目的:观察益气解毒通络方辅治肝硬化门静脉高压症对肝功能及凝血功能的影响.方法:78例随机分为研究组与对照组各39例.两组均给予西医基础治疗,对照组另用盐酸普萘洛尔,研究组另用益气解毒通络方.比较两组治疗前后肝功能指标及凝血功能指标变化情况.结果:研究组ALT、AST、TBIL指标低于对照组(P＜0.05).研究组PT、PTA指标优于对照组(P＜0.05).结论:益气解毒通络方辅治硬化门静脉高压症能改善肝功能及凝血功能.

随着广谱抗生素、激素、免疫抑制剂以及侵入性诊断治疗普遍应用,深部真菌感染的发病率日益增加,我院假丝酵母菌分离率居所有感染菌的第五位。但目前临床上应用的西药抗真菌药物,存在毒性大、费用高、耐药性增加等缺点。不少学者致力于中药的抗细菌、抗真菌方面的研究,笔者对黄连、茵陈、黄芪进行了体外抑菌试验,寻求中药在抗真菌感染方面的功效,旨在能更好的服务和指导临床用药。1材料1.1菌株2013年3月至2014年3月河北省中医院微生物室分离

目的:观察凉血消斑汤治疗过敏性紫癜临床疗效,探讨IL-12在过敏性紫癜发病机制中的作用及临床意义。方法:120例过敏性紫癜患者随机分为中西结合治疗组和西医对照组2组,同时设健康对照组。在治疗前、2个疗程后分别静脉取血,用ELASA法检测治疗前后的IL-12水平变化。结果:中西医结合治疗组有效率95.3%,西医对照组有效率76.7%,治疗组疗效优于对照组(P<0.05);中西医结合治疗组复发率3.1%,西医对照组复发率16.1%,治疗组低于对照组(P<0.05);中西医结合治疗组和西医治疗组治疗前IL-12水平分别与健康对照组比较差异均显著降低(P<0.05)。中西结合治疗组治疗后和治疗前IL-12水平比较差异有统计学意义(P<0.05);西医治疗组治疗后和治疗前IL-12水平差异有统计学意义(P<0.05)。西医治疗组治疗后IL-12水平与健康对照组比较差异有统计学意义(P<0.05),而中西结合治疗组治疗后IL-12水平与健康对照组比较差异无统计学意义(P>0.05)。结论:中西医结合治疗过敏性紫癜疗效显著,既减轻了单纯西医治疗的不良反应,又从根本上解决了过敏性紫癜的复发问题;且IL-12参与HSP的发生与发展,凉血消斑汤治疗HSP作用机制可能与调节T淋巴细胞功能紊乱、上调患者IL-12水平有关。

目的:观察自拟金海排石汤治疗泌尿系结石的临床疗效。方法:将112例泌尿系结石患者随机分为2组,治疗组60例采用自拟金海排石汤治疗,对照组52例采用排石汤1号(我院协定方)治疗,半个月为1个疗程,治疗2个疗程后比较临床疗效及治愈1年后复发情况。结果:治疗组治愈35例,好转19例,无效6例,总有效率为90.00%(95%CI=82.41%～97.59%);对照组治愈19例,好转22例,无效11例,总有效率为78.85%(95%CI=67.04%～89.46%);两组综合疗效比较(u=2.217 8,P=0.026 9),差异有显著性意义。1年后随访,治疗组复发率低于对照组,但未达到显著性意义。结论:自拟金海排石汤治疗泌尿系结石的疗效优于排石汤1号,其收益为OR=0.41(95%CI=0.11～1.17),NNT=9(95%CI=4.09～55.05)。

目的:探讨IL-6、IL-8在过敏性紫癜发病机制中的作用及凉血消斑汤治疗过敏性紫癜作用机制.方法:收集120例HSP患者,随机分为2组:中西医结合治疗组、西医对照组,同时设健康对照组.分别在治疗前、两个疗程后空腹采血,ELASA法检测血清中IL-6、IL-8含量.结果:中西医结合治疗组和西医对照组治疗前IL-6、IL-8水平分别与健康对照组相比较均显著升高,有显著差异(P＜0.05).西医治疗组治疗后IL-6、IL-8水平与健康对照组相比有显著差异(P＜0.05),中西医结合治疗组治疗后IL-6、IL-8水平与西医对照组治疗后相比较有显著差异(P＜0.05),但中西医结合治疗组治疗后IL-6、IL-8水平与健康对照组相比无显著差异(P＞0.05).结论:IL-6和IL-8在HSP患者局部血管炎症反应过程中发挥着重要的作用.凉血消斑汤治疗作用机制可能与其抑制炎性细胞因子的合成和分泌、抑制机体炎症反应有关.IL-6和IL-8水平的检测,对HSP的诊断及预后的判断有一定临床意义.

