目的 探讨乌司他丁联合序贯透析、持续血滤治疗重症急性胰腺炎(SAP)所致脓毒症休克的疗效,并分析其对血清炎症因子、高迁移率族蛋白1(HMGB1)、肥胖抑制素(Obestatin)及肝肾功能的影响.方法 选取自2019年1月至2021年8月收治的70例SAP所致脓毒症休克患者为研究对象,按照随机数字表法分为A组(n=35)与B组(n=35).A组给予乌司他丁治疗,B组在A组基础上创建体外循环,进行序贯透析、持续血滤治疗.两组患者均治疗7 d,评估并比较两组患者临床疗效.记录并比较两组患者治疗前、治疗后急性生理与慢性健康评分(APACHEⅡ),序贯器官衰竭(SOFA)评分,血清炎症因子[白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)]、HMGB1、Obestatin水平,及肝肾功能指标[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、血肌酐(SCr)、血尿素氮(BUN)].记录并比较两组患者28 d病死率.结果 治疗后,B组总有效率为91.4％(32/35),高于A组的71.4％(25/35),差异有统计学意义(P<0.05).治疗后,两组APACHEⅡ评分、SOFA评分及血清IL-6、IL-8、TNF-α、HMGB1、Obestatin、ALT、AST、BUN、SCr水平均较治疗前降低,且B组低于A组,差异有统计学意义(P<0.05).B组28 d病死率为8.6％(3/35),低于A组的28.6％(10/35),差异有统计学意义(P<0.05).结论 乌司他丁联合序贯透析、持续血滤可有效缓解SAP所致脓毒症休克患者炎症反应,促进病情恢复,改善患者预后.

目的 探讨血清微小RNA(miR)-223-3p和miR-17-5p水平与前列腺癌患者术后复发转移的关系,分析miR-223-3p和miR-17-5p对前列腺癌患者术后复发转移的预测价值.方法 选择2015年1月至2017年6月该院行前列腺癌根治术治疗并完成3年随访的116例患者为观察组,另选择同期体检健康志愿者30例作为对照组.收集患者临床资料,检测血清miR-223-3p、miR-17-5p、前列腺特异抗原(PSA)、睾酮水平.根据术后是否发生复发转移将观察组患者分为复发转移组(37例)和未复发转移组(79例).比较观察组与对照组血清miR-223-3 p、miR-17-5 p水平,分析复发转移组与未复发转移组临床资料及血清miR-223-3 p、miR-17-5p水平的差异.应用Cox回归模型分析前列腺癌复发转移的危险因素,采用受试者工作特征(ROC)曲线评价血清miR-223-3p、miR-17-5p、PSA单独和联合检测对前列腺癌患者术后复发转移的预测价值.结果 观察组术前血清miR-223-3p、miR-17-5p水平明显高于对照组(P<0.05).复发转移组临床分期Ⅲ期、Gleason评分>7分、血清PSA>20.33 ng/mL、游离前列腺特异抗原/总前列腺特异抗原(fPSA/tPSA)≤0.1、睾酮≤3.0 ng/mL的患者比例及血清miR-223-3p、miR-17-5p水平明显高于未复发转移组(P<0.05).Cox回归模型分析结果 显示,临床分期为Ⅲ期、Gleason评分>7分、血清PSA>20.33 ng/mL、fPSA/tPSA≤0.1、睾酮≤3.0 ng/mL、miR-223-3p>3.192、miR-17-5p>3.556是前列腺癌患者术后复发转移的独立危险因素(P<0.05).ROC曲线分析结果 显示,血清miR-223-3p、miR-17-5p、PSA联合检测预测前列腺癌患者术后复发转移的曲线下面积为0.859,明显高于3项指标单独检测的0.783、0.742、0.722(P<0.05).结论 血清miR-223-3p、miR-17-5 p水平升高与前列腺癌患者术后复发转移有关,是前列腺癌患者术后复发转移的独立危险因素,对前列腺癌患者术后复发转移具有较高的预测价值.

