“面肿曰风”临床体会

近日在家,研读《内经》,见“面肿曰风”,不禁忆起去年此时所诊一患者,其发病及诊治过程证实经典之妙。述之如下。

肿节风对白血病CEM细胞的抑制作用

目的:研究肿节风水提物对白血病CEM细胞的抑制作用及其机制。方法:以白血病CEM细胞作为研究对象,采用MTT比色试验检测肿节风水提物对CEM细胞的抑制率;光镜、电镜技术观察肿节风水提物作用CEM细胞后其形态的改变;DNA琼脂糖凝胶电泳检测肿节风水提取物对白血病CEM细胞的凋亡作用。结果:肿节风水提物能明显抑制CEM细胞的生长,生药浓度在1.79mg/ml作用24h后,即具有显著的抑制作用,抑制率随剂量的加大和时间的延长而增强,作用48h的半数抑制生药浓度(IC50)约为24.2mg/ml;与对照组相比,实验组光镜、电镜下可见细胞体积缩小,胞浆浓缩、细胞膜皱缩,核解聚、染色质明显浓缩、聚集,边聚于核膜下,甚至形成凋亡小体;琼脂糖凝胶电泳结果显示实验组出现明显的DNA梯形凋亡带,而对照组没有出现梯形条带。结论:肿节风水提物对白血病CEM细胞的生长具有明显的抑制作用,诱导细胞凋亡可能是其抑制白血病CEM细胞生长的机制之一。

肿节风总黄酮对免疫性血小板减少大鼠骨髓细胞微环境的影响

目的:通过建立免疫性血小板减少症(ITP)大鼠模型,研究肿节风总黄酮对模型大鼠血小板以及骨髓细胞微环境的影响。方法:将54只SD大鼠依据外周血小板数目随机均分为空白对照组、ITP模型组、肿节风总黄酮0.0945、0.0630、0.0315g/kg剂量组和阳性药物醋酸泼尼松龙组。除正常组外,每只大鼠于第1、3、4、6、7、8天腹腔注射兔抗大鼠血小板血清(APS)建立ITP大鼠模型,同时给予相应药物干预。第10天检测各组动物血小板数目,台酚蓝染色计算骨髓有核细胞活力,体外培养并观察骨髓基质细胞生长状况及形成集落数目。结果:与模型对照组比较,肿节风总黄酮0.0945、0.0630、0.0315g/kg剂量组和醋酸泼尼松龙组大鼠血小板数量均显著增加,肿节风总黄酮0.0945、0.0630、0.0315g/kg剂量组骨髓单核细胞活力、相同时间内基质细胞贴壁率均显著提高,肿节风总黄酮0.0945和0.0630剂量组成纤维细胞集落数目明显增多。结论:肿节风总黄酮可以提升ITP模型大鼠血小板数量,可能是通过影响骨髓基质细胞改善了骨髓细胞微环境,进而促进巨核细胞分化生成血小板。

肿节风总黄酮对阿糖胞苷所致血小板减少动物模型骨髓基质细胞和巨核细胞的影响

目的:利用阿糖胞苷建立化疗所致血小板减少症小鼠模型,研究肿节风总黄酮对模型小鼠血小板以及骨髓微环境中基质细胞和巨核细胞的影响。方法:将60只小鼠依据外周血小板数目随机均分为空白对照组、阿糖胞苷模型组、肿节风总黄酮31.50、63.00、94.50 mg/kg剂量组和阳性药物醋酸泼尼松龙组。除正常组外,每只小鼠腹腔注射阿糖胞苷建立化疗所致血小板减少小鼠模型,同时给予相应药物干预。动态检测外周血小板数目,实验结束时检测骨髓有核细胞活力,观察体外培养骨髓基质细胞生长状况,观察统计骨髓石蜡切片中巨核细胞数目及多倍体比例,免疫组化检测骨髓中基质细胞TPO以及巨核细胞相应受体C-mpl的表达量。结果:与模型组相比,肿节风总黄酮63.00 mg/kg和94.50 mg/kg剂量组显著提升模型动物外周血小板数目,显著提高骨髓有核细胞活力和骨髓基质细胞体外生长贴壁情况,显著提高骨髓中巨核细胞数目,肿节风总黄酮94.50 mg/kg剂量组显著提高多倍体巨核细胞比例;肿节风总黄酮63.00、94.50 mg/kg剂量组极显著促进骨髓内巨核细胞周围基质细胞TPO以及巨核细胞中相应受体C-mpl的表达。结论:肿节风总黄酮能显著提升阿糖胞苷诱导血小板减少症动物外周血小板数目,可能是影响了骨髓基质细胞生长状况,以及促进其产生有利于巨核细胞增殖分化的细胞因子,经过TPO-C-mpl通路促进巨核细胞增殖、分化和形成血小板。

