《诸病源候论》感冒导引法研究

在对《诸病源候论》一书中的导引法进行认真、系统地分析、研究基础上,结合习练导引法的实践经验与体会,针对感冒的发病机理,精心选择书中的导引条目,编创一套预防治疗感冒的导引功法,除预备式和收式外,共有五节正功,分别命名为"努肩缩项除寒热、撑臂推颏营卫和、按枕拉脊通阳气、撑手顿足肌表彻、搓掌摩面肺窍乐"。文章从原文依据、姿势要求、操作要领和作用原理四个方面,对每一节功法进行详细说明,既是继承和发扬古代导引的新尝试,也是对现代中医养生治病手段的新拓展。

Short-term Prediction of Occurrence Period of Main Diseases and Pests of Flos lonicerae using Phenoecology

The occurrence periods of Semiaphis heraclei Takahashi,Frankliniella sp.,Haptonchus luteolus and Microsphara linicerae Enchson wint.in Rabenh.causing damage on Flos lonicerae were investigated in F.lonicerae planting area in XinCheng county of Guangxi Province during 2008-2010,which were coincided with the occurrence periods of related phenology of local Prunus persica Rootstock.With P.persica Rootstock as indicator plant,the occurrence periods of three species of pests and one species of disease were predicted,respectively,and the method was simple and accurate,which could be the foundation for preventing these pests and diseases in the local field.

《诸病源候论》目病诸候篇研究概述

《诸病源候论》集隋以前养生方导引法之大成,在气功发展史上占据重要地位。该书卷二十八为"目病诸候"篇,是最早阐述眼科疾患的专篇文献,且其中三候下载有养生方导引法共11条。鉴于"目病诸候"篇对眼科的理论及临床研究均有重要指导意义,故仅对该篇的研究作以概述。

Research Advance on Sod Culture in Peach Orchard

Sod culture in peach orchards is an advanced soil management. The significances of sod culture in peach orchard are introduced, as well as the sod ways. The effects of sod culture in a peach orchard on soil, microclimate and growth and development of peach tree, and disease, pest and weed are reviewed. The problems in sod culture in peach orchard in China are summarized. Sod culture could increase soil fertility, improve soil physical properties, relieve soil temperature change, increase soil microbial growth and soil enzyme activity, improve microclimate and fruit quality, reduce physiological disease, insect pests and weeds.

Effects of N Rates on Canopy Microclimate and Population Health in Irrigated Rice

Objective The aim was to elucidate the effects of N rates on rice canopy microclimate and community health so as to provide a sci- entific basis for studying the production potential in irrigated rice with healthy canopy. Method The effects of rice population structure traits under different N rates on rice canopy temperature, relative humidity （ RH）, light transmittance and sheath blight were studied by using Sunscan canopy analysis system and HOBO（ Pro Temp/RH IS logger）. Result The results showed that leaf area index, plant height and tiller number had significant effects on canopy cooling, RH enhancing and light reducing. Extremely significant multiple linear regression relationships existed among canopy day temperature, day RH, LAI and tiller number, and among light transmittance, tiller number and plant height. At flowering stage, per unit LAI could result in a day-maximum-temperature （Tmax） deceasing of 0.87℃ and a day-minimum-RH （RHmin） enhancing of 2.5% within canopy. Similarly, 100 plants per ms could respectively cause a Tmax deceasing of 1.23℃ and an RHmin enhancing of 3.3% in rice canopy. And per 10 cm plant height and 100 plants per m^2 could respectively reduce 9.3% and 7.8% of light in canopy. Conclusion Sheath blight disease index was significantly enhanced as the canopy day temperature decreased, day RH increased and light transmittance reduced. Bigger canopy from higher nitrogen level treatment leads to a more stable canopy microclimate with little changes in temperature and RH during day and night, which has the risk of worsening canopy health. Thus, moderately controlling the space development of canopy is the basis of constructing healthy canopy in rice.

