王书臣从“气虚血损,毒络肺积”论治原发性气管支气管肺淀粉样变性

王书臣教授认为,原发性气管支气管肺淀粉样变性(PTBA)核心病机为本虚标实,以气虚血损为本,毒络肺积为标,其内涵为肺气络亏虚,血络受损,毒瘀胶结,损络成积。络以通为用,当益气活血解毒散结以通络消积,标本兼治,补中有通,补而不滞,寓通于补,通而不损。本文结合医案总结王老治疗PTBA经验,以期为中医相关治疗提供辨治思路。

《诸病源候论》卒被损瘀血候养生方导引法探析

在《诸病源候论》篇中记述腕伤病症共九候,其中主要是论述跌打损伤造成的局部瘀血,论的是瘀血证,而瘀血乃是"积血,血积于中之病也",其病因病机为气滞气虚,血热血寒,治疗运用意念行气、调息行气、按揉屈转为主,以达到舒达经脉之气,行气祛瘀的效果,共列出了4种导引法。

基于CFD螺旋离心式血泵与离心式血泵内部流场的数值分析

利用CFD软件对采用一元理论的方法所设计的螺旋离心式血泵和离心式血泵两种离心式心脏泵进行数值模拟,对比和分析两种离心式血泵内部流动特性,研究血液流经叶轮的速度、压力、切应力等参数的分布,得到相应的云图,分析两种血泵模型对血液的影响.研究结果显示:螺旋离心式血泵可以有效地避免血液在流动过程中产生的涡流、湍流和较高的剪切力.血液在螺旋离心式血泵内部的速度场、压力场及切应力分布都比离心式血泵均匀、合理.

养血消秘汤治疗功能性便秘疗效观察

目的:观察和评估自拟养血消秘汤治疗功能型便秘的疗效。方法:采用自拟养血消秘汤治疗功能性便秘98例,并与60例采用金双歧对照组比较。结果:治疗4周后,治疗组总有效率92.86%,对照组总有效率68.33%。两组总有效率比较,经统计学处理,差异有显著性意义(P<0.05),治疗后两组症状积分比较也有显著性差异P<0.05。结论:养血消秘汤治疗功能型便秘有显著疗效。

清热解毒益气活血法治疗2型糖尿病并脑梗死的理论探讨

气虚血瘀是2型糖尿病并脑梗死的发病基础,毒损脑络是其关键病机,气虚血瘀、毒损脑络是其主要病因病机。基于"气虚血瘀-瘀热生毒-毒损脑络"的病机渲变过程,确立清热解毒、益气活血法,并自拟益消复瘫汤运用于临床,疗效显著。

Protective Effects of Tea Polyphenol on Cerebral Ischemia-Reperfusion Injury in Rats and Its Scavenging Oxy-radical and Anticerebral Lipid Peroxidation Effects

AIM To study the protective effects of tea polyphenol (TP) on cerebral ischemia reperfusion injury in rats and its scavenging oxygen free radical(OFR) activities and antilipid peroxidation in vitro . METHODS Cerebral ischemia reperfusion injury was produced by bilateral ligation of the common carotid arteries with vagus nerves and reperfusion for 45 min. The mitochondrial lipid peroxidation of rat brain induced by oxygen free radical was measured by thiobarbituric acid spectrophotometry. Superoxide anion (O 2) from xanthine xanthine oxidase system and hydroxyl radical (·OH) from Fe 2+ -H 2O 2 system were determined with spectrophotometry. RESULTS During Cerebral ischemia reperfusion,TP improved the activities of superoxide dismutase ( P 【0 05), GSH peroxidase( P 【0 01) and catalase( P 【0 01), while decreasing the maiondialdchyde content in the brain( P 【0 05) and brain water content ( P 【0 01). Tea polyphenol possessed significantly scavenging effects on ·OH produced by Fenton reaction and O 2 produced by xanthine xanthine oxidase system (the IC 50 were 2 2 mmol·L -1 and 1 9 mmol·L -1 respectively). Tea polyphenol could significant inhibit the lipid peroxidation of cerbral mitochondrial membrane induced by ·OH in a concentration dependent manner. CONCLUSION The results indicate that tea polyphenol could protect the injury on cerebral ischemia reperfusion in rats for OFR, these effects may be related to its scavenging effects on oxygen free radicals and antilipid peroxidant.

