清热解毒方联合干扰素a-2b治疗宫颈高危型人乳头瘤病毒持续感染随机平行对照研究

[目的]观察清热解毒方联合干扰素a-2b治疗宫颈高危型人乳头瘤病毒(HR-HPV)持续感染疗效。[方法]使用随机平行对照方法,将68例住院患者按随机数字表法分为两组。对照组72例干扰素a-2b,隔日一粒,睡前放置于阴道后穹隆接近宫颈口处。治疗组142例清热解毒方(山药、车前子、苍术、鸡冠花、猪苓各15g,白花蛇舌草、生薏苡仁、蒲公英各30g,柴胡、芡实各10g,炒白术20g),1剂/d,水煎300mL,早晚口服,月经干净后服用,经期停药。西药治疗同对照组。连续治疗30d为1疗程。观测临床症状、血液学检查、HPV复查、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组痊愈93例,有效34例,无效15例,总有效率89.44%;对照组痊愈21例,有效39例,无效12例,总有效率83.33%。转阴93例,转阴率65.49%。临床疗效治疗组优于对照组(P<0.05)。治疗组HR-HPV病毒转阴率优于对照组(P<0.01)。[结论]清热解毒方联合干扰素a-2b治疗HR-HPV持续感染效果显著,值得推广使用。

益气活血化瘀汤联合阿司匹林治疗脑梗塞随机平行对照研究

[目的]观察益气活血化瘀汤联合阿司匹林治疗脑梗塞疗效。[方法]使用随机平行对照方法,将120例住院患者按抛硬币法随机分为两组。对照组60例阿司匹林肠溶片(拜耳),0.4g/次,1次/d,口服。治疗组60例益气活血化瘀汤(黄芪30g,丹参20g,甘草5g,克葛根、川穹各20g),1剂/d,水煎150mL,2次/d。西药治疗同对照组。连续治疗30d为1疗程。观测临床症状、人血浆颗粒膜蛋白、全血粘度、血浆粘度、血小板聚集率、不良反应。连续治疗1疗程,判定疗效。[结果]治疗组基本治愈38例,显著进步12例,进步6例,无效4例,恶化4例,死亡0例,总有效率93.33%。对照组基本治愈16例,显著进步11例,进步18例,无效7例,恶化5例,死亡3例,总有效率75.00%。治疗组疗效优于对照组(P<0.01)。相关指标两组均有改善(P<0.05),治疗组优于对照组(P<0.05)[结论]益气活血化瘀汤联合阿司匹林治疗脑梗塞效果显著,值得推广。

倍生颗粒联合血液透析治疗血液透析并发微炎症随机平行对照研究

[目的]观察倍生颗粒联合血液透析治疗血液透析并发微炎症疗效。[方法]使用随机平行对照方法,将80例门诊患者按照就诊顺序编号分为两组。对照组40例血液透析治疗,透析液流量500L/min,血流量250~300mL/min,4h/次,3次/周。对血压、血糖进行控制。治疗组40例倍生颗粒(人参、枸杞子各4g,何首乌、大黄各6g、当归7g,本院制剂),10g/次,2次/d。血液透析治疗同对照组。两组均连续治疗7d为1疗程。观测临床症状、生化指标(白蛋白、前白蛋白、转铁蛋白、白细胞介素、超敏反应蛋白、体重指数)、不良反应。连续治疗4疗程,判定疗效。[结果]治疗组显效19例,有效20例,无效1例,总有效率97.50%。对照组显效12例,有效15例,无效13例,总有效率67.50%。治疗组疗效优于对照组(P【0.05)。生化指标两组均有改善(P【0.05),治疗组改善优于对照组(P【0.05)。[结论]倍生颗粒联合血液透析治疗血液透析并发微炎症效果显著,值得推广。

