参苓白术散与美沙拉嗪对溃疡性结肠炎患者血清IL-17、IL-23及TNF-α水平的影响

目的:探讨参苓白术散联合美沙拉嗪治疗脾胃气虚型溃疡性结肠炎的疗效及对血清细胞因子水平的影响。方法:按照随机数字表法将2013年1月至2014年1月我院收治的脾胃气虚型溃疡性结肠炎患者分为两组,对照组给予美沙拉嗪口服治疗,观察组在对照组基础上予参苓白术散口服治疗,比较两组患者的临床疗效及血清细胞因子的水平变化。结果:观察组患者治疗的总有效率优于对照组,差异有统计学意义(P0.05);治疗后,两组患者Sutherland DAI评分均获得改善,且观察组优于对照组,差异具有统计学意义(P0.05);两组患者的IL-17、IL-23及TNF-α水平均显著降低,且观察组低于对照组,差异具有统计学意义(P0.05)。结论:参苓白术散联合美沙拉嗪对脾胃气虚型溃疡性结肠炎具有良好的临床疗效,能够改善患者血清细胞因子的水平。     

参苓白术散与美沙拉嗪对溃疡性结肠炎患者血清IL-17、IL-23 及TNF-alpha水平的影响

目的:探讨参苓白术散联合美沙拉嗪治疗脾胃气虚型溃疡性结肠炎的疗效及对血清细胞因子水平的影响。方法:按照随机数字表法将2013年1月至2014年1月我院收治的脾胃气虚型溃疡性结肠炎患者分为两组,对照组给予美沙拉嗪口服治疗,观察组在对照组基础上予参苓白术散口服治疗,比较两组患者的临床疗效及血清细胞因子的水平变化。结果:观察组患者治疗的总有效率优于对照组,差异有统计学意义(P<0.05);治疗后,两组患者Sutherland DAI评分均获得改善,且观察组优于对照组,差异具有统计学意义(P<0.05);两组患者的IL-17、IL-23及TNF-α水平均显著降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。结论:参苓白术散联合美沙拉嗪对脾胃气虚型溃疡性结肠炎具有良好的临床疗效,能够改善患者血清细胞因子的水平。     

马来酸曲美布汀联合参苓白术散治疗腹泻型肠易激综合征及对血浆生长抑素、神经肽Y水平影响

目的:观察马来酸曲美布汀联合参苓白术散治疗腹泻型肠易激综合征的临床疗效及对血浆生长抑素(SS)、神经肽Y(NPY)水平的影响.方法:将86例腹泻型肠易激综合征患者随机分为对照组和观察组,每组各43例.对照组采用西药马来酸曲美布汀进行治疗,观察组在此基础上,加用中药复方参苓白术散,治疗周期均为6周,治疗结束后评价疗效,并对治疗前后两组患者血浆SS、NPY水平进行比较.结果:观察组临床总有效率为88.37％,显著高于对照组的60.47％(P＜0.05),观察组患者治疗前后血浆SS、NPY水平差异显著,具有统计学意义(P＜0.05).结论:马来酸曲美布汀联合参苓白术散治疗腹泻型肠易激综合征的临床疗效确切,并能调节患者体内异常变化的血浆SS、NPY水平.     

参苓白术散加减联合酪酸梭菌活菌散治疗小儿腹泻疗效观察

目的观察和评价参苓白术散加减联合酪酸梭菌活菌散治疗小儿腹泻的临床疗效。方法选取玉田县医院60例患有腹泻的儿童,随机分成观察组和对照组。对照组给予补液纠正水、电解质紊乱等常规治疗,观察组在常规治疗基础上服用参苓白术散加减联合酪酸梭菌活菌散,其中酪酸梭菌活菌散剂量为0．5g/次,3次／d,急性腹泻疗程为3～7d,慢性腹泻疗程为14～21d,观察疗效。结果观察组显效率为63．3％,有效率为33．3％,总有效率为96．6％;对照组显效率为46．7％,有效率为30．O％,总有效率为76．7％,两组比较差异有统计学意义（P〈0．05）,观察组疗效明显优于对照组。结论参苓白术散加减联合酪酸梭菌活菌散治疗小儿腹泻疗效显著,能迅速恢复肠道菌群平衡和肠道生理功能,值得临床推广。     

