Comparison of early changes in ocular surface markers and tear inflammatory mediators after femtosecond lenticule extraction and FS-LASIK

AIM:To compare the short-term impacts of femtosecond lenticule extraction(FLEx)and femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)on ocular surface measures and tear inflammatory mediators.METHODS:This prospective comparative nonrandomized clinical study comprised 75 eyes(75 patients).Totally 20 male and 15 female patients(age 21.62±3.25 y)with 35 eyes underwent FLEx,and 26 male and 14 female patients(age 20.18±3.59 y)with 40 eyes underwent FS-LASIK.Central corneal sensitivity,noninvasive tear breakup time,corneal fluorescein staining,Schirmer I test,tear meniscus height,and ocular surface disease index were evaluated in all patients.Tear concentrations of nerve growth factor(NGF),interleukin-1α(IL-1α),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),and matrix metalloproteinase-9(MMP-9)were assessed by multiplex antibody microarray.All measurements were performed preoperatively,and 1 d,1 wk,and 1 mo postoperatively.RESULTS:Patients who underwent FLEx exhibited a more moderate reduction in central corneal sensation and less corneal fluorescein staining than those in the FS-LASIK group 1 wk after the procedure(P<0.01).NGF was significantly higher 1 d and 1 wk after surgery in the FS-LASIK group than in the FLEx group(P<0.01).By contrast,compared to those in the FLEx group,higher postoperative values and slower recovery of tear TGF-β1,IL-1α,and TNF-αconcentrations were observed in the FS-LASIK group(P<0.01).Tear concentrations of NGF,TGF-β1,TNF-α,and IL-1αwere correlated with ocular surface changes after FLEx or FS-LASIK surgery.CONCLUSION:There is less early ocular surface disruption and a reduced inflammatory response after FLEx than after FS-LASIK.NGF,TGF-β1,TNF-α,and IL-1αmay contribute to the process of ocular surface recovery.

Effect of Yanhuning in combined with azithromycin on the inflammatory cytokines and immunological function in children with mycoplasma pneumonia

Objective: To explore the effect of Yanhuning in combined with azithromycin on the inflammatory cytokines and immunological function in children with mycoplasma pneumonia. Methods: A total of 130 children with mycoplasma pneumonia were included in the study and randomized into the treatment group (n=65) and the control group (n=65). The patients in the control group were given azithromycin. On the above basis, the patients in the treatment group were given Yanhuning. The patients in the two groups were continuously treated for 7 d. The levels of serum inflammatory cytokines and immunological function indicators before and after treatment in the two groups were detected and compared. Results: When compared with before treatment, the serum IL-2 level after treatment in the two groups was significantly elevated, while IL-4, IL-10, IL-13, IL-6, TNF-α, and IFN-γ levels were significantly reduced;moreover, the improvement in the treatment group was significantly superior to that in the control group. When compared with before treatment, CD3+, CD4+, and CD4+/CD8+ after treatment in the two groups were significantly elevated, and those in the treatment group were significantly higher than those in the control group, while CD8+ was significantly reduced, but the comparison between the two groups was not statistically significant. When compared with before treatment, RBC-C3bR after treatment in the two groups was significantly elevated, while RBC-ICR was significantly reduced;moreover, the improvement in the treatment group was significantly superior to that in the control group. Conclusions: Yanhuning in combined with azithromycin in the treatment of mycoplasma pneumonia in children can significantly enhance the immunological function, and reduce the inflammatory reaction, with an effect significantly superior to that by single application of azithromycin.

Bile acids and their receptors: Potential therapeutic targets in inflammatory bowel disease

Chronic and recurrent inflammatory disorders of the gastrointestinal tract caused by a complex interplay between genetics and intestinal dysbiosis are called inflammatory bowel disease.As a result of the interaction between the liver and the gut microbiota,bile acids are an atypical class of steroids produced in mammals and traditionally known for their function in food absorption.With the development of genomics and metabolomics,more and more data suggest that the pathophysiological mechanisms of inflammatory bowel disease are regulated by bile acids and their receptors.Bile acids operate as signalling molecules by activating a variety of bile acid receptors that impact intestinal flora,epithelial barrier function,and intestinal immunology.Inflammatory bowel disease can be treated in new ways by using these potential molecules.This paper mainly discusses the increasing function of bile acids and their receptors in inflammatory bowel disease and their prospective therapeutic applications.In addition,we explore bile acid metabolism and the interaction of bile acids and the gut microbiota.