Mirizzi syndrome:History,current knowledge and proposal of a simplified classification

Chronic complications of symptomatic gallstone disease, such as Mirizzi syndrome, are rare in Western developed countries with an incidence of less than 1% a year. The importance and implications of this condition are related to their associated and potentially serious surgical complications such as bile duct injury, and to its modern management when encountered during laparoscopic cholecystectomy. The pathophysiological process leading to the subtypes of Mirizzi syndrome has been explained by means of a pressure ulcer caused by an impacted gallstone at the gallbladder infundibulum, leading to an inflammatory response causing first external obstruction of the bile duct, and eventually eroding into the bile duct and evolving to a cholecystocholedochal or cholecystohepatic fistula. This article reviews the life of Pablo Luis Mirizzi, describes the earlier and later descriptions of Mirizzi syndrome, discusses the pathophysiological process leading to the development of these uncommon fistulas, reviews the current diagnostic modalities and surgical approaches and finally proposes a simplified classification for Mirizzi syndrome intended to standardize the reports on this condition and to eventually develop a consensual surgical approach to this unexpected and seriously dangerous condition.

Particular evolution in a 72-year-old diabetic patient with acute coronary syndrome

Diabetes mellitus is an important risk factor for coronary atherosclerosis and many patients present extensive coronary stenosis at coronarography. However, in patients with diabetes, endothelial and microvascular dysfunction also participate in chronic and acute myocardial ischemia. Although the majority of diabetic patients with myocardial infarction have angiographic evidence of significant coronary artery disease.

Influenza vaccination in acute coronary syndromes patients in Thailand： the cost-effectiveness analysis of the prevention for cardiovascular events and pneumonia

Background Influenza vaccination has been clinically shown to reduce adverse cardiovascular outcomes in acute coronary syndrome （ACS） patients, but the economic perspectives can provide important data to make informed decisions. This study aimed to perform the economic evaluation of lifelong annual influenza vaccination for cardiovascular events and well-established pneumonia prevention. Methods Lifetime costs, life-expectancy, and quality-adjusted live years （QALYs） were estimated beyond one-year cycle length of a six-health states Markov model condition on whether a hospitalization for ACS, stroke, heart failure, pneumonia, no hospitalizations occurred, or death. The comparison of three age-groups of 40-49, 50-65, and 〉 65 years scenario was performed. Incremental cost-effectiveness ratio （ICER） and net monetary benefit （NMB） were presented as a societal perspective in 2016. The model robustness was determined by one-way and prob- abilistic sensitivity analyses. Results The influenza vaccination was cost-effective in all age-groups, by dominant ICERs （lower cost with higher effectiveness） which was completely lower than acceptable willingness-to-pay threshold of Thailand [160,000 THB （4,466.8 USD） per QALYs], with a great incremental value of NMB. Especially, the 50-year-old-and- above scenario was shown as the most benefit at 129,092 THB （3,603.9 USD） for each patient. Conclusions The annually additional influenza vaccination to standard treatment in ACS was cost-effective in all age-groups, which should be considered in clinical practice and health-policy making process.

Nonalcoholic fatty liver disease-A multisystem disease?

Non-alcoholic fatty liver disease(NAFLD) is one of the most common comorbidities associated with overweight and metabolic syndrome(Met S). Importantly, NAFLD is one of its most dangerous complications because it can lead to severe liver pathologies, including fibrosis, cirrhosis and hepatic cellular carcinoma. Given the increasing worldwide prevalence of obesity, NAFLD has become the most common cause of chronic liver disease and therefore is a major global health problem. Currently, NAFLD is predominantly regarded as a hepatic manifestation of Met S. However, accumulating evidence indicates that the effects of NAFLD extend beyond the liver and are negatively associated with a range of chronic diseases, most notably cardiovascular disease(CVD), diabetes mellitus type 2(T2DM) and chronic kidney disease(CKD). It is becoming increasingly clear that these diseases are the result of the same underlying pathophysiological processes associated with Met S, such as insulin resistance, chronic systemic inflammation and dyslipidemia. As a result, they have been shown to be independent reciprocal risk factors. In addition, recent data have shown that NAFLD actively contributes to aggravation of the pathophysiology of CVD, T2 DM, and CKD, as well as several other pathologies. Thus, NAFLD is a direct cause of many chronic diseases associated with MetS, and better detection and treatment of fatty liver disease is therefore urgently needed. As non-invasive screening methods for liver disease become increasingly available, detection and treatment of NAFLD in patients with MetS should therefore be considered by both(sub-) specialists and primary care physicians.

