枳术颗粒联合叶酸治疗幽门螺旋杆菌阳性慢性萎缩性胃炎 46例

目的 探讨枳术颗粒联合叶酸对幽门螺旋杆菌(Hp)阳性慢性萎缩性胃炎病人的治疗作用.方法 选取2016年1月至2018年12月宿迁市人民医院收治的92例Hp阳性慢性萎缩性胃炎病人,采用随机数字表法分为对照组与观察组,每组46例.对照组在四联疗法的基础上给予叶酸治疗,10毫克/次,3次/天,治疗2周;观察组在对照组的基础上给予枳术颗粒治疗,6克/次,3次/天,治疗2周.比较两组病人的临床疗效、临床症状积分、胃黏膜病理积分、血清中炎性因子含量、胃泌素与胃蛋白酶原(PG)含量、Hp清除率、不良反应.结果 观察组的总有效率(86.96％)高于对照组(67.39％)(P<0.05).治疗后,与对照组相比,观察组的临床症状(胃痛、胃中嘈杂、胃脘胀满、嗳气反酸、乏力)积分、胃黏膜病理积分(炎症、病变活动度、腺体萎缩、肠上皮化生)、血清炎性因子[白细胞介素-1β(IL-1β)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)]含量、血清胃蛋白酶原Ⅱ(PGⅡ)含量均降低(P<0.05),血清胃泌素、胃蛋白酶原Ⅰ(PGⅠ)含量均升高(P<0.05).观察组的Hp清除率(95.65％)高于对照组(78.26％)(P<0.05).两组不良反应发生率比较差异无统计学意义(P>0.05).结论 在四联疗法的基础上给予枳术颗粒和叶酸联合治疗,可以增强Hp阳性慢性萎缩性胃炎病人的治疗效果,改善临床症状和胃黏膜病变程度,降低炎症水平,调节胃泌素和胃蛋白酶原表达,提高Hp清除率,具有较好的药物安全性.     

胃癌患者血清miR-204、HSP-70及IL-2与Hp感染及病情关系研究

目的探讨胃癌患者血清中微小RNA-204(MicroRNA-204,miR-204)、热休克蛋白-70(Heat shock protein-70,HSP-70)及白细胞介素-2(Interleukin-2,IL-2)的变化与幽门螺杆菌(Helicobacter pylori,Hp)感染、TNM分期及淋巴结转移的关系。方法选取2015年1月-2018年10月郑州大学附属肿瘤医院经病理学或胃镜确诊的初诊胃癌患者96例作为胃癌组、胃炎患者96例作为对照组,检测对比两组的血清miR-204、HSP-70及IL-2与Hp感染水平,并按照Hp感染结果、TNM分期、淋巴结转移结果将胃癌组进行分层分析。结果胃癌组的血清HSP-70为(2.33±0.76)pg/ml高于对照组(1.16±0.40)pg/ml(P<0.05);胃癌组的血清miR-204(0.462±0.117)、IL-2(2.26±0.78)ng/ml低于对照组miR-204(1.330±0.205)、IL-2(3.95±0.92)ng/ml(P<0.05);Ⅰ期和Ⅱ期胃癌患者的血清HSP-70水平低于Ⅲ期和Ⅳ期,血清miR-204、IL-2水平高于Ⅲ期和Ⅳ期(P<0.05);Hp感染阳性胃癌患者的血清HSP-70水平高于阴性患者,血清miR-204、IL-2水平低于阴性患者(P<0.05)。结论胃癌患者血清HSP-70、miR-204、IL-2水平异常表达与TNM分期、淋巴结转移及Hp感染有一定的关系。     

小儿慢性胃炎与幽门螺杆菌感染及治疗

目的探讨小儿慢性胃炎患儿血清Hp-IgG检测率及治疗方法。方法65例慢性胃炎患儿采用血清Hp-IgG检测,把56例Hp抗体阳性患儿随机分为治疗组及对照组,两组皆用圣阳安中片、麦滋林—S颗粒治疗,治疗组加用阿莫仙胶囊和替硝唑治疗。疗程均为2周,于治疗后观察临床疗效及复查血清Hp-IgG。结果治疗组及对照组临床总有效率分别为96.9%和29.2%,Hp清除率分别为84.4%和12.5%,两者均有显著性差异(P＜0.01)。结论说明小儿慢性胃炎与Hp感染密切相关,采用圣阳安中片、表滋林-S颗粒+阿莫仙胶囊和替硝唑四联治疗临床效果好,Hp清除率高,副作用小。     