中西医结合治疗溃疡性结直肠炎的临床疗效分析

目的:探讨中西医结合治疗溃疡性结直肠炎的临床疗效。方法:将2009年6月~2011年6月我院收治的126例溃疡性结直肠炎患者,随机分为治疗组(65例)和对照组(61例)。对照组采用柳氮磺吡啶口服治疗,治疗组采用口服柳氮磺吡啶加中药保留灌肠治疗。7d为1个疗程,连续治疗3个疗程。结果:治疗组总有效率92.31%,显著优于对照组80.33%,差异有统计学意义(P<0.05);治疗后治疗组症状、体征改善程度优于对照组,差异有统计学意义(P<0.05);随访1年,治疗组和对照组痊愈者中复发率分别为22.22%、61.11%,差异有统计学意义(P<0.05)。结论:中西医结合治疗溃疡性结直肠炎疗效确切,药物毒副反应少,复发率低,值得临床推广。     

培菲康对高脂血症的临床疗效研究

目的探讨培菲康对原发性高脂血症(EHL)患者的临床疗效及血脂变化的影响。方法选择102例EHL患者为研究对象,随机分为对照组和观察组各51例。对照组口服阿托伐他汀钙胶囊10mg/d,睡前口服。观察组采用培菲康2.0g/次,3次/d,饭后半小时温水服用。12周为一疗程,比较两组患者治疗前后血脂水平及治疗效果。结果观察组临床控制率为31.37%,对照组为13.73%,差异有统计学意义(P0.05);观察组总有效率(94.12%)显著高于对照组(76.47%),差异有统计学意义(P0.01)。治疗后两组血脂水平均改善,但观察组TG、TC、LDL-C水平低于对照组(P0.01),HDL-C水平高于对照组(P0.01)。治疗后随访6个月,对照组复发率为27.45%,观察组为5.88%,两组差异有统计学意义(P0.01)。结论培菲康对血脂水平的改善优于阿托伐他汀钙,患者复发率低,且无明显不良反应。     

布拉酵母与培菲康对原发性高脂血症的临床疗效比较

目的比较布拉酵母与培菲康治疗原发性高脂血症(EHL)的临床疗效。方法将132例EHL患者采用随机数字表法分为对照组和观察组各66例。对照组患者口服培菲康2.0g/次,3次/d,饭后半小时温水服用;观察组患者口服布拉酵母1.0g/次,2次/d,8周为一疗程。比较两组患者治疗前后血脂水平及治疗效果。结果观察组患者临床显效率为59.69%,总有效率为93.94%。对照组患者临床显效率为46.96%,总有效率为77.27%,差异均有统计学意义(P0.05)。治疗后两组患者血脂水平均有改善,但观察组患者TG、TC、LDL-C水平显著低于对照组(P0.01),HDL-C显著高于对照组(P0.01)。治疗后随访6个月,对照组患者复发率为37.25%(19/51),观察组为8.06%(5/62),两组比较差异有统计学意义(P0.01)。结论布拉酵母对患者血脂的改善效果显著优于培菲康,患者复发率低,且无明显不良反应。     

布拉酵母联合制霉菌素对 婴幼儿鹅口疮的疗效评价

目的探讨布拉酵母联合制霉菌素干预婴幼儿鹅口疮的临床疗效。方法将90例患儿随机分为对照组和观察组各45例。对照组患儿单用制霉菌素涂口腔,3次/d。观察组在对照组基础上联用布拉酵母0.125g/次,2次/d,口服,2周一疗程。结果观察组患儿痊愈率为66.67%,显著高于对照组的33.33%(χ2=10.00,P0.01)。观察组患儿总有效率为97.78%,显著高于对照组的73.33%(χ2=10.88,P0.01)。治疗后随访6个月观察组患儿总复发率显著低于对照组(χ2=14.01,P0.01)。结论布拉酵母联合制霉菌素对婴幼儿鹅口疮具有良好的临床疗效,患儿复发率低。     

