黄金昶从少阳探讨针刺治疗良性甲状腺结节经验总结

甲状腺结节是临床常见病、多发病,黄金昶教授经过20余年临床实践总结,认为甲状腺结节的形成和少阳功能异常密切相关,少阳为气机升降出入的枢纽,内寄相火,是水液运行的通道。少阳枢机不利,气、火、痰、瘀壅结颈部是甲状腺结节形成的基本病机。在治疗中采用定位疏剿法治疗本病,分为一疏二调三剿;一疏为疏通局部经络郁滞,包括:刺络祛瘀疏通经络;针刺解结疏通经络;颈浅针刺横向疏通颈关;二调:左升右降通调少阳气机;三剿:结节围刺,加强针刺力量,同时结合辨证选穴治疗,临床上多获良效。

利奈唑胺治疗肺部MRSA感染效果及其对炎性因子和内皮功能的影响

目的观察利奈唑胺治疗肺部MRSA感染效果及其对炎性因子、内皮素(ET)及一氧化氮(NO)的影响。方法回顾性分析2016年1月-2018年1月辽宁省人民医院全科医疗科确诊为肺部MRSA感染患者80例的病例资料,按照治疗药物不同分为观察组与对照组各40例,2组均给予加强营养、化痰、止咳等常规治疗。对照组在常规治疗的基础上加应用万古霉素治疗,观察组在常规治疗的基础上加用利奈唑胺治疗,2组均治疗14 d。比较2组患者治疗后的临床疗效、治疗前后的炎性指标和内皮功能指标。结果观察组患者的总有效率明显高于对照组(92.5%vs.77.5%,χ~2=3.529,P=0.020);治疗14 d后,对照组及观察组患者的TNF-α、IL-1β、IL-6、CRP均降低(t_(对照组)=4.188、4.860、4.634、2.656,P均=0.001;t_(观察组)=6.948、8.794、8.591、18.244,P均=0.000),且观察组降低更明显(t=3.500、3. 303、4. 661、4. 914,P均=0. 000);治疗14 d后,2组患者的ET、NO均有显著降低(t_(对照组)=7. 778、8.234,P均=0.000;t_(观察组)=10.000、17.033,P均=0.000),且观察组低于对照组(t=5.263、9.616,P均=0.000)。结论使用利奈唑胺治疗肺部MRSA感染,能有效改善患者的炎性指标和血管内皮指标,临床疗效好,值得推广。

基于网络药理学探索半夏泻心汤治疗胃癌的作用机制

目的运用网络药理学研究半夏泻心汤治疗胃癌的物质基础与潜在作用机制。方法基于多源在线数据库收集半夏泻心汤化学成分集,筛选化学活性成分,运用化学相似性找靶,垂钓半夏泻心汤潜在靶点,同时通过多源在线数据库整合的方法获取胃癌的相关靶点,匹配半夏泻心汤、胃癌靶点,选取重合的靶点作为半夏泻心汤治疗胃癌的关键靶点,将虚拟筛选的靶点进行GO富集分析及相关信号通路注释,采用Cytoscape软件构建网络。结果收集半夏泻心汤953种化学成分,筛选出164种有效成分,前五位的活性成分为β-谷甾醇、豆甾醇、槲皮素、谷甾醇、山奈酚,与胃癌靶点关联度较强的分别为槲皮素、山奈酚、β-谷甾醇、吴茱萸次碱、黄柏酮。获取83个重合靶点,GO富集分析预测半夏泻心汤治疗胃癌主要涉及细胞凋亡、细胞增殖、肿瘤微环境和机体内环境四个方面。通过KEGG获取23条信号通路,其中PI3K-Akt、MAPK、NF-kappa B可能是其发挥抗肿瘤癌作用的主要通路。结论预测半夏泻心汤通过参与增殖、凋亡、神经内分泌免疫等机制发挥抗胃癌作用,其物质基础可能是β-谷甾醇、槲皮素、山奈酚。

