Inhibition of autophagy increases apoptosis during re‐warming after cold storage in renal tubular epithelial cells

Prolonged cold storage and re‐warming (CS/REW) of kidneys are risk factors for delayed graft function (DGF). Studies in renal tubular epithelial cells (RTECs) have determined apoptosis and autophagy in models of either cold storage (CS) or re‐warming alone. The effect of both cold storage and re‐warming on apoptosis and autophagy, in RTECS is not known and is relevant to DGF as the kidney is subjected to both CS and re‐warming. We hypothesized that CS/REW of RTECs would induce autophagy that protects against apoptosis. In CS/REW, there was increased autophagic flux of RTECs. Autophagy inhibition using an Atg5 siRNA resulted in increased cleaved caspase‐3 and increased apoptotic cells (on both morphology and annexin V staining) during CS/REW. The effect of autophagy inhibition on necrosis in RTECs is unknown. There were increased necrosis and caspase‐1, a mediator of necrosis, during CS/REW, and the Atg5 siRNA had no effect on necrosis and caspase‐1. In a kidney transplant model, there was an increase in LC3 II, a marker of autophagy, in kidneys transplanted after cold storage. In summary, autophagic flux is increased during CS/REW. Autophagy inhibition resulted in increased cleaved caspase‐3 and increased apoptosis during CS/REW without an effect on necrosis or caspase‐1. In conclusion, autophagy inhibition in RTECs after CS/REW induces apoptotic cell death and may be deleterious as a therapy to decrease DGF.     

Cold pain prolongs gastric emptying of liquid but not solid meal: an electrical impedance tomography (EIT) study

Stressful stimuli are reported to affect gastric emptying. However, methods for measuring gastric emptying are, in themselves, stressful. Electrical impedance tomography (EIT) is a method for measuring gastric emptying noninvasively. We used EIT to measure gastric emptying of liquid and solid meals to determine the effect of cold pain stress on gastric emptying. EIT (DAS-01P APT system; University of Sheffield, UK) was carried out in six healthy women (age, 21.6 ± 0.4 [mean ± SD] years) who had ingested a liquid (potage, 263 g; 139 kcal) or solid (beef patty, 205 g; 435 kcal) test meal. Cold pain stimuli consisted of repeated immersions of the subject's non-dominant hand into ice water (4°C) for 1 min, with a 15-s recovery period between immersions, for a total of 20 min. For the control stimulus, water at 37°C was used. The cold pain stimulus was applied immediately after the ingestion of a test meal. All studies were carried out randomly in each subject at intervals of more than 1 week. With cold pain, the half emptying time of the liquid meal was significantly greater than that with the control stimulus (47.6 ± 26.1 min vs 28.1 ± 10.8 min, P < 0.05). For the solid meal, the half emptying time did not differ between stimuli (101.9 ± 44.8 min with cold pain vs 92.6 ± 30.5 min with control stimulus). There were no significant differences in lag time between the liquid and solid meals. Cold pain stress delayed gastric emptying of liquid but not solid meals. Received: September 28, 1999 / Accepted: February 25, 2000     

丹红注射液在正常和寒凝血瘀大鼠中的药代动力学

目的 建立同时测定血浆中丹参素（DSS）、原儿茶酸（PA）及羟基红花黄色素A（HSYA）的HPLC分析方法,研究丹红注射液主要酚酸类成分DSS、PA以及HSYA在正常和寒凝血瘀大鼠中药代动力学行为。方法 连续冰水刺激20天制作寒凝血瘀模型,给正常及模型大鼠尾静脉注射丹红注射液,采用HPLC法检测给药后2、5、10、15、20、25、30、40、50、60、90min血浆中DSS、PA以及HSYA的浓度,流动相为0.2 %甲酸水（A）-甲醇（B）,梯度洗脱,梯度波长检测：280nm（0~40min）,402nm（40~60min）,DAS3.0软件计算药代动力学参数。结果 DSS和PA呈现二室开放模型,HSYA呈现三室模型,与正常组相比,模型大鼠体内,DSS、PA和HSYA的达峰浓度Cmax、DSS的分布半衰期t1/2α、PA和HSYA的消除半衰期t1/2α(t1/2r) 和药时曲线下面积AUC以及总表观分布容积V均显著增大;PA和HSYA的分布半衰期t1/2α和DSS药时曲线下面积AUC均显著降低。结论 在寒凝血瘀病理模型下,DSS在体内分布减慢,生物利用度降低;PA和HSYA的分布加快,消除减慢,表观分布容积增大,生物利用度增加,更能发挥好疗效。     

