地高辛对老年慢性心衰患者血清CA125，BNP及MMP-9 水平的影响

目的:探讨地高辛片对老年慢性心力衰竭患者血清血清糖类抗原(CA125)、心钠肽(ANP)、脑钠肽(BNP)、基质金属蛋白酶9(MMP-9)及金属蛋白酶组织抑制剂(TIMP-1)水平的影响。方法:收集我院老年慢性心力衰竭患者100例,随机分为对照组和实验组,每组各50例,对照组患者给予常规治疗,实验组患者在对照组的基础上给予地高辛片。比较治疗前后两组患者血清糖类抗原(CA125)、心钠肽(ANP)、脑钠肽(BNP)、基质金属蛋白酶9(MMP-9)及金属蛋白酶组织抑制剂(TIMP-1)水平。结果:与治疗前相比,两组患者血清CA125、ANP、BNP及MMP-9水平降低,TIMP-1水平升高(P0.05);治疗后与对照组相比,实验组CA125水平(34.05±4.63)较低,ANP水平较低(216.98±27.65),BNP水平较低(437.62±45.26),MMP-9水平较低(550.17±65.15),TIMP-1水平较高(182.32±21.78)(P0.05)。结论:地高辛片能够改善老年慢性心力衰竭患者心肌功能,推测其机制可能与降低血清CA125、ANP、BNP、MMP-9水平,升高TIMP-1水平有关。     

胸腺肽治疗慢性乙型肝炎疗效分析

研究胸腺肽对慢性乙型肝炎的治疗作用。治疗组在综合疗法基础上加用胸腺肽注射液,对照组采用综合保肝疗法,疗程均为３ 个月。结果：治疗组优于对照组（Ｐ＜ ０－０１） 。结论：胸腺肽对乙型肝炎病毒血清学指标（ＨＢＶ—Ｍ） 的复制有抑制作用     

Bim-mediated apoptosis and PD-1/PD-L1 pathway impair reactivity of PD1(+)/CD127(-) HCV-specific CD8(+) cells targeting the virus in chronic hepatitis C virus infection

PD-1 molecule promotes anergy and IL-7 receptor (CD127) induces an anti-apoptotic effect on T cells. Correlation between PD-1/CD127 phenotype and hepatitis C virus (HCV)-specific CD8⁺ cell reactivity in resolved infection (RI) after treatment and persistent HCV-infection (PI) was analysed. Directly ex vivo, PD-1 and CD127 expression on HCV-specific CD8⁺ cells displayed a positive and negative correlation, respectively with viraemia. Proliferation after stimulation on PD-1⁻/CD127⁺ cells from RI cases was preserved, while it was impaired on PD-1⁺/CD127⁻ cells from PI patients. PD1⁺/CD127⁺ population was observed in PI, and these maintained expansion ability but they did not target the virus. Frequency of PI cases with HCV-specific CD8⁺ cell proliferation increased after anti-PD-L1 and anti-apoptotic treatment. Bim expression on HCV-specific CD8⁺ cells from PI patients was enhanced. In conclusion, during chronic HCV infection non-reactive HCV-specific CD8⁺ cells targeting the virus are PD-1⁺/CD127⁻/Bim⁺ and, blocking apoptosis and PD-1/PD-L1 pathway on them enhances in vitro reactivity.     

促肝细胞生长素联合前列腺素E1治疗慢性乙型重型肝炎疗效观察

目的探讨促肝细胞生长素(PHGF)联合前列腺素E1(PGE1)在慢性乙型重型肝炎中的疗效.方法60例慢性乙型重型肝炎患者随机分为治疗组30例和对照组30例,对照组采用常规治疗,治疗组在常规治疗的基础上加用PGE1、PHGF,治疗前后分别检测肝功能、PT.结果治疗30 d后,治疗组显效率、死亡率、SB和PTA值分别为43.3%、36.7%、(120士102)μmol/L和(70±23)%,对照组分别为13.3%、63.3%、(202±87)μmol/L和(40±18%).2组间显效率、死亡率、SB及PTA值差异存在显著性(P＜0.01或0.05).结论 PGE1联合PHGF在治疗慢性乙型重型肝炎中有较好疗效.     

