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21.
二甲双胍治疗多囊卵巢综合征的临床研究 总被引:1,自引:0,他引:1
目的:探讨二甲双胍在治疗多囊卵巢综合征的临床效果。方法:30例多囊卵巢综合征(PCOS)患者,口服二甲双胍12周,采取自身对照,观察用药前、后临床症状、血清卵泡刺激素(FSH)、黄体生成激素(LH)、睾酮(T)、雄烯二酮(A2)、空腹血糖及空腹胰岛素水平的变化。结果:继发闭经13例中,7例恢复有排卵月经;月经稀发17例,10例恢复有排卵月经,不孕症16例,用药期间妊娠4例。用药后两组空腹胰岛素和雄激素水平均降低,比较差异有显著性(P<0.05)。结论:二甲双胍可有效改善PCOS患者的胰岛素抵抗状态,降低血中雄激素水平并恢复生育功能。 相似文献
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Progestin‐primed ovarian stimulation with or without clomiphene citrate supplementation in normal ovulatory women undergoing in vitro fertilization/intracytoplasmic sperm injection: A prospective randomized controlled trial
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24.
目的 回顾性分析探讨双重血浆分子吸附系统对百草枯中毒患者的影响,并探讨双重血浆分子吸附对百草枯中毒患者的保护作用及其保护作用机制,是否与下调miR-155并激活Nrf2/HO-1信号通路有关。方法 对广州市第十二人民医院2020年6月至2021年6月广州市第十二人民医院急诊收治的40例急性百草枯中毒患者的临床治疗资料进行回顾性分析,将患者按不同方案分为观察组20例和对照组20例;观察组男14例,女6例,年龄21~73岁,在常规药物治疗的基础上采用双重血浆分子吸附系统治疗;对照组男12例,女8例,年龄20~71岁,在常规药物治疗的基础上立即单纯使用血液灌流治疗;观察两组患者以下各指标不同时间点的变化:炎症因子[白细胞介素(IL)-10、IL-17、转化生长因子(TGF)-β、CRP、IL-6、肿瘤坏死因子(TNF)-α],肝功能[丙氨酸氨基转移酶(ALT)、总胆红素(TBil)、直接胆红素(DBil)],T淋巴细胞亚群(CD4+、CD8+),定血清miR-155、核因子E2相关因子2(Nrf2)及其下游基因GCLC、苯醌氧化还原酶(NQO1)和血红素氧化酶1(HO-1)。结果 入院8 h后,观察组IL-10、IL-17、TGF-β、CRP、IL-6、TNF-α显著低于对照组[(54.01±9.81)mg/L比(63.87±17.53)mg/L、(35.41±5.37)μg/L比(40.34±9.05)μg/L、(397.04±35.31)μg/L比(421.43±40.11)μg/L、(17.72±3.22)mg/L比(21.75±5.19)mg/L、(94.05±39.59)μg/L比(120.89±42.31)μg/L、(68.94±19.07)ng/L比(83.27±25.19)ng/L,均P<0.05];治疗后第3、6天,两组IL-10、IL-17、TGF-β、CRP、IL-6、TNF-α水平均呈逐渐下降趋势,且观察组较对照组下降更为明显(均P<0.05)。入院8 h,两组患者ALT、TBil、DBil水平均高于正常值,但观察组ALT、TBiL、DBil水平均显著低于对照组[(77.44±13.28)IU/L比(64.53±12.10)IU/L、(77.44±13.28)μmol/L比(92.32±22.04)μmol/L、(52.13±12.58)μmol/L比(63.84±20.17)μmol/L,均P<0.05];治疗后第3、6天,两组ALT、TBil、DBil水平均呈逐渐下降趋势,且观察组下降更为明显(均P<0.05)。治疗后第6天,两组CD4+、CD8+水平均低于入院8 h时(观察组t=6.816、5.517,均P<0.001;对照组t=2.415、2.069,P=0.020、0.045),观察组CD4+、CD8+水平均低于对照组[(39.32±4.31)%比(43.40±7.11)%、(27.05±3.18)%比(30.75±7.34)%,t=2.194、2.068,P=0.034、0.045]。百草枯中毒肝脏损伤患者在入院8 h的Nrf2、miR-155均处于高表达水平,治疗后第6天,两组miR-155明显低于入院8 h时(观察组t=18.109,P<0.001;对照组t=2.336,P=0.024),Nrf2、HO-1、NQ01则高于入院8 h时(观察组t=24.400、7.390、49.193,P<0.001;对照组t=10.846、2.296、14.264,P<0.001、=0.027、<0.001),组间比较,治疗后第6天观察组miR-155、Nrf2、HO-1、NQ01的表达均明显优于对照组(均P<0.05)。结论 双重血浆分子吸附清除百草枯成分更为快速,可快速有效清除胆红素、炎性介质等有害物质,增强机体抗氧化能力,改善免疫反应,从而起到对肝功能的保护作用;双重血浆分子吸附可有效降低患者氧化应激,从而显著降低氧化应激引起的miR-155表达,激活Nrf2/HO-1信号通路,增强机体对外界刺激的抵抗力,起到保护患者肝脏功能的作用。 相似文献
25.