肿节风总黄酮含药血浆对大鼠骨髓巨核细胞增殖及TPO、TGF-β1含量的影响

目的:探讨肿节风总黄酮含药血浆对大鼠骨髓巨核细胞增殖及TPO、TGF-β1含量的影响。方法:分别一次性灌胃给予SD大鼠肿节风总黄酮0.39、2.0 g/kg,于给药后20、40、60 min眼眶取血收集肿节风总黄酮含药血浆。采用兔抗大鼠血小板相关抗体(稀释倍数为128倍)建立大鼠骨髓巨核细胞增殖障碍模型,考察肿节风总黄酮0.39、2.0 g/kg含药血浆对大鼠骨髓巨核细胞增殖及培养上清液中TPO、TGF-β1含量的影响。结果:(1)兔抗大鼠血小板相关抗体可显著降低大鼠骨髓巨核细胞增殖;相对于空白血浆组,肿节风总黄酮0.39、2.0 g/kg含药血浆可显著促进大鼠骨髓巨核细胞的增殖。(2)兔抗大鼠血小板相关抗体可显著降低大鼠骨髓巨核细胞培养体系中TPO含量,显著增加TGF-β1含量;相对于空白血浆组,肿节风总黄酮0.39、2.0 g/kg含药血浆可显著增加大鼠骨髓巨核细胞培养体系中TPO含量,显著降低TGF-β1含量。结论:肿节风总黄酮0.39、2.0 g/kg含药血浆可显著促进大鼠骨髓巨核细胞的增殖,可能与增加大鼠骨髓巨核细胞培养体系中TPO含量,降低TGF-β1含量等有关。

肿节风总黄酮对体外骨髓基质细胞-巨核细胞共培养体系的影响

目的:探索肿节风总黄酮对骨髓基质细胞-巨核细胞共培养体系中巨核细胞分化成熟,以及基质细胞状态的影响。方法:模拟骨髓微环境,建立KM小鼠骨髓基质细胞和巨核细胞共培养体系,实验分为空白对照组、阿糖胞苷模型组、二甲基亚砜(DMSO)对照组、肿节风总黄酮组7.80、3.90、1.95μg/ml剂量组,每组3个复孔。各组培养4天后分离巨核细胞进行涂片、染色、统计多倍体数目,流式细胞术分析巨核细胞CD61表达量,消化培养体系中贴壁的基质细胞,流式细胞术检测其凋亡情况,ELISA检测培养体系中TPO和SDF-1的含量。结果:与阿糖胞苷模型组相比,肿节风总黄酮7.80μg/ml和3.90μg/ml剂量组中多倍体巨核细胞数目显著增加,肿节风总黄酮7.80μg/ml剂量组巨核细胞CD61表达水平明显提高。肿节风总黄酮7.80μg/ml和3.90μg/ml剂量组显著降低基质细胞的凋亡率。肿节风总黄酮7.80、3.90、1.95μg/ml剂量组显著提高培养体系中TPO和SDF-1的含量。结论:肿节风总黄酮可能是通过抑制共培养体系中基质细胞凋亡促进"量"的增加,增进其分泌细胞因子TPO、SDF-1影响"质"的变化,改善骨髓微环境,促进巨核细胞分化成熟和产生更多的血小板。

