三七对酒精性肝病大鼠肝组织NF-κB/IκB表达的影响

 目的观察三七对酒精性大鼠肝组织的防治及对NF-κB/IκB表达的影响。方法SD雄性大鼠随机分为正常组,模型组、三七高、低剂量组和硫普罗宁组,连续14周建立酒精性肝病模型。在模型制备同时,每天下午分别灌服给药,连续14周。ELISA法检测肿瘤坏死因子(TNF-α)。常规HE及Masson染色,光镜观察肝组织的脂肪变、炎症及纤维化程度;免疫组化法检测肝组织中NF-κBp65/IκBα蛋白的表达。结果酒精性肝病模型组大鼠肝组织脂肪变及炎症程度计分、血清TNF-α水平明显增高(P<0.01)。三七高、低剂量组,硫普罗宁组大鼠肝组织脂肪变及炎症程度、血清TNF-α水平较模型组明显减轻(P<0.01,P<0.05)。酒精性肝病模型组大鼠肝组织NF-κBp65和IκBα均较正常组明显升高(P<0.01);三七高、低剂量组大鼠肝组织NF-κBp65/IκBα表达较模型组明显降低(P<0.01,P<0.05)。相关分析显示,肝组织NF-κBp65表达与肝组织炎症程度计分呈正相关(r=0.63,P<0.01),与血清TNF-α水平呈正相关(r=0.43,P<0.01);肝组织IκBα表达与肝组织炎症程度计分呈正相关(r=0.36,P<0.05),与血清TNF-α水平呈正相关(r=0.44,P<0.01);血清TNF-α水平与与肝组织炎症程度计分呈正相关(r=0.60,P<0.01)。结论用白酒-玉米油-吡唑混合液灌服大鼠14周可成功制作ALD模型。三七可明显减轻酒精性肝病大鼠肝组织脂肪变和炎症程度。三七能显著抑制肝组织中NF-κBp65/IκBα的过度表达,降低血清TNF-α水平,这可能是其有效防治酒精性肝病的发生发展的重要机制之一。     

自然界水循环运行模式对理解三焦气化的启示

自然界水循环运行模式与人体三焦气化有很好的对应性,正常模式对应三焦气化生理,异常模式对应三焦气化病理。在此基础上进一步探讨了三焦气化异常导致三焦不畅的病机状态,并总结了三焦不畅的基本理法方药。     

宽胸气雾剂缓解冠心病心绞痛的多中心随机对照临床研究

目的评价宽胸气雾剂缓解冠心病心绞痛疗效及安全性。方法选择2011年11月—2012年12月,13个临床中心诊断为冠心病心绞痛患者780例,按区组随机序号随机分为宽胸气雾剂组（试验组）376例和硝酸甘油片组（对照组）374例。心绞痛发作时,治疗组宽胸气雾剂舌下连续3喷,每喷0.6 mL;对照组舌下含服硝酸甘油0.5 mg/片。观察心绞痛缓解有效率、心电图疗效、不良反应发生率。结果治疗组患者心绞痛 3 min缓解率为53.72% （202/376）,5 min缓解率为94.41% （355/376）;对照组患者心绞痛3 min缓解率为47.86%（179/374）,5 min缓解率为90.64%（339/374）。3 min、5 min心绞痛缓解率组间差值95%可信区间分别为［－1.84%,12.32%］和［－1.33%,6.85%］,组间比较差异均无统计学意义（P〉0.05）。治疗组治疗后心电图改善总有效率74.07%（140/189）,对照组心电图改善总有效率73.13%（147/201）,组间比较差异无统计学意义（P〉0.05）。治疗组和对照组不良反应发生率分别为9.31%（35/376）和22.46%（84/374）,两组比较差异有统计学意义（P〈0.01）。结论宽胸气雾剂缓解心绞痛和改善心电图缺血改变方面不劣于硝酸甘油片,不良反应发生率明显少于硝酸甘油片。     

3种常见脂多糖所致急性肺损伤大鼠模型肺损伤程度相关性研究

目的研究3种常见脂多糖所致急性肺损伤（ALI）大鼠模型,并探讨模型制作的方法和经验。方法选择130只健康SD大鼠,随机分4组,尾静脉注射组（40只）采用尾静脉注射造模,气管注入模型组（40只）采用气管注入造模．二次打击模型组（40只）采用“二次打击”方式造模,另选10只SD大鼠为对照组。结果完成实验后,尾静脉注射组死亡4只,气管注入模型组死亡10只,二次打击模型组死亡12只,尾静脉注射组与气管注入模型组、二次打击模型死亡率组比较具有明显差异。肺组织干湿质量比3组之间无显著性差异;病理学显示气管注入模型组病理损伤不均匀,以气道上皮的水肿、坏死脱落,气道内以中性粒细胞为主的多种炎细胞浸润为主要特点。尾静脉注射组及二次打击模型组病理损伤多较均匀,以毛细血管渗透性增高,纤维蛋白渗出,肺水肿形成为主要特点。尾静脉注射组较气管注入模型组量化值稍高,但未见明显统计学差异,尾静脉注射组、气管注入模型组与二次打击模型组量化值比较,量化值增高明显,具有显著差异（P〈0．05或0．01）。结论3种方式均能成功制造急性肺损伤模型,但尾静脉注射组死亡率低,操作简便且病理学较为符合人类ALI病理学改变,且稳定可靠。     

Effect of new glucose-lowering drugs on stroke in patients with type 2 diabetes: A systematic review and Meta-analysis

