美沙拉嗪联合双歧三联活菌治疗溃疡性结肠炎的疗效及对炎性因子的影响

目的探讨美沙拉嗪联合双歧三联活菌治疗溃疡性结肠炎的疗效及其对炎性因子的影响。方法选取2017年1月～2018年1月我院收治的溃疡性结肠炎患者80例,随机分为两组,每组各40例,两组患者均予常规对症治疗,同时两组均予美沙拉嗪缓释颗粒,观察组同时加用双歧三联活菌胶囊,治疗后比较两组患者治疗后的临床疗效,以及两组患者治疗前后TNF-α、IL-10水平的变化情况及两组患者治疗前后的临床症状积分变化情况。结果观察组治疗后的总有效率为95.00%,显著高于对照组的总有效率70.00%,两组疗效比较差异具有显著性(P0.05)。治疗后,两组患者的炎性因子TNF-α、IL-10水平较治疗前显著降低(P0.05)。且观察组患者治疗后的TNF-α、IL-10水平显著低于对照组(P0.05)。观察组患者治疗后的临床症状积分为(2.56±0.85)分,与治疗前及对照组比较,差异有统计学意义(P0.05)。结论美沙拉嗪联合双歧三联活菌治疗溃疡性结肠炎疗效确切,且可以抑制炎症反应,值得临床推广和应用。     

美托洛尔对充血性心力衰竭患者心功能、血浆脑钠肽、炎症因子的影响

目的探讨美托洛尔对充血性心力衰竭(CHF)患者心功能、血浆脑钠肽、炎症因子的影响。方法选取2017年6月～2018年6月在我院就诊的充血性心力衰竭患者92例,随机分为观察组和对照组,每组46例,对照组采取常规治疗,观察组在对照组治疗的基础上联合美托洛尔治疗,比较两组治疗前后的疗效、BNP及心功能指标LVEDD、LVESD、LVEF及炎症因子TNF-α、IL-6水平的变化情况。结果观察组患者治疗后显效率达60.8%、总有效率达97.8%,对照组患者治疗后显效率达50.0%、总有效率达74.0%,两组显效率比较,差异无统计学意义(P0.05),两组总有效率比较,差异具有统计学意义(P0.05)。治疗后,观察组患者的LVEDD、LVESD水平显著低于对照组,LVEF水平显著高于对照组,差异具有统计学意义(P0.05)。观察组患者治疗后的BNP水平显著低于对照组,差异具有统计学意义(P0.05)。观察组患者的TNF-α、IL-6水平显著低于对照组,差异具有统计学意义(P0.05)。结论充血性心力衰竭(CHF)患者应用美托洛尔治疗,能够改善其心功能,降低血浆脑钠肽水平,抑制炎症反应,值得临床广泛推广和应用。     

H型高血压患者脂联素及炎症标志物分析

<正>《中国心血管病报告2016》表明~([1]),高血压是多种心脑血管疾病的重要危险因素,其患病率逐年增长。高同型半胱氨酸(homocysteine,Hcy)血症是心血管疾病的独立危险因素之一,与其他危险因素相比较,高Hcy血症与高血压协同作用所导致的心血管疾病风险将进一步增加~([2])。在中国,约75%的高血压患者伴有高Hcy血症~([3])。其次C-反应蛋白(C-reactive protein,CRP)主要由肝细胞产生,受白细胞介素-6     

