保肝药物联合应用治疗化疗相关性药物肝损害的临床疗效观察

目的 探讨异甘草酸镁联合还原型谷胱甘肽对化疗引起的药物性肝损害的临床疗效.方法 采用单中心,随机分组、前瞻性研究的方法,将研究对象分为异甘草酸镁单药组(A组)、还原型谷胱甘肽单药组(B组)和联合用药组(C组),观察治疗2周后,三组患者血ALT、AST变化情况.结果 入选病例81例,均可评价疗效.在治疗结束后,A、B、C三组ALT水平分别为(73.64±19.28)U/L、(76.46±15.34)U/L、(56.80±17.33) U/L,显著低于(P<0.05)治疗前水平的(125.35±22.63)U/L、(122.22±21.69) U/L、(130.38±21.97)U/L;AST水平分别为(79.88±20.15)U/L、(80.48±15.72)U/L、(61.97±16.63) U/L,显著低于(P<0.05)治疗前水平的(140.37±20.15)U/L、(138.21±25.61) U/L、(147.59±24.38)U/L;三组ALT、AST下降幅度分别为(45.98±10.81)U/L、(40.76±13.57)U/L、(73.63±13.01)U/L和(60.56±13.88)U/L、(57.46±17.16) U/L、(84.96±15.59)U/L,两两比较,联合用药组与单药组(C组与A组、C组与B组)间有统计学差异(P<0.05),单药组(A组与B组)间无统计学差异(P>0.05).结论 与单一用药相比,异甘草酸镁联合还原型谷胱甘肽可显著降低化疗药物性肝损害患者的血ALT、AST水平.     

Oral Zinc Sulfate as Adjuvant Treatment in Children With Nephrolithiasis: a Randomized,Double-Blind,Placebo-Controlled Clinical Trial

Background:

Nephrolithiasis in children is associated with a high rate of complications and recurrence.

Objectives:

Since some evidences reported that zinc has an important place amongst inhibitors of crystallization and crystal growth, we decided to assess the effectiveness of oral zinc sulfate as adjuvant treatment in children with nephrolithiasis.

Patients and Methods:

This was a randomized, double-blind, placebo-controlled clinical trial. 102 children in the age range 1 month to 11 years with first nephrolithiasis were recruited. Patients were randomly divided into two equal groups (intervention and control groups). Intervention group received conservative measures for stones and 1 mg/kg/day (maximum 20 mg/day) oral zinc sulfate syrup for 3 months. Control group received placebo in addition to conservative measures, also for 3 months. Patients were followed up by ultrasonography for 9 months, in 5 steps (at the end of 1st, 2nd, 3rd, 6th and 9th month after treatment) assessing size and number of stones in the kidneys.

Results:

Only at the end of the first month, the average number (intervention: 1.15 ± 3.78, control: 1.3 ± 2.84) (P = 0.001) and size (cm) (intervention: 0.51 ± 1.76, control: 0.62 ± 1.39) (P = 0.001) of stones was significantly lower in the intervention group, and in other points there was no significant therapeutic efficacy in oral zinc adjuvant treatment compared to conservative treatment alone. Also, during the 9-month follow-up, the number and size of stones in both groups decreased significantly (both: P < 0.0001) in a way that the decrease in the intervention group showed no difference with the control group.

Conclusions:

Adjuvant treatment with zinc is not more effective than consecutive treatment in children with nephrolithiasis. However, further studies are recommended due to the lack of clinical evidence in this field.     

硝酸甘油微量泵入联合硫酸镁治疗妊高征临床疗效

目的：探讨不同药物治疗妊娠高血压综合征的临床疗效。方法将144例妊高征患者依据随机数字表法分成两组：对照组采用单纯硫酸镁治疗,观察组采用硫酸镁、硝酸甘油微量泵入治疗。比较两组的临床疗效、血压和24 h尿蛋白量的变化情况以及妊娠结果。结果观察组的总有效率显著高于对照组(90.28%vs 73.61)( P＜0.05);治疗后观察组患者的舒张压、收缩压、24 h尿蛋白量降幅均显著性大于对照组( P＜0.05);观察组患者出现胎盘早剥、早产、胎儿窘迫、剖宫产、产后出血、以及新生儿窒息等妊娠结局的概率显著低于对照组( P＜0.05)。结论临床应用硝酸甘油微量泵入辅助硫酸镁治疗妊高征能够明显降低血压、改善妊娠预后。     

