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成人乳糜泻的临床与内镜特征分析
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作者 史甜 冯燕 +9 位作者 王春 刘欢 李婷 刘卫东 周洪波 艾尼·阿布都热依木 梅歆 郭新文 姜茂森 高峰 《中华内科杂志》 CAS CSCD 北大核心 2023年第1期35-42,共8页
目的分析成人乳糜泻(CD)的临床与内镜特征, 为更有效地诊治CD提供科学依据。方法横断面研究。收集2016年3月至2021年12月在新疆维吾尔自治区人民医院消化科收治的96例CD患者的临床和内镜资料进行回顾性分析。计量资料组间比较采用t检验... 目的分析成人乳糜泻(CD)的临床与内镜特征, 为更有效地诊治CD提供科学依据。方法横断面研究。收集2016年3月至2021年12月在新疆维吾尔自治区人民医院消化科收治的96例CD患者的临床和内镜资料进行回顾性分析。计量资料组间比较采用t检验或非参数检验, 计数资料组间比较采用χ2检验。结果共确诊96例CD患者, 男性33例、女性63例, 男女比例为1∶1.9, 年龄18~81(47±14)岁, 31~60岁年龄段发病为主, 中位病程为2.0 (0.2, 40.0)年。经典型CD患者41例(42.7%), 非经典型CD患者55例(57.3%)。经典型CD患者均表现为慢性腹泻, 常伴有慢性腹痛(46.3%, 19/41)、腹胀(17.1%, 7/41)、贫血(65.9%, 27/41)和慢性疲劳(48.8%, 20/41)。非经典型CD主要表现为慢性腹痛(58.2%, 32/55)、腹胀(32.7%, 18/55), 常伴有贫血(40.0%, 22/55)和骨量减少/骨质疏松(38.2%, 21/55)。与非经典型CD相比, 经典型CD更容易出现贫血, 差异有统计学意义(P=0.012)。CD患者合并症的发生频率为36.5%(35/96), 主要合并症为甲状腺疾病(19.8%, 19/96)、结缔组织病(6.2%, 6/96)和肾脏疾病(6.2%, 6/96)。CD合并疾病在经典型CD与非经典型CD两组间比较差异无统计学意义(P>0.05)。CD患者有内镜下表现的频率为84.4%(81/96)。十二指肠球部内镜下主要表现为结节样改变(72.9%, 70/96), 沟槽样改变(10.4%, 10/96)和局灶性绒毛萎缩(9.4%, 9/96);降部内镜下主要表现为十二指肠皱襞减少、变平或消失(43.8%, 42/96), 扇贝样改变(38.5%, 37/96)和结节样改变(34.4%, 33/96)。结论成人CD患者女性居多, 31~60岁年龄段发病为主。临床表现以非经典型CD临床表现为主, 部分患者常合并其他自身免疫性疾病, 对于有特征性内镜表现的患者应警惕CD的可能。临床医师应加强对CD的认识, 减少漏诊。 展开更多
关键词 乳糜泻 胃镜 成人
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Mechanisms of Huangqi Decoction Granules (黄芪汤颗粒剂) on Hepatitis B Cirrhosis Patients Based on RNA-Sequencing 被引量:12
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作者 CHENG Yang LIU Ping +3 位作者 HOU Tian-lu Maerbiya Maimaitisidike Reyangguli Ababaikeli aini abudureyimu 《Chinese Journal of Integrative Medicine》 SCIE CAS CSCD 2019年第7期507-514,共8页
Objective: To explore the action mechanisms of Huangqi Decoction Granules(黄芪汤颗粒剂, HQDG) on hepatitis B cirrhosis. Methods: A total of 85 patients with hepatitis B cirrhosis were randomly divided into HQDG group(... Objective: To explore the action mechanisms of Huangqi Decoction Granules(黄芪汤颗粒剂, HQDG) on hepatitis B cirrhosis. Methods: A total of 85 patients with hepatitis B cirrhosis were randomly divided into HQDG group(42 cases) and control group(43 cases) by a random number table and were treated with HQDG or placebo for 48 weeks(6 g per times and orally for 3 times a day), respectively. After RNA-sequencing of serum samples extracted from the patients, the differentially expressed genes(DEGs) in HQDG and control groups before and after treatment were separately screened. The DEGs were then performed pathway enrichment analysis and proteinprotein interaction(PPI) network analysis. The expression levels of key genes were detected by quantitative realtime polymerase chain reaction(qRT-PCR). Results: After the investigation, 4 and 3 cases were respectively excluded from HQD and control groups because of the incomplete data. Additionally, 3 and 5 cases were lost to follow up in HQD and control groups, respectively. Finally, a total of 70 cases with good compliance were included for further DEGs analysis. A total of 1,070 DEGs(including 455 up-regulated genes and 615 down-regulated genes) in HQDG group and 227 DEGs(including 164 up-regulated genes and 63 down-regulated genes) in the control group were identified after treatment. Compared with the control group, 1,043 DEGs were specific in HQDG group. Besides, 1 up-regulated transcription factor(TF, such as GLI family zinc finger 1, GLI1) and 25 down-regulated TFs(such as drosophila mothers against decapentaplegic proteinfamily member 2, SMAD2) were identified. Pathway enrichment analysis showed that down-regulated Ras homolog gene family member A(RHOA) was enriched in pathogenic Escherichia coli infection. In the PPI network, up-regulated epidermal growth factor receptor(EGFR), and down-regulated cell division cycle 42(CDC42) as well as v-akt murine thymoma viral oncogene homolog 1(AKT1) had higher degrees. Moreover, long non-coding RNAs(lncR NA) growth arrest-specific 5(GAS5) was involved in the lncR NA-target regulatory network. Furthermore, qR T-PCR revealed that expression levels of CDC42 and GLI1 had significant differences in HQDG group before and after treatment(P<0.05). Conclusions: CDC42 and GLI1 may be the targets of HQDG in patients with hepatitis B cirrhosis. Additionally, SMAD2, EGFR, AKT1, RHOA and GAS5 might be associated with the curative effect of HQDG on hepatitis B cirrhosis patients. 展开更多
关键词 hepatitis B cirrhosis Huangqi DECOCTION GRANULES DIFFERENTIALLY expressed gene transcription factor long NON-CODING RNAS Chinese medicine
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