Fanconi Anemia and Ubiquitination

Fanconi anemia （FA） is a rare recessive hereditary disease characterized clinically by congenital defects, progressive bone-marrow failure, and cancer predisposition. Cells from FA patients exhibit hypersensitivity to DNA cross-linking agents, such as mitomycin C （MMC）. To date, at least 12 FA genes have been found deleted or mutated in FA cells, and 10 FA gene products form a core complex involved in FA/BRCA2 DNA repair pathway-FA pathway. The ubiquitin E3 ligase FANCL, an important factor of FA core complex, co-functions with a new ubiquitin conjugating enzyme UBE2T to catalyze the monoubiquitination of FANCD2. FANCD2-Ub binds BRCA2 to form a new complex located in chromatin foci and then take part in DNA repair process. The deubiquitylating enzyme USP1 removes the mono-ubiquitin from FANCD2-Ub following completion of the repair process, then restores the blocked cell cycle to normal order by shutting off the FA pathway. In a word, the FANCD2 activity adjusted exquisitely by ubiquitination and/or deubiquitination in vivo may co-regulate the FA pathway involving in variant DNA repair pathway.

Expression of Cyclooxygenase-2 in Nasopharyngeal Carcinoma and Its Relation to Angiogenesis and Prognosis

Objective： The purpose of this study was to evaluate cyclooxygenase-2 （COX-2） expression in nasopharyngeal carcinoma （NPC） and its correlation with clinicopathologic features, angiogenesis, and prognosis. Methods： The expressions of COX-2 and vascular endothelial growth factor （VEGF） and microvascular density （MVD） were determined with immunohistochemical methods in eighty-six NPC patients followed up over 5 years. Results： Sixty-three tumors （73.3%） were classified as COX-2 positive. COX-2 expression was positively related to VEGF expression （r=0.438, P〈0.01） and correlated with the tumor pathological grade, extent of primary lesion, lymph node metastasis, distant metastasis and shorter survival. Conclusion： Our results suggest that COX-2, being highly expressed and strongly correlated with angiogenesis in nasopharyngeal carcinoma, is apt to be used as a predictor of prognosis, including local recurrence and distant metastasis.

EFFECTS OF ELECTROACUPUNCTURE ON EXPRESSION OF INTERCELLULAR ADHESION MOLECULE-1 IN THE RAT OF LOCAL CEREBRAL ISCHEMIA-REPERFUSION

Objective To investigate effects of electroacupuncture （EA） on expression of intercellular adhesion molecule-1 （ICAM-1） in the rat of local cerebral ischemia-reperfusion. Methods Eighty SD rats were randomly divided into a normal control group, a sham operation group, a model group and an EA treatment group, 20 rats in each group. The thread-obstruction method was used for preparation of ischemia-reperfusion model. Zea-Longa rating criteria were used for evaluation of nervous function disorder; Immunohistochemical SABC method was used for detection of ICAM-1 expression in the microvascular endothelial cell of the ischemic brain region, and ELISA method for the soluble ICAM-1 （slCAM-1） content in peripheral blood. Re. suits After cerebral ischemia-reperfusion, both ICAM-1 expression level in the microvascular endethelium cell of the ischemic brain region and slCAM-1 content in the peripheral blood significantly increased in the model group as compared with the normal group and the sham operation group （P〈0.01）; After EA treatment, the ICAM-1 expression level in the microvascular endothelial cell of the ischemic brain region and slCAM-1 content in the peripheral blood were significantly down-regulated in the EA treatment group as com- pared with the model group （P〈 0.05）. Conclusion After cerebral ischemia-reperfusion, the microvascular endothelial cell of the ischemic brain region releases ICAM-1, which induces inflammatory injury of cerebral tissues; EA treatment can decease the expression of ICAM-1, so as to prevent the brain from the injury.