AimsPeople with diabetes tend to face a higher risk of stroke. Randomized controlled trials (RCTs) have demonstrated the different outcomes of new glucose-lowering drugs marketed in recent years on cardiovascular outcome events. The effects of glucagon-like peptide-1 (GLP-1) agonists, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors on stroke risk were evaluated in published RCTs.MethodsA search of Embase, Cochrane Library, and PubMed databases identified studies with stroke as an outcome event up to 3 December 2021. Risk ratios for stroke outcomes were analyzed using a fixed-effects model. I² was used to assess the heterogeneity of the study.Results19 RCTs with 155,027 participants with type 2 diabetes were identified. Pooled analysis showed that compared to placebo, GLP-1 agonists reduced non-fatal stroke by 15 % (RR = 0.85, 95%CI 0.77–0.94, P = 0.002, I² = 0 %) and total stroke (RR = 0.84, 95%CI 0.77–0.93, P = 0.000, I² = 0 %) by 16 %. SGLT-2 inhibitors and DPP-4 inhibitors were not significantly associated with lower stroke risk.ConclusionsThis meta-analysis indicates that GLP-1 agonists have potential benefits for stroke. However, further studies are needed if GLP-1 agonists are to be used to reduce the risk of stroke in patients with type 2 diabetes. More research is also needed to investigate the effects of new glucose-lowering drugs on different stroke subtypes.Systematic review registrationThis protocol was registered on the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/PROSPERO/; registration number: CRD42022326382).     

冬令进补 治当从本——杨少山习用膏方举隅

杨少山教授临证擅长运用膏方调治疾病,认为膏方并非单纯补剂,治疗上宗辩证论治,治病求本的原则。本文主要对其养阴平肝及调和肝脾的常用膏方加以总结分析。     

益气化痰散结方联合XELOX化疗方案治疗晚期复发性结肠癌的临床研究

目的 :探讨益气化痰散结方联合XELOX化疗方案治疗晚期复发性结肠癌的临床疗效。方法:将60例晚期复发性结肠癌患者随机分成对照组和治疗组各30例,对照组予XELOX方案化疗:奥沙利铂130 mg/m2,静滴,第1 d;希罗达1000 mg/m2,口服,每日2次,第1¹4 d;治疗组在化疗的同时内服益气化痰散结方,均21 d为1个周期。3周期后对临床近期疗效、疾病无进展生存期(PFS)、不良反应及生活质量进行评估。结果:两组治疗后,治疗组和对照组的有效率分别为56.7%,50.0%,两组比较差异无统计学意义(P>0.05);治疗组的中位PFS为(254.00±6.25)d,对照组的中位PFS为(217.00±7.38)d,治疗组优于对照组(P<0.05);治疗组与对照组血液学毒性主要表现为白细胞减少,发生率分别为53.3%和70.0%;恶心呕吐的发生率分别为40.0%,56.7%,治疗组明显低于对照组,两组比较有显著差异(P<0.05)。两组患者在治疗后生活质量评分均有明显升高,与治疗前比较差异有统计学意义(P<0.05),两组治疗后比较差异亦有统计学意义(P<0.05)。结论:与单纯化疗相比较,益气化痰散结方与化疗联合能进一步延长晚期结肠癌患者疾病无进展生存期,改善生活质量,并降低化疗毒副反应。     

芪连白术颗粒抗慢性溃疡性结肠炎作用

目的 观察芪连白术颗粒抗慢性溃疡性结肠炎的作用。方法 采用右旋葡聚糖硫酸钠(DSS)诱导小鼠形成溃疡性结肠炎模型,观察芪连白术颗粒3个不同剂量对小鼠慢性溃疡性结肠炎的治疗作用。结果 与模型组比较,芪连白术颗粒高、中剂量组症状不同程度地明显改善、高剂量组疾病活动指数(DAI)明显降低(P<0.05);动物的整体状况与结肠炎的病理状况与模型组比较均有明显好转。结论 芪连白术颗粒对DSS诱导小鼠慢性溃疡性结肠炎有明显的疗效。     

中医药防治滑胎研究

中医药防治滑胎历史悠久,疗效显著。从未病先防和既病防变两个方面综述了近十年来防治滑胎的中医药研究。     

Effect of mistletoe combined with carboxymethyl cellulose on dry eye in postmenopausal women

AIM: To investigate the protective effect of mistletoe combined with carboxymethyl cellulose eye drops on dry eye in postmenopausal women. METHODS: Sixty postmenopause female patients diagnosed of dry eye were assigned randomly to mistletoe combined with carboxymethyl cellulose eye drops treatment group (n=30) and control group treated with normal saline eye drops (n=30). The subjective symptoms of ocular surface, Ocular Surface Disease Index (OSDI), tear film function tests, tear protein and corneal morphology by confocal scanning microscopy were analyzed before treatment and at 1, 2, 4 and 8wk after treatment respectively. To ensure the safety of the trial, all patients were examined with systolic pressure, diastolic pressure, glutamic-pyruvic transaminase, glutamic oxaloacetic transaminase, urine creatinine, and blood urea nitrogen at 8wk after treatment. RESULTS: There were no obvious differences between two groups before the treatment (P>0.05). In two months after the treatment, the symptoms of ocular surface, OSDI, tear protein, and tear film function were only slightly changed in normal saline eye drops group. However, all indices were improved after the treatment of mistletoe combined with carboxymethyl cellulose eye drops group (P<0.05). In addition, the average amount of corneal epithelium basal cells and inflammatory cells of mistletoe treated group were 3174±379 and 38±25 cells/mm2, significantly decreased as compared to the control group with 4309±612 and 158± 61 cells/mm2, respectively. In the control group, although nerves still maintained straight under corneal epithelium, the number of nerves were significantly decreased, as compared with normal female. In the mistletoe treated group, the number of nerves was only slightly reduced, compared with normal female. CONCLUSION: Mistletoe combined with carboxymethyl cellulose eye drops can alleviate the symptoms and signs of dry eye symptoms.