急性胰腺炎患者腹腔镜胆囊切除术的时机研究

目的：探讨急性胰腺炎胆囊切除术的有效性及时机。方法：分别对患有急性胰腺炎而进行腹腔镜胆囊切除的38例患者的临床信息进行了研究。结果：首先对38例病人进行了3-15天非手术的保守治疗,当临床症状和表征基本消失,血、尿中的淀粉酶接近正常水平时,进行胆囊切除。手术时间为30分钟到90分钟（平均时间60分钟）,手术中无转化和严重并发症症状发生。对这38例病人随访6到56周后无复发现象发生。结论：当临床症状和表征基本消失,血、尿中的淀粉酶接近正常水平时,急性胰腺炎胆囊切除术是有效且可行的。在中国患有急性胰腺炎的患者中,进行腹腔镜胆囊切除的占50％～70％。胆结石治疗取决于患者胰腺炎的严重性,及患者是否患有梗阻性黄疸。对于非梗阻性胰腺炎的患者,早期是否要进行明确的手术治疗尚无定论。我院患有急性胰腺炎的38例患者进行腹腔镜胆囊切除术（2004年2月到2009年4月之间）后取得了满意的效果。详情如下。     

贫铀经口慢性染毒对小鼠肠道菌群多样性的影响

目的观察贫铀经口慢性染毒对小鼠肠道菌群多样性的影响。方法通过将不同剂量的贫铀混入饲料中饲养小鼠,以小鼠肝脏和肾脏铀含量作为判断贫铀在动物体内蓄积的指标,建立贫铀经121慢性染毒小鼠模型,观察各组小鼠之间的体重变化,对各组小鼠进行基于细菌16SrRNAV6－V8区的PCR－DGGE分析。结果食入贫铀的各组小鼠肝脏和肾脏铀含量显著高于对照组（P〈0．05）,各组小鼠体重差异无统计学意义（P〉0．05）,各组小鼠V6－V8IXDGGE图谱的丰富度和多样性指数差异均无统计学意义（P〉0．05）。结论贫铀经日慢性染毒对小鼠肠道菌群多样性无显著影响。     

Involvement of endogenous hydrogen sulfide in cigarette smoke-induced changes in airway responsiveness and inflammation of rat lung

Hydrogen sulfide (H₂S), recently considered the third endogenous gaseous transmitter, may have an important role in systemic inflammation. We investigated whether endogenous H₂S may be a crucial mediator in airway responsiveness and airway inflammation in a rat model of chronic exposure to cigarette smoke (CS). Rats randomly divided into control and CS-exposed groups were treated with or without sodium hydrosulfide (NaHS, donor of H₂S) or propargylglycine (PPG, inhibitor of cystathionine-γ-lyase [CSE], an H₂S-synthesizing enzyme) for 4-month exposure. Serum H₂S level and CSE protein expression in lung tissue were higher, by 2.04- and 2.33-fold, respectively, in CS-exposed rats than in controls (P < 0.05). Exogenous administration of NaHS to CS-exposed rats alleviated airway reactivity induced by acetylcholine (Ach) or potassium chloride (KCl) by 17.4% and 13.8%, respectively, decreased lung pathology score by 32.7%, inhibited IL-8 and TNF- α concentrations in lung tissue by 34.2% and 31.4%, respectively, as compared with CS-exposed rats (all P < 0.05). However, blocking endogenous CSE with PPG in CS-exposed rats increased airway reactivity induced by Ach or KCl, by 24.1% and 24.5%, respectively, and aggravated lung pathology score, by 44.8%, as compared with CS-exposed rats (all P < 0.01). Incubation in vitro with NaHS, 1–3 mmol/L, relaxed rat tracheal smooth muscle precontracted by Ach or KCl. However, the NaHS-induced relaxation was not blocked by glibenclamide (10^?4 mol/L), L-NAME (10^?4 mol/L), or ODQ (1 μmol/L) or denudation of epithelium. Endogenous H₂S may have a protective role of anti-inflammation and bronchodilation in chronic CS-induced pulmonary injury.     