目的 探讨Forns指数、基于4因子的纤维化指数(FIB-4)、天冬氨酸转氨酶/血小板比值(APRI)、谷氨酰转移酶/血小板比值(GPR)对慢性乙型肝炎病毒(HBV)感染合并非酒精性脂肪肝病(NAFLD)患者肝纤维化的诊断效能.方法 选取2017年10月—2019年5月我院收治的HBV感染合并NAFLD 106例,依肝穿刺活检结果分为非显著性纤维化76例(非显著组)与显著性纤维化组30例(显著组),并于入院次日行无创血清学筛查,按公式计算Forns指数、FIB-4、APRI与GPR,绘制受试者工作特征曲线分析4种无创模型对HBV感染NAFLD患者显著性肝纤维化的诊断效能,采用Spearman等级相关分析探讨4种无创模型与患者肝纤维化分级的关系.结果 显著组HBV DNA、丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶均高于非显著组,血小板计数、白细胞计数低于非显著组,差异有统计学意义(P<0.01).显著组Forns指数、FIB-4、APRI、GPR均高于非显著组(P<0.05,P<0.01).Forns指数、FIB-4、APRI、GPR中以GPR预测HBV感染合并NAFLD患者显著性肝纤维化的效能最高,其次为APRI,但4项联合诊断效能优于单独诊断.Spearman等级相关分析结果显示,HBV感染合并NAFLD患者Forns指数、FIB-4、APRI、GPR与肝纤维化分级均呈正相关(r=0.855、0.813、0.725、0.891,P<0.01).结论 Forns指数、FIB-4、APRI、GPR对HBV感染合并NAFLD患者显著性肝纤维化均有较高的预测效能,且联合诊断效能优于单独诊断;以上4种无创模型均与患者肝纤维化分级存在明显相关性.

目的评估血浆微小RNA-103（miR-103）和RNA-107（miR-107）对脓毒症患病死亡风险的预判,并探讨其与脓毒症患者疾病严重程度及预后有关联的因素。方法选取2016年1月至2019年6月接受治疗的脓毒症患者120例（脓毒症组）,入院24 h之内收集血液样本;选取同期健康对照者120例（健康对照组）,入组时收集血液样本,并分离血液样本中血浆。采用反转录-荧光定量聚合酶链式反应检测所有受试者血浆miR-103和miR-107的表达水平。采用酶联免疫吸附试剂盒检测脓毒症组血浆中某些炎症因子的表达水平。收集脓毒症组临床指标并计算其28 d死亡率。采用受试者工作曲线（ROC）对临床辅助诊断的预判分析,采用Cox?s回归模型分析脓毒血症死亡的关联因素。结果 miR-103和miR-107在脓毒症组表达水平相比健康对照组均降低,且可作为脓毒症临床诊断的辅助指标,其曲线下面积（AUC）分别为0.893（95%CI:0.854～0.933）及0.941（95%CI:0.913～0.968）。脓毒症组miR-103和miR-107表达水平与急性生理和慢性健康状态II评分、序贯器官功能衰竭评分、血清肌酐、C-反应蛋白、肿瘤坏死因子-α、白介素-1β、白介素-6及白介素-8均呈负相关,与白蛋白呈正相关。此外,miR-103和miR-107在脓毒症死亡患者中表达水平较脓毒症存活患者降低。多元Cox?s回归分析结果显示,miR-103表达是预测脓毒症组28 d死亡率的独立因素。结论 miR-103和miR-107低表达与脓毒症相关,并与脓毒症患者疾病严重程度及28 d死亡率相关。

目的 探讨MRI检查中DTI序列对急性脑梗死诊断及预后评估价值.方法 回顾分析本院2017年8月至2019年8月收治的88例脑梗死患者的临床资料.对患者MRI图像进行分析,以病理诊断结果为基准,对DTI诊断的灵敏度、特异度、准确度进行判断,在患者随访后3个月实行MRI检查,对预后良好组与预后不良组的FA、Exat、DCavg、VRA情况进行比较.结果 与病理结果对照,DTI检查诊断的灵敏度、特异度、准确度分别为97.77％(86/88)、100％(87/87)、98.88％(165/167).预后良好与预后不良组DCavg、Exa比较差异无统计学意义(P>0.05),预后良好组FA、VRA分别为(0.321±0.101)、(0.113±0.077),明显高于预后不良组(0.189±0.051)、(0.073±0.043),差异有统计学意义(P<0.05).结论 MRI检查DTI序列可提高对急性脑梗死诊断准确率,对预后评估有较高的参考价值,并可为临床治疗方案制定提供可靠的参考依据,值得临床推广.

