试论《三因司天方》与《辅行诀》五脏用药法要的互补性

[目的]研究《三因司天方》与《辅行诀》协同应用于临床的可行性。[方法]采用文献法对《三因司天方》与《辅行诀》进行研究,从诊断和治疗两方面作梳理分析和比较,依据中医经典理论体系,结合临床实践经验,合理推导得出结论。[结果]《三因司天方》以五运六气为理论核心,《辅行诀》以五脏补泻为理论核心。《三因司天方》的诊断以发病时间和临床表现为依据,重视症状。《辅行诀》的诊断以临床表现为依据;除症状外,更加注重发病以及就诊时间这个重要因素。《三因司天方》的组方思路基于五行生克之理,利用药物的五味,而不是单纯依据药物的功效来治疗。《辅行诀》方药更有特点,结构严谨,有明确的组方规则;从五行五脏论治的角度,细分药物。[结论]《三因司天方》与《辅行诀》都以《内经》为理论基础,并加以发挥和创新,在疾病的诊断和治疗上是互通的,同时又各有侧重和优势,可以互为补充。对《三因司天方》与《辅行诀》的互补性进行深入研究和阐发,并在临床实践中应用与验证,具有现实意义。     

CD11c+ CD103+ cells of Mycobacterium tuberculosis‐infected C57BL/6 but not of BALB/c mice induce a high frequency of interferon‐γ‐ or interleukin‐17‐producing CD4+ cells

The magnitude of the cellular adaptive immune response is critical for the control of Mycobacterium tuberculosis infection in the chronic phase. In addition, the genetic background is equally important for resistance or susceptibility to tuberculosis. In this study, we addressed whether lung populations of dendritic cells, obtained from genetically different hosts, would play a role in the magnitude and function of CD4⁺ populations generated after M. tuberculosis infection. Thirty days post-infection, C57BL/6 mice, which generate a stronger interferon-γ (IFN-γ)-mediated immune response than BALB/c mice, exhibited a higher number and frequency of lung CD11c⁺ CD11b⁻ CD103⁺ cells compared with BALB/c mice, which exhibited a high frequency of lung CD11c⁺ CD11b⁺ CD103⁻ cells. CD11c⁺ CD11b⁻ CD103⁺ cells, purified from lungs of infected C57BL/6 mice, but not from infected BALB/c mice, induced a higher frequency of IFN-γ-producing or interleukin-17 (IL-17)-producing CD4⁺ cells. Moreover, CD4⁺ cells also arrive at the lung of C57BL/6 mice faster than in BALB/c mice. This pattern of immune response seems to be associated with higher gene expression for CCL4, CCL19, CCL20 and CCR5 in the lungs of infected C57BL/6 mice compared with infected BALB/c mice. The results described here show that the magnitude of IFN-γ-producing or IL-17-producing CD4⁺ cells is dependent on CD11c⁺ CD11b⁻ CD103⁺ cells, and this pattern of immune response is directly associated with the host genetic background. Therefore, differences in the genetic background contribute to the identification of immunological biomarkers that can be used to design human assays to predict progression of M. tuberculosis infection.     

Role of combined DWIBS/3D-CE-T1w whole-body MRI in tumor staging: Comparison with PET-CT

Objectives

To assess the diagnostic performance of whole-body magnetic resonance imaging (WB-MRI) by diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in malignant tumor detection and the potential diagnostic advantages in generating fused DWIBS/3D-contrast enhanced T1w (3D-CE-T1w) images.

Methods

45 cancer patients underwent 18F-FDG PET-CT and WB-MRI for staging purpose. Fused DWIBS/3D-CE T1w images were generated off-line. 3D-CE-T1w, DWIBS images alone and fused with 3D-CE T1w were compared by two readers groups for detection of primary diseases and local/distant metastases. Diagnostic performance between the three WB-MRI data sets was assessed using receiver operating characteristic (ROC) curve analysis. Imaging exams and histopathological results were used as standard of references.

Results

Areas under the ROC curves of DWIBS vs. 3D-CE-T1w vs. both sequences in fused fashion were 0.97, 0.978, and 1.00, respectively. The diagnostic performance in tumor detection of fused DWIBS/3D-CE-T1w images were statistically superior to DWIBS (p < 0.001) and 3D-CE-T1w (p ≤ 0.002); while the difference between DWIBS and 3D-CE-T1w did not show statistical significance difference. Detection rates of malignancy did not differ between WB-MRI with DWIBS and 18F-FDG PET-CT.

Conclusion

WB-MRI with DWIBS is to be considered as alternative tool to conventional whole-body methods for tumor staging and during follow-up in cancer patients.     

R mapping in the presence of macroscopic B0 field variations

mapping has important applications in MRI, including functional imaging, tracking of super‐paramagnetic particles, and measurement of tissue iron levels. However, measurements can be confounded by several effects, particularly the presence of fat and macroscopic field variations. Fat introduces additional modulations in the signal. Macroscopic field variations introduce additional dephasing that results in accelerated signal decay. These effects produce systematic errors in the resulting maps and make the estimated values dependent on the acquisition parameters. In this study, we develop a complex‐reconstruction, confounder‐corrected mapping technique, which addresses the presence of fat and macroscopic field variations for both 2D and 3D acquisitions. This technique extends previous chemical shift‐encoded methods for , fat and water mapping by measuring and correcting for the effect of macroscopic field variations in the acquired signal. The proposed method is tested on several 2D and 3D phantom and in vivo liver, cardiac, and brain datasets. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.     

