加巴喷丁在老年人带状疱疹后三叉神经痛中的应用

目的探讨加巴喷丁应用于老年带状疱疹后三叉神经痛治疗的临床疗效。方法将2009年1月,2010年5月收治的60例老年带状疱疹后三叉神经痛患者,随机分为对照组和治疗组各30例,对照组口服卡马西平、维生素肌肉注射、神经阻滞治疗。治疗组在对照组治疗的基础上口服加巴喷丁,比较两组患者的临床疗效及不良反应。结果治疗组30例中治愈17例,显效12例,总有效率为96．7％（29／30）,显著高于对照组的86．7％（26／30）（P〈0．05）。两组患者均未发生严重不良反应。结论口服加巴喷丁治疗带状疱疹后神经痛效果确切,见效快,能明显缓解患者症状,副反应小,值得临床推广。     

阿霉素神干注射治疗带状疱疹后神经痛疗效观察

目的通过对照研究观察阿霉素神经干注射治疗带状疱疹后神经痛的临床疗效。方法60例带状疱疹后神经痛患者,根据不同治疗方法随机分为4组:A组:阿霉素神经干注射+射频热凝术+常规治疗;B组:阿霉素神经干注射+常规治疗;C组:射频热凝术+常规治疗;D组:常规治疗(对照组)。在治疗前、治疗后1、3、6个月和1年时进行VAS评分。结果A组的显效率和有效率最高, 但与B组之间并无统计学差异。B组治疗的显效率要高于C组(P<0.05)。A、B、C 3组和D组间的疗效有统计学差异(P<0.05)。A、B组治疗前后的VAS评分存在统计学差异(P<0.01),并且随时间的推移, VAS评分逐渐减小,没有患者出现复发。而C组虽然治疗前后的VAS评分差异有统计学意义(P<0.01), 但随时间的推移,VAS评分逐渐增加,部分患者疼痛复发。1年后的随访VAS评分时,A、B组和C组之间出现统计学差异(P<0.05)。结论阿霉素神经干注射治疗带状疱后神经痛具有较好的治疗效果,并且远期疗效好,复发率低。     

Efficacy,immunogenicity, and safety of available vaccines in children on biologics: A systematic review and meta-analysis

Vaccinations are essential for preventing infectious diseases in children with chronic diseases as they have increased risk of infection from frequent use of biologics. Response to immunizations in this group is not well known.ObjectiveA systematic review was performed to evaluate three primary outcomes: efficacy; immunogenicity; and safety of vaccines in children with chronic conditions treated with biologics.MethodsThe protocol for our systematic review and meta-analysis was registered and published with PROSPERO. We searched electronic bibliographic databases for studies published from 2009 to 2019, focusing on vaccinations in children with chronic conditions treated with biologics.ResultsWe retrieved 532 records. Thirty-one full-text articles were selected, and 14 were included in the meta-analysis. No significant publication bias was found. Efficacy: limited data are available regarding the efficacy of vaccination, as most studies have focused on immunogenicity as surrogate outcome for efficacy. Immunogenicity: patients receiving anti-TNF-alpha therapy had a statistically significant risk of poor seroconversion (p = 0.028) and seroprotection by the serotype B influenza vaccine [inflammatory bowel disease (IBD) p = 0.013; juvenile idiopathic arthritis (JIA) p = 0.004]. We found adequate responses with H1N1 and H3N2 serotypes. Few studies existed for pneumococcal, hepatitis A virus, hepatitis B virus, varicella-zoster virus, Measles Mumps Rubella virus, and multiple vaccine administration. Safety: vaccine administration was not associated with serious side effects, but JIA patients on anti-TNF alpha therapy had a statistically significant risk of presenting with myalgia or arthralgia postinfluenza vaccine (p = 0.014).ConclusionsMore evidence concerning efficacy, immunogenicity, and safety of vaccinations is needed to guide physicians in the vaccine decision process for this pediatric population.     

Recombinant zoster vaccine (RZV) second-dose series completion in adults aged 50–64 years in the United States

In 2018, CDC recommended a highly efficacious adjuvanted recombinant zoster vaccine (RZV) as a 2-dose series for prevention of herpes zoster (HZ) for immunocompetent persons age ≥ 50 years, with the 2nd dose recommended 2–6 months after the 1st dose. We estimated second-dose RZV series completion in the U.S. among 50–64-year-olds using two administrative databases. Second-dose RZV series completion was ～70% within 6-months and 80% within 12-months of first dose. Among those who received only 1 RZV dose with at least 12 months of follow-up time, 96% had a missed opportunity for a second-dose vaccination, defined as a provider or pharmacy visit, among whom 36% had a visit for influenza or pneumococcal vaccination within 2–12 months of their first-dose of RZV. We found that RZV series completion rates in 50–64-year-olds was high. Availability of RZV at pharmacies has potentially helped increase series completion, but missed opportunities remain.     