美托洛尔联合心脉隆注射液对慢性心力衰竭患者心功能和炎性因子的影响

目的观察美托洛尔联合心脉隆注射液对慢性心力衰竭患者心功能和炎性因子的影响。方法选择2017年1月～2018年1月我院住院治疗的慢性心力衰竭患者60例,采用随机数字表法随机分为两组,每组各30例,两组患者均针对病因予强心、利尿、吸氧等对症治疗,对照组加用美托洛尔,观察组在对照组治疗方法的基础上予心脉隆注射液。治疗后对比分析两组的疗效及治疗后的LVEDD、LVESD、LVEF水平、IL-6、TNF-α、CRP水平。结果观察组患者治疗后的总有效率为96.67%,显著高于对照组。观察组患者治疗后的LVEDD、LVESD、LVEF水平分别显著优于治疗前,且显著优于对照组治疗后(P0.05)。观察组患者治疗后的IL-6、TNF-α、CRP水平分别显著低于治疗前,且显著低于对照组治疗后(P0.05)。结论美托洛尔联合心脉隆注射液治疗慢性心力衰竭疗效确切,可以显著改善患者的心功能和抑制炎症反应,从而显著改善患者的预后。     

炎症标志物与妊娠期肝内胆汁淤积症程度判定的关系

[目的]探讨炎症标志物在妊娠期肝内胆汁淤积症(ICP)程度判定中的应用价值;[方法]采用回顾性病例对照研究,选取110例ICP患者和188例正常妊娠女性为研究对象。ICP患者根据总胆汁酸水平(TBA)分为轻度ICP组(＜40 μmol/L)和重度ICP组(≥40μmol/L),分析比较两组炎症标志物白细胞(WBC),血小板(PLT),中性淋巴比率(NLR),血小板淋巴比率(PLR),血小板平均体积(MPV),红细胞平均分布宽度(RDW)的平均水平;[结果]重度ICP组患者WBC、MPV、NLR含量与轻度ICP组,正常对照组相比显著增加(P＜0.05);[结论]WBC、MPV、NLR可以作为评价ICP严重程度的炎症标志物,具有潜在的临床应用价值。     

Kupffer细胞在梗阻性黄疸致肝损害作用中的研究进展

在梗阻性黄疸(obstructive jaundice,OJ)的病理过程中,肝脏是最容易受到损害的器官。梗阻性黄疽致肝损害的机制是复杂多样的。Kupffer细胞作为肝脏内的巨噬细胞,参与了梗阻性黄疸致肝损害的诸多环节。梗阻性黄疸致肝损害的首要病理因素是内毒素血症(Endotoxemia)的形成。当人血的内毒素浓度达到一定程度后就可激活Kupffer细胞,被激活的Kupffer细胞不仅可产生大量的炎性因子导致肝损害,而且还加剧内毒素血症的形成、参与肝脏炎性反应、氧化应激等病理过程来损害肝细胞。     

Inflammatory Myofibroblastic Tumor of the Ileocecal Mesentery Mimicking Abdominal Lymphoma in Childhood: Report of Two Cases

An inflammatory myofibroblastic tumor is an uncommon benign tumor located in various organs that can be misdiagnosed as a malignant neoplasm. We herein present two patients with ileocecal inflammatory myofibroblastic tumors. An abdominal mass was detected in a 13-year-old girl and a 15-year-old boy who presented with paleness, fatigue, intermittent fever, and night sweating. The radiological findings confirmed a mass originating from the ileocecal region. The presumptive diagnosis was Burkitt’s lymphoma. The histopathological diagnosis was inflammatory myofibroblastic tumor. After a surgical resection, all systemic symptoms rapidly resolved. Inflammatory myofibroblastic tumor is a rare pseudosarcomatous clinical and pathological entity. Although this tumor is more commonly reported in the lung, it can be detected in extrapulmonary sites, including the mesentery. Because the choice of treatment for this tumor is conservative surgery, an accurate preoperative analysis is important to avoid any unnecessary aggressive surgical intervention or other therapeutic approaches.     

