高容量血液滤过联合集束化治疗对感染性休克合并MODS疗效分析

目的 探讨高容量血液滤过联合集束化治疗对感染性休克合并多器官功能障碍综合征(MODS)患者的效果。方法 选择2019年2月—2020年12月期间本院收治的119例感染性休克合并MODS患者符合本次纳入、排除标准的90例患者作为研究对象,利用分层随机分组法分为两组各45例,对照组接受集束化治疗,研究组接受高容量血液滤过联合集束化治疗,对比两组患者治疗前后APACHE Ⅱ评分、SOFA评分,炎症因子水平、降钙素原PCT水平和动脉血乳酸水平、乳酸清除率。结果 治疗后,研究组APACHE Ⅱ评分、SOFA评分(12.15±6.28,9.25±4.28)低于对照组(20.14±5.16,14.17±5.12),差异有统计学意义(t=6.594、4.946,P<0.001);治疗后,研究组血清IL-6、IL-10水平(38.25±15.24,4.21±0.89)低于对照组(64.21±18.21,6.25±1.31),研究组降钙素原PCT水平(9.81±3.94)低于对照组(11.1±4.19),差异有统计学意义(t=7.305、8.641、7.830,P<0.001);治疗后,研究组...     

潜阳育阴颗粒对阴虚阳亢型高血压合并高脂血症患者血管弹性功能的影响

目的  探讨潜阳育阴颗粒对阴虚阳亢型高血压合并高脂血症患者颈动脉血管弹性功能的影响。方法  选择符合纳入标准的阴虚阳亢型高血压合并高脂血症患者80例, 随机分为观察组及对照组各40例。对照组给予钙通道阻滞剂氨氯地平+阿托伐他汀钙片标准治疗, 观察组在对照组治疗基础上联用潜阳育阴颗粒, 疗程均为12周, 观察患者治疗前后中医证候积分及临床疗效、血压血脂水平[低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、总胆固醇(TC)、甘油三酯(TG)]、炎症因子水平[C反应蛋白(CRP)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)]、凝血功能指标[部分活化凝血酶原时间(APTT)、凝血酶原时间(PT)]、血液流变学指标[全血高切、全血中切、全血低切、红细胞沉降率(ESR)]、颈动脉内膜中层厚度(cIMT)、极速成像脉搏波传导速度[双侧颈动脉收缩起始脉搏波速度(PWV-BS)、收缩末期脉搏波速度(PWV-ES)]以及安全性指标的变化。结果  治疗后, 2组中医证候积分及临床疗效均有所改善(P < 0.01), 观察组优于对照组(P < 0.05)。2组血压明显降低(P < 0.01),LDL、HDL、TC、TG、CRP、IL-6、TNF-α、APTT、PT、全血高切、全血中切、全血低切、ESR均有所改善(P < 0.05,P < 0.01), 其中观察组TC、LDL、TNF-α、APTT、ESR改善优于对照组(P < 0.05,P < 0.01);2组PWV-BS、PWV-ES均有所改善(P < 0.05,P < 0.01)。结论  潜阳育阴颗粒联合基础治疗可提高阴虚阳亢型高血压合并高脂血症患者临床疗效,改善血压血脂水平、炎症状态、凝血功能、血液流变学及动脉弹性功能。      

膝关节镜结合中药熏洗治疗膝骨关节炎的临床效果

目的:探讨膝关节镜结合中药熏洗方案治疗膝骨关节炎(KOA)患者的临床效果.方法:收集2014年1月—2016年12月玉田县中医医院诊治的66例KOA患者,按照治疗方案不同分为两组,对照组(32例)行单纯中药熏洗治疗,观察组(34例)行关节镜清理术联合中药熏洗治疗,回顾观察并分析患者疼痛程度、关节症状、炎性因子水平、生活...     

Potential nanotherapeutic strategies for perioperative stroke

AimsBased on the complex pathological environment of perioperative stroke, the development of targeted therapeutic strategies is important to control the development of perioperative stroke.DiscussionsRecently, great progress has been made in nanotechnology, and nanodrug delivery systems have been developed for the treatment of ischemic stroke.ConclusionIn this review, the pathological processes and mechanisms of ischemic stroke during perioperative stroke onset were systematically sorted. As a potential treatment strategy for perioperative stroke, the review also summarizes the multifunctional nanodelivery systems based on ischemic stroke, thus providing insight into the nanotherapeutic strategies for perioperative stroke.     

