Hp既往感染胃癌前病变的证型判别分析

目的探究幽门螺杆菌(Hp)既往感染状态下胃癌前病变的肝胃郁热证与脾胃虚弱证的证候特点。方法收集153例在东直门医院就诊的Hp既往感染胃癌前病变患者基本资料及四诊信息,其中脾胃虚弱证81例、肝胃郁热证72例,运用逐步判别分析法筛选出对证型判别有意义的变量,带入Fisher判别函数计算准确率。结果隐痛、脉弦、反酸、口中乏味、肠鸣、发热/自觉发热、口臭、畏寒、烧心、苔燥、多尿、舌淡红、口苦、黏液便、灼痛对判别证型均有影响(P<0.001)。根据Fisher判别函数,81例肝胃郁热证的患者中有72例判别为肝胃郁热证,准确率为88.9%;72例脾胃虚弱证患者中有69例判别为脾胃虚弱证,准确率为95.8%,总体准确率为92.2%。结论Hp既往感染下胃癌前病变患者脉弦、发热/自觉发热、苔燥、口苦判别肝胃郁热证,隐痛、畏寒、舌淡红、多尿用于判别脾胃虚弱证,与临床较为吻合,可以较为准确地反映症状变量与证型之间的关系。

“因热成毒致虚”三期廓清理论辨治自身免疫性胃炎经验

自身免疫性胃炎(AIG)作为进展性疾病,病机复杂,病程较长,结合内镜下微观表现与中医宏观理论,根据AIG病理组织学及内镜下表现,将其分为三期。以“廓清论”为治疗总纲,病初在气,病机在热气结盛,治当清热泻实通腑;病进入血,病机在毒热积聚,治当以理气解毒散结;病久致虚,病机在耗气败血,治当益胃和肝健脾。

中医外治法治疗青少年特发性脊柱侧弯的研究进展

青少年特发性脊柱侧弯为了防止演变成严重的脊柱畸形、脊柱疼痛、限制疼痛,严重的损害到青少年的身心健康及心肺、腹腔脏器功能,对青少年特发性脊柱侧弯患者要早发现、早诊断、早治疗以及提前预防。中医主要治疗方式是中医外治法,为进一步了解中医外治法治疗青少年特发性脊柱侧弯的研究进展,本文从推拿手法、传统功法、针刀治疗、中药熏蒸、推拿结合针灸、推拿结合传统功法等几个方面进行阐述,望对青少年特发性脊柱侧弯的防治有所助益。

田德禄运用清降法治疗慢性胰腺炎经验

慢性胰腺炎(chronic pancreatitis,CP)是消化系统常见疾病。田德禄教授认为从形态位置及中医学功能来看,胰可以被认为是脾的一部分;辨治CP时应以中焦脾胃为重点进行论治;其在临床诊治CP时运用清降理论,用清利肝胆、清化湿热、滋阴清降、甘平养中等治法,且重视对“痰”“瘀”“毒”等病理产物的施治,取得满意疗效。

基于Nrf2⁃NQO1/γ⁃GCS信号通路探讨续断种子方对少弱精子症模型大鼠附睾氧化损伤的保护机制

目的:探讨续断种子方对少弱精子症模型大鼠附睾氧化损伤的保护机制。方法:将40只SD大鼠随机平均分为空白组、模型组、续断种子方组(10 g/kg)、左卡尼汀组(0.1 g/kg)。除空白组外,均诱导为少弱精子症。其中空白组、模型组给予生理盐水灌胃,续断种子方组给予续断种子方溶液灌胃,左卡尼汀组给予左卡尼汀灌胃,8周后HE染色观察附睾组织结构;通过精子质量检测大鼠附睾精子浓度和活动率;采用RT-qPCR、免疫组化检测附睾组织Nrf2、NQO1、γ-GCS mRNA和蛋白表达水平。结果:(1)HE染色:空白组附睾管排列紧密规则,组织结构完整,上皮细胞排列规整,管腔精子数目多,分布均匀。模型组附睾管出现结构萎缩,排列疏松,间质变大,细胞碎片增多,精子细胞明显减少。与模型组相比,续断种子方组、左卡尼汀组附睾管腔病变具有显著改善,腔内正常精子量增多,分布均匀。(2)各组精液质量比较结果:精子密度和精子活动率:相较于空白组,其余组精子密度、活动率均明显降低(P<0.05),模型组精子密度、活动率明显降低(P<0.05);与模型组比较,续断种子方组和左卡尼汀组精子密度和活动率均明显升高(P<0.05)。(3)RT-qPCR:与空白组相比,模型组大鼠附睾Nrf2、NQO1、γ-GCS mRNA和蛋白水平明显降低(P<0.05),与模型相比,续断种子方组、左卡尼汀组Nrf2、NQO1、γ-GCS mRNA和蛋白水平明显升高(P<0.05)。结论:续断种子方能够减轻少弱精子症大鼠氧化应激损伤,提高少弱精子症大鼠精子质量。其作用机制可能是促进少弱精子症大鼠附睾组织Nrf2-NQO1/γ-GCS信号通路活化,上调Nrf2、NQO1和γ-GCS蛋白表达相关。

