拉米夫定对不同中医证型的慢性乙型肝炎疗效辨析

拉米夫定是一种有效的抗乙肝病毒药物,它对病毒的逆转录酶有明显的抑制作用,可抑制乙肝病毒的复制,降低血液和肝脏中的病毒数量,改善肝脏生化功能和组织学病变,从而提高患者生存质量。为进一步提高拉米夫定治疗慢性乙型肝炎的疗效,本文收集统计了近4年的80例相关病例,从中医辨证的角度,分析应用拉米夫定治疗不同证型的慢性乙型肝炎的疗效。现报告如下。1临床资料1·1一般资料收集本院肝炎科门诊慢性乙型肝炎患者80名,其中男性47名,女性33名,年龄17~64岁,平均35岁。诊断标准依据2000年全国传染病与寄生虫病学会和肝病学会修订的病毒性肝炎诊…     

Neuroprotective strategies in parkinson’s disease: protection against progressive nigral damage induced by free radicals

Brain undergoes neurodegeneration when excess free radicals overwhelm antioxidative defense systems during senescence, head trauma and/or neurotoxic insults. A site-specific accumulation of ferrous citrate-iron complexes in the substantia nigra dopaminergic neurons could lead to exaggerated dopamine turnover, dopamine auto-oxidation, free radical generation, and oxidant stress. Eventually, this iron-catalyzed dopamine auto-oxidation results in the accumulation of neuromelanin, a progressive loss of nigral neurons, and the development of Parkinson's disease when brain dopamine depletion is greater than 80%. Emerging evidence indicates that free radicals such as hydroxyl radicals ((.-)OH) and nitric oxide ((.-)NO) may play opposite role in cell and animal models of parkinsonism. (.-)OH is a cytotoxic oxidant whereas oNO is an atypical neuroprotective antioxidant. (.-)NO and S-nitrosoglutathione (GSNO) protect nigral neurons against oxidative stress caused by 1-methyl-4-phenylpyridinium (MPP(+)), dopamine, ferrous citrate, hemoglobin, sodium nitroprusside and peroxynitrite. MPP(+), the toxic metabolite of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), increases the nigral uptake of iron complexes and dopamine overflow leading to the generation of (.-)OH, protein oxidation, lipid peroxidation, and associated retrograde degeneration. In addition to GSNO, MPP(+)-induced oxidative neurotoxicity can be prevented by antioxidants including selegiline, 7-nitroindazole, 17beta-estradiol, melatonin, alpha-phenyl-tert-butylnitrone and U78517F. Similar to selegiline, 7-nitroindazole is a MAO-B inhibitor, which blocks the bio-activation of MPTP and oxidative stress. Freshly prepared but not light exposed, (.-)NO-exhausted GSNO is about 100 times more potent than the classic antioxidant glutathione. Via S-nitrosylation, GSNO also inhibits proteolysis and cytotoxicity caused by caspases and HIV-1 protease. Furthermore, in addition to protection against serum deprivation stress, the induction of neuronal NOS1 in human cells increases tolerance to MPP(+)-induced neuro-toxicity since newly synthesized (.-)NO prevents apoptosis possibly through up-regulation of bcl-2 and down regulation of p66(shc). In conclusion, reactive oxygen species are unavoidable by-products of iron-catalyzed dopamine auto-oxidation, which can initiate lipid peroxidation, protein oxidation, DNA damage, and nigral loss, all of which can be prevented by endogenous and exogenous (.-)NO. Natural and man-made antioxidants can be employed as part of preventative or neuroprotective treatments in Parkinson's disease and perhaps dementia complexes as well. For achieving neuroprotection and neuro-rescue in early clinical parkinsonian stages, a cocktail therapy of multiple neuroprotective agents may be more effective than the current treatment with extremely high doses of a single antioxidative agent.     

Antioxidative and in vitro hepatoprotective activity of Bupleurum kaoi leaf infusion

The roots of Bupleurus spp. have been used in traditional Chinese herbal medicine for curing liver diseases. Although bioactive saikosaponins have been detected in the leaves as well as in the roots, the aerial parts of the plants are discarded as waste. In the present study, a leaf infusion of B. kaoi Liu, Chao et Chuang, an indigenous Bupleurus species in Taiwan, was prepared and the antioxidant properties and in vitro hepatoprotective activity were demonstrated. The results show that the leaf infusion exerted DPPH free radical scavenging activity, inhibitory capacity on superoxide anion formation and superoxide anion scavenging activity. The hepatotoxicity of acetaminophen (APAP) and carbon tetrachloride (CCl4) on the rat liver cells were also decreased by the leaf infusion.     

