试论运气学说中“主气”的物候学基础与辨证意义

从现代物候学的观点出发，认为一定时间内由昼夜长短变化引起的生物内部生理状态相应的一定改变是物候变化的重要决定因素，亦是运气学说中“主气”的物候学基础。主气因素在中医辨证中是一个重要的参数。     

薛伯寿教授“和合”思想的临证体现

和合思想在中国哲学及文化中都具有非常悠久的历史,也是中医学基础理论及临床应用的重要体现。“和”有和谐、包容、合而为一之意,“合”为统一,把握大道之意。著名中医学家薛伯寿教授认为中医学大道至简,因此执简驭繁是临证关键。薛老在临床过程中,处处体现谨守和合思想。在遣方用药中,善于针对不同疾病多运用调和阴阳、表里分消、补泻同用、寒热并用、调畅气血、升降互用等治则综合运用。在方剂配伍以及用药剂量方面,认为中药配伍本身就是和合增效减毒思想的具体反映。药物配伍是通过有效整合药物的偏性,来纠正人体阴阳气血的偏盛偏衰。临床用药或从七情配伍,或遵脏腑配伍,或依性味配伍,随证而变,灵活组方施治。其他如待人谦和、与人为善,药物治疗与心理调节相辅相成等亦体现和合思想。     

刘温舒与《素问入式运气论奥》

刘温舒,北宋哲宗文官朝散郎,任大医学司业。于北宋元符二年即公元1099年撰《素问入式运气论奥》3卷。该书阐述五运六气之理,解惑分图,推究五运六气的本源,是五运六气研究史上的重要著作之一。对传承五运六气之学、运用图表概释运气规律、引经据典阐述天地造化之理等3个方面的研究表明,《素问入式运气论奥》是中医运气学史上的重要著作。其对于研究天地阴阳变化之理,探索自然规律的恒动性与规律性,解释五运六气经典问题具有重要价值。其中还有很多重要的观点值得深入研究。     

基于五运六气理论对新型冠状病毒感染肺炎的几点思考

基于五运六气理论,尤其是三年化疫理论,对当前正在流行的新型冠状病毒感染的肺炎进行病因病机分析及分期诊疗指导。     

连云港疗养区疗养因子的调查分析及应用

目的　调查连云港疗养区自然疗养因子情况,发挥自然疗养因子在防病治病,促进疾病康复,增强人民体质的作用。方法　调查连云港疗养区气温、气压、风速、温度、负离子等气象资料,并进行分析。结果　年平均气温１４ ．６ ℃;平均气压１０１６ ．７ＨＰＡ,平均风速３ ．１ｍ／Ｓ,相对温度７０ ％ ,负离子浓度平均值为１０３２ 个／ｍ ３ 。结论　连云港疗养区自然疗养因子对循环、神经、消化、血液、呼吸系统等疾病都有较好的治疗作用,对肿瘤的康复也有一定作用。     

Predictors and outcomes of jejunostomy tube placement at the time of pancreatoduodenectomy

BackgroundClinically relevant postoperative pancreatic fistula and delayed gastric emptying cause substantial morbidity after pancreatoduodenectomy. Per international guidelines, the placement of jejunostomy tubes may be considered for patients at risk for malnutrition, such as those with a high risk for clinically relevant postoperative pancreatic fistula and related complications. This study determined predictors and postoperative outcomes of jejunostomy tube placement.MethodsPatients undergoing pancreatoduodenectomy in 2014 to 2015 were identified using the American College of Surgeons National Surgical Quality Improvement Program and Procedure-Targeted Pancreatectomy Participant Use Files. Multivariable logistic regressions were used to identify factors associated with concurrent jejunostomy tube placement and postoperative outcomes.ResultsOf 3,600 patients, 8.9% underwent jejunostomy tube placement. Patients given a jejunostomy tube were more likely white (odds ratio 1.46, P = .016), to have low preoperative serum albumin levels (odds ratio 2.13, P < .001), to have received neoadjuvant radiotherapy (odds ratio 2.14, P < .001), and to have received an intraoperative transfusion (odds ratio 1.50, P = .004). We observed no association between jejunostomy tube placement and an increasing number of risk factors for clinically relevant postoperative pancreatic fistula (P = .96) or delayed gastric emptying (P = .54). Overall, jejunostomy tube placement was associated with increased morbidity (odds ratio 1.34, P = .020) and duration of stay (P < .001), but not mortality (P = .12). Among patients with low serum albumin or those who developed clinically relevant postoperative pancreatic fistula or delayed gastric emptying, jejunostomy tube utilization was not associated with morbidity or mortality.ConclusionJejunostomy tube placement during pancreatoduodenectomy was not driven by risk factors for clinically relevant postoperative pancreatic fistula or delayed gastric emptying, suggesting that practice patterns play a role. Among patients with at-risk preoperative albumin or who developed these complications, jejunostomy tube placement was not associated with worse outcomes, supporting selective utilization per guideline recommendations.     

Effect of Prostaglandin E1 Injected Into Donors in a Heterotopic Heart Transplant Model of Sprague Dawley Rats

IntroductionProstaglandin E₁ (PGE₁) administered to patients in the immediate post-transplant period has been known to reduce ischemic reperfusion injuries (IRIs), but the effect on IRI of PGE₁ administered to the donor is unknown. The purpose of this study was to determine the effect on IRI of PGE₁ injected into donor rats during heterotopic heart transplantation.MethodsGenetically identical male Sprague Dawley rats with a body weight of 300–320 g at 8–9 weeks of age were used for the study. Experimental methods were the same in the control (G₀, n = 6) and experimental groups (G₁, n = 6), but only the donor rats in the experimental group received an intramuscular injection of PGE₁ (5 μg/kg) prior to the donor surgery. On day 1 the animals were sacrificed with the removal of the transplanted heart. Histologic analysis was performed in the hematoxylin-eosin-stained slides to assess interstitial edema and neutrophil infiltration by a pathologist.ResultsMedian times of the donor organ procurement, cold ischemia, and warm ischemia were 37, 69, and 35 minutes, respectively, in the G₀ group and 38, 76.5, and 33 minutes respectively in G₁ group; there were no statistical differences. Heartbeats were observed in the transplanted graft in 2 of the G₀ group and 2 of G₁ group immediately after heart transplantation, but in all transplanted grafts on day 1 after surgery. Histologic scores for neutrophil infiltration showed significantly lower in the G₁ group than in the G₀ group.ConclusionPGE₁ administration to donors in a rat heart transplantation model may significantly reduce IRI.     

复方连栀愈疡汤治疗心脾蕴热型复发性口腔溃疡

复发性口腔溃疡属"口疮"、"口糜"等范畴,"诸痛痒疮,皆属于心","心脾有热常患口疮……",多为心脾蕴热型,辨证关键是火热内蕴,火郁发之,热宜清之,治宜清泻脾胃伏火兼清心热,关键是发越伏火,兼清心脾之热,自拟连栀愈疡汤主之(栀子12g,黄连6g,藿香10g,茵陈12g,竹叶6g,防风10g,川牛膝6g,丹参10g,升麻3g,生甘草6g)。邪气阻滞使火邪闭郁,虽以痰湿多见,食积、瘀血亦不少,时有相互搏结,应具体情况具体分析,灵活化裁,忌过用寒凉使邪气冰伏。