目的:观察气血双补方结合肠内营养(EN)治疗腹腔镜胃癌术后气血两虚证的临床疗效.方法:选取2017年1月至2018年12月邯郸市中心医院收治的行腹腔镜胃癌术后气血两虚型患者90例作为研究对象,按照随机数字表法分对照组和观察组,每组45例.对照组给予常规EN治疗,观察组在此基础上结合气血双补方治疗,2组均治疗15 d.比较2组临床疗效;治疗前后中医证候评分、生命质量(SF-36)评分及营养状况[血清白蛋白(ALB)、转铁蛋白(TRF)、体质量指数(BMI)];喂养不耐受(FI)发生情况.结果:观察组治疗有效率(86.67％)高于对照组(66.67％),差异有统计学意义(P<0.05).治疗后,2组中医证候评分均下降,且观察组低于对照组,差异有统计学意义(P<0.05);2组SF-36各维度评分及ALB、TRF、BMI均有提升,且观察组高于对照组,差异有统计学意义(P<0.05).观察组发生FI7例,低于对照组16例,差异有统计学意义(P<0.05).结论:气血双补方结合EN可减轻腹腔镜胃癌术后气血两虚证患者临床症状,提高临床治疗效果,改善患者生命质量,改善营养状况,降低发生FI.

目的 观察分析胃癌患者术后早期应用免疫增强型肠内营养制剂联合肠外营养的临床疗效及可行性.方法 选择2014年10月至2017年10月河北省邯郸市中心医院120例手术治疗的胃癌患者作为研究对象.按随机数字表法分为早期免疫增强型肠内营养制剂联合肠外营养(EEN+PN)组和全肠外营养(TPN)组,各60例.比较两组患者术后的营养指标[白蛋白(Alb)、前白蛋白(PA)、血红蛋白(Hb)、转铁蛋白(TRF)]、免疫指标[IgA、IgG、IgM、CD3+、CD4+、CD4+/CD8+]/人体指标[体质量指数(BMI)、上臂肱三头肌皮褶厚度(TSF)、上臂肌围(AMC)、上臂围(AC)]及排气排便时间、经口进流食时间、下床时间、住院时间.结果 两组手术后7 d ALB、PA和TF水平均高于手术前(P<0.05),且EEN+PN组明显高于TPN组(P<0.05).两组手术后7 d Hb水平低于手术前(P<0.05),但EEN+PN组高于TPN组(P<0.05).两组手术后7 d BMI水平均较治疗前显著改善(P<0.05),且EEN+PN组BMI、AC均优于TPN组(P<0.05).术后7 d各免疫功能指标两组均明显改善,且EN+PN组改善的更加明显(P均<0.05).EEN+PN组术后排气排便时间、经口进流食时间、下床时间、住院时间均优于TPN组(P<0.05).结论 胃癌患者术后早期应用免疫增强型肠内营养制剂联合肠外营养优于全肠外营养.

