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。     

眼底动脉硬化与血压、血糖、血脂的多元分析与评估

目的探讨眼底动脉硬化与血压、血脂、血糖的相关性，评估中风危险度。方法对2004年5月至2008年10月就诊的患者335例，作为观察组，并与无症状的健康体检者180例作对照，动态检测眼底动脉硬化、血压、血糖、血脂的异常变化，并做综合量化评估。结果脑血管疾病与眼底动脉硬化、血压、血糖、血脂等因素密切相关。结论眼底动脉硬化、血糖、血脂、血压异常的量化评分，能够预估中风，以便采取预防性治疗。     

Conjugated linoleic acid evokes de-lipidation through the regulation of genes controlling lipid metabolism in adipose and liver tissue

Conjugated linoleic acid (CLA) is a unique lipid that elicits dramatic reductions in adiposity in several animal models when included at < or = 1% of the diet. Despite a flurry of investigations, the precise mechanisms by which conjugated linoleic acid elicits its dramatic effects in adipose tissue and liver are still largely unknown. In vivo and in vitro analyses of physiological modifications imparted by conjugated linoleic acid on protein and gene expression suggest that conjugated linoleic acid exerts its de-lipidating effects by modulating energy expenditure, apoptosis, fatty acid oxidation, lipolysis, stromal vascular cell differentiation and lipogenesis. The purpose of this review shall be to examine the recent advances and insights into conjugated linoleic acid's effects on obesity and lipid metabolism, specifically focused on changes in gene expression and physiology of liver and adipose tissue.     

血液标本放置时间和抗凝剂对血糖检测结果的影响

目的 :探讨两种抗凝剂的血液标本放置时间对血糖测定的影响。方法 :采集门诊健康人血液标本 30份 ,分别以肝素钠和氟化钠作抗凝 ,放置不同时间检测血糖值。结果 :及时分离血浆的血液标本血糖在 5h内差异无显著性。而血液离体后不及时分离血浆 ,血糖是随着时间延长而降低。氟化钠抗凝的血糖比肝素钠抗凝的血糖下降的程度要缓慢一些 ,所以临床上采集血液标本必须及时分离血浆 ,选用合适的抗凝剂 ,及时测定 ,减少误差 ,提高准确性 ,给临床提供准确的诊断依据     

健脾活血方对2型糖尿病大鼠胰岛素抵抗的影响

目的:探讨健脾活血方对2型糖尿病胰岛素抵抗(Insulin Resistance,IR)的改善作用及机理。方法:取Wistar大鼠60只,雌雄各半,采用链脲佐菌素(Streptozotocin,STZ)加高脂饮食造成2型糖尿病IR大鼠模型,设空白组、模型组、健脾活血方组和罗格列酮组,以血糖仪检测大鼠空腹血糖(Fasting BloodGlucose,FBG),采用放射免疫分析法检测大鼠空腹胰岛素(Fasting Plasma Insulin,Fins),并计算胰岛素敏感性指数(Insulin SensitivityIndex,ISI)。用全自动生化检测仪检测游离脂肪酸(Free Fat Acid,FFA)。结果:健脾活血方能够调节血糖和胰岛素水平,降低血清FFA含量,提高ISI,其作用与罗格列酮相当,与模型组比较有显著性差异(P<0.05,P<0.01)。结论:健脾活血方对2型糖尿病大鼠IR有改善作用。     

A comparison of two rehabilitation protocols after total knee arthroplasty: does flexion affect mobility and blood loss?

We report a prospective trial comparing the effectveness of a post-operative flexion regime versus a standard extension regime on the early outcome and on the post-operative blood loss of total knee arthroplasty. Fourty-eight knees were divided to two different post-operative rehabilitation regimes: a flexion regime and an extension regime. The two groups were well matched with respect to age, gender, operation side and pre-op diagnosis All patients were implanted with a NexGen cemented total knee prosthesis and all operations were performed by the same surgeon. Patients were assessed pre-operatively, at the time of discharge, at 6 weeks and at 12 weeks, and were evaluated by means of the Knee Society Score (KSS) and the WOMAC score, the Clarkson criteria for range of motion and muscolar strength measurement, and the Verbal Numeric Scale (VNS) for the pain. Futhermore, postoperative blood loss was assessed by comparing the volume of blood in the drain at the time of their removal and measuring the difference in preoperative and postoperative blood haemoglobin (Hb) in the 2 groups. Patients subjected to the flexion regime had a better KSS and Womac score after 12 weeks and had less post-operative blood loss, requiring fewer blood transfusions. No differences were found between the two groups in terms of pain and muscolar strength. We believe a flexion regime after a total knee arthroplasty is a valid option of rehabilitation treatment and does not result in an increase in wound problems.     