目的 基于中医传承辅助平台软件(TCMISS,V2.5)对吕英教授治疗自闭症语言障碍的处方进行数据挖掘,探索其病因病机及组方规律。方法 收集吕英教授治疗自闭症语言障碍的医案,将其方药信息录入TCMISS,借助该平台集成的关联规则、改进互信息法、复杂系统熵聚类法、无监督熵层次聚类法等分析方法探索吕英教授治疗自闭症语言障碍的药物组方规律。结果 共筛选出120个医案,包含处方共120首,涉及中药89味,其中使用频次前6味中药为桂枝、鸡蛋花、白术、泽泻、石膏、桔梗,药性以寒、温为主,药味以甘、苦居多,归经多属肺、脾、肝经。通过关联规则分析所得的用药模式中,使用频次最高的为桂枝与鸡蛋花、桂枝与泽泻、白术与桂枝,进一步分析得到的核心药物为泽泻、桂枝、白术,为五苓散的药物组成,并基于复杂熵聚类方法演化出6首新处方。结论 吕英教授治疗自闭症语言障碍以阳明“气血津”不足和三焦气化功能失常为主要病机线路,清解阳明伏火、加强阳明本体液津血的生化化生及恢复三焦气化功能正常为主要治法,其核心代表方剂为木防己汤和五苓散。 相似文献
26.
【摘要】 目的 分析化妆品相关皮肤不良反应的临床特点及主要致病成分,为化妆品不良反应起到预警作用并提供客观的风险评估依据。方法 收集2018年3月至2019年10月在重庆市中医院门诊就诊的512例化妆品不良反应可疑患者,男14例,女498例,通过填写统一制定的化妆品不良反应报告卡,记录患者的病史资料和所使用化妆品的相关信息;对其中103例(男3例,女100例)进行化妆品原物斑贴试验及化妆品成分斑贴试验,结合48和72 h斑贴试验结果综合判定并汇总分析。结果 512例可疑化妆品不良反应病例中,主要表现类型为接触性皮炎(495例,96.7%)。化妆品不良反应的皮损形态主要为红斑501例(97.9%)、丘疹313例(61.1%)、水肿249例(48.6%)、鳞屑166例(32.4%);症状主要为瘙痒480例(93.8%),其次为灼热感359例(70.1%)和紧绷感297例(58.0%)。103例化妆品成分斑贴试验显示,阳性71例,最易引起化妆品不良反应的变应原分别为硫柳汞(31例,30.1%)、十二烷基硫酸钠(29例,28.2%)、秘鲁香脂(17例,16.5%)、布罗波尔(12例,11.7%)及三乙醇胺(10例,9.7%)。将化妆品变应原系列分为14个类别,阳性率前4位的类别分别为乳化剂54例(45.8%)、防腐剂47例(39.8%)、芳香剂17例(14.4%)和表面活性剂10例(8.5%)。2例男性和69例女性斑贴试验阳性,男女阳性率差异无统计学意义(2/3比69/100,χ2 = 0.01,P > 0.05);18 ~ 29岁组、30 ~ 49岁组及50 ~ 70岁组阳性率分别是34%、34%、32.4%,各组间阳性率差异无统计学意义(χ2 = 0.693,P > 0.05)。结论 化妆品不良反应最常见的表现为接触性皮炎,致病成分具有多样性,最易引起化妆品皮肤不良反应的变应原分别为硫柳汞、十二烷基硫酸钠、秘鲁香脂、布罗波尔及三乙醇胺。 相似文献
27.
Mian Peng Di Ren Xue-Yan Liu Jin-Xiu Li Rong-Lin Chen Bao-Jun Yu Yong-Feng Liu Xi Meng Yan-Si Lyu 《World Journal of Clinical Cases》2020,8(9):1705-1712
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become an immense public health burden,first in China and subsequently worldwide.Developing effective control measures for COVID-19,especially measures that can halt the worsening of severe cases to a critical status is of urgent importance.CASE SUMMARY A 52-year-old woman presented with a high fever(38.8°C),chills,dizziness,and weakness.Epidemiologically,she had not been to Wuhan where COVID-19 emerged and did not have a family history of a disease cluster.A blood test yielded a white blood cell count of 4.41×109/L(60.6±2.67%neutrophils and 30.4±1.34%lymphocytes).Chest imaging revealed bilateral ground-glass lung changes.Based on a positive nasopharyngeal swab nucleic acid test result and clinical characteristics,the patient was diagnosed with COVID-19.Following treatment with early non-invasive ventilation and a bundle pharmacotherapy,she recovered with a good outcome.CONCLUSION Early non-invasive ventilation with a bundle pharmacotherapy may be an effective treatment regimen for the broader population of patients with COVID-19. 相似文献
28.