肿节风总黄酮及迷迭香酸、落新妇苷对大鼠骨髓巨核细胞增殖的影响

目的:探讨肿节风总黄酮部位及其成分迷迭香酸、落新妇苷对大鼠骨髓巨核细胞增殖及血小板生成素(TPO)、转化生长因子-β1(TGF-β1)的影响。方法:采用兔抗大鼠血小板相关抗体(稀释倍数为128倍)建立大鼠骨髓巨核细胞增殖障碍模型,研究肿节风总黄酮部位500、250、125、62.5μg/ml,迷迭香酸500、250、125、62.5μg/ml及落新妇苷500、250、125、62.5μg/ml对大鼠骨髓巨核细胞增殖及培养上清液中TPO及TGF-β1含量的影响。结果:(1)肿节风总黄酮部位500、250、125μg/ml,迷迭香酸250、125μg/ml及落新妇苷500、250μg/ml均可显著促进大鼠骨髓巨核细胞的增殖;(2)肿节风总黄酮部位500、250、125、62.5μg/ml,迷迭香酸500、250μg/ml及落新妇苷500、250、62.5μg/ml均可显著降低培养体系中TPO的含量;肿节风总黄酮部位250、125、62.5μg/ml及落新妇苷500、125μg/ml均可显著增加培养体系中TGF-β1的含量,迷迭香酸对培养体系中TGF-β1的含量无明显影响。结论:肿节风总黄酮部位、迷迭香酸及落新妇苷均可以促进大鼠骨髓巨核细胞的增殖,迷迭香酸及落新妇苷是肿节风总黄酮部位促骨髓巨核细胞增殖的物质基础。

A Preliminary Investigation on Anti-inflammatory and Antibacterial Effect of Compound Sarcandra Aerosol

[Objective] This study aimed to reveal the therapeutic mechanism of compound sarcandra aerosol, which was exclusively owned by the Second Affiliated Hospital of Guiyang College of Traditional Chinese Medicine. [Method] An inflammation model was established by xylene-induced inflammation test and carrageenan- induced inflammation test to analyze the anti-inflammatory effect of compound sarcandra aerosol. By bacteriostasis test in vitro, the antibacterial effect of compound sarcandra aerosol against five common pathogens of pharyngitis was investigated. Blood samples were collected from Wistar rats in different compound sarcandra aerosol groups and control group to compare blood routine indicators and interleukin-1 （IL-1） levels. [Result] Three different concentrations of compound sarcandra aerosol could reduce degrees of xylene-induced ear edema in mice and carrageenan- induced paw edema in rats, but the anti-inflammatory effect of compound sarcandra aerosol was reduced as the concentration declined. In bacteriostasis test in vitro, the minimum inhibitory concentration of compound sarcandra aerosol against Streptococcus pneumoniae, Streptococcus hemolytis, Corynebacterium diphtheriae, Staphylococcus aureus and Salmonella typhimurium was 76, 105 38, 65 and 30 mg/ml, respectively. Compound sarcandra aerosol reduced white blood cell count, neutrophil count and lymphocyte percentage in pharyngitis model rats. Moreover, interleukin-1 level in watermelon frost lozenge group and different compound sarcandra aerosol groups was lower compared with control group. [Conclusion] Compound sarcandra aerosol can effectively treat pharyngitis by exerting anti-inflammatory and antibacterial effect and reducing interleukin-1 level. This study laid a solid foundation for clinical application of compound sarcandra aerosol.

蔓菁无公害高产栽培

蔓菁也叫芜菁、大头菜、圆头菜,是十字花科芸薹属二年生草本植物,以肥大的肉质根为食用器官,富含维生素A、叶酸、维生素C、维生素K、钙、亚油酸、芸薹素、蛋白质等十几种物质;此外蔓菁具有较高的药用价值,味苦辛甘,平开胃下气,利湿解毒,治食积不化,黄疸,消渴,热毒风肿,疔疮,乳痈,是一种健康功能型蔬菜,常食对身体极为有利。蔓菁是洱源县特色蔬菜之一,多种植在海拔2000 m以上,可作鲜品食用,也可切片晒成干品存放。