Impact of Vibrio parahaemolyticus and white spot syndrome virus(WSSV)co-infection on survival of penaeid shrimp Litopenaeus vannamei

White spot syndrome virus(WSSV) is an important viral pathogen that infects farmed penaeid shrimp, and the threat of Vibrio parahaemolyticus infection to shrimp farming has become increasingly severe. Viral and bacterial cross or superimposed infections may induce higher shrimp mortality. We used a feeding method to infect L itopenaeus vannamei with WSSV and then injected a low dose of V. parahaemolyticus(WSSV+Vp), or we fi rst infected L. vannamei with a low-dose injection of V. parahaemolyticus and then fed the shrimp WSSV to achieve viral infection(Vp+WSSV). The effect of V. parahaemolyticus and WSSV co-infection on survival of L. vannamei was evaluated by comparing cumulative mortality rates between experimental and control groups. We also spread L. vannamei hemolymph on thiosulfate citrate bile salt sucrose agar plates to determine the number of V ibrio, and the WSSV copy number in L. vannamei gills was determined using an absolute quantitative polymerase chain reaction(PCR) method. L v My D88 and Lvakt gene expression levels were detected in gills of L. vannamei by real-time PCR to determine the cause of the different mortality rates. Our results show that(1) the cumulative mortality rate of L. vannamei in the WSSV+Vp group reached 100% on day 10 after WSSV infection, whereas the cumulative mortality rate of L. vannamei in the Vp+WSSV group and the WSSV-alone control group approached 100% on days 11 and 13 of infection;(2) the number of Vibrio in the L. vannamei group infected with V. parahaemolyticus alone declined gradually, whereas the other groups showed signifi cant increases in the numbers of Vibrio( P <0.05);(3) the WSSV copy numbers in the gills of the WSSV+Vp, Vp+WSSV, and the WSSV-alone groups increased from 10 5 to 10 7 /mg tissue 72, 96, and 144 h after infection, respectively. These results suggest that V. parahaemolyticus infection accelerated proliferation of WSSV in L. vannamei and vice versa. The combined accelerated proliferation of both V. parahaemolyticus and WSSV led to massive death of L. vannamei.

Penicillium marneffei chylous ascites in acquired immune deficiency syndrome:A case report

Penicillium marneffei （R marneffei） infection usually occurs with skin, bone marrow, lung or hepatic involve- ment. However, no cases of P. mameffei infection with chylous ascites have been reported thus far. In this re- port, we describe the first case of acquired immune de- ficiency syndrome （AIDS） which has been complicated by a P. marneffei infection causing chylous ascites. We describe the details of the case, with an emphasis on treatment regimen. This patient was treated with am- photericin B for 3 mo, while receiving concomitant ther- apy with an efavirenz-containing antiretroviral regimen, but cultures in ascitic fluid were persistently positive for P. marneffei. The infection resolved after treatment with high-dose voriconazole （400 mg every 12 h） for 3 too. R marneffei should be considered in the differential di- agnosis of chylous ascites in human immunodeficiency virus patients. High-dose voriconazole is an effective, well-tolerated and convenient option for the treatment of systemic infections with R marneffei in AIDS patients on an efavirenz-containing antiretroviral regimen.

Economic burden of irritable bowel syndrome in China

AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome(IBS) and subtypes.METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct(including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t-tests were performed to determine differences between groups after controlling for IBS subtypes.RESULTS A total of 105 IBS patients(64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNy18262.84(USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similarto published studies in other countries. Nationally, the total costs of managing IBS would amount to CNy123.83 billion(USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNy18891.18(USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes(P = 0.031).CONCLUSION IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.

Shrimp arginine kinase being a binding protein of WSSV envelope protein VP31

Viral entry into the host is the earliest stage of infection in the viral life cycle in which attachment proteins play a key role. VP31(WSV340/WSSV396), an envelope protein of white spot syndrome virus(WSSV), contains an Arg-Gly-Asp(RGD) peptide domain known as a cellular attachment site. At present, the process of VP31 interacting with shrimp host cells has not been explored. Therefore, the VP31 gene was cloned into p ET30a(+), expressed in Escherichia coli strain BL21 and purifi ed with immobilized metal ion affi nity chromatography. Four gill cellular proteins of shrimp( Fenneropenaeus c hinensis) were pulled down by an affi nity column coupled with recombinant VP31(r VP31), and the amino acid sequences were identifi ed with MALDI-TOF/TOF mass spectrometry. Hemocyanin, beta-actin, arginine kinase(AK), and an unknown protein were suggested as the putative VP31 receptor proteins. SDS-PAGE showed that AK is the predominant binding protein of VP31. An i n vitro binding activity experiment indicated that recombinant AK's(r AK) binding activity with r VP31 is comparable to that with the same amount of WSSV. These results suggested that AK, as a member of the phosphagen kinase family, plays a role in WSSV infection. This is the fi rst evidence showing that AK is a binding protein of VP31. Further studies on this topic will elucidate WSSV infection mechanism in the future.

