大黄内服配合芒硝外敷治疗重症急性胰腺炎患者43例

目的：观察大黄泻下配合芒硝外敷治疗重症急性胰腺炎的临床效果。方法：将83例重症急性胰腺炎患者随机分为对照组与治疗组,对照组40例给予常规治疗,治疗组43例在常规治疗的基础上加用大黄泻下配合芒硝外敷治疗,观察对比2组患者腹痛及腹胀缓解时间、首次排便时间、住院天数及死亡率。结果：与对照组相比,治疗组患者腹痛及腹胀缓解时间、首次排便时间、住院天数均明显缩短（P〈0.05）,死亡率显著降低（P〈0.05）。结论：在综合治疗的基础上加用大黄泻下配合芒硝外敷治疗可显著缩短重症急性胰腺炎患者的腹痛及腹胀缓解时间、首次排便时间、住院天数,从而降低死亡率。     

拉米夫定联合阿德福韦酯治疗拉米夫定耐药慢性乙型肝炎患者48周的疗效

拉米夫定是第一个批准用于治疗慢性乙型肝炎(CHB)的核苷类似物,虽具有口服吸收完全、半衰期长、不良反应小和抑制HBV复制迅速等优点,但长期应用后部分病例产生病毒变异耐药.本研究采用拉米夫定联合阿德福韦酯对74例拉米夫定耐药的CHB患者进行抗病毒治疗.     

干扰素α-2b联合利巴韦林治疗慢性丙型肝炎患者疗效观察

目的：观察普通干扰素联合利巴韦林治疗慢性丙型肝炎患者的临床疗效。方法87例慢性丙型肝炎患者被随机分成对照组44例和观察组43例,均应用重组人干扰素α-2b 联合利巴韦林治疗,分别治疗48周和72周,随访24周,观察疗效。结果在44例对照组患者中,HCV 1b型感染者28例（63.6%）,2a型感染者8例（18.2%）,在观察组43例患者中则分别为29例（67.4%）和6例（14.0%）;对照组获得快速病毒学应答率（RVR）、早期病毒学应答（EVR）、治疗结束时应答（ETR）和持续病毒学应答率（SVR）分别为40.9%、59.1%、68.2%和38.6%,而观察组则分别为39.5%、60.5%、88.4%（P＜0.05）和65.1%（P＜0.05）;根据血清HCV RNA水平是否≥1×106copies/m1,将两组患者分为高病毒载量组和低病毒载量组,结果两组低病毒载量组患者的ETR和SVR均显著高于高病毒载量组（P＜0.05）。结论延长干扰素联合利巴韦林治疗慢性丙型肝炎的疗程有助于提高SVR。     

阿片受体激动剂对缺血/再灌注心肌的保护作用

近来,随着溶栓和介入治疗的发展,AMI再灌注成功率显著提高。但是,血管再通时随之可能会发生缺血心肌的再灌注损伤。已证实缺血预处理(IPC)可产生心肌保护作用。而阿片受体激动剂通过激活心肌阿片受体能模拟缺血预处理对心脏的保护作用,心肌阿片受体激活能产生早期时相和后时相的心肌保护作用,信号途径涉及Gi/Go、蛋白激酶C、酪氨酸激酶和ATP敏感钾离子通道等。另外,阿片受体激动药对缺血/再灌注心肌也可产生直接的保护作用。但其作用机制有待于进一步的研究。     

苦参素联合拉米夫定治疗慢性乙型肝炎对肝纤维化指标的影响

目的: 探讨苦参素联合拉米夫定治疗慢性乙型肝炎对肝纤维化血清生化指标的影响.方法: 慢性乙型肝炎患者64例分为治疗组33例和对照组31例,两组基础治疗相同.治疗组前3 mo用苦参素注射液(正大天晴)600 mg静脉滴注,每日1次,以后改口服苦参素胶囊0.2 g,每日3次,同时口服拉米夫定100 mg,每日1次,疗程1 a;对照组口服复方鳖甲软肝片 2 g,每日3次,疗程1 a.结果: 治疗结束时,治疗组ALT复常率(100%),HBeAg阴转率(60.6%),HBVDNA阴转率(96.9%)均明显高于对照组(分别为87.1%,9.7%和3.2%),P <0.01;血清肝纤维化指标HA,LN,PCⅢ,Ⅳ-C与对照组相比有显著性差异(P <0.01).结论: 苦参素联合拉米夫定治疗慢性乙型肝炎,随着肝功能恢复正常,HBVDNA阴转,肝纤维化指标迅速降低.     

前列地尔治疗慢性重型肝炎疗效观察

目的 探讨前列地尔脂微球载体制剂在慢性重型肝炎治疗中的作用.方法 慢性重型肝炎患者76例,对照组按常规综合治疗,治疗组在常规治疗的基础上加用前列地尔脂微球载体制剂,比较两组患者临床疗效.结果 治疗组疗效明显优于对照组,且无明显不良反应,患者能很好耐受.结论 前列地尔脂微球载体制剂安全,确能改善肝功能,提高重型肝炎的治疗效果,患者可以耐受,可作为慢性重型肝炎综合治疗的有效措施之一.     

甲泼尼龙联合环磷酰胺对博来霉素诱导的肺纤维化大鼠模型炎症反应与免疫细胞活性的影响CSCD

Objective To observe the effect of methylprednisolone (MP) combined with cyclo‑ phosphamide (CTX) on inflammation and immune cell activity in bleomycin (BLM)‑induced pulmonary fibrosis rat model. Methods Forty healthy 6 to 8‑week‑old SD rats were randomly divided into blank control, BLM model, BLM+MP, and BLM+MP+CTX groups, with 10 rats in each group. The rat model of pulmonary fibrosis was prepared by intratracheal infusion of BLM (5 mg/kg, only once). From the 7th day of modeling, MP (3 mg/kg) was injected in rats in the BLM+MP group and MP (3 mg/kg)+CTX (8 mg/kg) was injected via tail vein in rats in the BLM+MP+CTX group, once daily for 21 days. The degree of lung inflammation and fibrosis in rats was detected using HE and Masson staining methods. The numbers of granulocytes and neutrophils in bronchoalveolar lavage fluid (BALF) and blood T cell subsets in rats were detected using flow cytometry. Results On the 7th day of modeling, the external morphology, HE and Masson staining results of rat lung tissue showed that BLM‑induced pulmonary fibrosis model was successfully prepared. On the 28th day of modeling, the lung tissue structure of the BLM group was disordered with obvious collagen deposition, the number of granulocytes and neutrophils in BALF increased significantly, the propor‑ tion of blood T cells, CD4+ T cells, and regulatory T cells (Tregs) decreased, the proportion of CD8+ T cells, and the CD4+/CD8+ T cells ratio decreased significantly (all P<0.05). Compared with the BLM group, the degree of pulmonary fibrosis in the BLM+MP+CTX group was improved significantly, the number of granulo‑ cytes and neutrophils in BALF decreased significantly, the proportion of blood T cells, CD4+ T cells and Tregs cells increased significantly, the proportion of CD8+ T cells decreased, and the ratio of CD4+/CD8+ T cells increased significantly (all P<0.05). The improvement effect in rats of BLM+MP+CTX group was better than that of BLM+MP group, and the difference was statistically significant (P<0.05). Conclusion MP com‑ bined with CTX can reduce the degree of inflammatory reaction in rats with pulmonary fibrosis and improve T cell immune activity. © 2023 Chinese Medical Association. All rights reserved.