Opisthorchis viverrini:The carcinogenic human liver fluke

Opisthorchiasis caused by Opisthorchis viverrini remains a major public health problem in many parts of Southeast Asia, including Thailand, Lao PDR, Vietnam and Cambodia. The infection is associated with a number of hepatobiliary diseases, including cholangitis, obstructive jaundice, hepatomegaly, cholecystitis and cholelithiasis. Multi-factorial etiology of cholangiocarcinoma, mechanical damage, parasite secretions, and immunopathology may enhance cholangiocarcinogenesis. Moreover, both experimental and epidemiological evidences strongly implicate liver fluke infection as the major risk factor in cholangiocarcinoma, cancer of the bile ducts. The liver fluke infection is induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region, particularly in rural areas, of Thailand. The health education programs to prevent and control opisthorchiasis are still required in the high-risk areas.

复方肿节风雾化剂对慢性咽炎模型大鼠咽部黏膜组织炎症因子的影响

目的探讨复方肿节风雾化剂治疗慢性咽炎的可能作用机制。方法将60只SD大鼠随机分为正常组10只和造模组50只。造模组大鼠采用A族乙型溶血性链球菌注射液咽部注射构建慢性咽炎大鼠模型,将造模成功的42只大鼠随机分为模型组10只,氨苄西林钠组及复方肿节风低、中、高剂量组,每组8只。复方肿节风低、中、高剂量组分别给予20ml含有复方肿节风雾化剂2.33、4.66、9.32g/(kg·d)的氯化钠溶液进行超声雾化,正常组、模型组给予等体积生理盐水雾化,氨苄西林钠组腹腔注射氨苄西林钠0.93g/(kg·d)。在造模开始后第4、14天观察各组大鼠毛发、精神状态、口腔分泌物、咽部黏膜等情况,14天后HE染色观察咽部黏膜组织病理;ELISA法检测咽部黏膜组织肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)含量。采用RT-qPCR和免疫组化法检测咽部黏膜组织中肿瘤坏死因子受体相关因子6(TRAF6)、核因子κB p65(NF-κB p65)蛋白及mRNA表达。结果与正常组比较,模型组大鼠咽部黏膜结构不完整,破坏明显,上皮脱落、坏死,见大量炎性细胞浸润,咽部黏膜组织TNF-α、IL-1β、IL-6水平,TRAF-6、NF-κB p65蛋白及mRNA表达量均升高(P<0.05)。与模型组比较,复方肿节风高、中剂量组及氨苄西林钠组咽部黏膜上皮未见明显角质化,复合鳞状上皮未见明显增生,可见少量炎症细胞浸润,肌层纤维排列整齐;复方肿节风低剂量组咽部黏膜组织复层鳞状上皮角质化、增生、脱落,黏膜下层水肿,大量炎症细胞浸润,肌层纤维排列欠规则。与模型组比较,复方肿节风高、中剂量组及氨苄西林钠组大鼠咽部黏膜组织中TNF-α、IL-1β、IL-6含量,TRAF-6、NF-κB p65蛋白及mRNA表达均降低(P<0.05)。结论复方肿节风雾化剂能有效改善慢性咽炎模型大鼠咽部黏膜炎性状态,其中高、中剂量效果更好,其作用机制可能与调控咽部黏膜组织TRAF6/NF-κB p65通路有关。

Risk factors for neoplastic progression in Barrett's esophagus

Barrett's esophagus (BE) confers a significant increased risk for development of esophageal adenocarcinoma (EAC), with the pathogenesis appearing to progress through a "metaplasia-dysplasia-carcinoma" (MDC) sequence. Many of the genetic insults driving this MDC sequence have recently been characterized, providing targets for candidate biomarkers with potential clinical utility to stratify risk in individual patients. Many clinical risk factors have been investigated, and associations with a variety of genetic, specific gastrointestinal and other modifiable factors have been proposed in the literature. This review summarizes the current understanding of the mechanisms involved in neoplastic progression of BE to EAC and critically appraises the relative roles and contributions of these putative risk factors from the published evidence currently available.