抗纤软肝胶囊联合阿德福韦酯治疗脾肺肾虚型慢性乙型肝炎随机平行对照研究

[目的]观察抗纤软肝胶囊联合阿德福韦酯治疗脾肺肾虚型慢性乙型肝炎疗效。[方法]对65例脾肺肾虚型慢性乙型肝炎患者口服抗纤软肝胶囊(丹参30g,茵陈蒿、薏苡仁各20g,炮山甲、三七各6g,鳖甲、桃仁、当归、莪术、土鳖虫、白术、黄芪各10g),5g/次,3次/d;阿德福韦酯片,10mg/次,1次/d,口服;保肝、降酶、营养支持等常规药物,戒烟酒。连续治疗6个月为1疗程。观测病毒学应答、HBV-DNA平均水平、不良反应。连续治疗1疗程,判定疗效。[结果]病毒学应答比较HbeAg阳性、HbeAg阴性间无明显差异(P>0.05),核苷初治优于LMV耐药(P<0.05),ALT≤2×(ULN)、2×(ULN)<ALT≤5×(ULN)、ALT>5×(ULN)间无明显差异(P>0.05)。HBV-DNA平均水平治疗后优于治疗前(P<0.05)。[结论]抗纤软肝胶囊联合阿德福韦酯治疗不同类型慢性乙型肝炎效果显著,值得推广。

百合固金汤联合西药治疗复治肺结核随机平行对照研究

[目的]百合固金汤联合西药治疗复治肺结核疗效。[方法]使用随机平行对照方法,将60例门诊患者按随机数字表法分为两组。对照组30例采用2HBZES/6HBE方案行抗结核治疗,H为异烟肼0.3g/次,1次/d;B为利福布汀600mg/次,1次/d;Z为吡嗪酰胺0.5g/次,3次/d,口服;E为盐酸乙胺丁醇0.5g/次,1次/d,口服;S为链霉素0.75g/次,1次/d,肌注。治疗组30例百合固金汤(百合12g,生地黄、熟地黄各20g,玄参、麦冬、黄精、贝母、桔梗各10g,太子参24g,五味子6g,沙参、丹参、当归各15g,白芍12g,甘草6g)。6剂/周,800mL水煎至300mL,2次/d。西药治疗同对照组。连续治疗90d为1疗程。观测临床症状、X线片、细菌、不良反应。连续治疗1疗程,判定疗效。[结果]治疗组显效18例,有效8例,无效4例,总有效率86.67%。对照组显效11例,有效9例,无效10例,总有效率66.67%。治疗组疗效优于对照组(P<0.05)。两组X线片均有改善(P<0.05),治疗组优于对照组(P<0.05)。[结论]百合固金汤联合西药治疗复治肺结核效果显著,值得推广。

健脾解毒汤治疗幽门螺杆菌相关消化性溃疡随机平行对照研究

[目的]观察健脾解毒汤治疗幽门螺杆菌相关消化性溃疡疗效。[方法]使用随机平行对照方法,将140例门诊患者按抽签法随机分为两组。对照组95奥美拉唑胶囊,20mg/次,2次/d。硫糖铝片,0.75g/次,3次/d。前五天阿莫西林胶囊,1.0g/次,3次/d,服用5d停药。后五天克拉霉素片,0.5g/次,2次/d,服用5d停药。治疗组45例健脾解毒汤(三七粉分吞4g,川贝母粉分吞、甘草、黄连后下各6g,枳实、香附、柴胡、半枝莲、延胡索、丹参各12g,白术、茯苓、白芍、黄芩、蒲公英各15g,白芨粉分吞10g,海螵蛸、党参各20g,黄芪30g)。1剂/d,水煎200mL,早晚温服,忌生冷。连续治疗28d为1疗程。观测临床症状、不良反应。治疗1疗程(28d),判定疗效。[结果]治疗组治愈88例,有效5例,无效2例,总有效率97.89%。对照组治愈33例,有效3例,无效9例,总有效率80.00%。治疗组疗效优于对照组(P<0.05)。[结论]健脾解毒汤治疗幽门螺杆菌相关消化性溃疡效果显著,值得推广。

