四妙丸加味配合TDP治疗急性痛风性关节炎30例

笔者用四妙丸加味配合TDP照射治疗急性痛风性关节炎30例，收到满意疗效，现报告如下。     

72例支气管哮喘临床分析

目的全面分析72例支气管哮喘的发病原因和治疗方法。方法随机抽取我院2014年12月至2017年12月72例支气管哮喘患者的临床资料,总结其发病因素及有效治疗方法。结果对患者采用了糖皮质激素方法     

萝卜硫素对人胃癌SGC-7901细胞凋亡的影响及其机制研究

目的 研究萝卜硫素对人胃癌SGC-7901细胞凋亡的影响及其可能的作用机制。方法 应用细胞计数试剂盒(CCK-8)检测萝卜硫素对SGC-7901细胞增殖的影响,流式细胞术分析萝卜硫素对SGC-7901细胞周期和凋亡的影响,蛋白免疫印迹法(Western blotting)分析萝卜硫素对SGC-7901细胞中Notch1、Hes1、Bax及Bcl-2蛋白表达的影响。结果 萝卜硫素能够显著抑制SGC-7901细胞的增殖,促使其凋亡,表现出时间和剂量依赖性,萝卜硫素还能将SGC-7901细胞停留在G_1期;萝卜硫素能显著抑制Notch1、Hes1、Bcl-2蛋白表达,诱导促凋亡蛋白Bax表达,与对照组相比,差异均有统计学意义(P0.05)。结论 萝卜硫素可以明显诱导胃癌SGC-7901细胞凋亡,可能通过抑制Notch1/Hes1信号通路、降低Bcl-2/Bax比例实现。     

围生期心肌病34例临床分析

目的：探讨围生期心肌病的临床特征。方法回顾性分析34例围生期心肌病的临床特征及随访资料。结果34例病人中33例痊愈,1例转化为扩张型心肌病。结论围生期心肌病常发生于妊娠末期或产后几个月内,临床表现以心脏扩大和充血性心力衰竭为主,多见于高龄妊娠和多胎生育者。治疗主要是及时终止妊娠及控制心力衰竭。     

不同类型妊娠期高血压疾病对妊娠结局的影响

目的探讨不同类型妊娠期高血压疾病（DHCP）对妊娠结局的影响。方法采用简单抽样法,选取合并不同类型DHCP孕妇168例为观察组,随机选取同时期的正常孕妇168例为对照组,详细记录、统计并分析产妇、胎儿及新生儿的不良结局。结果观察组围产妇不良结局总发生率为48.81%,对照组3.57%。2组产妇除妊娠期高血压心脏病并发症发生率差异无统计学意义（P>0.05）外,观察组产妇胎盘早剥等并发症发生率均高于对照组（P < 0.05~P < 0.01）,观察组产妇合并2种并发症发生率高于对照组（P < 0.01）,而2组产妇合并3种并发症发生率差异无统计学意义（P>0.05）。观察组胎儿不良结局总发生率为58.42%,对照组为6.90%。观察组胎儿死亡、宫内窘迫、胎儿生长受限发生率均高于对照组（P < 0.05~P < 0.01）,观察组胎儿合并2种并发症发生率高于对照组（P < 0.01）,而2组胎儿合并3种并发症发生率差异无统计学意义（P>0.05）。观察组围新生儿不良结局总发生率为46.55%,对照组为4.93%。观察组新生儿窒息、小于胎龄儿发生率均高于对照组（P < 0.01）,观察组新生儿合并2种并发症发生率高于对照组（P < 0.01）,而2组新生儿死亡及合并3种并发症发生率差异无统计学意义（P>0.05）。妊娠期高血压、子痫前期、子痫、妊娠合并慢性高血压和慢性高血压并发子痫前期围产妇胎盘早剥、胎儿死亡、新生儿死亡等不良结局发生率差异均无统计学意义（P>0.05）。结论DHCP严重影响围产妇母婴预后,且随着疾病进程的发展,影响逐渐增加。临床应加强筛查,尽早发现和干预,改善母婴预后质量。     

