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《Digestive and liver disease》2017,49(1):63-69
BackgroundUrsodeoxycholic acid (UDCA) therapy is commonly used in intrahepatic cholestasis of pregnancy (ICP).AimTo evaluate the efficacy and tolerance of UDCA in real-world conditions and to search for factors predictive of response to treatment.MethodsThis observational study included 98 consecutive patients suffering from pruritus during pregnancy associated with increased ALT levels or total bile acid (TBA) concentrations, without other causes of cholestasis. The entire ABCB4 gene coding sequence was analyzed by DNA sequencing.ResultsUDCA was prescribed until delivery in all patients (mean dose 14.0 mg/kg/day; mean duration 30.4 days). Pruritus improved in 75/98 (76.5%) patients, and totally disappeared before delivery in 25/98 (25.5%). After 2–3 weeks of treatment, ALT levels decreased by more than 50% of base line in 67/86 (77.9%) patients and normalized in 34/86 (39.5%), and TBA concentrations decreased in 28/81 (34.6%). Only one patient stopped the treatment before delivery. On multivariate analysis, ALT >175 IU/l before treatment was associated with improvement of pruritus (OR 2.97, 95% CI 1.12–7.89, P = 0.029) and with decreased ALT (OR 18.61, 95% CI 3.94–87.99, P = 0.0002). ABCB4 gene mutation was not associated with response to treatment.ConclusionThis study supports the use of UDCA as first line therapy in ICP. 相似文献
994.
Plasmacytoid dendritic cells (pDCs) are specialized sensors of viral nucleic acids that initiate protective immunity through the production of type I interferons (IFNs). Normally, pDCs fail to sense host-derived self-nucleic acids but do so when self-nucleic acids form complexes with endogenous antimicrobial peptides produced in damaged skin. Whereas regulated expression of antimicrobial peptides may lead to pDC activation and protective immune responses to skin injury, overexpression of antimicrobial peptides in psoriasis drives excessive sensing of self-nucleic acids by pDCs resulting in IFN-driven autoimmunity. In skin tumors, pDCs are unable to sense self-nucleic acids; however, therapeutic activation of pDCs by synthetic nucleic acids or analogues can be exploited to generate antitumor immunity. 相似文献
995.
Yukiko Ueda Yuko Kawakami Daisuke Kunii Hiroyuki Okada Masami Azuma Duc Son N.T. Le Shigeru Yamamoto 《Nutrition Research》2008
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn disease (CD), is a disorder characterized by diffuse inflammation of the gastrointestinal tract. The immune response and inflammation are mediated by polyunsaturated fatty acids and influenced by dietary fats and lipid metabolism. This study examined the qualitative and quantitative fat intake of IBD patients and healthy controls on plasma phospholipid and erythrocyte membrane phospholipid (EMP) fatty acid content. Measurement of the fatty acid composition of plasma phospholipid and EMP were performed in 29 UC patients, 20 CD patients, and 31 healthy controls. Anthropometric characteristics and data on dietary intake were also collected. We observed significantly lower lipid intake in UC and CD patients vs controls. The UC and CD patients had significantly higher levels of linoleic acid in their EMP than did controls. There were no significant differences in the levels of n-3 polyunsaturated fatty acids, but there were significantly higher levels of the n-6 in the EMP of UC and CD patients compared with controls. The significant differences persisted after the data were adjusted for potential confounders and lipid intake. Higher levels of linoleic acids and n-6 fatty acids, which are involved in production of proinflammatory mediators, were found in IBD patients compared with controls, thereby implicating n-6 fatty acids in the pathophysiology of the disease. 相似文献
996.
146例胆汁反流与胃炎和胃溃疡的临床分析 总被引:2,自引:0,他引:2
目的了解胆汁反流与胃炎和溃疡的致病关系。方法将经胃镜证实有胆汁反流的患者146例作一分析(内44例系胃次全切除术后症状再发者),并结合文献探讨其与胃炎和溃疡病之间的关系。结果146例均有胃肠炎,胃炎合并食道炎3例,胃炎合并溃疡者43例,胃炎合并胃癌者3例。结论胆汁反流是胃炎和溃疡的致病因素之一。 相似文献
997.
Yan Meng 《中德临床肿瘤学杂志》2007,6(1):18-21
Objective: To evaluate the outcome of radiotherapy (RT) in locally advanced hepatic hilar cholangiocarcinoma. Methods: During March 1992 to December 1997, 47 patients who had positive microscopic surgical margins after surgery were treated by postoperative radiotherapy (S+RT, 28 patients, with a median dose of 50 Gy, 45-62 Gy) and surgery alone (S, 19 patients). The median follow-up was 30 months (4-113 months). Results: The overall 5-year survival rate was 28%, with a median survival length of 19.6 months while 5-year survival rates of S+RT group and S group were 34% and 14%, with median survival lengths of 29 and 10 months respectively (P=0.015). The occurrence rate of complications was 11% in either group. Conclusion: Postoperative radiotherapy significantly prolongs survival lengths in patients with hepatic hilar cholangiocarcinoma who had positive microscopic surgical margins. Radiation toxicities are tolerable. 相似文献
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999.
目的探讨肝内外胆管结石的腹腔镜联合内镜治疗的方法。方法选择自2002年10月至2007年12月收治的46例肝内、外胆管结石患者,先采用十二指肠镜治疗肝外胆管结石,再联合应用腹腔镜肝切除治疗肝内胆管结石,对围手术期相关指标进行观察分析。结果应用腹腔镜联合内镜方法治疗肝内外胆管结石患者46例,中转开腹2例,术后恢复顺利,无严重并发症。结论腹腔镜联合内镜治疗肝内外胆管结石是一种安全有效的方法,它能最大限度地减少对患者的创伤,充分体现了内镜、腹腔镜联合治疗的优越性。该方法对于内镜、腹腔镜技术较高的医疗单位是切实可行的。 相似文献
1000.