参芪麦味地黄汤联合西药治疗2型糖尿病随机平行对照研究

[目的]观察参芪麦味地黄汤联合西药治疗2型糖尿病疗效。[方法]使用随机平行对照方法,将128例住院患者按抽签法随机分为两组。饮食及运动控制基础上,对照组64例盐酸二甲双胍片500 mg/次,3次/d;格列齐特片80mg/次,1次/d。治疗组64例参芪麦味地黄汤(太子参15g,黄芪20g,麦冬15g,五味子12g,熟地黄、山茱萸各10g,山药12g,丹皮、泽泻各10g,茯苓12g),口干、消谷善饥加天花粉30g,肉桂3g;畏寒神疲加巴戟天15g;舌质有明显瘀点瘀斑加水蛭10g,西药治疗同对照组。连续治疗7d为1疗程。观测空腹血糖和餐后2h血糖、不良反应。连续治疗6疗程,判定疗效。[结果]空腹血糖和餐后2h血糖两组均从第2周开始呈下降趋势,治疗组优于对照组(P<0.05)。[结论]参芪麦味地黄汤联合西药治疗糖尿病效果显著,安全可靠。

鸦胆子油乳联合参芪扶正注射液治疗晚期肺癌随机平行对照研究

[目的]观察鸦胆子油乳联合参芪扶正注射液治疗晚期肺癌疗效。[方法]使用随机平行对照方法,将32例住院患者按随机数字表法分为两组。对照组50例非小细胞肺癌采用TP方案:紫杉醇135mg/m2,1次/d;顺铂175 mg/m2,1~3次/d。小细胞肺癌采用EP方案:卡铂300mg/m2,1次/d;依托泊苷100 mg/m2,1~5次/d;同时给予恩丹西酮8mg/次,1次/d,静注。治疗组32例鸦胆子油乳及参芪扶正注射液佐治,静脉滴注鸦胆子油乳30mL/次及参芪扶正注射液250mL/次,1次/d,静滴。西药治疗同对照组。连续治疗10d为1疗程。观测临床症状、生存质量、不良反应。治疗1疗程,判定疗效。[结果]治疗组CR6例,PR11例,SD10例,PD5例。总有效率53.13%。对照组CR3例,PR14例,SD22例,PD11例,总有效率34.00%。治疗组疗效优于对照组(P【0.05)。生存质量改善治疗组优于对照组(P【0.05)。[结论]鸦胆子油乳联合参芪扶正注射液治疗晚期肺癌方面效果显著,值得广泛推广。

参芎注射液联合西药治疗急性脑梗死随机平行对照研究

[目的]观察参芎注射液联合西药治疗急性脑梗死疗效。[方法]使用随机平行对照方法,将92例住院患者按病志号抽签方法随机分为两组,急性期(颅内压高)20%甘露醇0.25~2g/kg,30min内静滴。对照组46例胞二磷胆碱、阿司匹林、维生素C等,根据实际病情调整剂量。治疗组46例参芎注射液10~20m L+250m L葡萄糖溶液,1次/d,静滴;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、血浆内皮素、不良反应。连续治疗2疗程(14d),判定疗效。[结果]治疗组临床控制18例,显效10例,有效3例,无效1例,总有效率96.87%;对照组临床控制6例,显效9例,有效11例,无效6例,总有效率81.12%;治疗组疗效优于对照组(P<0.05)。血浆内皮素两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]参芎注射液联合西药治疗急性脑梗死,疗效满意,无严重不良反应,值得推广。

