慢加急性乙型肝炎肝衰竭并发症与预后的关系研究

目的探讨慢加急性乙型肝炎肝衰竭并发症与预后的关系,为临床上预后判断和有效治疗提供重要依据。方法回顾性分析2002年7月至2004年12月北京地坛医院收治的206例慢加急性乙型肝炎肝衰竭患者。结果慢加急性乙型肝炎肝衰竭最常见的并发症是肝性脑病(HE)、肝肾综合征(HRS)、消化道出血(GB)和继发细菌感染(SBI),HE组与无HE组好转率分别是6.9%和55.5%,HRS组与无HRS组好转率分别是0和58.9%,GB组与无GB组好转率分别是9.7%和40%,SBI组与无SBI组好转率分别是27.6%和54.1%,以上各组比较P值均≤0.001,差异有统计学意义。结论慢加急性乙型肝炎肝衰竭并发症的出现预后差,临床上预防、早期诊断和有效治疗并发症,能有效改善预后,应引起临床工作者更大重视和关注。     

大剂量美能与贺普丁治疗慢性重型乙型肝炎的临床研究

目的　探讨应用大剂量美能与贺普丁能否阻断慢性重型乙型肝炎 (慢重肝 )病人病情的恶化。　方法　观察应用该疗法组 (联合组 ) ,并与普通组及单剂组比较慢重肝病人各项临床症状、体征、化验结果的变化。　结果　应用该疗法后能减轻慢重肝的临床症状与体征 ,降低病死率。与普通组及单剂组比较有显著性差异 (P <0 .0 5 )。　结论　大剂量美能与贺普丁治疗慢重肝疗效确切 ,降低了病死率 ,可推广应用。     

前列腺素E1治疗慢性乙型肝炎慢加急性肝衰竭早期患者的临床研究

目的:探讨前列腺素E1(PGE1)对早期乙型肝炎慢加急性肝衰竭患者的临床疗效及安全性。方法:采用随机对照方法进行前瞻性试验。将100例早期乙型肝炎慢加急性肝衰竭患者随机分为前列腺素E1治疗组和综合治疗组(对照组),前列腺素E1治疗组在常规内科综合治疗的基础上加用PGE1 10μg治疗,每天1次,疗程4周,综合治疗组为常规内科综合治疗。观察和比较治疗前后两组的肝功能指标水平、消化道和全身症状以及不良反应的发生情况,评价两组的临床疗效。结果:治疗过程中,前列腺素E1治疗组的总有效率为80%,显著优于综合治疗组的62%(P0.05)。治疗过程中,两组患者血清胆红素水平均明显下降,但前列腺素E1治疗组下降幅度较对照组更加明显。治疗第2周时,治疗组和对照组患者血清胆红素水平分别为252±103μmol/L和269±113.2μmol/L(P0.05),4周时,则分别为89.8±53.2μmol/L和114.8±62.5μmol/L(P0.01),显著低于第2周时水平。临床症状好转率和其他化验指标(如ALT、GGT)均较治疗前显著降低,但无统计学差异(P0.05)。前列腺素E1治疗组不良反应的发生率为14%,而综合治疗组未见不良反应发生。结论:PGE1治疗早期乙型肝炎慢加急性肝衰竭患者的疗效明显优于综合内科治疗组,能显著改善肝功能,促进黄疸消退,不良反应少。     

银杏叶提取物联合恩替卡韦对慢性乙肝致肝纤维化的干预研究

目的:探讨银杏叶提取物(EGb761)联合恩替卡韦对慢性乙型肝炎患者肝纤维化指标的影响.方法:将45例慢性乙型肝炎患者分为治疗组22例及对照组23例,治疗组应用EGb761及恩替卡韦治疗,对照组仅予恩替卡韦治疗,连续治疗2个月.治疗前后分别检测肝功能、Ⅲ型前胶原(PCⅢ)、Ⅳ型前胶原(PClⅣ)、透明质酸(HA)、层黏连蛋白(LN)水平.结果:治疗后治疗组肝纤雏化指标较对照组明显改善(P均＜0.001).结论:银杏叶提取物EGb761恩替卡韦联合应用对慢性乙肝有明显的抗肝纤维化作用.     

