骨髓铁染色、幼稚红细胞百分率和网织红细胞百分率对贫血的诊断价值

目的：探讨骨髓铁染色、幼稚红细胞百分率和网织红细胞百分率对贫血的诊断价值。方法：对1688例贫血病例,分别作骨髓铁染色、幼稚红细胞百分率和网织红细胞百分率检查。结果：缺铁性贫血患者骨髓铁染色内外铁降低,幼稚红细胞百分率30%～40%,网织红细胞百分率0.5%～5.0%;巨幼细胞性贫血患者幼稚红细胞百分率40%～50%;缺铁伴轻度巨幼细胞性贫血患者骨髓铁染色内外铁降低,幼稚红细胞百分率40%～50%,网织红细胞百分率0.5%～5.0%;溶血性贫血患者幼稚红细胞百分率〉50%,网织红细胞〉10%;再生障碍性贫血患者网织红细胞百分率〈0.5%;慢性疾病性贫血患者骨髓铁染色外铁正常或增加,内铁降低,幼稚红细胞百分率〈30%。结论：骨髓铁染色、幼稚红细胞百分率和网织红细胞百分率对贫血诊断具有重要价值。     

神经母细胞瘤骨髓象观察

本文对病理检查和临床确诊的19例神经母细胞瘤患者的血象及骨髓象进行了观察。结果13例发生骨髓转移的患者,外周血象大部分呈中度或重度贫血。9例出现幼粒和幼红细胞。5例血小板减少。骨髓象变化根据瘤细胞浸润程度不同有较大差异。神经母细胞瘤细胞在不同病例中可有不同形态,即使在同一病例的涂片中,瘤细胞形态亦不尽一致。多数呈原粒细胞样或淋巴细胞样。13例骨髓穿刺涂片阳性的病例均出现许多裸核、破碎细胞。有11例见到瘤细胞团。此外,还讨论了骨髓穿刺涂片中瘤细胞团出现的意义和骨髓穿刺涂片对诊断神经母细胞瘤骨髓转移的价值。     

骨髓坏死8例分析

骨髓坏死(Bone Marrow Necrosis)是指骨髓中的造血细胞发生原位性坏死,其原发病见于某些血液病,转移癌等,预后不良。本文就1978～1990年5月进行1853例骨髓涂片镜检中有8例骨髓坏死,报道如下。1 临床资料:患者中男5、女3,年龄2～45岁。其中急性白血病3例,慢性粒细胞白血病1例,慢性粒细胞白血病急性变2例,骨髓转移癌2例;均在明确骨髓坏死后短期内死亡或自动出院。临床表现主要与原发病有关,但全身持续性剧烈骨痛较明显,一般止痛药不能缓解;受累部位有明显的压痛;伴发热37.6℃～40.0℃;均有不同程度的贫血和出血。血徐片有6例白血病均可见到原始及幼稚细胞。各病例经髂骨穿刺1～4次,多为干抽,仅抽出少许“脓性”骨髓液,镜检特点是坏死,细胞结构模糊不清,胞膜破裂,浆溶解,核退变,细胞间满布片状及颗粒状嗜酸性、无结构物质,尚见少许散在完整细胞。     

骨髓坏死三例分析

1 .病例资料例 1　女性患者 2 4岁 ,因全身骨痛 ,关节疼痛 ,贫血查因入院。初次骨髓检查显示 :ANLL—M 2a。进行化疗一周后复查骨髓显示 :ANLL—M2a并骨髓坏死。例 2　患儿、男、8岁 ,发热、肌肉疼痛、贫血 3天入院。初次骨髓象示ALL—L2并骨髓坏死。例 3　男性患者 37岁 ,骨痛、发热、贫血入院 ,初次骨髓象示骨髓坏死。 1个月后复查骨髓显示ALL—L2。该患者在鞋厂工作 12年 ,有长期接触化学类试剂史。2 .临床表现3例患者均表现为骨痛、发热、贫血、有淋巴结肿大或肝脾肿大。3.实验室检查外周血象有 2系或 3系减少 ,3例均有红细胞减…     

骨髓转移癌19例血象分析

目的 探讨骨髓转移癌的血象变化。方法 对19例已行骨髓穿刺和临床确诊的骨髓转移癌患者进行血细胞计数和血涂片细胞分数。结果 主要表现为细胞分数可见幼稚红细胞和幼稚粒细胞(占68．4％)，血红蛋白(HGB)减低(占63．2％)，血小板(PLT)减低(占57．9％)。结论 对于肿瘤患者应该重视血液常规的检查，若血涂片细胞分数可见幼稚红细胞和幼稚粒细胞，结合HGB或PLT的数值减低和一些临床表现，提示临床肿瘤细胞可能已向骨髓转移。     

