针药并用治疗书写痉挛症5例

Combined acupuncture and Chinese herb decoction were applied for 5 cases with graphospasm. Acupuncture included scalp acupuncture and body acupuncture. Using transcranial repeated needling, Băihuì (百会GV20), Chorea-trembling controlled area, Emotional area, as well as Dàzhuī (大椎GV14), Fēngchí (风池 GB20), and Yíngxiāng (迎香EX-HN8) etc. were stimulated by proposed by Sun Shentian. Meanwhile, the patients took orally Chinese herb decoction, on the basis of the Sìwù decoction (四物汤four substances decoction) addition and subtraction, relieve symptoms under syndrome differentiation. The treatment was carried out for 4 courses in total. One course consisted of 5 days, with an interval of 2 days between two courses. After treatment of 5 patients, 2 patients were cured, 2 patients achieved markedly effective response, and 1 patient achieved effective response.     

牛黄利咽丸防治鼻咽癌患者急性放射性口腔黏膜炎

目的探讨牛黄利咽丸治疗火毒困结证鼻咽癌急性放射性口腔黏膜炎患者的临床疗效。方法使用随机数字表法将100例符合纳入标准的鼻咽癌患者分为治疗组与对照组,各50例。对照组及治疗组均采用相同的放射治疗方案,治疗组在此基础上口服牛黄利咽丸,观察2组患者治疗后的疗效。结果治疗组3~4级口腔黏膜炎、唾液腺损伤发生率显著低于对照组,1级发生率明显优于对照组(P <0.05),治疗后治疗组卡氏评分为(74.12±3.22)分,优于对照组的(69.28±3.91)分(P <0.05)。结论牛黄利咽丸可以减轻鼻咽癌患者放疗引起的火毒困结症的口腔黏膜炎,改善患者局部肿痛溃疡,提高患者生活质量。     

卵巢癌干细胞标记物的研究进展

卵巢癌是致命的妇科癌症之一。虽然目前的治疗策略相对有效,但存在易复发及化疗耐药,其与卵巢癌干细胞有着密切的联系。肿瘤干细胞（CSC）是肿瘤内罕见的化疗耐药性细胞,其可以用更多分化的子细胞填充大部分肿瘤,并可能导致复发性疾病。目前,对卵巢癌干细胞的分离与鉴定已经开展了很多研究,并分析了卵巢癌干细胞特异性标记物的特性。本文旨在对卵巢癌干细胞标记物的相关研究以及其作为治疗靶点的潜力进行综述。     

延长辅助内分泌治疗在激素受体阳性早期乳腺癌治疗中的价值

雌激素受体（estrogen receptor,ER）阳性早期乳腺癌的复发风险一直存在。MA.17试验证明,在淋巴结阳性、雌激素受体阳性的乳腺癌患者中,常规应用5年来曲唑治疗后继续应用他莫昔芬治疗,其无病生存期（disease-free survival,DFS）和整体生存期（overall survival,OS）都得到了明显改善。MA.17R试验证明,完成5年芳香化酶抑制剂治疗的患者,继续随机应用来曲唑或安慰剂,来曲唑组的DFS明显改善。在这些研究中,延长内分泌治疗能减少远期复发的绝对益处是适度的,然而其耐受性和依从性的挑战依然存在。对于完成5年常规内分泌治疗的患者,最终是选择他莫昔芬还是来曲唑来延长治疗,主要应该考虑患者的绝经状态、淋巴结情况、耐受性和潜在的利益大小这些因素。     

MYC抑制剂与小细胞肺癌关系的研究进展MYC抑制剂与小细胞肺癌关系的研究进展

MYC在多种肿瘤中高表达,发挥重要的生物学作用,MYC抑制剂Omomyc可抑制MYC和其他基因或蛋白结合。Omomyc可停滞小细胞肺癌细胞的细胞周期,并促进细胞凋亡,机制与p21相关。本文综述MYC的概念和作用,总结MYC与肿瘤的关系,论述MYC抑制剂Omomyc的作用机制和研究进展,讨论Omomyc促小细胞肺癌细胞凋亡的作用机制与p21的相关性。MYC与肿瘤密切的关系使MYC抑制剂Omomyc的研究日益重要,本文旨在为临床治疗靶点提供新思路。     