Immune response modulation in inflammatory bowel diseases by Helicobacter pylori infection

Many studies point to an association between Helicobacter pylori(H.pylori)infection and inflammatory bowel diseases(IBD).Although controversial,this association indicates that the presence of the bacterium somehow affects the course of IBD.It appears that H.pylori infection influences IBD through changes in the diversity of the gut microbiota,and hence in local chemical characteristics,and alteration in the pattern of gut immune response.The gut immune response appears to be modulated by H.pylori infection towards a less aggressive inflammatory response and the establishment of a targeted response to tissue repair.Therefore,a T helper 2(Th2)/macrophage M2 response is stimulated,while the Th1/macrophage M1 response is suppressed.The immunomodulation appears to be associated with intrinsic factors of the bacteria,such as virulence factors-such oncogenic protein cytotoxin-associated antigen A,proteins such H.pylori neutrophil-activating protein,but also with microenvironmental changes that favor permanence of H.pylori in the stomach.These changes include the increase of gastric mucosal pH by urease activity,and suppression of the stomach immune response promoted by evasion mechanisms of the bacterium.Furthermore,there is a causal relationship between H.pylori infection and components of the innate immunity such as the NLR family pyrin domain containing 3 inflammasome that directs IBD toward a better prognosis.

Transmembrane serine protease 2 and angiotensin-converting enzyme 2 anti-inflammatory receptors for COVID-19/inflammatory bowel diseases treatment

long-term,and relapsing inflammatory disorders.IBD may spontaneously grow in the colon,and in severe cases may result in tumor lesions such as invasive carcinoma in inflamed regions of the intestine.Recent epidemiological reports indicate that old age and underlying diseases such as IBD contribute to severity and mortality in patients with coronavirus disease 2019(COVID-19).Currently,the ongoing COVID-19 pandemic caused serious morbidity and mortality worldwide.It has also been shown that the transmembrane serine protease 2 is an essential factor for viral activation and viral engulfment.Generally,viral entry causes a'cytokine storm'that induces excessive generation of proinflammatory cytokines/chemokines including interleukin(IL)-6,IL-2,IL-7,tumor necrosis factor-α,and interferon-γ.Future research could concentrate on developing inflammatory immunological responses that are efficient to encounter COVID-19.Current analysis elucidates the role of inflammation and immune responses during IBD infection with COVID-19 and provides a list of possible targets for IBD-regulated therapies in particular.Data from clinical,in vitro,and in vivo studies were collected in English from PubMed,Google Scholar,Scopus,and the Cochrane library until May 2021.

Effect of Kangfuxin solution on inflammatory, immune, oxidative indexes and vascular factors in patients with ulcerative colitis

Objective:To explore the effect of Kangfuxin solution on inflammatory, immune, oxidative indexes and vascular factorsin patients with ulcerative colitis.Methods: 172 cases of ulcerative colitis from August 2015 to February 2017 were selected and divided into control group (n=86) and observation group (n=86) according to random principle, the control group was treated with Mesalazin Enteric-coated Tablets, and the observation group was treated with enema by infusion of rectal drip on the basis of the control group, and the levels of the two groups of inflammatory factors, immune indexes, oxidation indexes and vascular factors were compared.Results: After treatment, the total effective rate of the observation group (88.37%) was significantly higher than that of the control group (73.26%) (P<0.05);the two groups of CRP and TNF-α were significantly lower than those before treatment (P<0.05), and the observation group was significantly lower than that of the control group (P<0.05);the two groups of CD4+, CD4+/CD8+ and SOD increased significantly compared with those before treatment (P<0.05), while CD8+, MDA and LOP were significantly lower than those before treatment (P<0.05), and the CD4+, CD4+/CD8+ and SOD in the observation group were significantly higher than those in the control group (P<0.05), while CD8+, MDA and LOP were significantly lower than those in the control group (P<0.05);The levels of VEGF and PDGF in both groups were significantly higher than those before treatment (P<0.05), and the levels of VEGF and PDG in observation group were significantly higher than those in control group (P<0.05).Conclusions:The combined treatment of Kangfuxin Liquid and mesalazine can significantly improve the clinical efficacy of the patients. The mechanism of its action is related to reducing the inflammatory response and enhancing the immune, antioxidant functionsand vascular factors. It is worthy of further study in clinical.

