参芪心复康对心气虚细胞模型ET和NOS基因表达的影响

目的研究参芪心复康对心气虚细胞模型内皮素(ET)和一氧化氮合酶(NOS)基因表达的影响.方法采取培养心肌细胞缺氧再给氧损伤的方法建立心气虚细胞模型.设参芪心复康组、人参组、水蛭组、丹参组、对照组、模型组,采用逆转录聚合酶链反应(RT-PCR)基因表达检测心气虚细胞模型和各中药治疗组的ET和NOS基因表达情况.结果各中药组ET和NOS mRNA表达与心气虚的细胞模型的ET和NOS表达有显著性差异(P＜0.01);参芪心复康组与其他中药组的ET和NOS mRNA表达情况有显著性差异(P＜0.01或P＜0.05).结论参芪心复康防治心气虚证的机制与其干预ET和NOS mRNA表达有关.     

张琪教授治疗慢性肺源性心脏病经验介绍

张琪教授认为，慢性肺源性心脏病属本虚标实证，血瘀贯穿于本病始终。治疗肺心病不宜大剂量应用补气药，适当益气，升中有降；注重活血化瘀并贯穿治疗始终；利水消肿，主张中西汇参，衷中参西；并保持患者大便通畅，对缓解症状和预后具有重要意义。     

Dravet综合征患儿致病基因定位及GEFS+基因突变检测

目的分析海南地区Dravet综合征患儿的遗传特征。方法收集2015—2017年期间海南省18例Dravet综合征患儿及家系成员的外周血,采用PCR扩增及Sanger测序法进行SCN1A基因检测,运用连锁分析应用软件GenomeStudio进行致病基因定位分型与连锁分析;对Sanger测序法未发现SCN1A基因突变的患儿,采用多重连接依赖的探针扩增(MLPA)方法分析SCN1A基因片段缺失或重复,并筛查父母SCN1A基因,分析其突变来源。结果 18例Dravet综合征患儿及父母基因定位扫描结果完全符合亲子间的孟德尔遗传关系。SCN1A基因突变患儿可定位到5号、9号、22号染色体3个候选突变区域。其中5号染色体区域位于SNPRs 4957954至Rs 728937,在Rs 1459085处可获取到最大LOD值2. 13;9号染色体区域位于SNPRs 720974至Rs 1220087,在Rs 71332677处可获取到最大LOD值1. 92;22号染色体区域位于SNPRs 756658至Rs 713751,在Rs 374225处可获取到最大LOD值1. 91。18例患儿中,12例SCN1A基因突变,其中6例CDS区域的第5383位碱基呈现杂合变异(G→A),4例13号外显子和CDS区域的第2292位碱基纯合变异(T→C),2例SCN1A基因非编码区域碱基纯合变异(A→T)。结论海南Dravet综合征患儿的基因定位完全符合孟德尔遗传关系,推测Rs4957954至Rs728937、Rs720974至Rs1220087、及Rs756658至Rs713751区域是Dravet综合征的可能致病性区域。     

益气化痰活血法对血脂正常的高血压患者血管内皮功能的影响

目的:探讨益气化痰活血法对血脂正常的原发性高血压(Essential Hypertension,EH)患者血管内皮功能的影响。方法:218例EH患者按1∶1随机分为对照组和试验组。前者给予常规西医治疗,后者在常规治疗基础上加用益气化痰活血法。治疗30d,比较两组的临床效果、内皮依赖性血管舒张功能(Flow-mediated Vasodilation,FMD)和收缩压。结果:疗程结束时,试验组总有效率显著高于对照组(97.25%VS 86.24%,P0.05);试验组FMD显著高于对照组[(8.17±0.85)%VS(6.26±0.74)%,P0.05];试验组SBP明显低于对照组[(128.64±17.35)VS(134.72±19.57),P0.05]。结论:在常规西医治疗基础上加用益气化痰活血法能显著提高血脂正常EH患者的临床疗效,改善FMD和降低SBP。     

Pollen shells and soluble factors play non-redundant roles in the development of allergic conjunctivitis in mice

