Effect of Chishao Chengqi Decoction(赤芍承气汤)on Endotoxin and TNF-α in Patients with Severe Hepatic Diseases

Objective:To observe the effect of Chishao Chengqi decoction (CCD) in treating severehepatopathy and its influence on serum endotoxin(ET) and tumor necrosis factor a (TNF-α), in order toexplore the possible mechanism of CCD in protecting liver cells and in preventing liver failure. Methods:Sixty patients suffering from hepatopathy were divided into the treated group and control group randomly,30 in each group. They were treated with comprehensive treatment, including hepatocyte growth-promo-ting factors, thymosin, Transmetil and albumin. CCD was given to the treated group additionally. Thetherapeutic effects were observed and the changes of some biochemical criteria, including alanine transami-nase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), albumin (ALB) as well as such pa-rameters as prothrombin activity (PTA), serum levels of ET and TNF-α were all detected respectively be-fore treatment and after treatment. Results: In the treated group, 8 patients was clinically cured after treat-ment, 11 were markedly alleviated, 7 improved and 4 remained unchanged, while in the control group, therespective numbers were 5, 8, 8 and 9. The total effective rate of the treated group was significantly betterthan that of the control group by(P＜0.05). ET and TNF-a levels in patients were significantly higherthan the normal range before treatment, and they were lowered after treatment. Comparison of the effectbetween the two groups showed significant difference ( P＜0.05 ) , with that in the treated group betterthan that in the control group. Conclusion: CCD decoction could reduce the production and releasing of ETand TNF-α in severe hepatopathy patients, which might be one of its therapeutic mechanisms.     

哌唑嗪治疗肝硬化腹泻和痔静脉曲张破裂出血的疗效观察

作者在哌唑嗪能改善肝硬化犬肝脏血液动力学的基础上，观察了哌唑嗪对肝硬化腹泻和痔静脉曲张破裂出血的作用。结果表明哌唑嗪能缓解肝硬化病人大便时的里急后重症状、减少大便数，对痔静脉曲张破裂出血有良好的止血作用，其有效率分别为９５．０％和９０．０％。     

通里攻下法为主预防和治疗重型肝炎患者腹胀的疗效观察

目的:探讨防治重型肝炎腹胀的中西医结合疗法。方法:22例重型肝炎患者分成两组;采用综合治疗加中药8例(治疗组),综合治疗14例(对照组)。治疗组尚未发生腹胀者,用凉血活血、通里攻下中药(赤芍60g,厚朴、枳实各15～30g,生大黄10～30g);已发生腹胀者用清热解毒、通里攻下中药(蒲公英、厚朴、枳实、生大黄各30g,元明粉4g)。结果:治疗组有效率为50％,对照组为14.3％(P<0.01);治疗组并发症发生率为33.0％,对照组为60％(P<0.01);肝功能检查结果显示,治疗组病例在入院第2～3周,胆红素开始下降,PTA、总胆固醇、白蛋白等开始回升,对照组的上述指标在入院第4～5周才开始好转。结论:通里攻下法对于防治重型肝炎的腹胀有较好效果。     

牙龈表型分型的现状与展望

牙龈表型对口腔治疗的风险评估、治疗方案的制定和预后评估有重要意义.2018年欧洲牙周病联合会与美国牙周病学会的共识性报告,建议采用牙周探针透视法将牙龈表型分为薄厚两型,薄型的牙龈厚度≤1 mm,厚型的牙龈厚度>1 mm.此分型未被证明是最佳的指导临床实践的分型方法,并且定量测量牙周探针可见时的牙龈厚度值与1 mm也有明...     

健脾化痰祛瘀中药联合干扰素治疗慢性乙型肝炎合并非酒精性脂肪肝临床观察

目的观察健脾化痰祛瘀中药联用干扰素对慢性乙型病毒性肝炎合并脂肪肝患者抗病毒疗效的影响。方法将64例慢性乙型病毒性肝炎合并脂肪肝患者随机分对照组和治疗组,对照组用干扰素治疗(长效或短效),治疗组在对照组基础上加用健脾化痰祛瘀中药治疗。治疗前后分别进行体重、腰围、臀围、肝功能、血脂、乙型肝炎病毒血清学标志物和HBVDNA定量、超声学检查,治疗6个月后评估疗效。结果治疗组血脂、体重指数及腰臀比均明显降低,治疗后两组比较,差异有统计学意义(P0.05);治疗组脂肪肝的好转率明显升高,两组比较差异有统计学意义(P0.05);治疗组抗病毒有效率明显升高,两组比较差异有统计学意义(P0.05)。结论健脾化痰祛瘀中药能显著改善慢性乙肝合并非酒精性脂肪肝患者的脂肪肝程度,并能提高干扰素对该类患者的抗病毒疗效。     