Ophthalmic manifestations in patients with inflammatory bowel disease: a review

Clinical manifestations of inflammatory bowel disease(IBD) are not locally restricted to the gastrointestinal tract, and a significant portion of patients have involvement of other organs and systems. The visual system is one of the most frequently affected, mainly by inflammatory disorders such as episcleritis, uveitis and scleritis. A critical review of available literature concerning ocular involvement in IBD, as it appears in Pub Med, was performed. Episcleritis, the most common ocular extraintestinal manifestation(EIM), seems to be more associated with IBD activity when compared with other ocular EIMs. In IBD patients, anterior uveitis has an insidious onset, it is longstanding and bilateral, and not related to the intestinal disease activity. Systemic steroids or immunosuppressants may be necessary in severe ocular inflammation cases, and control of the underlying bowel disease is important to prevent recurrence. Our review revealed that ocular involvement is more prevalent in Crohn's disease than ulcerative colitis, in active IBD, mainly in the presence of other EIMs. The ophthalmic symptoms in IBD are mainly nonspecific and their relevance may not be recognized by the clinician; most ophthalmic manifestations are treatable, and resolve without sequel upon prompt treatment. A collaborative clinical care team for management of IBD that includes ophthalmologists is central for improvement of quality care for these patients, and it is also cost-effective.

Ocular diseases: immunological and molecular mechanisms

Many factors, such as environmental, microbial and endogenous stress, antigen localization, can trigger the immunological events that affect the ending of the diverse spectrum of ocular disorders. Significant advances in understanding of immunological and molecular mechanisms have been researched to improve the diagnosis and therapy for patients with ocular inflammatory diseases. Some kinds of ocular diseases are inadequately responsive to current medications;therefore, immunotherapy may be a potential choice as an alternative or adjunctive treatment, even in the prophylactic setting. This article first provides an overview of the immunological and molecular mechanisms concerning several typical and common ocular diseases; second, the functions of immunological roles in some of systemic autoimmunity will be discussed; third, we will provide a summary of the mechanisms that dictate immune cell trafficking to ocular local microenvironment in response to inflammation.

烧山火针刺法联合甲氨蝶呤治疗类风湿关节炎活动期的效果及其对患者炎症因子和免疫功能的影响

目的 观察烧山火针刺法联合甲氨蝶呤治疗类风湿关节炎(RA)活动期的效果,并探讨其抗炎和调节免疫作用机制。方法 选取2020年2月至2022年10月郑州市第一人民医院收治的60例RA活动期患者纳入研究,按照随机数表法分为常规组和联合组各30例。常规组患者给予甲氨蝶呤治疗,联合组患者给予烧山火针刺法联合甲氨蝶呤治疗,均治疗两周。于治疗两周后比较两组患者的治疗效果,以及治疗前后的中医证候评分、28个关节疾病活动(DAS28)评分、疼痛(VAS)评分、炎性指标[血沉(ESR)、C反应蛋白(CRP)、肿瘤坏死因子-α (TNF-α)、类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体]、免疫指标(Treg细胞、Th17细胞、Treg/Th17细胞),同时比较两组患者治疗期间的不良反应发生情况。结果 联合组患者的治疗总有效率为93.33%,明显高于常规组的73.33%,差异有统计学意义(P<0.05);联合组患者治疗两周后的中医证候关节肿胀、冷痛、压痛、晨僵、屈伸不利评分分别为(0.72±0.18)分、(0.70±0.20)分、(0.81±0.22)分、(0.68±0.15)分、(0.77±0.19)分,明显低于常规组的(1.03±0.24)分、(0.96±0.23)分、(1.14±0.26)分、(0.91±0.21)分、(1.09±0.23)分,差异均有统计学意义(P<0.05);联合组患者治疗两周后的DAS28、VAS评分分别为(2.18±0.33)分、(2.46±0.22)分,明显低于常规组的(3.26±0.47)分、(2.89±0.27)分,差异均有统计学意义(P<0.05);联合组患者治疗两周后的ESR、抗CCP抗体、RF、CRP、TNF-α水平分别为(16.23±2.29) mm/h、(172.30±30.14) IU/mL、(130.85±15.42) IU/mL、(10.20±1.68) mg/L、(18.95±4.38) pg/mL,明显低于常规组的(21.84±3.41) mm/h、(205.68±36.77) IU/mL、(157.62±24.10) IU/mL、(13.65±2.06) mg/L、(24.51±6.02) pg/mL,差异均有统计学意义(P<0.05);联合组患者治疗两周的外周血Treg细胞百分比、Treg/Th17比值分别为(2.61±0.35)%、2.44±0.37,明显高于常规组的(2.17±0.28)%、1.68±0.32,Th17细胞百分比为(1.07±0.18)%,明显低于常规组的(1.29±0.22)%,差异均有统计学意义(P<0.05);两组患者治疗期间的不良反应发生率差异无统计学意义(P>0.05)。结论 烧山火针刺法联合甲氨蝶呤治疗RA活动期能明显减轻患者的临床症状,降低炎症反应,调节免疫功能,临床应用疗效显著,且安全性良好。

