谢力子教授从“肠-肝-脾轴”论治克罗恩病经验

克罗恩病(Crohn’s disease,CD)已成为最常见的消化系统疑难病之一。此病病位在肠道,涉及脾、胃、肝、肾、肺等多个脏腑。谢力子教授强调其发病与脾胃升降失常、肝失疏泄以及二者藏血、统血关系失常密切相关。故克罗恩病应基于“肠-肝-脾轴”同时治疗。CD活动期注重祛邪,方选自拟方乌梅败酱方;缓解期注重扶正,方选自拟肠炎方。采用中药口服、药物灌肠、食疗多种方式联合治疗CD。选取一例克罗恩病医案加以分析,反映谢力子教授临床调治经验。

谢力子教授经验方坐浴治疗原发性肛门瘙痒症疗效观察

目的:观察谢力子教授经验方坐浴治疗原发性肛门瘙痒症的临床疗效。方法:将符合纳入标准的66例患者随机分为两组各33例,治疗组予以谢力子教授经验方(土茯苓60 g,黄柏20 g,蛇床子20 g,白鲜皮20 g,苦参20 g,百部20 g,花椒9 g,生大黄20 g,蒺藜20 g,荆芥10 g)坐浴治疗,对照组予以高锰酸钾溶液坐浴治疗。两组均以7天为1个疗程,分别于第1、2、3个疗程结束后观察治疗结果。结果:治疗组在第1个疗程结束后瘙痒症状及皮损体征即有显著改善,对照组在第2个疗程后皮损有所改善,第3个疗程后瘙痒有所改善,且治疗组改善程度均优于对照组(P<0.05)。总疗程完成后治疗组总有效率为90.9%,对照组为78.8%,治疗组疗效优于对照组(P<0.05)。结论:谢力子教授经验方坐浴治疗原发性肛门瘙痒症患者的疗效优于高锰酸钾溶液,能显著改善患者肛门瘙痒症状及肛周皮损,疗效确切,起效迅速,无明显副作用。

基于“肝主筋膜”探讨椒梅汤对肛窦炎的治疗经验

肛窦炎是肛窦、肛门瓣、肛门腺内发生的急性或慢性炎症性疾病,反复炎症刺激极易造成患者排便不尽、坠胀、异物感以及疼痛。据相关文献报道,极大部分肛肠疾病均起源于肛窦炎,故肛窦炎的早期诊断和治疗非常重要。谢力子教授认为肛管直肠黏膜及周围的血管、淋巴等皆属于中医学“筋膜”范畴,“肝主筋膜”,故临床上常运用温肝散寒、柔肝缓急、酸敛肝阴之椒梅汤,从肝论治,以此缓解或治愈肛窦炎,为临床治疗肛窦炎提供了新思路。

PHARMACOKINETICS OF MAGNESIUM ISOGLYCYRRHI-ZINATE AFTER SINGLE INTRAVENOUS DOSE IN HEALTHY VOLUNTEERS

Objective To study the pharmacokinetics of intravenous magnesium isoglycyrrhizinate injection in health volunteers with HPLC-UV. Methods Single doses of 2OOmg magnesium isoglycyrrhizinate were administrated to 10 health volunteers by i. v. infusion. The concentrations of magnesium isoglycyrrhizinate in plasma were assayed by HPLC-UV method. The pharmacokinetic parameters of magnesium isoglycyrrhizinate injection were calculated by program 3P87. Results The main pharmacokinetic parameters of intravenous magnesium isoglycyrrhizinate were as follows： cmax （ 67. 58 ± 8. 84 ） mg/L, T1/2α （ 1.46 ± 0. 35 ） h, T1/2β （ 23. 95 ± 4. 72 ） h, Vd （ 2. 921 ± 0. 382） L, CL （0. 186 ±0. 048） L/h,k10（0. 064 ±0. 016） h^-1, AUC0-T（1015.29 ±225. 14） mg·h^-1·L^-1 ,respectively. Conclusion We have successfully used the analytical method for magnesium isoglycyrrhizinate to study its pharmacokinetical properties of health volunteers after i. v. infusion. The method is found to be simple, accurate, stable and sensitive for application in clinical pharmacokinetics study. The concentration-time plot was fitted to a two-compartment open model with first-order elimination.

Mechanistic considerations for the use of monoclonal antibodies for cancer therapy

Since the approval of rituximab in 1997, monoclonal antibodies(mAbs) have become an increasingly important component of therapeutic regimens in oncology. The success of mAbs as a therapeutic class is a result of great strides that have been made in molecular biology and in biotechnology over the past several decades. Currently, there are 14 approved mAb products for oncology indications, and there are ten additional mAbs in late stages of clinical trials. Compared to traditional chemotherapeutic agents, mAbs have several advantages, including a long circulating half-life and high target specificity. Antibodies can serve as cytotoxic agents when administered alone, exerting a pharmacologic effect through several mechanisms involving the antigen binding(Fab) and/or Fc domains of the molecule, and mAbs may also be utilized as drug carriers, targeting a toxic payload to cancer cells. The extremely high affinity of mAbs for their targets, which is desirable with respect to pharmacodynamics(i.e., contributing to the high therapeutic selectivity of mAb), often leads to complex, non-linear, target-mediated pharmacokinetics. In this report, we summarize the pharmacokinetic and pharmacodynamics of mAbs that have been approved and of mAbs that are nearing approval for oncology indications, with particular focus on the molecular and cellular mechanisms responsible for their disposition and efficacy.

The molecular dynamics of neural metabolism during the action potential

Neural information processing is tightly coupled to both energy consumption and derivation from substrates.In this study,the energy function of the neuron during the action potential(AP)is described and analyzed.It has been observed that energy consumption during the AP does not match predictions of the conventional theory of neural energy dynamics.On short time scales,neural energy expenditure shifts between positive and negative phases.During the AP,the energy source switches from neuronal stores(positive expenditure or net consumption)to exploitation of external substrates,specifically the glucose and oxygen carried in cerebral blood(the negative consumption phase).Based on the idea of reductionism,this paper demonstrates how ion channels,membrane pumps and transporters,ionotropic and metabotropic receptor signaling pathways,astrocyte glycolysis and the production lactate,and the glutamate-glutamine cycle all serve to relate cerebral blood flow and neuronal metabolism to neuronal activity and so maintain neuronal energy charge during the AP.

The sulfur metabolism regulator MetR is a global regulator controlling phytochrome-dependent light responses in Aspergillus nidulans

Phytochrome-dependent light signaling has been studied in several fungi.In Aspergillus nidulans lightstimulated phytochrome activates the high-osmolarity glycerol(HOG)signaling pathway and thereby controls the expression of a large number of genes,many of which are related to stress responses.In a genome-wide expression analysis in A.nidulans we found that phytochrome,fph A,is under strict expression control of the central regulator of the sulfur-starvation response,Met R.This transcriptional regulator is required for the expression of genes involved in inorganic sulfur assimilation.In the presence of organic sulfur,Met R is probably ubiquitinated and possibly degraded and the transcription of sulfur-assimilation genes,e.g.,sulfate permease,is turned off.The expression analysis described here revealed,however,that Met R additionally controls the expression of hundreds of genes,many of which are required for secondary metabolite production.We also show that met R mutation phenocopies fph A deletion,and five other histidine-hybrid kinases are down-regulated in the met R1 mutant.Furthermore,we found that light and phytochrome regulate the expression of at least three carbon–sulfur hydrolases.This work is a further step towards understanding the interplay between light sensing and metabolic pathways.