论《内经》中的“守神”“守机”“守气”

在针刺过程中,医者不能只拘守手部形式,针刺关键在于"治神"。治神是医者手法的核心,贯穿于整个施治过程中。以神"侯气"、"调气",进而"调神"、"调形体"。其理论在《内经》中已有叙述,具体包括:守神、守机和守气。这三者是对针灸医生针刺手法的要求,也是衡量针灸医生水平高低的标准之一。然而针道易陈而难入,针灸医生须认真钻研针刺手法和心法。针刺治神在于医者必须"心领神会",方能感悟。     

肠易激综合征辨证分析

肠易激综合征（IBS）是一组持续存在或反复发作的临床症候群,主要症状有腹痛、腹胀、排便习惯改变和大便性状异常、黏液便等,经检查排除可引起这些症状的器质性疾病。临床分为肝木乘脾型腹泻、脾胃虚弱型腹泻、脾肾阳虚型腹泻、肝郁脾虚型便秘四型,根据临床辨证分别施以不同治法,不同方药治疗,有显著疗效。同时,教育患者平时养成良好的饮食卫生习惯,不饮生水,不食生冷瓜果,忌食辛辣、油腻、肥厚之品,保持心情舒畅,怡情悦志,注意保暖,可加强疗效,防止复发。     

Iron deficiency down-regulates the Akt/TSC1-TSC2/mammalian Target of Rapamycin signaling pathway in rats and in COS-1 cells

Iron deficiency (ID) is one of the most commonly known forms of nutritional deficiencies. Low body iron is thought to induce neurologic defects but may also play a protective role against cancer development by cell growth arrest. Thus, ID may affect cellular pathways controlling cell growth and proliferation, the mechanism of which is still not fully understood. The serine/threonine protein kinase Akt and its downstream target, the mammalian Target of Rapamycin (mTOR), is known to play a crucial role in the regulation of cell growth and survival. Therefore, we hypothesized that Akt/mTOR pathway could be influenced by ID. Three-week-old male Wistar-strain rats were divided into 3 groups and the 2 groups had free access to a control diet (C group) or an iron-deficient diet (D group). The third group (PF group) were pair-fed the control diet to the mean intake of the D group. After 4 weeks, rats were killed and their brains were sampled. In separate experiments, COS-1 cells were cultured with or without the iron chelator deferoxamine. Western blots of brain samples and COS-1 lysates were used to analyze the expression and phosphorylation state of Akt, TSC2, mTOR, and S6 kinase proteins implicated in the Akt/mTOR pathway. Using 2 different ID models, we show for the first time that iron deficiency depresses Akt activity in rats and in COS-1 cells, leading to a decrease in mTOR activity.     

邻近皮瓣修复面部皮肤缺损

目的 探讨邻近皮瓣修复面部皮肤缺损的应用效果。方法 162例面部病变切除后皮肤缺损患者，其中先天性色素痣63例，基底细胞癌28例，鳞状细胞癌6例，其他皮肤病变65例。均采用邻近皮瓣即时修复，其中菱形皮瓣57例、双叶皮瓣8例，A-T皮瓣23例、V-Y皮瓣13例、Z成形术23例、推进皮瓣27例、鼻状皮瓣11例。结果 162例皮瓣存活良好，手术切口1期愈合，存活后皮瓣颜色与邻近部位无明显差异，术后无眼睑、眉毛、鼻梁及口角牵扯歪钭，术后3个月切口不显露。结论 邻近皮瓣是修复面部较大皮肤缺损的良好方法，手术外观效果好。     

益气活血方对气虚血瘀证脑缺血再灌注损伤大鼠Fas、FasL蛋白表达的影响

目的：探讨益气活血方对气虚血瘀证局灶性脑缺血再灌注损伤大鼠Fas、FasL蛋白表达的影响。方法：采用气虚血瘀证局灶性脑缺血再灌注损伤大鼠模型，用线栓法阻塞大鼠大脑中动脉复制局部脑缺血再灌注模型，缺血2h后再灌注l，3，7d。用免疫组化染色法分别检测缺血皮质Fas、FasL蛋白表达。结果：与模型组比较。益气活血方组Fas、FasL蛋白表达显降低。结论：益气活血方可能通过抑制Fas、FasL蛋白表达，减轻气虚血瘀证局灶性脑缺血再灌注损伤。     

