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471例克罗恩病患者治疗方案分析 被引量:5
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作者 邬思远 杨川华 +3 位作者 孙伟力 孙筱 张尧 戈之铮 《中国现代医学杂志》 CAS 2019年第17期63-70,共8页
目的回顾分析患者临床表现和治疗方案,为根据病情选择合理治疗方案提供依据。方法根据诊断年份分为2005 ~ 2009 年和2010 ~ 2014 年两组。结果两组临床表现无差异(P >0.05),2010 ~ 2014 年的手术率低于2005 ~ 2009 年(P <0.05),... 目的回顾分析患者临床表现和治疗方案,为根据病情选择合理治疗方案提供依据。方法根据诊断年份分为2005 ~ 2009 年和2010 ~ 2014 年两组。结果两组临床表现无差异(P >0.05),2010 ~ 2014 年的手术率低于2005 ~ 2009 年(P <0.05),合并肛周疾病手术率低,穿透者手术率高。确诊时首先采用内科药物治疗人数2010 ~ 2014 年比2005 ~ 2009 年增加(P <0.05)。5-氨基水杨酸使用率2010 ~ 2014 年低于2005 ~ 2009年(P <0.05),在结肠累及、非狭窄非穿透行为和狭窄的患者中使用率高。免疫抑制剂的使用率2010 ~ 2014 年高于2005 ~ 2009 年(P <0.05),在17 ~ 40 岁、结肠累及和狭窄者中使用率高。抗TNF-α单克隆抗体(英夫利昔)的使用率2010 ~ 2014 年也高于2005 ~ 2009 年(P <0.05),≤ 16 岁、非狭窄非穿透行为和肛周疾病者使用率高。结论诊断时无并发症的患者多采用经典的“升阶梯”方案,而应用英夫利昔的“降阶梯”方案选择的是≤ 16 岁合并肛周疾病的非狭窄非穿透患者;已发生并发症的患者手术率降低,更多狭窄患者使用免疫抑制剂控制疾病活动性;如果条件不允许,则换用加速的“升阶梯”方案,等待时机。总之,针对不同病情采用不同治疗方案最大可能惠及患者。 展开更多
关键词 克罗恩病/胃肠道 硫唑嘌呤 抗TNF-Α单克隆抗体
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A subset of ulcerative colitis with positive proteinase-3 antineutrophil cytoplasmic antibody 被引量:2
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作者 Jin Xu chuan-hua yang +3 位作者 Xiao-Yu Chen Xu-Hang ki Min Dai Shu-Dong Xiao 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第45期7012-7015,共4页
A small subset of patients with active ulcerative colitis is non-responsive to major known non-biological therapies. We reported 5 patients with positive serum proteinase-3 antineutrophil cytoplasmic antibody (PR3-ANC... A small subset of patients with active ulcerative colitis is non-responsive to major known non-biological therapies. We reported 5 patients with positive serum proteinase-3 antineutrophil cytoplasmic antibody (PR3-ANCA) and tried to (1) identify the common clinical features of these patients; (2) investigate the efficacy of a novel therapy using a Chinese medicine compound; and (3) attract more gastroenterologists to be engaged in further study of this subset of patients. The common manifestations of disease in these 5 patients included recurrent bloody diarrhea and inflammatory lesions involving the entire colorectal mucosa. Initial treatment with intravenous methylprednisolone successfully induced remission. Four of these 5 patients were steroid-dependence, and immunosuppressants, such as azathioprine and cyclophosphamide, were in effective. In 3 patients, only the particular Chinese medicine compound could induce and maintain remission. One patient underwent colectomy. No vascular inflammatory lesions were found by histopathological examination. Although more cases are needed for confirmation, our study indicates thatulcerative colitis with positive PR3-ANCA may belong to a subtype of refractory ulcerative colitis. The particular Chinese medicine compound used in our study is by far the most effective in the management of these patients, with additional advantages of having no noticeable side-effects and less financial burden. 展开更多
关键词 Refractory ulcerative colitis Proteinase-3 antineutrophil cytoplasmic antibody Methyprednisolone Steroid-dependence Chinese medicine
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Study on key genes and pathways of myocardial fibrosis and prediction of effective traditional Chinese medicine
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作者 Zhou Zhou Zhen Wang +2 位作者 yang Liu Yong Wang chuan-hua yang 《Journal of Hainan Medical University》 2022年第13期37-45,共9页
Objectives:Bioinformatics was applied to screen the key genes of Myocardial fibrosis,explore its pathogenesis and predict the potential traditional Chinese medicines for the treatment of Myocardial fibrosis.Methods:Ba... Objectives:Bioinformatics was applied to screen the key genes of Myocardial fibrosis,explore its pathogenesis and predict the potential traditional Chinese medicines for the treatment of Myocardial fibrosis.Methods:Based on raw data of gene chip GSE59437 from gene expression database(GEO),myocardial tissue samples from 3 control mice and 3 mice treated with angiotensin II-induced myocardial fibrosis were included.Using R language processing data and screening of gene express significant differences(DEG),use a database of DAVID and the R language finish Gene Ontology(GO)annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment for differences gene,using the STRING database structure protein protein interactions(PPI)networks,using Cytoscape software visualization and use the MCODE plug-in screening key function modules in the network.Coremine Medical database was used to map the key genes,construct the gene-Chinese medicine network,and screen the traditional Chinese medicines for the treatment of myocardial fibrosis.Results:208 DEGs were screened,94 of which were up-regulated and 114 were down-regulated.DEGs is mainly involved in a variety of biological processes such as extracellular matrix remodeling,collagen fiber deposition and lipid metabolism disorders.KEGG pathway enrichment involves Platelet activation,Oxytocin signaling pathway,Insulin secretion,ECM-receptor interaction,GnRH signaling pathway,TNF signaling pathway and other signaling pathways.Key modules of PPI network including:CTGF,TIMP1,SPP1,SERPINE1,COL3A1,POSTN and FOS.The potential traditional Chinese medicines for the treatment of myocardial fibrosis are Astragalus membranaceus(Fisch.),Lepidium apetalum Willd and Salvia miltiorrhiza Bge.Conclusion:Myocardial fibrosis is a complex pathological process,and the genes related to the imbalance of extracellular matrix synthesis and degradation and excessive deposition of collagen fibers play an important role in this process.This study provides a scientific reference for further exploring the pathogenesis of myocardial fibrosis,looking for therapeutic targets and potential therapeutic traditional Chinese medicines. 展开更多
关键词 BIOINFORMATICS Myocardial fibrosis Traditional Chinese traditional Pathological mechanism
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