中药消补汤治疗非糜烂性胃食管反流病临床疗效

目的观察中药消补汤治疗非糜烂性胃食管反流病(NERD)的临床疗效。方法选取86例NERD患者,用数字随机法分为对照组和治疗组各43例。研究组予以中药消补汤治疗,对照组予以西药治疗,治疗4周后比较两组的Gerd Q量表评分、NRS疼痛评分,症状积分和疗效。结果对照组总有效38例,总有效率88.37%,治疗组总有效41例,总有效率95.35%。两组比较差异显著,有统计学意义(P<0.05);两组的Gerd Q量表评分、NRS疼痛评分,症状积分,与治疗前比较都有明显的改善;治疗组与对照组比较,改善的效果更好,差异有统计学意义(P<0.05)。结论中药消补汤治疗非糜烂性胃食管反流病症状改善明显,疗效显著,值得推广。

基于“消托补”法思辨治疗复发性尿路感染

中医将复发性尿路感染归属于“劳淋”范畴。因其反复发作,迁延难愈,一直是困扰患者和医务人员的难题。“消、托、补”三法是对中医外科疾病所应用的内治法总纲。由于复发性尿路感染的发生和常见的中医外科疾病在病机方面存在高度相似性,故笔者将“消、托、补”三法应用于对复发性尿路感染的中医组方治疗中,取得较好疗效。

基于“消”“托”“补”三法的银屑病中医治疗研究进展

银屑病是一种免疫介导的慢性复发性炎症性系统性疾病,全球发病率为1%~3%,且病程迁延不愈,严重影响患者的生活质量。目前西医缺乏有效根治此病的方法。祖国医学在银屑病治疗中发挥着重要作用,具有独特优势。“消”“托”“补”三法为中医外科疾病内治法的三个总则,适用于疮疡及各类皮肤疾病。近年来诸多临床医家在从血论治银屑病的基础上,提出了解表、清热、祛痰、温阳、行气、和营、补益等治法,可收获良效。文章通过查阅祖国古医籍以及近20年临床相关文献,对中医外科“消”“托”“补”三法在银屑病中的应用进行阐述,以期为银屑病的诊治及研究提供新思路。

补肺消痿汤联合阿帕替尼治疗晚期肺癌的临床疗效及对CEA、SCC及CA125的影响

目的探讨补肺消痿汤联合阿帕替尼治疗晚期肺癌的临床疗效及对CEA、SCC及CA125的影响。方法选择2016年6月—2020年5月南京中医药大学连云港附属医院及徐州市中医院收治的晚期肺癌患者120例,依据随机对照法将患者分为研究组和对照组,每组60例。对照组患者口服甲磺酸阿帕替尼治疗,500 mg/次,1次/d,连续治疗4周。研究组在对照组治疗的基础上,口服补肺消痿汤治疗。连续治疗4周。比较两组治疗疗效,治疗前后肿瘤标志物癌胚抗原(carcino-embryonic antigen, CEA)、鳞状细胞癌抗原(squamouscellcarcinomaantigen, SCC)、糖链抗原125 (carbohydrate antigen 125, CA125)水平,比较两组治疗前后恶性肿瘤患者生活质量核心问卷(QLQ-C30)以及治疗过程中发生的不良反应。结果研究组治疗总有效率高于对照组(P<0.05);研究组治疗后神疲乏力、胸脘痞闷、恶心呕吐等中医证候积分低于对照组(P<0.05);研究组治疗后肿瘤标志物CEA、SCC及CA125水平低于对照组(P<0.05);研究组治疗后QLQ-C30评分高于对照组(P<0.05);研究组患者不良反应总发生率低于对照组(P<0.05)。结论补肺消痿汤结合阿帕替尼治疗晚期肺癌疗效确切,可有效的改善患者的临床症状,降低肿瘤标志物CEA、SCC、CA125的水平,提高治疗疗效,降低机体不良反应,提高患者的生活质量,减轻痛苦,有广阔的应用前景。

