基于仝小林院士脏腑风湿理论探讨新型冠状病毒肺炎康复期的中药治疗

仝小林院士将新型冠状病毒肺炎定名为"寒湿疫"，并以此理论为基础制定了初期、中期、重症期及恢复期的中医治疗方案，同时基于仝院士学术理论体系中的"脏腑风湿"理论，根据恢复期 "余毒未清，正虚邪恋"的病机特点，探讨其符合具备脏腑风湿行成3个基本要素：即外受寒湿裹挟戾气为必要外因；脏腑内虚为重要基础；邪疫伏留胶着，正邪交争为致病关键。故在辨证施治中可应用脏腑风湿理论以调理脾胃，化湿透邪，补益肺脾，顾护阳气，养阴生津。     

Análisis del tratamiento del prolapso de órganos pélvicos mediante colposacropexia mínimamente invasiva con 24 horas de ingreso

ObjectivesThe objective of this study is to analyze the impact (in terms of safety and saving of hospital costs) of the implementation of a new protocol for the correction of pelvic organ prolapse (POP) by minimally invasive sacrocolpopexy (MISC) with 24-hour hospital stay.Material and methodsProspective observational study of the first 78 MISC procedures performed consecutively. 46 procedures (59%) were performed with 24-hour hospital stay, and 32 (41%) required more than 24 hours. The postoperative complications were determined for each group: visits to the Emergency Department, reoperations, and the average cost per procedure regarding hospital stay and ER visits. The cost model was established according to the data of the Analytical Accounting System of the Jiménez Díaz Foundation Hospital and of the Official State Gazette of Madrid.ResultsThere were no differences regarding intraoperative or postoperative complications between both groups. The number of visits to the Emergency Department, reinterventions or hospital re-admissions was lower in the 24-hour hospital stay group, without reaching statistical significance. The implementation of the MISC protocol with 24-hour hospital stay represented a saving of 607.91€ per procedure in hospital costs.ConclusionsCorrection of the POP with MISC with a 24-hour hospital discharge policy was feasible and safe in at least 59% of the patients, with similar complications, visits to the Emergency Department or hospital readmission rates.     

Lymphoid Neogenesis in Murine Cardiac Allografts Undergoing Chronic Rejection

Lymphoid neogenesis is the process by which ectopic lymphoid accumulations that resemble lymph nodes arise in nonlymphoid tissues. Such lymphoid accumulations, known as tertiary lymphoid organs (TLO), are observed in chronic autoimmunity and they propagate immune pathology by setting up local antigen presenting sites. Whether lymphoid neogenesis occurs in transplanted organs and contributes to rejection is not well understood. To begin to address this question, we retrospectively analyzed 319 murine cardiac allografts for microscopic evidence of lymph-node-like structures. We found 78 allografts that had either classical TLO, characterized by discrete T- and B-cell zones and high endothelial venules (HEV) expressing peripheral node addressin (PNAd) (n = 34), or PNAd(+) HEV without organized lymphoid accumulations (n = 44). These changes were present in both short- and long-lived allografts and were invariably associated with rejection. Importantly, they occurred in 78% of allografts undergoing chronic rejection (n = 85) but in only 7% of allografts undergoing primarily acute rejection (n = 184). These findings indicate that, like autoimmunity, alloimmunity is associated with lymphoid neogenesis in the target organ and suggest a role for local T-cell activation in chronic allograft rejection.     

同时应用融合和非融合技术治疗创伤性腰椎间盘损伤(附4例临床病例报道及文献复习)

目的观察同时应用融合及非融合技术治疗腰椎间盘损伤的远期疗效,对照该术式与非手术治疗的远期疗效。方法对4例由于急性外伤引起的L4/L5及L5/S1椎间盘损伤患者进行影像学评价。根据生物力学稳定性对病变节段分别采用融合和非融合技术。手术全部经前路腹膜外切口。L5/S1采用椎间融合(自体髂骨 cage植入),L4/L5采用人工椎间盘植入。术后随访4年,摄术后X线正侧位、动力位片,术后2年MRI检查,SF36问卷调查。同期8例患者采用非手术治疗作为对照。结果术后6、12、24、36及48个月X线片显示,融合节段正侧位椎体间无移位,全部患者均有明显的骨性融合。非融合节段人工椎间盘假体位置良好,术后2年MRI显示有正常活动。同期8例非手术治疗患者5例缓解,3例因症状加重实施手术。结论前路融合技术可以有效稳定椎节,缓解腰椎不稳所致的疼痛。人工腰椎间盘植入可以有效地维持放射学稳定性,但不能完全替代正常椎间盘的功能。     

