Clinical factors predictive of spontaneous remission or relapse in cases of autoimmune pancreatitis

BACKGROUND: The rates of spontaneous remission and relapse of autoimmune pancreatitis (AIP) are not known. OBJECTIVE: To study the clinicopathologic factors predictive of remission and relapse in cases of AIP. DESIGN: Retrospective study. PATIENTS: Of the 20 patients with AIP, complete response to steroid therapy was recognized in 12 patients, and the remaining 8 patients improved without steroid therapy. Seven patients experienced a relapse. RESULTS: Patients who were seronegative for immunoglobulin (Ig) G4, had no obstructive jaundice, no diabetes mellitus, no swelling of the duodenal papilla, negative staining of the duodenal papilla for IgG4, and focal pancreatic swelling showed a greater tendency toward spontaneous remission (P < .05). The results of multivariate analysis revealed that negative staining of the duodenal papilla for IgG4 was the only independent predictor of spontaneous remission of AIP (odds ratio [OR] 1.395, P = .0304). Seropositivity for IgG4, diffuse swelling of the pancreas, and the presence of stricture in the lower part of the bile duct were significantly associated with a relapse of AIP (P < .05) according to the results of univariate analysis, whereas the results of multivariate analysis revealed only diffuse pancreatic swelling as an independent predictor of a relapse of AIP (OR 26.197, P = .0331). CONCLUSIONS: Endoscopic findings are of useful prognostic value, because patients with AIP and with negative staining of the duodenal papilla for IgG4 appeared to have a higher frequency of remission without steroid therapy. Patients with AIP and with diffuse pancreatic swelling were found to be at an increased risk of relapse after the initial steroid administration.     

寒痹酊湿敷联合电磁波照射治疗膝关节骨性关节炎病人的临床观察

[目的]观察寒痹酊湿敷联合电磁波照射治疗膝关节骨性关节炎病人的效果。[方法]对51例膝关节骨性关节炎病人给予寒痹酊湿敷联合电磁波照射膝关节治疗,同时给予针对性护理,参照加拿大西安大略和麦克玛斯特大学膝关节骨性关节炎指数(WOMAC)评分法和膝关节综合评定表,对病人的治疗效果进行观察和评价。[结果]优15例,良21例,可12例,差3例,治疗有效率为94.12%。[结论]寒痹酊湿敷联合电磁波照射可有效治疗膝关节骨性关节炎,加强护理可确保治疗方案发挥最佳效应,提高治疗效果并减轻不良反应。     

痿痹消联合PKP术治疗骨质疏松性椎体压缩骨折临床观察

目的:观察痿痹消联合PKP术治疗骨质疏松性椎体压缩性骨折的临床疗效;方法:将符合标准的110例骨质疏松性椎体压缩性骨折的患者随机分为治疗组和对照组,每组55例,对照组予以单纯pkp术处理,治疗组在对照组基础上,术后第二天即开始口服痿痹消治疗。分别于术前、术后一周及术后2月观察患者VAS评分、Cobb角及Oswestry功能评分,并对各项指标进行治疗前后比较及组间比较,并做统计学处理分析结果。结果:治疗组与对照组治疗前随机各因素(包括性另、年龄及病程等)无统计学差异。治疗后,2组患者VAS评分、cobb角度数、Oswestry功能评分均明显降低,治疗组低于对照组。术后2月,治疗组Cobb角度数分较术后1周减小,对照组无明显变化。结论:PKP治疗骨质疏松性椎体压缩性骨折术后联合口服痿痹消,能有效促进骨折愈合,改善临床症状,并能极大的提高患者的生活质量。     

BiPAP治疗老年COPD合并严重呼吸衰竭疗效观察

目的探讨双水平无创正压通气（BiPAP）对老年慢性阻塞性肺疾病（COPD）合并严重呼衰的治疗价值。方法采用随机对照试验方法,74例老年COPD严重呼衰患者中随机分成二组,通气组和对照组,对照组给予常规抗感染、平喘、祛痰对症治疗和低浓度氧疗,通气组除了常规治疗外,加用双水平无创正压通气（BiPAP）治疗。结果通气组治疗后动脉血气指标改善,呼吸困难减轻,呼吸频率和心率减慢。结论本法治疗老年慢性阻塞性肺疾病合并严重呼衰有效,减少气管插管或气管切开以及相应的并发症,减少病人的痛苦和医疗费用。     

无创双水平正压通气治疗COPD合并Ⅱ型呼吸衰竭的临床观察及护理

目的：观察BiPAP呼吸机对治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效。方法：将56例慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者进行随机分组,采用无创双水平正压通气（BiPAP呼吸机）辅助通气28例为治疗组;采用鼻导管低流量氧气吸入28例为对照组。两组同时给予抗感染、解痉、平喘、化痰等常规治疗并辅以积极护理措施。观察两组患者的外周血氧饱和度及动脉血气分析结果及临床体征变化。结果：对照组患者在血气分析结果、血氧饱和度提示有轻度改变,而治疗组在血气分析结果、血氧饱和度有显著改善,两者有显著性差异（P〈0．01）。结论：无创双水平正压通气（BiPAP呼吸机）对治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的疗效显著,对低氧血症和C02潴留改善明显,可提高患者的生活质量。     

