丹参酮ⅡA通过NLRP3/Caspase-1信号通路对心肌成纤维细胞的保护作用

目的:探讨丹参酮ⅡA对心肌成纤维细胞损伤的保护作用及可能机制.方法:分离和培养大鼠心肌成纤维细胞(Cardiac Fibroblast,CFs).以脂多糖(LPS)刺激CFs建立脓毒症心肌损伤体外模型,以不同浓度丹参酮ⅡA预处理CFs 30 min后,给予LPS刺激,设对照组,LPS模型组,LPS+不同浓度TSA(2μ...     

慢性重型肝炎合并血栓性血小板减少性紫癜1例报道

1病例介绍 患者,女,43岁.因双下肢浮肿1月余于2007年11月入住我科.患者8年前发现乙肝标志物阳性,未治疗.5年前出现双下肢浮肿,肾穿刺活检提示"乙肝相关性肾炎",HBV DNA 2×105copies/ml.1个月前,受凉后出现乏力、纳差、尿黄,伴腹胀、双下肢水肿.病情逐渐加重,入住我科.     

Fas配体启动子区-844T/C单核苷酸多态性与重型乙型肝炎转归的关系

目的 探讨中国汉族人Fas配体(FasL)基因单核苷酸多态性与重型乙型肝炎之间的关系.方法 采用病例一对照研究方法,将HBV感染者作为研究对象.收集相关的非活动性HBsAg携带者233例,重型肝炎患者68例,HBV自发清除者100例,肝硬化患者102例,肝细胞癌患者112例的全血标本及临床相关资料.应用TaqMan探针实时荧光分型PCR方法检测患者FasL基因-844T/C位点的基因多态性,计算比值比(OR)值及95%可信区间(CI).结果 应用二元Logistic回归分析,控制年龄、性别等因素后,非活动性HBsAg携带者的FasL-844 CC、CT、TT基因型频率分别为50.64%、39.91%及9.44%;重型肝炎组中FasL-844 CC、CT、TT基因型频率分别为79.41%、17.65%及2.94%.携带FasL-844CC基因型的非活动性HBsAg携带者与重型肝炎的发生呈显著关联(OR=4.729,95%CI:0.510～21.282,P=0.043),而其他病例对照组中存在的关联差异均无统计学意义(P>0.05).结论 携带FasL-844CC基因型的非活动性HBsAg携带者易发生乙型肝炎重症化,应对这部分人群给予更多的关注.

Abstract：

Objective To investigate the relationship between single nucleotide polymorphism (SNP) of Fas ligand (FasL) and fulminant hepatitis B in Han Chinese. Methods HBV infected subjects were enrolled in this case-control study, including 233 cases of inactive HBsAg carrier, 68 patients with fulminant hepatitis B,100 cases of spontaneous hepatitis B clearance, 102 patients with hepatitis B virus (HBV) related cirrhosis and 112 patients with HBV related primary hepatocellular carcinoma. The blood samples and clinical data were collected. FasL-844T/C polymorphisms of enrolled subjects were examined by TaqMan real time fluorescent genotyping polymerase chain reaction (RT-PCR). A adjusted odds ratios (OR)and 95% confidence intervals (CI)were calculated using the Logistic regression model. Results After adjusting the factors of gender and age, binary Logistic regression analyses indicated that the genotype frequencies of FasL-844 CC,CT,TT in inactive HBsAg carriers were 50. 64% ,39. 91% and 9. 44% respectively, and those in cases of fulminant hepatitis B were 79. 41%, 17. 65% and 2. 94%, respectively. The analysis also revealed that FasL-844CC genotype in inactive HBsAg carriers was high risk factor of developing fulminant hepatitis B (OR =4. 729,95%CI:0. 510 - 21. 282,P = 0. 043), while there were no statistic significances in other cases (P>0. 05). Conclusion The inactive HBsAg carriers harboring FasL-844CC may have greater susceptibility to fulminant hepatitis B, which need arouse high attention.     

ECMO联合CRRT治疗爆发性心肌炎一例报告及文献复习

爆发性心肌炎（Fulminant myocarditis, FM）起病症状不明显,较难早期诊断,而又因其病情进展快,病人可迅速出现急性心力衰竭,严重者甚至可发生全身多器官功能衰竭。本文对本院一例爆发性心肌炎合并多器官功能衰竭病例进行讨论分析,探究爆发性心肌炎的早期诊断方法及治疗方案。     

恩替卡韦和拉米夫定治疗乙肝病毒相关重型肝炎的临床疗效比较

[目的]比较核苷（酸）类似物恩替卡韦和拉米夫定治疗乙肝病毒相关重型肝炎的临床疗效.[方法]回顾性分析58例乙肝病毒相关重型肝炎患者的临床资料,均接受内科标准治疗和核苷（酸）类似物抗乙肝病毒治疗.其中30例患者使用恩替卡韦抗病毒治疗,28例患者使用拉米夫定.收集并随访患者的存活时间、生化指标、凝血功能、血液常规检查和并发症等临床资料,比较恩替卡韦和拉米夫定的临床效果.[结果]恩替卡韦或拉米夫定组抗病毒治疗的乙肝病毒相关重型肝炎患者血清DNA水平均下降.30d生存率分别为80％和82.1％（P=0.554）,90 d生存率分别为63.3％和57.14％（P=0.416）.2组患者30 d和90 d的生存率无显著差异.[结论]恩替卡韦较拉米夫定更快地抑制HBV复制,能较快改善乙肝病毒相关重型肝炎患者的肝脏功能,但对短期生存率无明显改善.