丹参营养器官中脂溶性成分的动态变化规律

目的 测定丹参营养器官中丹参酮Ⅰ和丹参酮Ⅱ_A的含量,并揭示丹参生长过程中,丹参酮Ⅰ和丹参酮Ⅱ_A的动态变化规律.方法 采用反相高效液相色谱法,以Zorbax SB-C_(18)(150mm×4.6mm, 5.0μm)为色谱柱;甲醇-0.4%磷酸为流动相,梯度洗脱,流速为1.0 ml/min;二极管阵列检测器:检测波长分别为246, 270 nm;柱温为30℃.结果 丹参叶和茎中均未检出丹参酮Ⅰ和丹参酮Ⅱ_A,根中丹参酮Ⅱ_A和丹参酮Ⅰ的含量变化呈"单峰"曲线,丹参酮Ⅱ_A的含量在7月份最高,为2.94%,丹参酮Ⅰ含量在5月份最高,为0.78%.结论 4月至7月是丹参根中丹参酮积累的关键时期.     

急性中风中脏腑证型与垂体-肾上腺轴激素关系的研究

目的 :探讨急性中风中脏腑证型与垂体—肾上腺轴激素的促肾上腺皮质激素 (ACTH)、皮质醇 (CS)的关系。方法 :对 78例中脏腑患者进行辨证分型 ,同时利用放射免疫分析 (RIA)法测定血中 ACTH、CS含量 ,按证型分为四组 ,对比不同证型间 ACTH、CS的水平 ,并与健康人组 (60例 )作对照。结果 :ACTH、CS含量水平比较 :1四种证型的 ACTH、CS均比正常健康人组高 (P <0 .0 0 1 ) ;2四种证型间比较有明显差异 (P<0 .0 1 ) ,从高到低为 :痰热内闭心窍证 >风火上扰清窍证 >痰湿蒙塞心神证 >元气败脱、心神散乱证。结论 :ACTH、CS含量水平可作为判别中脏腑不同证型间的微观指标     

亮菌多糖抗小鼠辐射损伤作用的研究

目的观察亮菌多糖（ATS）对辐射损伤的保护作用。方法将小鼠随机分为空白对照组（0．9％生理盐水）、辐射模型组、阳性对照组（参芪片）和ATS多糖不同剂量实验组（80、160和320mg／kg）。以γ射线照射小鼠全身，引起辐射损伤后观察各组小鼠30d存活率、白细胞（WBC）数、精子畸变率、骨髓微核（MN）细胞数、骨髓DNA含量和免疫器官重量及血清和肝组织中的超氧化物歧化酶（SOD）和丙二醛（MDA）含量等。结果ATS能提高受照小鼠存活率（P〈0．05）及SOD活性（P〈0．05）、升高WBC数（P〈0．05）和骨髓DNA含量（P〈0．05），抑制小鼠精子畸变率（P〈0．05）和骨髓MN细胞数的增加（P〈0．05），并使受照小鼠胸腺、脾脏重量回升（P〈0．05），还能增加内源性脾结节数（P〈0．05），降低MDA含量。结论ATS对γ射线所致小鼠辐射损伤有较好的保护作用。     

长春地区不同孕周胎儿5种脏器组织中甲基汞含量的研究

本文对长春地区３１例不同孕周胎儿５种脏器组织（肝、肾、脑、心、肺）样品采用巯基棉气相色谱法测定甲基汞含量。结果表明，胎儿脏器中均含有微量甲基汞。各组织中有显著差异（Ｐ＜０．０１），以代谢功能为主的肝肾组织中甲基汞含量最高。各脏器组织中甲基汞含量与胎儿的性别及孕周无明显差异（Ｐ＞０．０５）。     

内毒素血症时大鼠脂多糖结合蛋白的变化及其意义

目的　探讨内毒素血症时大鼠肝组织中脂多糖结合蛋白mRNA的表达、血浆中脂多糖结合蛋白 (LBP)含量的变化及其意义。方法　经大鼠尾静脉注入内毒素 (5mg/kg)建立内毒素血症动物模型 ,检测不同时点模型鼠肝组织中LBPmRNA的表达 ,同时检测血浆中LBP、内毒素、TNF α及IL 6含量的变化 ,并与对照组相比较。另取肝组织在电镜下观察其病理学改变。结果　随着内毒素血症时间的延长 ,内毒素组大鼠肝组织LBPmRNA的表达明显增强 ,血浆中LBP、TNF α和IL 6含量也明显增加 ,与对照组比较差异有高度显著性 (P<0 .0 1)。电镜观察见肝细胞脂肪变 ,线粒体空化 ,枯否氏细胞数量增多、体积增大、吞噬功能增强。结论　内毒素血症时 ,大鼠肝组织中LBPmRNA表达明显增强 ,血浆中LBP含量也明显增加。由此提示 ,增高的LBP可能在脂多糖介导的枯否氏细胞激活及产生、释放各种炎性介质中可能起了重要作用。