基于文献的老年人群常见证候分布特征研究＊

目的 了解我国老年人中医证候分布特征，为中医药辨治老年人提供参考依据。方法 系统检索中国知识基础设施（CNKI）、中文科技期刊数据库（CCD）、万方数据资源系统数据库（CSPD），纳入研究对象为老年人的临床流行病学调查研究文献，对其调查目的、调查疾病及调查结果等进行描述统计。结果 ①最终纳入168篇文献，其中2010至2020年之间发表138篇（82.14%）；调查地区涵盖全国28个省市自治区，共纳入43948例老年人，累计覆盖340个研究中心；②主要研究结果显示，老年人中医证候阴虚阳亢证（10.05%）>血瘀证（9.5%）>痰浊（湿）证（8.91%）>阴阳两虚证（4.98%）>痰瘀互结证（4.96%）；单元证分布阴虚证（14.70%）>痰证（11.22%）>气虚证（7.15%）>肾虚证（4.72%）>血瘀证（4.18%）；涉及病变脏腑肾>肝>脾>肺>心。结论 根据统计结果，可以看出老年人证候分布虚证多于实证，虚证中又以阴虚证、气虚证最为多见，实证常见血瘀证、痰浊（湿）证等，且多见痰瘀互结证；老年人五脏皆损，其中又以肾、肝、脾功能失调最为突出。     

四妙勇安汤方源探析

四妙勇安汤由金银花、玄参、当归、甘草4味药物组成,为《古代经典名方目录(第一批)》中100个经典名方之一。经溯源发现,四妙勇安汤源于《石室秘录》,后由《古今图书集成·医部全录》《验方新编》等书引用。从古代文献记载来看均有方无名,"四妙勇安汤"之名,最早见于1956年《中医治疗动脉栓塞性坏疽症的成效》,是由当时记者吕民报道河北省释迦宝山用"四妙勇安汤"治疗当地的动脉栓塞性坏疽时冠名。四妙勇安汤从方药组成与剂量上看,从《石室秘录》开始即是"金银花三两,当归二两,生甘草一两,玄参三两",历代版本《方剂学》确定四妙勇安汤金银花、玄参、当归、甘草的比例就是3∶3∶2∶1。而查阅文献,释迦宝山临证所用的四妙勇安汤由"玄参132 g,当归99 g,银花66 g,甘草33 g"组成,金银花、玄参、当归、甘草的比例变成2∶4∶3∶1。从治疗时间上看,原方记载的7日愈或是10日愈,而释迦宝山将其用到了三四个月,甚至五六个月。研究认为,古籍中的四妙勇安汤,应该是用于疾病的初期,尽早发现和治疗;而释迦宝山修改过的剂量,是广泛用于脱骨疽的中后期,甚至出现坏疽的严重病情所使用的,因此服药时间长,剂量大。且四妙勇安汤临证不仅限于治疗脱骨疽,也用于大头疮等,现代该方的使用已经大为拓展。相关研究已证实四妙勇安汤具有抗炎、稳定斑块、降脂、保护血管、改善血液流变学、抗凝、抑制血栓形成和促纤溶等作用,后续应开展君臣佐使辨析,对其临床应用范围重新进行界定。     

Deoxynivalenol induces apoptosis in PC12 cells via the mitochondrial pathway

Deoxynivalenol (DON) has broad toxicity in animals and humans. In this study the impact of DON treatment on apoptotic pathways in PC12 cells was determined. The effects of DON were evaluated on (i) typical indicators of apoptosis, including cellular morphology, cell activity, lactate dehydrogenase (LDH) release, and apoptosis ratio in PC12 cells, and on (ii) the expression of key genes and proteins related to apoptosis, including Bcl-2, Bax, Bid, cytochrome C (Cyt C), apoptosis inducing factor (AIF), cleaved-Caspase9, and cleaved-Caspase3. DON treatment inhibited proliferation of PC12 cells, induced significant morphological changes and apoptosis, promoted the release of Cyt C and AIF from the mitochondria, and increased the activities of cleaved-Caspase9 and cleaved-Caspase3. Bcl-2 expression decreased with increasing DON concentrations, in contrast to Bax and Bid, which were increased with increasing DON concentration. These data demonstrate that DON induces apoptosis in PC12 cells through the mitochondrial apoptosis pathway.     