干燥综合征怎样辨治？

答:干燥综合征(SS),又称为口眼干燥关节炎综合征,是一种以外分泌腺病变为主的全身性、慢性、炎症性自身免疫性疾病.以口、眼或其它粘膜干燥为主,并伴有类风湿性关节炎或其它自身免疫性疾病的一组综合征.主要临床症状为眼部干燥、口腔干燥、涎腺肿大、关节疼痛.西医治疗主要采用对症、替代和补充疗法,并应用激素和免疫制剂.根据临床表现,属于中医"燥证"、"燥毒症"范畴.临床实践表明,中医药治疗SS,在缓解症状方面有明显优势,且无毒副反应,可长期使用.中医可分如下证型辨治.

帕金森病的外科治疗现状

帕金森病的外科治疗现状沈阳医学院附属中心医院杨晓健邹维君张冰本世纪３０年代和４０年代，人们就开始寻求用外科方法治疗帕金森病（ＰＤ）。由于当时影像学和手术器械的限制，手术的死亡率高，手术方式未能被普遍接受。６０年代，Ｌ－多巴应用于临床，对ＰＤ治疗取得了...

ApoE^-/-小鼠动脉粥样硬化模型的中医证型

目的:探讨长期高脂饲养ApoE^-/-小鼠中医的证型,为抗动脉粥样硬化证候中药的研究提供证型动物模型。方法:将20只雄性ApoE^-/-小鼠按随机数字表法分为四妙勇安汤组(SM组)和模型组(M组),每组10只,采用高脂饲料喂养14周建立动脉粥样硬化模型,SM组于造模开始进行预防性给药。同时以C57BL/6小鼠10只作为正常对照组(N组)。检测血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,观察主动脉和肝脏病理,评价是否为血瘀痰湿证型;通过IL-6、核因子-κB免疫组织化学变化评价是否为毒损证型。结果:与N组比较,M组小鼠血清TC、TG、LDL-C显著提高,HDL-C显著降低,差异有统计学意义(P<0.05);肝脏病理出现球形脂滴及炎性细胞浸润;主动脉出现明显斑块,血管内膜厚度(IT)、中膜厚度(MT)、斑块面积(PA)及IT/MT明显增大,差异有统计学意义(P<0.05),血管管腔面积(LA)明显减小,差异有统计学意义(P<0.05);免疫组织化学显示IL-6、核因子-κB在主动脉的表达明显增加,差异有统计学意义(P<0.05)。与模型组比较,SM组能够明显降低ApoE^-/-小鼠主动脉PA、IT及IT/MT,明显降低IL-6及核因子-κB表达,差异有统计学意义(P<0.05);减轻肝脏病变;但对血脂水平无明显作用。结论:长期高脂饲料饲养ApoE^-/-小鼠制备的动脉粥样硬化模型为痰湿血瘀毒损型病证结合动物模型。

Protective Effects of Zingiberis and Acniti Praeparatae Decoction on Myocardial IschemiaReperfusion Injury in Rats

This study aimed to investigate the protective effects of zin-giberis and acniti praeparatae decoction on oxidative stress injury induced by my-ocardial ischemia reperfusion in rats. [Method] Myocardial ischemia-reperfusion was performed by ligation of the left anterior descending coronary artery for 30 min, fol-lowed by reperfusion for 60 min. The effects of zingiberis and acniti praeparatae decoction on ECG ST segment, myocardial infarction percentage, malondialdehyde （MDA） content in the serum, superoxide dismutase （SOD） activity and other indica-tors were observed. [Result] Zingiberis and acniti praeparatae decoction could effec-tively inhibit ECG ST segment elevation caused by myocardial ischemia-reperfusion injuries, reduce the percentage of myocardial infarction, decline the content of MDA in the serum, and increase the activity of SOD. [Conclusion] Zingiberis and acniti praeparatae decoction exhibits protective effects on oxidative injuries caused by my-ocardial ischemia-reperfusion injuries in rats, which may be involved in reducing the formation of myocardial free radicals and enhancing antioxidant capacity of my-ocardium.