顺德口岸容奇港蝇类本底调查报告

目的掌握顺德口岸容奇港蝇类的种群构成、不同生境密度分布及季节消长情况,为口岸蝇类控制和传染病监测提供依据。方法 2011年3月-2012年2月以容奇港(内河集装箱港口)内职工饭堂、货物堆场、职工宿舍区为调查点,采用笼诱法,对捕获的成蝇用乙醚熏杀后进行种群鉴定、计数及选择性制成标本。结果本次调查共捕获蝇类366只,经鉴定隶属于4科6属9种,优势种蝇为丝光绿蝇占46.17%;蝇密度随季节消长,平均密度为3.39只/笼·d,高峰期出现在四月,峰值为17只/笼·d。结论基本摸清容奇港蝇类的本底情况,港区内蝇类平均密度较低,符合SN/T1415-2004《国境口岸医学媒介生物控制标准》的规定(成蝇密度<10只/笼·d)。     

不同文化程度对男男性行为人群艾滋病知识知晓率的影响

目的了解湖州市男男性行为人群(MSM)的不同文化程度对艾滋病知识知晓率的影响,为制定艾滋病防治对策提供科学依据。方法采用统一的问卷,利用湖州地区MSM交友QQ群在线收集相关的资料,对MSM进行问卷调查,统计分析。结果共收集有效调查问卷410份,调查对象以20～29岁为主,占79.3%(325/410);工厂职员占46.8%(192/410);大专及以上占64.1%(263/410);未婚占72.7%(298/410)。艾滋病相关知识知晓率为67.1%(275/410)。大专及以上组的知晓率较其他文化程度组高,为89.4%(235/263);艾滋病知识知晓率与各文化程度组之间的差异有统计学意义(χ2=165.1,P<0.01)。Logistic回归分析结果表明,大专及以上组的调查对象的知晓率是初中及以下组的26.2倍,差异有统计学意义(OR=26.2,95.0%CI:6.8～101.4)。结论湖州市的MSM中,受教育程度高者对艾滋病知识的知晓率明显高于受教育程度低者,但是依然需要加强对MSM健康教育和行为干预,以有效控制艾滋病经性途径传播。     

普通话可接受噪声级测试材料的开发与等价性评估

目的 开发普通话版可接受噪声级(acceptable noise level,ANL)测试材料.方法 从小学、初中和高中语文教材中选取3篇难易程度不同的短文材料;选取31例听力言语正常人分别进行3种材料的ANL测试,获得3种材料下的最舒适响度级(most comfortable loudness,MCL)、最大背景噪声...     

六淫概念的发生学探讨

从发生学角度探析六淫的概念。认为生活观察是气候致病认识的直接来源,天人相应是六气致病框架的指导思想,"三才"思想确立"六淫"之为"六",意象思维是六淫概念构建的主要思维方式。指出六淫是以风、寒、暑、湿、燥、热六气为原型的外感病因符号,其概念具有抽象及气象学双重意义。     

世界银行一云南省妇幼卫生扶贫资金研究的背景及目的

世界银行一云南省妇幼卫生扶贫资金运作式研究是在卫Ⅵ项目有效地改善了贫困农村妇幼卫生服务的基础上,进一步探索对贫困妇女及儿童提高医疗救助的有效途径。通过探讨,比较不同模式下妇幼卫生扶贫资金服务的提供与利用情况,更好地理解对贫困人群提供医疗救助的关键问题及其解决的策略,探索扶贫资金有效的运作及管理模式,为贫困人群的医疗救助提供经验及决策依据。简要介绍了世界银行一云南省妇幼卫生扶贫资金运作式研究的背景及目的。     

Spontaneous fetal loss rates in a non‐selected population

The objective of this work was to determine the rate of spontaneous fetal loss up to 28 weeks of gestation in uncomplicated pregnancies of a low‐risk population after sonographically identified intact intrauterine pregnancy during the first trimester. Transvaginal ultrasounds were given to 2,534 women at between six and 12 weeks of gestation. Inclusion criteria were a positive fetal cardiac activity and no antecedent signs of vaginal bleeding. Gestational age was confirmed by measurement of the crown‐rump length and/or biparietal diameter (BIP). Patients were followed until delivery or up to a fetal loss. The mean fetal loss rate between 12 and 28 weeks was 3.86% (n = 99). Fetal loss increased with maternal age: fetal loss rate under 20 yr: 2.94% (OR 0.75; CI 0.23–2. 46), 20–24 yr: 3.20% (OR 0.77; CI 0.48–1.23), 25–29 yr: 3.39% (OR 0.77; CI 0.50–1.19), 30–34 yr: 3.89% (OR 1.01; CI 0.59–1.71), 35–39 yr: 7.82% (OR 2.13; CI 1.04–4.32), 40–45 y: 50% (OR 13.84; CI 6.67–28.72) and > 45 yr: 50% (OR 13.05; CI 1.96–86.71) respectively. The frequency of spontaneous fetal loss before 28 weeks gestation was assessed systematically in a low‐risk population. There was a very clear correlation with advancing maternal age. These data now can be used as background loss rate information for evaluating the safety of invasive prenatal diagnosis, and they will be more valid for this purpose than the available data taken from selected cohorts of women, such as those from hospital clinics or from infertility programs. © 2001 Wiley‐Liss, Inc.