海珠益肝胶囊对小鼠免疫性肝损伤的影响

目的:进一步证实海珠益肝胶囊对肝损伤小鼠的保肝降酶作用。方法:来用卡介苗 脂多糖(BCG LPS)造成免疫性肝损伤模型小鼠,观察本品对血清中ALT、AST活力单位、肝脾脏器系数和肝脏病理组织学损伤程度的影响。结果:药物能降低血清中ALT、AST活力单位(P<0.01);减小肝脾肿大及脏器系数(P<0.01);减轻肝组织病理损伤程度。结论:海珠益肝胶囊对BCG LPS所致肝损伤小鼠有明显保肝降酶作用。     

Uso de la cápsula endoscópica en enfermedad inflamatoria intestinal en práctica clínica en España. Resultados de una encuesta nacional

IntroductionSmall bowel capsule endoscopy (SBCE) is a non-invasive diagnostic technique whose use in inflammatory bowel disease (IBD) has spread. A panenteric capsule, PillCam Crohn's (PCC), has recently been developed. We lack information on the availability and use of the CEID and PCC in our environment.MethodsWe conducted an electronic and anonymous survey among the members of the Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) [Spanish Working Group on Crohn's Disease and Ulcerative Colitis] and the Asociación Española de Gastroenterología (AEG) [Spanish Association of Gastroenterology], consisting of 37 multiple-choice questions.ResultsOne hundred and fifty members participated, the majority dedicated to IBD (69.3%). 72.8% worked at centres with an IBD unit. 79% had SBCE available at their hospital, 14% referred patients to another centre; 22% had a PCC available, 9% referred patients to another centre. 79.3% of respondents with available SBCE used it in a small percentage of patients with IBD and 15.6% in the majority. The most frequent scenarios were suspicion of Crohn's disease (76.3%), assessment of inflammatory activity (54.7%) and assessment of the extent of the disease (54.7%). More than half (59.7%) preferentially used the Patency capsule to assess intestinal patency. Almost all respondents (99.3%) considered that training resources should be implemented in this technique.ConclusionsSBCE is widely available in Spanish hospitals for the management of IBD, although its use is still limited. There is an opportunity to increase training in this technique, and consequently its use.     

Utilidad de la cápsula endoscópica en el diagnóstico de la enfermedad injerto contra huésped gastrointestinal

Introduction and aimGraft-versus-host disease (GvHD) is a complication of hematopoietic cell transplantation, and the small bowel is one of the main targets in the gastrointestinal tract. Capsule endoscopy is a safe procedure and can be useful in the diagnosis of GvHD. The aim of the present study was to compare the diagnostic yield of capsule endoscopy with the histopathologic findings in GvHD.Materials and methodsA retrospective diagnostic test study included all the patients with suspected GvHD that underwent gastroscopy and colonoscopy, with histopathologic evaluation of the biopsies taken, and capsule endoscopy, within the time frame of July 2015 and July 2019. Capsule endoscopy findings were compared with the histopathologic diagnosis, considered the gold standard.ResultsTwenty-one patients with GvHD (7 [33%] women; 37 ± 11.9 years of age) were included, 20 (95%) of whom had acute GvHD. The median gastric transit time of the capsule was 55 minutes (20-113) and the median small bowel transit time was 261 minutes (238-434). The entire small bowel was visualized through capsule endoscopy in 17 cases (80.95%). The histopathologic findings and capsule endoscopy findings resulted in the diagnosis of GvHD in 17 and 16 cases, respectively. There was agreement between the histopathologic and capsule endoscopy findings in 18 cases (15 positive and 3 negative). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic yield of capsule endoscopy were 88%, 75%, 94%, 60%, and 85%, respectively.ConclusionsCapsule endoscopy is a safe tool for the diagnosis of GvHD, with high sensitivity and positive predictive value, as well as moderate agreement with histopathologic findings.     