Effects of angelica sinensis polysaccharide-iron complex on hemolytic anemia and bone marrow injury in mice

To investigate the therapeutic effects of angelica sinensis polysaccharide-iron complex （APIC） on hemolytic anemia and bone marrow injury in mice models. The hemolytic anemia mouse model was established by i.p. of phenylhydrazine （PHZ）. Changes of the indices including red blood cell count （RBC）, hemoglobin （Hb） and hematocrit （HCT） were determined by blood analyzer, and reticulocytes were observed by brilliant cresol blue staining during administration. Bone marrow injured mouse model was established by i.p. of cytoxan （CY） and chloramphenicol （CH）, and the therapeutic effect was observed by H-E staining. The indices of APIC treated groups with the medium and high doses were higher than those of the model group significantly. Moreover, the Hb and HCT were restored to the normal level after drug treatments. In addition, APIC can promote the proliferation and differentiation of reticulocytes obviously in the early stage of anemia mice, decrease adipose cell proliferation in bone marrow of injured mice and hasten the recuperation. In conclusion, APIC has therapeutic efficacy on hemolytic anemia and bone marrow injury caused by chemicals, which is reported for the first time.

Effects of ischemic preconditioning on cyclinD1 expression during early ischemic reperfusion in rats

AIM： To observe the effect of ischemic preconditioning on cyclinD1 expression in rat liver cells during early ischemic reperfusion.METHODS： Fifty-four SD rats were randomly divided into ischemic preconditioning group （IP）, ischemia/ reperfusion group （IR） and sham operation group （SO）. The IP and IR groups were further divided into four sub-groups （n = 6）. Sham operation group （SO） served as the control group （n = 6）. A model of partial liver ischemia/reperfusion was used, in which rats were subjected to liver ischemia for 60 min prior to reperfusion. The animals in the IP group underwent ischemic preconditioning twice for 5 min each time prior to the ischemia/reperfusion challenge. Alter 0, 1, 2, and 4 h of reperfusion, serum and liver tissue in each group were collected to detect the level of serum ALT, liver histopathology and expression of cyclinD1 mRNA and protein. Flow cytometry was used to detect cell cycle as the quantity indicator of cell regeneration. RESULTS： Compared with IR group, IP group showed a significantly lower ALT level in 1h to 4h sub-groups （P 〈 0.05）. Proliferation index（PI） indicated by the S-phase and G2/M-phase ratio [（S＋G2/M）/（G0/G1＋S＋G2/M）] was significantly increased in IP group at 0 and 1 h （26.44 ± 7.60% vs 18.56 ± 6.40%,41.87 ± 7.27% vs 20.25 ± 6.70%, P 〈 0.05）. Meanwhile, cyclinD1 protein expression could be detected in IP group. But in IR group, cyclinD1 protein expression occurred 2 h alter reperfusion. The expression of cyclinD1 mRNA increased significantly in IP group at 0 and 1h （0.568 ± 0.112 vs 0.274 ± 0.069, 0.762 ± 0.164 vs 0.348 ± 0.093,P 〈 0.05）.CONCLUSION： Ischemic preconditioning can protect liver cells against ischemia/reperfusion injury, which may be related to cell proliferation and expression of cyclinD1 during early ischemic reperfusion.

Alanyl-glutamine dipeptide inhibits hepatic ischemiareperfusion injury in rats

AIM： To investigate the protective effect and mechanism of alanyl-glutamine dipeptide （Ala-GIn） against hepatic ischemia-reperfusion injury in rats. METHODS： Rats were divided into group C as normal control Group （/7=16） and group G as alanyl-glutamine pretreatment 07=16）. Rats were intravenously infused with 0.9% saline solution in group C and Ala-GIn -enriched （2% glutamine） 0.9% saline solution in group G via central venous catheter for three days. Then all rats underwent hepatic warm ischemia for 30 min followed by different periods of reperfusion. Changes in biochemical parameters, the content of glutathione （GSH） and the activity of superoxide dismutase （SOD） in liver tissue, Bcl-2 and Bax protein expression and morphological changes of liver tissue were compared between both groups. RESULTS： One hour after reperfusion, the levels of liver enzymes in group G were significantly lower than those in group C （P〈0.05）. Twenty-four hours after reperfusion, the levels of liver enzymes in both groups were markedly recovered and the levels of liver enzyme in group G were also significantly lower than those in group C （P〈0.01）. One and 24 h after reperfusion, GSH content in group G was significantly higher than that in group C （P 〈0.05）. There was no statistical difference in activities of SOD between the two groups. One and 24 h after reperfusion, the positive expression rate of Bcl-2 protein was higher in group G than in group C （P〈0.05） and the positive expression rate of Bax protein was lower in group G than in group C （P〈0.05）. Histological and ultrastructural changes of liver tissue were inhibited in group C compared to group G. CONCLUSION： Our results suggest that Ala-GIn pretreatment provides the rat liver with significant tolerance to warm ischemia-reperfusion injury, which may be mediated partially by enhancing GSH content and regulating the expression of Bcl-2 and Bax proteins in the liver tissue.