目的评价Twin Tail TightRope带袢钛板Y型固定术治疗急性肩锁关节脱位的早期临床疗效。
方法回顾性分析2015年6月至2017年6月昆明市第一人民医院采用Twin Tail TightRope带袢钛板内固定系统在关节镜下行Y型固定治疗急性肩锁关节脱位患者共16例。采用视觉模拟评分法(visual analogue scale,VAS)及Constant-Murley评分评估手术效果。
结果所有患者获得随访,随访时间3~12个月,平均(6.48±1.51)个月。术后无血管、神经损伤及切口感染,末次随访时均未发生复位丢失、锁骨应力性骨折、喙突切割等并发症。末次随访时VAS评分(0.36±0.04)分较术前(7.46±1.24)分降低,Constant-Murley评分(90.07±3.13)分较术前(46.13±3.25)分提高。
结论采用Twin Tail TightRope带袢钛板Y型固定术治疗急性肩锁关节脱位可有效解决术后水平、前后方向不稳定问题,此技术具有较低的锁骨、喙突骨折发生率,关节镜下操作可以减少手术损伤、提高精准度。 相似文献
29.
Feng-Ying Ye Guo-Rong Lyu Shang-Qing Li Jian-Hong You Kang-Jian Wang Ming-Li Cai Qi-Chen Su 《Ultrasound in medicine & biology》2021,47(1):114-124
The aim of the work described here was to evaluate the diagnostic performance of ultrasound thyroid computer-aided diagnosis (CAD) software. This multicenter prospective study included 494 patients (565 thyroid nodules) who underwent surgery or biopsy after ultrasonography at four hospitals from January 2019 to September 2019. The diagnostic performance metrics of different readers were calculated and compared with the pathologic results. The sensitivity of CAD was outstanding and was equivalent to that of a senior radiologist (90.51% vs. 88.47%, p > 0.05). The area under the curve of CAD was equivalent to that of a junior radiologist (0.748 vs. 0.739, p > 0.05). However, the specificity was only 49.63%, which was lower than those of the three radiologists (75.56%, 85.93% and 90.37% for the junior, intermediate and senior radiologists, respectively). The diagnostic performance of the junior radiologist was significantly improved with the aid of CAD (junior + CAD). The sensitivity and area under the curve of junior + CAD were improved from 72.20% to 89.93% and from 0.739 to 0.816, respectively (both p values <0.05), and the positive predictive value, negative predictive value and κ coefficient improved from 76.3% to 78.6%, 82.0% to 86.8% and 0.394 to 0.511, respectively. Though specificity slightly decreased from 75.56% to 73.33%, the difference was not statistically significant (p > 0.05). In general, the clinical application value of CAD is promising, and its instrumental value for junior radiologists is significant. 相似文献
30.
Li Zhan Xie Xinfang Zhang Xue Shi Sufang Liu Lijun Chen Pei Sui Guili Lyu Jicheng Zhang Hong 《中华肾脏病杂志》2019,35(2):81-87
Objective To establish the measurement of IgA1 O-glycan-specific antiglycan autoantibodies in patients with IgA nephropathy (IgAN), and evaluate their role in the development and progression of IgAN. Methods In the IgAN regular follow-up cohort of Peking University Institute of Nephrology from January 2006 to December 2015, 170 patients drawn by stratified randomization were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of plasma galactose-deficient IgA1 (Gd-IgA1) and antiglycan autoantibody (IgG and IgA1). The correlation between antiglycan autoantibodies and clinicopathological parameters was analyzed by linear correlation and multiple linear regression analysis. The receiver operating characteristic curve (ROC) was used to evaluate the value of plasma anti glycide antibodies in the diagnosis of IgAN. Results IgG and IgA1 antiglycan autoantibodies that specifically recognized Fab-hinge region (Fab-HR) antigens could be detected in both IgAN and healthy control group. Agglutinin inhibition test showed that the specific antigen epitope was N-acetylgalactosamine (GalNAc) residue exposed to galactose deficiency in IgA1 hinged region. There was no significant difference in the absolute levels of plasma IgG antiglycan autoantibodies between IgAN and healthy controls (P=0.963). After adjustment of the plasma level of IgG, the normalized antiglycan autoantibody (ln[IgG antiglycan antibody/IgG]) in patients with IgAN was significantly higher than that in healthy controls (0.58±0.31 vs 0.37±0.11, P﹤0.01). The normalized level of IgG antiglycan autoantibody in IgAN patients was positively correlated with 24 h urine protein level during renal biopsy (Spearman r=0.183, P﹤0.05), and was also significantly correlated with 24 h urinary protein level after adjusting for baseline clinical and pathological factors (β=0.713, 95%CI 0.323-1.102, P﹤0.01). The area under ROC curve (AUC) of normalized IgG antiglycan autoantibody in the diagnosis of IgAN was 0.764 (95% CI 0.682-0.845, P﹤0.05). Using the cut-off value of 0.396, the sensitivity and specificity of normalized IgG antiglycan autoantibody for IgAN were 0.729 and 0.700 respectively. There was no significant difference in the absolute or normalized levels of IgA1 antiglycan autoantibodies between IgAN patients and healthy controls. Conclusions Gd-IgA1-specific antiglycan autoantibodies can be detected both in IgAN patients and healthy controls. They are elevated in some patients with IgAN and possibly involved in the development of IgAN. 相似文献