生肌止血散联合艾司奥美拉唑治疗消化性溃疡出血的临床疗效及其安全性

目的探讨生肌止血散联合艾司奥美拉唑治疗消化性溃疡(PU)出血的临床疗效及其安全性。方法选取茂名市中医院2016年3月-2018年10月收治的PU出血患者110例,随机分为对照组和观察组,各55例。对照组给予艾司奥美拉唑治疗,观察组在对照组基础上给予止血生肌散治疗。比较两组临床疗效、止血时间、出血剂量及不良反应发生率。结果观察组总有效率高于对照组,止血时间长于对照组,出血剂量少于对照组,不良反应发生率低于对照组(P<0.05)。结论生肌止血散联合艾司奥美拉唑治疗PU出血的临床疗效确切,可缩短出血时间,减低出血量,且安全性高。     

康复新液联合熊去氧胆酸治疗胆汁反流性胃炎的临床疗效

目的探讨康复新液联合熊去氧胆酸治疗胆汁反流性胃炎的临床疗效。方法选取万安县中医院2018年2月-2019年2月收治的胆汁反流性胃炎患者68例,采用随机数字表法分为对照组与观察组,各34例。对照组予以铝碳酸镁联合莫沙必利治疗,观察组在对照组基础上予以康复新液联合熊去氧胆酸治疗。两组均连续治疗2个月。比较两组临床疗效、临床症状(胃痛、胃胀、恶心及嗳气)评分、胆汁反流情况(24 h胆汁反流次数、最长反流时间、反流时间超过5 min次数),并观察两组不良反应发生情况。结果观察组治疗总有效率高于对照组,胃痛、胃胀、恶心、嗳气评分及不良反应发生率低于对照组,24 h胆汁反流次数、反流时间超过5 min次数少于对照组,最长反流时间短于对照组(P<0.05)。结论康复新液联合熊去氧胆酸治疗胆汁反流性胃炎的临床疗效确切,可有效改善临床症状和胆汁反流情况,且安全性较高。     

酮康唑联合克霉唑栓治疗老年念珠菌性阴道炎的临床疗效及其安全性

目的探讨酮康唑联合克霉唑栓治疗老年念珠菌性阴道炎的临床疗效及其安全性。方法选取南昌县中医院2017年1月-2019年1月收治的老年念珠菌性阴道炎患者50例,根据单盲分组法分成参照组与研究组,各25例。参照组予以酮康唑治疗,研究组在参照组基础上联合克霉唑栓治疗。两组均治疗9 d。比较两组临床疗效,并观察两组不良反应发生情况。结果研究组治疗总有效率高于参照组,不良反应发生率低于参照组(P<0.05)。结论酮康唑联合克霉唑栓治疗老年念珠菌性阴道炎的临床疗效确切,可有效改善患者临床症状与体征,且安全性较高。     

IL-27 and autoimmune rheumatologic diseases: The good,the bad,and the ugly

The footprint of cytokines is evident in almost every biological process, such as development, as well as the pathogenesis of the different diseases, immune responses to pathogens, etc. These small proteins are categorized into different functional classes; for instance, they can play a pro-inflammatory or anti-inflammatory role in different situations, or they can confer a polarization to the immune system. Interleukin (IL)-27 is a member of the IL-12 family. Antigen-presenting cells are the primary source of IL-27 production, which exerts its effects by bindings to the IL-27 receptor expressed on the surface of target cells. Interaction of IL-27 and IL-27 receptor leads to activation of the JAK-STAT and p38 MAPK signaling pathways. Most studies focused on the inflammatory effects of this cytokine, but gradually anti-inflammatory effects were also revealed for this cytokine, which changed the traditional perception of the function of this cytokine. The functionality of IL-27 in the pathogenesis of rheumatic diseases has been attributed to a double-blade sword. Hence, novel therapeutic approaches have been devised targeting IL-12 family that has been accompanied with promising results. In this review, we focused on the inflammatory and anti-inflammatory properties of IL-27 in different autoimmune rheumatologic diseases and its plausible therapeutic potentials.     