Comparative Study of the Impact of Climate Variability on Prevalence of Urinary Schistosomiasis： Cases at Sunyani Regional Hospital and among School Children in Atronie, Sunyani

A study has been conducted to determine the impact of climate variability on Schistosoma haematobium infection among patients and school children in Sunyani between 2006 and 2009. Urine samples from the subjects were collected and examined in the laboratory using the Filteration technique for the detection and quantification ofSchistosoma haematobium eggs. The prevalence rate of urinary schistosomiasis at the Sunyani Regional Hospital for 2006, 2007, 2008 and 2009 were found to be 0.24%, 0.55%, 0.55% and 0.75% respectively while that for Methodist Junior High School in 2008 and 2009 were 60.1% and 60.3% respectively. A decrease in the relative humidity and average annual rainfall were identified as factors contributory to the increase in urinary schistosomiasis prevalence rate. The temperature values obtained throughout the study period did not have any significant effect on the prevalence rate. The temperature values, however, were those that enhanced cercarial incubation （15-35 ℃） with a resultant increase in shedding of cercariae leading to more infections among water contacts. The infection rate due to the stream Amama was 20.1%, while that due to river Tano was 36.6%. The highest risk group was children aged 15-19 years. Praziquantel was administered to treat the infection, producing a cure rate of 93%. Recognition of urinary schistosomiasis as a public health problem in Ghana is the main challenge to prevention and control of the disease.

Study of 160 breast cancer patients with distant metastasis after operation by way of TCM syndromes classification

Objective: To discuss the relationship between the postoperative breast cancer with distant metastasis and the TCM syndromes classification. Methods: 160 postoperative 5-year breast cancer patients from 1995 to 2000 were tracked, summed up and analysized TCM syndromes as stagnation of hepatic qi, deficiency of spleen and pathogenic phlegm reten- tion, blood stasis and toxin stagnation, deficiencies of both blood and qi. Results: (1) For blood stasis and toxin stagnation TCM syndrome, the metastatic rate raised to 45% during 5 years. However, the metastatic rates of other three TCM syn- dromes are 15%, 17.5% and 22.5% respectively. The general distant metastasis rate was 27.5% (P<0.01). (2) Lymph node metastasis, tumor size, Her-2 and its receptor have no obvious relation with TCM syndromes classification (P>0.05). Conclu- sion: (1) TCM syndrome classification has close relation with breast cancer distant metastasis. Distant metastasis have close relationship with blood stasis and toxin stagnation syndrome. (2) Lymph node metastasis, tumor size, Her-2 and its receptor have no obvious relation with TCM syndromes classification, which suggested that metastatic ability has been programmed in the early stage of carcinoma initiation. (3) Significantly enlightening for predict the prognosis under the guide of TCM syn- drome classification and take right therapeutic strategy: attack pathogen and activate blood circulation against cancer.

ON THE STUDY OF THE RELATIONSHIPS BETWEEN GUANGZHOU ATMOSPHERIC ENVIRONMENT FACTORS AND THE SARS EPIDEMIC

Based on SARS epidemic data and the corresponding atmospheric data, we used the timescale-partitioning technique, spectrum analysis and correlation analysis to investigate the impacts of the atmospheric environmental factors on the SARS epidemic. Results showed that there were close relations between environmental factors and SARS: The daily probable cases of SARS varied in 3-5 day cycles, much the same as the atmospheric elements did. The variations of the epidemics correlated remarkably with atmospheric elements. So conclusions can be drawn that weather changes have influences on the variations of daily SARS cases. In addition, statistical results showed that cold air activities aggravated the SARS epidemic.

