目的:观察非布司他治疗痛风伴高尿酸血症患者的疗效.方法:按照随机数字表法将40例痛风伴高尿酸血症患者分为非布司他组(非布司他,40 mg/d)和别嘌醇组(别嘌醇,30 mg/d),每组20例,治疗24周.检测治疗前后的尿酸变化与治疗后各组尿酸低于360μmol/L的例数.结果:治疗24周后,两组患者尿酸均较治疗前下降,差异均有统计学意义(P＜0.01).非布司他组尿酸下降程度高于别嘌醇组,但两组比较差异无统计学意义(P＞0.05).非布司他组较别嘌醇组有更多患者尿酸水平达到低于360μmol/L的控制目标,但差异无统计学意义(P＞0.05).结论:非布司他每日40 mg与别嘌醇每日300 mg治疗痛风伴高尿酸血症疗效相当.

目的 探究左旋甲状腺素应用于亚临床甲减、临床甲减患者的疗效及对血脂水平的影响.方法 选取某院2011年2月至2012年12月临床、亚临床甲状腺功能减退患者各100例,给予左旋甲状腺素雷替斯治疗,分别在治疗前后测定甲状腺功能、血脂指标,统计患者治疗转归与副作用反应.结果 所有患者甲减症状消失,甲状腺功能恢复正常,出现3例不良反应减少剂量后正常;临床甲减者治疗后TC、TG、LDL较治疗前显著改善(P＜0.05),其中TC、LDL指标差异极其显著(P＜0.01),亚临床甲减者治疗后TC、LDL相较于治疗前显著改善(P＜0.05),其中LDL指标差异极其显著(P＜0.01).结论 左旋甲状腺素应用于亚临床甲减、临床甲减患者的疗效显著,安全可靠,能有效改善患者血脂状况.

Objective: To explore the optimum treatment for acute myeloid leukemia(AML) in the elder.Methods: Sixty-three elder patients with AML were retrospectively analyzed.Three treatments,including normal does,decreased does and CAG were selected.Results: CAG treatment had a higher CR rate,a shorter BM restranint,a lower early death and a milder infection or bleeding after therapy than normal dose or decreased dose treatment.Conclusion: CAG treatment is worth popularizing in the treatment of elder AML.

Objective:To explore the correlation between p15 gene methylation and pathogenesis, development and prognosis of multiple myeloma(MM). Method:P15 gene methylation from 33 cases of MM and 20 of controls was investigated with methylation-spectific PCR(MSP) methods. Result:P15 gene showed methylation in 24 cases of 33 MM patients and none in 30 control cases. The methylation rate was higer in MM than controls( P 0. 01). In 8 stage I and 2 stage II cases of MM with mature typed bone marrow profile, p15 gene was non-methylated. In cased of stage I , II and III MM with naive plasma cell in bone marrow profile which were plasma cell-typed or mixed typed, p15 gene methylation was frequently detected. There was a significant diffrence between the two groups. The methylation rates for stage I , II and III MM were 27. 2% (3/11) ,92. 31% (12/13) , 100%(9/9), respectively. It was significantly higher in stage II , III than in stage I MM( P0. 01). Conclusion:P15 gene methylation might be related with the pathogenesis, and prognosis of MM.

Objective:To evaluate the efficacy and safety of buflomedil hydrochloride for injection in the treatment of diabetic peripheral neuropathy.Methods:48 inhospitalized patients with diabetic peripheral neuropathy were randomly assigned to one of treatment groups: the treatment group(n=25) received adjuvant therapy of conventional glucose-controlled drug with buflomedil hydrochloride for injection(200 mg),the control group(n=23) administered the combination of conventional glucose-controlled drug with a compound Salvia miltiorrhiza for injection(total 16 mL).Both groups were infused once daily for 14 days.The therapeutic regimens were repeated for additional 14 days in a 2-day interval after the first cycle of the 14-day therapy.The efficacy of the therapy was assessed based on the SCV(sensery nerves conduction velocity) status prior to and post therapy.Results:The total efficacy rate of the treatment and control group showed a significant difference(88.0% vs.60.8%,P0.05).Compared to the control group,the patients in the treatment group experienced significant improvements of the SCV(P0.05).The common adverse events in the treatment of buflomedil hydrochloride for injection were abdominal disorder,dizzy and somnolence.Conclusion:Buflomedil hydrochloride for injection showed an adjuvant therapeutic benefit in the treatment of diabetic peripheral neuropathy.

目的:观察重组人粒细胞刺激因子(G-CSF)不同给药时间对急性白血病初治患者预后的影响.方法:设立对照组,治疗组分正规治疗(A)组和非正规治疗(B)组,比较对照组及治疗A、B两组粒细胞恢复的时间及患者缓解率、缓解时间.结果:A组粒细胞恢复时间明显优于对照组及B组(P＜0.01),缓解率提高,缓解时间缩短.结论:正规应用C-CSF可提高缓解率,预后较好。

为探讨血清IL-6、IL-8水平变化与儿童急性白血病(AL)发生、发展及预后的关系.采用夹心酶联免疫吸附法检测68例儿童AL患者血清IL-6、IL-8水平.结果,儿童AL患者血清IL-6、IL-8水平愈高;发生出血愈严重,血清IL-6水平愈高,但血清IL-8水平在轻、中度出血时显著升高,而发生严重出血倾向时并不升高;当儿童AL治疗获缓解时,血清IL-6、IL-8水平逐渐下降,完全缓解时,接近于正常水平.结果表明:血清IL-6、IL-8的异常表达在儿童AL的发生、发展中可能起着一定作用,检测儿重AL血清IL-6、IL-8水平可能作为判断疗效、估计预后及监测复发的指标之一.