桑白皮汤联合西医治疗痰热郁肺型慢性阻塞性肺疾病随机平行对照研究

[目的]观察桑白皮汤联合西医治疗痰热郁肺型慢性阻塞性肺疾病疗效。[方法]使用随机平行对照方法,将70例住院患者按抽签法分为两组。对照组35例①控制性吸氧。②敏感抗生素抗感染治疗:多索茶碱0.3g/次,2次/d,静滴;氨溴索30mg/次,2次/d,静滴;异丙托溴铵/沙丁胺醇气雾剂2.5mL/次,3次/d,雾化吸入;必要时加用甲泼尼龙40mg/次,1~2次/d,静注。治疗组35例桑白皮汤(栀子9g,麻黄炙、甘草炙、苦杏仁各10g,黄连、法半夏各12g,苏子、川贝母、桑白皮、黄芩各15g,生石膏30g);1剂/d,水煎200mL,早晚口服。西医治疗同对照组。连续治疗10d为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效18例,有效15例,无效2例,总有效率94.29%。对照组显效13例,有效13例,无效9例,总有效率74.29%。治疗组疗效优于对照组(P【0.05)。[结论]桑白皮汤联合西医治疗痰热郁肺型慢性阻塞性肺疾病效果显著,值得推广。

辨证分型联合西药治疗眩晕随机平行对照研究

[目的]观察辨证分型联合西药治疗眩晕疗效。[方法]使用随机平行对照方法,将156例住院患者按抽签法随机分为两组。对照组78例倍他司汀4～8mg/次,3次/d,口服;美可洛嗪25mg/次,3次/d,口服。治疗组78例辨证分型,气血亏虚-益气养血、肝阳上亢-平肝潜阳、瘀血阻窍-活血通窍、肾精不足-补肾填精、痰浊中阻-祛湿化痰。西药治疗同对照组。连续治疗28d为1疗程。观测临床症状、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组显效44例,有效30例,无效4例,总有效率94.87%。对照组显效27例,有效24例,无效27例,总有效率65.38%。治疗组疗效优于对照组(P<0.05)。[结论]辨证分型联合西药治疗效果显著,值得推广。

Multicenter Clinical Randomized Controlled Trial and Network Pharmacology Analysis of Zhenzhu Qingyuan Granules for the Treatment of Gastroesophageal Reflux Disease

Objective To evaluate the clinical efficacy and safety of Zhenzhu Qingyuan Granules through a clinical randomized controlled trial and to analyze the potential action targets and pathways of this formula using network pharmacology.Methods Patients with gastroesophageal reflux disease(GERD)of liver–stomach stagnant heat pattern who met the inclusion and exclusion criteria were randomly divided into the control group and the observation group.The control group received oral rabeprazole,whereas the observation group were given Zhenzhu Qingyuan Granules in addition to the rabeprazole.The treatment duration was 8 weeks.Clinical efficacy was observed in both groups after 8 weeks.Network pharmacology was used to analyze the action targets of ZhenzhuQingyuanGranules and the genes related to GERD,and core targets were inferred.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were conducted to explore the potential mechanisms of this formula.Results The clinical research results showed that the total effective rate in the treatment group was 92.68%,compared with 70.00%in the control group,with a statistically significant difference(p<0.05).After treatment,both Chinese medicine syndrome score and endoscopic score improved in both groups compared with before treatment(p<0.05),and the treatment group showed greater improvement than the control group(p<0.05).Network pharmacology identified effective components of Zhenzhu Qingyuan Granules for treating GERD,including quercetin,luteolin,andβ-sitosterol,with potential action targets such as tumor protein 53(TP53),protein kinase B(AKT1),and tumor necrosis factor.Conclusion Zhenzhu Qingyuan Granules can significantly improve clinical symptoms in patients with GERD of liver–stomach stagnated heat pattern,enhance clinical efficacy,and have high safety.This formula may exert therapeutic effects through multiple targets and pathways.

