朱丹溪善用风药治疗血证谈

复习朱丹溪有关医学文献 ,阐发其应用风药治疗血证的机制 ,主要有 :风药直接止血 ;风药升阴散火止血 ;风药散火解毒、凉血止血 ;风药炒黑止血 ;风药振脾益气止血 ;祛除致病因素 ;其它。     

Molecular genetics of familial parkinsonism

Parkinson's disease (PD) is a progressive, neurodegenerative disorder associated with tremor, rigidity, bradykinesia, and postural instability. There exists a familial form of PD that is indistinguishable from the sporadic form. In addition, there exists a class of syndromes classified as parkinsonism-plus syndromes (PPS), in which parkinsonism is an essential but not the only phenotypic characteristic. The etiology of PD remains unclear. Both environmental and genetic factors contribute to the disease pathogenesis. Recent progress in the molecular genetics of parkinsonism has demonstrated that six different chromosomal regions are associated with forms of familial parkinsonism. Mutations in four candidate genes have been identified and include both point mutations and deletions. Both gain-of-function and loss-of-function mutational mechanisms have been implicated. The molecular genetic characterization has led to a new classification of PD and PPS based on the type of genetic defect. Understanding the mechanisms by which these mutations lead to disease should provide further insights into the etiology of parkinsonism.     

Classification of childhood epilepsy syndromes in newly diagnosed epilepsy: interrater agreement and reasons for disagreement

PURPOSE: The International League Against Epilepsy (ILAE) classification of the epilepsies is in increasingly widespread use. The following analysis was done to assess the interrater agreement in classifying epilepsy syndromes in children with newly diagnosed epilepsy. METHODS: In a prospective, community-based study, 613 children with newly diagnosed epilepsy were recruited. Based on information available at diagnosis or generated as part of the initial diagnostic assessment, three pediatric neurologists independently classified epilepsy syndromes. Interrater agreement was assessed with kappa. RESULTS: Interrater agreement was extremely good, with kappa scores > or = 0.80 for almost all comparisons. Relatively limited quality of the EEG and seizure information in some cases, as well as discrepancies between the two, were associated with a tendency for more disagreement. CONCLUSIONS: A high degree of interrater agreement was obtained in this study, indicating that the system for classifying syndromes can be meaningfully used in a community-based sample. Quality of the information, which is often, by necessity, less than optimal in newly diagnosed epilepsy, is a potential barrier to identification of syndromes. A substantial proportion of children were classified into relatively nonspecific syndromes. Over time, additional information may come to light to allow more precise identification of their forms of epilepsy. In an epidemiologic setting, the ILAE classification of the epilepsies can be successfully used with a high degree of reliability to classify newly diagnosed epilepsy in children.     

肝炎辨证论治中的几个基本问题

对肝炎辨证论治的特点、分型论治与辨证论治、辨别肝炎的主症和次症、肝(胆)脾(胃)的几个证论和“无证可辨”5个问题进行了临床探讨。     

《时病论》与脏腑辨证

简要介绍了清末温病学派医家雷丰的生平、著述及影响。重点论述其代表作《时病论》的辨证方法，总结了《时病论》运用脏腑辨证的规律和特点，进而阐明其在整个中医“辨证”历史上的位置和特色。主要从三个方面阐述《时病论》对“脏腑辨证”的运用，1)在温病领域的运用情况。雷氏治温病虽也采用三焦辨证卫气营血辨证，但所占比例较小，而广泛地使用脏腑辨证，且能明确反映温病的传变及分期特点。2)治泄痢的脏腑辨证特色，3)创新辨证脏腑证型。     

鼻塞对阻塞性睡眠呼吸暂停综合征发病影响的研究

目的:探讨鼻塞对阻塞性睡眠呼吸暂停综合征(OSAS)发病的影响。方法:对18例诊断为鼻塞和腭咽平面阻塞的OSAS患者,单纯行鼻腔手术改善通气,6个月后复诊。结果:12例睡眠阻塞症状缓解,其中4例效果明显;6例无效。睡眠呼吸紊乱指数(AHI)由术前的29.9±2.1降至22.8±2.7;夜间最低血氧饱和度由(75.0±2.9)％升至(83.4±2.3)％;而体重指数无明显差异。无效组与有效组的术前AHI值差异有显著性意义。结论:鼻塞是OSAS的重要致病因素,早期治疗解除鼻塞是预防OSAS发病的重要措施之一;长期鼻塞引发的OS-AS患者,早期通过鼻腔手术解除鼻塞是治疗OSAS的有效方法之一。     

慢性肾功能衰竭中医证候研究现状

中医证候规范化研究已成为当前中医界的重大课题之一，近年来，诸多医家从不同角度对慢性肾功能衰竭（CRF）的病因病机，辨证分,下候规范化进行了较深层次的探讨。由于CRF的中医证候复杂，并且呈动态变化，故应加强对其辨证分型和证候规范化的进一步研究。     

辨证治疗中风病248例临床分析

本文通过对２４８例中风病临床分型分析，以气虚血瘀证最多，占３８．３１％，其次为阴虚风动证，肝阳暴亢，风火上扰证。本组病人不论是出血性中风，还是缺血性中风，均采用中药辨证治疗基础上，口服中成药及静脉滴注活血化瘀针剂以加强活血化瘀、涤痰通络这一治疗法则，总有效率为８４．２７％，其中出血性中风和缺血性中风的总有效率分别为８６．９５％和８３．２４％，对血液流变学、脑出血患者治疗前后脑ＣＴ对照观察，认为 一     

Initial transforming event in myelodysplastic syndromes may be viral: case for cytomegalovirus

Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders which begin in a pluripotential bone marrow (BM) stem cell. This early stem cell is believed to acquire a growth advantage over its neighbors as a result of an initial transforming event, the nature of which has remained obscure. In this paper, we propose that pathogens such as those belonging to the herpesvirus family of DNA viruses may play a role in the initial transformation of the stem cell. The case for cytomegalovirus (CMV) as a representative of this family of viruses is discussed at length and a molecular mechanism which may be involved in the oncogenic activity of CMV is proposed. No proof has been presented to implicate CMV directly in MDS, but circumstantial evidence which supports such a possibility is provided.