目的:观察加味十全大补汤联合瑞素治疗老年胃癌术后气血两虚证的临床疗效.方法:选取老年胃癌术后气血两虚证患者70例,按照随机数字表法分为治疗组与对照组,每组35例.治疗组使用加味十全大补汤联合瑞素肠内营养支持治疗,对照组仅使用瑞素治疗.治疗10d后观察并比较2组患者治疗前后中医症候积分、免疫指标、炎症指标水平,比较治疗后2组患者每日氮平衡、总蛋白(TP)、前白蛋白(PA)指标水平,并比较2组临床疗效.结果:2组患者治疗后头晕目眩、少气懒言、神疲乏力、心悸失眠、面色少华、畏寒肢冷、自汗盗汗、唇甲色淡等中医症候均较治疗前明显改善(P<0.01),治疗组改善程度明显优于对照组(P<0.05,P<0.01).治疗组患者每日氮平衡、TP、PA随时间增长的趋势明显优于对照组(P<0.05,P<0.01).2组患者的CD4+?T淋巴细胞亚群及CD4+/CD8+均较治疗前明显提高(P<0.01),CD8+?T淋巴细胞亚群较治疗前明显降低(P<0.01),治疗组各指标改善程度较对照组更加显著(P<0.05).2组患者的白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、C-反应蛋白(CRP)均较治疗前显著降低(P<0.01),治疗组下降程度较对照组更加显著(P<0.05).治疗组中医症候总有效率为94.3％,明显高于对照组的65.7％(P=0.009).结论:加味十全大补汤联合瑞素治疗老年胃癌术后气血两虚证能减轻中医症候,改善营养状况,提高免疫功能,减轻炎症反应,临床疗效确切.

[目的]研究苦参素(OMT)对局灶性脑缺血再灌注大鼠血液流变学指标的影响并探讨其可能的作用机制.[方法]通过线栓法复制局灶性脑缺血再灌注大鼠模型,设假手术组 、模型组和OMT低[25 mg/(kg·d)]、中[50 mg/(kg·d)]、高[100 mg/(kg·d)]剂量组,每组20只,术后第2天开始腹腔注射给药,疗程7 d.通过盲法神经功能评分评测神经功能损伤,测定脑组织含水量及脑组织梗死体积.通过苏木精-伊红(HE)染色观察海马CA1区神经元形态;生化分析脑组织抗氧化酶活性和丙二醛(MDA)含量;测定血液流变学指标及红细胞膜流动性指标.[结果]与模型组比较,OMT中、高剂量组神经功能评分显著降低(P<0.01)、神经功能状况明显改善,脑组织含水量显著降低、梗死体积显著减小(P<0.05或P<0.01);海马CA1区神经元病理性形态结构改变明显改善,抗氧化酶[(超氧化物歧化酶(SOD)、过氧化氢酶(CAT)]活性显著升高且MDA含量显著降低(P<0.05或P<0.01);血液流变学指标(全血黏度、血浆黏度、红细胞聚集指数、红细胞变性指数、红细胞刚性指数、红细胞压积、血沉)显著降低(P<0.05或P<0.01),红细胞膜流动性指标(荧光偏振度、平均微黏度、各向异性)显著降低(P<0.05或P<0.01).[结论]OMT可能通过改善血液流变学而对脑缺血再灌注损伤起到一定的保护作用.

目的 探讨十全大补汤辅助肠内营养支持治疗对胃癌术后患者营养和免疫指标及肠内营养并发症的影响.方法 将75例胃癌术后患者随机分为治疗组35例和对照组40例.2组患者术后均给予规范化治疗,对照组于术后第2天肠功能恢复后给予肠内营养支持,治疗组在此基础上辅助使用中药十全大补汤,连续使用至术后第8天.检测2组患者术前及术后第8天营养指标[血清白蛋白(ALB)、血清前白蛋白(PAB)、转铁蛋白(TFN)、血红蛋白(Hb)]及免疫指标[淋巴细胞总数(TLC)和血清IgA、IgG、IgM],统计2组患者肠内营养并发症(腹痛、腹胀、腹泻、恶心)发生情况.结果 术后第8天,2组患者ALB、PAB、TFN、Hb、TLC、IgA、IgG、IgM水平均显著升高(P均<0.05),且治疗组均显著高于对照组(P均<0.05).治疗组肠内营养并发症发生率显著低于对照组(P<0.05).结论 十全大补汤辅助肠内营养支持治疗可以更加有效地改善胃癌术后患者机体营养状况,增强免疫功能,降低肠内营养并发症发生率,促进患者康复.