艾灸对放、化疗患者淋巴细胞及其亚群影响的Meta分析

目的评价艾灸对放化疗患者淋巴细胞及其亚群影响的临床疗效,为指导临床应用提供证据。方法在中国知网(CNKI)、中国学术期刊数据库(万方数据库)、中国科技期刊数据库(维普)、中国生物医学文献数据库(SinoMed)、PubMed、Cochrane图书馆等数据库,检索艾灸治疗恶性肿瘤患者的随机对照临床试验(Randomized Controlled Clinical Trails,RCTs),日期截止至2019年12月,由2名单独研究者进行数据提取及循证方法学质量评价,并应用RevMan 5.3软件进行数据分析,二分类变量数据结果采用相对危险度(RR)来分析效应量,连续性变量数据结果则采用平均差(MD)表示,区间估计用95%CI。结果纳入14篇RCTs,治疗后试验组CD^(+)_(3)、CD^(+)_(4)淋巴细胞计数、NK细胞计数及CD^(+)_(4)/CD^(+)_(8)比值较对照组升高,差异有统计学意义,结果分别为(MD=5.27,P<0.00001,95%CI[3.76~6.79];MD=3.96,P<0.00001,95%CI[3.01~4.91];MD=5.74,Z=3.58,P=0.0003,95%CI[2.60~8.88];MD=3.96,P<0.00001,95%CI[3.01~4.91])。CD^(+)_(8)淋巴细胞亚群计数比较,差异无统计学意义(MD=-1.01,P=0.44,95%CI[-3.59~1.57])。试验组患者KPS评分较对照组升高,差异有统计学意义(MD=9.57,P=0.007,95%CI为[2.61~16.53])。由于纳入文献整体质量偏低,异质性较高,倒漏斗图提示可能存在发表偏倚。结论艾灸可升高恶性肿瘤患者淋巴细胞及其亚群计数,提高其KPS评分,能够保护机体免疫功能,提高患者生活质量。受纳入研究整体质量影响,尚需设计严谨、报告规范的高质量临床研究进一步证实。

Enhancement of radiosensitivity of lung adenocarcinoma using a decoction from the Fuzhengzengxiao formula

OBJECTIVE: To study the effects of a decoction of Fuzhengzengxiao formula on lung adenocarcinoma regarding the inflammatory protein S100A9 known to enhance cancer cell sensitivity.METHODS: A nude mouse model of human lung adenocarcinoma was established. The mice were randomly divided into four groups using the random number table method: Group Ⅰ, control;Group Ⅱ, treatment with a decoction of the Fuzhengzengxiao formula alone; Group Ⅲ, treatment with radiotherapy alone; and Group Ⅳ, treatment with radiotherapy plus a decoction of Fuzhengzengxiao formula. When the tumor body was 1 cm^3 in diameter, the tumor bearing mice in GroupsⅢ and Ⅳ were irradiated at a single dose of 10 Gy and the tumor inhibition rate was evaluated.The expression of S100A9 was determined using Western blotting and q-PCR(Real-time Quantitative PCR Detecting System). The sensitivity of cells containing RNAi S100A9 to radiotherapy was evaluated using the Click multiple target model,and the cell cycle was analyzed using flow cytometry.RESULTS: Relative to the control group,the expression of S100A9 in the tumors in each treatment group was decreased,especially in Group Ⅳ. The sensitizing enhancement ratio(SER) Dq was >1 after RNAi S100A9; it decreased the surviving fraction after a 2 Gy dose exposure,and also the D_0 and Dq of the tumor cells; in addition, the radiosensitivity of G_2/M cells was significantly increased.CONCLUSION: The decoction of the Fuzhengzengxiao formula downregulated the expression of S100A9 in lung adenocarcinoma cells.

Effect of decoction of Fuzheng Jiedu Xiaoji formula(扶正解毒消积方) plus chemoembolization on primary liver cancer in patients

OBJECTIVE:To investigate the effect of the decoction of Fuzheng Jiedu Xiaoji formula(扶正解毒消积方,FJXF)plus chemoembolization(TACE)on primary liver cancer(PLC)in patients,and study the underlying mechanism.METHODS:Patients with PLC who met the inclusion criteria were randomized into case group and control group.The case group was treated with FJXF combined with TACE.The control group was treated with TACE alone.The short-term clinical effect was evaluated;liver biochemistry,liver function index and multidrug resistance-associated indicators were detected.RESULTS:FJXF combined with TACE in the case group significantly increased the disease control rate than TACE alone in the control group(83.3%vs 61.1%).There was a reduction in the serum alpha-fetoprotein at 8 weeks after treatment in each group,while no difference between the two groups.The same trend can be observed for transaminase and direct bilirubin in both groups.In the case group,it showed a significant increase for albumin at 8 weeks after treatment,while no change in the control group.Multidrug resistanceassociated indicators for multidrug resistance protein 1 and p-glycoprotein were upregulated in the case group but remained stable in the control group.CONCLUSIONS:FJXF combined TACE had a better short-term effect than TACE alone in patients with PLC.The potential mechanism was probably associated with alleviated multidrug resistance induced by FJXF.Additionally,FJXF didn’t increase the risk of liver damage in the combined therapy.