“消、托、补”三步法治疗胃溃疡

目的:观察"消、托、补"三步法治疗胃溃疡的疗效及对溃疡愈合情况的影响。方法:将80例胃溃疡患者随机平均分为两组,治疗过程中脱落5例,最终对照组37例,治疗组38例。对照组给予常规西医治疗,治疗组在对照组的基础上予"消、托、补"三步法中药治疗,持续治疗8周。观察两组临床疗效、胃镜疗效、临床症状积分、幽门螺旋杆菌根除情况、胃溃疡复发率,并检测胃组织增殖细胞核抗原(proliferating cell nuclear antigen PCNA)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)和再生蛋白Ⅰ(regenaration gene I,RegI)的表达。结果:治疗组在临床疗效、幽门螺旋杆菌清除率、胃溃疡复发率方面显著优于对照组(P<0.05),胃镜疗效与对照组相当(P>0.05)。与对照组相比,治疗组胃痛、反酸、纳差症状显著改善,胃黏膜PCNA表达显著升高,TGF-β1表达显著降低(P<0.05)。结论:"消、托、补"三步法可以较好地改善临床症状,促进溃疡面修复,提高黏膜愈合质量,提高幽门螺旋杆菌的根除率,减少复发,临床疗效显著。     

微化地奥司明片在糖尿病足溃疡愈合中的应用价值

目的探讨地奥司明片治疗糖尿病足患者中的临床效果。方法选择2008年8月~2009年8月收治的72例糖尿病足患者,按照Wagner分级,随机分配为2组,以治疗前后患足创面大小变化情况作为评价指标。结果地奥司明组治愈27例(75.0%),好转7例,(19.4%),无效2例(5.5%),治疗后创面大小变化与治疗前比较,差异有统计学意义(P<0.05)。对照组治愈14例(38.9%),好转13例(33.3%);无效9例(25.0%),治疗后创面大小变化与治疗前比较,差异无统计学意义(P>0.05)。结论地奥司明片能有效促进糖尿病足患者创面愈合时间,值得临床推广。     

骨巨细胞瘤中的多核巨细胞体外骨吸收研究

目的：比较破骨细胞与骨巨细胞瘤中多核巨细胞的特点，明确后者的性质和来源。方法：用倒置相差显微镜观察体外培养的多核巨细胞的一般形态及降钙素对它的影响；用骨片与多核巨细胞共同培养法观察多核巨细胞的体外骨吸收功能，用扫描电镜观察骨吸收陷窝，Ｇｏｍｏｒｉ染色观察多核巨细胞的酸性磷酸酶活性。结果：倒置相差显微镜下可见多核巨细胞胞核较多（２０个以上），胞浆周边不规则，有伪足样突起；胞浆内可见较多大小不等的空泡；降钙素（１００μｇ·Ｌ－１）可抑制多核巨细胞的伪足样运动；多核巨细胞与灭活的骨片共同培养时可见骨吸收陷窝形成，扫描电镜下可见吸收陷窝底面有原纤维；Ｇｏｍｏｒｉ染色时可见多核巨细胞的酸性磷酸酶呈阳性。结论：证实了多核巨细胞具有破骨细胞的形态特征与骨吸收功能，可能来源于骨髓的破骨细胞前体细胞     

卡培他滨节律化疗对胃癌肿瘤血管生成的影响

目的:探讨卡培他滨节律化疗对胃癌肿瘤血管生成的影响,并观察其抑瘤效果。方法:建立裸鼠人胃癌移植瘤模型,观察肿瘤生长情况和毒副作用。采用实时定量PCR测定肿瘤组织中血管内皮生长因子(VEGF)mRNA的表达水平,用免疫组织化学染色测定CD31和VEGF的表达。结果:体内试验证实低剂量卡培他滨明显抑制了肿瘤的生长,毒副作用小,且肿瘤组织内的微血管密度(MVD)及VEGF表达均下降。结论:卡培他滨节律化疗能够有效抑制裸鼠胃癌移植瘤的生长及微血管的形成,且无明显的毒副作用。     

胃钙化性纤维性肿瘤九例并文献复习

目的:探讨胃钙化性纤维性肿瘤（CFT）的临床病理特征和病理诊断方法。方法:回顾性分析2015年8月至2020年5月河北医科大学第二医院收治的9例胃CFT患者的临床病理资料。采用免疫组织化学法检测胃CFT免疫表型特征,并复习相关文献。结果:9例胃CFT患者中,男性1例,女性8例,中位年龄53岁（18~63岁）。7例发生在...     

胃溃疡穿孔修补术在基层医院的应用再探讨

目的探讨胃溃疡穿孔修补术在基层医院的应用。方法回顾性分析我院外科2006年1月—2011年12月47例胃溃疡穿孔行修补术患者的临床资料。结果 47例均进行了穿孔修补术,其中45例行电话和门诊检查随访,随访时间为6个月~36个月,无1例发生癌变。结论在基层医院单纯修补术仍是胃溃疡穿孔的主要手术方法,但是必须严格掌握手术指征,彻底性手术仍不能摒弃,临床医师要权衡利弊选择最佳治疗方案,并严格执行随访制度。     

Treatment of lepromatous ulcers using citric acid as a sole antimicrobial agent

A prospective study was carried out to assess the role of citric acid as a sole antimicrobial agent in the management of lepromatous ulcers. Thirty-four known cases of lepromatous ulcers not responding to conventional antibiotic therapies for long duration were investigated for culture and susceptibility studies. Staphylococcus aureus (25·00%) and Klebsiella spp. (23·43%) were found to be the most common isolates. Amikacin (68·75%) and ciprofloxacin (67·18%) were found to be the most effective antimicrobial agents. Topical application of citric acid ointment resulted in complete healing in 25 (73·52%) cases. In eight cases (26·48%), there was elimination of infective agent from ulcer site and formation of healthy granulation, but no complete healing of ulcer was seen. Results indicate that citric acid is the best alternative for the effective management of lepromatous ulcers when other therapies are exhausted.     

Enhanced Heterosexual Transmission Hypothesis for the Origin of Pandemic HIV-1

HIV-1 M originated from SIVcpz endemic in chimpanzees from southeast Cameroon or neighboring areas, and it started to spread in the early 20th century. Here we examine the factors that may have contributed to simian-to-human transmission, local transmission between humans, and export to a city. The region had intense ape hunting, social disruption, commercial sex work, STDs, and traffic to/from Kinshasa in the period 1899–1923. Injection treatments increased sharply around 1930; however, their frequency among local patients was far lower than among modern groups experiencing parenteral HIV-1 outbreaks. Recent molecular datings of HIV-1 M fit better the period of maximal resource exploitation and trade links than the period of high injection intensity. We conclude that although local parenteral outbreaks might have occurred, these are unlikely to have caused massive transmission. World War I led to additional, and hitherto unrecognized, risks of HIV-1 emergence. We propose an Enhanced Heterosexual Transmission Hypothesis for the origin of HIV-1 M, featuring at the time and place of its origin a coincidence of favorable co-factors (ape hunting, social disruption, STDs, and mobility) for both cross-species transmission and heterosexual spread. Our hypothesis does not exclude a role for parenteral transmission in the initial viral adaptation.