Pituitary prolactin adenoma with Toxoplasma gondii infection

Objective: To report two recent cases of pituitary adenoma associated with Toxoplasma gondii (T.Gondii) infection.Methods: Histological changes were observed in H & E and PAS staining sections microscopically.Immunohistochemistry was performed to classify the pituitary tumors and to confirm the diagnosis of T.gondii.Results: The cases were 43- and 19-year-old females, in which the latter one was a recurring case, and radiology examination showed that tumors existed in sellar region.Microscopically, the tumors consisted of small homogenous polygonal or round cells with abundant eosinophilic granular cytoplasm.Immunohistochemistry revealed they were prolactin-producing adenomas.Interestingly, we found toxoplasma infection in the tumor tissues, being confirmed by T.gondii sepicific antibody immunohistochemistry.Conclusion: The association of pituitary adenoma with toxoplasma raises the possibility that T.gondii may be involved in the development of certain cases of pituitary adenoma.

ATM in breast and brain tumors:a comprehensive review

The ATM gene is mutated in the syndrome,ataxia-telangiectasia(AT),which is characterized by predisposition to cancer.Patients with AT have an elevated risk of breast and brain tumors Carrying mutations in ATM,patients with AT have an elevated risk of breast and brain tumors.An increased frequency of ATM mutations has also been reported in patients with breast and brain tumors;however,the magnitude of this risk remains uncertain.With the exception of a few common mutations,the spectrum of ATM alterations is heterogeneous in diverse populations,and appears to be remarkably dependent on the ethnicity of patients.This review aims to provide an easily accessible summary of common variants in different populations which could be useful in ATM screening programs.In addition,we have summarized previous research on ATM,including its molecular functions.We attempt to demonstrate the significance of ATM in exploration of breast and brain tumors and its potential as a therapeutic target.

Spontaneous pineal apoplexy in a pineal parenchymal tumor of intermediate differentiation

Pineal apoplexy is a rare clinical presentation of pineal parenchymal tumors. We report the curative treatment of a case of pineal parenchymal tumor of intermediate differentiation with spontaneous apoplectic hemorrhage. This case is shown through computed tomography and magnetic resonance imaging of the brain, and is confirmed via histopathological studies. Recurrent upward gaze paresis was observed after the stereotactic biopsy. The paresis required an expeditious tumor resection. The mechanism of the pineal apoplectic hemorrhage remains unclear although it has been observed in different pineal region lesions. Clinical and radiological evidence of the cure 5 years post-surgery is available.

Diabetes mellitus as a risk factor for gastrointestinal cancer among American veterans

AIM:To assess the risk of biliary and pancreatic cancers in a large cohort of patients with type 2 diabetes mellitus(DM) .METHODS:Eligibility for this study included patients with type 2 DM(ICD-9 code 250.0) who were discharged from Department of Veteran Affairs hospitals between 1990 and 2000.Non-matched control patients without DM were selected from the same patient treatment files during the same period.Demographic information included age,sex and race.Secondary diagnoses included known risk factors based on their ICD-9 codes.By multivariate logistic regression,the occurrence of biliary and pancreatic cancer was compared between case subjects with DM and controls without DM.RESULTS:A total of 1172496 case and control subjects were analyzed.The mean age for study and control subjects was 65.8 ± 11.3 and 64.8 ± 12.6 years,respectively.The frequency of pancreatic cancer in subjects with DM was increased(0.9%) in comparison to control subjects(0.3%) with an OR of 3.22(95% CI:3.03-3.42) .The incidence of gallbladder andextrahepatic biliary cancers was increased by twofold in diabetic patients when compared to controls.The OR and 95% CI were 2.20(1.56-3.00) and 2.10(1.61-2.53) ,respectively.CONCLUSION:Our study demonstrated that patients with DM have a threefold increased risk for developing pancreatic cancer and a twofold risk for developing biliary cancer.

Anti-mycobacterium and Anti-cancer Activities of Combretin, an Isolated Steroidal Alkaloid from the Seeds of Combretum quadrangulare Kurz.

