目的 观察加味身痛逐瘀汤治疗老年骨质疏松性椎体压缩性骨折的临床疗效.方法 2016年9月—2018年3月,将120例老年骨质疏松性椎体压缩骨折患者随机分为4组.实验组与对照组的比例为1:1.实验组A(保守治疗加味身痛逐瘀汤组):加味身痛逐瘀汤,水煎剂,每日1剂,分为2次.1个月为一个疗程,连续3个疗程治疗.对照组A(鲑鱼降钙素保守治疗组):鲑鱼降钙素组(密钙息)50 IU,肌注,每日一次,鲑鱼降钙素鼻喷雾剂,每日一次,持续2个月.实验组B(手术治疗加味身痛逐瘀汤组):加味身痛逐瘀汤,水煎剂1次,每日1次,分2次.1个月为一个疗程,连续3个疗程,对照组B(手术治疗鲑鱼降钙素(密钙息)组):鲑鱼降钙素(50 IU,肌肉注射,每日1次,连续使用1个月);鲑鱼降钙素(密钙息)喷雾剂,每日1次,共2个月.评估术前、术后1个月、3个月VAS评分.结果 实验组和对照组患者临床治疗皆显著有效,差异无统计学意义(P>0.05).实验组和对照组患者治疗前与治疗后的VAS评分均差异显著,差异有统计学意义(P<0.05).治疗前实验组和对照组患者骨密度比较差异无统计学意义(P>0.05);治疗后实验组和对照组的骨密度均得到了显著改善,且实验组患者的改善程度优于对照组,差异有统计学意义(P<0.05).结论 加味身痛逐瘀汤能明显减轻老年骨质疏松性椎体压缩性骨折的临床疗效,提高患者骨密度.是治疗OVCF的有效方法.

目的 评价血清白蛋白、前白蛋白、转铁蛋白在慢性肝功能衰竭患者中的作用和对预后的影响.方法 选取2017年1月至2018年3月漳州市中医院收治的慢性肝功能衰竭患者60例作为试验组,健康体检者30名作为对照组,测量两组的血清白蛋白、前白蛋白、转铁蛋白水平.结果 试验组血清白蛋白、前白蛋白、转铁蛋白均低于对照组(P<0.05);出院患者的血清白蛋白、前白蛋白与死亡或放弃治疗的患者对比,差异有统计学意义(P<0.05),但转铁蛋白之间对比,差异无统计学意义(P>0.05).结论 血清白蛋白、前白蛋白、转铁蛋白3项指标的动态变化用于评估慢性肝功能衰竭患者有一定的价值,可以对患者的预后进行综合评估.

Objective:To investigate the changes of serum high sensitive C reactive protein,troponin I and serum lipid levels in patients with coronary heart disease and its clinical significance.Methods:From March 2013 to March 2015 134 patients with coronary heart disease in our hospital,including 56 cases of patients with stable angina pectoris, as group A,43 cases of unstable angina patients,as group B,35 cases of patients with acute myocardial infarction,as C group,and selected 75 cases in our hospital physical examination center health examination as the control group.The serum levels of hs-CRP,cTnI,TG,TC,LDL-C,HDL-C and other related biochemical indexes of the four groups were monitored and compared.Results:Hs-CRP index in A group were higher than the control group,P<0.05;B group and C group of hs-CRP,cTnI,TG,TC,LDL-C index was higher than the control group,P<0.05,but the HDL-C index is lower than the control group,P<0.05,hs-CRP,cTnI,TG,TC,LDL-C index lower than that of C group A group and the B group,HDL-C index was higher than that in C group,P<0.05;A group of hs-CRP,cTnI index lower than that of B group,P<0.05,the level of hs-CRP,TG,cTnI associated with TC,LDL-C positive,with HDL-C negative correlation,P<0.05,the level of TG,TC,LDL-C,HDL-C associated with cTnI negative,P>0.05,with hs-CRP positive correlation,P<0.05.Conclusion:Hs-CRP,cTnI,TG,TC,LDL-C index for coronary heart disease in patients with the disease prediction has important significance.