原发性骨髓纤维化50例分析

本文总结1955～1980年的原发性骨髓纤维化共50例,其中48例经骨髓活检证实,另2例经脾脏病理检查证实有髓外造血而确诊.本组病例男性39例,女性11例。常见症状为乏力、头昏。脾脏肿大为最突出的体征,有5例在诊断本病前,已做了脾脏切除术。周围血有11例出现泪滴状红细胞,36例出现幼红细胞,有37例出现幼稚粒细胞。骨髓病理检查以骨髓萎缩与纤维化型最为常见。怍者对诊断、鉴别诊断、中西医结合治疗,以及本病与骨髓增殖性疾病间的关系作了讨论。     

小儿骨髓增生异常综合症(MDS)13例临床分析

目的：探讨小儿骨髓增生异常综合症(MDS)的实验室检查特征及临床特点。方法：对13例诊断为MDS患儿的外周血、骨髓像及临床表现进行回顾性分析：结果：13例患儿11例为男性，2例女性。临床以发热、贫血、肝脾肿大为主要表现。13例患儿均为中重度贫血，外周血见有核红细胞，白细胞表现为增高、正常或减低。4例患儿外周血见幼稚细胞，血小板可正常或减低，网织红细胞多数偏高。骨髓均增生活跃，有红系或粒系病态造血，以巨幼样改变为主；诊断为RA10例，RAEB2例，RAEB-t1例。结论：小儿MDS诊断仍主要靠骨髓检查，骨髓至少一系出现病态造血，巨幼样改变较易见，并除外其他引起病态造血的疾病，需注意和再障相鉴别：     

116例急性白血病初诊时外周血幼稚细胞检出率及髓象分析

目的　了解急性白血病初诊时外周血幼稚细胞的检出率及髓象情况。方法　对 116例急性白血病初诊时外周血幼稚细胞检出率及髓象进行分析。结果　幼稚细胞检出率为 93 .10 % ,以急非淋中的M3 型比例最高 ,未检出幼稚细胞的病例外周血常呈全血细胞减少的表现 ,且分类部分以成熟淋巴细胞为主 ,易误诊为再障 ,此类病例骨髓检查部分为低增生性急性白血病。结论　外周血检出幼稚细胞对诊断急性白血病具有重要意义。对未检出者应做骨髓检查确诊     

细胞毒药所致的骨髓造血异常综合征

观察了15例接受过细胞毒药物患者的造血系统的变化,其中肿瘤9例,非肿瘤性疾病6例。在化疗后1～96个月,对临床上出现不能解释的两系或全血细胞减少者,进行了全血细胞计数、骨髓形态学、细胞遗传学和外周血的扫描电镜检查。13例诊断为骨髓造血异常综合征,包括难治性贫血6例,伴环形铁粒幼的难治性贫血3例,伴原始细胞增多的难治性贫血2例,骨髓增生综合征2例。8例表现为红系过度增生,13例有巨幼样红细胞,幼红细胞核的变化尤为显著。5例检查了染色体,4例为亚二倍体。对4例用扫描电镜检查了外周血,3例发现有小巨核细胞。     

22例患者骨髓移植后血象和骨髓像分析

观察２２例白血病患者骨髓移植后的血象及骨髓像。研究结果表明，骨髓移植后１４ｄ骨髓像首先出现少数幼稚造血细胞与造血岛；３５ｄ左右患者骨髓像基本恢复正常。在骨髓恢复初期外周血可出现幼稚红细胞及幼稚粒细胞。     

程丑夫教授论治情志病验案举隅

程丑夫是国家级名老中医,湖南中医药大学第一附属医院主任医师、教授、博士生导师,享受政府特殊津贴专家,出身于中医世家,从医40余年,经验丰富,对于内科系统及疑难杂症的治疗颇有心得,笔者有幸跟师学习,聆听教诲,受益匪浅,现将程师论治情志病的经典验案略陈一二。1思虑伤脾案患者肖某,女,27岁。初诊：2014年5月20日。半年前因婚变后出现忧心忡忡,多思多虑,近1月来反复腹部胀满,刻诊：腹胀,食后为甚,呃逆,无反酸,通气后可减轻,无腹痛,不欲食,夜寐不安,二便调。舌红苔厚白腻,脉弦,BP：110／70mmHg。     