目的 探讨十全大补汤联合肠内营养支持对老年胃癌术后气血两虚证病人营养状况和免疫功能的影响.方法 选取2016年1月至2017年12月邯郸市第一医院老年胃癌手术后气血两虚证病人76例,按照随机数字表法分为观察组38例和对照组38例.对照组给予常规肠内营养支持治疗,观察组在对照组基础上辅助使用中药十全大补汤,给予中西医结合肠内营养支持治疗.经治疗后,比较两组病人肠鸣音恢复时间及排气、排便时间.对比两组病人在治疗前、治疗第8天后病人的营养状况和免疫功能指标的变化情况.结果 观察组在术后肠鸣音恢复时间(41.2±5.2)h及排气(69.5±7.8)h、排便时间(81.5±9.8)h上显著快于对照组(49.5±6.5)h、(73.6±8.6)h、(88.2±10.5)h,差异有统计学意义(P<0.05).治疗8 d后,观察组总蛋白(TP)(64.09±5.07)g·L-1、转铁蛋白(TRF)(2.10±0.18)g·L-1及血红蛋白(Hb)(117.59±14.32)g·L-1上升幅度均显著高于对照组(61.16±5.01)、(1.99±0.19)、(110.45±16.42)g·L-1(P<0.05);观察组血清IgA、IgG、IgM水平升高幅度均显著高于对照组(P<0.05).两组病人治疗8 d后CD4+均升高(P<0.05),但观察组高于对照组(P<0.05);两组病人CD8+均降低(P<0.05),但观察组低于对照组(P<0.05);两组病人CD4+/CD8+均提升(P<0.05),但观察组高于对照组(P<0.05).结论 对于老年胃癌术后气血两虚证病人,运用中西医结合理念,应用十全大补汤联合肠内营养支持不仅可在一定程度上促进肠功能恢复、改善机体营养状况,而且还能提高机体免疫力,起到了促进病人早日康复的目的.

目的 观察十全大补汤辅助肠内营养支持治疗胃癌术后气血两虚证患者对营养状况及免疫功能的影响并探讨其作用机制.方法 患者64例随机分为两组,均给予胃癌术后规范化治疗,对照组于术后第2日肠功能恢复后给予肠内营养支持,观察组在对照组基础上加服中药十全大补汤.观察两组患者术前及术后第10日营养指标:血清白蛋白(ALB)、血清前白蛋白(PAB)、转铁蛋白(TRF)、红细胞计数(RBC)、血红蛋白(Hb)、三头肌皮褶厚度(TSF)、上臂肌围(AMC)和免疫指标(血清IgA、IgG、IgM、CD3+、CD4+)的变化情况.结果 治疗后两组血清ALB、PAB、TRF、血常规(RBC、Hb)、TSF、AMC、体液免疫指标(IgA、IgG、IgM)及细胞免疫指标(CD3+、CD4+)均高于治疗前(均P＜0.05),且观察组改善均较对照组明显(均P＜ 0.05).结论 十全大补汤辅助肠内营养支持治疗胃癌术后气血两虚证患者可以更加有效地改善机体营养状况及免疫功能,起到了提高临床疗效、促进患者早日康复的目的.

Objective It is to investigate the effects of enteral nutrition support adding glutamine combined with microecological preparations on the prognosis of patients with severe acute pancreatitis (SAP).Methods 78 patients with SAP were randomly divided into treatment group and control group,each group had 39 cases.All patients were treated with conventional treatment.Additionally,the control group was given parenteral nutrition support,the treatment group was given enteral nutrition adding glutamine combined with microecological preparations therapy through jejunal nutrient canal.The times of relief of abdominal signs (abdominal pain and distension) and recovery of laboratory indexes were compared,the changes of APACHE Ⅱ scores,nutrition indicators (serum ALB,PAB) and immune indexes (TLC,IgA,IgG,IgM) were observed after treatment in both groups.Results After treatment,the times of relief of abdominal pain and distension and recovery of blood and urine amylase were shorter in treatment group than that in control group (P ＜ 0.05).After treatment for 7,14 days,the APACHE Ⅱ scores were decreased while the levels of ALB and PAB were increased significantly in both groups (P ＜ 0.05),and the decrease or increase in treatment group was more obvious than that in control group(P ＜ 0.05).After treatment for 14 days,the levels of TLC,IgA,IgG,IgM were significantly increased in both groups,and the increase in treatment group was more significant than that of control group(P ＜0.05).Conclusion Enteral nutrition support adding glutamine combined with microecological preparations can more effectively relieve clinical symptoms,reduce inflammation reaction,improve the patient g nutritional status and immune function,thus to improve the clinical curative effect,it is worthy of wide application.