补肾活血消癥汤治疗复发性卵巢子宫内膜异位囊肿及其对卵巢功能保护作用临床研究

目的探讨补肾活血消癥汤治疗复发性卵巢子宫内膜异位囊肿及其对卵巢功能保护作用的影响。方法选择辽宁中医药大学附属医院2019年3月—2020年5月来诊患者进行筛选,依据纳入和排除标准,最终纳入74例复发性卵巢子宫内膜异位囊肿患者,按随机数字表法分为两组,各37例,对照组予常规治疗,治疗组在对照组基础上加服补肾活血消癥汤,疗程均为6个月。两组以主要指标[中医证候积分、糖类抗原125(CA125)和糖类抗原199(CA199)]及次要指标[白介素-2(IL-2)和白介素-6(IL-6)、卵巢功能指标]进行比较,观察患者中医症状、肿瘤指标、免疫功能及卵巢功能变化情况,并比较两组临床疗效。结果治疗后,两组患者经行腹痛、腰膝酸软、神疲乏力等中医证候积分及CA125、CA199水平均呈下降趋势(P<0.05),且治疗组下降趋势较对照组更显著(P<0.05);治疗后,两组患者IL-6水平明显降低,IL-2水平明显上升,且治疗组指标改善幅度较对照组更大(P<0.05);治疗后,两组卵泡刺激素(FSH)、促黄体生成素(LH)水平较治疗前均明显上升,雌二醇(E2)水平明显下降(P<0.05),且治疗组指标改善较对照组更显著(P<0.05);治疗组临床总有效率为91.89%,对照组临床总有效率为72.97%,治疗组临床疗效优于对照组(P<0.05)。结论补肾活血消癥汤具有补肾益气、化瘀活血、散结消癥之效,能够调节患者体内免疫功能,保护卵巢功能,抑制肿瘤细胞的生成,可以较好的控制病情,临床疗效较好,值得推广。

十全大补汤合五味消毒散加减对剖宫产产妇术后恢复及抗生素使用的影响

目的 探讨十全大补汤合五味消毒散加减对剖宫产产妇术后恢复及抗生素使用的影响。方法 选取2018年9月—2020年月邯郸明仁医院收治的剖宫产产妇150例,随机分为两组,各75例。对照组术后予以常规干预,观察组术后排气后口服十全大补汤合五味消毒散加减,并于术后第2天采用中药包(由大黄、芒硝混合制成)外敷腹部切口,连用5 d;比较两组术后抗生素使用情况、中医症状评分(面色、腹痛、恶露血色及血质)、免疫功能(CD_(3)^(+)T、CD_(4)^(+)T、CD_(8)^(+)T、CD_(4)^(+)/CD_(8)^(+))、术后恢复情况(最高体温、泌乳始动时间、术后住院时间、血性恶露持续时间及切口愈合情况)及安全性。结果 观察组剖宫产术后抗生素使用情况优于对照组(P<0.05)。术后7 d,观察组面色、腹痛、恶露血色及血质评分、CD_(8)^(+)T水平显著低于对照组(P<0.05),CD_(3)^(+)T、CD_(4)^(+)T、CD_(4)^(+)/CD_(8)^(+)显著高于对照组(P<0.05)。观察组最高体温明显低于对照组(P<0.05),泌乳始动时间、术后住院时间、血性恶露持续时间明显少于对照组(P<0.05),切口甲级愈合率明显高于对照组(P<0.05)。结论 十全大补汤合五味消毒散加减不仅能促进剖宫产产妇术后恢复,还能减少抗生素的使用。

国医大师徐景藩辨治消化性溃疡经验

国医大师徐景藩教授在长期诊治消化性溃疡的临床过程中,形成了"消补、润燥、升降、清化"的学术思想,其诊疗特色为:(1)谨守病机、灵活施辨。脾胃虚弱为发病基础,脾胃失和是常见病机,其中脾胃阴虚、湿阻中焦亦不少见,瘀血阻滞为其发展趋势。(2)把握病变趋势,未病先防。补益脾胃,不忘消健助运,化湿常需润燥相合,以防伤阴。徐教授尤其注重脾阴虚的治疗和预防,临床灵活运用参苓白术散、慎柔养真汤加减。(3)巧用药对,执简驭繁。常用药对如陈皮与法半夏、枳壳与白术、谷芽与麦芽、绿萼梅与佛手、刀豆壳与柿蒂、黄连与吴茱萸、百合与麦冬等。(4)古为今用,继承创新。徐教授师古不泥,以经方为宗,结合现代病理药理研究,古方今用、验方活用,中西医结合治疗本病,常获良效。