重叠Cypher西罗莫司洗脱支架的围手术期和晚期预后:5项临床试验的汇总分析

Objectives: The purpose of this research was to determine the relative safety and efficacy of multiple(≥2) overlapping Cypher sirolimus-eluting stents(SES)(Johnson &Johnson, New Brunswick, New Jersey). Background: Overlapping coronary stents are common. The periprocedural and late clinical and angiographic consequences of overlapped coronary stents are not clearly defined, particularly for drug-eluting stents. Methods: All patients enrolled into five clinical trials of the SES were analyzed. Three of these trials were prospective randomized comparisons of the SES to the bare-metal stent(BMS), and two were prospective non-randomized trials of SES-treated patients with historical controls. All clinical and angiographic outcomes in overlap-stent-treated patients were compared by stent type and with single-stent-treated patients for the same stent device. Results: In all, 575 patients with stent overlap(337 SES, 238 BMS) and 1,162 patients with single stents(697 SES, 465 BMS) were analyzed. Stent overlap was associated with a greater late lumen loss in stent and more frequent angiographic restenosis regardless of stent type. Among overlap-stent-treated patients, the SES provided similar magnitude of restenosis benefit as observed for single-stent-treated patients. Overlapped SES was not associated with an increase in myocardial infarction. Conclusions: The strategy of SES overlap, when required, is both safe and efficacious in reducing restenosis with no increase in the incidence of myocardial infarction or major adverse cardiovascular events, when compared with a bare metal coronary stent prosthesis.

Efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy:A prospective,randomized study

AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok, from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS:There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P=0.053).CONCLUSION: Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy. However, preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption.

Comparison of early enteral nutrition in severe acute pancreatitis with prebiotic fiber supplementation versus standard enteral solution:A prospective randomized double-blind study

AIM: To compare the benefi cial effects of early enteral nutrition (EN) with prebiotic fiber supplementation in patients with severe acute pancreatitis (AP).METHODS: Thirty consecutive patients with severe AP, who required stoppage of oral feeding for 48 h, were randomly assigned to nasojejunal EN with or without prebiotics. APACHE Ⅱ score, Balthazar’s CT score and CRP were assessed daily during the study period.RESULTS: The median duration of hospital stay was shorter in the study group [10 ± 4 (8-14) d vs 15 ± 6 (7-26) d] (P < 0.05). The median value of days in intensive care unit was also similar in both groups [6 ± 2 (5-8) d vs 6 ± 2 (5-7) d]. The median duration of EN was 8 ± 4 (6-12) d vs 10 ± 4 (6-13) d in the study and control groups, respectively (P > 0.05). Deaths occurred in 6 patients (20%), 2 in the study group and 4 in the control group. The mean duration of APACHE Ⅱ normalization (APACHE Ⅱ score < 8) was shorter in the study group than in the control group (4 ± 2 d vs 6.5 ± 3 d, P < 0.05). The mean duration of CRP normalization was also shorter in the study group than in the control group (7 ± 2 d vs 10 ± 3 d, P < 0.05).CONCLUSION: Nasojejunal EN with prebiotic fiber supplementation in severe AP improves hospital stay, duration nutrition therapy, acute phase response and overall complications compared to standard EN therapy.

Albendazole versus metronidazole treatment of adult giardiasis:An open randomized clinical study

AIM:To investigate the efficacy and tolerability of albendazole and metranidazole treatment in giardiasis. METHODS:The open comparative randomized trial was carried out prospectively from December 1999 to July 2001 in Duzce City of Turkey.The diagnosis was based on the presence of signs and symptoms compatible with giardiasis including a positive stool examination of giardia cysts or trophozoite.Metranidazole group consisted of 29 patients and was given metranidazole 500 mg,three times a day for 5 d and albendazole group was consisted of 28 patients and was given albendazole 400 mg/d for 5 d. RESULTS:There were no significant differences in demographical and therapeutical effects and patient's compliance between both groups.But side effects were seen more in metranidazole group than in albendazole group. CONCLUSION:Albendazole is as effective as metranidazole in adults' giardiasis.Albendazole has less side effect potentials than metranidazole in the treatment of giardiasis.