Objective To investigate the effect of enteral nutrition support in the treatment of severe acute pancreati -tis with nutritional index , immune index and inflammatory response index .Methods We collected 72 patients with severe a-cute pancreatitis from January 2013 to December 2015 .They were randomly divided into research group and control group , each group had 36 cases.All patients were treated with conventional treatment , research group were received immune enteral nutrition therapy by jejunum nutrition tube , control group were received parenteral nutrition support .Compare two groups after treatment, patients’ nutrition indicators (Alb, PAB), humoral immunity (IgA, IgG, IgM), cellular immunity (TLC, CD3 +, CD4 +) and inflammatory indicators (CRP, TNF-α, IL-6) changes.Results Two groups of patients given different nutrition after treatment , the indicators were obviously improved .At 7 days and 14 days, the ALB and PAB levels of the re-search group were significantly higher than that of the control group ( t 7 =1.717, t 7 =2.957;t 14 =2.411, t 14 =2.182, P <0.05);Treatment for 14 days, the IgA, IgG, IgM, TLC, CD3 +, CD4 +of the research group were improved significantly better than the control group ( t =2.031, t =2.106, t =2.198, t =2.050, t =2.182, t =1.850, P <0.05).At the same time, the CRP, TNF-α, IL-6 of the research group declined significantly than the control group ( t =2.437, t =1.705, t =2.697, P <0.05).Conclusion The jejunum nutrition tube given immune enteral nutrition in treatment of severe acute pan -creatitis can effectively improve the nutritional status and immune function of patients , reduce the inflammatory reaction in pa-tients with acute reaction period , so as to improve the prognosis and improve the clinical efficacy .

Objective:To investigate the protective effect of hawthorn leaves favonoids on the kidneys of type 2 diabetic rats.Methods:Ninety-six experimental rats were randomly devided into 6 groups:normal control group,model group,HLF low (50 mg/kg),medium(100 mg/kg),high(200 mg/kg) dose groups and metformin hydrochloride 200 mg/kg treatment group;except the rats in normal control group,others were injected STZ to make type 2 diabetic model rats;the drugs were given by intragastric administration for 6 weeks,once a day.Six weeks later,the level of blood sugar was determined;the body weight was determined and the renal index(RI) was calculated;the urine volume and the UPro were determined;the contents of BUN,SCr,UA in serum were determined;the activity of SOD,GSH-Px,T-AOC and the content of MDA in renal tissue were determined;the histopathological changes of renal tissue were observed by HE staining and the apoptosis of renal tissue cells was observed by TUNEL;the levels of TNF-α,IL-1β,IL-6,ICAM-1 in plasma were determined.Results:Compared with the type 2 diabetic models in the control group,the blood sugar levels of HLF medium and high dose groups were significantly decreased;the body weight was significantly increased and the RI was significantly decreased;the urine volume and the UPro were significantly decreased,and the contents of BUN,SCr and UA in serum were significantly decreased;the activities of SOD were significantly increased and the contents of MDA were significantly decreased;the activities of GSH-PX and T AOC in HLF 200 mg/kg treatment group were significantly increased,and all of the above differences were significant(P ＜ 0.05,P ＜ 0.01);the histopathological changes and apoptosis were significantly improved,especially the HLF 200 mg/kg treatment group,and the AI of HLF medium and high dose groups was significantly decreased(P ＜ 0.01);the levels of TNF-α,IL-6 and ICAM-1 in plasma of medium and high dose groups were significantly decreased(P ＜ 0.05,P ＜ 0.01),and the level of IL-1β in HLF high dose group was significantly decreased(P ＜ 0.01).Conclusion:HLF has dose-dependent effects on improving renal function,reducing the damage of oxidative stress,depressing the apoptosis,lowering the level of inflammatory mediators and the level of ICAM-1 and improving the renal tissue histopathological changes,which suggests that HLF has dose-dependently protective effects on the kidneys in type 2 diabetic rats.

