柴芍四金汤预防ERCP术后胆总管结石复发的临床观察

目的 研究柴芍四金汤预防ERCP术后胆总管结石复发的临床疗效。方法 选取昆山市中医医院脾胃肝胆科2014年1月至2016年12月因胆总管结石行ERCP取石病例120例，按随机数字表法将120例病例随机分为治疗组和对照组，每组各60例，治疗组口服自拟柴芍四金汤，每日1剂，水煎400 mL，分早晚两次温服，随证加减；对照组口服熊去氧胆酸250 mg/次，3次/d，2组均连续药物治疗6月，观察术后2周血清中总胆红素（Tbil）、直接胆红素（Dbil）、碱性磷酸酶（ALP）、谷氨酰转肽酶（GGT）指标、术后半年临床症状（包括腹痛、腹胀、恶心、纳差）及术后6月、12月、18月胆总管结石复发情况。结果 治疗组术后6月、12月及18月结石复发率略低于对照组，但两者差异无统计学意义（ P >0.05）；治疗组在改善腹痛、腹胀、恶心、纳差症状方面优于对照组（ P <0.05）；治疗组在改善血清Tbil、Dbil、ALP、GGT水平方面优于对照组（ P <0.01）。结论 柴芍四金汤能有效预防ERCP术后胆总管结石的复发，且能改善胆总管结石引起的临床症状及血清生化指标。      

垂黄清脉冲剂干预治疗冠心病稳定型心绞痛热毒痰瘀证患者NF-κB信号通路的研究

目的 探讨垂黄清脉冲剂对冠心病稳定型心绞痛（热毒痰瘀证）患者NF-κB信号通路的调控。方法 本试验研究方法采用单盲、随机、对照法，选取就诊于宁夏医科大学总医院临床诊断为冠心病稳定型心绞痛（热毒痰瘀证）患者94例，将其随机分入对照组48例和试验组46例。两组均给予内科常规西药治疗，对照组加服银丹心脑通软胶囊，试验组加服垂黄清脉冲剂，疗程为3个月。于治疗前、后记录患者的基本情况，并采集血清样本，用酶联免疫吸附测定法（Elisa法）检测血清中TNF-α、NF-κB、IL-6、ICAM-1、VCAM-1、ET-1、NO浓度水平进行对比，用SPSS22.0将数据进行统计学分析。结果 与治疗前比较，两组治疗后Gensini积分、血清中TNF-α、NF-κB、IL-6、ICAM-1、VCAM-1、ET-1浓度水平均较治疗前显著降低，NO浓度水平显著升高（P < 0.05，P < 0.01），其中试验组显著程度尤为明显（P < 0.01）。与治疗后对照组比较，试验组Gensini积分、血清中TNF-α、NF-κB、IL-6、ICAM-1、VCAM-1、ET-1浓度水平降低，NO浓度水平升高趋势更明显（P < 0.01）。结论 垂黄清脉冲剂治疗冠心病稳定型心绞痛（热毒痰瘀证）在改善患者症状；改善冠状动脉管腔狭窄程度；通过降低炎症标志物TNF-α、NF-κB、IL-6、ICAM-1、VCAM-1的水平，减小ET-1/NO比值，从而对NF-κB信号通路进行部分调控，以有效抑制或截断血管内皮的炎症级联反应过程，清除炎症损伤因素以及保护血管内皮功能等方面均有显著优势，临床疗效确切值得肯定和推广应用。     

帕拉米韦注射液治疗儿童流感的临床疗效分析

目的探讨儿童流感应用帕拉米韦注射液治疗的临床疗效以及用药安全性。方法随机选定在2016年1月-2019年1月期间佛山市高明区人民医院儿科住院治疗并确诊流感A或B型患儿200例,通过随机数字法将其分为治疗组和对照组。治疗组100例用帕拉米韦注射液治疗,对照组100例用国产磷酸奥司他韦颗粒治疗,评价两组患儿治疗前后症状评分、治疗效果、治疗指标以及不良反应发生情况。结果两组患儿治疗前流感样症状评分无统计学意义(P>0.05),两组患儿治疗后较治疗前流感样症状评分均下降,差异有统计学意义(P<0.05);治疗组治疗后流感样症状评分略小于对照组,但是无统计学意义(P>0.05);治疗组治疗总有效率高于对照组,治疗组患儿发热症状缓解、全部症状缓解以及住院时间均小于对照组,存在统计学意义(P<0.05)。治疗组与对照组不良反应发生率较低,且无统计学意义(P>0.05)。结论帕拉米韦注射液可用于儿童流感治疗,不仅能够保证临床疗效,而且可加快症状缓解,同时存在较高用药安全性。     