逍遥丸联合布拉氏酵母菌治疗围绝经期功能性消化不良的疗效观察

目的探讨逍遥丸联合布拉氏酵母菌治疗围绝经期功能性消化不良(MPFD)的临床疗效。方法将64例MPFD患者随机分为对照组(n=30)和观察组(n=34),对照组用布拉氏酵母菌1.0g/次,2次/d,餐后服;治疗组在对照组基础上用逍遥丸8丸/次,3次/d口服,4周为1疗程。随访6个月的复发率。结果观察组显效率为47.06%,总有效率为88.23%;对照组显效率为23.33%,总有效率为66.67%。两组比较观察组明显优于对照组(P0.05)。6个月后两组复发率比较:观察组3例(10.00%),对照组8例(40.00%),两组比较差异有统计学意义(P0.05)。结论逍遥丸联合布拉氏酵母菌对MPFD有良好的临床疗效。     

左氧氟沙星联合阿奇霉素治疗32例宫颈炎患者疗效观察

目的考察左氧氟沙星联合阿奇霉素治疗宫颈炎的临床疗效。方法将64例宫颈炎患者随机分为治疗组与对照组各32例,其中对照组仅采用阿奇霉素进行治疗,而治疗组则在对照组基础上加用左氧氟沙星进行治疗。结果治疗1月后,治疗组总有效率为93.8%,对照组为65.6%,治疗组疗效更为显著,比较有统计学意义(P0.05);两组不良反应情况比较无统计学意义(P0.05),且均较轻微不会影响治疗进程;治疗半年后,治疗组复发1例,复发率3.3%,对照组复发4例,复发率19.0%,治疗组复发率显著低于对照组(P0.05)。结论氧氟沙星联合阿奇霉素治疗宫颈炎疗效理想且用药安全性好,值得在临床进一步推广应用。     

国际抗糖尿病药物研发新进展

根据美国药物研究与生产商协会( PhRMA) 发布的相关报告和新药数据库中的数据,对2013 年至今进入Ⅲ期临床试验或递交新药申请(NDA)/ 生物制剂许可申请（BLA）的用于治疗糖尿病及其相关疾病的65 种候选新药的临床研发情况进行综述。将这些候选新药分为非胰岛素类、胰岛素类和复方制剂类抗糖尿病药,并重点对递交NDA/BLA 或已获得批准的抗糖尿病新药开发进行了分析和讨论。     

温度和光周期对水稻抽穗期调控的交互作用

光周期和温度是植物开花的2个关键的调控因素,植物成花转变决定于植物对光周期和温度变化的精确测量.作为短日照植物,水稻在长日低温条件下抽穗期推迟,为了阐明温度和光周期对水稻开花时间的调控效应,本文利用1个光周期不敏感的突变体及其野生型,系统地分析了不同温度和光周期处理条件下,调控水稻开花时间几个关键基因（Hd3a,RFT1,Ehd1,Ghd7,RID1/Ehd2/OsId1,Se5）的表达调控模式,结果表明Ehd1-Hd3a/RFT1通路在光周期和温度调控水稻开花途径中保守.Ehd1,Hd3a和RFT1的表达在低温（23℃）条件下急剧下降,表明Ehd1,Hd3a和RFT1表达阻抑是低温条件下水稻开花推迟的主要原因.另外,在长日照条件下,低温（23℃）处理促进了水稻开花抑制子Ghd7的表达,表明低温条件和长日照条件对Ghd7的表达具有协同作用.此外,本文还分析了Hd1与光周期开花调控途径中几个关键基因的调控关系,发现Hd1在长日照条件下负向调控Ehd1的表达而正向调控Ghd7的表达,表明在长日照条件下,Hd1-Ghd7-Ehd1-RFT1通路也是水稻抽穗期调控的一条重要途径.     

