Objective To explore the curative effect of the combined regimen of low-dose thalidomide (THD) on the elderly with Crohn's disease (CD) and its safety.Methods A retrospective analysis was made to the clinical data of 37 CD elderly treated with low-dose THD;they were divided into 2 groups:observation group (n=32) and control group (THD group) (n=5),the combined regimen of low-dose THD was applied to cases in observation group while THD was signally administrated to cases in control group;the observation group was further divided into 3 subgroups:THD+ hormone group (n=13),THD+ infliximab (IFX) group (n=12) and THD+ azathioprine (AZA) group (n=7);the induction remission rate,mucosa healing rate,occurrence of side effects and the severity of side effect in each group were evaluated and a comparative study was performed.Results The clinical remission rate in THD group,THD+hormone group,THD+ IFX group and THD+AZA group was 40.0％,53.8％,66.7％ and 71.4％ respectively;the mucosa healing rate in the 4 groups was 20.0％,23.1％,16.7 ％ and 28.6％ respectively;the occurrence of side effects in the 4 groups was 60.0％,92.3 ％,83.3 ％ and 71.4 ％ respectively.Conclusions In the application of combined regimen of low-dose THD,THD + IFX is of best curative effect without increasing the side effects of THD obviously;hormone and AZA can promote the curative effect of THD but will cause more side effects.

目的 了解Peutz-Jehgers综合征(PJS)患者癌症担忧状况及与精神症状、生活满意度的关系.方法 采用人口学资料和临床资料问卷、癌症担忧量表、抑郁-焦虑-压力反应量表和生活满意度量表,对127例PJS患者进行调查.结果 86.3％的患者在20岁之前出现临床症状,>6次内镜检查的患者达40.2％,75.6％的患者经历至少一次外科剖腹手术,31例(24.4％)患者有癌症家族史,发生恶性肿瘤年龄为(43.97±11.55)岁(19～71岁).患者癌症担忧平均得分为(17.83±5.84)分,分级为较严重癌症担忧;不同人口学和临床特征患者的癌症担忧得分为16.15～19.33分,癌症担忧程度均为较严重水平,得分变化幅度小,差异均无统计学意义(P>0.05).患者抑郁、焦虑、压力反应和生活满意度得分分别为(14.34±11.30)分、(12.64±8.85)分、(16.07±9.94)分和(14.41±6.80)分,表明被试存在中度抑郁和焦虑、轻度压力反应、对生活不满意.癌症担忧水平越高,抑郁、焦虑、压力反应越严重,生活满意度越低.癌症担忧可直接影响抑郁-焦虑-压力反应,也可通过影响生活满意度间接影响抑郁-焦虑-压力反应.结论 本研究首次报道我国PJS患者表现出较严重癌症担忧,并伴随中度抑郁焦虑、轻度压力反应及低生活满意度,癌症担忧是患者的核心问题.

目的 探讨云南白药联合小剂量沙利度胺(THD)组合方案治疗克罗恩病(CD)的疗效、安全性和优势,为中西医结合防治CD提供依据.方法 回顾性分析CD患者的临床资料,根据THD的组合方案和单用分为观察组和对照组.观察组接受云南白药联合小剂量THD组合方案治疗,对照组只接受THD单独治疗.比较两组的CD活动度、粘膜愈合率、不良反应发生率及其严重程度等,评价THD的组合方案和单用的临床疗效和安全性.结果 与治疗前比较,两组治疗后CDAI均显著下降(P＜0.05),观察组CDAI明显低于对照组(P＜0.05),观察组治疗前后的CDAI降幅明显大于对照组(P＜0.01),治疗后观察组的病情和临床应答率明显得到改善,提示云南白药联合THD组合方案治疗CD的疗效显著优于单用THD治疗CD.治疗后观察组黏膜愈合率明显高于对照组(47.2％ vs 20.0％,P＜0.05).两组不良反应最常见的是外周神经炎,其次是嗜睡、皮炎、便秘、肝功能损害、烦躁和焦虑等.治疗后观察组的不良反应发生率比对照组虽下降,但差异无统计学意义(P＞0.05).与治疗前比较,两组治疗后CRP值和ESR值均显著下降(P＜0.01),观察组CRP值和ESR值明显低于对照组(P＜0.01).结论 云南白药联合THD组合方案治疗CD的消炎作用明显强于单用THD治疗CD.云南白药联合小剂量THD组合方案治疗CD,效果较好,可协同提高THD的疗效,为临床上采取中西医结合治疗CD提供依据.

