316例输卵管性不孕患者生殖道Ct、Uu及Mh的检测及耐药性分析

目的通过对316例输卵管性不孕患者生殖道沙眼衣原体、解脲支原体、人型支原体感染以及耐药情况进行检测分析,研究其与不孕症的关系,并探讨用药合理性。方法收集316例2013年2月至2016年9月至我院进行诊治的输卵管性不孕患者作为研究组,并选取同期297例来进行检查的健康人作为对照组。对两组人员生殖道分泌物进行沙眼衣原体(Chlamydia trachomatis,Ct)、解脲支原体(Ureaplasma urealyticum,Uu)、人型支原体(Mycoplasma hominis,Mh)检测,并进行药敏试验。结果研究组患者Ct、Uu、Mh、Ct+Uu、Uu+Mh感染率以及总感染率均明显高于对照组,差异均具有统计学意义(Ps0.05)。Uu对原始霉素、四环素、强力霉素、交沙霉素、阿奇霉素、克拉霉素、红霉素敏感性较高(90%以上),对氧氟沙星、环丙沙星耐药性较高。Mh对原始霉素、四环素、强力霉素、交沙霉素敏感性较高(90%以上),对氧氟沙星、环丙沙星、阿奇霉素、克拉霉素耐药性较高。Uu+Mh对原始霉素、四环素、交沙霉素敏感性较高(90%以上),对阿奇霉素、氧氟沙星、环丙沙星耐药性较高。结论对输卵管性不孕患者,应进行生殖道分泌物Ct、Uu、Mh的检测,判断是否发生感染或混合感染,并根据药敏结果选择合适的抗生素进行治疗,以提高治疗效果。     

经皮神经电刺激联合布洛芬缓释胶囊对盆腔炎性疾病所致慢性盆腔疼痛患者血清炎症因子和致痛物质水平的影响

摘要 目的：观察经皮神经电刺激（TENS）联合布洛芬缓释胶囊治疗盆腔炎性疾病（PID）所致慢性盆腔疼痛（CPP）的疗效及对血清炎症因子和致痛物质水平的影响。方法：选择2020年6月～2021年6月期间河北省人民医院收治的120例PID所致CPP患者。根据随机数字表法分为对照组和研究组,各为60例,对照组患者接受布洛芬缓释胶囊治疗,研究组患者接受TENS联合布洛芬缓释胶囊治疗,对比两组疗效、症状评分、血清炎症因子、致痛物质水平和安全性情况。结果：研究组（91.67%）的临床总有效率高于对照组（75.00%）,差异有统计学意义（P<0.05）。治疗后,两组疼痛视觉模拟（VAS）评分、症状体征（McCormack）评分均下降,研究组低于对照组同期（P<0.05）。治疗后,两组血清肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、白介素-1β（IL-1β）、C反应蛋白（CRP）水平均下降,研究组低于对照组同期（P<0.05）。治疗后,两组血清5-羟色胺（5-HT）、P物质（SP）和强啡肽（DYN）水平均下降,研究组低于对照组同期（P<0.05）。两组不良反应发生率组间对比,未见差异（P>0.05）。结论：TENS联合布洛芬缓释胶囊治疗PID所致CPP,疗效确切,可促进症状缓解,降低炎症因子和致痛物质水平。     

胆红素对慢性阻塞性肺疾病大鼠血小板源性生长因子和胰岛素样生长因子表达的影响

目的探讨胆红素对慢性阻塞性肺疾病（COPD）大鼠肺组织血小板源性生长因子（PDGF-B）和胰岛素样生长因子（IGF-I）表达的影响。方法30只健康清洁级雄性Wistar大鼠（200-250g）,随机分为正常对照组、COPD模型组、胆红素干预组。观察肺组织病理形态,采用免疫组织化学染色检测肺组织中PDGF-B和IGF-I的表达。结果（1）肺病理组织学结果显示胆红素干预组肺病变局限且程度减轻;（2）COPD模型组PDGF-B（1.58±0.72）和IGF-I含量（2.23±0.63）与正常对照组（0.65±0.35,1.34±0.65）比较显著升高（均P〈0.05）;（3）胆红素干预组PDGF-B（1.20±0.56）和IGF-I含量（1.64±0.56）比模型组明显减低（均P〈0.05）,但与正常对照组比较仍较高（均P〈0.05）。结论PDGF-B和IGF-I在COPD显著增加,胆红素可以抑制PDGF-B和IGF-I的表达,可能是其对抗COPD的作用机制之一。     

慢性阻塞性肺疾病大鼠海马区和血清中脑源性神经营养因子蛋白的表达变化

本文旨在探讨脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)大鼠模型海马区和血清中的表达情况,以及了解吸烟和气管内注入脂多糖的干预是否参与BDNF表达变化.采用被动...     