目的:分析血清NSE及S-100B蛋白的动态变化与急性脑梗死患者病情、预后的相关性.方法:选取笔者所在医院收治的急性脑梗死患者60例为研究组,选取同期来院健康体检者60例为对照组,分别检测研究组和对照组的血清NSE及S-100B蛋白数值,比较脑梗死患者血清NSE及S-100B蛋白与梗死病情之间的关系.结果:研究组患者血清NSE和S-100B蛋白水平均高于对照组,差异有统计学意义(P<0.05);轻度脑梗死患者血清S-100B蛋白、NSE水平分别为(19.26±4.63)μg/L、(18.34±5.02)μg/L;中度患者分别为(23.58±5.37)μg/L、(31.54±6.32)μg/L;重度患者分别为(28.77±7.29)μg/L、(37.29±8.36)μg/L,血清S-100B蛋白、NSE数值随着神经功能损伤程度增高而增高,差异有统计学意义(P<0.05).结论:NSE及S-100B蛋白可作为脑梗死患者病情判断、预后评估的敏感性实验室指标.

Objective To analyze the results of liver function test results of patients with hepatitis and cirrhosis,and to evaluate the results.Methods Selected 50 patients with hepatitis and cirrhosis( study group) and 50 cases of healthy per-sons for physical examination(control group) in the hospital from June 2014 to June 2015.The activity of serum cholinester-ase,serum cholesterol level,albumin level and total bile acid level between two groups was compared.Results The serum cholinesterase activity,albumin level and serum cholesterol level of study group were lower than those of control group,and total bile acid level of study group was higher than that of control group,the differences were statistically significant(P<0.05). Conclusion The detection of liver function related indexes is of great significance in understanding the extent of liver tissue loss and the clinical diagnosis of the disease.

目的 探讨慢性乙型肝炎病毒(HBV)感染者血浆甘露糖结合凝集素(MBL)含量对慢性HBV感染患者疾病进展的影响.方法 采用酶联免疫吸附法(ELISA)对395例慢性HBV感染者[包括244例慢性乙型肝炎(CHB)、73例代偿性肝硬化(LC)、78例失代偿性LC]和88例正常对照组血浆MBL的含量进行检测.结果 血浆MBL浓度在轻度、中度、重度CHB及代偿性和失代偿性LC患者分别为(5.701±2.419)、(5.462±2.378)、(4.609±2.116)、(4.876±2.175)和(4.528±2.045) mg/L,明显高于正常对照组(2.187±1.392) mg/L,差异均有统计学意义(P均＜0.01);轻度与中度CHB患者血浆MBL浓度相近(P＞0.05),高于重度CHB、代偿性和失代偿性LC患者(P均＜0.05);中度CHB与代偿性LC患者血浆MBL浓度相近(P＞0.05),高于重度CHB、失代偿性LC患者(P均＜0.05);重度CHB与代偿性LC和失代偿性LC患者血浆MBL浓度相近(P均＞0.05).结论 慢性HBV感染者血浆MBL含量明显高于正常对照组;血浆MBL含量对CHB患者疾病进展有一定的影响.

Objective:To determine the influences of Mannose binding protein(MBP) gene polymorphisms on the Liver function or HBV markers and on progression of liver disease in patients with chronic HBV infection.Method:The cordons on 54 MBP gene polymorphisms and the Liver function or HBV markers in a cohort of 395 patients with chronic HBV infection,including 244 with chronic hepatitis B(CHB),151 with liver cirrhosis(LC) and 88 normal controls were examined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) and Elisa method.Result:The MBP genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC in CHB group showed no significant differences comparing to the control group(P>0.05).The MBP genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC on CHB group(severe),compensation phase of LC group and decompensation phase of LC group were higher than those in the normal control group(P<0.05),the genetic polymorphism of decompensation of LC was 36.5%,highest of all.The MBP genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC of patients with chronic HBV infection were not changed with the differences of the Liver function or HBV markers.Conclusion:The codes on 54 MBP gene polymorphisms is not closely related to the Liver function or HBV marker patterns,but was associated with the progression of hepatitis B infection.