滋肾育胎丸对反复失败肾虚型IVF-ET患者子宫内膜容受性影响的临床观察

[目的]滋肾育胎丸对反复失败肾虚型体外受精-胚胎移植(IVF-ET)患者子宫内膜容受性的影响。[方法]观察60例肾虚型IVF-ET失败患者口服滋肾育胎丸前后临床症状的改善情况,其中36例患者在HCG的注射日子宫内膜厚度及类型、雌孕激素水平、子宫螺旋动脉搏动指数(PI)和阻力指数(RI),及其胚胎种植率与临床妊娠率的变化情况。[结果]服药后患者证候积分明显降低(P0.01);患者子宫内膜厚度明显增厚(P0.01),子宫内膜类型A+B型明显增加(P0.01);患者血清雌孕激素水平变化无统计学意义,但雌激素/孕激素的数值较服药前降低(P0.05);患者子宫螺旋动脉PI及RI值明显下降,子宫动脉血流显著改善(P0.01);患者胚胎种植率和临床妊娠率有显著升高(P0.05)。[结论]滋肾育胎丸改善反复失败肾虚型IVF-ET患者的子宫内膜容受性与临床症状,提高胚胎种植率和临床妊娠率。     

内皮祖细胞在急性肺损伤中应用的研究进展*

急性肺损伤是由各种肺内外因素导致的进行性呼吸困难和难治性低氧血症,其病理特征包括炎 症反应及肺泡-毛细血管屏障功能破坏,微循环血管内皮损伤是主要标志。内皮祖细胞可以从骨髓动员迁移 到损伤部位,分化为成熟内皮细胞发挥直接修复作用,并通过间接免疫调节作用改善微环境。此外内皮祖细 胞还可以分泌细胞因子以自分泌或旁分泌方式促进新生血管生成从而减少器官功能障碍。文章旨在综述内皮 祖细胞在急性肺损伤中的应用,从而为治疗急性肺损伤提供新思路。     

孢子丝菌病诊断及治疗进展

孢子丝菌病是由孢子丝菌复合体感染引起的亚急性或慢性感染性疾病,广泛分布于世界各地,特别是热带和亚热带地区。诊断的金标准为经典的菌种培养及鉴定,但其耗时较长,且结果易受杂菌影响,不利于临床的快速诊断。随着分子生物学、血清学及免疫研究的深入,涌现出一系列快速的诊断方法,如基于PCR的一系列诊断方法、酶联免疫吸附试验、孢子丝菌皮内试验等;孢子丝菌病的治疗有新进展,如传统治疗药物的新发现、治疗的新手段、新药的研究等。该文围绕孢子丝菌病诊断及治疗的进展进行综述。     

Comparative Study of the Genetic Diversity,Antimicrobial Resistance,and Pathogenicity of Aeromonas Isolates from Clinical Patients and Healthy Individuals

Objective This study was performed to compare the genetic diversity, virulence, and antimicrobial resistance of Aeromonas strains isolated from patients and healthy individuals. Methods A total of 38 clinical strains and 19 strains from healthy individuals were isolated from the samples collected in Ma'anshan City, Anhui Province. Their taxonomy was investigated using concatenated gyrB-cpn60 sequences, and their resistance to 12 antibiotics was evaluated. The pathogenicity of these strains was examined through beta-hemolysis, protease activity, and virulence gene assays. Results The 57 Aeromonas strains were divided into 55 sequence types. Of these types, 21 were novel, suggesting that their genetic diversity was high. These Aeromonas isolates could be divided into 7 species, and the positive rates of beta-hemolysis and protease activity were 49.1％ and 73.7％, respectively. The detection rate of clinical patients in terms of beta-hemolysis and protease activity was higher than that of healthy individuals. Among the four most common Aeromonas strains, A. dhakensis had the highest detection rate of virulence genes. The multidrug resistance rate of the clinical isolates was much higher than that of the strains isolated from healthy individuals. Conclusions The taxonomy, virulence properties, and antibiotic resistance of Aeromonas isolates from patients differ from those of the isolates from healthy individuals.     

基于分类树模型的产后盆底肌筋膜疼痛的危险因素分析

目的构建产后盆底肌筋膜疼痛( MFPP)发病影响因素的分类树模型,寻找产后 MFPP发生的危险因素。方法选取 2017年 1—12月在南京市妇幼保健院常规产后检查的 975例产妇,进行流行病学调查。 205例产妇患有 MFPP分为病例组, 229例产妇无盆底功能障碍性疾病( PFD)情况分为对照组。结果病例组中轻、中、重度疼痛人数分别为 27例、 173例、 5例。我们对病例组研究发现产后 MFPP发病影响因素的分类树模型共有 5层,筛选出 4个解释变量:快肌最大值,慢肌平均值,产妇体质量指数( BMI)新生儿出生体质量。其中快肌最大值 ≤41.20 μv且慢肌平均值 ≤6.85 μv时,产后 MFPP发生率为 76.0％,分类树模型预测的受试,者操作特征( ROC)曲线下面积( AUC)为 69.1%,95%CI:(0.64,0.74)。结论快肌最大值、慢肌平均值、产妇 BMI及新生儿出生体质量为影响产后 MFPP发生的危险因素,盆底肌电筛查中快肌最大值 ≤41.20 μv和慢肌平均值 ≤6.85 μv可作为筛查指标,对于这部分的产妇,需联合盆底肌疼痛检查是否存在产后 MFPP。