双水平气道内正压通气治疗慢性阻塞性肺疾病急性发作并Ⅱ型呼吸衰竭的临床疗效观察

摘要目的：观察双水平气道正压通气（bilevelpositiveairwaypressure,BiPAP）呼吸机治疗慢性阻塞性肺疾病急性加重期（acuteex—acerlationofchronicobstructivepulmonarydisease,AECOPD）合并Ⅱ型呼吸衰竭的临床疗效。方法：148例经诊断为AEc0PD合并II型呼吸衰竭的患者,按照入院的先后顺序随机分为对照组及治疗组,每组74例;对照组患者给予抗感染、祛痰、平喘、吸氧等常规治疗;治疗组在上述治疗的基础上,给予BiPAP呼吸机治疗,8h／天,分析治疗前两组患者的基线资料及生命体征,抽取治疗前及治疗后24h、72h股动脉血液进行动脉血气分析（包括pH、PaCO2、PaO2、Sa02等）,并比较两组患者的住院天数。结果：治疗前两组患者的基线资料及生命体征指标无显著性差异（P〉0．05）;两组患者治疗后pH、PaCO2、PaO2、SaO2均较治疗前有所改善（P〈0．05或P〈0．01）;与对照组比较,治疗组pH、P02、PC02、Sa02的改善情况显著优于对照组（P〈0．05）,且患者的住院天数显著缩短（P〈0．05）。结论：采用BiPAP呼吸机辅助治疗AECOPD合并II型呼衰的患者疗效较常规治疗更好,安全可靠,值得临床推广应用。     

腰痹通胶囊联合塞来昔布胶囊治疗椎间盘源性腰痛的疗效及对血清炎性因子和疼痛介质的影响

摘要 目的：探讨腰痹通胶囊联合塞来昔布胶囊治疗椎间盘源性腰痛（DLBP）的疗效及对血清炎性因子和疼痛介质的影响。方法：选择2017年5月~2022年5月期间我院接收的75例DLBP患者。依据信封抽签法将患者分为对照组（n=37）和研究组（n=38）,对照组接受塞来昔布胶囊治疗,研究组接受腰痹通胶囊联合塞来昔布胶囊治疗。对比两组疗效、临床症状评分、血清炎性因子和疼痛介质的变化情况,同时观察两组用药安全性。结果：研究组痊愈8例,显效10例,有效18例,临床总有效率94.74%,高于对照组的痊愈4例,显效8例,有效17例,临床总有效率78.38%（P<0.05）。治疗1个月后,研究组的视觉疼痛模拟（VAS）评分、Oswestry功能障碍指数（ODI）较对照组更低（P<0.05）,改良日本骨科协会（JOA）评分较对照组更高（P<0.05）。治疗1个月后,研究组的血清白细胞介素-6（IL-6）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）水平较对照组更低（P<0.05）。治疗1个月后,研究组的血清 P物质（SP）、多巴胺（DA）、前列腺素E₂（PGE₂）水平较对照组更低（P<0.05）。两组不良反应发生率组间对比差异不显著（P>0.05）。结论：腰痹通胶囊联合塞来昔布胶囊治疗DLBP,可有效减轻疼痛,恢复腰椎功能,降低血清炎性因子和疼痛介质水平。     

电子支气管镜下氩气刀联合冷冻疗法治疗晚期肺癌的临床疗效及对患者癌性疼痛和免疫功能的影响

目的:评价电子支气管镜下氩气刀联合冷冻疗法治疗晚期肺癌的疗效及对患者癌性疼痛和免疫功能的影响。方法:选择我院2016年7月～2018年7月收治的94例晚期肺癌患者,按随机数字表法分为对照组(51例)和4研究组(43例)。对照组采用常规化疗,研究组在对照组基础上联合电子支气管镜下氩气刀和冷冻疗法。治疗后,比较两组的临床疗效,治疗前后疼痛程度、疼痛介质、免疫功能、生活质量的变化和不良反应的发生情况。结果:治疗后,研究组疾病控制率显著高于对照组(P0.05),两组疼痛Ⅰ级率、CD4~+、CD4~+/CD8~+及生活质量评分均较治疗前显著上升(P0.05),而疼痛介质及CD8~+均较治疗前明显下降(P0.05),研究组疼痛Ⅰ级率、CD4~+、CD4+/CD8~+及生活质量评分明显高于对照组,而疼痛介质及CD8~+均显著低于对照组(P0.05)。两组总不良反应发生率比较差异无统计学意义(P0.05)。结论:电子支气管镜下氩气刀联合冷冻疗法用于治疗晚期肺癌的疗效明显优于常规化疗,其可显著减轻癌性疼痛,改善患者免疫功能斌提高患者的生活质量。     

