目的:针对反流性食管炎病人展开讨论,分析利用埃索美拉唑以及莫沙必利共同治疗该疾病的作用效果.方法:从本院2019年7月至2020年7月之间收治的病人中随机抽选200例符合要求的反流性食管炎患者,将其作为主要对象开展实验探究.随后将其按照随机性、平均性等原则进行分组讨论,两组病人分别利用不同的药物展开治疗探究.根据两组治疗后的表现对二者进行评析比较.结果:根据调查数据显示,两组的治疗有效率相差较大,其中实验组的治疗有效率要远超对照组.观察两组在治疗过程中临床症状改善情况可知,实验组仍处于优势地位.结论:在治疗反流性食管炎时,可以联合使用两种治疗药物开展治疗活动,这样不仅能够有效改善治疗效果,同时还能有效控制病人的病情发展,使用安全性比较高,值得推广应用.

Objective:To investigate the clinicopathological characteristics of renal light and heavy chain amyloidosis (AHL).Methods:Ten patients with renal AHL diagnosed by renal biopsy in Peking University First Hospital and Institute of Nephrology of Peking University from January 2015 to June 2020 were enrolled. Clinicopathological data of these patients was collected and reviewed.Results:AHL typically affected older patients, with a male/female ratio of 7:3. The clinical manifestations were mainly edema and heavy proteinuria. At the same time, 7/10 of patients presented with nephrotic syndrome, 7/10 presented with microscopic hematuria, and 3/10 presented with renal insufficiency. Laboratory examinations showed monoclonal immunoglobulin in blood and urine in all patients, and IgGλ was the most common one (5/10). Decreased serum complement could be seen in some patients. The ratio of serum free κ light chain and free λ light chain was abnormal in all patients who underwent serum free light chain test. None of the 10 patients met the diagnostic criteria of multiple myeloma. Except for one of the 10 patients who was diagnosed as Waldenstrom's macroglobulinemia, the rest were diagnosed as monoclonal gammopathy of renal significance (MGRS). Bone marrow of 2/6 of patients were positive for amyloid. Cardiac involvement was confirmed in only one patient. Renal biopsy demonstrated amorphous eosinophilic material, which was Congo red positive, was deposited in glomerular mesangial area (10/10), capillary vessels (8/10), renal interstitium (9/10), peritubular capillary walls (9/10) and arterioles (8/10). This material showed apple green birefringence under polarized light. Immunofluorescence showed that single heavy chain and single light chain were positive at the same time, which was consistent with the results of mass spectrometry analysis. Ultrastructural evaluation revealed randomly oriented, non-branching fibrils with a diameter of 8-12 nm.Conclusions:Main clinical manifestations of AHL amyloidosis are edema and massive proteinuria, along with a high incidence of hematuria, a low portion of heart involvement and high frequency of whole molecule of monoclonal immunoglobulin (IgGλ dominant) by serum immunofixation electrophoresis. Renal pathology shows the commonly involved kidney compartments of amyloid deposits are glomerular capillary walls and peritubular capillary walls in patients with AHL amyloidosis.

类风湿性关节炎（RA）是一种慢性系统性炎性疾病，以外周关节滑膜炎为主要表现。包括甲氨喋呤等改善病情抗风湿病药物已广泛用于治疗 RA。由于老年病人生理特点特殊，对药物的耐受性较差，不良反应较多，难以长期坚持治疗。为探索适合老年类风湿关节炎患者的治疗方案，本项研究旨在观察甲氨喋呤单用与甲氨喋呤联合雷公藤多甙片治疗老年类风湿性关节炎的疗效及安全性比较。

目的探讨格林巴利综合征(GBS)神经电生理特点。方法对26例四肢运动神经远端、近端多节段检查;F波、H反射及感觉传导速度和肌电图检查。结果每例均有3条以上神经受累;远端潜伏期延长77.9%;MCV减慢70.2%;SCV减慢50%;F波异常率91.3%,H反射异常率100%,神经传导阻滞占84.1%和波形离散占57.7%。EMG出现失神经电位占42.3%。结论 GBS为神经根和周围神经损害,早期以神经根和近端神经损害为主:肌电图表现近端损害重、F波、H反射阳性率高。神经电生理检查是GBS早期诊断、分型、判断预后的重要方法 。

目的观察干预生活疗法对非酒精性脂肪肝(NAFLD)患者的治疗效果。方法 NAFLD患者131例进行单纯干预生活方式治疗,观察6个月后比较治疗前后肝酶学、腰围、血压、血脂、血糖、胰岛素以及胰岛素抵抗指标的变化。结果治疗后体质量指数、腰围、收缩压、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酸酰转移酶(GGT)及胰岛素抵抗指标(HOMA-IR)均低于治疗前(P<0.05)。6个月治疗后空腹血糖、空腹胰岛素、24h血糖、2h胰岛素和三酰甘油浓度明显下降(P<0.05)。结论对NAFLD患者进行饮食-运动治疗,改善肝酶学的异常和胰岛素抵抗疗效明显。

目的本研究为了探讨胃食管反流病(GERD)与EGG的相关性,从而确定EGG在反映胃(肠)动力的价值.方法 50例GERD病人,其中男23例,女27例,年龄52.6±14.4岁(26～85岁 ),多有反酸、烧心、反胃(食)或腹胀等症状.应用Medtronic公司的Digitrapper EGG型胃电图仪及分析系统检测体表胃电变化,同时应用Pc Polygraf消化道检测仪及Digitrappr Mk -Ⅲ24h食管pH监测仪比较胃电活动与胃食管动力的关系.结果 GERD组与健康对照组(n=30例,男11例,女19例,平均44.3±15.8岁 )比较,正常节律百分率(餐前、餐后)均低于正常人(78.46%比90.55%,P＜0.05;70 .97%比88.13%,P＜0.01),而胃动过缓、胃动过速百分比均高于正常人.反酸+反胃组较单纯反酸组胃电节律紊乱更为明显.反酸+反胃组与单纯反酸组及对照组比较LESP减低 ,食管体下段蠕动波幅减低,24h食管pH监测酸反流指数增高.胃动过缓、胃动过速均增加 .胃食管反流病与幽门螺杆菌的感染二者之间有相关性.结论胃食管反流患者体表胃电节律(餐前、餐后)紊乱百分率高于正常人. 反酸伴反胃(食)者较单纯反酸者胃电节律紊乱更为明显,与食管测压及食管pH监测结果一致 .胃电图可对GERD的发病机理的推断提供帮助.