TGAb、TMAb及TRAb联检在复方甲亢片配合131I治疗Graves病中的价值

通过观察131I治疗前后Graves病(GD)患者TGAb、TMAb及TRAb浓度变化,探讨复方甲亢片配合131I治疗对GD患者的免疫功能的影响.将121例GD患者分为:(1)对照组:单纯131I治疗组58例,采用131I一次性口服治疗;(2)研究组:131I加复方甲亢片治疗组61例.于治疗后2、4、12个月随访患者,比较两组治疗后TGAb、TMAb、TRAb浓度的变化.结果表明治疗前研究组和对照组TGAb、TMAb阳性者分别有9例和8例,治疗后12个月时TGAb、TMAb转阴率分别为44.4%(4/9)和12.5%(1/8),研究组的转阴率高于对照组(P＜0.05);两组治疗后2、4、12个月时TRAb值均逐渐下降,以4、12个月时较治疗前下降明显(P＜0.05),12个月时研究组TRAb值较对照组下降明显(P＜0.05),但2、4个月时两组TRAb值无明显差异(P＞0.05).复方甲亢片配合131I治疗能提高患者TGAb、TMAb的转阴率,较快地降低TRAb值,复方甲亢片具有增强GD患者机体免疫调节功能的作用.     

A practical guide to the sublingual immunotherapy tablet adverse event profile: implications for clinical practice

Objectives: Treatment with allergy immunotherapy improves allergic rhinoconjunctivitis, but can also improve comorbidities associated with allergic rhinitis such as asthma. Sublingual immunotherapy (SLIT)-tablets are a convenient and efficacious method of allergy immunotherapy. They are self-administered after the first tablet has been provided under medical supervision. Therapy may elicit local reactions or, rarely, systemic allergic reactions. The objective of this report is to inform healthcare practitioners about the safety and tolerability profile of SLIT-tablets and use this information to provide practical guidance that may inform patients regarding potential adverse reactions and how to manage them.

Methods: Pooled analyses of safety data from completed randomized, multicenter, double-blind, placebo-controlled phase 2 and phase 3 US and EU trials of timothy grass, short ragweed, and SQ house dust mite SLIT-tablets were conducted to characterize safety and tolerability.

Results: SLIT-tablets are generally well tolerated. No life-threatening events, serious systemic allergic reactions, or events that compromised the airway have been reported. The most common treatment-related adverse events (AEs) are oral site reactions, most of which begin on day 1 of treatment, recur for less than 2 weeks, and resolve after approximately 30–60 minutes. Systemic allergic reactions have been managed with conventional pharmacotherapy. Reactions treated with epinephrine are uncommon, but have been reported. Treatment of AEs, treatment discontinuation considerations, and patient FAQs regarding SLIT-tablet safety/tolerability are discussed.

Conclusions: This report gives healthcare providers valuable information to educate patients regarding what to expect in terms of SLIT-tablet safety and tolerability. Practical guidance is also provided to ensure proper treatment of any adverse reactions.     

单硝酸异山梨酯缓释片联合治疗老年单纯收缩期性高血压病

目的探讨单硝酸异山梨酯缓释片联合治疗老年单纯收缩期性高血压病的疗效。方法将182例经血管紧张素转换酶抑制剂(ACEI)、钙离子阻滞剂、β-受体阻滞剂、利尿剂等合理剂量治疗4周后全天平均收缩压仍≥160mmHg、舒张压<95mmHg的患者分为两组,治疗组加用单硝酸异山梨酯缓释片40mg,每天1次,对照组加用α-受体阻滞剂或外周肾上腺能神经元阻滞剂。均实行24小时动态血压(24hABP)监测。结果治疗组全天收缩压平均值较对照组明显减小,总有效率治疗组87.9%,对照组35.2%(P<0.01)。结论单硝酸异山梨酯缓释片联合治疗老年单纯收缩期性高血压病是一种有效的方法。     

银杏叶提取物对大鼠肝纤维化的治疗作用

目的：观察银杏叶提取物（EGB）对大鼠肝纤维化的治疗作用，并探讨其作用机制。方法：采用CCl4腹腔注射制造大鼠肝纤维化模型，观察EGB对肝纤维化大鼠肝功能生化指标、肝脏HE染色、Aetivin A（激活素A）表达及肝细胞凋亡的影响。结果：EGB对肝纤维化大鼠的肝功能指标和肝脏病理分级有明显改善作用，并能显著降低肝纤维化大鼠肝脏Aetivin A表达和肝细胞凋亡的数量。结论：EGB对CCl4诱导的大鼠肝纤维化有良好的治疗作用，Activin A表达及肝细胞凋亡减少可能是其机制之一。     

Budesonide Oral Suspension Improves Outcomes in Patients With Eosinophilic Esophagitis: Results From a Phase 3 Trial