“消、托、补”三步法治疗胃溃疡

目的:观察"消、托、补"三步法治疗胃溃疡的疗效及对溃疡愈合情况的影响。方法:将80例胃溃疡患者随机平均分为两组,治疗过程中脱落5例,最终对照组37例,治疗组38例。对照组给予常规西医治疗,治疗组在对照组的基础上予"消、托、补"三步法中药治疗,持续治疗8周。观察两组临床疗效、胃镜疗效、临床症状积分、幽门螺旋杆菌根除情况、胃溃疡复发率,并检测胃组织增殖细胞核抗原(proliferating cell nuclear antigen PCNA)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)和再生蛋白Ⅰ(regenaration gene I,RegI)的表达。结果:治疗组在临床疗效、幽门螺旋杆菌清除率、胃溃疡复发率方面显著优于对照组(P<0.05),胃镜疗效与对照组相当(P>0.05)。与对照组相比,治疗组胃痛、反酸、纳差症状显著改善,胃黏膜PCNA表达显著升高,TGF-β1表达显著降低(P<0.05)。结论:"消、托、补"三步法可以较好地改善临床症状,促进溃疡面修复,提高黏膜愈合质量,提高幽门螺旋杆菌的根除率,减少复发,临床疗效显著。

补阴消郁汤配方颗粒对更年期小鼠抑郁的抑制作用研究

目的:考察补阴消郁汤配方颗粒对更年期模型小鼠抑郁行为的保护作用,并考察其可能的机制。方法:通过卵巢摘除建立更年期模型,补阴消郁汤配方颗粒2g/kg、6g/kg、18g/kg连续给药4周,通过小鼠旷场实验、糖水消耗实验、悬尾实验和强迫游泳实验观察小鼠抑郁行为,高效液相色谱法测定小鼠前额叶皮层单胺类神经递质的水平。结果:行为学检测结果显示补阴消郁汤配方颗粒6g/kg、18g/kg剂量组能明显改善更年期抑郁模型小鼠行为,明显增加小鼠在旷场中央站立次数以及糖水消耗量,并且显著减少小鼠悬尾不动时间和游泳不动时间。脑内单胺类神经递质检测结果显示,补阴消郁汤配方颗粒18g/kg剂量组能明显增加5-HT和DA含量。结论:补阴消郁汤配方颗粒预防给药可以改善更年期模型小鼠的抑郁行为,其机制可能与调节小鼠脑内单胺类神经递质的含量有关。

Implementation of a DC-10Mb/s 0.5μm CMOS Laser Diode Driver

A DC-10Mb/s laser diode driver,compatible with TTL and CMOS levels,is presented. The optical power corresponding to‘1＇ and ‘0＇ can be set independently with resistors off-chip and stabilized with a closed loop. A novel peak-to- peak optical power monitor and stabilization mechanism is introduced. The circuit, fabricated in a CSMC 0. 5μm mixed signal CMOS process, can provide 120mA maximum drive current and 0. 6dB extinction ration fluctuation over - 20 ＋ 80℃ ,which is independent of input pattern.

Compensation/consumption hierarchical control strategy based on wind-solar-hydrogen coupling grid connection

In the process of grid-connected wind and solar power generation,there are problems of high rate of abandoning wind and light and insufficient energy.In order to solve these problems,we construct a grid-connected wind-solar hydrogen storage(alkaline electrolyzer(AE)-hydrogen storage tank-battery-proton exchange membrane fuel cell(PEMFC))coupled system architecture.A grid-connected compensation/consumption hierarchical control strategy based on wind-solar hydrogen coupling is proposed.During the grid-connected process of wind and solar power generation,the upper-level control allocates power reasonably to the hydrogen energy storage system by dispatching the power of wind and solar power generation.At the same time,the control strategy ensures that the pressure of the hydrogen storage tank is within the safety range limit,and the lower control completes the control of the duty cycle of the converter in the system.Due to the randomness of wind and light,the hydrogen energy storage system is divided into three working conditions,namely compensation,balance and consumption,and five working modes.The simulation results show that the hydrogen energy storage system compensates for 40%of the power shortage,and consumes 27.5%of the abandoned wind and solar energy,which improves the utilization rate of clean energy.