<正>过敏性紫癜是由于机体对某种物质过敏,导致全身小血管受损而引起的出血性疾病,皮肤、黏膜、关节腔或内脏器官都可发生出血,因出血部位和程度不同而出现不同的症状,临床以皮肤紫癜为主要症状,还常有关节肿痛、腹痛、血便、血尿等症状[1],部分患者有复发倾向。2009-01—2011-11,我们在西医常规治疗的基础上加凉血消斑

Objective To observe the interfering effect of irbesartan on the levels of cytokines correlated with inflammation,interleukin-8 and interleukin-10 in diabetic nephropathy rats,and to investigate the possible drug action mechanism of irbesartan.Methods 36 Wistar rats were randomly divided into three groups:control group of right kidney nephrectomized,diabetic nephropathy group and irbesartan treatment group.There were 12 rats in each group.At the 8th and the 12th week ends,serum and urine of the rats were collected.The levels of interleukin 8,interleukin 10,glucose,creatinine,urea nitrogen in serum and 24-hour urinary albumin in urine were determined.At the same time,the ratio of kidney mass/body mass was determined.Results At the 8th and the 12th week ends,the levels of interleukin 8 in irbesartan treatment group and diabetic nephropathy group were all significantly higher than those in control group,and the level of interleukin 8 in diabetic nephropathy group was significantly higher than that in irbesartan treatment group(26.51±2.34) ng/L vs(16.12±2.11) ng/L,(59.32±1.28) ng/L vs(21.46±2.59) ng/L(P<0.01);In irbesartan treatment group and diabetic nephropathy group,the level of interleukin 8 at the 12th week ends was both significantly higher than that at the 8th week end(21.46±2.59) ng/L vs(16.12±2.11) ng/L,(59.32±1.28) ng/L vs(26.51±2.34) ng/L(P<0.01);However,the rising format in irbesartan treatment group was less than that in diabetic nephropathy group.At the 8th and the 12th week ends,the levels of interleukin 10 in irbesartan treatment group and diabetic nephropathy group were all significantly lower than that in control group,and the level of interleukin 10 in diabetic nephropathy group was significantly lower than that in irbesartan treatment group(21.27±2.49) ng/L vs(25.58±3.52) ng/L,(18.05±3.55) ng/L vs(33.22±2.97) ng/L(P<0.01).In diabetic nephropathy group,the level of interleukin 10 at the 12th week end was significantly lower than that at the 8th week end(18.05±3.55) ng/L vs(21.27±2.49) ng/L(P<0.01).But in irbesartan treatment group,the level of interleukin 10 at the 12th week end was significantly higher than that at the 8th week end(33.22±2.97) ng/L vs(25.58±3.52) ng/L(P<0.01).At the 8th and the 12th week ends,the levels of interleukin 8 and interleukin 10 in control group showed no significant difference(P>0.05).IL-10 was significantly negative correlated with IL-8(r=-0.659,P<0.01).IL-8 was significantly positive correlated with glucose,creatinine,urea nitrogen,24-hour urinary albumin and the ratio of kidney mass/body mass(r=0.596,0.764,0.845,0.635,0.830,P<0.01),IL-10 was significantly negative correlated with glucose,creatinine,urea nitrogen,24-hour urinary albumin and the ratio of kidney mass/body mass(r=-0.835,-0.739,-0.757,0.745,-0.810,P<0.01).Conclusion Irbesartan makes proinflammatory cytokines IL-8 secretion decreased through suppressing the immune inflammatory reaction,meanwhile,it stimulates the secretion of anti-inflammatory cytokines IL-10.Thus,it will contribute to improving renal hypertrophy and decreasing proteinuria of the rats with diabetic nephropathy,react on the protective effect to renal function.