Objective To investigate the protection and mechanism of Hawthorn leaves flavonoids (HLF)on hepatic tissue injury in diabetic rats induced by streptozocin(STZ). Methods 60 diabetic rat models made by feeding with high fat and sugar and intraperitoneal injecting STZ were randomly divided into five groups:the diabetic model control group,the HLF(50,100 and 200 mg/kg)treatment group and the met-formin hydrochloride 200 mg/kg control group,and selected 12 same-aged rats as the normal control group;the drugs were given by intragastric administration for 6 weeks,and once a day. Before the drugs were given and after 2,4 6 weeks,the level of blood sugar was determined. And 6 weeks later,the activity of ALT,AST, ALP in serum were determined;the activity of SOD,GSH-Px,CAT and the content of MDA in hepatic tissue were also determined;the histopathological changes of the hepatic tissue was observed by HE staining;the he-patic cells apoptosis were observed by TUNEL staining,and the Apoptosis Index( AI)were analyzed. Results Compared with the diabetic model control group,the level of blood sugar in the HLF 100,200 mg/kg treatment&nbsp;group was significantly decreased(P﹤0. 01);the activity of ALP,AST in serum were significantly decreased (P﹤0. 05,P﹤0. 01);the activity of SOD,CAT in hepatic tissue were significantly increased and the content of MDA were significantly decreased(P﹤0. 05,P﹤0. 01). The level of T-AOC and the activity of GSH-Px in the HLF 200 mg/kg treatment group was significantly increased(P﹤0. 05,P﹤0. 01). The hepatic tis-sue histopathological changes and hepatic cells apoptosis were significantly improved,especially in the HLF 200 mg/kg treatment group,and the AI of the HLF 100,200 mg/kg treatment group were significantly de-creased(P﹤0. 05,P﹤0. 01). Conclusion HLF had dose-dependent protective effects on hepatic tissue injury in diabetic rats induced by STZ,which perhaps related to its effects on enhancing the activity of antiox-idant enzymes,inhibiting the damage of oxidative stress.

Objective To explore the influence of the whole course psychological intervention on negative emotion, side effect of chemotherapy and the quality of life in patients with rectal cancer. Methods A total of 112 pa-tients with rectal cancer in our department from February 2008 to November 2014 were selected as the research sub-jects, which were randomly divided into intervention group and non-intervention group based on the digital table meth-od, with 56 patients in each group. Patients in the intervention group received whole course of psychological interven-tion, and patients in the non-intervention group did not receive psychological intervention with other treatments the same. Self-rating anxiety scale (SAS) and Self-rating Depression Scale (SDS) were used to compare the scores of anxi-ety and depression between the two groups before the psychological intervention and before discharge. The scores of quality of life were compared between two groups before the psychological intervention after 1 year of psychological intervention by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). Results The scores of anxiety in the intervention group and the non-intervention group were (42.63 ± 3.66) and (57.56 ± 4.13), and the scores of depression were (39.85 ± 6.37) and (56.67 ± 8.35), respectively. The scores of anxiety and depression in the intervention group were significantly lower than those in the non-intervention group (P<0.05). The scores of physical function, role function and other scores of quality of life in the intervention group were significantly higher than those in non-intervention group, and the differences were statistically significant (P<0.05). The incidence of severe fatigue and weakness in the intervention group and the non-intervention group were 13%and 25%, respectively. The incidence of severe nausea and vomiting were 14%and 27%, respectively. The adverse reaction of chemotherapy in the intervention group was lower than that in the non-intervention group, and the difference was sta-tistically significant (P<0.05). Conclusion The whole course psychological intervention on the basis of routine treat-ment can reduce the patient's negative emotions, significantly improve the quality of life of patients, and reduce the side effects of chemotherapy, which is worth to clinical promotion.

