聚乙二醇IFNα-2a联合利巴韦林治疗自身免疫抗体阳性慢性丙型肝炎的临床疗效及安全性评估

目的探讨聚乙二醇IFNα-2a联合利巴韦林对自身免疫抗体阳性慢性丙型肝炎的临床疗效。方法慢性丙型肝炎病毒(HCV)感染者102例,筛查自身抗体,分为自身抗体阳性组和阴性组,均给予IFNα-2a联合利巴韦林治疗。观察治疗前HCV RNA载量、治疗过程中血ALT和AST水平变化、病毒学应答情况及不良反应。结果 102例慢性HCV感染者中,共检出自身抗体阳性患者31例,其中,抗线粒体抗体(AMA)阳性18例,抗平滑肌抗体(SMA)阳性10例,抗1型肝肾微粒抗体(LKM1)阳性3例。治疗前,阳性组和阴性组HCV RNA载量,以及治疗后快速和持续病毒学应答率比较差异无统计学意义。治疗0~20周,两组患者ALT和AST水平比较差异无统计学意义(P>0.05),治疗24周后,阳性组高于阴性组。两组患者的不良反应发生率比较差异无统计学意义。结论聚乙二醇IFNα-2a联合利巴韦林可有效治疗自身抗体阳性和阴性慢性丙型肝炎患者,自身抗体的存在与否对治疗安全性无明显影响。     

胃癌组织中Her-2蛋白的表达及意义

目的:观察Her-2基因在胃癌组织中的表达,探究Her-2与胃癌发生的关系。方法:采用组织芯片技术、免疫组织化学(IHC)技术及荧光原位杂交(FISH)技术检测60例患者胃癌组织中Her-2蛋白的表达情况,分析Her-2基因扩增与肿瘤的侵袭、转移及预后的相关性。结果:Her-2蛋白在不同分化程度的胃癌组织中的表达量不同,43例(71.67%)阳性表达Her-2蛋白,其中12例弱阳性(+)表达,17例中等阳性(++)表达,14例强阳性(+++)表达。运用FISH技术检测7例胃癌组织中的Her-2基因扩增情况,其中3例为IHC检测强阳性(+++)表达,3例为中-弱阳性(+～++)表达,1例阴性(-)。结论:Her-2蛋白在不同分化程度的胃癌组织中表达不同,虽然尚未证明其确切的相关性规律,但以此为出发点研究胃癌的发生发展及恶性进展具有重大的意义。     

Therapeutic observation of cranial suture acupuncture in treating depression

Objective

To observe the clinical efficacy and safety of cranial suture acupuncture plus paroxetine in treating depression, and to discuss the action mechanism of this acupuncture method.

Methods

One hundred depression patients were allocated to an observation group and a control group according to the random number table, with 50 cases in each group. The control group was intervened by oral administration of paroxetine tablets, 20 mg each time, once a day for successive 6 weeks; the observation group was additionally given cranial suture acupuncture, once a day for 6 weeks. They were scored by Hamilton depression scale-17 (HAMD-17) before the treatment and respectively after 1-week, 2-week, 4-week and 6-week treatment. The clinical efficacy and safety were also observed.

Results

After 6-week treatment, the total effective rate was 94.0% in the observation group versus 78.0% in the control group, and the between-group difference was statistically significant (P<0.01). The HAMD-17 scores respectively after 1-week, 2-week, 4-week and 6-week treatment were significantly lower than the score before the treatment in the observation group (all P<0.05); the HAMD-17 scores respectively after 2-week, 4-week and 6-week treatment were significantly different from the score before the treatment in the control group (all P<0.05). There were significant differences in the HAMD-17 score between the two groups respectively after 4-week and 6-week treatment (both P<0.05).

Conclusion

Cranial suture acupuncture plus paroxetine can ease the symptoms of depression, with faster onset and more significant therapeutic efficacy compared with paroxetine alone.

     

自拟排石汤治疗泌尿系结石54例

本组54例,其中男性39例,女性15例,青壮年多见。临床均具有典型的泌尿系刺激症状,并均经B超、X线腹部平片和肾脏造影检查而确诊。基本方石苇、滑石、篇蓄、金钱草各30克,海金砂30克(包煎),车前、瞿麦各15克,鸡内金、炮山甲各10克,甘草9克。加减法:尿道痛加川牛膝;尿血加小蓟、茜草炭、白茅根;腰及小腹痛加广木香、台乌、川断;腰绞痛加制乳香、醋元胡、沉香;阴虚加石斛、麦冬;气虚加党参、黄芪。治疗结果 54例中,结石在肾者20例,在膀胱者24例,在输尿管者10例,全部服用排石汤加减治疗。据统计,结石在肾者服药12～16付,在膀胱者服药9～12付,在输尿管者服药3～6付,便可将结石排出。本组全部获愈,服药后疼痛消失,结石     

激光针刀联合微创介入治疗腰椎间盘突出症对血浆β-EP、Dyn-A的影响

目的观察激光针刀联合微创介入治疗腰椎间盘突出症对血浆β-内啡肽、A-强啡肽的影响。方法将符合纳入标准的180例患者随机分为激光针刀组、微创介入组和联合组,每组各60例。激光针刀组采用激光针刀治疗,微创介入组采用微创介入等离子射频+胶原酶溶核术治疗,联合组采用两组方法的联合治疗。分别于治疗前后,测定三组患者的血浆β-啡肽、A-强啡肽的含量。结果经相应方法治疗后,血浆β-内啡肽及A-强啡肽含量较治疗前比较,联合组含量增加均最明显,其次是激光针刀组,而微创介入组较治疗前含量未见明显变化,三组相比差异均具有统计学意义(P0.05)。结论激光针刀联合微创介入治疗腰椎间盘突出症能够提高血浆β-内啡肽、A-强啡肽活性,这可能是联合治疗腰椎间盘突出症镇痛作用机制之一。