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资源有限地区HIV/AIDS疾病进展监测及抗病毒治疗疗效评价的替代指标
外周血CD4+T淋巴细胞计数和血浆病毒载量是监测HIV/AIDS疾病进展及评价高效抗逆转录病毒治疗(HAART)疗效的两项关键指标.目前公认的主流检测手段包括:经流式细胞术检测CD4+T淋巴细胞计数,采用实时荧光定量PCR技术分析血浆HIV RNA.这两种方法均要求专门仪器及配套试剂,价格昂贵,对操作者要求也较高,难以在资源有限地区广泛应用.因此,寻找适合我国国情的技术简便、费用相对低廉、结果可靠的替代指标具有重要的现实意义.
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Review on Intestinal Fibrosis of IBD Treated by Acupuncture and Moxibustion
Objective:To evaluate investigations of intestinal fibrosis of IBD treated by acupuncture and moxibustion and to analyze the current research situation of intestinal fibrosis.Methods:All reported studies were indexed about intestinal fibrosis of IBD treated by acupuncture and moxibustion and summarized the therapeutic effects of acupuncture and moxibustion on intestinal fibrosis.Results:Ten studies were included in this review,the research results indicated that acupuncture and moxibustion had beneficial effects not only on cytokines and colonic fibroblast but on collagen related to intestinal fibrosis.The expressions of TGF-beta and its mRNA were down regulated,and the expressions of IGF-1、IGF-1R and IGFBP-5 were decreased by acupuncture and moxibustion.The proliferative index of CBF was prohibited and the expression of type Ⅰ,Ⅲ,Ⅳ collagen was degraded by this therapy.Conclusion:Acupuncture and moxibustion can prevent and improve the colonic tissue fibrosis of IBD in some extent,but many research settings and methods should be improved to lucubrate the real therapeutic effects and the effective mechanism of acupuncture and moxibustion.
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肺动脉导管过时了吗?
上世纪70年代起肺动脉导管(PAC)引入了临床,因其可以提供前、后负荷、心肌收缩力、组织氧合等重要血流动力学信息而成为危重病及高危手术患者的标准监护措施,在危重病学、心脏病学及围术期得到了广泛应用.然而在近10年中,Swan-Ganz导管的应用因其临床报道结果的不同而受到质疑,有些病情改善,有些并无明显效果,有些甚至恶化.本文讨论了PAC的益处及潜在的危害,分析PAC临床无效的原因,给出PAC临床使用的未来趋势.