Width and depth of resection for small colorectal polyps: hot versus cold snare polypectomy

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咳嗽并见背冷症证因特点临床研究

目的观察咳嗽并见背冷症患者的临床表现及中医证候特点,探讨分析其病因病机,为咳嗽的临床诊疗提供依据。方法选取以"咳嗽"为主诉且并见背冷症的患者作为研究对象,就其一般性资料、所患呼吸系统基础疾病、咳嗽及背冷症发生的临床特点、相关因素进行分析,总结其发病特点、病因病机及证候学特点。结果咳嗽并见背冷症临床常见,背冷症与咳嗽症状密切相关,病理要素包含湿热、阳虚、痰饮、风邪等。中医辨证分型可见脾胃湿热证占22.8%、脾胃湿热证兼肺阳虚证占21.3%、肺阳虚证占17.3%、肺脾阳虚证占12.7%等。结论背冷症与咳嗽常相兼而见,可见于不同年龄段、不同肺系疾病中,轻重程度各异,且与季节、气候变化等有关。脾胃湿热证、肺阳虚证及其相兼证为咳嗽并见背冷症的常见证候,湿热邪气阻滞气机及肺脾阳虚、卫阳失布而致肺失宣肃是主要病机。     

大艾段温针灸治疗肺气虚寒型变应性鼻炎100例

目的 观察大艾段温针灸治疗肺气虚寒型变应性鼻炎(AR)的疗效并探索其作用机制。方法 将入选病例随机分为观察组、对照组各105例。观察组大艾段温针灸,每日1次,每周治疗4次,4周为1个疗程。对照组急性期丙酸氟替卡松鼻喷雾剂喷鼻,枸地氯雷他定片口服。病情稳定后,枸地氯雷他定片停药,丙酸氟替卡松鼻喷雾剂继续喷鼻。4周为1个疗程。观察2组治疗结束时及治疗后30 d的中医证候总积分、西医临床症状总积分、体征总积分、视觉模拟评分法（VAS评分）以及血清免疫球蛋白E（IgE）、白细胞介素-4（IL-4）、γ干扰素（IFN-γ）水平的变化。结果 治疗后2组中医证候总积分、临床症状总积分、体征总积分以及鼻部整体症状的严重程度VAS评分均明显低于同组治疗前(P<0.01),观察组明显低于对照组(P<0.05~0.01);血清3项指标,组内及组间差异均具有统计学意义(P<0.01)。治疗结束后30 d随访,观察组疗效优于对照组(P<0.05);2组中医证候总积分、临床症状总积分、体征总积分以及鼻部整体症状的严重程度VAS评分均明显低于同组治疗前(P<0.01);观察组明显低于对照组(P<0.05~0.01);血清3项指标,IFN-γ含量,对照组治疗结束后30 d与治疗前比,差异无统计学意义(P＞0.05),其余各组内、组间3项指标比较,差异有统计学意义（P<0.01）。结论 大艾段温针灸法治疗肺气虚寒型变应性鼻炎的疗效较好,可显著改善患者的中医证候、临床症状、体征、VAS评分,在调节血清IgE、IL-4、IFN-γ含量方面优于对照组,作用机制可能也与降低血清IgE、IL-4含量,升高IFN-γ含量相关。      

从湿毒疫论治新型冠状病毒肺炎医案探析

新型冠状病毒肺炎属于中医疫病范畴。通过对两则临床医案的辨析,认为其主要病机为湿毒为患,有寒湿和湿热之分,早期以寒湿为主,日久向湿热发展;亦有平素湿热体质者,疾病初期即表现为湿热证。病位主要在肺与脾,以化湿解毒为主要治疗大法,除了散寒除湿、清热化湿之外,还需要注意条畅气机、活血化瘀、健脾益气等法,忌过用辛温、柔腻、寒凉之品。初期恶寒者还需与伤寒表证相鉴别。