中西医治疗抗心磷脂抗体阳性复发性流产概况

抗心磷脂抗体可使子宫内膜呈分泌不足状态,干扰受精卵着床以致不孕或自然流产,是导致复发性流产原因之一。肾虚导致冲任不固,系胎无力;脾虚则气血不足,胎元失养。肾虚元气不足或脾虚中气不足则运血无力,瘀血内阻,胎失所养而胎元不固。西医口服小剂量阿司匹林、皮下注射小剂量低分子肝素、口服小剂量阿司匹林联合强的松、口服小剂量阿司匹林合并低分子肝素皮下注射治疗。中医辨证论治,脾肾两脏虚损为本,血瘀、热毒为标,补肾、健脾、活血、清热、解毒,补肾益气方可明显提高活产率,大补元煎明显降低流产率,参芪归芍汤可使抗心磷脂抗体阳性全部转阴,消抗地黄汤促进体液免疫,提高免疫球蛋白含量,降低血小板聚粘附性,抗凝血,改善微循环,恢复胎盘血运以充分供血供氧,补肾消抗汤补益脾肾,活血化瘀,清热解毒,标本兼顾。中西医治疗各有优势,亦存在一定局限性,中西医结合治疗既可降低西药所产生的不良反应,又具备中医辨证论治思想,还需从基础理论及药理学方面深入研究。

Radiofrequency ablation of atrial tachycardia in patients with repaired atrial septal defect

Objective:To evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) in patients with repaired atrial septal defects(ASD). Methods: In 76 consecutive patients with AT who underwent the electrophysiological study and radiofrequency catheter ablation (RFCA). 4 patients (one male and three female aged 35. 5±11. 5 years) had AT-related myocardial scar or incision. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results: Re-entry related to the lateral atriotomy scar was inducible in 3 of 4 patients. With en-trainment mapping, the PPI-TCL difference was <30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 2 patients had successful linear ablation between scar area to inferior vena cava, and 1 patient between scar areas to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 4 patients. PPI-TCL differences <30 ms were found when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of incision-related AT was found during follow-up except for the failed patient. Conclusion: Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation also can be obtained in patients with IRAT related to myocardial scar or incision.

A 155 Mbps laser diode driver with automatic power and extinction ratio control

An integrated laser diode driver(LDD) driving an edge-emitting laser diode was designed and fabricated by 0.35 μm BiCMOS technology. This paper proposes a scheme which combines the automatic power control loop and temperature com-pensation for modulation current in order to maintain constant extinction ratio and average optical power. To implement tem-perature compensation for modulation current,a novel circuit which generates a PTAT current by using the injecting base current of a bipolar transistor in saturation region,and alternates the amplifier feedback loop(closed or not) to control the state of the current path is presented. Simulation results showed that programmed by choice of external resistors,the IC can provide modu-lation current from 5 mA to 85 mA with temperature compensation adjustments and independent bias current from 4 mA to 100 mA. Optical test results showed that clear eye-diagrams can be obtained at 155 Mbps,with the output optical power being nearly constant,and the variation of extinction ratio being lower than 0.7 dB.

Secondary aortoduodenal fistula

Aorto-duodenal fistulae (ADF) are the most frequent aorto-enteric fistulae (80%), presenting with upper gastrointestinal bleeding. We report the first case of a man with a secondary aorto-duodenal fistula presenting with a history of persistent occlusive syndrome. A 59-year old man who underwent an aortic-bi-femoral bypass 5 years ago, presented with dyspepsia and biliary vomiting. Computed tomography scan showed in the third duodenal segment the presence of inflammatory tissue with air bubbles between the duodenum and prosthesis, adherent to the duodenum. The patient was submitted to surgery, during which the prosthesis was detached from the duodenum, the intestine failed to close and a gastro-jejunal anastomosis was performed. The post-operative course was simple, secondary ADF was a complication (0.3%-2%) of aortic surgery. Mechanical erosion of the prosthetic material into the bowel was due to the lack of interposed retroperitoneal tissue or the excessive pulsation of redundantly placed grafts or septic procedures. The third or fourth duodenal segment was most frequently involved. Diagnosis of ADF was difficult. Surgical treatment is always recommended by explorative laparotomy. ADF must be suspected whenever a patient with aortic prosthesis has digestive bleeding or unexplained obstructive syndrome. Rarely the clinical picture of ADF is subtle presenting as an obstructive syndrome and in these cases the principal goal is to effectively relieve the mechanical bowel obstruction.

