双黄连注射剂的不良反应及防范措施

双黄连注射剂是由双花、黄芩、连翘等中药制成的天然药物注射剂,主要成分为黄芩苷、绿原酸,其具有抗病毒和抗细菌的双重作用,现已成为国内医院临床治疗肺炎、上呼吸道感染等多种疾病的常用药物之一。但目前有关双黄连注射剂不良反应的报道日渐增多,且有些不良反应较为严重,已引     

类风湿关节炎护理干预特点研究

类风湿关节炎(RA)临床药物治疗固然重要,但护理干预对RA患者的身心恢复亦起到了不可替代的作用。本文就近年来在RA护理领域中,有关护理因素、心理护理、药物治疗护理、饮食护理等方面进行综述,以供临床借鉴。     

1例类风湿性关节炎患者口服甲氨蝶呤

甲氨蝶呤(MTX)具有抗炎和抗免疫作用[1],临床上常用于治疗类风湿性关节炎(RA)和其他自身免疫性疾病.MTX是一种常见的细胞毒性药物,是目前治疗RA的首选药物,临床上常联合其他药物应用[2].MTX的副作用有肠道反应、肝脏毒性、肺损伤、血液系统异常等[1].我科于2011年11月收治1例MTX治疗类风湿关节炎导致重度中毒的患者,经过精心的护理,取得良好的护理效果.     

雷公藤多苷治疗溃疡性结肠炎的作用机制研究进展

溃疡性结肠炎是一种慢性非特异性炎症性肠病，临床上主要采用氨基水杨酸制剂、糖皮质激素、免疫抑制剂等药物对该病进行治疗，但目前的临床用药存在易复发、药物抵抗等问题。雷公藤多苷是中药雷公藤的一种提取物，是雷公藤的主要活性成分，具有抗炎、免疫抑制等作用，有“中草药激素”之称。研究表明，雷公藤多苷对溃疡性结肠炎有明确疗效，其可从调节免疫细胞、抑制炎症反应、抗细胞凋亡、调节肠道菌群、抑制氧化应激和保护抗氧化系统等方面，发挥其治疗溃疡性结肠炎的作用。本文主要针对雷公藤多苷治疗溃疡性结肠炎的作用机制研究进展进行综述。     

糖皮质激素在类风湿关节炎中的应用进展

类风湿关节炎(RA)是以关节滑膜炎及关节外病变为主要表现的一种慢性炎症性疾病,伴有软骨及骨质破坏,具有渐进及反复发作的特点。目前药物治疗是RA的主要治疗手段之一,临床用于治疗RA的药物众多,糖皮质激素即是主要治疗药物之一,但糖皮质激素用于治疗RA临床一直存在争议,争议主要集中在糖皮质激素带来的抗炎、抗免疫、镇痛效果与治疗过程中产生的一系列不良反应,即效益/风险比。     

芍药苷治疗类风湿关节炎及其他疾病的研究进展

类风湿关节炎(RA)的发病机制十分复杂,目前还无有效的根治方法。生物制剂虽然疗效较好,但是价格昂贵,限制了大多数患者的使用。芍药苷(PAE)是从赤药中提取的活性成分,具有解痉、止痛、改善微循环、调节免疫及神经保护等作用。白芍总苷的主要成分即是芍药苷(PAE),已是风湿免疫科常用的药物。芍药苷(PAE)具有多种药理作用,目前不仅在RA的治疗中应用,对很多其他临床疾病也有较好的疗效,如对肿瘤细胞的抑制作用及神经细胞的保护作用等。     

新风胶囊治疗活动期类风湿性关节炎20例

目的：观察健脾化湿通络中药新风胶囊(XFC)治疗活动期类风湿性关节炎(RA)的临床疗效，并探讨其作用机制。方法：40例活动期RA患随机分为2组，治疗组20例采用XFC，对照组20例采用雷公藤多苷片，两组均以3个月为1个疗程，均治疗1个疗程，观察临床疗效及C反应蛋白、类风湿因子、CD4^ 、CD8^ 、CD4^ /CD8^ 、细胞因子(IL-l、TNFα、IL—4、IL—10)及血管内皮生长因子(VEGF)等指标的变化。结果：XFC在总有效率、改善活动期RA关节症状及部分实验室指标方面与雷公藤多苷片作用相似，但在改善全身症状及治疗脾虚湿盛、血瘀证候，调节CD4^ ／CD8^ ，调整细胞因子平衡及降低VEGF方面显优于雷公藤多苷片；而且XFC药物不良反应(如食欲减退、腹胀、腹泻)的积分值显低于对照组。结论：XFC可综合改善活动期RA的关节及全身病变，无不良反应，其作用机制是调节T细胞免疫功能，下调致炎因子，上调抑炎因子，降低血管通透性，抑制血管增生，促进微循环和保护胃黏膜。     

白芍及白芍总苷治疗自身免疫性皮肤病的作用及机制研究进展

药理研究表明白芍具有抗炎、免疫调节、保肝、镇痛等作用,在临床上白芍及白芍总苷常用于治疗自身免疫性疾病。随着白芍及白芍总苷在抗炎和免疫调节中的作用机制逐步被认识,它们在免疫相关性、炎症性皮肤病中的临床应用得到了不断扩展,通过抗炎、免疫调节和抗氧化等机制在增效减毒、降低疾病复发率方面发挥重要作用。本文对白芍及白芍总苷治疗免疫相关性、炎症性皮肤病的作用及机制的研究进展进行综述,为其深入研究提供依据。     

天然多糖类活性物质抗乙肝病毒的研究进展

天然多糖类活性物质对人体的免疫机能具有明显的促进作用,已有多种多糖类活性物质用于抗乙肝病毒和治疗慢性肝炎的研究。目前,国内在多糖防治乙型肝炎病毒方面积累了一定的经验,在临床上也取得了一定的疗效。现综述国内近几年对天然多糖活性物质在抗乙肝病毒、临床治疗及免疫机制方面的研究进展,并认为多糖类活性物质作为安全、有效的抗乙肝病毒天然药物,其应用前景十分广阔,值得进行更深入的作用机制研究。     

中药抗炎机制研究进展

将近年来研究较多的抗炎免疫中药活性成分按苷类、生物碱类、黄酮类、挥发油类等化学结构分类简述其抗炎免疫作用。为进一步开发抗炎免疫中药和天然药物提供参考。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.