黄连解毒汤对小鼠酒精性脂肪肝的预防作用

目的 研究黄连解毒汤(HLJDT)对小鼠酒精性肝损伤的预防作用,为黄连解毒汤临床防治酒精性肝病提供实验依据。方法 选取60只C57小鼠随机分为空白对照组、模型对照组和HLJDT低、中、高剂量(0.61、1.22、2.44 g/kg/d)模型组,每组各12只。模型组用50%乙醇灌胃,同时采用HLJDT进行实验干预,6周后,对各组小鼠的体质量、肝指数、血清生化指标以及肝脏和结肠的病理学改变进行综合对比分析。结果 HLJDT各剂量模型组小鼠的体重增长量均显著增加(P<0.05),肝指数明显降低(P<0.05),同时HLJDT各剂量模型组能显著降低血清ALT、AST和TG的含量(P<0.05)。病理结果显示HLJDT各剂量均对酒精性肝损伤有显著的改善作用,且从低剂量到高剂量组对肠粘膜通透性具有递增的改善作用。结论 黄连解毒汤可显著降低肠粘膜的通透性,对小鼠酒精性肝损伤具有一定的预防保护作用。     

A Multicenter,Randomized,Double-blind Clinical Study on Wufuxinnaoqing Soft Capsule(五福心脑清胶囊) in Treatment of Chronic Stable Angina Patients with Blood Stasis Syndrome

Objective:To confirm the efficacy and safety of Wufuxinnaoqing Soft Capsule(五福心脑清胶囊,WSC)in the treatment of chronic stable angina(blood stasis syndrome).Methods:A multicenter,randomized,double-blind,placebo-controlled trial with superiority test was designed.A total of 240 patients with chronic stable angina(blood stasis syndrome)from multiple centers were randomly and equally assigned to the treatment group and the control group.Based on standard treatment of Westem medicine,the treatment group was given WSC,while the control group was given WSC mimetic,both for 12 weeks.Observed indicators included the efficacy in angina,the efficacy in Chinese medicine syndrome,the withdrawal or reduce rate of nitroglycerin and routine safety indices.Results:After 12-week treatment,the significant effective rate and total effective rate of the treatment group were significantly better than those of the control group(23.5%vs.9.2%,64.7%vs.30.8%),respectively,with statistically significant difference(P0.01).After 12-week treatment,the decreased points and the decreased rate of angina symptom score in the treatment group were better than in the control group(5.1±4.2 points vs.2.8±3.5 points,44.9%±37.2%vs.25.4%±30.7%)respectively,with significant difference(P0.01).After 12-week treatment,the significant effective rate and total effective rate of the treatment group were better than the control group(respectively,30.3%vs.15.0%,67.2%vs.45.0%,P0.01).After 8-or 12-week treatment,the decreased points and the decreased rate of Chinese medicine syndrome score in the treatment group were better than the control group(P0.05 or P0.01).After 12-week treatment,nitroglycerin withdrawal rate and the withdrawal or reduce rate in treatment group were better than the control group(P0.01).On safety evaluation,the incidence of adverse events(7.563%vs.7.500%)and the incidence of cardiovascular events(0.840%vs.0.000%)in the treatment group were similar with the control group,and the difference was not statistically significant(P0.05).Conclusion:In treatment of chronic stable angina(blood stasis syndrome),WSC can reduce angina attacks and consumption of nitroglycerin,decrease angina severity degree,effectively relieve the blood stasis syndromes,such as chest pain,chest tightness,palpitations,dark purple tongue and other symptoms.Besides,adverse events and cardiovascular adverse events in the treatment group and the control group showed no difference.All shows that the drug is safe and effective.[This study was registered in Chinese Clinical Trial Registry(ChiCTR),with registration number:ChiCTR-TRC-14005158.]     

益心解毒方对Nox2和Nox4亚基过表达的心肌细胞NADPH氧化酶活性的影响

目的通过观察益心解毒方含药血清对Nox2、Nox4亚基过表达的H9c2心肌细胞NADPH氧化酶活性的影响,揭示其作用环节是否与干预相应亚型的NADPH氧化酶调控环节有关。方法采用PCR方法扩增Nox2、Nox4基因全长序列,经双酶切、连接载体和转化后提取重组质粒,经酶切鉴定的阳性质粒进行DNA测序,测序正确后按照lipofectamine 2000试剂的说明书瞬时转染H9c2细胞,转染后的心肌细胞分组给予不同的药物干预,24 h后检测NADPH氧化酶活性。结果 1含有Nox2/Nox4亚基的重组质粒载体通过测序鉴定,结果与Gen Bank报道的完全一致。2通过荧光显微镜下观察转染72 h后的H9c2细胞,可见大量发绿色荧光的细胞,流式细胞术计数结果显示转染率均在60%左右,符合实验要求。3空质粒载体组、模型组、益心解毒方组的NADPH氧化酶活性表达明显高于正常组(P<0.01,P<0.05);模型组和益心解毒方组的NADPH氧化酶活性表达高于空载体组(P<0.01);模型组NADPH氧化酶活性表达均明显高于其他各组,而益心解毒方各组的NADPH氧化酶活性表达均明显低于模型组(P<0.01,P<0.05)。结论成功构建大鼠心肌细胞Nox2、Nox4亚基的重组质粒载体,该重组质粒载体可以在心肌细胞中过表达,益心解毒方可以有效地降低NADPH氧化酶活性的表达。提示此复方治疗心衰的机制可能是抑制了Nox2和Nox4型NADPH氧化酶的表达。     