Objective To explore the relationship between mannose-binding protein (MBP) codon 54 polymorphism and patients with liver cirrhosis and hepatocellular carcinoma. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and fluorescent quantitative PCR (FQ-PCR) were conducted on the MBP codon 54 polymorphism in 73 patients with compensated cirrhosis (CC), 78 with decompensated cirrhosis (DC), 35 with hepatocellular carcinoma (HCC) and 88 normal controls. Results The genotype frequency of GGC/GAC heterozygotes and GAC allele frequency were significantly higher in group CC and DC as compared with that of control group and HCC group (P < 0.05), while no difference was found between HCC group and normal subjects (P > 0.05). GAC allele frequency was also highest prevalence (36.5%) in DC group than that in CC group and HCC group (P < 0.05). Conclusions The MBP codon 54 polymorphism is associated with the progression of liver cirrhosis and might not play an important role in the development of hepatocellular carcinoma.

OBJECTIVE:To determine the influences of Mannose binding protein (MBP) gene polymorphisms on HBV DNA loads and on the progression of liver disease in patients with chronic HBV infection.METHOD:The Codons on 54 MBP gene polymorphisms and HBV DNA loads in a cohort of 395 patients with chronic HBV infection, including 244 with chronic hepatitis B (CHB), 151 with liver cirrhosis (LC) and 88 normal controls were examined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and fluorescent quantitative PCR (FQ-PCR).RESULT:The MBP genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC in CHB group showed no significant differences comparing to the normal control group (P > 0.05). The MBP genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC on CHB group (severe), compensation phase of LC group and decompensation phase of LC group were higher than those in the normal control group (P < 0.05), the genetic polymorphism of decompensation of LC was 36.5%, highest of all. The MBP genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC of patients with chronic HBV infection were not changed with the differences of HBV-DNA loads.CONCLUSION:The codes on 54 MBP gene polymorphisms is not closely related to HBV DNA loads, but was associated with the progression of hepatitis B infection.

目的探讨脑卒中患者血清γ-谷氨酰转移酶(GGT)的变化及与血脂的关系,为脑卒中的预防与治疗提供一个实验依据。方法测定605例(其中男477例,女128例)脑卒中患者血清GGT、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。按GGT值分为4个级别,将结果进行统计学处理。结果 605例脑卒中患者中GGT升高者为131例,异常率21.65%,其中男、女患者GGT异常率分别为21.59%、21.87%,男、女患者间GGT异常率的差异无统计学意义(P>0.05);男性患者大多数血脂指标随GGT水平升高而改变,血清TC、TG、LDL-C与GGT水平呈正相关,HDL-C与GGT呈负相关。而女性患者GGT不同分级组间血脂水平的差异均无统计学意义。结论血清GGT活性升高有可能是男性脑卒中患者的一种危险因素。

Objective To determine the influences of Mannose binding protein(MBP)genetic polymorphisms and HBV genotype on the progression of liver disease.Methods The codon 54 polymorphisms of MBP gene in a cohort of 360 patients with chronic HBV infection,including 66 with asymptomatic HBV carriers(ASC),the remaining 182 with chronic hepatitis B(CH),112 with liver cirrhosis(LC)and 65 with controls were analyzed by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)and fluorescent quantitative PCR(FQ-PCR).Results ASC group,CH group(mild),CH group(moderate)all demonstrated the advantage with B Genotype,the genotype frequencies of GGC/GAC and alleles genetic frequencies of GAC no significant differences comparing to the control group(P>0.05);CH group(severe),compensation phase of LC,decompensation of LC all demonstrated the advantages with C Genotype,higher than those in the control group(P<0.05),the decompensation of LC was 37.7%,highest of all.Conclusion The genotype B and genotype C are the major genotype in patients with hepatitis B infection in the area analyzed.Codon 54 mutation of MBP gene is not related to the persistence of hepatitis B,but Codon 54 mutation of MBP gene and genotype C are associated with the progression of hepatis B infection.