特布他林联合羧甲司坦片治疗慢性阻塞性肺疾病的疗效及对血清MMP-9、MMP-12、TIMP-1的影响

目的:研究特布他林联合羧甲司坦片治疗慢性阻塞性肺疾病的疗效及对血清基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶-12(MMP-12)、组织型金属蛋白酶抑制物(TIMP-1)水平的影响。方法:选取2015年3月至2018年2月我院收治的170例COPD患者,根据随机数字法分为观察组(87例)和对照组(83例)。对照组使用特布他林,观察组联合使用羧甲司坦。比较两组患者的临床疗效,治疗前后血清MMP-9、MMP-12、TIMP-1水平,肺功能指标,炎性因子水平的变化及不良反应的发生情况。结果:治疗后,观察组临床总有效率显著高于对照组(P<0.05),血清MMP-9、MMP-12、TIMP-1水平显著低于对照组(P<0.05),最大呼气流速(PEF)、1秒用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1/FVC显著高于对照组(P<0.05),血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、中性粒细胞弹性蛋白酶(NE)水平均显著低于对照组(P<0.05)。观察组和对照组不良反应的发生率比较无显著差异(P>0.05)。结论:特布他林联合羧甲司坦片治疗COPD的临床疗效显著优于单用特布他林,且安全性更高,可能与其能有效降低血清MMP-9、MMP-12、TIMP-1水平有关。     

Combined detection of Chlamydia trachomatis-specific antibodies against the 10 and 60-kDa heat shock proteins as a diagnostic tool for tubal factor infertility: Results from a case-control study in Cameroon

A case-control study was conducted to determine the diagnostic value of Chlamydia trachomatis-associated anti-Chsp10 and/or anti-Chsp60 antibodies in the detection of secondary infertility. There were significant associations between C. trachomatis infection and infertility (p<0.01), and between C. trachomatis-specific anti-Chsp10 or anti-Chsp60 antibodies and secondary infertility (p<0.001). A significant correlation was found between anti-Chsp10 and anti-Chsp60 titers (p<0.01). The detection of either C. trachomatis-associated anti-Chsp10 or anti-Chsp60 antibodies cumulatively allowed specific diagnosis of secondary infertility (57.4% sensitivity, 75.5% specificity).     

Aryl sulfones as novel bradykinin B1 receptor antagonists for treatment of chronic pain

We report the development of aryl sulfones as Bradykinin B1 receptor antagonists. Variation of the linker region identified diol 23 as a potent B1 antagonist, while modifications of the aryl moiety led to compound 26, both of which were efficacious in rabbit biochemical challenge and pain models.     

Structure-activity relationships of 2,4-diphenyl-1H-imidazole analogs as CB2 receptor agonists for the treatment of chronic pain

A series of 2,4-diphenyl-1H-imidazole analogs have been synthesized and displayed potent human CB2 agonist activity. Many of these analogs showed high functional selectivity over human CB1 receptors. The syntheses, structure-activity relationships, and selected pharmacokinetic data of these analogs are described.     

花青素对完全弗氏佐剂诱导慢性炎性痛的镇痛作用及其机制

目的：本研究旨在探索金叶女贞果实花青素对完全弗氏佐剂（CFA）诱导慢性炎性痛的镇痛作用及其可能的中枢机制。方法：雄性SD大鼠30只随机分为三组（n=10）：正常对照组、慢性炎性痛模型组（左后足跖注射100 μl CFA）、花青素治疗组（模型+花青素90 mg·kg^-1,ig,qd）。造模前和术后第1、3、5、7、9、11、13日测量各组大鼠的体重、基础痛阈（热痛阈和机械痛阈）,左后肢足趾容积;术后第14日实验结束,分光光度计法测定血清各项生化指标,Western blot检测海马区总辣椒素受体（TRPV1）和磷酸化辣椒素受体（p-TRPV1）的表达。结果：花青素能提高模型组大鼠热痛阈和机械痛阈（P<0.05）,降低足趾肿胀度（P<0.05）,提高血清SOD水平（P<0.01）,降低血清MDA和NO含量（P<0.05）,降低大脑海马区p-TRPV1/TRPV1蛋白比例。结论：花青素灌胃14日处理对完全弗氏佐剂诱导的大鼠慢性炎性痛有镇痛作用,其机制可能与降低炎性因子释放,提高抗氧化能力和下调TRPV1磷酸化有关。     