Cytokines and persistent viral infections

Intracellular pathogens such as the human immunodeficiency virus, hepatitis C and B or Epstein–Barr virus often cause chronic viral infections in humans. Persistence of these viruses in the host is associated with a dramatic loss of T-cell immune response due to functional T-cell exhaustion. Developing efficient immunotherapeutic approaches to prevent viral persistence and/or to restore a highly functional T-cell mediated immunity remains a major challenge. During the last two decades, numerous studies aimed to identify relevant host-derived factors that could be modulated to achieve this goal. In this review, we focus on recent advances in our understanding of the role of cytokines in preventing or facilitating viral persistence. We concentrate on the impact of multiple relevant cytokines in T-cell dependent immune response to chronic viral infection and the potential for using cytokines as therapeutic agents in mice and humans.     

痰热清注射液联合孟鲁司特治疗慢性阻塞性肺疾病急性加重期患者的疗效观察

目的:探讨痰热清注射液联合孟鲁司特治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效。方法:将2014年5月至2016年12月我院收治的AECOPD患者116例按照随机数字表法分为研究组和对照组,每组58例,对照组患者给予AECOPD常规治疗,同时口服孟鲁司特10 mg/d,研究组则在此基础上静脉滴注痰热清注射液20 mL/d,两组疗程均为2周。观察两组临床疗效、患者临床症状改变,并对比两组治疗前后血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平。结果:研究组总有效率为98.28%,明显高于对照组的87.93%(P0.05)。研究组患者咳嗽消失时间、气促消失时间、哮鸣音消失时间明显低于对照组(P0.05)。治疗后两组患者血清IL-6、IL-8以及TNF-α水平均降低(P0.05),且研究组较对照组降低(P0.05)。结论:痰热清注射液联合孟鲁司特治疗AECOPD能够有效缓解患者症状,降低患者炎症反应,临床效果较好。     

张家口市大气颗粒物PM2.5、PM10浓度与慢性阻塞性肺疾病住院人次的关系研究

目的:研究张家口市大气颗粒物对慢性阻塞性肺疾病(COPD)的影响,并分析大气颗粒物对不同特征人群的影响。方法:从张家口市医保办公室获取张家口市2013年1月1日-2015年12月31日两家三甲医院COPD患者的住院病历资料,从中国环境监测总站网站获取大气污染物的监测数据,从张家口市气象局获取气象资料。建立广义相加模型(GAM),在控制长期趋势、星期几效应和温湿度影响后,应用条件Logitic回归方法评估PM_(2.5)、PM_(10)对COPD住院人次的影响。根据患者不同特征(性别、年龄、季节)进行分层分析,评估颗粒物污染的高危人群。结果:研究纳入两家三甲医院,共1984例住院COPD患者,其中男性患者1258例(63.4%)、女性患者726例(36.6%),≥75岁患者678例(34.2%),60~75岁患者936例(47.2%)、芨60岁患者370例(18.6%)。2013-2015年PM_(2.5)、PM_(10)年均浓度分别为[(36.54±20.34)μg/m~3、(84.37±52.54)μg/m~3],[(34.50±27.08)μg/m~3、(78.43±69.78)μg/m~3],[(32.04±21.35)μg/m~3、(75.46±50.02)μg/m~3],两者在移动平均滞后3d时,对COPD的影响最大,即PM_(2.5)每增加10μg/m~3,COPD住院人次增加1.90%(95%CI:1.002-1.033,P0.05),PM_(10)每增加10μg/m~3,COPD住院人次增加2.10%(95%CI:1.005-1.045,P0.05)。分层分析结果显示:PM_(2.5)、PM_(10)每升高10μg/m~3,女性COPD患者住院人次增加1.09%、1.14%,差异具有统计学意义(P0.05);≥75岁患者,COPD住院人次增加1.03%、0.99%,差异具有统计学意义(P0.05);而年龄芨60岁、60~75岁、男性以及季节分层分析中,PM_(2.5)、PM_(10)浓度与COPD住院人次无统计学意义(P0.05)。结论:颗粒物污染会增加COPD住院率,≥75岁的老年患者及女性患者更敏感。