益智健脑颗粒联合针灸对阿尔茨海默病大鼠学习记忆的影响

目的观察益智健脑颗粒联合针灸对阿尔茨海默病（Alzheimers disease,AD）大鼠学习记忆的影响。方法将大鼠随机分为假手术组（A组）、模型组（B组）、针灸组（C组）、益智＋针灸组（D组）各10只,B、C、D 3组分别以海马CA1区注射β淀粉样蛋白25-35（Aβ25-35）造模,A组注射等量的双蒸水,各组分别治疗20 d后行Morris水迷宫试验,观察大鼠学习记忆能力变化。结果B组较A组的平均潜伏期明显延长,差异具有统计学意义（P〈0.05）;与B组比较,C组、D组的平均潜伏期明显缩短,过台次数增多,差异具有统计学意义（P〈0.05,P〈0.01）;与C组比较,D组的潜伏期缩短,过台次数增多,差异具有统计学意义（P〈0.05）。结论益智健脑颗粒联合针灸能够提高Aβ25-35介导的AD模型大鼠的学习记忆能力。     

补肾活血方对PCOS大鼠模型卵巢中PAI-1mRNA表达的影响

目的探讨补肾活血方对大鼠PCOS模型卵巢局部纤溶酶原激活物抑制因子-1（PAI—1mRNA）表达的影响。方法选用未成年24d龄SD雌性大鼠60只,随机分为模型组、克罗米酚组、补肾活血方高剂量组、补肾活血方低剂量组、正常对照组5组。用Bogovich法建立大鼠多囊卵巢病理模型。以克罗米酚为对照。用原位杂交法观察补肾活血方对多囊卵巢大鼠局部PAI—1mRNA的影响。结果模型组卵巢局部PAI—1mRNA存在卵泡膜间质细胞显著增高,用补肾活血方高、低剂量与克罗米酚药后,卵巢局部PAI-1mRNA的表达明显降低．差异具有统计学意义（P〈0．05、P〈0．01）。补肾活血方高剂量组与克罗米酚组比较,差异具有显著统计学意义（P〈0．01）;低荆量组与克罗米酚组比较差异无统计学意义（P〉0．05）,补肾活血方高、低剂量组比较,低剂量组卵泡膜间质细胞上PAI-1的基因表达增高更明显,但二者差异无统计学意义（P〉0．05）。结论PAI-1mRNA可能与多囊卵巢综合征的发病机制有关。以补肾活血立法的补肾活血方能降低多囊卵巢大鼠局部PAI—1mRNA的显著增高表达．降低PAI—1mRNA卵巢局部的作用。提示补肾活血方可能通过PAI—1mRNA途径促进卵巢排卵的机制。     

表皮生长因子受体酪氨酸激酶抑制剂在非小细胞肺癌应用的瓶颈——获得性耐药

以表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI）分子靶向治疗研究为肇始,转化性研究使基础实验和临床实践间的鸿沟迅速填平,改变着人们认识治疗肺癌的视角。无可否认,EGFR-TKI上市后极大地延伸了肿瘤学家治疗肺癌的手段,但不管从临床经验、临床研究数据、分子生物学层面还是文献计量学的角度,     

New Mechanism of Herb-herb Interaction between Ginseng and Trogopterus Based on CYPs in Rat Livers

The study was designed to investigate the potential mechanism of herb-herb interaction between ginseng and Trogopterus （Trg） based on Cytochrome P450 isozymes （CYPs） in rat livers. We estimated the influence on CYP1A2, CYP2E1, and CYP3A1/2 activity caused by ginseng and Trg used in combination. The CYP1A2 and CYP2E1 enzyme activity were induced by ginseng and Trg used in combination. And this induction effect was caused via inducing CYP1A2 and CYP2E1 protein expression which was supposed caused by inducing the gene expression of CYP1A2 and CYP2E1.     