目的:研究山楂叶总黄酮(Hawthorn Leaves Favonoids,HLF)对2型糖尿病大鼠调节血脂和抗氧化能力的改善作用.方法:采用腹腔注射链脲佐菌素(STZ,60mg/kg)破坏胰岛β细胞的方法诱导制备实验性2型糖尿病大鼠模型,取80只模型大鼠根据血糖水平随机分为模型组、盐酸二甲双胍(200mg/kg)治疗组和HLF低、中、高剂量(50、100、200mg/kg)组,并另设正常对照组.认定造模成功后,各治疗组大鼠每天灌胃给药1次,疗程6周.给药前和给药后每2周测定血糖;6周后,检测血清血脂指标;通过苏木精-尹红(HE)染色观察肝脏和心肌组织形态结构变化,测定肝脏和心肌组织中抗氧化酶活性和丙二醛(MDA)含量.结果:与模型组比较,治疗后BLF中、高剂量组大鼠空腹血糖水平显著降低(P<0.05,P<0.01),血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)含量明显降低(P<0.05,P<0.01),肝脏和心肌组织中超氧化物歧化酶(SOD)、过氧化氢酶(CAT)活性明显提高(P<0.05,P<0.01),MDA含量明显降低(P<0.05,P<0.01);治疗后BLF高剂量组大鼠血清高密度脂蛋白(HDL-C)含量显著升高(P<0.05),肝脏和心肌组织中GSH-Px活性显著提高(P<0.05);治疗后HLF各剂量组大鼠肝脏和心肌组织病变呈不同程度减轻,其中以HLF高剂量组效果最为显著.结论:HLF能够有效改善2型糖尿病大鼠血糖血脂和抗氧化能力.

目的 研究山楂叶总黄酮(hawthorn leaves favonoids,HLF)对2型糖尿病大鼠脑组织损伤的保护作用.方法 通过高脂高糖饮食8周后腹腔注射链脲佐菌素(STZ)的方法诱导制备2型糖尿病大鼠模型,选取100只随机分为:糖尿病模型对照组、山楂叶总黄酮(50、100、200mg/kg)治疗组和盐酸二甲双胍(200mg/kg)阳性对照组,另取20只同龄大鼠作为正常对照组;每天灌胃给药1次,疗程6周.分别于给药前和给药后第2周、第4周和第6周测定各组大鼠空腹血糖水平;6周后,测定各组大鼠血浆中磷酸肌酸激酶、乳酸脱氢酶活性和丙二醛含量;测定各组大鼠脑组织中超氧化物歧化酶、谷胱甘肽过氧化物酶、过氧化氢酶活性和丙二醛含量;并通过苏木精-伊红(HE)染色观察脑组织病变;通过TUNEL染色观察各组大鼠神经细胞凋亡并计算凋亡指数.结果 较糖尿病模型对照组,山楂叶总黄酮200mg/kg治疗组大鼠空腹血糖水平显著降低(P＜0.01);山楂叶总黄酮100、200mg/kg治疗组大鼠血浆中磷酸肌酸激酶、乳酸脱氢酶活性和丙二醛含量均显著降低(P ＜0.05,P＜0.01),脑组织中超氧化物歧化酶、过氧化氢酶活性显著升高且丙二醛含量显著降低(P＜0.05,P＜0.01);山楂叶总黄酮200mg/kg治疗组大鼠脑组织中谷胱甘肽过氧化物酶显著升高(P＜0.05).山楂叶总黄酮各治疗组大鼠脑组织病变和神经细胞凋亡均明显改善,其中200mg/kg治疗组效果最为显著,并且100、200mg/kg治疗组大鼠神经细胞凋亡指数显著降低(P＜0.05,P＜0.01).结论 山楂叶总黄酮能够有效降低2型糖尿病大鼠空腹血糖、改善脑组织病变、抑制神经细胞凋亡,提示山楂叶总黄酮对2型糖尿病大鼠脑组织损伤具有剂量依赖性的保护作用,其作用机制可能与其能够有效改善抗氧化酶活性、降低氧化应激损伤有关.