Cellular targets of regulatory B cell-mediated suppression

Regulatory B cells (Bregs) are defined by their ability to restrain inflammatory responses both in vivo and in vitro. Interleukin 10 (IL-10) production by Bregs is thought to be central to their ability to regulate inflammation, largely due to IL-10s’ ability to suppress pro-inflammatory cytokine production by effector lymphocytes and to maintain the differentiation of regulatory T cells (Tregs). However, with an increase in available published data, it has become evident that Bregs utilize a number of suppressive mechanisms in order to alter the activation of a variety of different lymphocytes. Here, we summarize the multiplicity of cellular targets of Breg-mediated suppression and describe the mechanisms employed by Bregs to suppress chronic inflammatory responses.     

Inactivated influenza vaccine formulated with single-stranded RNA-based adjuvant confers mucosal immunity and cross-protection against influenza virus infection

Influenza vaccination is considered the most valuable means to prevent and control seasonal influenza infections, which causes various clinical symptoms, ranging from mild cough and fever to even death. Among various influenza vaccine types, the inactivated subunit type is known to provide improved safety with reduced reactogenicity. However, there are some drawbacks associated with inactivated subunit type vaccines, with the main ones being its low immunogenicity and the induction of Th2-biased immune responses. In this study, we investigated the role of a single-stranded RNA (ssRNA) derived from the intergenic region in the internal ribosome entry site of the Cricket paralysis virus as an adjuvant rather than the universal vaccine for a seasonal inactivated subunit influenza vaccine. The ssRNA adjuvant stimulated not only well-balanced cellular (indicated by IgG2a, IFN-γ, IL-2, and TNF-α) and humoral (indicated by IgG1 and IL-4) immune responses but also a mucosal immune response (indicated by IgA), a key protector against respiratory virus infections. It also increases the HI titer, the surrogate marker of influenza vaccine efficacy. Furthermore, ssRNA adjuvant confers cross-protective immune responses against heterologous influenza virus infection while promoting enhanced viral clearance. Moreover, ssRNA adjuvant increases the number of memory CD4⁺ and CD8⁺ T cells, which can be expected to induce long-term immune responses. Therefore, this ssRNA-adjuvanted seasonal inactivated subunit influenza vaccine might be the best influenza vaccine generating robust humoral and cellular immune responses and conferring cross-protective and long-term immunity.     

Gene expression of human sperm component related to A4 amyloid precursor protein.

Monoclonal antibodies were raised against a specific human sperm protein and designated as the YWK-II mAb. The partial cDNA encoding the protein was isolated from a rat testis lambda gt11 expression library and the amino acid sequence of the protein was deduced. The cytoplasmic-transmembrane domains of the deduced protein had high homology with the A4 amyloid precursor protein of Alzheimer's disease. To evaluate the stage of spermatogenesis when the gene was expressed, single-stranded 35S-labeled RNA probes were prepared from the cDNA. By an in situ hybridization technique the mRNA for the antigen was detected in germ cells at all stages of spermatogenesis. The finding that the gene is expressed in spermatogonia suggests possible involvement in the initiation of germ cell differentiation or in the detachment of spermatogonia from the basement membrane.     

大鼠脑多梗死性栓塞痴呆模型的建立

 目的建立大鼠脑多梗死性痴呆(MID)模型及观察指标,评价药物对该模型的作用。方法采用从颈外动脉逆行注入微血栓颗粒的方法,制备MID模型,通过对术后大鼠的苏醒时间测定、倾斜板实验、神经症状评分3个方面评价动物的一般状态;采用大鼠穿梭箱实验、水迷宫实验检测各组大鼠学习记忆能力;并测定脑中丙二醛(MDA)的含量及超氧化物歧化酶(SOD)的活性,考察MID大鼠的行为学异常以及其作用机制。结果MID大鼠与正常组、假手术组比较,苏醒时间明显延长,在倾斜板上停留的时间显著变短,神经症状评分有显著差异;穿梭箱实验中电击时间明显延长,水迷宫实验学习记忆潜伏期延长;同时脑组织中MDA含量明显升高,SOD活力显著降低。给予药物氢化麦角碱(商品名:喜得镇)治疗后症状有所改善。结论该造模方法能显著造成大鼠脑多梗死性痴呆的多项体征,符合临床病理过程,为进一步判定一些药物是否具有治疗MID的前景打下基础。