Objective:To investigate the histopathological and clinical features of asymptomatic HBV carriers.Methods:420 patients with asymptomatic HBV carrier were performed the liver puncture pathological detection for evaluating the inflammatory activity and fibrosis degree of liver tissue.At the same time,alanine aminotransferase(ALT),HBV markers and HBV DNA were detected.Results:Positive HBeAg was mainly in the cases aged less than 45 years,positive anti-HBe was mainly in the cases aged more than 45 years.HBV DNA virus loads in the HBeAg group were significantly higher than those in the positive anti-HBe group.Among 420 asymptomatic HBV carriers,only 205 cases(48.8%) had normal liver histological diagnosis,while 215 cases(51.2%) had chronic liver diseases.Of these 215 cases,158 cases were inflammation grade 1 fibrosis stage 0(GISO),42 cases were grade 2 stage 1(G2S1),11 cases were grade 3 stage 1(G3S1),4 cases were grade 4 stage 4(G4S4) and 14 cases were steatosis change.Conclusion:Asymptomatic HBV carriers are not regarded as having no progressive liver lesion.Except dynamic observing liver function,HBV markers and HBV DNA,the chronic HBV carriers aged over 45 years should be mobilized to perform liver biopsy for early finding hepatic histological changes and even liver cirrhosis.

Objective:To determine the distribution of mannose binding protein(MBP) genetic polymorphisms in Fujian Hans.Methods:The codon 54 polymorphisms of MBP gene in a total of 152 healthy Fujian Hans were studied with Polymerase chain reaction and restrictive fragment length polymorphisrn(PCR-RFLP).Current results were compared with the data on other ethnic groups.Results:The genotype frequencies of MBP gene codon 54 was found to be GGC/GGC(71.1%),GGC/GAC(28.9%),GAC/GAC(0.0%) respectively,while the alleles genetic frequencies were found to be GGC(85.5%),GAC(14.5%).Conclusion:The codon 54 polymorphisms of MBP gene in Fujian Hans were similar to those in Chinese Hans,Mongols,Tibetans,Yis population;but were significantly different from those in north and east European people.

Objective:To investigate the expression of interleukin-1(IL-1) and IL-1β mRNA in peripheral blood of patients with acute lumbar intervertebral disc herniation(LIDH),and to explore the mechanism of traditional Chinese medicine Fufang Duzhong tablet for treating LIDH.Methods:The expression levels of IL-1 and IL-1β mRNA were detected by ELISA and RT-PCR methods in peripheral blood of patients with LIDH before and after treatment respectively,as well as normal people.Results:The expression levels of IL-1 and IL-1β mRNA in peripheral blood of patients with LIDH before treatment were obviously higher compared with the healthy controls(P<0.05).However,they were decreased markedly after treatment,and there was no statistically significant difference compared with the healthy controls(P>0.05).But compared the levels before and after treatment,there was statistically significant difference(P<0.05).Conclusion:Fufang Duzhong tablet could down-regulate expression of IL-1and IL-1β mRNA in peripheral blood for treating LIDH.

