保妇康凝胶联合诺氟沙星治疗宫颈糜烂50例疗效观察

目的：探讨保妇康凝胶联合诺氟沙星治疗宫颈糜烂的临床效果。方法将100例宫颈糜烂患者根据随机数字表法分为观察组和对照组各50例。观察组给予保妇康凝胶和诺氟沙星联合治疗，对照组单独给予治糜灵栓治疗，比较两组患者临床症状的变化，并对临床疗效进行评价。结果观察组治愈率为86.00%，明显高于对照组的74.00%，临床症状评分改善较对照组明显，且其临床症状消失的时间短于对照组，差异均有统计学意义(P<0.05)。结论保妇康凝胶与诺氟沙星合用比治糜灵栓治疗宫颈糜烂效果更佳，且治愈时间上明显较优，值得临床上推广应用。     

Lysophosphatidylcholine‐induced cytotoxicity and protection by heparin in mouse brain bEND.3 endothelial cells

A pathological feature in atherosclerosis is the dysfunction and death of vascular endothelial cells (EC). Oxidized low‐density lipoprotein (LDL), known to accumulate in the atherosclerotic arterial walls, impairs endothelium‐dependent relaxation and causes EC apoptosis. A major bioactive ingredient of the oxidized LDL is lysophosphatidylcholine (LPC), which at higher concentrations causes apoptosis and necrosis in various EC. There is hitherto no report on LPC‐induced cytotoxicity in brain EC. In this work, we found that LPC caused cytosolic Ca²⁺ overload, mitochondrial membrane potential decrease, p38 activation, caspase 3 activation and eventually apoptotic death in mouse cerebral bEND.3 EC. In contrast to reported reactive oxygen species (ROS) generation by LPC in other EC, LPC did not trigger ROS formation in bEND.3 cells. Pharmacological inhibition of p38 alleviated LPC‐inflicted cell death. We examined whether heparin could be cytoprotective: although it could not suppress LPC‐triggered Ca²⁺ signal, p38 activation and mitochondrial membrane potential drop, it did suppress LPC‐induced caspase 3 activation and alleviate LPC‐inflicted cytotoxicity. Our data suggest LPC apoptotic death mechanisms in bEND.3 might involve mitochondrial membrane potential decrease and p38 activation. Heparin is protective against LPC cytotoxicity and might intervene steps between mitochondrial membrane potential drop/p38 activation and caspase 3 activation.     

A Type 1 diabetes technology pathway: consensus statement for the use of technology in Type 1 diabetes

In both adults and children with diabetes, technologies such as continuous subcutaneous insulin infusion using insulin pumps and continuous glucose monitoring can help improve diabetes control, reduce hypoglycaemia and improve quality of life. Access to these technologies in the UK is very variable. Some technologies are recommended by the National Institute for Health and Care Excellence, while others have not been appraised, and new technologies are emerging all the time. Additionally, different guidelines for adults and children further complicate access to diabetes technology in the transition from paediatric to adult care. Against this background, Diabetes UK and NHS England have brought together a multidisciplinary group of experts, including clinicians and people with diabetes, to develop this consensus guideline, combining the different technologies into a common pathway to aid clinical and policy decision‐making. We created a pathway that supports the incremental addition of technology as monotherapy and then dual therapy in the same way that we incrementally add in therapeutic agents to support people with Type 2 diabetes to achieve their personalized glycaemic targets. The pathway emphasizes the importance of structured education, specialist support and appropriate access to psychological therapies, as essential pillars for optimized use of diabetes‐related technology, and recommends the re‐evaluation of its use when the individual is unable either to use the technology appropriately or to achieve the intended outcomes. This pathway is endorsed by UK‐wide clinical and patient associations and we recommend that providers and commissioners use it to ensure the right individual with diabetes has access to the right technology in a timely way to help achieve better outcomes.     

MRI评估控便功能异常的研究进展

控便功能是指当产生便意时,可以辨别粪便干稀急缓,并能正常控制其排出的能力.因一些意外因素,如盆底功能障碍、某些先天性疾病及盆腔恶性肿瘤术后会导致此功能受损,而严重影响患者的生活质量.近年来,诸多国内外学者对控便功能障碍患者进行了临床和影像学研究,能够认知控便功能受损的造成因素及改善方法,对于术前术后制定治疗方案具有重要的临床价值,是目前研究的焦点.以MRI从影像学角度为阐述其障碍发生的可能机制及改善预后提供一定依据.因此,笔者对近年来控便功能障碍的MRI研究进展做简要综述.     