Liuwei Dihuang,a traditional Chinese herbal formula,suppresses chronic inflammation and oxidative stress in obese rats

OBJECTIVE： To investigate the anti-inflammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang （LWDH）, a traditional Chinese herbal formula, in obese rats. METHODS： After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived （OP-CD） rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water （n=12 rats per group）. Twelve obese-resistant-CD （OR-CD） rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacrifice and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters. RESULTS： After 9 weeks of treatment, LWDH lowered serum C-reactive protein （CRP） and tumour necrosis factor-α （TNF-α） levels. Serum interleukin-6 （IL-6） levels showed a tendency towards reduction, but were not significantly different from the OP-CD control. Liver superoxide dismutase （SOD） activity was increased in response to all three doses of LWDH, while the levels of reduced （GSH） and oxidized glutathione （GSSG） and thiobarbituric acid reactive substances （TBARS） were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inflammatory and oxidative stress biomarkers and circulating adiponectin levels. CONCLUSION： The results show, for the first time, the anti-inflammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OP-JOP-CD rat model as     

中医疗法治疗运动性疲劳的研究进展

随着竞技体育的发展，运动员经常承受着大负荷、超强度的体力训练，因此极易产生运动性疲劳。疲劳的出现使肌内压增高，局部缺血，造成氧化代谢、H^＋排出率与pH值降低，血乳酸增高，从而影响肌纤维神经传导速度和肌内收缩力量，减弱了肌肉保护能力。致使较多的冲击力传到骨骼上，故易导致疲劳骨折的发生,严重影响了运动员的训练和比赛成绩，对运动员身心产生不必要的伤害。运动性疲劳消除手段的研究一直是竞技体育工作和运动医学关注和研究的焦点。     

郭振球教授高血压病辨治特色

郭振球教授是湖南中医药大学教授,从事临床、科研、教学工作六十一年,积累了丰富的临床经验,在学术上治学严谨。学验俱丰。1986年人选我国首批中医学博士研究生导师．1990年被评为我国首批全国继承老中医学术经验指导老师,开创了微观证治学,系世界传统医学诊断学学科奠基人。     

UniPron is A Fully Effective Non-hormonal Reversible Contraceptive in Baboon Model （Papio Anubis）

Objective To determine the safety and efficacy of UniPron as a reversible contraceptive.
Methods Vaginal swabs were obtained before and after UniPron administration, cultured onto appropriate culture media and bacteria identification was done based on type of media used, Gram stain reactions, colony morphology and biochemical tests. Vaginal biopsy tissues were processed using paraffin wax method, stained with hematoxylin and eosin and examined under light microscopy to determine the effect of the product on vaginal tissues. The effect of UniPron on sperm was examined by mixing the product with electroejaculated spermatozoa in vitro at different concentrations. For efficacy studies, male baboons of proven fertility were mated with UniPron treated or untreated females of proven fertility during the fertile stages.
Results All the five females （100%） that were treated with UniPron did not conceive and they regained total fertility when the treatment was stopped while all the controls conceived. At a concentration of 40%, UniPron completely immobilized spermatozoa in an in-vitro system. UniPron mechanism of action was by lowering the vaginal pH and on application in baboon, the pH was lowered for at least 3 h after which it went back to normal.
Conclusions As we plan for a study to test UniPron as a microbicide to prevent STIs including HIV, our current study has established that this novel product is effective in contraception and harmless to vaginal tissues and vaginal microbial flora in a baboon model （Papio anubis）.     

Effects of tacrolimus and cyclosporine treatment on metabolic syndrome and cardiovascular risk factors after renal transplantation: a meta-analysis

Background The therapeutic success of renal transplantation has been largely attributable to the development of effective and balanced immunosuppressive treatment regimens.This study provides a meta-analysis of a series of randomized controlled trials that compared the effects of tacrolimus and cyclosporine on metabolic syndrome （MetS） and cardiovascular risk factors after renal transplantation.Methods We searched various electronic databases and bibliographies,including MEDLINE,the Cochrane Central Register of Controlled Trials,and EMBASE,for relevant studies published prior to October 2012.Results Our meta-analysis included five randomized controlled trials that examined a total of 923 patients.The tacrolimus group and the cyclosporine group exhibited no significant differences in MetS incidence after renal transplantation; risk ratio （RR）：1.06,95％ confidence interval （C/）：0.73-1.55,P=0.76.Cyclosporine treatment was associated with a higher incidence of hyperlipidemia （RR：0.50,95％ CI：0.39-0.64,P ＜0.01）.Although there were no statistically significant differences,cyclosporine treatment was associated with a higher incidence of hypertension （RR：0.91,95％ CI：0.83-1.00,P=0.06） after renal transplantation compared to tacrolimus treatment,and tacrolimus treatment was associated with a higher incidence of diabetes after renal transplantation （RR：1.79,95％ CI：0.98-3.27,P=0.06） compared to cyclosporine treatment.Conclusions Compared to tacrolimus treatment,cyclosporine treatment was associated with a higher incidence of hyperlipidemia.Future large-scale studies are expected to be conducted to further confirm our findings.