正肝方对黄曲霉毒素B_1诱发的大鼠癌前病变肝组织胰岛素样生长因子-Ⅱ表达的影响

目的:观察正肝方对黄曲霉毒素B1(AFB1)诱发的大鼠癌前病变肝组织胰岛素样生长因子-Ⅱ(IGF-Ⅱ)表达的影响。方法:100只Wistar大鼠随机分为4组:模型对照组30只、正肝方小剂量预防组30只、正肝方大剂量预防组30只、正常大鼠对照组10只。除正常对照组外,先后用AFB1和2-乙酰氨基芴(2-AAF)处理各组大鼠造模。正肝方大、小剂量预防组在造模期间,将不同浓度正肝方水剂(0.6g/ml,0.3g/ml)按10ml/kg分别灌喂大鼠;模型对照组用无菌蒸馏水按10ml/kg灌喂大鼠。8周后处死大鼠,肝组织取材。分别采用免疫组化染色法和RT-PCR法,检测肝组织中IGF-Ⅱ蛋白和mRNA表达。结果:模型组肝组织IGF-Ⅱ染色阳性细胞百分率(LI)和表达强度(PU)最高,并且IGF-ⅡmRNA表达水平也最高(P0.01)。正肝方能降低大鼠癌前病变肝组织IGF-Ⅱ蛋白和mRNA的异常高表达(P0.01),且呈现出一定的量效关系。结论:正肝方能通过下调IGF-Ⅱ异常高表达,从而减弱IGF-Ⅱ通过自分泌生长刺激机制导致的AFB1启动的肝细胞异常增生。     

干扰素-γ基因+874位点及肿瘤坏死因子-α基因-238位点单核苷酸多态性与HBV宫内感染相关性研究

目的:研究IFN-γ+874位点T/A以及TNF-α-238位点G/A的单核苷酸多态性与HBV宫内感染的相关性。方法:采集HBV标记物单项或多项阳性孕妇的外周血,提取基因组DNA,根据新生儿是否感染HBV将孕妇分为宫内感染组和对照组。利用等位基因特异性PCR检测IFN-γ+874位点等位基因型,利用PCR-RFLP方法检测TNF-α-238位点等位基因型。结果:等位基因特异性PCR可以准确判断IFN-γ+874位点等位基因型,对照组IFN-γ+874位点等位基因频率A为0.562,T为0.438,而宫内感染组A为0.738,T为0.262,两组之间的差异具有统计学意义(χ2=4.38,P=0.036)。TNF-α-238位点等位基因型的检测可以使用PCR-RFLP方法,对照组TNF-α-238位点等位基因频率A为0.146,G为0.854,宫内感染组A为0.262,G为0.738,两组之间的差异无统计学意义(χ2=3.26,P=0.071)。结论:IFN-γ+874位点T/A等位基因与HBV宫内感染具有一定相关性,T等位基因对胎儿HBV宫内感染具有防护作用。TNF-α-238位点G/A等位基因型与HBV宫内感染的关系尚不明确。     

艾滋病合并结核病与单纯性结核病的临床特点分析

目的提高对HIV（＋）／AIDS并发肺结核临床表现的认识。方法选取2007年以来我院收治的HIV（＋）／AIDS并发肺结核的病例共90例为观察组（A组）,及同期住院的HIV（-）的单纯肺结核病例90例为对照组（B组）进行回顾性对照分析。结果A组发烧和体重下降较B组更常见,而咳嗽和咯血较B组少见;A组痰抗酸杆菌阳性率显著低于B组;A组结核分枝杆菌培养阳性率显著低于B组;肺结核的x线表现为弥漫性浸润或粟粒性阴影及合并空洞率,A组和B组无显著性差异,而A组影像学胸腔积液显著高于B组;A组合并肺外结核较B组多见,其中以淋巴结核,结核性胸膜炎、脑膜炎,肠结核多见;PPD结核菌素反应阳性率A组显著低于B组。结论HIV（＋）／AIDS患者并发肺结核临床表现不典型。     

静脉输氧治疗感染性疾病43例

严荸急性呼吸综合征（SARS）患背肺泡弥散功能障碍，通气／血流比例严重失调。以至于无论是自主呼吸或是经气道给氧。吸入肺泡腔的氧分子均不能仃效地透过肺泡壁进入血流。导致患者发生Ⅰ型呼吸衰竭的低氧血症。而且常规气道输氧疗法难以纠正。我们根据该病的这一病理生理学特点。率先提出试用静脉输氧疗法。绕过患者病变的肺泡，以纠正机体严重的低氧血症。抢救此类患者。