Evaluation of novel X-ray protective eyewear in reducing the eye dose to interventional radiology physicians

The new recommendation of the International Commission on Radiological Protection for occupational eye dose is an equivalent dose limit to the eye of 20 mSv year ^–1 , averaged over a 5-year period. This recommendation is a drastic reduction from the previous limit of 150 mSv year ^–1 . Hence, it is important to protect physicians’ eyes from X-ray radiation. Particularly in interventional radiology (IVR) procedures, many physicians use protective lead (Pb) glasses to reduce their occupational exposure. This study assessed the shielding effects of novel 0.07 mm Pb glasses. The novel glasses (XR-700) have Pb–acrylic lens molded in three dimensions. We studied the novel type of 0.07 mm Pb glasses over a period of seven consecutive months. The eye dose occupational radiation exposure of seven IVR physicians was evaluated during various procedures. All IVR physicians wore eye dosimeters (DOSIRIS™) close to the left side of the left eye. To calculate the shielding effects of the glasses, this same type of eye dosimeter was worn both inside and outside of the Pb lenses.The average shielding effect of the novel glasses across the seven physicians was 61.4%. Our results suggest an improved shielding effect for IVR physicians that use these glasses. No physician complained that the new glasses were uncomfortable; therefore comfort is not a problem.The lightweight glasses were acceptable to IVR physicians, who often must perform long procedures. Thus, the novel glasses are comfortable and reasonably protective. Based on the results of this study, we recommend that IVR physicians use these novel 0.07 mm Pb glasses to reduce their exposure.     

含不同抗生素四联方案根除幽门螺杆菌的疗效比较

目的比较临床常用3组幽门螺杆菌(Hp)根除方案(EBAF、EBAC、EBAT)在Hp感染患者中的根除情况、症状缓解情况和成本-效果及不良反应。方法选取我院消化内科门诊Hp感染患者134例,按照数字随机法将Hp感染患者随机分成3组。患者均给予埃索美拉唑、枸橼酸铋钾胶囊、阿莫西林基础治疗,在基础治疗的同时,A组(EBAF)、B组(EBAC)、C组(EBAT)分别添加呋喃唑酮、克拉霉素、替硝唑治疗,疗程为10 d;停药1个月后复查呼气试验。结果 A组的Hp根除率、症状缓解率高于B组、C组,且成本-效果优于B组、C组,差异有统计学意义(P<0.05)。A组的不良反应发生率与B组、C组比较差异无统计学意义(P>0.05)。结论三组根除Hp治疗方案中,EBAF方案的根除率高,成本-效果佳,且不良反应无明显增加,可作为一线方案用于临床根除Hp。     

基于根除Hp治疗对胆汁反流性胃炎病人的临床疗效观察

为观察根除幽门螺杆菌(Hp)治疗及艾普拉唑和复方尿囊素联合枳术宽中疗法对胆汁反流性胃炎的治疗效果影响,将171例胆汁反流性胃炎病人进行Hp检测,Hp阳性病人分别给予非根除Hp治疗和根除Hp治疗,Hp阴性病人分别给予非联合枳术宽中和联合枳术宽中治疗。结果显示,治疗后,Hp阳性病人有效率分别为60.00%和87.10%,Hp阴性病人有效率分别为64.70%和91.53%。对Hp阳性的胆汁反流性胃炎病人,根除Hp治疗疗效优于非根除Hp治疗;对Hp阴性的胆汁反流性胃炎病人,艾普拉唑和复方尿囊素联合枳术宽中疗效优于非联合枳术宽中治疗。     

