Objective To investigate the intervention effect of 3-phosphoinositede dependent protein kinase-1 (PDK1) inhibitor on prostaglandin E2 (PGE2) in smoking-induced chronic obstructive pulmonary disease (COPD) mice. Methods Fifty C57BL/6 male mice were randomly divided into normal control group, smoking group, smoking +low dose PDK1 inhibitor group, smoking + medium dose PDK1 inhibitor group and high dose PDK1 inhibitor group with 10 mice in each group. The mice in the normal control group inhaled phosphate-buffered saline twice a day for 12 weeks, and the mice in the smoking group were fumigated twice a day, 5 days per week for 12 weeks, and the other three groups were given intraperitoneal injection of low-dose PDK1 inhibitor OSU-03012 (0.25 mg/kg), medium-dose PDK1 inhibitor (0.5 mg/kg) and high-dose PDK1 inhibitor (1.0 mg/kg) respectively before smoking. After smoking, lung function was tested, the bronchoalveolar lavage fluid (BALF) of each mouse was taken for cell count, the PGE2 in serum and BALF of mice was determined by enzyme linked immunosorbent assay, and the lung tissue of mice was sectioned with paraffin and stained by hematoxylin-eosin (HE), and pathological changes were observed under microscope. Results Compared with the control group, FEV100/FVC and FEV200/FVC of the mice in each smoking group were significantly decreased (P<0.05); The number of cells in BALF of smoking group was significantly higher than that of normal control group (P<0.05). There was no significant difference in the total number of BALF cells, the proportion of neutrophils and macrophages between the smoking + low-dose PDK1 inhibitor group and the smoking group. However, the total number of BALF cells and the proportion of neutrophils in the smoking + medium dose PDK1 inhibitor group and the high dose PDK1 inhibitor group gradually decreased, while the proportion of macrophages gradually increased, compared with the normal control group, the PGE2 concentrations of serum and BALF in the smoking group and the smoking + PDK1 inhibitor group were significantly higher than those in the control group. Compared with the smoking group, the PGE2 concentrations of serum and BALF in the middle and high dose PDK1 inhibitor groups were significantly lower than those in the smoking group. HE staining of lung tissue showed that there were a large number of inflammatory cell infiltration, alveolar cavity dilatation, alveolar wall rupture and fusion, alveolar formation, significant decrease in the number of alveoli and other pathological changes in the smoking group, which were consistent with the pathological changes of COPD. The inflammatory cell infiltration, mucus obstruction and alveolar dilatation were slightly alleviated in the smoking + low-dose PDK1 inhibitor group, while the inflammatory cell infiltration, alveolar wall thinning and alveolar dilatation were improved in both the medium-dose inhibitor group and the high-dose inhibitor group, and the improvement was more obvious in the high-dose inhibitor group. Conclusion The lung function of the smoked COPD mouse decreases, the airway inflammation is obvious, and the secretion of PGE2 is also increased, while the use of PDK1 inhibitor could reduce the secretion of PGE2, reduce airway inflammation and pathological changes, and improve lung function in a dose-dependent manner.
【摘要】 目的 探討住院患者肝功異常病因及影像學診斷意義。方法 對2008年1月—12月住院的223例18～83歲肝功異常患者進行相關實驗室檢查,以及B超、CT和MRI檢查。結果 肝臟本身疾病引起135例,占6054%,肝外疾病引起83例,占37.22%,原因不明5例,占2.24%。B超作為無創性檢查,價格低亷,準確率高,可作為常規檢查。結論 住院患者肝功損害病因復雜,以藥物性肝炎、膽道系統疾病及脂肪肝較多見。
目的:探討青年人群中脂肪肝的相關危險因素。方法:收集2008年在我院體檢中心同期體檢,年齡≤45歲脂肪肝患者127人,非脂肪肝患者116人,詢問病史,進行身高、體重、血生化及B超檢查并分脂肪肝組和非脂肪肝組進行比較。結果:脂肪肝組肥胖、飲酒、高血脂、高血糖、肝功異常發病率明顯高于對照組。結論:肥胖、飲酒是脂肪肝的重要危險因素,脂肪肝患者多伴有糖脂代謝紊亂及肝功受損。