目的 利用秀丽隐杆线虫-肺炎克雷伯菌感染模型,探讨白藜芦醇对肺炎克雷伯菌致病性影响.方法 取同期化处理后的L4期线虫,经肺炎克雷伯菌感染5d后,洗涤、离心,转移至96孔板内(10只/孔),每孔加入LB溶液40μl、M9缓冲液160μ1、FUDR及不同浓度的白藜芦醇,每组5个复孔,20℃静置培养.实验组加入不同浓度的白藜芦醇(0,0.1,0.2,0.4,0.8mg/ml),空白对照组L4期线虫经大肠埃希菌OP50喂养5d后转移至96孔板内,不加白藜芦醇;每24h观察线虫生存情况.结果 经Log Rank检验法进行组间差异比较发现,与0mg/ml白藜芦醇比较,0.2,0.4,0.8mg/ml浓度对线虫生存时间的影响有统计学差异(P＜0.05,x2值分别为29.262,35.148,37.040);0.1mg/ml浓度的白藜芦醇对线虫生存时间的影响无统计学差异(P ＞0.05,x2=0.05);同时采用Log Rank检验法对0.2,0.4,0.8mg/ml三组浓度白藜芦醇对感染后线虫生存时间进行组间比较发现,该三组对线虫生存时间的影响无统计学差异(P ＞0.05,x2值分别为0.05,0.25,0.56).结论 在秀丽隐杆线虫-肺炎克雷伯菌感染模型中,高浓度白藜芦醇能使感染后线虫生存时间延长,但随着浓度的增加,对线虫生存时间并无明显影响.

OBJECTIVETo investigate the efficacy of Yunnan Baiyao (YNBY)as an adjuvant treatment of active ulcerative colitis.METHODSA total of 221 patients with active ulcerative colitis were randomized into YNBY group (78 cases) and control group (143 cases). The patients were followed up for 26 weeks and time of remission and serological data (WBC, HGB, PLT, and CRP) were recorded.RESULTSThe patients receiving YNBY as an adjuvant therapy had a median remission time of 9 weeks (95% CI: 8.293-9.707), significantly shorter than that of 13 weeks (95% CI: 11.855-14.145) in the control patients (P<0.001). According to the extent of the lesion, both YNBY group and control group were classified into E1, E2 and E3 subgroups, and the median remission time was 7 versus 11 weeks in E1 subgroups (P=0.09), 10 versus 13 weeks in E2 subgroups (P=0.04), and 9 versus 14 weeks in E3 subgroups (P<0.001). According to the disease severity, the patients in YNBY group and control group had a median remission time of 9 versus 10 weeks in mild cases (P=0.568), 9 versus 14 weeks in moderate cases (P<0.001), and 11 versus 20 weeks in severe cases (P=0.001). According to the standard treatment received, the median remission time in YNBY group and control group was 9 versus 12 weeks in those receiving mesalazine (P<0.001), 9 versus 13 weeks in those receiving corticosteroid (P=0.001), and 7 versus 14 weeks in those receiving infliximab (P=0.04). Cox proportional hazards regression analysis showed that YNBY was a protective factor for disease remission. The remission time was shortened by 2.283 times (95% CI: 1.69-3.070, P<0.001) in patients having YNBY as an adjuvant treatment compared to the control group.CONCLUSIONPatients with active ulcerative colitis can benefit from YNBY as an adjuvant treatment, which shortens the time of disease remission, relieves the symptoms and improves the quality of life of the patients.

目的:研究三伏天灸与平常穴位贴敷对过敏性鼻炎患者的临床疗效和生活质量的影响.方法:将55例过敏性鼻炎患者按随机数字表分为三伏灸组与平常灸组,在规定的时间内,用自制天灸方配合新鲜姜汁调敷的药泥,贴敷在大椎、风门、肺俞等穴位上.10 d贴1次,5次为1个疗程.治疗后用统计学的方法分别比较2组患者治疗前后的临床疗效和生活质量的改善情况.结果:三伏灸组总有效率89.29％；平常灸组总有效率96.30％,且2组的疗效比较无统计学意义；而生活质量总分在治疗后和随访时分值均降低,且与治疗前比较均有统计学意义(P＜0.01),2组的生活质量总体改善情况比较则无统计学意义.结论:三伏天灸与平常灸的治疗均能获效,且均能明显改善患者的生活质量,但二者的比较无统计学意义.