Fruits and dietary phytochemicals in bone protection

Osteoporosis is a disease of bone characterized by loss of bone matrix and deterioration of bone microstructure that leads to an increased risk of fracture. Cross-sectional studies have shown a positive association between higher fruit intake and higher bone mineral density. In this review, we evaluated animal and cellular studies of dried plum and citrus and berry fruits and bioactive compounds including lycopene, phenolics, favonoids, resveratrol, phloridzin, and pectin derived from tomato, grapes, apples, and citrus fruits. In addition, human studies of dried plum and lycopene were reviewed. Animal studies strongly suggest that commonly consumed antioxidant-rich fruits have a pronounced effect on bone, as shown by higher bone mass, trabecular bone volume, number, and thickness, and lower trabecular separation through enhancing bone formation and suppressing bone resorption, resulting in greater bone strength. Such osteoprotective effects seem to be mediated via antioxidant or anti-inflammatory pathways and their downstream signaling mechanisms, leading to osteoblast mineralization and osteoclast inactivation. In future studies, randomized controlled trials are warranted to extend the bone-protective activity of fruits and their bioactive compounds. Mechanistic studies are needed to differentiate the roles of phytochemicals and other constitutes in bone protection offered by the fruits. Advanced imaging technology will determine the effective doses of phytochemicals and their metabolites in improving bone mass, microarchitecture integrity, and bone strength, which is a critical step in translating the benefits of fruit consumption on osteoporosis into clinical data.     

幽门螺杆菌感染者C-erbB-2蛋白在胃癌、胃炎和正常组织的表达

目的探讨C-erbB-2癌基因在Hp感染中的表达与胃癌、胃炎及正常组织的关系.方法采用免疫组化卵白素-生物素-辣根过氧化酶法,分别检测正常组织21例,浅表性胃炎22例,胃癌27例C-erbB-2癌基因抗体的表达变化.结果C-erbB-2在70例Hp感染者中随胃粘膜病理变化不同而增高,其中,正常组织的阳性率为19%(4/21),浅表性胃炎为77.27%(17/22),胃腺癌为100%(27/27),相互之间均有显著性差异(P＜0.01);同时,随着组织类型变化,炎症出现,免疫反应类型由镶嵌型向局灶型和弥漫型转变.结论C-erbB-2癌基因的异常表达对胃炎、胃癌的形成有一定作用,与胃腺癌的发生有密切关系.     

疏肝健脾方剂治疗肝郁脾虚型脾胃病的临床疗效

目的探讨疏肝健脾方剂治疗肝郁脾虚型脾胃病临床疗效及其对患者Hp清除和胃黏膜修复的影响效果。方法选择2014年2月~2016年12月在我院治疗的80例肝郁脾虚型脾胃病患者,按照随机数字法分为两组,对照组40例予以常规西药治疗,研究组40例予以常规西药联合疏肝健脾汤治疗。比较两组患者临床疗效、胃黏膜修复情况、临床症状改善情况、Hp清除情况。结果研究组患者临床总有效率(95.00%)显著高于对照组(77.50%)(P0.05)。研究组患者胃黏膜修复率(92.50%)显著高于对照组(65.00%)(P0.05)。研究组患者脘腹隐痛、腹部胀满、食欲减退、嗳气反酸、神疲乏力、大便不调、胸胁胀痛、烦躁易怒、口苦咽干、失眠多梦等临床症状改善情况优于对照组,且脘腹隐痛、食欲减退、神疲乏力等临床症状改善率显著高于对照组(P0.05)。两组患者Hp清除率比较差异有统计学意义(P0.05)。研究组Hp清除率(92.50%)显著高于对照组(67.50%)(P0.05)。结论疏肝健脾方剂治疗肝郁脾虚型脾胃病可显著改善患者临床症状,清除Hp修复胃黏膜,疗效确切,值得在临床上推广使用。     

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??Helicobacter pylori??Hp?? infection rate is high and has strong pathogenicity??so the eradication of Hp has great significance. The combination of a proton pump inhibitor with two antibiotics??or bismuth-based triple therapy or quadruple therapy is recommended as a alternate first-line regimen for treating Hp infection in children. In recent years??the success of eradication therapies has declined??party due to the increassing rate of Hp resistant strains. Hp eradication therapy with probiotics has received more and more attention. In this article??we comprehensively review the possible mechanisms of probiotics in treating Hp infection in children??and its advantage in the prevention of antibiotic-associated side effects is also discussed.