.结果 (1)有效率:对照组轻、中度抑郁症患者,治疗总有效率为96%;HRT组治疗总有效率为93%.两组比较,差异无统计学意义(P＞0.05).重度抑郁症的治疗有效率对照组为93%,HRT组为42%,两组比较,差异有统计学意义(P＜0.01).(2)HRSD评分:轻、中度抑郁症患者用药前、用药第4、8、12周时,对照组分别为(26.8±5.7)、(10.7±3.6)、(6.4±3.6)、(3.5±2.5)分;HRT组分别为(25.3±4.7)、(15.2±5.3)、(11.4±4.4)、(4.4±3.8)分.两组内治疗后各时间点HRSD评分与治疗前比较,差异均有统计学意义(P＜0.01);对照组与HRT组用药前及用药第12周时HRSD评分比较,差异无统计学意义(P＞0.05).重度抑郁症患者用药前、用药第4、8、12周时,HRSD评分对照组分别为(37.6±5.6)、(21.4±5.2)、(14.2±4.2)、(7.3±2.3)分;HRT组分别为(38.2±4.8)、(32.6±5.4)、(28.2±4.6)、(24.3±4.5)分.对照组内治疗后各时间点比较,差异有统计学意义(P＜0.01),HRT组用药前与用药第12周比较,差异也有统计学意义(P＜0.05).两组用药后各时间点HRSD评分比较,差异有统计学意义(P＜0.01).(3)SDS评分:对照组轻、中、重度患者用药前与用药第4、8、12周各时间点SDS评分比较,差异均有统计学意义(P＜0.01).HRT组轻、中度患者用药前与用药第4、8、12周各时间点SDS评分比较,差异也有统计学意义(P＜0.01);HRT组重度抑郁症患者用药前与用药第12周比较,差异有统计学意义(P＜0.05).在重度抑郁症患者中,对照组用药后HRSD、SDS评分与HRT组比较,明显降低,差异有统计学意义(P＜0.01).结论 HRT可用于治疗围绝经期及绝经后轻、中度抑郁症,对于重度抑郁症患者,抗抑郁药物的治疗效果优于性激素.