Advising Patients on the Use of Complementary and Alternative Medicine

Complementary and alternative medicine (CAM) is an area of great public interest and activity, both nationally and worldwide. Many alternative medical practices have existed for hundreds, even thousands of years. Patients and professionals are turning to CAM for a variety of reasons. Most have tried conventional medicine for a particular (usually chronic) medical condition and have found the results inadequate. Some are concerned over the side effects of conventional therapies. Some are seeking out a more “holistic” orientation in health care where they can address body, mind, and spirit. A continuing challenge will be how to address CAM services that are based on time, practitioner–patient interactions, and self-care, using modern standards of evidence, education, licensing, and reimbursement. For most CAM therapies, there is insufficient research to say definitively that it works and CAM research is especially limited in the area of cancer. Given that situation, the questions (but not answers) facing the medical practitioner are clear-cut. Should the practitioner await the definitive results of formal Phase III randomized clinical trials, or should the practitioner rely on limited data, seeking out evidence that makes physiological sense and small trials that seem to offer some benefit to the patient? When and at what point do you discourage, permit, or recommend an available alternative therapy? The answers are not simple. There may be differences of opinion and values among the patient, the practitioner, and the organizations that pay for a therapy. CAM areas should be approached with every patient who enters the office recognizing that there are precautions to consider when patients are using, or plan to use, such therapies. This paper presents a broad survey of what complementary and alternative medicine is from the perspectives of both the public as user and the conventional medical practitioner, as well as provides examples of issues pertinent to understanding and evaluating research in CAM. The past is back and the future will involve integration of modern and ancient ways.     

关于转化医学在生化教学中的几点对策与思考

转化医学(translational medicine),其核心是要将生物医学基础研究成果迅速有效的转化为可在临床医学实际应用的理论、技术、方法和药物。作者作为生物化学与分子生物学教师,在转化医学大背景下在生化教学改革方面进行了一些尝试,提出了转化医学在生化教学中的几点对策与思考,以供大家探讨。     

The emergence of integrative medicine in Australia: the growing interest of biomedicine and nursing in complementary medicine in a southern developed society

In this article, I examine the process by which some biomedical physicians and nurses in Australia have come to adopt various alternative therapies in their regimens of practice, largely in response to (1) the growing interest on the part of many Australians in what is generally called "complementary medicine", and (2) a recognition that biomedicine is not particularly effective in treating an array of chronic ailments. Some Australian biomedical physicians and nurses have come to embrace "integrative medicine," which purports to blend the best of biomedicine and complementary medicine, and have even created an Australasian Integrative Medical Association and established integrative medical training programs and centers. I argue that the adoption of alternative therapies and the development of integrative medicine on the part of Australian biomedical physicians and nurses constitute another national manifestation of the co-option of complementary and alternative medicine.     

Potential role of metabolomics in the improvement of research on traditional African medicine

The global market for herbal medicine is growing steadily. The usage of herbal medicine is particularly common in many parts of Africa; the World Health Organization estimates that approximately 80% of Africans rely on traditional African medicines (TAMs) for treating various diseases. TAMs hold promise in preventive treatment, early disease intervention and personalized medicine. However, clinical integration of TAMs is restricted due to limited information concerning their characterization. Presently, many studies on TAMs utilize a reductionist approach, making it extremely difficult to understand the holistic modifying effects that these therapeutic agents may have on biological systems. Fortunately, emerging technologies such as metabolomics platforms adopt a ⿿top-down⿿ strategy that permits a holistic evaluation of the components, metabolic pathways and biomarkers modified by TAMs, which can aid in addressing common concerns over safety and toxicity, while also ensuring that quality control standards are met. Metabolomics approaches may also be beneficial for advancing our understanding of the efficacy and mechanism of action of TAMs, and may contribute to the advancement of research and drug discovery, early diagnosis, preventive treatment and TAMs-driven personalized medicine in Africa. This review also considers the main challenges that may hinder the adoption and integration of metabolomics approaches in research on TAMs in Africa and suggests possible solutions.     