未经抗病毒治疗慢乙肝患者YMDD变异检测及HBV基因分型

目的 :探讨未接受拉米呋啶及干扰素抗病毒治疗的慢性乙型肝炎患者中YMDD是否存在变异及HBV的基因亚型。方法 :采用PCR荧光分子信标探针检测技术及PCR微板核酸杂交 ELISA技术进行HBVYMDD变异株 (YIDD YVDD)及HBV基因分型检测。结果 :2 9例慢性乙肝患者HBVYMDD变异阳性 6例 ,阳性率为 2 0 6%。 5例变异阳性中 3例为YIDD阳性 ,2例为YVDD阳性 ,6例均为YMDD野生株和变异株同时存在 ;HBV基因亚型以C、B、D亚型为主 ,分别占41 3% ( 1 2 2 9)、2 4 1 % ( 7 2 9)、2 0 6% ( 6 2 9)。结论 :在未经抗病毒治疗的慢乙肝患者中存在YMDD变异株 ,临床上在应用拉米呋啶对慢性乙型肝炎患者进行抗病毒治疗前 ,应对患者是否存在YMDD变异加以重视 。     

抗糖尿病药物有助于治疗阿尔茨海默病和帕金森病(英文)

2型糖尿病已被证实是阿尔茨海默病(Alzheimer’s disease,AD)和帕金森病(Parkinson’s disease,PD)的一个危险因素。已有报道表明,AD和PD患者脑内的胰岛素信号转导受到损害。这一发现使抗糖尿病药物的应用有了新的研究,并显示出良好效应。临床前期试验表明,胰岛素或长效肠促胰岛素肽(incretin peptide)类似物具有良好的神经保护作用。在AD和PD转基因模型动物中,胰高血糖素样肽1(GLP-1,一种肠促胰岛素的类似物)阻止了神经退行性变进程,改善了神经元和突触的功能,并减轻了疾病的症状。在AD转基因小鼠模型中,GLP-1类似物阻止了淀粉样斑块的沉积、突触的丧失以及认知功能的损害;在PD动物模型中,GLP-1类似物改善了多巴胺能神经传递和运动功能。在此基础上,临床试验也在进行之中,并显示出令人鼓舞的结果。在AD患者中的初步研究表明,鼻腔给予胰岛素可改善患者的认知功能并减少脑内的AD标志物。对PD患者的初步研究也表明,目前已经上市用于治疗2型糖尿病的一种GLP-1受体激动剂(exendin-4,Byetta)对PD病人具有良好的疗效。另一种上市用于治疗糖尿病的GLP-1类似物(liraglutide,Victoza)也正在AD患者中进行临床测试。最近,第三种GLP-1受体激动剂(Lixisenatide,Lyxumia)已经在欧洲被批准上市,该药物也显示了良好的神经保护作用。本文将就以上抗糖尿病药物的神经保护作用进行归纳。可见,GLP-1类似物所显示的神经保护乃至神经再生作用为AD和PD提供了一种新的治疗手段,这些作用是当前其它药物所不具备的。     

慢传输型便秘的病因及发病机制研究进展

慢传输型便秘(STC)是由多因素引起的临床上常见的一种顽固疾病,其病因及发病机制尚不明确。目前对慢传输型便秘的病因研究主要集中在:药物的滥用、生活习惯、内分泌、心理因素这几个方面,发病机制的研究主要在肠道动力、胃肠神经肽、肠神经系统、Cajal间质细胞这几方面。从不同的层面分析,寻找关键因子,是本病的研究方向。本文对慢传输型便秘的病因及发病机制的研究进展作最新的综述。     

慢性乙型肝炎重叠急性戊型肝炎患者血清肿瘤坏死因子α和白细胞介素6的检测及其意义

本文旨在探讨肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)在慢性乙型肝炎重叠急性戊型肝炎病情加重中的作用和临床意义。采用酶联免疫吸附试验(ELISA)测定慢性乙型肝炎重叠急性戊型肝炎患者(30例)和慢性乙型肝炎患者(20例)、急性戊型肝炎患者(20例)、健康体检者(20例)的血清TNF-α、IL-6,同时检测慢性乙型肝炎重叠急性戊型肝炎、慢性乙型肝炎和急性戊型肝炎患者的主要生化指标。结果显示,与慢性乙型肝炎患者、急性戊型肝炎患者、健康体检者相比,慢性乙型肝炎重叠急性戊型肝炎患者的血清TNF-α、IL-6水平显著升高(P<0.01);与慢性乙型肝炎、急性戊型肝炎患者相比,慢性乙型肝炎重叠急性戊型肝炎患者主要生化指标丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、血清胆红素(TBIL)显著升高(P<0.05),胆固醇酯(CHE)、血浆白蛋白(ALB)、血清凝血酶原活动度(PTA)显著降低(P<0.05);慢性乙型肝炎重叠急性戊型肝炎患者的血清TNF-α、IL-6升高水平与ALT、TBIL、PTA升高或降低水平呈直线相关关系(P<0.05)。结果提示,TNF-α、IL-6参与慢性乙型肝炎重叠急性戊型肝炎免疫病理损伤过程,检测血清TNF-α、IL-6对判断慢性乙型肝炎重叠急性戊型肝炎患者肝损伤程度及预后有一定价值。     