云南省600例0~5岁儿童维生素A缺乏调查

目的:了解云南省城乡0~5岁儿童维生素A营养状况及影响因素。方法:省、地、县随机整群抽取600例儿童,采用微量荧光光度法检测VitA含量。结果:VitA缺乏发生率16·17%,地、县明显高于省会城市;0岁儿童明显高于其他年龄组;腹泻儿童明显高于正常儿童;VitA缺乏的影响因素:近1周内进食鸡蛋、奶类制品、鱼虾类、肝类、黄绿色蔬菜、鱼肝油等食物有利于维生素A的吸收,急性呼吸道感染、发烧与维生素A缺乏发生率差异不明显。结论:维生素A缺乏发生率城市明显低于农村地、县两级,说明维生素A缺乏防治工作重点在农村,特别是0岁儿童,防治的主要措施是采取合理膳食,均衡营养,控制腹泻流行。     

补碘对7～12岁轻度碘缺乏病儿童脑功能及生长、发育的影响

通过半年对３５名７～１２岁轻度碘缺乏病儿童进行补碘，并与同龄、同地的正常儿童和缺碘未补碘儿童进行比较，以观察补碘对儿童脑功能及生长发育的影响。结果发现：①补碘可使儿童碘营养状况恢复正常，尿碘值由（８３．２±３．５）μｇ／Ｌ上升到（１６２．２±１．６）μｇ／Ｌ，血清Ｔ４、ＦＴ４Ｉ和ｒＴ３：也与正常儿童一致而与未补碘儿童有显著性差异（Ｐ＜０．０５）．②轻度碘缺乏病儿童智商低于正常儿童（Ｐ＜０．０１），补碘在一定程度上改善其智商水平。③轻度碘缺乏病及补碘未能明显影响儿童的生长发育，可能与儿童总营养水平较差有关。     

Diminished effect of etidronate in vitamin D deficient osteopenic postmenopausal women

Objective: The effects of vitamin D deficiency in osteopenic postmenopausal women treated with intermittent cyclical etidronate have been studied. Bone mass and biochemical parameters as bone markers were measured before and after one year of therapy with intermittent cyclical etidronate. Results: In 30 patients without vitamin D deficiency, bone mass in the lumbal spine and femoral neck was significantly increased compared to 28 vitamin D deficient patients. After cyclical intermittent etidronate therapy, serum osteocalcin and PTH were significantly increased in the vitamin D deficient patients, whereas in non-vitamin D deficient patients they did not change. Conclusion: It is worthwhile measuring serum vitamin D before starting etidronate therapy and, in case of deficiency, to give vitamin D. Received: 6 April 1995/Accepted in revised form: 23 April 1996     

Benign intracranial hypertension and recombinant growth hormone therapy in Australia and New Zealand

Benign intracranial hypertension (BIH) is reported in three children from Australia and one from New Zealand, who were being treated with recombinant human growth hormone (rhGH). Three males and one female, aged between 10.5 and 14.2 y, developed intracranial hypertension within 2 weeks to 3 months of starting treatment. A national database, OZGROW, has been prospectively collecting data on all 3332 children treated with rhGH in Australia and New Zealand from January 1986 to 1996. The incidence of BIH in children treated with growth hormone (GH) is small, 1.2 per 1000 cases overall, but appears to be greater with biochemical GHD (<10IUml ^-1), i.e. 6.5/1000 (3 in 465 cases), relative risk 18.4, 95% confidence interval 1.9-176.1, than in all other children on the database. The incidence in patients with Turner's syndrome was 2.3/1000 (1 in 428 cases). No cases in patients with partial GHD (10–20 IUml ^-1) or chronic renal failure were identified. Possible causative mechanisms are discussed. The authors'practice is now to start GH replacement at less than the usual recommended dose of 14IUm-² week^-1 in those children considered to be at high risk of developing BIH. Ophthalmological evaluation is recommended for children before and during the first few months following commencement of rhGH therapy and is mandatory in the event of peripheral or facial oedema, persistent headaches, vomiting or visual symptoms. The absence of papilledema does not exclude the diagnosis.     

海南文昌汉族人群中两种葡萄糖-6-磷酸脱氢酶基因突变的研究

目的:分析海南文昌人群中葡萄糖-6-磷酸脱氢酶基因1376G→T、95A→G突变。方法:应用硝基四氮唑蓝定量法进行G6PD缺乏症的筛查,用等位基因特异PCR检测1376G→T、95A→G突变。结果:在358位海南文昌汉族人中,发现G6PD缺乏症患者20例,其中9例患者有1376G→T突变,3例患者有95A→G突变。结论:1376G→T、95A→G突变是文昌人群中常见的突变。