Behavioural defences in animals against pathogens and parasites: parallels with the pillars of medicine in humans

No other theme in animal biology seems to be more central than the concept of employing strategies to survive and successfully reproduce. In nature, controlling or avoiding pathogens and parasites is an essential fitness strategy because of the ever-present disease-causing organisms. The disease-control strategies discussed here are: physical avoidance and removal of pathogens and parasites; quarantine or peripheralization of conspecifics that could be carrying potential pathogens; herbal medicine, animal style, to prevent or treat an infection; potentiation of the immune system; and care of sick or injured group members. These strategies are seen as also encompassing the pillars of human medicine: (i) quarantine; (ii) immune-boosting vaccinations; (iii) use of medicinal products; and (iv) caring or nursing. In contrast to animals, in humans, the disease-control strategies have been consolidated into a consistent and extensive medical system. A hypothesis that explains some of this difference between animals and humans is that humans are sick more often than animals. This increase in sickness in humans leading to an extensive, cognitively driven medical system is attributed to an evolutionary dietary transition from mostly natural vegetation to a meat-based diet, with an increase in health-eroding free radicals and a dietary reduction of free-radical-scavenging antioxidants.     

以技术创新驱动医疗服务质量新跃升

阐述了技术创新的定义与内涵,剖析了技术创新在提升医疗服务质量中的支撑、牵引与驱动作用。结合自身实践,从技术创新的理论与实践、高新技术的引进与应用、微创技术的拓展与延伸、信息技术的整合与挖掘等方面,对技术创新促进服务质量提升的实现途径进行了探讨,并指出要实现技术创新,必须突出以人为本、规模适度、绿色医疗等发展理念。     

Bioethical aspects of regenerative and reproductive medicine

The birth announced in 1997 of Dolly, the lamb cloned from the somatic mammary cells of an adult ewe, and the discovery of human embryonic stem cells in 1998 have been the most exciting developments in the biological sciences in the past decade. Reproductive somatic cell nuclear transfer (SCNT) in additional species has been inefficient in that relatively few births, harmful side effects and high fetal and neonatal death rates have resulted from many attempts. Ongoing debates about the ethics of reproductive SCNT have revealed that some researchers regard human reproductive SCNT as morally unacceptable in all circumstances, others see merit in reproductive SCNT in certain circumstances and others await more information before making judgment about the ethical status of the procedure. Regenerative medicine and emerging biotechnologies started to revolutionize the practice of medicine. Advances in stem cell biology, including embryonic and postnatal somatic stem cells, have made the prospect of tissue regeneration a potential reality. Mammal cloning experiments have provided new impetus to the prospect of regenerative medicine through stem cell research. The procedure of SCNT could be used to create the raw material to replace defective or senescent tissue as a natural extension of the biology of stem cells. Researchers working in reproductive medicine should consider the potential hope given to many patients against the requisite and ethically contentious creation of human blastocysts for therapeutic intent.     

五年制临床医学专业防原医学课程标准的制定与探索

防原医学是为五年制临床医学专业开设的一门必修的军事医学课程,理解和掌握防原医学知识,是成为具有全面技能的军事医学人才的基础。为了通过本门课程的学习,更好地培养高素质的新型军事医学人才,本文结合第四军医大学五年制临床医学专业学员的培养目标和实际情况,对课程标准的内容制定和实施进行思考,探索课程标准下的防原医学教学模式与方法,旨在进一步提升教学效果,造就新时期军事变革条件下的优秀人民军医。