基于骨免疫学论中医药抑制类风湿关节炎骨破坏的研究进展

类风湿关节炎(RA)是一种以滑膜炎、软骨与骨破坏为主要病理表现的自身免疫性疾病,致残率较高。RA免疫及炎症反应与骨细胞代谢互为影响,其核心环节为破坏机体核因子κB受体活化因子配体/核因子κB受体活化因子/骨保护素(RANKL/RANK/OPG)信号通路的平衡,导致成骨细胞减少,以及破骨细胞凋亡减退及异常活化。西药目前以抑制炎症反应及相关细胞因子分泌,减缓疾病进展,但长期使用其不良反应难以忽视。中医药在防治骨破坏中研究逐步深入,但在基础及临床研究方面仍存在一定局限性。

免疫治疗联合抗血管生成治疗在晚期非小细胞肺癌患者中的应用效果

目的探讨免疫治疗联合抗血管生成治疗在晚期非小细胞肺癌(NSCLC)患者中的应用效果。方法依据治疗方法的不同将82例晚期NSCLC患者分为观察组(n=49)和对照组(n=33),两组均给予化疗,在此基础上,对照组患者接受抗血管生成药物贝伐珠单抗治疗,观察组患者接受卡瑞利珠单抗联合贝伐珠单抗治疗。比较两组患者的临床疗效、T淋巴细胞亚群(CD3+、CD4+、CD4+/CD8+)、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、生活质量[卡氏功能状态(KPS)评分]及不良反应发生情况。结果观察组患者的客观缓解率为34.69%,高于对照组患者的12.12%(P﹤0.05),疾病控制率为87.76%,高于对照组患者的66.67%(P﹤0.05)。治疗后,两组患者CD3+、CD4+水平和CD4+/CD8+均高于本组治疗前,观察组患者CD3+、CD4+水平和CD4+/CD8+均高于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者TNF-α、IL-6水平均低于本组治疗前,KPS评分均高于本组治疗前,观察组患者TNF-α、IL-6水平均低于对照组,KPS评分高于对照组,差异均有统计学意义(P﹤0.05)。两组患者不良反应发生率比较,差异均无统计学意义(P﹥0.05)。结论免疫治疗联合抗血管生成治疗对晚期NSCLC的治疗效果较好,可改善机体免疫功能,减轻炎症反应,提高生活质量,安全性相对较高。

乙型肝炎相关慢加急性肝衰竭免疫损伤机制研究进展

乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)定义为在乙型肝炎病毒(HBV)引起的慢性肝病(包括肝硬化和非肝硬化)基础上,表现为肝功能急性失代偿合并肝脏或肝外器官衰竭的一组具有短期高病死率的临床综合征。该病以短期高病死率和显著的全身炎症反应为特征,其发病是一个动态变化的复杂过程,目前机制并不明确,“三重打击”是较为公认的学说,免疫损伤在其中发挥重要作用,本文将重点阐述HBV-ACLF患者免疫炎症损伤相关研究进展。