《黄帝内经》带下病探微

带下病指女性白带的量、色、质、味异常,早在《黄帝内经》就有带下及带下病详细的论述。秦汉时期有不同称谓,隋代《诸病源候论》基本固定病名。广义 "带下" 即妇女疾病总称;狭义 "带下"指女性阴中流出的液体,亦称白带,有生理性的,也有病理性的,狭义 "带下" 之名,始见《神农本草经》。《内经》中详细记载 "带下" 的来源、作用:为女性体内之精华物质,与入骨孔补益脑髓的物质同源。白带量过多则为病,即《内经》中之"淫"病,为阴阳不和,肾虚无摄;怵惕思虑,神伤恐惧;脾邪传肾,少腹疝瘕;暴食不洁,升降失常。淫之重症有四逆、五逆之说,均指病势深重,积重难返。白淫,男女皆可有,男子随溲而下,溺中若有精之状,即后世所言"白浊";女子则下于阴中,即后世所言之"带下"。《灵枢·五色》"有润如膏状",未述及 "带下" 之颜色及性状。《神农本草经》中论述了赤、白之分。老官山汉墓出土竹简涉及白带颜色、质地及气味。《诸病源候论》根据白带颜色分成"五色带"。傅山归纳总结"五色带",并给出相应的病机及治疗。

Nodular lymphoid hyperplasia: A marker of low-grade inflammation in irritable bowel syndrome?

AIM To evaluate the prevalence of nodular lymphoid hyperplasia(NLH) in adult patients undergoing colonoscopy and its association with known diseases. METHODS We selected all cases showing NLH at colonoscopy in a three-year timeframe, and stratified them into symptomatic patients with irritable bowel syndrome(IBS)-type symptoms or suspected inflammatory bowel disease(IBD), and asymptomatic individuals undergoing endoscopy for colorectal cancer screening.Data collection included medical history and final diagnosis. As controls, we considered all colonoscopies performed for the aforementioned indications during the same period.RESULTS One thousand and one hundred fifty colonoscopies were selected. NLH was rare in asymptomatic individuals(only 3%), while it was significantly more prevalent in symptomatic cases(32%). Among organic conditions associated with NLH, the most frequent was IBD, followed by infections and diverticular disease. Interestingly, 31% of IBS patients presented diffuse colonic NLH. NLH cases shared some distinctive clinical features among IBS patients: they were younger, more often female, and had a higher frequency of abdominal pain, bloating, diarrhoea, unspecific inflammation, self-reported lactose intolerance and metal contact dermatitis. CONCLUSION About 1/3 of patients with IBS-type symptoms or suspected IBD presented diffuse colonic NLH, which could be a marker of low-grade inflammation in a conspicuous subset of IBS patients.

Cardiac Complications in Maroteaux-Lamy Syndrome： Case Report

MLS （Maroteaux-Lamy syndrome） or MPS VI （mucopolysaccharidosis VI） is an autosomal recessive pathology in which there is absence or low activity of the enzyme N-Acetylgalactosamine-4-Sulfatase, which hydrolyzes GAGs （glycosaminoglycans） in the body （mainly dermatan sulfate）. Consequently, there occurs lysosomal deposition of GAGs in connective tissue multisystemic. Myocardium and heart valves are frequently affected structures, presenting a direct correlation with the reports of complications and deaths. Case report： RGS, male, 3 years and 2 months, diagnosed with MPS VI from the first month of life, in weekly ERT （enzyme replacement therapy） since 4 months of age （inconstant）. At physical examination： normotensive, with holosystolic heart murmur 3＋/6＋ in mitral focus. Complementary tests： normal electrocardiogram, echocardiogram with pronounced mitral regurgitation, concentric left ventricular hypertrophy of moderate degree and mild aortic insufficiency. Discussion： Mitral valve disease is common in patients with MLS. Conditions such as cardiomyopathy, fibroelastosis, aneurysm and pulmonary hypertension may occur in these patients, indicative of morbidity and mortality. Early and constant ERT may be useful in slowing a progression of heart disease. Conclusions： follow-up with a cardiologist is important to evaluate the progression of cardiac complications in MPS VI. Constant and early ERT provides better prognosis for these patients.

Long-term Effect of TCM Decoctions in Treatment of Nephrotic Syndrome

Fifty-seven cases of nephrotic syndrome were treated with TCM decoctions as accessory treatment for prednisone and cyclophosphamide, and the effects were observed in a follow-up period of 5-15 years. The long-term complete remission rate of 68.4% and recurrence rate of 26.3% in the treatment group were respectively higher and lower than those in the control group (P