慢性盆腔炎常见证型宫颈分泌物菌群分析

目的研究不同证型慢性盆腔炎患者生殖道菌群的变化。方法2002年6月至2003年5月广州中医药大学妇科住院慢性盆腔炎患者,湿热证组29例和气滞血瘀证组20例的宫颈分泌物进行菌群密集度、菌群多样性、优势菌的检测,并与24例正常人组对照。结果慢性盆腔炎湿热证和气滞血瘀证两者的衣原体感染率、细菌多样性、菌群密集度分级高于正常人组。优势菌群,以革兰阳性球菌为主,占75%,其中表皮葡萄球菌最多,占45%,其次为粪肠球菌,占16%;革兰氏性杆菌以大肠埃希菌为主,占13%,其次为棒状杆菌,占11%。湿热证和气滞血瘀证两者差异无显着性。结论慢性盆腔炎湿热证与气滞血瘀证均与菌群失调有关。     

盐酸莫西沙星治疗慢性阻塞性肺疾病急性加重期的疗效及安全性

目的 探讨盐酸莫西沙星序贯疗法治疗慢性阻塞性肺疾病急性加重期的临床疗效及安全性。方法 选取200例慢性阻塞性肺疾病急性加重期的患者,随机分为对照组和观察组,对照组静脉给予盐酸莫西沙星氯化钠注射液治疗,观察组采用莫西沙星序贯疗法进行治疗,前5日静脉给予盐酸莫西沙星氯化钠注射液,病情好转后口服盐酸莫西沙星片,考察两组治疗前、后肺功能指标参数及血液中IL-8、TNF-α水平,比较两组的临床疗效和安全性。结果 经治疗后,观察组临床总有效率为94.0%,与对照组的95.0%比较,差异无统计学意义（χ2=0.0481,P>0.05）;两组患者的肺功能指标参数与治疗前比较,差异有统计学意义（P＜0.05）,但观察组改善程度与对照组比较,差异有统计学意义（P＜0.05）;两组患者血液中IL-8、TNF-α水平与治疗前比较,差异有统计学意义（P＜0.05）,观察组与对照组比较,差异无统计学意义（P>0.05）;观察组不良反应发生率8.0%与对照组17.0%比较,差异有统计学意义（χ2=1.8514,P＜0.05）。结论 采用序贯疗法治疗慢性阻塞性肺疾病,具有安全、有效等优点,有较大的临床推广意义。     

Alterations of plasma inflammatory biomarkers in the healthy and chronic obstructive pulmonary disease patients with or without acute exacerbation

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortally and morbidity, associated with acute exacerbations (AECOPD) resulted from smoking, infection or air pollution. Systemic inflammation has been considered as one of major pathophysiologic alterations in AECOPD. The present study aimed at developing disease-specific biomarker evaluation by integrating proteomic profiles of inflammatory mediators in AECOPD with clinical and biological informatics. Plasma samples from 18 subjects including healthy people or patients with stable COPD or AECOPD were collected to measure 507 inflammatory mediators using antibody microarray. Clinical informatics was achieved by a Digital Evaluation Score System (DESS) for assessing severity of patients. 20 mediators were significantly different between 3 groups (p<0.05), of which, Cerberus 1, Growth Hormone R, IL-1F6, IL-17B R, IL-17D, IL-19, Lymphotoxin beta, MMP-10, Thrombopoietin and TLR4 were correlated with DESS scores (p<0.05). There was a down-regulation of systemic inflammatory responses in AECOPD. The integration of proteomic profile with clinical informatics as part of clinical bioinformatics is important to screen disease-specific and disease-staged biomarkers. This article is part of a Special Issue entitled: Proteomics: The clinical link.     

Aloperine attenuated neuropathic pain induced by chronic constriction injury via anti-oxidation activity and suppression of the nuclear factor kappa B pathway

Objective

To investigate whether aloperine (ALO) has antinociceptive effects on neuropathic pain induced by chronic constriction injury, whether ALO reduces ROS against neuropathic pain, and what are the mechanisms involved in ALO attenuated neuropathic pain.