急性肺损伤的氧化作用与抗氧化研究进展

急性肺损伤(ALI)是临床常见的呼吸系统急症,发病率高,确切发病机制不甚明确,临床治疗效果欠佳。本文对近几年ALI的氧化作用研究和抗氧化对ALI的治疗作用和相关研究进展,以及抗氧化作用对ALI的治疗前景作一综述。     

中药膳食配合运动干预对肥胖性脂肪肝的影响

目的 探讨中药膳食配合运动干预对肥胖性脂肪肝的影响。方法 将68例脂肪肝患者随机分为对照组和观察组各34例。对照组常规给予低脂饮食和易善复、大黄庶虫丸等降酶保肝治疗；观察组按常规方法治疗外，采用中医辨证施食予以活血化淤、健脾利湿的中药膳食疗法配合运动干预．疗程均为1年。结果 治疗后观察组体重、甘油三酯、总胆固醇、谷丙转氨酶等显著低于对照组（均P〈0．01）。结论 中药膳食配合运动干预对肥胖性脂肪肝疗效显著。     

Effects of erythromycin on the propulsive motility of upper gastrointestinal tract in rats

The differences between the postprandial mixing or propulsion and the interdigestive motility of the gastrointestinal (GI) tract are already known. Earlier studies showed dose-dependent differences in the effects of erythromycin on interdigestive motility. The various GI side-effects (vomiting, diarrhoea) also suggest that there are different effects of erythromycin on the GI motility. The aim of our study was to examine postprandially the propulsive effects of different doses of erythromycin on the movement of intraluminal contents in the upper GI tract of the rat. The animals were fasted for 24 h before the experiments but water was given freely. The rats received 1.5 ml 1.5% methylcellulose painted with 0.05% phenol-red intragastrically (test solution). Erythromycin(E. lactobionate) was given intravenously at doses of 0.05, 0.1, 0.25, 0.5, 1.0 and 5.0 mg/kg 15 min before the administration of a test solution. The animals were sacrificed 20,60 and 120 min after administration of methylcellulose, when the distance between the front of the painted intraluminal contents and the pylorus was measured and expressed as a percentage of the total length of small intestine. The phenol-red content in the stomach and small intestine was measured spectrophotometrically and the gastric emptying was calculated from the ratio of the measured total and intestinal phenol-red content. Our results showed that the small doses of erythromycin (0.1 and 0.25 mg/kg) accelerated gastric emptying after 20 min but did not change significantly the propulsive motility of upper small intestine; however, large doses of erythromycin (1.0 and 5.0 mg/kg) decreased gastric emptying and upper GI motility after 20 and 60 min. In summary, the prokinetic action of small doses of erythromycin was demonstrated, but its effecttime on GI motility is short and the ratio of the stimulating and inhibitory doses is 1:10. This paper was presented at the Section of IUPHAR GI Pharmacology Symposium on ’Biochemical pharmacology as an approach to gastrointestinal disorders (basic science to clinical perspectives)‘, October 12-14, 1995, Pécs, Hungary.     

Evidence that the serotonin agonist, DOI, increases renin secretion and blood pressure through both central and peripheral 5-HT2 receptors

DOI [(+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane HCI] is a serotonin (5-HT1C/5-HT2) agonist, with potent cardiovascular effects. The purpose of the present studies was to determine the identity and location of the 5-HT receptor subtype(s) mediating the renin and blood pressure responses to DOI. Injection (i.p.) of DOI to conscious male rats elevated plasma renin activity in a dose-dependent manner. The 5-HT1C/5-HT2 antagonist ritanserin completely blocked the DOI-induced increase in plasma renin activity. In order to distinguish the 5-HT2- from the 5-HT1C- mediated effect of DOI, spiperone was administered before DOI. Low doses of spiperone (0.01 and 0.1 mg/kg, s.c.) significantly reduced the renin response to DOI. Because spiperone has a higher affinity for 5-HT2 than 5-HT1C receptors, these data suggest that DOI stimulates renin secretion through 5-HT2 receptors. To separate central from peripheral 5-HT receptors, we injected DOI into rats pretreated with saline or xylamidine, a 5-HT2 antagonist which does not cross the blood-brain barrier. Xylamidine produced a shift to the right and suppression of the maximal effect of DOI on plasma renin activity, suggesting a role for peripheral 5-HT2 receptors in the effect of DOI. On the other hand, i.c.v. administration of DOI, using doses lower than the peripherally effective doses, caused a significant elevation of plasma renin activity at 200 micrograms/kg. These experiments suggest that DOI's elevation of plasma renin activity has both peripheral and central sites of action.(ABSTRACT TRUNCATED AT 250 WORDS)     

肝硬化患者幽门螺杆菌感染的临床特点

目的:探讨肝硬化患者幽门螺杆菌( Hp)感染的临床特点.方法:对162例已行胃镜和幽门螺杆菌检查的肝硬化患者Hp感染情况进行回顾性分析.结果:Hp感染在性别和年龄间差异均无显著性(P＞0.05);Hp感染率随食管静脉曲张加重、肝功能恶化、门脉高压性胃病加重而降低(P＜0.05～P＜0 .01);Hp感染在消化性溃疡的有无发生间差异无显著性(P＞0.05).结论:在肝硬化患者中,Hp感染与食管静脉曲张、肝功能恶化、门脉高压性胃病、消化性溃疡的发生无关.对有Hp感染的肝硬化患者无需行根除治疗.