Objective To observe the effect of irbesartan intervention on the levels of inflammatory cytokines including interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10(IL-10) and C-reactive protein(CRP) in rats with diabetic nephropathy(DN),and to investigate the possible drug action mechanism.Methods 36 Wistar rats were randomly divided into three groups:control group(right nephrectomized),diabetic nephropathy group(DN group) and irbesartan treatment group,and there were 12 rats in each group.At the end of the 8th and the 12th week,the serums of the rats were collected.The levels of IL-6,IL-8,IL-10 and C-reactive protein in serum were detected by ELASA.Results At the end of the 8th and the 12th week,the levels of IL-6,IL-8 and CRP in irbesartan treatment group and DN group were significantly higher than those in control group,and the levels of IL-6,IL-8 and CRP in DN group were significantly higher than those in irbesartan treatment group(P<0.01).At the end of the 8th and the 12th week,the levels of IL-10 in irbesartan treatment group and DN group were significantly lower than those in control group,and the levels of IL-10 in diabetic nephropathy group were significantly lower than those in irbesartan treatment group(P<0.01).Conclusion Irbesartan can inhibit the production of IL-6,IL-8 and CRP and can stimulate the secretion of IL-10,as a result,which can improve partly the unbalance of inflammatory cytokines and anti-inflammatory cytokines,decrease and inhibit glomerular sclerosis,thereby,which can delay the advancement of diabetic nephropathy.

Objective To investigate the protective effect of kidney of irbesrtan in diabetic nephropathy rats.Methods 36 Wistar rats were randomly divided into three group,including control group,diabetic nephropathy group and irbesartan group.At the weekends of the 8th and the 12th,serum and urine of the rats was collected.The levels of C reactive protein,interleukin 6,glucose,creatinine,urea nitrogen in serum and 24-hour urinaryalbumin were determined.Result The levels of C reactive protein,interleukin 6,glucose,creatinine,urea nitrogen and 24-hour urinaryalbumin in diabetic nephropathy group were significantly higher than that in control group.However,the levels of C reactive protein,interleukin 6,glucose,creatinine,urea nitrogen and 24-hour urinaryalbumin in irbesartan treatment group were significantly lower than that in diabetic nephropathy group.Conclusion Irbesartan can delay the progress of the renal function impairment of diabetic nephropathy rats.It may be associated with the mechanism that irbesartan inhibits the production of C reactive protein and interleukin 6 in blood of diabetic nephropathy rats.

糖尿病肾病(DN)是糖尿病常见而严重的慢性微血管病变的并发症,是引起终末期肾病的最常见病因之一.在DN的发生发展过程中,糖或脂代谢紊乱、氧化失衡、血管活性物质、遗传因素以及细胞因子等均起着重要作用.目前,炎性反应在DN发病中的作用越来越受到人们的关注.本实验旨在观察DN大鼠血液细胞因子白介素(IL)-6、IL-8、IL-10、C-反应蛋白(CRP)变化并从炎症方面探讨其可能的发病机制.

随着生活水平提高,糖尿病(DM)的发病率明显增高,严重影响人类的生活质量.糖尿病患者存在着严重的糖脂代谢紊乱,脂肪细胞型脂肪酸结合蛋白(A-FABP)作为脂肪酸结合蛋白(FABP)家族成员之一,不仅调控脂肪细胞的分化,而且参与糖及脂肪代谢.

目的 通过病原体检测,观察混合感染情况和病原体感染的季节相关性.方法 采用ELISA间接检测法测定血清中各种病原体的IgM抗体.结果 混合感染(2种以上病原体)占到总受检人数的61.74%,以支原体合并腺病毒感染最多;支原体检出率最高(71.66%),秋冬高发,其次为夏季;3种呼吸道病毒感染无季节性差异.结论 病原体检测对呼吸道感染临床治疗、流行病学调查以及疫苗的研究有重大意义.