Combretin is the steroidal alkaloid isolated from the seeds of Combretum quadrangulare Kurz. by macerated powder of the seeds with 95% ethanol. Purified further by avicel column chromatography and preparative thin layer chromatography. Combretin was investigated for anti-mycobacterium and anti-cancer activities. Combretin was inactive against Mycobacterium tuberculosis but showed anti-cancer activities against human hepatocarcinoma （Hep G2） ATCC HB-8065 and human caucasian colon adenocarcinoma （Caco2） ATCC HTB-39 at concentration greater than 300 mcg/ml in DMSO （Dimethyl sulfoxide）.

Glutathione-S-transferase (GSTM1,GSTT1) and the risk of gastrointestinal cancer in a Korean population

AIM： To evaluate the association of glutathione S-trans-ferase mu （GSTM1） and glutathione S-transferase theta （GSTT1） null genotypes with the risk of gastric cancer （GC） and colorectal cancer （CRC） in a South Korean population. METHODS： We conducted a population-based, large- scale case-control study including 2213 GCs, 1829 CRCs, and 1699 controls. Null and non-null genotypes of GSTM1 and GSI-F1 were determined using realtime PCR. RESULTS： The null genotypes of GSTM1 and GSTT1 were not significantly associated with elevated risk of gastric （OR = 1.070, 95% CI = 0.935-1.224; OR = 1.101, 95% CI = 0.963-1.259, respectively） or colorectal cancer （OR = 1.065, 95% CI = 0.923-1.228; OR = 1.041, 95% CI = 0.903-1.200, respectively）. The frequency of the combined null GST genotype was not different between the two cancer groups and controls. Moreover, smoking, drinking, and age did not modify the association between these genotypes and the risk of gastric or colorectal cancer. CONCLUSION： GSTM1 and GSCI-1 null genotypes were not associated with increased risk of GC or CRC in Koreans.

Effects of Gancao Nourish-Yin Decoction on Liver Metabolic Profiles in hTNF-αTransgenic Arthritic Model Mice

Objective Gancao Nourish-Yin Decoction(GNYD)has been applied to clinical rheumatoid arthritis(RA)patients,and it had shown effectiveness not only in disease activity controlling but also in improving patients'physical status.However,its mechanism of function has not been investigated.Metabolic perturbations have been associated with RA,and targeting the metabolic profile is one of the ways to manage the disease.The aim of this study is to observe the effect of GNYD on metabolic changes of human tumor necrosis factorα(hTNF-α)transgenic arthritic model mice.Methods hTNF-αtransgenic arthritic model mice were divided into the control group and the GNYD group with six mice in each group.After 8 weeks of treatment,liver tissues of mice in both groups were obtained for liquid chromatography-mass spectrometry analysis.Significantly regulated metabolites by GNYD treatment were first identified,followed by Kyoto Encyclopedia of Genes and Genomes pathway and network analysis.Results A total of 126 metabolites were detected in the liver.Compared with the control group,17 metabolites in the GNYD group were significantly altered.Specifically,thiamine,gamma-L-glutamyl-L-valine,pantothenic acid,pyridoxal(vitamin B6),succinic acid,uridine 5′-diphospho-glucuronic acid,uridine,allantoic acid,N-acetyl-D-glucosamine,nicotinamide ribotide,and N2,N2-dimethylguanosine were down-regulated by GNYD treatment,whereas isobutyrylglycine,N-acetylcadaverine,N-carbamoyl-L-aspartic acid,L-anserine,creatinine,and cis-4-hydroxy-D-proline were up-regulated.Six metabolic pathways were significantly altered including the alanine,aspartate,and glutamate metabolism;pyrimidine metabolism;thiamine metabolism;amino sugar and nucleotide sugar metabolism;pantothenate and CoA biosynthesis;and citrate cycle.Integrative metabolic network analysis suggested the possibility of GNYD having both positive and negative effects on RA through the suppression of angiogenesis and the promotion of leukocyte extravasation into the synovium,respectively.Conclusions GNYD can modulate the hepatic metabolism of hTNF-αtransgenic arthritic model mice.Further optimization of this decoction may lead to better therapeutic effects on RA patients.