Methods

Mechanical and cold allodynia, thermal and mechanical hyperalgesia and spinal thermal hyperalgesia were estimated by behavior methods such as Von Frey filaments, cold-plate, radiant heat, paw pressure and tail immersion on one day before surgery and days 7, 8, 10, 12 and 14 after surgery, respectively. In addition, T-AOC, GSH-PX, T-AOC and MDA in the spinal cord (L4/5) were measured to evaluate anti-oxidation activity of ALO on neuropathic pain. Expressions of NF-κB and pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) in the spinal cord (L4/5) were analyzed by using Western blot.

Results

Administration of ALO (80 mg/kg and 40 mg/kg, i.p.) significantly increased paw withdrawal threshold, paw pressure, paw withdrawal latencies, tail-curling latencies, T-AOC, GSH-PX and T-SOD concentration, reduced the numbers of paw lifts and MDA concentration compared to CCI group. ALO attenuated CCI induced up-regulation of expressions of NF-κB, TNF-α, IL-6, IL-1β at the dose of 80 mg/kg (i.p.). Pregabalin produced similar effects serving as positive control at the dose of 10 mg/kg (i.p.).

Conclusion

ALO has antinociceptive effects on neuropathic pain induced by CCI. The antinociceptive effects of ALO against neuropathic pain is related to reduction of ROS, via suppression of NF-κB pathway.     

Changes of nutritional status and the variations of serum indicators of patients with chronic kidney disease accompanied by hypothyroidism taking thyroid hormone replacement therapy as the therapeutic models

This study aimed to analyze the incidence of malnutrition in patients with chronic kidney disease (CKD) at stage III-IV accompanied by hypothyroidism and indicate the improvement in nutritional status and kidney disease of CKD patients after undergoing thyroid hormone replacement (THR) therapy as therapeutic models. The included 156 CKD patients in stage III-IV were divided into the CKD stage III group (CKD-III group) (n = 80) and CKD stage IV group (CKD-IV group) (n = 76), and the clinical indicators of all the patients were collected. Based on changes in thyroid function, the included patients were again divided into the following groups: subclinical hypothyroidism group (the experimental group, hereinafter referred to Y-group, n = 78) and non-subclinical hypothyroidism group (the control group, hereinafter referred to N-group, n = 78), in which the CKD-III group was divided into CKD-IIIN group (n = 38) and CKD-IIIY group (n = 42), and also the CKD-IV group was divided into CKD-IVN group (n = 40) and CKD-IVY group (n = 36). At the beginning, patients in the Y-group was orally given 25 μg/dL of levothyroxine; based on the progression of the disease, the dosage was regulated; the concentration of serum thyroid stimulating hormone (TSH) was assessed once per month, as well as changes in tri-iodothyronine (T3) and tetraiodothyronine (T4). Estimated glomerular filtration rate (eGFR) in the CKD-IIIY group was significantly changed compared with that of the CKD-IVY group after THR therapy. Comparison of nutrition-based indicators between the N-group and the Y-group showed that the serum albumin (ALB) level, the hemoglobin (HGB) level, and the grip strength of both the left and right hand were notably decreased (P < 0.05). After THR therapy, the indicators related to CKD patients were accompanied by subclinical hypothyroidism changes; the levels of ALB and HGB, as well as the grip strength of both the left and right hand were notably increased compared with before undergoing THR therapy (P < 0.05). In conclusion, malnutrition of chronic kidney disease caused by subclinical hypothyroidism could be partially recovered after THR therapy as therapeutic models.     

Reliability of surface electromyography for the gluteus medius muscle during gait in people with and without chronic nonspecific low back pain

The purpose of this study was to determine the intratester reliability of surface electromyography (EMG) assessment of the gluteus medius muscle in healthy people and people with chronic nonspecific low back pain (CNLBP) during barefoot walking. Gluteus medius muscle activity was measured twice in 40 people without and 30 people with CNLBP approximately 7 days apart. Walking gluteus medius muscle activity was normalised to maximal voluntary isometric contractions during side-lying hip abduction with manual resistance. Good intratester reliability (ICC > 0.75) was found for mean, peak, and peak to peak amplitude for healthy people. Only mean amplitude demonstrated good intratester reliability in those with CNLBP. Peak amplitude and peak to peak amplitude of the gluteus medius muscle of those with CNLBP, and the time of peak amplitude in both groups, demonstrated moderate reliability (ICC ranged from 0.50 to 0.58). Moderate to large standard error of measurement and minimal detectable change values were reported for outcome measurements. These results suggest that potentially large levels of random error can occur between sessions. Future research can build on this study for those with pathology and attempt to establish change values for EMG that are clinically meaningful.