白芍总苷胶囊联合甲氨蝶呤治疗类风湿关节炎患者的效果

目的:观察白芍总苷胶囊联合甲氨蝶呤治疗类风湿关节炎患者的效果。方法:选取2021年1月—2023年9月蚌埠医科大学第二附属医院收治的71例类风湿关节炎患者作为研究对象,按照随机数表法将患者分为研究组(n=36)和对照组(n=35)。对照组给予甲氨蝶呤治疗,研究组在对照组基础上给予白芍总苷胶囊,比较两组治疗效果、免疫功能、中医症候积分、炎症因子、骨代谢及不良反应。结果:研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,治疗后,两组CD3^(+)、CD4^(+)、N端骨钙素(N-terminal middle osteocalcin,N-MID)、总I型胶原氨基端延长肽(total typeⅠcollagen amino terminal extension peptide,T-PⅠNP)、骨碱性磷酸酶(bone alkaline phosphatase,BALP)水平高于治疗前,中医症候积分和CD8^(+)、β-骨胶原交联(β-crosslaps,β-CTX)、白细胞介素-6(interleukin-6,IL-6)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)水平低于治疗前,且研究组优于对照组,差异有统计学意义(P<0.05)。研究组不良反应发生率高于对照组,但差异无统计学意义(P>0.05)。结论:白芍总苷胶囊联合甲氨蝶呤治疗类风湿关节炎能显著缓解关节炎症刺激,改善机体免疫功能和骨代谢,促进临床症状好转,治疗安全性和实用性较高。

喉咽清口服液联合重组人干扰素a2b雾化对小儿疱疹性咽峡炎血清炎症因子及免疫功能的影响

目的探讨重组人干扰素a2b治疗小儿疱疹性咽峡炎的基础上加用喉咽清口服液对患儿临床疗效、炎症因子及免疫功能的影响。方法选取济南市儿童医院2021年1月至2022年6月收治的90例疱疹性咽峡炎患儿作为研究对象,按照随机数表法将其分为对照组和观察组,每组各45例。对照组给予重组人干扰素a2b治疗,观察组给予喉咽清口服液+重组人干扰素a2b治疗,5 d为1个疗程。比较两组患儿症状消失时间及恢复进食时间,治疗前及治疗5 d结束时进行C反应蛋白、降钙素原、肿瘤坏死因子α、T淋巴细胞亚群测定,评估治疗5 d后的临床效果,并统计不良反应事件发生情况。结果观察组退热时间、疱疹消失时间、流涎消失时间、咽痛消失时间、恢复进食时间短于对照组,差异有统计学意义(P<0.05)。与治疗前及对照组治疗后比较,观察组治疗后血清C反应蛋白、降钙素原、肿瘤坏死因子α明显降低,差异有统计学意义(P<0.05)。与治疗前及对照组治疗后比较,观察组治疗后CD4^(+)、CD4^(+)/CD8^(+)明显升高,CD8^(+)明显降低,差异有统计学意义(P<0.05)。观察组治疗总有效率为95.56%(43/45),明显高于对照组的77.78%(35/45),差异有统计学意义(P<0.05)。两组患儿治疗期间均未出现严重不良反应,个别患儿出现厌食。结论重组人干扰素a2b治疗小儿疱疹性咽峡炎的基础上加用喉咽清口服液,可快速缓解患儿临床症状,提升临床治疗效果,同时可有效减轻患儿炎症反应及调节免疫球蛋白水平,提高机体免疫功能,且安全性较高。

