加味天麻钩藤饮治疗原发性高血压肝阳上亢型临床观察

目的：探讨加味天麻钩藤饮与依那普利联合治疗原发性高血压肝阳上亢型的疗效。方法：选择116例 原发性高血压肝阳上亢型患者,随机分为治疗组60例,对照组56例。两组患者均服用依那普利西药治疗,治疗组 在此基础上加用加味天麻钩藤饮。结果：治疗组显效36例,有效20例,无效4例,总有效率93． 33%;对照组显效 19例,有效25例,无效12例,总有效率78． 57%,两组比较有显著性差异(x~2=4． 139,P＜0． 05) 。结论：加味天麻 钩藤饮与依那普利合用治疗原发性高血压肝阳上亢型临床效果较好。     

常见贫血临床诊断流程

<正>1概述贫血的原因可涉及多种因素和系统疾病。判断贫血是否存在、确定贫血的类型与病因,是临床医生需要掌握的诊疗思路之一。本流程将贫血临床诊断的思路进行归纳(图1、图2)。流程图包含2个部分。一部分是贫血诊断的初步评价,包括(1)贫血伴白细胞、血小板异常。(2)单纯贫血:1大细胞性贫血;2小细胞性贫血;3正常细胞性贫血。另一部分是贫血病因诊断的其他相关检查。确定贫血后应继续     

盐酸法舒地尔对急性脑梗死患者血清S-100B蛋白和超敏C反应蛋白的影响

[目的]研究盐酸法舒地尔对急性脑梗死(ACI)患者血清S100B蛋白和超敏C反应蛋白(hs-CRP)水平的影响。[方法]选择某院2009.06～2010.12治疗的ACI患者106例,随机分为盐酸法舒地尔组56例,常规治疗组50例,常规治疗组给予常规治疗,盐酸法舒地尔组在此基础上给予盐酸法舒地尔,观察评价2组患者的血清S100B蛋白浓度变化、血清hs-cRP浓度变化、神经功能改善。[结果]2组总体病情均明显好转,差异有统计学意义。盐酸法舒地尔组与常规治疗组的血清S100B蛋白变化、血清hs-CRP变化、神经功能改善等比较差异均有统计学意义(P﹤0.05)。[结论]盐酸法舒地尔能明显降低ACl患者血清S100B蛋白和hs-CRP水平,并有助于ACI患者的神经功能恢复。     

HCV核心抗原酶联免疫检测与HCV—RNA定量检测敏感性的比较

[目的]比较ELISA法测定总HCV—cAg与荧光定量PCR法测定HCV—RNA两种检测方法对诊断HCV感染的敏感性,分析HCV—cAg ELISA法诊断试剂的重要意义。[方法]ELISA法测定血清样本中的HCV抗体,改进型ELISA法测定血清样本中的HCV—cAg,实时荧光定量PCR法测定血清样本中的HCV—RNA,阳性样本经重复实验确认。[结果]通过用HCV抗体检测试剂对门诊病人或献浆员进行筛查,获得HCV抗体阳性血清样本264例。对这些病例别进行ELISA法测定总HCV—cAg实验和荧光定量PCR法测定HCV—RNA实验,测到HCV—cAg阳性病例101例,HCV—RNA阳性病例115例。经统计学分析,两种检测方法的敏感性差别不太大（0．01〈P〈0．05）。[结论]HCV—cAgELISA法检测和HCV—RNA定量检测具有相近的敏感性,日存某种稗序上HCV—cAg ELISA法榆测可以作为HCV—RNA定量榆测的有效替代。     

制备源自HBsAg基因修饰树突状细胞的外切体

目的:制备一种新型负载HBsAg基因的外切体(exosome)瘤苗,并探讨其生物学特性、免疫学功能。方法:运用分子克隆和病毒载体转染HBsAg基因构建AdVHBsAg-DC肝癌瘤苗,采用流式细胞术鉴定转染基因表达;提取exosome;以透射电镜观察、Western blot法鉴定exosome。结果:构建的重组AdVHBsAg腺病毒载体,经PCR和酶切鉴定,结果显示HBsAg基因片段已正确插入腺病毒载体中。包装的腺病毒载体具有良好的感染性,可以在293细胞中形成病毒颗粒。提取的exosome在透射电镜下可观察到直径为50-100nm的膜性微囊,圆形或椭圆形,有完整包膜。Western blot检测结果表明,exosome含有DC的特征分子和HBsAg基因。结论:成功制备并获得HBsAg基因修饰树突状细胞为来源的exosome瘤苗,为治疗乙肝相关肝癌提供新的思路。     

