何华治疗不寐常用药对经验采撷

何华教授临证数十载,擅长治疗各类内科杂病,尤其对不寐的诊治见解尤为独到。其临证时根据病情的不同,在主方基础上加用养心安神、重镇安神、行气活血解郁、健运脾胃等药对,临床疗效显著。该文主要介绍何华教授诊治不寐常用药对的临床经验,以期为临床辨治不寐提供参考。     

Efficacy of Telbivudine in the Treatment of Chronic Hepatitis B and Liver Cirrhosis and Its Effect on Immunological Responses

This study was aimed to evaluate the long-term effects of telbivudine(Ld T) in the treatment of chronic hepatitis B(CHB) and HBV-related liver cirrhosis(LC) and to observe the changes of immunological responses during Ld T treatment. Clinical data of 80 CHB and 28 HBV-related LC patients who were administered with Ld T for 108 weeks and followed up were retrospectively analyzed. The liver function indicators including ALT, AST and γ-GT, HBV DNA copy number in serum and the rates of hepatitis B e antigen(HBe Ag) seroconversion were analyzed before and 12, 24, 36, 48, 60, 72, 84, 96 and 108 weeks after Ld T treatment in CHB and LC groups. Four serum fibrosis-related markers, including hyaluronic acid(HA), human laminin(LN), human type Ⅳ collagen(Ⅳ-C) and human N-terminal procollagen Ⅲ peptide(PC-Ⅲ), were detected before and after Ld T treatment in LC group. The results showed favorable viral suppression and biochemical responses after treatment with Ld T for 12 weeks, and a high rate of virological and biochemical control was maintained during the course of 108-week treatment in both CHB and LC groups. The four fibrosis-related markers, especially HA and LN, were down-regulated to some degrees in LC group. Moreover, Ld T treatment led to the fluctuation of the circulating interferon-γ(IFN-γ) and interleukin-10(IL-10) levels at different time points in CHB group. It was concluded that Ld T could favorably lead to the virological suppression and biochemical remission. Besides, IFN-γ and IL-10 may represent a suitable and effective predictor of responsiveness during Ld T therapy.     

克罗恩病患者幽门螺杆菌感染情况分析及其临床意义

<正>克罗恩病(CD)是一组病因不明、慢性复发性胃肠道疾病,可累及全消化道^[1]。研究发现胃肠道微生物可能与CD的发病有关,但其具体机制尚未完全明确^[2-3]。随着对幽门螺杆菌(Hp)的研究不断深入,发现Hp感染与多种临床疾病的发生密切相关,如1型糖尿病、肥胖、过敏性哮喘等^[4-5]。近年来,有研究报道Hp感染与CD呈负相关,但也有学者有不同的声音^[6-7]。研究提示Hp可能通过某些途径逃避免疫监视,