Association of Multimodal Pain Control with Patient-Reported Outcomes in Children Undergoing Surgery

IntroductionOur aim was to describe practices in multimodal pain management at US children's hospitals and evaluate the association between non-opioid pain management strategies and pediatric patient-reported outcomes (PROs).MethodsData were collected as part of the 18-hospital ENhanced Recovery In CHildren Undergoing Surgery (ENRICH-US) clinical trial. Non-opioid pain management strategies included use of preoperative and postoperative non-opioid analgesics, regional anesthetic blocks, and a biobehavioral intervention. PROs included perioperative nervousness, pain-related functional disability, health-related quality of life (HRQoL). Associations were analyzed using multinomial logistic regression models.ResultsAmong 186 patients, 62 (33%) received preoperative analgesics, 186 (100%) postoperative analgesics, 81 (44%) regional anesthetic block, and 135 (73%) used a biobehavioral intervention. Patients were less likely to report worsened as compared to stable nervousness following regional anesthetic block (relative risk ratio [RRR]:0.31, 95% confidence interval [CI]:0.11–0.85), use of a biobehavioral technique (RRR:0.26, 95% CI:0.10–0.70), and both in combination (RRR:0.08, 95% CI:0.02–0.34). There were no associations of non-opioid pain control modalities with pain-related functional disability or HRQoL.ConclusionUse of postoperative non-opioid analgesics have been largely adopted, while preoperative non-opioid analgesics and regional anesthetic blocks are used less frequently. Regional anesthetic blocks and biobehavioral interventions may mitigate postoperative nervousness in children.Level of evidenceIII.     

微创环切技术在老年牙列缺损患者中的应用效果

目的 分析微创环切技术在老年牙列缺损患者治疗中的作用。方法 选取2021年1月-12月我院收 治的98例老年牙列缺损患者作为研究对象,应用随机数字表法分为对照组和观察组,各49例。对照组采 用传统翻瓣种植术进行治疗,观察组采用微创环切术进行治疗,比较两组不良事件发生率、炎症应激反 应、疼痛介质含量、种植牙稳定性、骨吸收水平以及美观度。结果 观察组不良事件发生率低于对照组 （ P ＜0.05）;观察组术后3 d炎症应激各项指标均低于对照组（ P ＜0.05）;观察组术后3 d各项疼痛介质含 量均低于对照组（ P ＜0.05）;观察组种植牙稳定性高于对照组,骨吸收量低于对照组（ P ＜0.05）;观察 组术后3、6、12个月美观度评分均高于对照组（ P ＜0.05）。结论 微创环切技术应用于老年牙列缺损治疗 中效果确切,可以促进骨吸收、提高牙体稳定性和美观度,有利于减轻炎症应激反应以及疼痛情况。     

Hirschsprung-associated inflammatory bowel disease: A multicenter study from the APSA Hirschsprung disease interest group

Background/PurposeA small number of Hirschsprung disease (HD) patients develop inflammatory bowel disease (IBD)-like symptoms after pullthrough surgery. The etiology and pathophysiology of Hirschsprung-associated IBD (HD-IBD) remains unknown. This study aims to further characterize HD-IBD, to identify potential risk factors and to evaluate response to treatment in a large group of patients.MethodsRetrospective study of patients diagnosed with IBD after pullthrough surgery between 2000 and 2021 at 17 institutions. Data regarding clinical presentation and course of HD and IBD were reviewed. Effectiveness of medical therapy for IBD was recorded using a Likert scale.ResultsThere were 55 patients (78% male). 50% (n = 28) had long segment disease. Hirschsprung-associated enterocolitis (HAEC) was reported in 68% (n = 36). Ten patients (18%) had Trisomy 21. IBD was diagnosed after age 5 in 63% (n = 34). IBD presentation consisted of colonic or small bowel inflammation resembling IBD in 69% (n = 38), unexplained or persistent fistula in 18% (n = 10) and unexplained HAEC >5 years old or unresponsive to standard treatment in 13% (n = 7). Biological agents were the most effective (80%) medications. A third of patients required a surgical procedure for IBD.ConclusionMore than half of the patients were diagnosed with HD-IBD after 5 years old. Long segment disease, HAEC after pull through operation and trisomy 21 may represent risk factors for this condition. Investigation for possible IBD should be considered in children with unexplained fistulae, HAEC beyond the age of 5 or unresponsive to standard therapy, and symptoms suggestive of IBD. Biological agents were the most effective medical treatment.Level of EvidenceLevel 4