骨化三醇治疗桥本甲状腺炎的临床效果

目的 探讨骨化三醇治疗桥本甲状腺炎的临床效果。方法 选取辽阳市中心医院新城医院2019年1月至2021年1月收治的110例桥本甲状腺炎患者,采取随机数字表法分为对照组与观察组,各55例。对照组给予左旋甲状腺素片治疗,观察组在对照组的基础上加用骨化三醇治疗。比较两组的临床疗效、治疗前后甲状腺激素指标、抗甲状腺球蛋白抗体（TGAb）、抗甲状腺过氧化物酶抗体（TPOAb）浓度水平,同时观察治疗期间的不良反应。结果 观察组的临床总有效率高于对照组,差异有统计学意义（P<0.05）。观察组治疗后的游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）水平高于对照组,促甲状腺激素（TSH）水平、TGAb及TPOAb浓度均低于对照组,差异有统计学意义（P<0.05）。两组治疗期间均未出现血常规、尿常规、肝肾功能指标病变等不良反应。结论 在左旋甲状腺素片的基础上加用骨化三醇治疗桥本甲状腺炎,可获得显著的临床疗效,能够促进甲状腺激素水平改善,调节TgAb、TPOAb浓度,且治疗期间无明显不良反应,安全性较高。     

Cyclopeptides with anti-inflammatory activity from seeds of Annona montana

Four new cyclopeptides, cyclomontanins A-D (1- 4), annomuricatin C (5), and (+)-corytuberine were isolated from a methanol extract of Annona montana seeds. Their structures were elucidated by 2D NMR analysis, ESIMS/MS fragment evidence, and chemical means. The structure of 1 was confirmed by synthesis. Compounds 1, 3, and 4 exhibited anti-inflammatory activity in vitro using the J774.1 macrophage model.     

胸痛特征诊断冠心病的准确性

目的 探讨胸痛特征诊断冠心病的准确性.方法 连续入组2012年6月至2016年6月经过冠状动脉造影(CAG)和冠状动脉血流储备分数(FFR)检查的住院患者240例,根据临床病史的描述将患者分成无胸痛组(55例),不典型胸痛组(79例),典型劳力心绞痛组(64例)和支架植入组(42例).将不同胸痛性质与CAG和FFR进行...     

Solitary cavities of the lung: diagnostic implications of cavity wall thickness

Sixty-five solitary cavities of the lung were evaluated for wall thickness. All lesions in which the thickest part of the cavity wall was 1 mm were benign. Of the lesions whose thickest measurement was 4 mm or less, 92% were benign. Of cavities that were 5-15 mm in their thickest part, 51% were benign and 49% malignant. Of those over 15 mm thick, 95% were malignant. Measurement of the thickest part of te cavity wall gives a more reliable indication of benignancy or malignancy than measurement of the thinnest part.     

Single-Incision Laparoscopic Common Bile Duct Exploration with Conventional Instruments: an Innovative Technique and a Comparative Study

Background

Single-incision laparoscopic surgery developed rapidly in recent years. We introduce an innovative technique: single-incision laparoscopic common bile duct exploration (SILCBDE) with conventional instruments. A retrospective comparison between SILCBDE and standard laparoscopic common bile duct exploration (LCBDE) was analyzed.

Methods

Thirty-four patients who underwent LCBDE for choledocholithiasis in a period of 17 months were enrolled. Seventeen standard LCBDEs and 17 SILCBDEs were attempted. Simultaneous cholecystectomies were performed.

Results

The stone clearance rate was 94.1 % (16 patients) in the standard LCBDE group and 100 % in the SILCBDE group. There was no statistical difference in demographic distribution, clinical presentations, and operative results between the two groups, except the SILCBDE group had a higher rate of acute cholecystitis than the standard LCBDE group (76.5 vs. 35.3 %; p?<?0.05). One procedure (5.9 %) in the SILCBDE group was converted to a four-incision transcystic LCBDE. The complication rate was 11.8 % (two patients) in the standard LCBDE group and 5.9 % (one patient) in the SILCBDE group. The average follow-up period was 4.2 months.

Conclusion

SILCBDE is as safe and efficacious as standard LCBDE in experienced hands. Choledochoscope manipulation and bile duct repair are the key skills. Long-term follow-up and further prospective randomized trials are anticipated.