红大戟醇提物灌胃对小鼠支气管哮喘的治疗作用及其机制

目的观察红大戟醇提物灌胃对支气管哮喘(简称哮喘)小鼠呼吸功能的改善作用,并探讨其可能的机制。方法将32只Balb/c雌性小鼠适应性喂养1周,随机分为正常对照组、模型组、地塞米松组、红大戟醇提物组,每组8只。模型组、地塞米松组、红大戟醇提物组以腹腔注射及雾化卵蛋白(OVA)激发液的方式建立哮喘模型,红大戟醇提物组、地塞米松组分别给予红大戟醇提物200 mg/kg、地塞米松1 mg/kg灌胃,正常对照组和模型组均给予等量生理盐水灌胃。各组末次雾化激发第2天,使用全身体积描记系统检测0、6.25、12.5、25、50、100 mg/mL乙酰甲胆碱(Mch)作用后的气道反应性指标呼气间歇(Penh)值,采用ELISA法检测血清总免疫球蛋白E(IgE)、卵清蛋白特异性IgE抗体(OVA-IgE)和支气管肺泡灌洗液(BALF)中的Th1细胞因子γ-干扰素(IFN-γ)、Treg细胞因子白细胞介素10(IL-10)以及Th2细胞因子(IL-4、IL-5、IL-9、IL-13)。各组小鼠处死后取右肺中叶组织,HE及PAS染色后观察肺组织病理情况。结果与正常对照组同浓度Mch作用后比较,模型组小鼠25、50、100 mg/mL Mch作用后的Penh值均升高(P均<0.05)。与模型组同浓度Mch作用后比较,地塞米松组、红大戟醇提物组小鼠50、100 mg/mL Mch作用后的Penh值均降低(P均<0.05)。与正常对照组比较,模型组小鼠血清总IgE、OVA-IgE水平均升高,BALF中IL-10、IFN-γ水平均降低而IL-4、IL-5、IL-9、IL-13水平均升高(P均<0.05)。与模型组比较,地塞米松组、红大戟醇提物组小鼠血清总IgE、OVA-IgE水平均降低,BALF中IL-10、IFN-γ水平均升高而IL-4、IL-5、IL-9、IL-13水平均降低(P均<0.05)。与正常对照组比较,模型组小鼠肺组织出现气道炎症细胞浸润、杯状细胞增生和黏液高分泌等病理改变;与模型组比较,地塞米松组、红大戟醇提物组小鼠肺组织上述病理改变明显减轻。结论红大戟醇提物灌胃有助于降低哮喘小鼠的气道反应性及肺组织炎症反应、黏液分泌等,其机制可能与恢复Th1/Th2的免疫平衡有关。

肺炎一号合剂对社区获得性肺炎儿童免疫功能和临床预后的影响

目的:分析中药制剂“肺炎一号合剂”对社区获得性肺炎(community-acquired pneumonia,CAP)儿童免疫功能和临床预后的影响。方法:选择CAP患儿180例,随机分为观察组和对照组,各90例。对照组给予西医基础治疗,观察组在对照组的基础上增服肺炎一号合剂,连续治疗4周。对比两组临床疗效、症状消失时间和不良反应发生情况;比较两组治疗前后CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、炎性因子白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)和C反应蛋白(C-reactive protein,CRP)水平、肺通气功能指标氧合指数(oxygenation index,OI)、肺动态顺应性(pulmonary dynamic compliance,Cdyn)和呼吸做功量(work of breathing,WOB)水平。结果:观察组总有效率[94.44%(85/90)]高于对照组[84.44%(76/90)](P<0.05);观察组症状消失时间均短于对照组(P<0.05);治疗后,两组CD8^(+)水平较治疗前降低,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前升高,且观察组免疫功能改善较对照组更为显著(P<0.05);治疗后,两组IL-6、CRP及TNF-α均较治疗前下降,且观察组炎性因子水平均低于对照组(P<0.05);治疗后,两组OI、Cdyn及WOB水平均较治疗前升高,且观察组肺通气指标水平在治疗后均高于对照组(P<0.05)。结论:在西医抗生素治疗的基础上联合肺炎一号合剂治疗儿童CAP疗效确切,可明显缩短病程,改善患者免疫功能,降低血清炎性因子水平,改善肺通气功能。