瑞格列奈与迪沙片治疗新诊断2型糖尿病的疗效对比观察

比较对新诊断2型糖尿病患者应用瑞格列奈（11例）和迪沙片（10例）治疗4周后空腹血糖（FPG）、餐后2h血糖（2hPG）、晨3点血糖（3aPG）,空腹胰岛素（FIns）、餐后2h胰岛素（2hIns）,糖化白蛋白的值。结果显示,与迪沙片组相比,瑞格列奈组治疗后空腹血糖、餐后2h血糖的下降幅度更为明显,但低血糖的发生次数反而减少。     

Uncooked rice of relatively low gelatinization degree resulted in lower metabolic glucose and insulin responses compared with cooked rice in female college students

Cooking processes that gelatinize granules or disrupt structure might increase the glucose and insulin responses because a disruption of the structure of starch by gelatinization increases its availability for digestion and absorption in the small intestine. We hypothesized that the uncooked form of rice, which has a relatively low degree of gelatinization even though in powder form, would result in lower metabolic glucose and insulin responses compared with cooked rice (CR). To assess the effects of the gelatinization of rice on metabolic response of glucose and insulin, we investigated the glucose and insulin responses to 3 rice meals of different gelatinization degree in female college students (n = 12): CR (76.9% gelatinized), uncooked rice powder (UP; 3.5% gelatinized), and uncooked freeze-dried rice powder (UFP; 5.4% gelatinized). Uncooked rice powders (UP and UFP) induced lower glucose and insulin responses compared with CR. The relatively low gelatinization degree of UPs resulted in low metabolic responses in terms of the glycemic index (CR: 72.4% vs UP: 49.7%, UFP: 59.8%) and insulin index (CR: 94.8% vs UP: 74.4%, UFP: 68.0%). In summary, UPs that were less gelatinized than CR induced low postprandial glucose and insulin responses.     

男性青少年性腺功能减退症患者短期雄激素替代治疗对血脂和hsCRP水平的影响

目的 探讨性腺功能低减的青少年男性，短期雄激素替代治疗对血脂和超敏C反应蛋白（hsCRP）的影响。方法 本研究为前瞻性自身对照研究，共纳入33例性腺功能减退青少年男性。行短期（9个月）雄激素替代治疗，比较治疗前后血睾酮水平、第二性征发育程度、身高、握力、血红蛋白、血脂和hsCRP的差异。结果 （1）替代治疗后，睾酮水平明显升高，第二性征明显发育，身高、握力、血红蛋白显著增加（P值均〈0.05）；（2）短期雄激素替代治疗后，总胆固醇（TC），低密度脂蛋白（LDL-c），高密度脂蛋白（HDL-c）和甘油三酯（TG）部有所下降，但无统计学差异（P〉0．5）。超敏CRP显著下降（P=0.025）。结论 （1）性腺功能低减的青少年男性，短期雄激素替代治疗，可以促进第二性征发育，增加身高、握力和血红蛋白；（2）短期雄激素替代治疗，对血脂无显著性影响。但是，可以使hsCRP明显下降。     

化疗药物对轴型皮瓣血运影响的组织学观察

目的探讨抗癌药物动脉灌注后对局部轴型皮瓣血运影响的组织学评价。方法在猪腹部的腹壁上动脉插管灌注抗癌药物,10d后在猪腹部形成以腹壁上血管为蒂的岛状皮瓣,通过对灌注区域轴型血管供养的岛状皮瓣的成活率、光镜、透射电镜及血管铸型透明标本的组织学观察,显示其血管结构及构筑的变化。结果抗癌药物用于局部动脉灌注后,使局部轴型血管支配的血管网有损伤的表现,岛状皮瓣远端的血运显著降低。结论抗癌药物经动脉灌注后可影响局部轴型皮瓣的血运,使皮瓣血供的安全范围缩小,为提高相关修复手术的成功率提供可靠的科学依据。