胰康降血糖作用

胰康能明显降低四氧嘧啶糖尿病小鼠及肾上腺素高血糖大鼠血糖；促进四氧嘧啶损伤小鼠胰腺胰岛新生；对正常大鼠血糖的降低呈现一定的时效、量效趋势。     

病毒学因素对ALT持续正常的e抗原阴性慢性乙型肝炎病毒感染者肝脏组织学改变的影响

Objective To investigate the correlation between viral factors and liver histological changes of HBeAg-negative chronic hepatitis B patients with persistently normal serum ALT levels (PNAL). Methods HBV DNA level, HBV genotype, basal core promoter (BCP) and precore mutation were exam- ined in 52 HBeAg-negative chronic hepatitis B patients with PNAL (defined as normal ALT measured on at least 3 occasions in the intervals of about two months over a period of 12 months or more prior to the biopsy). Viral factors influencing histological changes of HBeAg-negative chronic hepatitis B patients with per-Results Subjects with both BCP and precore mutations had significantly higher HBV DNA levels than those without mutations [(4.9±1.4) vs (4.1±1.1) log10copies/ml, t = 2.308, P < 0.05]. A higher proportion of patients with histological activity index (HA1)≥ 4 was found in patients with both mutations (32.1% vs 16.7%) than in patients without mutation, however, the proportion of patients with histological activity index (HAl)≥ 3 in patients with mutations was not significantly different from that in patients without mutations (14.3% vs. 12.5%, χ2 = 0.000, P > 0.05). In patients without precore or BCP mutations, there was a strong positive correlation between viral load and liver inflammation as well as fibrosis (precore: r = 0.626, 0.592, P < 0.01; BCP: r = 0.730, 0.641, P < 0.01). In patients without both mutations, HBV DNA has shown a high accuracy for predecting fibrosis (F≥3) (AUC = 0.905, 95% CI: 0.771±1.039, P < 0.05) with the cutoff value of 4.5 log10copies/ml (sensitivity = 1.000, specificity = 0.778, PPV = 42.9%, NPV = 100.0%). Results of both genotypes and mutations were successfully obtained in 40 samples with HBV DNA≥ 104 copies/ml. The higher viral load was observed in the patients with genotype B than genotype C (5.1 vs 4.3 Iog,0copies/ml, t = 2.059, P < 0.05), but no difference was seen of liver pathologic changes between these two genotypes. Conclusions Virus harboring both BCP and precore mutants has the higher replication level than wild type virus. 32.1% and 14.3% of the patients with both mutations have moderate or severe inflammation and fibrosis. There was a strong positive correlation between viral load and liver histological changes in patients without precore or BCP mutations, and viral load shows a high accuracy for predecting sig-nificant fibrosis (F ≥ 3).     

不同程度肝纤维化的肝脏多层螺旋CT灌注成像初步研究

目的 探讨多层螺旋CT灌注成像在肝纤维化早期诊断中的应用价值.方法 33例受检者接受多层螺旋CT肝脏灌注成像检查,其中11例为无明显肝脏疾病的志愿者(对照组),22例经肝脏穿刺活检证实为肝纤维化患者,根据Ishak评分系统再分为轻度肝纤维化组(10例)和显著肝纤维化组(12例).计算各组的各项灌注指标并进行组间比较.结果 对照组、轻度肝纤维化组和显著肝纤维化组的肝动脉分数(HAF)晕升高趋势,均值分别为(18.49±9.69)%、(19.92±6.01)%、(21.31±7.47)%;平均通过时间(MTT)则呈降低趋势.三组的均值分别为(13.80±2.60)s、(12.35±1.31)s和(12.19±3.33)s.对照组、轻度肝纤维化组和显著肝纤维化组的平均血流量(BF)值分为(107.77±37.80)ml·100 g-1·min-1、(114.54±25.81)ml·100 g-1·min-1和(111.98±19.81)ml·100 g-1·min-1;平均血容量(BV)值分别为(16.61±5.78)ml·100 g-1、(17.07±2.94)ml·100 g-1和(16.42±5.53)ml·100 g-1.统计结果显示各组平均HAF、MTT、BF及BV值的差异无统计学意义(P>0.05).结论 CT肝脏灌注可定量测量各项肝脏血流灌注参数,一些灌注值的变化对肝纤维化分期具有一定程度的参考价值,但尚不能有效地进行肝纤维化的早期诊断.