PurposeWe aimed to clarify the role of particulate allergen exposure to the conjunctiva in the development of allergic conjunctivitis.MethodsWe administered ragweed pollen suspension, pollen extract, pollen shell, particulate air pollutants, and their combinations to the mouse conjunctiva five days a week without prior sensitization. Clinical signs were scored. Histological changes, cellular infiltrations, mRNA expressions, lymph node cell recall responses, and serum immunoglobulin levels were assessed. Immune cell-depleting antibodies and ST2 knockout mice were used to investigate the cellular and molecular requirements.ResultsPollen suspension, but not the extract or shell alone, induced robust eosinophilic conjunctivitis, accompanied by a proliferative response of epithelial cells. A combination of pollen extract and shell completely restored eosinophil accumulation. In addition, eosinophilic conjunctivitis was induced by a mixture of particulate air pollutants and pollen extract. Mechanistically, eosinophil accumulation was ameliorated by deficiency of the IL-33 receptor ST2 and abolished by depleting CD4⁺ T cells. Pollen shells, but not the extract, induced IL-33 release from conjunctival epithelial cells in vivo.ConclusionsOur results indicate the non-redundant roles for the allergens’ particulate properties and soluble factors in the development of allergic conjunctivitis.     

海南地区35例头癣临床和病原菌分析

目的: 了解我院确诊头癣的临床特征和病原菌。方法: 对我院门诊2014年6月到2017年5月收治的头癣病例进行回顾性分析。结果: 共有35例头癣患者，其中脓癣25例 (71.4%)，白癣和黑点癣各5例(14.3%)。28例患者真菌培养阳性，其中须癣毛癣菌复合体10例，断发毛癣菌7例，石膏样小孢子菌4例，犬小孢子菌3例，红色毛癣菌和紫色毛癣菌各2例。结论: 我院确诊的头癣以脓癣为主，多见于0～10岁的儿童，最常见病原菌是须癣毛癣菌复合体。     

肺癌患者条件致病性真菌感染的特征

目的：调查唐山市人民医院2005年至2009年住院肺癌患者感染条件致病性真菌的临床特点及种类,探讨条件致病性真菌感染的危险因素。方法：采用回顾性调查研究的方法,对2005年至2009年在唐山市人民医院住院并发生条件致病性真菌感染的肺癌患者进行研究。结果：住院肺癌患者送检标本的送检率和条件致病性真菌检出率均逐年增高,以念珠菌属为主,白色念珠菌是最常见的感染真菌,年龄≥60岁、住院时间长、吸烟、肿瘤恶性程度高、接受化疗及放疗、广谱抗生素和激素的大量使用、各种侵入性诊疗操作的应用等因素与肺癌患者发生条件致病性真菌感染有关。结论：控制危险因素,提高患者免疫力是预防肺癌患者条件致病性真菌感染的主要措施。     

Obstructive sleep apnea syndrome (OSAS) and hypertension: Pathogenic mechanisms and possible therapeutic approaches

Obstructive sleep apnea syndrome (OSAS), a chronic condition characterized by collapse of the pharynx during sleep, has been increasingly recognized as a health issue of growing importance over the last decade. Recently emerging evidence suggests that there is a causal link between OSAS and hypertension, and hypertension represents an independent risk factor in OSAS patients. However, the pathophysiological basis for patients with OSAS having an increased risk for hypertension remains to be elucidated. The main acute physiological outcomes of OSAS are intermittent hypoxia, intrapleural pressure changes, and arousal from sleep, which might induce endothelial dysfunction, sympathetic activation, renin–angiotensin–aldosterone system activation, lipid metabolism dysfunction, and increased oxidative stress. This brief review focuses on the current understanding of the complex association between OSAS and hypertension.     

浅析秦伯未治疗水肿六法

秦伯未根据《黄帝内经》思想,将各脏腑生理功能与病理表现相结合,认为水肿之为病,以肺、脾、肾三脏为主,涉及胃、大肠、小肠、三焦、膀胱等脏,因而提出利尿、逐水、发汗、燥湿、温化、理气六大基本治法。同时认为此六法可因具体情况而出入变通,多种治法相结合,以发挥更好的临床疗效。     

行气解郁平衡饮食方干预气郁体质的临床观察

目的观察行气解郁平衡饮食方干预气郁体质临床疗效。方法选取2017年9月～2018年5月我市体检中心体检者中气郁体质者166例,根据随机数字表法分为干预组和对照组各83例。干预组采用行气解郁平衡饮食方,对照组采用常规饮食指导连续干预12周,观察两组干预前、后体质量化积分及各条目量化积分变化情况。结果干预组总有效率为87.95%(73/83),高于对照组的49.40%(41/83),差异有统计学意义(P0.05)。干预组干预后各条目量化积分均明显低于干预前,差异有统计学意义(P0.05)。结论行气解郁平衡饮食方干预气郁体质干预效果明显,可以改善气郁体质量化积分,患者气郁体质症状好转。