目的 探讨血清游离脂肪酸(FFA)水平在慢性原发性肾小球肾炎进展中的临床价值.方法 采用铜显色法,检测49例原发性肾小球肾炎和23例正常健康成人的血清FFA水平;同时检测血尿素氮(BUN)、肌酐(Cr)、白蛋白(ALB)、甘油三酯(TG)、胆固醇(CH0)水平.结果 与对照组相比,原发性肾小球肾炎组(肾炎组)和肾病综合征组(肾综组)的FFA水平均高于正常对照组(P＜0.05);肾炎组和肾综组FFA与传统肾功能受损指标BUN和Cr成正相关.结论 血中FFA水平与慢性肾小球肾炎进展密切相关;在慢性肾小球肾炎时,FFA与传统的肾功能监测指标BUN、Cr成正相关,所以FFA可作为监测慢性肾小球肾炎肾功能受损的指标之一.

胰岛素抵抗(IR)和胰岛素分泌不足是2型糖尿病(DM)发病的主要因素,其机制尚未阐明[1].近年来炎症学说备受关注,认为DM为一先天性免疫和慢性炎症性疾病[2].

在我国,慢性原发性肾小球肾炎是导致终末期肾脏疾病的最主要原因.南京医科大学肾病研究所报道,导致肾损害的原因中原发性肾小球肾炎占68.6%.脂肪细胞型脂肪酸结合蛋白(A-FABP)作为脂肪酸结合蛋白(FABP)家族成员之一,不仅调控脂肪细胞的分化,而且参与糖及脂肪代谢[1-2].

目的探讨超高倍显微诊断仪(MCMDY)在快速检测泌尿生殖道病原体感染中的临床价值。方法应用多功能超高倍显微分析系统,对泌尿生殖道患者的分泌物体液标本进行活体动态观察和分析。结果580例次标本中检出阳性标本472例,阳性率81.4%。结论该方法检测病原体快捷、简便、准确,可为临床诊断提供依据。

终末期肾功能衰竭已经成为近年来日益关注的重要公共健康问题之一.在中国,慢性肾小球肾炎和糖尿病肾病是导致终末期肾脏疾病的2个最主要原因.笔者通过对63例慢性肾脏病患者的血清非酯化脂肪酸(NEFA)及其相关指标测定,探讨NEFA在慢性肾脏病进展中的意义及临床应用价值.

作为医院感染的重要致病菌,革兰阴性杆菌由于产生质粒介导的超广谱β-内酰胺酶(ESBLs),不仅对β-内酰胺类药物耐药,而且也对氨基糖苷类、喹诺酮类药物耐药,引起临床抗感染治疗困难.

Objective To investigate the antimicrobial activity of Scutellaria baicalensis Georgi,Coptis chinensis Franch,Prunus mume Sieb,Lonicera japonica Thunb,Patrinia scabiosaefolia Fisch on bacteria producing AmpC β-lactamases.Methods Antimicrobial activity of Scutellaria baicalensis Georgi,Coptis chinensis Franch,Prunus mume Sieb,Lonicera japonica Thunb,Patrinia scabiosaefolia Fisch was detected by M-H agar dilution method.Results The results showed that they had different antimicrobial activity,the effects of Scutellaria baicalensis Georgi,Coptis chinensis Franch,Prunus mume Sieb were better,their MIC90 was 15.62,31.25,31.25 mg/mL,respectively.Conclusion Scutellaria baicalensis Georgi,Coptis chinensis Franch,Prunus mume Sieb can be used to treat the infection caused by bacteria producing AmpC β-lactamases.

Objective To investigate the incidence of clinical isolates of gram-negative bacilli producing AmpC β-lactamases and its drug resistance.Methods AmpC β-lactamases were identified by three-dimensional test;and the susceptibilities of antimicrobial agents were detected by KirbyBauer disk diffusion test.Results Of 236 gram-negative bacilli,29 strains produced β-lactamases with three-dimensional test,17 strains(7.2%) only had AmpC β-lactamases,8 strains(3.4%) only had extended-spectrum beta-lactamases(ESBLs),2 strains(0.8%) had both ESBLs and AmpC,2 strains(0.8%) had no AmpC-ESBLs β-lactamases.Therefore,19 strains produced AmpC β-lactamases,the frequency of AmpC β-lactamases was 8.1%.The susceptibility test showed that the drug resistant rate of AmpC producer was higher than non-AmpC producer except imipenem and cefepime.Conclusion The frequency of AmpC β-lactamases was 8.1% in the hospital.Multiple drug resistance appeared in AmpC producer.The fourth-generation cephalosporins and carbapenems should be considered to treat the infection caused by AmpC producer at first.