早期液体管理联合肠内营养支持在急性呼吸窘迫综合征中应用效果

目的探究早期液体管理联合肠内营养支持在急性呼吸窘迫综合征中应用效果。方法选择2020年3月至2022年3月期间在安阳市人民医院接受治疗的呼吸窘迫综合征患者84例,应用随机数表法将其分为对照组(液体管理+常规治疗)及观察组(液体管理+肠内营养支持)各42例,对比两组临床指标、炎症因子、营养指标、血气指标、免疫指标。结果观察组机械通气时间、住院时间、病死率低于对照组,差异有统计学意义(P<0.05)。治疗后,两组炎症因子均降低,观察组白介素-1(IL-1)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组营养指标均升高,观察组转铁蛋白(TRF)、白蛋白(ALB)、前白蛋白(PAB)高于对照组,差异有统计学意义(P<0.05)。治疗后,两组pH、血氧分压(PaO_(2))升高、血二氧化碳分压(PaCO_(2))降低,观察组pH、PaO_(2)高于对照组、PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。治疗后,两组免疫功能指标均升高,观察组免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)高于对照组,差异有统计学意义(P<0.05)。结论对急性呼吸窘迫综合征患者进行早期液体管理联合营养支持,可改善患者血气指标,促进相关蛋白质合成,提升免疫功能,降低炎症因子。

疏气定痛方化裁联合经皮穴位电刺激治疗老年慢性盆腔炎患者的疗效分析

目的 探讨疏气定痛方化裁联合经皮穴位电刺激(TEAS)在老年慢性盆腔炎患者中的应用效果。方法选取2018年2月-2021年3月贵阳市妇幼保健院收治的老年慢性盆腔炎患者,按照随机数字表法分为对照组(常规治疗)和观察组(常规治疗联合疏气定痛方化裁),每组60例。对比两组患者临床疗效,治疗前后主要症状中医证候积分、免疫学指标及血流动力学指标;记录两组治疗期间不良反应发生情况;治疗后随访6个月,对比两组患者复发情况。结果 观察组总有效率高于对照组(P <0.05);观察组治疗前后带下异常、腰骶胀痛、下腹胀痛、神疲乏力症状积分的差值均高于对照组(P <0.05);观察组治疗前后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、CD8^(+)的变化均大于对照组(P <0.05);观察组治疗前后红细胞电泳时间、血沉率及血浆黏度的差值均高于对照组(P <0.05);两组患者治疗过程中均未出现不良反应,随访6个月后,观察组复发率低于对照组(P <0.05)。结论 对老年慢性盆腔炎患者予以疏气定痛方化裁联合TEAS疗效显著,可有效降低中医证候积分,提高机体免疫力,还可改善血液流变学,且复发率低。

GP化疗方案联合来曲唑内分泌治疗在乳腺癌中的应用价值

目的:探讨吉他西滨联合顺铂(GP)化疗方案联合来曲唑内分泌治疗在乳腺癌中的应用价值。方法:选取阜宁县人民医院2019年4月-2022年3月收治的乳腺癌患者100例作为本次研究对象,采用电脑随机数字法将其均分为两组,各50例。对照组予以GP化疗方案治疗,研究组予以GP化疗方案联合来曲唑内分泌治疗。比较两组疗效、氧化应激、炎症、免疫水平及用药不良反应发生情况。结果:研究组疗效明显优于对照组(P<0.05)。两组治疗前丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)水平比较差异无统计学意义(P>0.05);两组治疗后MDA水平较治疗前降低(P<0.05),研究组明显低于对照组(P<0.05);两组治疗后GSH-Px、SOD水平较治疗前升高(P<0.05),研究组明显高于对照组(P<0.05)。两组治疗前白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、白细胞介素-10(IL-10)水平比较差异无统计学意义(P>0.05);两组治疗后IL-6、hs-CRP水平较治疗前降低(P<0.05),研究组明显低于对照组(P<0.05);两组治疗后IL-10水平较治疗前升高(P<0.05),研究组明显高于对照组(P<0.05)。两组治疗前免疫球蛋白A(IgA)、免疫球蛋白M(IgM)水平比较差异无统计学意义(P>0.05);两组治疗后IgA、IgM水平较治疗前降低(P<0.05),研究组明显低于对照组(P<0.05)。两组用药不良反应比较差异无统计学意义(P>0.05)。结论:对乳腺癌患者应用GP化疗方案联合来曲唑内分泌治疗,患者疗效有显著提高,氧化应激、免疫、炎症水平有显著改善,且用药安全,不会增加不良反应,临床应用效果较好。