Recent findings on the Coronavirus disease 2019 (COVID-19); immunopathogenesis and immunotherapeutics

Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) is responsible for recent ongoing public health emergency in the world. Sharing structural and behavioral similarities with its ancestors [SARS and Middle East Respiratory Syndrome (MERS)], SARS-CoV-2 has lower fatality but faster transmission. We have gone through a long path to recognize SARS and MERS, therefore our knowledge regarding SARS-CoV-2 is not raw. Various responses of the immune system account for the wide spectrum of clinical manifestations in Coronavirus disease-2019 (COVID-19). Given the innate immune response as the front line of defense, it is immediately activated after the virus entry. Consequently, adaptive immune response is activated to eradicate the virus. However, this does not occur in every case and immune response is the main culprit causing the pathological manifestations of COVID-19. Lethal forms of the disease are correlated with inefficient and/or insufficient immune responses associated with cytokine storm. Current therapeutic approach for COVID-19 is in favor of suppressing extreme inflammatory responses, while maintaining the immune system alert and responsive against the virus. This could be contributing along with administration of antiviral drugs in such patients. Furthermore, supplementation with different compounds, such as vitamin D, has been tested to modulate the immune system responses. A thorough understanding of chronological events in COVID-19 contributing to the development of a highly efficient treatment has not figured out yet. This review focuses on the virus-immune system interaction as well as currently available and potential therapeutic approaches targeting immune system in the treatment of COVID-19 patients.     

急性髓系白血病患者诱导缓解治疗期症状群的纵向研究

目的 探讨急性髓系白血病（acute myeloid leukemia,AML）患者诱导缓解治疗（induction therapy,IT）期症状群的变化情况。方法 2018年1月—2020年6月,便利选取山东省某三级甲等医院血液内科首次确诊为AML并接受IT的130例患者,运用中文版记忆症状评估量表在IT开始前1 d（T1）、IT结束当天（T2）、IT结束后第7天（T3）对其进行评估,运用因子分析确立症状群的组成。 结果 T1存在4个症状群,为心理症状群、营养症状群、神经症状群和疼痛-出汗症状群。T2存在3个症状群,为胃肠道症状群、疲乏症状群和治疗相关症状群。T3存在4个症状群,为心理症状群、胃肠道症状群、疲乏症状群和形象改变症状群。其中心理症状群在T1和T3存在,疲乏症状群和胃肠道症状群在T2和T3持续存在。结论 AML患者在IT期经历的症状群呈动态变化。IT前的心理症状群、IT中的胃肠道症状群、IT结束后的疲乏症状群可作为优先干预的症状群。     

肾移植受者手术决策参与满意度的调查研究

目的 了解肾移植受者手术决策参与满意度现状并分析其影响因素。 方法 2020年11月—2021年1月,采用便利抽样法选取成都市某三级甲等综合医院器官移植门诊随访的272例肾移植受者进行调查。采用肾移植受者一般资料调查表、决策期待量表、患者家属手术决策参与程度调查表、患者对医疗决策知情程度调查表、患者对医疗决策参与的满意度调查问卷,对肾移植受者进行调查。 结果 肾移植受者手术决策参与满意度总分为（78.84±11.47）分,其中,信息维度得分为（70.70±17.14）分,交流协商维度得分为（79.69±13.75）分,决策维度得分为（80.73±12.47）分,总满意度及信心维度得分为（84.25±12.67）分。年龄、家属参与手术决策的程度、医疗费用支付方式以及患者对于手术决策知情程度等对肾移植受者手术决策参与满意度有影响（均P<0.05）。多元线性回归分析显示,患者对于手术决策知情程度是肾移植受者手术决策参与满意度的独立影响因素（P<0.001）。 结论 肾移植受者手术决策参与满意度水平有待提高,对手术决策的知情程度是影响其参与满意度的主要因素。医护人员应结合肾移植受者年龄和家属参与程度,对其手术决策知情情况进行综合评估,制订个体化决策辅助干预措施。     

Small Cell Osteogenic Sarcoma of the Ribs: Cytological,Immunohistochemical, and Ultrastructural Study With Literature Review

Small cell osteosarcoma (OS) is a rare variant of OS that is composed of small cells resembling those of Ewing's sarcoma (ES) with recognizable osteoid. This type of tumor often creates difficulty in making a diagnosis when tissue samples do not include osteoid. The frequent sites are long bones and until now there have been no reported cases arising in the ribs. A case is reported here of small cell OS occurring in the ribs of a 37-year old female with its aspiration cytologic and electron microscopic characteristics. In the cytologic smear, the small round neoplastic cells were individually scattered or arranged in small nests. The nuclei were hyperchromatic and oval with no visible nucleoli. Ultrastructurally, the nuclei had a round or oval euchromatic chromatin pattern and occasional nucleoli. The scanty cytoplasm contained a small quantity of organelles including either tubular or dilated cisternae of RER, a few mitochondria, and free or polyribosomes. Other organelles were absent. Although the electron microscope sample of this case did not include bone mineral (hydroxy apatite), the electron microscopic features of the tumor cells were unique and useful for exclusion of other small round cell neoplasms.