(加味)柴芍承气汤对重症急性胰腺炎及其并发症的作用

目的探讨(加味)柴芍承气汤对重症急性胰腺炎(SAP)及其并发症的防治作用。方法65例SAP患者分为中药组35例,对照组30例。2组的内科治疗相同,中药组一经确诊即予柴芍承气汤加味银杏叶治疗,每剂煎成100~150m l,自鼻胃管内注入或口服,每日2~3次,直至患者腹痛缓解、腹胀基本消失、肠鸣恢复。分别观察2组患者治疗72 h后的PaO2、SaO2肾功能、脑病、局部并发症情况、腹痛缓解时间、肠鸣恢复时间、病死率,以及血清中血小板活化因子(PAF)、肿瘤坏死因子(TNF-α)、白介素-1(IL-1)水平变化。结果治疗72 h后中药组与对照组低氧血症的发生率分别为45.71%、73.73%,P<0.05;肾损害、脑病、局部并发症发生率以及病死率均低于对照组,但无统计学差异;腹痛缓解时间、肠鸣恢复时间均优于对照组(P<0.05);中药组血清中PAF、TNF-α、IL-1水平显著降低(P<0.01),而对照组则无明显变化。结论该汤剂对SAP及其并发症有较好的防治作用。抑制细胞因子或炎症介质可能是该汤剂治疗SAP的重要机制。     

The nature of breast dense core granules: uranaffin reactivity

In this study breast tissue that contained ultrastructural dense core granules has been examined from 24 patients. The possible neuroendocrine characteristics of the granules were studied using the uranaffin reaction and an ultrastructural argyrophil stain. The tissue included 15 breast carcinomas and nine benign samples. Two types of breast dense core granules can be distinguished on the basis of intracellular distribution patterns and histochemical reactivity. Type I dense core granules are the most common and they were found subluminally distributed in non-pathological tissues and benign lesions as well as carcinomas. They were uranaffin-negative and are unlikely to be of endocrine nature. Type II dense core granules were found only in four carcinomas, where they occurred abundantly throughout the cytoplasm. These granules were uranaffin-positive and argyrophilic and thus exhibited characteristics consistent with neuroendocrine structure.     

大承气颗粒剂对胃肠动力影响的影像观察

目的 :探讨大承气颗粒剂对健康人群胃肠道动力的影响。 方法 :利用加入大承气颗粒剂钡餐造影技术 ,通过监视器、录像和摄片观察记录造影剂由胃排入十二指肠、十二指肠排入空肠、空肠排入空回肠、空回肠排入回肠、回肠排入回盲部的时间 ,结肠排出时间以及造影全过程总时间。受试者分三组各 3 0人。一组大承气颗粒剂组 (大承气组 ) ;二组为甘露醇组 ;三组为常规钡餐组。 结果 :大承气组除胃排入十二指肠、十二指肠排入空肠的时间与常规钡餐组比较无明显差别外 ,余各组小肠的排入时间、结肠排出时间以及造影全过程总时间与常规钡餐组比较P <0 0 5,与甘露醇组比较无明显差异。 结论 :大承气汤颗粒剂具有提高肠道张力、促进其推进作用     

Mycetoma of the calf

 Actinomycetous infections typically involve either the head and neck or the extremities following a traumatic implantation. Classic clinical associations are draining sinus tracts. This case report describes the pathologic and MR findings of a relatively acute mycetomatous process involving the soft tissues. Pathologic findings in this case included an occasional granule composed of gram positive, thin branching elements. These and other findings were consistent with actinomycetes bacterium infection. The discussion centers around the use of MR, both with and without gadolinium, in evaluating this type of granulomatous infection. Infiltration of the adjacent subcutaneous tissues was easier to appreciate on both the T1-weighted images without gadolinium and the T1-weighted images with gadolinium when compared to the T2-weighted images. Signal characteristics as described in this case report may suggest a granulomatous process.     

Professor Ahmed Shafik (1933–2007)

Most cases of anal abscess are caused by anal fistula and invasion of the surrounding tissues by a mixed colonic flora. Treatment consists of excision of the abscess and, in case of fistula, fistulectomy. Primary anorectal and perianal forms of actinomycosis are very rare and caused by actinomyces, as ubiquitous anaerobics bacterium. We report a case of perianal actinomycosis. The patient had a short history of painless perineal induration without fever and leukocytosis with normal results at routine blood examination. After excision, sulfur granules drained from the cavity and pathological investigations indicated perianal actinomycosis. Appropriate surgery and antibiotic treatment healed the perianal infection. After exclusion of possible diagnoses such as Crohn’s disease, tuberculosis and malignant growths, the rare case of perianal actinomycosis should be considered in the differential diagnosis of painless perianal masses.     

宣肺清热颗粒剂稳定性研究

目的:研究宣肺清热颗粒剂中橙皮甙热稳定性变化,为该颗粒剂有效期的确定、制剂生产、贮存条什提供实验参考依据。方法:采用加速实验法对橙皮甙热稳定性进行研究,用甲醇超声提取样品,HPLC进行含量测定。根据Arrhenius公式处理数据。结果:Arrhenius公式得室温下的速度常数K298=3.38×10-5/h,得出常温下该颗粒剂以橙皮甙为指标的有效期为3.6年。结论:宣肺清热颗粒剂稳定性好,初步符合中药稳定性要求。