Effect of atrial natriuretic peptide on ischemia-reperfusion injury in a porcine total hepatic vascular exclusion model

AIM： To evaluate the effect of ANP on warm I/R injury in a porcine THVE model.METHODS： Miniature pigs （mini-pigs） weighing 16-24 kg were observed for 120 min after reperfusion following 120 min of THVE. The animals were divided into two groups. ANP （0.1 μg/kg per min） was administered to the ANP group （n = 7）, and vehicle was administered to the control group （n = 7）. Either vehicle or ANP was intravenously administered from 30 min before the THVE to the end of the experiment. Arterial blood was collected to measure AST, LDH, and TNF-α. Hepatic tissue blood flow （HTBF） was also measured. Liver specimens were harvested for p38 MAPK analysis and histological study. Those results were compared between the two groups.RESULTS： The AST and LDH levels were lower in the ANP group than in the control group; the AST levels were significantly different between the two groups （60 min： 568.7 ± 113.3 vs 321.6 ± 60.1, P = 0.038 〈 0.05, 120 rain： 673.6± 148.2 vs 281.1±44.8, P = 0.004 〈 0.01）. No significant difference was observed in the TNF-α levels between the two groups. HTBF was higher in the ANP group, but the difference was not significant. A significantly higher level of phosphorylated p38 MAPK was observed in the ANP group compared to the control group （0min： 2.92± 1.1 vs 6.38 ±1.1,,P= 0.011 〈 0.05）.Histological tissue damage was milder in the ANP group than in the control group.CONCLUSION： Our results show that ANP has a protective role in I/R injury with p38 MAPK activation in a porcine THVE model.

The Correlation of Indices in r-TEG with Intra-operative Blood Loss in Neurosurgical Patients

Objective Intra-operative coagulopathy has a close relationship with blood loss and the prognosis of patients. Rapid-thrombelastography （r-TEG） is a comprehensive assessment of coagulation abnormalities and also an effective way for constructing blood transfusion. This study attempts to investigate the correlation of r-TEG indices with intra-operative hemorrhage. Methods Patients who underwent transphenoidal hypophysectomy and craniotomy from January 15 to April 30, 2013 in Peking Union Medical College hospital were recruited. All patients had pre- and post-operative r-TEG and conventional coagulation tests （CCTs）. Patients’ information and intra-operative blood loss as a percentage of estimated blood volume were recorded. Spearman’s correlation analyses were used for discovering the relationship between indices in r-TEG or CCTs and the intra-operative blood loss. The significant correlated index of r-TEG was further investigated using linear regression analysis. Results A total of 181 patients participated in this study. Intra-operative change of α-angle, which reflects the fibrinogen level and function, was the only r-TEG index that correlated with blood loss significantly （P=0.013, r= ？0.184）, thus challenging the current empirical cognition of the effects of intra-operative hemorrhage on coagulation. As intra-operative blood loss increased, α-angle decreased, and every 1% loss of estimated blood volume （EBV） led to 0.60 degree decrease of α-angle. As for CCT results, changes of fibrinogen and platelet count were also significantly correlated with blood loss （P=0.015 and P=0.001, respectively）.Conclusions Peri-operative change of α-angle, as an index of r-TEG, exhibited a significant negative correlation with intra-operative blood loss. The impact of hemorrhage on fibrinogen, instead of clotting factors, should be scrutinized.