镁合金网联合兔颗粒骨植入在兔体内异位成骨的实验研究

目的:使用普通和带涂层的镁合金网联合自体颗粒骨植入大兔体内,观察颗粒骨的愈合情况和镁合金网的降解速度.方法:用微弧氧化法在镁合金网表面制成20μm的涂层.将金属网制成直径为8 mm,高度为16 mm的圆柱状.分为A、B、C三组,分别为明胶海绵、普通镁合金网和20μm涂层镁合金网制作圆筒.取新西兰大白兔的自体的髂骨,制成细小颗粒骨,填充于圆筒中,植入白兔的臀部肌袋中.分别在第4、8周测血清镁离子并给予X线检查,观察植入物形态并且骨荧光标记镜下检测.结果:涂层20μm的镁合金网降解速度要慢于普通镁合金网,在X线和直观观察下在3组颗粒骨的愈合过程中未见明显差异;3组大白兔在不同时间段的血清镁离子浓度比较,差异无统计学意义(P＞0.05);镜下观察荧光染色带分布和间隔的紧密程度依次是C组最致密、B组次之、A组较为稀疏;3组植入物在大白兔体内未见明显排异反应,组织相容性较好.结论:镁合金植入物有较好的组织相容性,镁合涂层可减慢降镁合金解速度,并且对于骨的生长具有一定的促进作用.具有一定的临床意义.     

The development and validation of methods for evaluating the immune system in preweaning piglets

The preweaning piglet has been found to be a valuable research model for testing ingredients used in infant formula. As part of the safety assessment, the neonates' immune system is an important component that has to be evaluated. In this study three concurrent strategies were developed to assess immune system status. The methods included (1) immunophenotying to assess circulating innate immune cell populations, (2) monitoring of circulating cytokines, particularly in response to a positive control agent, and (3) monitoring of localized gastrointestinal tissue cytokines using immunohistochemistry (IHC), particularly in response to a positive control agent. All assays were validated using white papers and regulatory guidance within a GLP environment. To validate the assays precision, accuracy and sample stability were evaluated as needed using a fit for purpose approach. In addition animals were treated with proinflammtory substances to detect a positive versus negative signal. In conclusion, these three methods were confirmed to be robust assays to evaluate the immune system and GIT-specific immune responses of preweaning piglets.     

甘草酸在肝外疾病中的研究进展

异甘草酸镁是常用的护肝降酶药物,其主要成分由甘草酸制备而得,后者具有抗炎、抗氧化、抗病毒感染的作用。近年研究证实,甘草酸可能对缺血-再灌注损伤、神经系统损伤、多种炎症、免疫相关疾病、内分泌疾病和肿瘤有治疗作用,有广阔的应用前景。本文系统总结近年来甘草酸在肝外疾病中的研究进展,概括甘草酸治疗上述疾病的可能机制,并对未来的研究方向做前瞻性的展望。     

硫酸镁联合罗哌卡因在小儿骶管阻滞中的应用

目的探讨硫酸镁联合罗哌卡因在小儿骶管阻滞中运用的有效性和安全性。方法将59例接受单侧腹股沟疝修补术的患儿随机分为罗哌卡因组(R组)和硫酸镁罗哌卡因组(RM组),R组患儿于全麻成功后用0.15%罗哌卡因1 m L/kg行骶管阻滞,RM组患儿在全麻后以0.15%罗哌卡因1 m L/kg联合硫酸镁50 mg行骶管阻滞。比较两组患者FLACC评分、MBS评分、AS评分及术后1周的FAS评分,同时比较患儿术后止痛药物使用情况及术后不良反应发生情况。结果两组患儿一般情况比较差异无统计学意义,术后不同时间点FLACC评分、AS评分比较,RM组均低于R组,差异有统计学意义(P<0.05)。两组术后M BS评分、术后不良反应比较差异无统计学意义(P>0.05)。R组患儿术后镇痛药物芬太尼及对乙酰氨基酚的用量均大于RM组,差异有统计学意义(P<0.05)。两组术后1周FAS评分均为0。结论 50 mg硫酸镁联合罗哌卡因小儿骶管阻滞较单纯罗哌卡因能提供更好的术后镇痛效果。     

Magnesium substitution in acute ischaemic heart syndromes.