Management of liver cirrhosis between primary care and specialists

This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: "ascites", "liver fibrosis", "cirrhosis", "chronic hepatitis", "chronic liver disease", "decompensated cirrhosis", "hepatic encephalopathy", "hypertransaminasemia", "liver transplantation" and "portal hypertension". Forty-nine papers were selected based on the highest quality of evidence for each section and type (original, randomized controlled trial, guideline, and review article), with respect to specialist setting (Gastroenterology, Hepatology, and Internal Medicine) and primary care. Liver cirrhosis from any cause represents an emerging health issue due to the increasing prevalence of the disease and its complications worldwide. Primary care physicians play a key role in early identification of risk factors, in the management of patients for improving quality and length of life, and for preventing complications. Specialists, by contrast, should guide specific treatments, especially in the case of complications and for selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for providing better outcomes and appropriate home care for patients with liver cirrhosis.

A Survey on Device-Independent Quantum Communications

Quantum communications helps us to enhance the security and efficiency of communications and to deepen our understanding of quantum physics. Its rapid development in recent years has attracted the interest of researchers from diverse fields such as physics, mathematics, and computer science. We review the background and current state of quantum communications technology, with an emphasis on quantum key distribution, quantum random number generation, and a relatively hot topic: device independent protocols.

Current situation on the reporting quality of randomized controlled trials in 5 leading Chinese medical journals

Objective:The Consolidated Standards for Reporting of Trials(CONSORT) statement has already proved to be an efficient standard for reporting quality of randomized controlled trials(RCTs).However,most of the Chinese medical journals have not endorsed the CONSORT statement.The current situation about the reporting quality of RCTs in Chinese medical journals is still unclear.The purpose of the study was to evaluate the reporting quality of RCTs on papers published in 5 leading Chinese medical journals.Methods:We evaluated 232 original RCT papers using a reporting quality scale based on CONSORT statement from 2001 to 2006 in 5 Chinese medical journals(Journal type 1) without adoption of CONSORT and Chinese Journal of Evidence-based Medicine(Journal type 2) which adopted CONSORT in 2004.We measured the inclusion of 26 items for the reporting quality scale and 6 core items of each RCT report,gave score to each item and calculated the total score obtained in each report and the proportion of reports including individual items.The reporting quality of RCT trials from 2001 to 2003(pre-adoption period) was compared with that from 2004 to 2006(post-adoption period).Results:The average reporting quality of RCTs was moderate(mean score,15.18),and the mean score of the 6 core items was low(mean score,1.09) in 5 leading journals.The difference in the total score and the score of the 6 core items between pre-adoption period(2001-2003) and post-adoption period(2004-2006) was statistically significant(P=0.003;P=0.000).Interaction between journal type and period was not significant(F=0.76;P=0.383).We concluded that the change tendency of reporting quality between Journal type 1 and 2 was not different.But as to the core items of sequence concealment and intention-to-treat analysis,the increases were greater for Journal type 2 when evaluated against Journal type 1(P=0.038;P=0.016).Conclusion:The reporting quality of RCT trials in 5 leading Chinese medical journals is improving.However,the lack of important items in RCT trials remains a serious problem.We recommend the endorsement of the Consolidated Standards for Reporting of Trials statement in Chinese medical journals and the continuing education on evidence-based medicine in China.

ALTERNATING METHOD STUDY ON STRESS ANALYSIS OF SURROUNDING ROCK FOR TWO RANDOM GEOMETRY TUNNELS

The stress analysis of surrounding rock for two random geometry tunnels is studied in this paper by using Schwarz’s alternating method. The simple and effective alternating algorithm is found, in which the surplus surface force is approximated by Fourier series, thus the iteration derivation can be conducted according to the precision required, finally, the stress results with high precision are obtained.