Background & AimsEosinophilic esophagitis (EoE) is a chronic, immune-mediated disease for which there is currently no pharmacologic therapy approved by the U.S. Food and Drug Administration.MethodsIn this double-blind, placebo-controlled, phase 3 trial, patients 11–55 years of age with EoE and dysphagia were randomized 2:1 to receive budesonide oral suspension (BOS) 2.0 mg twice daily or placebo for 12 weeks at academic or community care practices. Co-primary endpoints were the proportion of stringent histologic responders (≤6 eosinophils/high-power field) or dysphagia symptom responders (≥30% reduction in Dysphagia Symptom Questionnaire [DSQ] score) over 12 weeks. Changes in DSQ score (key secondary endpoint) and EoE Endoscopic Reference Score (EREFS) (secondary endpoint) from baseline to week 12, and safety parameters were examined.ResultsOverall, 318 patients (BOS, n = 213; placebo, n = 105) were randomized and received ≥1 dose of study treatment. More BOS-treated than placebo-treated patients achieved a stringent histologic response (53.5% vs 1.0%; Δ53% [95% confidence interval (CI), 43.8%–59.5%]; P < .001) or symptom response (52.6% vs 39.1%; Δ13% [95% CI, 1.6%–24.3%]; P = .024) over 12 weeks. BOS-treated patients also had greater improvements in least-squares mean DSQ scores and EREFS over 12 weeks than placebo-treated patients: DSQ, –13.0 (SEM 1.2) vs –9.1 (SEM 1.5) (Δ–3.9 [95% CI, –7.1 to –0.8]; P = .015); EREFS, –4.0 (SEM 0.3) vs –2.2 (SEM 0.4) (Δ–1.8 [95% CI, –2.6 to –1.1]; P < .001). BOS was well tolerated; most adverse events were mild or moderate in severity.ConclusionsIn patients with EoE, BOS 2.0 mg twice daily was superior to placebo in improving histologic, symptomatic, and endoscopic outcomes over 12 weeks. BOS 2.0 mg twice daily was well tolerated. ClinicalTrials.gov number: NCT02605837.     

复方鳖甲软肝片治疗原发性胆汁性肝硬化的临床疗效评价

目的评价复方鳖甲软肝片治疗原发性胆汁性肝硬化(PBC)患者的临床疗效。方法按照随机双盲安慰剂对照设计方法,纳入上海中医药大学附属曙光医院2011年11月-2013年12月确诊的56例PBC患者,分为治疗组和对照组各28例。治疗组给予复方鳖甲软肝片(4片/次,3次/d,口服)联合熊去氧胆酸片(UDCA)(50 mg/片,10~15 mg·kg-1·d-1)治疗。对照组给予空白安慰剂(4片/次,3次/日,口服)联合UDCA 50 mg/片,10~15 mg·kg-1·d-1)治疗。两组患者均治疗12个月。观察治疗前后患者临床症状、PBC-40量表、肝功能(ALT、AST、ALP、GGT、TBil)、肝脏弹力硬度值的变化。组间计量资料比较采用t检验,计数资料比较采用χ2检验。结果治疗12个月后,治疗组患者肝功能ALT、AST、GGT、ALP、TBil均有显著下降,与治疗前相比差异有统计学意义(t值分别为3.2019、3.0953、3.0279,P值均<0.01;t值分别为2.4420、2.1621,P值均<0.05),对照组患者肝功能仅GGT显著下降,与治疗前相比差异有统计学意义(t=1.9981,P<0.05);治疗后两组患者肝功能比较,治疗组GGT、ALP较对照组显著下降,两组相比差异有统计学意义(t值分别为2.0061、2.3106,P值均<0.05)。治疗组患者脏弹力硬度值由治疗前(14.37±10.58)k Pa显著下降至(10.02±5.96)k Pa,差异有统计学意义(t=2.1134,P<0.05)。治疗组患者治疗后PBC-40量表皮肤瘙痒、社交和疲劳维度较治疗前显著下降,差异有统计学意义(t值分别为2.5158、2.1409、3.2441,P值均<0.05),两组患者治疗后在疲劳和社交维度差异有统计学意义(t值分别为3.1491、2.6287,P值均<0.05)。结论复方鳖甲软肝片可显著改善PBC患者肝功能,降低患者肝脏弹力硬度值,显著改善患者PBC-40皮肤瘙痒和疲劳等临床症状,在临床上具有一定推广应用价值。     

氨氯地平阿托伐他汀钙片治疗高血压合并冠心病的效果及安全性分析

目的观察氨氯地平阿托伐他汀钙片治疗高血压合并冠心病患者的临床效果与安全性。方法随机选取2012-07~2014-07收治的100例高血压合并冠心病患者作为研究对象,按照随机数字表法将其分为观察组与对照组各50例。观察组给予氨氯地平阿托伐他汀钙片治疗,对照组给予硝苯地平控释片治疗,比较两组患者血压、血脂、临床疗效及不良反应发生情况。结果观察组显效34例,有效13例,无效3例。对照组显效13例,有效22例,无效15例,观察组临床疗效优于对照组(P0.01)。治疗后,观察组收缩压、舒张压、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均低于对照组(P0.05),高密度脂蛋白胆固醇(HDL-C)高于对照组(P0.05)。观察组总不良反应发生率为4.0%,明显低于对照组的26.0%(P0.05)。结论采用氨氯地平阿托伐他汀钙片治疗高血压合并冠心病,可有效控制血压,改善患者的血脂水平,药物安全性较高,患者不良反应发生率较低,且疗效显著,值得推广。     

山楂叶原花青素多聚体对人脐静脉内皮细胞钙活化的影响

目的:探讨山楂叶原花青素多聚体(PPC)对血管内皮细胞钙浓度的影响及其机理,以期阐明其血管活性的机制。方法:体外培养人脐静脉内皮细胞(HUVECs)。以Fura-2标记细胞内钙离子,活细胞工作站连续测定细胞内钙离子浓度30 min。结果:12.5~50 mg/L PPC可以浓度依赖地升高HUVECs内钙离子浓度,其作用方式与经典血管内皮细胞钙激动剂ATP明显不同。其中25和50 mg/L的PPC效果与正常组比较,差异有统计学显著性(P0.01)。抑制胞内钙释放,对这一作用没有影响;而去除胞外钙离子、使用钠钙交换体抑制剂以及去除胞外钠离子,均可显著抑制,甚至取消PPC的作用。结论:PPC具有显著的血管内皮细胞钙活化作用,这可能是其调节血管内皮细胞功能的机制之一。这一作用可能是通过促进胞内钠内流,激活钠钙交换体的逆向转运,从而引起胞外钙内流而达到的。