It has recently been suggested that intravenous infusion of magnesium may reduce mortality and the incidence of serious arrhythmias in patients with ischaemic heart disease and acute myocardial infarction. In the present double-blind, placebo-controlled study, 298 patients with suspected acute myocardial infarction were randomized to receive either intravenous magnesium chloride (80 mmol.24 h-1) or placebo. Infusions were started immediately after admission to the coronary care unit. One hundred and fifty patients received magnesium and 148 the placebo. Ischaemic heart disease was diagnosed in 244 patients. Acute myocardial infarction was observed among 83 patients in the magnesium group and 79 in the placebo group. Both treatment groups were comparable regarding sex, age, clinical status, previous cardiac disease and medication. Serum magnesium was significantly raised during magnesium infusion compared to placebo (P less than 0.01). Fatal events were only observed among patients with myocardial infarction, but neither the in-hospital mortality (magnesium: 12.1%; placebo 10.1%) nor the mortality after a follow-up period of 245 days (median observation time) was affected by magnesium substitution. Magnesium infusion was accompanied by a significantly increased incidence of atrioventricular conduction disturbances. The results suggest that patients suffering from acute ischaemic heart syndromes do not benefit from intravenous magnesium supplementation.     

The relationship between serum trace element levels and clinical parameters in patients with fibromyalgia

We examined the association between serum trace elements and clinical findings such as number of sensitive tender points, severity of fatigue and functional status in patients with fibromyalgia (FM). Thirty-two patients diagnosed as having FM according to the ACR 1990 criteria and 32 normal healthy controls (NHC) were included in this study. The demographic data, disease duration, number of tender points and accompanying symptoms (fatigue, sleep disorders, headache, paresthesia, irritable bowel syndrome, sicca symptoms, Raynaud's phenomena) of the patients were noted. Visual analog scale (10 cm) was implemented to estimate daily severity of pain and fatigue. Fibromyalgia impact questionnaire was used for functional assessment. Serum selenium (mug/dL) and serum zinc (mug/dL) levels were measured by atomic absorption spectrometer. Serum magnesium (mmol/L) level was measured by the original kits of Abbott Aeroset auto-analyzer. The mean age of patients in FM group and NHC were calculated as 42.9 (SD = 7.7) years and 41.3 (SD = 9.7) years, respectively. Serum levels of zinc (P = 0.001) and magnesium (P = 0.002) were significantly decreased by FM groups, whereas there was no considerable difference with selenium levels of both groups (P > 0.05). Association between serum zinc level and number of tender points (P = 0.008) and that between fatigue and magnesium level (P = 0.003) was found as meaningful. According to the results of this study, it was asserted that serum magnesium and zinc levels may play an important role in the pathophysiology of FM.     

Identification of the major allergenic proteins from silkworm moth (Bombyx mori) involved in respiratory allergic diseases

Introduction and ObjectivesMoths are a significant source of indoor and outdoor aeroallergens. High prevalence of IgE-mediated sensitization was demonstrated in a group of patients with allergic respiratory diseases. There are no studies on adult stage of these moth species allergens involved in allergic respiratory reactions - the aim of this study.Material and Methods36 participants were included in an experimental study, submitted to skin prick test with Bombyx mori wing extract and six other common allergens, as well as Western blot analysis with incubated nitrocellulose membrane impregnated with silkworm moth extract and human IgE-antibody. The participants were divided into 3 groups: 1) 21 allergic patients whose skin prick test was positive to Bombyx mori wing extract, 2) eight allergic patients whose skin prick test was positive to mite and negative to Bombyx mori extract 3) seven negative non-allergic subjects.ResultsAmong the 21 participants from group 1, 19 serum samples reacted to Bombyx mori extract by Western blot. All of them reacted to a protein at 80 kDa and five other proteins (66, 50, 45, 37 and 30 kDa) were identified in more than 50% of the individuals tested, considered as major allergenic proteins. Sera from seven out of eight patients sensitized to house dust mite demonstrated IgE-reactivity to Bombyx mori extract by Western blot analysis. Serum samples from healthy participants did not react at all.ConclusionSix major reactive proteins by immunoblot analysis from moth’s wings sensitized patients can be potential allergens. The one at 80 kDa is the major protein, seen in all IgE-reactive patients from group 1 and in none from group 2, yet to be identified. Future studies should be conducted to better characterize these proteins.