内江地区慢性乙型肝炎患者的基因型及拉米夫定联合阿德福韦酯抗病毒治疗效果

目的探讨内江地区慢性乙型肝炎患者的基因型及拉米夫定联合阿德福韦酯抗病毒的治疗效果。方法将201例慢性乙型肝炎患者进行HBV基因型的测定,其中120例HBeAg(+)慢性乙型肝炎患者随机分为三组:A组、B组和C组,每组40例。A组给予拉米夫定(LAM)治疗;B组给予恩替卡韦(ETV)治疗;C组给予LAM联合阿德福韦酯(ADV)治疗,比较治疗情况。结果 201例慢性乙型肝炎患者中B型119例(59.2%),C型68例(33.8%),B/C混合型10例(5.0%),未知型4例(2.0%),各分型之间的性别、年龄差异无统计学意义(P0.05)。C型感染者HBeAg阳性率为86.8%,显著高于B型的51.3%(P0.05)。HBeAg(+)的3组患者治疗12、24和48周时,B组和C组患者的ALT复常率、HBV DNA阴转率及48周时的HBeAg血清转换率均显著高于A组(P0.05);C组患者与B组比较差异无统计学意义(P0.05)。治疗期间均未见不良反应发生。C组患者(包括B型19例、C型21例)中B型的HBV DNA阴转率及HBeAg血清转换率显著高于C型(P0.05)。结论地处西南方的内江地区慢性乙型肝炎患者主要以B型为主,C型次之,B型和C型共占93.0%,其他型别仅占较少部分。ETV方案或LAM联合ADV方案治疗HBeAg(+)慢性乙肝疗效优于LAM治疗。初始LAM联合ADV治疗基因B型HBeAg(+)慢性乙型肝炎疗效优于C型。     

急性肺损伤保护作用机制研究进展

急性肺损伤(acute lung injury,ALI)是临床常见危重症,病死率极高,其发病机制极为复杂,临床上针对急性肺损伤缺乏有效的治疗药物及治疗手段。现从抗炎、抗氧化、内皮细胞保护及改善微循环等方面对急性肺损伤保护作用机制作一综述。     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

真菌类遗传学分析的知识结构教学

本文以认知结构理论为指导,讨论了真菌类遗传分析与高等动植物遗传分析的内在联系,认为利用这种内在联系进行教学可收到好的效果并说明了作者的具体教学过程。 Abstract:In the paper, the relationship between genetic analysis of Fungi and genetic analysis of high animal and plant was discussed.A good results were obtained when we adopted this method in the teaching.     

The effects of glutamine of the maintenance of embryogenic cultures of Cryptomeria japonica

Summary Embryogenic tissues of sugi (Cryptomeria japonica) were induced on a modified Campbell and Durzan (CD) medium containing 1 μM 2,4-dichlorophenoxyacetic acid (2,4-D) and 600 mg l⁻¹ glutamine, and subcultured in the medium of the same composition for over 1 yr. This resulted in a mixed culture of embryogenic and non-embryogenic cells. When embryogenic cells were isolated and cultured independently, their capacity to form embryogenic aggregates was lost. Thus, the non-embryogenic cells present within a mixed culture system were essential to the formation of embryogenic aggregates. When embryogenic tissues were isolated and cultured independently on a high glutamine-containing (2400 mg l⁻¹) medium, dry weights and endogenous levels of glutamine increased, and the tissue could generate a large number of embryogenic aggregates. Amino acid analysis of embryogenic and non-embryogenic cells from the maintenance culture indicated a higher level of glutamine was present in the latter. The high endogenous level of glutamine in the non-embryogenic portion of mixed cell masses may be the supplier of glutamine for maintaining the embryogenic property of the tissues.     

Specificity of action of piperidylcholine derivatives as substrates of cholinesterases of various origin

The review deals with study of enzymologic properties of a novel highly specific acetylcholinesterase substrate, N-(β-acetoxyethyl) piperidinium iodomethylate (“piperidylcholine”), and its 30 derivatives that were tested as effectors of cholinesterases of mammals and various species of Pacific squids. It was proven for the first time that responsible for specificity of action was structure of cyclic ammonium grouping of the alcohol part of molecule of the ester substrate. Analysis of specificity is performed based on enzymatic hydrolysis parameters—activity of catalytic center of cholinesterases and bimolecular constant of the reaction rate that are determined at optimal and low substrate concentrations. Among the specially synthesized group of thioester compounds there is revealed one more highly specific acetylcholinesterase substrate—N-(β-acetoxyethyl) piperidinium.     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.     

医疗机构合理用药评价模型的构建研究

目的 针对医疗机构的合理用药水平进行评价研究。方法 根据医疗机构合理用药的具体要求,构建医疗机构合理用药评价指标体系,采用基于模糊群决策的方法和多指标评价分析法构建医疗机构合理用药评价模型。结果 构建了基于模糊群决策的医疗机构合理用药评价模型,并通过实例分析证明了评价模型的可行性。结论 建立的基于模糊群决策的医疗机构合理用药评价模型能够对医疗机构的合理用药水平进行科学评价,为提高医疗机构合理用药水平奠定基础。