【摘要】 目的 總結慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD） 患者院外用藥情況，并分析其院外用藥情況、痰真菌檢出率以及激素不良反應發生率的變化。 方法 調查2011年1-6月住院的161 例COPD 患者院外用藥情況，將其分為遵醫囑使用糖皮質激素組（A組，包括口服和吸入激素）、使用非準字號藥物組（B組）和未使用以上兩種藥物組（C組），對各組的痰真菌檢出率進行統計學分析，并對A、B組激素不良反應的發生率進行分析。再將現階段的調查結果與2006年同樣研究結果進行比較。 結果 161例患者中使用口服糖皮質激素6例，使用吸入激素29例，使用非準字號藥物32例，未使用以上兩種藥物94例。痰真菌檢出率情況:B組檢出率為62.5%，明顯高于A組的17.14%、C組的27.66%；組間比較有統計學意義（Plt;0.001）。B組的藥物不良反應發生率為37.5%；A組中口服激素發生率為50%，而使用吸入激素發生率為0%。與2006年同樣研究結果比較，B組患者的比例明顯下降，A組患者明顯增多。 結論 使用非準字號藥物的患者，真菌感染的危險性及激素不良反應的發生率較高，健康教育對于減少這些不良現象的發生發揮了重要作用。【Abstract】 Objective To investigate the use of drugs in patients with chronic obstructive pulmonary disease (COPD) outside the hospital, and analyze the detection rate of fungus and the side effects of glucocorticosteroids (GCs), and their changes. Methods We investigated the drugs used outside the hospital in 161 patients with stable COPD between January and June 2011, who were divided into prescribed medication GCs group (group A, including oral GCs group and inhaled GCs group), drugs without authorization by SFDA (DWAS) group (group B) and other drugs group (group C). Then we made a statistical analysis on the detection rate of fungus, and the incidence rate of the side effects of GCs in the three groups. Finally we compared the present findings with the similar studies five years ago. Results Among the 161 patients, 6 took oral GCs, 29 used inhaled GCs, 32 used DWAS, and 94 used other drugs. The detection rate of fungus in group B was 62.5%, obviously higher than the other groups (17.14% in group A, and 27.66% in group B, Plt;0.05). The rate of side effects of GCs in group B was 37.5%, and 50% in oral GCs group, while no side effects of GCs was found in the inhaled GCs group. Compared with the similar study five years ago, the use of DWAS decreased, and the use of prescribed medication GCs among the patients increased significantly. Conclusions Patients taking DWAS have a high incidence rate of mycotic infection and side effects of GCs. Health education plays an important role in reducing the occurrences of these undesirable phenomena.
【Abstract】ObjectiveTo investigate whether heme oxygenase-1 can alleviate the ischemiareperfusion injury of the aged donor liver. MethodsThe activity of superoxide dismutase (SOD) and catalase (CAT), and the contents of tocopherol (Vit E), ascorbic acid (Vit C) and malondialdehyde (MDA) were measured in the livers of adult SD rats (n=5) and aged SD rats (n=5). The experimental aged donor group (n=30) received intraperitoneal injection of Hemin 24 hours before operation, the control aged donor group(n=30) received saline. The histologic changes and apoptosis in the donor liver were observed. ResultsThe activity of SOD and the contents of Vit E and Vit C decreased significantly in 5 aged rats（P＜0.05）, but the content of MDA increased（P＜0.05）. Before the harvesting of the grafts, the activity of SOD and the contents of Vit E and Vit C increased significantly in rats pretreated with Hemin （P＜0.05） and the content of MDA decreased（P＜0.05）. The apoptotic cells in the livers pretreated with Hemin also decreased significantly after reperfusion（P＜0.05）. ConclusionThe liver of aged rat presents oxidative stress and peroxidative state. Ischemia-reperfusion injury can be alleviated by the induction of HO-1.
Objective To evaluate the efficacy and safety of domestic ambroxol hydrochloride injection in the treatment of lower respiratory tract infection. Methods A total of 120 patients with respiratory tract infections were included and randomized into the treatment group (ambroxol hydrochloride injection 30mg, iv, q12h) and the control group (mucosolvan ampoule 30mg, iv, q12h). The duration of treatment was 6 days. Results 118 patients completed the trial, 59 in each group. From Day 1 to Day 6, the severity scores of cough, sputum amount, difficulty in expectoration and rales were similar between the two groups (Pgt;0.05), but a significant difference was observed in the nature of sputum (Plt;0.05). The total effective rates of the treatment group and the control group were 96.6% (FAS analysis and PP analysis) or 93.3% (FAS analysis), and 94.9% (PP analysis), respectively. There was no significant difference between the two groups (Pgt;0.05). The incidence of adverse effects was comparable between the two groups (1.7% vs. 0%, Pgt;0.05), and no severe adverse effect was observed. Conclusion The efficacy of domestic ambroxol hydrochloride injection in the treatment of lower respiratory infection was equal to that of mucosolvan ampoule, and it can even further improve the nature of sputum. Ambroxol hydrochloride was as safe as mucosolvan ampoule.