异维A酸胶丸联合红霉素肠溶胶囊治疗难治性痤疮疗效观察

目的：观察异维A酸胶丸联合红霉素肠溶胶囊治疗难治性痤疮的效果。方法：将106例难治性痤疮患者随机均分成两组,治疗组给予异维A酸胶丸联合红霉素肠溶胶囊,对照组给予异维A酸胶丸治疗4周,观察用药后两组临床指标的改善情况。结果：治疗组与对照组总有效率分别为86.79%、67.92%（P<0.05）,临床疗效治疗组优于对照组。结论：异维A酸胶丸联合红霉素肠溶胶囊治疗难治性痤疮安全、有效。     

胶囊内镜对小肠疾病的诊断价值分析

目的 了解胶囊内镜检查在国人运用的临床特性，评价胶囊内镜对国人小肠疾病的诊断价值。方法 分析55例次胶囊内镜检查的临床资料。结果 (1)53例受检者进行了55次胶囊内镜检查，成功54次，成功率为98．2％。53例受检者均耐受了检查，未出现并发症。(2)胶囊内镜在胃内滞留平均时间为44min(6—135min)，小肠内滞留平均时间为334min(90—433mim)。在检查记录有效期间，胶囊内镜顺利通过回盲瓣42例，未通过12例。52例胶囊在检查结束后顺利排出体外，排出平均时间为24h(5h 10min～72h)。(3)检出了小肠癌、淋巴瘤、息肉、平滑肌瘤、黄色瘤、克罗恩病、非特异性炎症、蛔虫症、鞭虫症、异物及血管畸形等。结论 胶囊内镜检查操作简单、安全、有效，检查成功率高，对小肠黏膜、血管及黏膜下等病变的检出能力较小肠钡剂灌肠、血管造影为高，具有较好的诊断价值。胶囊内镜的最大缺点是观察不能重复，不能获得组织学诊断和较为准确的定位诊断。     

双甲五灵胶囊与肝纤维化血清TIMP-1的变化及临床疗效观察

目的观察自行研制的中药双甲五灵胶囊治疗慢性肝炎患者前后血清基质金属蛋白酶组织抑制剂1(TIMP1)的变化及意义,并观察双甲五灵胶囊治疗的临床疗效。方法将226例慢性肝炎患者随机分为双甲五灵胶囊治疗组和对照组,观察两组治疗半年前后临床症状、体征、肝功能、血清透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)以及TIMP1的变化,并进行统计学处理。结果双甲五灵胶囊治疗组与对照组比较,治疗组患者临床症状、体征、肝功能及血清肝纤维化指标明显好转(P<0.01)。结论双甲五灵胶囊可使患者血清中TIMP1水平明显降低,用于防治肝纤维化有效。双甲五灵胶囊对防治慢性肝炎肝纤维化有一定效果。     

脾虚大鼠螺杆菌感染模型的实验研究

本实验将ｗｉｓｔａｒ大鼠以劳倦、饮食失节、寒暑失宜诸因素致脾虚后，感染幽门螺杆菌（ＨＰ）成功。其脾虚表现符合有关统一标准，扫描电镜下鼠胃粘膜可见微绒毛损伤；ＨＰ感染１０天后在培养、尿素酶、ｗ—ｓ银染及涂片检测、免疫酶标ＡＢＣ法阳性率分别为６６．６７％、８０％、７０％、１００％、８０％。以半夏泻心汤治疗后大鼠脾虚症状改善，ＨＰ培养阴性。该模型对ＨＰ感染与胃肠疾病的关系，抗ＨＰ的药效学，脾虚证、扶正祛邪治则等研究，均具较大的意义。