抗凝治疗

抗凝治疗是通过抑制体内凝血过程的某些环节,制止血栓形成及防止血栓扩大,但对已形成的血栓则无效,故应争取尽早治疗,以获得较好的防栓效果。抗凝药物以肝素和华法林最为常用。 1 肝素(heparin) 1.1 抗凝机制肝素是治疗急性静脉血栓、各种血栓栓塞性疾病,以及心肺体外循环、血液透析的主要抗凝药物,它也可用于短期静脉血栓形成的预防用药。普通肝素并非均一物质,其分子量为3000～40000,平均15000。它是一种酸性粘多糖,为粘多糖硫酸酯,其硫酸基团带有强大的阴电荷,当硫酸基团被水解或被带有阳电荷的鱼精蛋白中和,肝素的抗凝作用即消失。肝素本身无抗凝作用,其抗凝效应必须通过抗凝血酶III(AT-III)和肝素辅因子II(HcII)。AT-III是一种肝素依赖性抗凝蛋白质。肝素与AT-III分子上的赖     

人工智能与药物研发

新药研发是一个系统工程,周期长、成功率低。传统药物研发在于发现疾病相关的有效靶点,借助各种技术进行小分子（或大分子）的筛选与设计。人工智能技术在医学多个领域已取得显著进展,其在新药研发领域能整合大量高通量组学数据、网络药理学数据和图像等高维表型数据,进行有效靶点的筛选和药物设计,节省药物研发成本,缩短药物研发时间。本文探讨了在新一代人工智能技术驱动下的药物发现过程,旨在为新药研发提供参考。     

抗结核药物的研究进展

随着结核病耐药频率不断升高,结核病治疗面临严峻的挑战,因此,研发新型抗结核药物显得尤为重要。在过去十年中,抗结核药物的研发取得了重要进展。本文将对近年来被批准用于临床和正在进行临床试验的新化学实体按靶点进行分类,并综述其作用机制、体内外药理活性、药代动力学性质以及临床研究结果。对抗结核药物的研发进行了展望,以期对结核病药物研发提供参考。     

肝素—血小板减少—血栓形成综合征(讲座)

1 引言已知多种药物能引起血小板量和质的改变而发生出血倾向。近年来,常有肝素引起血小板减少,可伴有血栓形成,甚可无血小板减少而有血栓形成的报告。抗凝药肝素为治疗和预防静脉血栓形成有效的药物。在用药过程中发生出血,多归咎为肝素过量;有血栓形成又多认为系肝素用量不足,可招致不良后果。本文简要复习肝素——血小     

新型抗凝药物治疗的安全性监测

目前抗凝药物在临床上已得到广泛使用,尤其是在骨科术后静脉血栓栓塞症(VTE)的预防、内科急性冠脉综合征(ACS)等疾病的治疗中。由于新型抗凝药物上市时间短,应用范围有限,与普通肝素(UFH)、低分子肝素(LMWHs)等传统抗凝药物相比其使用尚缺乏足够的临床经验,本文对上市的常用新型抗凝药物的抗凝安全性及合理监测综述如下。     

低分子肝素预防心衰患者深静脉血栓形成的临床观察

临床上充血性心力衰竭患者（NYHA分级Ⅳ级）体力活动受限,卧床时间长,因而静脉血栓形成（VTE）的发生率高,是死亡的重要原因。目前,低分子肝素（LMWH）为公认的预防深静脉血栓形成（DVT）有效药物,但LMWH的疗效及出血风险与用药时间相关性的研究报道较少。本文旨在探讨LMWH预防充血性心力衰竭患者发生DVT的疗效及发生应用LMWH相关出血并发症与用药时间的关系。     

综合方法预防腰椎减压术后静脉血栓形成的临床观察

目的探讨腰椎减压术后静脉血栓形成的预防措施及临床效果。方法选择腰椎管减压手术治疗且具有高或极高静脉血栓形成风险的63例患者作为研究对象,对其实施基本预防、物理预防并结合低分子肝素药物预防的综合方法预防术后静脉血栓形成。住院期间观察静脉血栓形成及出血并发症、药物不良反应情况,监测患者深静脉血栓形成和肺栓塞发生率。结果 63例患者经综合方法预防静脉血栓形成后,有3例出现深静脉血栓(4.76%),均为单纯小腿肌间静脉血栓形成,经保守治疗后血栓消失。无肺栓塞病例发生,所有患者住院期间无死亡,未出现伤口异常出血、术后硬膜外血肿等出血事件及严重血小板减少等并发症。结论应用基本预防、物理预防结合低分子肝素药物预防的综合方法,能显著降低具有高或极高静脉血栓形成风险的腰椎管减压手术患者术后静脉血栓的发生率,且不增加出血风险,预防效果确切,安全性好。     

动脉血栓相关治疗靶点及新药研究进展

动脉血栓(arterial thrombosis,AT)为一种临床常见病及多发病,并可诱发急性心肌梗死、缺血性脑卒中等缺血性心脑血管疾病,具有高致残率和高致死率的特点,严重危害人类健康。AT形成过程中涉及到内皮细胞、白细胞、血小板等多种因素的参与。积极寻找AT形成过程中可干预进程的治疗靶点,并根据靶点开发相关治疗药物具有重大的意义。本文就近5年来防治AT形成和抗栓治疗涉及到的相关靶点研究现状,及针对上述靶点研发的抗栓药物进展研究作一综述,以期为研制治疗AT的创新药物提供可能线索和依据。     

计算机辅助药物设计在中药作用靶点研究中的应用

传统中药在我国有着近三千年的悠久历史,许多方剂至今仍被人们广泛用于临床。但由于中药作用机制及其靶点的不明确,阻碍了实现中药现代化的进程。计算机辅助药物设计(computer-aided drug design,CADD)是随着分子生物学、计算机科学等相应学科发展而研发的一种新的药物研究手段,CADD从理论角度出发,大大减少了药物研发的盲目性。本文就CADD的一些常用技术手段进行了综述,并对各项技术用于中药作用靶点研究的方法、策略以及应用实例进行了介绍。作为一种有效的技术手段,CADD在对中药作用靶点的预测以及推动中药现代化发展方面必将发挥重要作用。     

新型口服抗凝药物临床应用研究进展

传统抗凝药物例如华法林、低相对分子质量肝素（LMWH）和磺达肝癸钠的临床应用存在一定局限性,因而促进了新型口服抗凝药物的研发。新型口服抗凝药物包括直接凝血酶抑制剂（direct thrombin inhibitors,DTI）和直接因子Xa抑制剂,具有可口服给药、治疗窗较宽、与药物和食物间相互作用较小和不需要常规实验室监测的优势。现已对达比加群（DTI：Dabigatran）、直接因子Xa抑制剂：利伐沙班（rivaroxaban）和阿哌沙班（apixaban）治疗和预防多种疾病包括静脉血栓栓塞症（venous thromboembolism,VTE）、非瓣膜病房颤以及急性冠状动脉综合征（acute coronary syndrome,ACS）的有效性和安全性进行了较为的深入研究,并取得了较大的进展。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.