见骨损而非独责之于肾

受肾主骨理论的影响,在类风湿关节炎骨破坏的病机论述上多不离肾。通过梳理痹证骨损的中医论治思路以及后世发展变化,阐述各医家中医整体观念下的多角度辨证思路,提出见骨损而非独责之于肾的观点。认为湿热瘀阻、伏邪、毒邪、肝脾失调等均与类风湿关节炎骨破坏相关。治疗上应多系统合参、虚实同治、标本兼治,抓主要病机,解决主要矛盾。     

MUC1 expression in primary and metastatic pancreatic cancer cells for in vitro treatment by (213)Bi-C595 radioimmunoconjugate

Control of micrometastatic pancreatic cancer remains a major objective in pancreatic cancer treatment. The overexpression of MUC1 mucin plays an important role in cancer metastasis. The aim of this study was to detect the expression of MUC1 in human primary tumour tissues and three pancreatic cancer cell lines (CAPAN-1, CFPAC-1 and PANC-1), and target MUC1-positive cancer cells in vitro using (213)Bi-C595 alpha-immunoconjugate (AIC). The expression of MUC1 on pancreatic tumour tissues and cancer cell lines was performed by immunohistochemistry and further confirmed by confocal microscope and flow cytometry analysis on the cell surface. Cytotoxicity of (213)Bi-C595 was tested by MTS assay. Apoptosis was documented using TUNEL assay. Overexpression of MUC1 was found in approximately 90% of tested tumour samples and the three pancreatic cancer cell lines. (213)Bi-C595 is specifically cytotoxic to pancreatic cancer cells in a concentration-dependent fashion. These results suggest that overexpression of MUC1 in pancreatic cancer is a useful target, and that the novel (213)Bi-C595 AIC selectively targets pancreatic cancer cells in vitro. (213)Bi-C595 may be a useful agent for the treatment of micrometastases or minimal residual disease (MRD) in pancreatic cancer patients with overexpression of MUC1 antigen.     

活血通痹液治疗风湿类疾病120例临床观察

目的:研究提高风湿病的疗效,探讨养血活血药对风湿病患者甲襞微循环异常的治疗作用。方法:将就诊患者随机分为两组,治疗组以具有祛风除湿、养血活血作用的活血通痹液治疗观察,并与风湿圣药治疗的患者对照。结果:治疗组无论是对风湿病还是对甲襞微循环异常的疗效,与对照组比较差异均有显著性(P<0.05或P<0.01)。显示了养血活血药的治疗作用及优越性。结论:在祛风湿药中适当加入养血活血药能显著提高疗效,并能改善甲襞微循环,对风湿病的治疗及预后均有重要意义。     

大鼠风寒湿痹证模型的建立与前列腺素E2的关系

运用Ｆｒｅｕｎｄ＇ｓ完全佐剂合用风寒湿因素的方法成功地建立了大鼠痹症病理模型。造模二周后，致炎足（右足）肿胀率（％）达１１１±４８（Ｐ＜０．０１）；第三周后，右足肿胀率为１３７±５１，达到最高值；第四周，肿胀率仍非常明显。左足肿胀率也非常明显。病理学研究发现，模型组大鼠全部患有关节周围组织炎，中性粒细胞、淋巴细胞、巨噬细胞大量浸润其间。９只有关节滑膜炎，３只为关节软骨炎。模型组大鼠踝关节前列腺素Ｅ２含量明显高于正常组，且与关节肿胀成比例。此方法为慢性痹证模型的建卓提供了依据。比单用Ｆｒｅｕｎｄ＇ｓ完全佐剂有炎症周期长、模型稳定的特点。     

血必净对严重腹腔感染患者肠道功能及炎症反应的影响

目的：探讨血必净对严重腹腔感染患者肠道功能及炎症反应的影响。方法将我院2008年1月-2013年5月严重腹腔感染患者60例随机均分为对照组(常规治疗)和实验组(常规治疗基础上给予血必净注射液)各30例,比较两组患者治疗前后血浆DAO、LPS、TNF-α、IL-6水平及氧合指数(OI)、APACHE-II评分。结果经5d治疗后,实验组血浆DAO、LPS、TNF-α、IL-6水平明显低于对照组(P<0.05),氧合指数明显高于对照组(P<0.05),APACHE-II评分明显低于对照组(P<0.05)。结论血必净注射液对改善严重腹腔感染患者的肠道功能及炎症反应效果显著,并能有效减少内毒素入血,值得临床推广。