穿透性角膜移植术后继发性青光眼的临床研究

目的:探讨穿透性角膜移植术(penetrating keratoplasty,PK)后继发性青光眼(post-penetrating keratoplasty glaucoma,PPKG)的病因、分类及防治措施。方法:对197例206眼穿透性角膜移植进行回顾性分析。结果:其中52例52眼(25.2%)诊断为PPKG;34例34眼经联合药物治疗后眼压得到控制;18例18眼行手术或激光治疗后眼压控制良好。结论:PK围手术期的正确处理能够降低继发性青光眼的发生率。根据PPKG的不同病因进行不同治疗,疗效满意。     

骨髓单个核细胞Coombs试验阳性的血细胞减少患者补体水平变化及其意义

Objective To investigate the variation of bone marrow complement level in cytopenia pa-tients with positive BMMNC-Coombs test(CBCPC), and probe the role of complement in destroying hemato-poietic cells of CBCPC patients. Methods One hundred and twenty-four patients with CBCPC and twenty-three healthy donors as controls were enrolled in this study. The levels of CI-150, C3, C4, C5b-9 were tested with ELISA. The auto-antibodies on bone marrow hematupoietic cells (BMHC) were examined with flow cy-tometry. Results The level of C5b-9 in bone marrow(BM) of untreated CBCPC patients [(119.8 ± 54.0)μg,/L] was significantly higher than that of recovered patients [(100.7 ± 33.4) μg/L] or normal controls [(93.9 ± 28.8) μg/I.] (P < 0.05). The levels of CH50 in BM of untreated or recovered CBCPC patients [(33.3 ± 11.5) kU/L, (30.8 ± 10.3) kU/L] were significantly higher than that of normal controls [(24.1 ±6.4) kU/L] (P < 0.05). The level of C3 in BM of untreated or recovered CBCPC patients [(4.9 ± 2.2) mg/ L], (5.0 ± 3.5) mg/L] was significantly lower than that of normal controls [(7.0 ± 5.6) mg/L] (P < 0.05). The level of complement in peripheral blood was consistent with that in BM. CH50 in BM of CBCPC patients was negatively correlated with their C3 (r = - 0. 303, P = 0. 007) and positively correlated with their C5b-9(r = 0. 241, P = 0. 003) levels. The level of C5h-9 in BM of CBCPC patients was higher in the BMHC-IgM positive group [(117.6 ± 55.7) μg/L] than in the BMHC- IgM negative group [(99.2 ± 26.2)μg/L] (P < 0. 05). The positive rate of CD34+ -IgG or CD34 + -IgM of CBCPC patients was positively corre-lated with their C5 b-9 level (r = 0. 593, P = 0.000, r = 0. 326, P = 0. 049). The reticulocyte percentage (r =0. 421, P = 0.000) and serum indirect bilirubin level (r = 0. 230, P = 0. 032) of CBCPC patients were posi-tively correlated with their CHSO level. Conclusions The hematocytopenia of CBCPC patients might be re-lated to the hematopoietic cells destruction caused by auto-antibedy activated complements.     

蒽环类药物治疗非霍奇金淋巴瘤心脏毒性的临床研究

蒽环类化疗药物作为一种疗效肯定的抗恶性肿瘤药物在临床上已得到广泛应用,但该类药物的心脏毒性也日益引起人们的关注.现对我院收治的94例非霍奇金淋巴瘤(NHL)患者应用蒽环类化疗药物后出现的心脏毒性进行临床分析.     

骨髓单个核细胞Coombs试验(+)血细胞减少症患者有核红细胞膜EPO受体与自身抗体关系的初步研究

骨髓单个核细胞(BMMNC)Coombs试验(+)的免疫相关性血细胞减少症(IRP)是由于B淋巴细胞分泌多种针对骨髓造血细胞自身抗体引起的外周血细胞减少[1-2].目前推测自身抗体的作用机制之一可能是封闭骨髓造血细胞膜功能抗原进而抑制造血.