Objective To study the effect of preoperative urination training combined with restrictive fluid therapy with enhanced recovery after surgery (ERAS) on postoperative urination in total knee arthroplasty (TKA) patients. Methods A total of 150 patients who were conducted the unilateral TKA from March to May 2018 were divided into two groups, the trial group and the control group, with 75 patients in each group. The patients in the control group did not undergo urination training before surgery and were given liberal intravenous fluid therapy on the day of surgery; while the patients in the trial group received urination training before surgery and were given restrictive fluid therapy on the day of surgery. The pre-, intra-, and post-operative infusion volume and the total infusion volume on the day of surgery of the two groups were recorded; and the urination situation, urination time for the first time and the hospital days in the two groups were compared. Results The total infusion volume on the day of surgery in the trial group and the control group was (1 581.40±277.54) and (2 395.00±257.40) mL, respectively. After operation, in the trial group, there were 73 patients with smooth urinating, 2 with smooth urinating after inducing method, and none with urethral catheterization; in the control group, there were 66 patients with smooth urinating, 3 with smooth urinating after inducing method, and 6 with urethral catheterization. The urination time for the first time after operation in the trial group and the control group was (1.85±0.91) and (2.93±1.48) hours after back to the ward, respectively. These differences between the two groups were statistically significant (P<0.05). The hospital stay in the trial group and the control group was (5.86±2.48) and (6.28±1.60) days, respectively, and the difference between the two groups was not statistically significant (P>0.05). Conclusions Preoperative urination training combined with restrictive fluid therapy (the total infusion volume controls in about 1 500 mL on the day of surgery) in the TKA patients after ERAS is good for postoperation urination. It also can reduce the rate of postoperative urinary retention, and enhance rehabilitation.
目的 評估中醫藥臨床研究是否與我國主要疾病負擔相關。 方法 首先從1999年－2004年出版的13種中醫、中西醫結合雜志中手工檢索出隨機對照試驗（RCT），并提取出雜志名稱、出版年限、治療的疾病類別及樣本含量等數據。然后采用死亡率和傷殘調整壽命年（DALY）作為衡量標準，統計2002年我國疾病負擔前30位病因的RCT數量，采用秩相關分析這些疾病負擔與發表的中醫藥RCT及其受試者數量的關系。 結果 最終確認7 422個RCT，約38%的RCT來自于3種國家級雜志。這些RCT覆蓋了我國疾病負擔中的主要病種，其中4 280個RCT（57.7%）研究前30位病因合并產生的42個病種，只有3個病種（7%）沒有任何RCT研究。采用DALY得到的相關系數分別是0.108（P=0.569）、0.092（P=0.628），通過死亡率產生的相關系數分別是0.453（P=0.012）、0.536（P=0.002）。 結論 中醫藥RCT與采用死亡率衡量的疾病負擔明顯相關，但采用DALY分析卻未發現二者存在相關性。中醫藥臨床研究可能更注重死亡率高的病種，一定程度上忽略了DALY衡量的疾病負擔。
Objectives To evaluate the effect and safety of mycobacterium vaccae in the treatment of recurrent treated pulmonary tuberculosis. Methods We searched PubMed (1997 to 2006), VIP (1997 to 2006), Wanfang database (1997 to 2006), The Cochrane Central Register of Controlled Trials (Issue 4, 2006) and the National Research Register (1996 to 2006). Randomized controlled trials comparing the mycobacterium vaccae immunotherapy group and the control group were included. Two reviewers independently performed data extraction and quality assessment. Data were analyzed using RevMan 4.2.2 software by The Cochrane Collaboration. Results Eleven high quality trials were included. Meta-analyses showed that mycobacterium vaccae immunotherapy plus chemotherapy resulted in higher sputum negative conversion rate (RR=1.36, 95%CI 1.21 to 1.54), higher lesion absorption rate (RR=1.39, 95%CI 1.13 to 1.72), and lower lesion non-absorption rate (RR=0.46, 95%CI 0.36 to 0.60), compared with the control group. These differences were all statistically significant. No serious adverse events were reported. Conclusion As an adjunct to chemotherapy, mycobacterium vaccae is helpful for patients with recurrent treated pulmonary tuberculosis in terms of improving cell-medicated immunity, sputum negative conversion and X-ray manifestation. More high quality studies are needed for further analysis.
Objective To systematically assess the effectiveness of traditional Chinese medicines (TCM) in treating upper airway cough syndrome (UACS) or postnasal drip syndrome (PNDS). Methods Such databases as MEDLINE (1950 to 2011), PubMed (1996 to 2011), VIP (1989 to 2011), WanFang Data (1998 to 2011), CNKI (1979 to 2011) and CBM (1978 to 2011) were searched for collecting the randomized controlled trials (RCT) or quasi-RCTs about TCM treating UACS/PNDS. The trials were screened according to the inclusive and exclusive criteria, and then after the quality assessment and data extraction were conducted, the statistical analysis was conducted by using RevMan 5.0 software. Results A total of 10 RCTs and quasi-RCTs in Chinese were identified. The results of analysis showed that: a) The integrated Chinese and western medicine was superior to western medicine alone, either for adults and children with UACS, or for adults with PNDS. However the effectiveness had to be further assessed due to lack of high-quality literatures; b) TCM alone was probably more effective than western medicine alone for adults with PNDS, but not for adults and children with UACS. No obvious adverse reaction related to TCM was reported. Conclusion The recent research outcomes show that the integrated Chinese and western medicine is superior to western medicine alone, either for adults and children with UACS, or for adults with PNDS, but no definite evidence is found to support the superiority of TCM in treating UACS/PNDS. More high-quality RCTs with large scale need to be conducted in future to verify this conclusion due to the overall low methodological quality and significantly different intervention of the included trials.