全国名中医田德禄以“清降论”治疗胆汁反流性胃炎经验

从胆胃生理、病理、病机、辨证分型及治疗等方面,总结田德禄教授治疗胆汁反流性胃炎(BRG)的临床经验。田教授认为BRG的临床症状与中医学“呕胆”“胆瘅”等证类似,病位在胆胃,病性多属实,病机为胆胃郁热、气机升降斡旋失常;临床分为胆热犯胃证及胃热移胆证,治疗以“清降论”为指导,以“清”胆、“降”胃为基本原则,胆胃同治,分清胆胃病变之主次,明其重,而后知所从治。

幽门螺杆菌既往感染胃癌前状态的中医证候学特点探究

目的基于《京都胃炎分类》中的内镜表现探讨幽门螺杆菌(helicobacter pylori,Hp)既往感染状态胃癌前状态的中医证候学特点。方法按照《京都胃炎分类》中的方法,收集内镜下表现符合Hp既往感染胃癌前状态特征的205例患者的中医四诊信息,采用因子分析和聚类分析,浅析其中医证候学特点。结果经过因子分析提取出15个公因子,主要病位证素为肝、脾、胃,涉及的病性证素为气虚、阴虚、阳虚、火热、湿浊、血瘀、血热、痰浊、食积,经聚类得出肝胃气滞兼脾气亏虚证、脾胃湿热兼气阴两伤证、湿热瘀阻证、胃气壅滞证、肝胃郁热证、肝郁脾虚证共6个证型。结论应用《京都胃炎分类》中的内镜观察方法,结合Hp既往感染病史及病理结果,所获得的Hp既往感染状态下胃癌前状态的中医证候学特点,能够为中医药诊治本病提供较为准确的辨证依据和思路。

不同氧化剂处理三乙醇胺缓蚀剂废水的试验研究

为了分析氧化剂对三乙醇胺缓蚀剂废水COD去除效果,通过对比试验及梯度试验优选高效的乙醇胺缓蚀剂废水处理药剂。根据废水中污染物的特性,采用高铁酸钾、双氧水、次氯酸钠、次氯酸钙、二氧化氯处理含有乙醇胺混合物有机缓蚀剂及消泡剂等多种污染物的高浓度COD生产废水。试验结果表明,次氯酸盐较其他氧化剂对废水的降解适用条件较低,效果更好,当次氯酸钠投加量为60 mL,pH值为4-5,反应时间在3 h以上时,COD去除率可达90%以上,为后续生化处理创造了有利条件。

Based on the expression of HSP60 and HSP90, to explore the effect of Xuduan Zhongzi prescription on semen quality of oligoasthenospermia model rats

Objective:To investigate the effect of Xuduan Zhongzi prescription on the expression of HSP60 and HSP90 in testicular spermatogenic cells and semen quality of oligozoospermia and asthenospermia model rats.Methods:A total of 40 SPF male rats were randomly divided into 10 blank control group and 30 model group.After successful modeling,the model group was divided into model control group,levocarnitine group and Xuduan Zhongzi prescription group with 10 rats in each group.The rats in levocarnitine group and Xuduan Zhongzi prescription group were given corresponding drugs by gavage according to the equivalent measurement of humanbody,the blank control group and model control group were given the same amount of normal saline by gavage,and the rats in each group were killed after 8 weeks of continuous administration.Take the left epididymis of each group for sperm quality detection,take the left testis of each group,observe the histomorphological changes by HE staining,and detect the expression of HSP60 and HSP90 in testicular tissue by immunohistochemistry and Western blot.Results:HE staining showed that compared with the blank control group,the convoluted tubules in the model group were significantly atrophic,degenerated and irregularly arranged,the spermatogenic epithelium showed a large number of vacuoles,Sertoli cell degeneration,obvious inflammatory infiltration in stromal cells,stromal cell proliferation,scattered rows of epithelial cells,a large number of exfoliation and degeneration,and sperm were rare.After the intervention of Xuduan Zhongzi prescription,the above lesions were significantly improved,the structure of seminiferous tubules was relatively regular and orderly,denser than that of the model group,sertoli cells and stromal cells increased significantly,the seminiferous epithelium was thicker than that of the model group,with rich layers,and a large number of sperm could be seen in the lumen.Immunohistochemistry and Western Blot showed that the expression of HSP60 and HSP90 increased significantly after the intervention of Xuduan Zhongzi prescription in model rats(P<0.01).The sperm quality test results showed that compared with the blank control group,the sperm concentration and activity rate in the model group decreased significantly,(P<0.01).After continuous seed cutting,the sperm concentration and activity rate of model rats were significantly increased,(P<0.01).Conclusion:Xuduan Zhongzi prescription may inhibit the apoptosis of testicular spermatogenic cells in oligoasthenospermia model rats by increasing the expression of HSP60 and HSP90,so as to improve sperm quality.

新旧规范中圆形偏心受压构件承载力计算对比分析

从圆形偏心受压构件计算的原理入手,结合新旧规范中圆形偏心受压构件的计算公式,对简化方式和内容进行了公式推导,并结合算例对比新旧两版规范中计算结果的差距。