The diagnostic significance of antibody specificity indices in multiple sclerosis and herpes virus induced diseases of the nervous system

Summary The antibody specificity index (ASI) indicates the cerebrospinal fluid (CSF)/serum difference of antibody amounts per weight unit IgG (normal < 1.5). It has proven to be the most sensitive inflammation parameter in CSF analysis so far, more sensitive than the Western blot, the oligoclonal response, and the empirical differentiation of CSF immunoglobulins. By this diagnostic criterion, several benign viral meningitis cases were found to be caused by the varicella/zoster virus. The diagnostic relevance of local zoster antibody synthesis was greatest in ganglionitis cases, e.g., in zoster oticus sine herpete (facial paresis) and acute radicular syndromes of the elderly. The diagnostic significance of the local immune response against measles, rubella, and zoster antigens (MRZ response) was ascertained further. Together with oligoclonal gamma-globulin fractionation, there is now only 1 out of 100 multiple sclerosis (MS) patients left who has been found to have a normal CSF.Abbreviations AB antibody - Alb albumin - ASI antibody specificity index - AU arbitrary unit - CSF cerebrospinal fluid - HIV human immunodeficiency virus - HSV herpes simplex virus - Ig immunoglobulin - Igloc locally synthesized immunoglobulin - MRI magnetic resonance imaging - MRZ measles, rubella, zoster - MS multiple sclerosis - MSL measles - Q CSF/serum concentration quotient - QLim limiting concentration quotient - RUB rubella - SDS sodium dodecyl sulfate - Ser serum - VZV varicella/zoster virus     

中西医结合治疗带状疱疹13例

目的寻找治疗带状疱疹的最佳方法。方法对内蒙古呼和浩特市某社区13例带状疱疹采用中西药结合方法治疗。结果 13例患者中12例痊愈,1例患者疗效不明显;11例患者完全恢复健康无复发症状,1例患者恢复健康,1年后复发,结论中西药结合治疗带状疱疹疗效明显。     

水痘-带状疱疹病毒抗原的ELISA定量检测方法的建立

目的:建立水痘-带状疱疹病毒(VZV)抗原的双抗体夹心ELISA定量检测方法,用于质控VZV灭活疫苗研发和生产中抗原含量.方法:以VZV中和单抗5F6C8为包被抗体、8H5D1为酶标抗体,构建定量检测VZV抗原的双抗体夹心ELISA方法,并对本方法的特异性、灵敏度、准确性、线性和稳定性等性能进行分析.结果:建立的双抗体夹心定量检测VZV抗原的ELISA方法,线性范围为0.4 μg～13 μg/ml,相关系数为R2=0.994,定量限度为0.4.μg/ml;变异系数CV＜ 15％、准确性回收率介于87.5％ ～ 111.6％之间,稳定性37℃6天的回收率＞80％.与VZV以外的相关病毒样本没有交叉反应.结论:构建的VZV抗原ELISA定量检测方法的各项性能符合定量检测需要,可用于VZV灭活疫苗的研发和生产过程的抗原含量检测.     

中药黄硝软膏外用治疗带状疱疹98例疗效观察

目的：探讨中药黄硝软膏外用治疗带状疱疹疗效。方法：每日1次擦患处，10天为一疗程。结果：治疗组治愈率高于对照组。结论：中药黄硝软膏外用治疗带状疱疹疗效显著。     

“蛇串疮”中医辨治用药规律浅探

目的:探求"蛇串疮"的中医辨治用药规律。方法:选取近十年中医文献中有关治疗蛇串疮的医案、方剂,用excel建立数据库,运用计量学方法对其进行系统学分析。结果:药物类别上以清热药、补益药、利水渗湿药及解表药为主,其次为活血化瘀药及理气药;药性以寒性药物占多数,其次为微寒药、温性药和平性药;药味以苦、甘、辛味药物的使用频率明显高于其他药味的药物;药物归经以肝经、胃经为主;高频药物包括甘草、柴胡、栀子、黄芩、当归、生地、龙胆草、板蓝根、泽泻、蒲公英、车前子、金银花、木通、大青叶、赤芍。结论:中医治疗"蛇串疮"用药以寒温并用、补泻兼施、宣散通滞并用的特点,同时又注重疏肝清心健脾胃。     

龙胆泻肝汤加减对带状疱疹的临床疗效观察及对免疫功能的影响

目的：分析龙胆泻肝汤加减对带状疱疹的临床疗效观察及对免疫功能的影响。方法：将本院60例带状疱疹患者根据数字随机法分为对照组和观察组,各30例。对照组口服巴喷丁胶囊＋阿昔洛韦,观察组在对照组治疗方案基础上加用龙胆泻肝汤,于治疗后第1周、第4周进行简易 McGill 疼痛评分、Oswestry 功能障碍指数、汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）量表评分的变化,以及治疗前及治疗4周后 Th17细胞浓度变化。结果：1）治疗前2组McGill 疼痛评分比较无统计学意义（P ＞0.05）,经过治疗后2组患者的 McGill 疼痛评分均有所下降,但是观察组下降的趋势更明显;2）治疗前2组 Oswestry 功能障碍指数比较差异无统计学意义（P ＞0.05）,经过治疗后2组患者的 Oswestry 功能障碍指数均有所下降,但是观察组下降的趋势更明显。3）2组治疗前 HAMA、HAMD 负面情绪积分比较,差异均无统计学意义（P ＞0.05）,治疗后2组 HAMA 和 HAMD 负面情绪积分与治疗前差异有统计学意义（P ＜0.05）,其中观察组 HA-MA 和 HAMD 负面情绪积分降低趋势更明显（P ＜0.05）;4）2组治疗前 Th17表达差异无统计学意义（P ＞0.05）;治疗1个月后,观察组的 Th17细胞表达明显低于对照组。结论：龙胆泻肝汤加减能有效治疗带状疱疹,其机制可能与改善患者Th17细胞相关。