苦碟子注射液预处理对急性缺血性脑卒中后脑缺血再灌注损伤血瘀毒损证模型大鼠神经功能及海马神经元的影响研究

背景急性缺血性脑卒中(AIS)后脑缺血再灌注损伤血瘀毒损证患者的神经功能损伤具有不可逆的特点,因此探讨苦碟子注射液预处理对其神经功能及海马神经元的影响具有一定价值。目的 分析苦碟子注射液预处理对AIS后脑缺血再灌注损伤血瘀毒损证模型大鼠神经功能及海马神经元的影响。方法 本实验时间为2020年10月至2021年2月。采用随机数字表法将64只SPF级成年雄性Wistar大鼠分为假手术组、模型组和治疗组,每组18只,余10只备用。治疗组构建AIS后脑缺血再灌注损伤血瘀毒损证模型,并进行苦碟子注射液预处理。模型组构建AIS后脑缺血再灌注损伤血瘀毒损证模型,不进行苦碟子注射液预处理。假手术组不构建AIS后脑缺血再灌注损伤血瘀毒损证模型。观察各组大鼠整个实验过程中的症状、体征;分别于造模后1、3、6、24、72 h及7 d选取各组大鼠4只,评估其Zea Longa评分以观察其神经功能缺损情况;分别于造模后1、3、6、24、72 h及7 d选取各组大鼠3只,透射电镜下观察其海马神经元形态及超微结构。结果 症状、体征:假手术组大鼠活动灵活,四肢对称;模型组大鼠随着造模时间的延长,逐渐出现爪甲肿胀,鼠尾黑紫甚至出现断尾,易激惹,活动受限;治疗组大鼠爪甲肿胀及黑尾、断尾程度较模型组减轻,活动轻微受限,四肢稍显不对称。假手术组大鼠Zea Longa评分均为0分。治疗组大鼠造模后24h、72 h、7 d Zea Longa评分低于模型组(P <0.05)。模型组大鼠造模后24 h、72 h、7 d Zea Longa评分高于本组造模后1 h,造模后72 h、7 d Zea Longa评分高于本组造模后3、6 h(P <0.05);治疗组大鼠造模后7 d Zea Longa评分高于本组造模后1 h(P <0.05)。海马神经元形态及超微结构:假手术组大鼠海马神经元及细胞器结构完整。模型组大鼠造模后6 h海马神经元体积缩小;造模后24、72 h可见细胞核破碎,细胞器大量减少,线粒体肿胀,高尔基体和粗面内质网囊性扩张、肿胀;造模后7 d可见神经元大量减少,形态不规则,细胞器结构破坏严重,线粒体呈空泡状态。治疗组大鼠造模后6 h海马神经元与模型组相比细胞器增多,细胞器结构轻度改变;造模后72 h可见线粒体肿胀程度减轻,高尔基体、粗面内质网形态较好,空泡减少甚至消失,各细胞器结构状态明显好于同期模型组。结论 苦碟子注射液预处理可以减轻AIS后脑缺血再灌注损伤血瘀毒损证模型大鼠的神经功能缺损情况,抑制大鼠患侧海马神经元形态及超微结构的改变,对脑组织具有一定的保护作用,且在造模后6~72 h的作用最明显。

Effect of Platelet Activation and Endothelial Cell Injury on Malignant Cancer

Objective: To study the effects of platelet activation and endothelial cell injury on the patients with malignant tumor and their prognoses.Methods: Radioimmunity and ELISA methods were employed to detect the TXB2, GMP-140, vWF, cGMP and FN in 78 cases of malignant tumor and 40 healthy control persons.Results: The levels of TXB2, MP-140 and cGMP were increased in intestinal cancer group, lung cancer group and hepatic cancer group, while FN decreased in intestinal cancer and lung cancer group. cGMP was positively related to TXB2, GMP-140, vWF in malignant tumor group. FN was decreased in the group complicated with infection and the group with metastasis, while the other indexes increased. GMP-140, vWF and cGMP was decreased after operation except for the increasing of FN.Conclusion: Activations of platelet and injury of endothelial cells developed in patients with malignant tumor, and both of them affected the metastasis and prognosis of malignant tumor. Key words platelet activation - epithelium injury - malignant tumor - metastasis This work was supported by grants from Guangdong Medical Science foundation (A2000633).