A New Carbon and Oxygen Balance Model Based on Ecological Service of Urban Vegetation

The application of human induced oxygen consumption and carbon emission theory in urban region was summed up and on this base a new model of urban carbon and oxygen balance (UCOB) was constructed by calculating the carbon and oxygen fluxes. The purpose was to highlight the role of vegetation in urban ecosystems and evaluate the effects of various human activities on urban annual oxygen consumption and carbon emission. Hopefully,the model would be helpful in theory to keep the regional balance of carbon and oxygen,and provide guidance and support for urban vegetation planning in the future. To test the UCOB model,the Jimei District of Xiamen City,Fujian Province,China,a very typical urban region,was selected as a case study. The results turn out that Jimei′s vegetation service in oxygen emission and carbon sequestration could not meet the demand of the urban population,and more than 31.49 times of vegetation area should be added to meet the whole oxygen consumption in Jimei while 9.60 times of vegetation area are needed to meet the carbon sequestration targets. The results show that the new UCOB model is of a great potential to be applied to quantitative planning of urban vegetation and regional eco-compensation mechanisms.

Non-technical Losses in Brazil： Subsidies for mplementation of Smart-Grid

The amount of non-technical losses in Brazil is quite elevated, accounting for nearly 5.5% of the country＇s total generated power. Such losses are asymmetrically distributed within the various regions of the country. Meter tampering （fraud）, meter bypassing by regular consumers （theft） and irregular hookups to the network by unlawful consumers are the most predominant forms of irregularities. Part of it which is caused by non-technical losses is being passed on to the consumers through the tariffs they pay. This paper presents an overview of the current situation related to non-technical losses in Brazil involving： quantification, regional asymmetry, nature and stratification, tariff management, and strategies employed to its reduction. Advanced measurement techniques provided by smart-grids can significantly reduce them. It is suggested a potential reduction of 60%. An innovative way of using these indicators in order to identify irregularities is briefly presented in this work.

Comparative Evaluation between Water Parallel Pricing System and Water Pricing System in China: A Simulation of Eliminating Irrigation Subsidy

The reform in water pricing plays a critical role in agricultural production, which is believed to have great water savings potential. We consider eliminating irrigation subsidies as a simulation and conduct a comparative evaluation between the water parallel pricing system （WPPS） and the water pricing system （WPS）, which are incorporated into two computable general equilibrium （CGE） models, respectively. The results prove that, compared with WPPS, WPS would contribute higher capacities for water savings with more farming imports and less loss in farming output; households in rural and urban areas would benefit from more income and food consumption, which would be matched by increasing farming imports. A policy recommendation is that eliminating the irrigation subsidy should pay more concerns on alleviating the negative effects on farming outputs. Moreover, improvements in agricultural labor mobility and water demand elasticity are needed to enable more focus on the water conservation policy, particularly in WPS.

白彦萍对痤疮的中医辨识体会

痤疮是一种累及毛囊及皮脂腺的慢性炎症性疾病,中医学称之为“肺风粉刺”。白彦萍教授认为其发病与风、湿、热、虚、郁有关,病机为肺经风热、湿热、阴虚、血热瘀滞、痰湿凝聚等,病位主要在肺胃。治疗方面以“消、托、补、通”四法为基础,结合全息理论适当加以引经药物,女性患者多用调周法。局部辨证与整体辨证相结合,在临床上取得满意疗效。文章举2例病案,以供探讨。

Application of proteomic approaches to assess the effect of anti-epileptic drug on seizure foci

Epilepsy is one of the most common neurological disorders characterized by epileptic seizures.The anti-epileptic drugs(AEDs)are the main form of treatment for people with epilepsy.Classically,people thought that AEDs modify the activities of ion channels to suppress epileptic seizures.However,accumulating evidence suggests that targeting at ion channels cannot completely account for the numerous effects of the AEDs on its broad clinical activity in epileptic patients.In our study,proteomic methods were used to quantify the proteome of hippocampal tissues from patients who were treated or not treated by AEDs(Carbamazepine).Further bioinformatics methods,including Gene Ontology(GO)annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis,were utilized to analyze the differences between two patient groups.We found that more than 400 proteins,including metabolism and immune related proteins,had a higher expression level in the carbamazepine-treated group compared with the controls.These altered proteins were considered to be involved in many different biological pathways.Among these pathways,immune-system related pathway modulated by complement C3 and microglia was highly remarkable,which regulated the synapses elimination in physiological condition.In epilepsy,the carbamazepine induced up-regulation of complement C3 might decrease the abnormal synaptic connections between neurons and thus contribute to the therapeutic role of carbamazepine.The results of our study suggested that apart from ion channels,carbamazepine exerted numerous effects on human epileptic foci,which might be the fundamental mechanisms of AEDs for treatment,adverse-effects and pharmacoresistance of epilepsy.