电针预处理对脂多糖诱导的小鼠心功能障碍及炎性反应的影响

目的  观察电针预处理对脂多糖(LPS)诱导的脓毒症模型小鼠心功能障碍和炎性反应的影响, 探讨电针预处理促心肌保护的可能机制。方法  24只SPF级雄性C57BL/6J小鼠随机分为对照组、模型组和电针预处理组, 每组8只。电针预处理组在异氟烷麻醉状态下电针双侧足三里穴, 疏密波, 频率2/15 Hz, 强度2 mA, 持续15 min; 对照组、模型组同样的方式抓取、固定。电针结束后, 模型组和电针预处理组腹腔注射LPS(10 mg/kg)构建脓毒症模型; 对照组注射等量生理盐水。采用超声心动图评价心功能; ELISA法检测血清TNF-α、IL-1β水平; qPCR和Western blot法检测心肌组织中TNF-α、IL-1β、IL-6和IL-10 mRNA和蛋白表达量; 流式细胞术检测心肌组织中F4/80+CD11b+总巨噬细胞、F4/80+CD11b+CD206lowM1型和F4/80+CD11b+CD206highM2型巨噬细胞含量。结果  与对照组相比, 模型组小鼠的LVEF、LVFS均显著下降(P < 0.01), 血清中TNF-α、IL-1β含量均升高(P < 0.01), 心肌组织中TNF-α、IL-1β、IL-6、IL-10 mRNA和蛋白表达增加(P < 0.05,P < 0.01), 心肌组织中巨噬细胞含量增多(P < 0.01), 且M1型巨噬细胞比例增高(P < 0.01);与模型组相比, 电针预处理组的LVEF、LVFS均显著提高(P < 0.01), 血清中TNF-α、IL-1β含量下降(P < 0.05,P < 0.01), 心肌组织中TNF-α、IL-1β、IL-6 mRNA和蛋白表达下降(P < 0.05,P < 0.01), 而IL-10表达上升(P < 0.05,P < 0.01), 巨噬细胞含量下降(P < 0.01), 且M2型巨噬细胞比例增高(P < 0.01)。结论  电针预处理可能通过促进心肌组织中巨噬细胞由促炎M1型向抗炎M2型极化, 减轻全身和局部炎性反应水平, 改善心功能, 产生心肌保护效应。      

Sirt1抑制由ox-LDL诱导的人冠状动脉内皮细胞的炎症反应

目的:探讨Sirt1对动脉粥样硬化中人冠状动脉内皮细胞炎症反应的影响.方法:选取人冠状动脉内皮细胞,分别用不同浓度的ox-LDL诱导并筛选出最适浓度建立体外动脉粥样硬化细胞模型;将细胞分为正常对照组、空质粒对照组、空质粒+ox-LDL组、Sirt1过表达+ox-LDL组、Sirt1干扰+ox-LDL组;用荧光显微镜观察...     

Nutrition in Spondyloarthritis and Related Immune-Mediated Disorders

Recent research on the pathogenesis of spondyloarthritis and related immune-mediated diseases associated with human leukocyte antigen class I molecule B27 (HLA-B27) has led to significant progress in terms of management and prognosis, with multiple treatments being constantly evaluated and implemented. Correlations between the genetic background of spondyloarthritis and inflammatory bowel diseases and the inflammatory processes involving gut microbiota have been established. This knowledge has allowed progress in pharmacological therapy. The role of diet in the pathogenesis and treatment of diseases pertaining to the HLA-B27 spectrum is of great significance, considering possible future applications in individualized medicine. Diet impacts the composition of gut microbiota, representing a substrate for the synthesis of metabolites affecting the mucosal immune system. Certain pro-inflammatory mediators, such as emulsifiers and microparticles, induce a more profound cytokine response, promoting inflammation. Numerous diets, including the low-starch diet, the Mediterranean diet, diets with low contents of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (low-FODMAP diets), gluten-free diets and fasting, have been analysed and correlated with patients’ symptomatology and dietary adherence. The aim of this review is to provide an extensive perspective on the diets available to patients with spondyloarthritis and related immune-mediated disorders.     

Efficacy of FODMAP Elimination and Subsequent Blinded Placebo-Controlled Provocations in a Randomised Controlled Study in Patients with Ulcerative Colitis in Remission and Symptoms of Irritable Bowel Syndrome: A Feasibility Study

Background: Patients with inflammatory bowel disease (IBD) and symptoms of irritable bowel syndrome (IBS) may be intolerant to fermentable carbohydrates (FODMAPs). The aim of this study was to test the feasibility of eliminating and subsequently reintroducing FODMAPs in patients with IBS symptoms as part of the IBD manifestation and to compare the severity of IBS symptoms and pain, bloating and quality of life (QoL). Methods: An eight-week randomised open-label FODMAP elimination with double-blinded, crossover provocations of FODMAP and placebo. Diet patients were on a low-FODMAP diet for eight weeks with blinded two-week provocations after two and six weeks. Questionnaires, blood and stool samples were collected. Results: Patient enrolment was challenging. Nineteen participants were included in the study. Eliminating low FODMAP for two weeks resulted in significant decreases in pain and bloating scores (p < 0.003), whereas there were no statistical differences in pain scores between diet patients and controls. Pain and bloating scores increased, returning to baseline levels after two weeks of double-blinded provocations with placebo, (p > 0.05). Conclusions: The results document the possibility of performing a randomised controlled study following the gold standard for testing food intolerance with blinding of the Low FODMAP diet. Recruitment of participants was challenging.