红斑性狼疮是一种多发于青年女性的自身免疫性累及多脏器的炎症性结缔组织病.男女之比约1:9.临床表现多种多样,变化多端,治疗原则为消除变应性炎症.本文根据中医辨证,以红藤逐瘀汤为基本方进行分型施治,治疗红斑性狼疮24例,取得较为满意疗效.

对探讨p15基因甲基化在儿童急性白血病(AL)微小残留病灶(MRD)诊断中的价值,采用甲基化特异性聚合酶链反应(MSP)研究49例初治儿童AL(包括ALL31例及AML 18例)和20例对照组的p15基因甲基化情况.动态观察4例ALL及2例AML治疗前后p15基因甲基化的变化.结果显示,儿童AL患者p15基因甲基化阳性率为67.3%,ALL与AML的阳性率(分别为61.3%和77.7%),差异无显著性:对照组20例均阴性.动态观察的6例儿童AL,初诊时均呈现p15基因甲基化;完全缓解时,4例仍呈现甲基化,其中3例分别于3个月、5个月、6个月后复发:另一例甲基化转为阴性,未复发:MSP敏感度可达10-3.因此,MSP检测p15基因甲基化有助于检测儿童AL的MRD.

目的观察依那普利(enalpvi1)对糖尿病肾病(DN)尿蛋白排泄及血压的影响.方法将42例DN患者分为三组,早期DN组(A)、临床DN组(B)及并发高血压的临床DN组(C).均口服依那普利10～30mg/d,共60天.于治疗前和治疗后的第30天、第60天检测24小时尿蛋白定量和平均动脉压等项指标.结果 3组24小时尿蛋白定量均较治疗前下降(P＜0.05),A、B二组平均动脉压治疗前后比较无显著性差异,C组平均动脉压明显降低(P＜0.05).结论依那普利对DN有一定的保护作用,对尿蛋白排泄的影响是非血压依赖性的,可能与阻止血管紧张素Ⅱ生成而降低肾小球的滤过率有关.

糖尿病酮症酸中毒(DKA)及高渗性昏迷(NHDC)常合并多脏器功能衰竭(MOOF),病情危重复杂,治疗难度大.我院自1981年1月至1999年12月共收治DKA并MOF20例NHDC并MOFO18例,报告如下.1 临床资料1.1 诊断标准糖尿病诊断标准按WHO标准,DKA及NHDC诊断标准按国内提出的标准[1],MOF诊断标准按Fry Eiseman等提出的标准[1].

高渗性非酮症性糖尿病昏迷(NHDC)是糖尿病的一种严重并发症,因其临床表现复杂多变故易误诊或漏诊,死亡率较高.本院近20年共收治52例,死亡11例,死亡率21.2%,报告如下. 1 临床资料 1.1 一般资料:NHDC患者52例,男20例,女32例;年龄13～88岁,平均53.7±17.5岁;其中60岁以上23例.43例有2个月至21年的糖尿病史.诱因:感染43例,停药4例,脑血管意外及应用高渗葡萄糖、甘露醇后促发3例,胃癌手术及精神创伤各1例.

目的通过对慢性粒细胞白血病(CML)预后的检测,指导CML治疗方案的选择.方法应用Cox模型对59例CML患者进行回顾性分析.结果高危组32例,中危组27例,无一例低危组,高、中危组2年急变率分别为28%和7%,3年急变率分别为53%和14%.结论在影响预后的许多因素中,脾脏大小及末梢中原始细胞的百分数是最危险的因素,红细胞压积对46岁以下患者的预后亦有意义,而血小板计数对判断CML预后在高、中危组中差异并不显著.

真性红细胞增多症传统的静脉放血、32磷或烷化剂治疗均有一定的缺点 ,我们试用红细胞单采术及高三尖杉酯碱治疗2 4例真性红细胞增多症 ,近期内 2 2例达到完全缓解 ,1例改善 ,1例无效。达到完全缓解的中数时间为 2 1d,较单用马利兰、马法兰及放血合并羟基脲等方法治疗时间均短。对 2 0例病人进行随诊 ,16例未复发 ,完全缓解的中数时间为 19个月。另外至目前为止尚未发现引起白血病者 ,而其它烷化剂、32磷有增加继发性的白血病的可能。所以本疗法具有一定的优点 ,值得推广

本文病例系我院近3年来的门诊病人,均具有"甲亢"症状,并经化验室检查确诊.24例中初治者10例,余14例在治疗前曾用过抗甲状腺药物治疗.