Objective To study the characteristics and clinical significance of hepatitis B virus(HBV)genotypes distribution in Zhangzhou.Methods All 271 serum samples of patients with chronic HBV infection were selected and detected by nested PCR with multiplex pairs of genotype-specific primers and the positive results were investigated by DNA sequencing in order to detect the genotypes.Results The prevalence of genotype B was 84.1%(228/271)of 271 patients with chronic hepatitis B,type C was 14.0%(38/271),type D was 1.5%(4/271),mixed genotype B and C was 0.4%(1/271),while none of genotype A,E and F were found.There were no significant difference and relation in the distribution characteristics of genotype B and C among various degree of patients with HBV infection.No significant difference was found in the positive rate of HBeAg or the serum level of HBV DNA,ALT,AST,TBil,DBil,TP,ALB or the age,gender among the patients of genotype B and C.Conclusions Genotype B was the major type in patients with HBV infection in this area,genotype C was the medium,genotype D and mixed genotype B and C were both low.There were no significant association between genotypes B,C and ALT level or HBV DNA load,or HBeAg positive rate of patients with chronic hepatitis B.

腰椎间盘突出症(1umbar intervertebral disc herniation,LIDH)是骨科常见病、多发病,是腰腿痛的最常见原因之一[1].到目前为止,其病机尚不清楚,比较公认的观点有机械压迫学说、化学刺激学说、自体免疫学说等[2].本病发病率为5%～10%,占腰腿痛病人的30%～40%以上.目前学者普遍认为,80%～90%的初发性腰椎间盘突出症患者可以通过非手术治疗而消除症状.

目的 观察复方杜仲片治疗腰椎间盘突出症的疗效

乙型肝炎(下称乙肝)病毒(HBV)感染是世界上最主要的慢性病毒性疾病之一,对人类的健康危害极大.全球大约有3.5亿HBV慢性携带者,中国人群慢性HBV携带者约占10%～15%,造成了广泛的疾病谱.近年来一些研究发现,机体感染HBV后对病毒的清除能力以及感染后疾病的转归,在很大程度上取决于个体问基因组的差异.

Objective To explore the establishment of hepatocellular carcinoma cell line with stable RNA interference vector targeting cyclin E1 gene.Methods A neo gene from pSSC-9 was subcloned into pSilencer 1.0-U6 to construct a stable RNAi vector pSineo.Then,it was ligased with a synthesized RNA interference DNA template targeting cyclin E1 gene.The recombinant was introduced into BEL-7402 cells with Lipofectamine~(TM)2000.After G418 selection,the genomic DNAs of anti-G418 clones were isolated and PCR experiments were carried out for the identification of integration of RNAi vectors.Results The results of digestion of recombinants with restriction enzymes and sequencing indicated that the recombinant pSineo-cycE 1 was meet the design.Our PCR indetification also demonstrated that all 6 cell clones sorted out with G418 selection had stably integrated RNAi vector targeting cyclin E1 gene.Conclusion Six cell lines with stable RNA interference vector targeting cyclin E1 gene are established in this study.This work will be helpful in investigating oncogene targeting RNAi therapy of cancer.

目的探讨经载体介导的RNA干扰对肝癌细胞周期蛋白E1表达抑制效率.方法针对周期蛋白E1基因设计并合成特定的RNA干扰模板片段,连接到pSilencer 1.0-U6载体上构建siRNA真核表达载体;脂质体转染法将上述重组质粒转入BEL-7402肝癌细胞株.RT-PCR分析周期蛋白E1表达抑制率;流式细胞术测细胞周期S期和凋亡细胞比率;MTT比色法测定活细胞数并绘制细胞生长曲线.结果重组载体介导肝癌细胞BEL-7402周期蛋白E1抑制率达62%;转染重组质粒32 h测得S期细胞为19%,空载体转染对照为27%;转染重组质粒96 h流式细胞术测得凋亡细胞为13.1%,高于空载体对照的6.6%;细胞生长曲线作图表明,重组载体转染组细胞生长明显减缓.结论肝癌细胞周期蛋白E1的表达可被载体介导诱发的RNA干扰成功抑制,进而导致细胞生长受抑并诱导凋亡;本研究为探索肝癌的RNAi治疗提供了初步的实验依据.