温补派薛己活用补中益气汤治疗外科疾病的经验探析

薛己为明代著名医家,温补派先驱,尤其擅长外科。本文通过研究薛己的外科著作发现其治疗外科疾病时,主张治病求本,以资化源;重视保护脾胃,强调内外兼治;合方用药灵巧,突出朝夕用药。他运用补中益气汤常治疗的外科疾病由高到低依次为痈证、疮证、瘰疬、鹤膝风、疽证、流注、赤白游风、发背、脱肛、发痉、注夏、瘤赘等,常合用的方剂由高到低依次为六味地黄丸、六君子汤、十全大补汤、八珍汤、八味丸、逍遥散、益气养荣汤、仙方活命饮、四神丸、归脾汤等。     

HPLC法同时测定外感风寒颗粒中10种成分

目的建立HPLC法同时测定外感风寒颗粒(桂枝、防风、葛根等)中苦杏仁苷、3’-羟基葛根素、葛根素、3’-甲氧基葛根素、升麻素苷、升麻素、5-O-甲基维斯阿米醇苷、亥茅酚苷、肉桂酸、桂皮醛的含有量。方法该药物甲醇提取液的分析采用Agilent ZORBAX Eclipse XDB-C18色谱柱(4.6 mm×250 mm,5μm);流动相乙腈-0.1%磷酸,梯度洗脱;体积流量1.0 m L/min;柱温25℃;检测波长207、254、280 nm。结果 10种成分在各自范围内线性关系良好(r≥0.999 1),平均加样回收率为96.97%~100.08%,RSD为0.80%~1.45%。结论该方法简便、重复性好,可用于外感风寒颗粒的质量控制。     

Interval breast cancer risk associations with breast density,family history and breast tissue aging

Interval breast cancers (those diagnosed between recommended mammography screens) generally have poorer outcomes and are more common among women with dense breasts. We aimed to develop a risk model for interval breast cancer. We conducted a nested case–control study within the Melbourne Collaborative Cohort Study involving 168 interval breast cancer patients and 498 matched control subjects. We measured breast density using the CUMULUS software. We recorded first-degree family history by questionnaire, measured body mass index (BMI) and calculated age-adjusted breast tissue aging, a novel measure of exposure to estrogen and progesterone based on the Pike model. We fitted conditional logistic regression to estimate odds ratio (OR) or odds ratio per adjusted standard deviation (OPERA) and calculated the area under the receiver operating characteristic curve (AUC). The stronger risk associations were for unadjusted percent breast density (OPERA = 1.99; AUC = 0.66), more so after adjusting for age and BMI (OPERA = 2.26; AUC = 0.70), and for family history (OR = 2.70; AUC = 0.56). When the latter two factors and their multiplicative interactions with age-adjusted breast tissue aging (p = 0.01 and 0.02, respectively) were fitted, the AUC was 0.73 (95% CI 0.69–0.77), equivalent to a ninefold interquartile risk ratio. In summary, compared with using dense breasts alone, risk discrimination for interval breast cancers could be doubled by instead using breast density, BMI, family history and hormonal exposure. This would also give women with dense breasts, and their physicians, more information about the major consequence of having dense breasts—an increased risk of developing an interval breast cancer.     

南星骨痛凝胶贴膏对兔膝骨关节炎关节形态及血清IL-1、TNF-α、MMP-13、TIMP-1表达的影响

目的观察南星骨痛凝胶贴膏对兔膝骨关节炎关节形态及血清IL-1、TNF-α、MMP-13、TIMP-1表达的影响,探讨南星骨痛凝胶贴膏治疗兔膝骨关节炎可能的作用机制。方法 18只健康6月龄新西兰兔随机分成3组:空白组(A组)、模型组(B组)、骨痛膏治疗组(C组). BC组用3%木瓜蛋白酶关节腔内注射造模后C组给予南星骨痛凝胶贴膏外敷,给药4周后,用Aloka Latheta LCT-200观察兔膝骨关节影像学改变、用ELISA法检测血清IL-1、TNF-α、MMP-13、TIMP-1含量。结果 C组兔膝关节病变程度较B组轻,C组兔血清中IL-1、TNF-α、MMP-13含量较B组降低(P<0. 05),TIMP-1含量较B组升高(P <0. 05)。结论南星骨痛凝胶贴膏能减轻兔膝关节骨关节炎病变程度,对关节软骨有保护作用,其作用机制可能与抑制炎症因子IL-1、TNF-α及MMP-13表达,增加TIMP-1表达有关。     

江一平运用中药外敷癌瘤方治疗癌性疼痛经验

总结江一平对癌性疼痛病因病机的见解以及运用中药外敷癌瘤方治疗癌性疼痛的经验。江一平认为痰瘀互结、癌毒壅滞是癌痛的基本病机,癌毒壅滞为病机关键,“痰”“瘀”“毒”三者贯穿疾病始终,故治疗上以祛痰化瘀、解毒散癌为主要原则,祛瘀化痰为治疗根本,解毒散癌为治疗关键。     

非小细胞肺癌新辅助靶向及免疫治疗研究进展和展望

肺癌是全球发病率和死亡率最高的恶性肿瘤。近年来,随着新型药物的出现和治疗模式的优化,肺癌患者的预后已有一定改善。新辅助治疗是指对潜在可接受手术切除的患者,先给予术前抗肿瘤治疗后再行手术治疗。新辅助治疗通过术前治疗可以缩小肿瘤体积,降低肿瘤分期;并且可以杀灭患者机体中循环肿瘤细胞及微转移病灶,令患者远期生存获益。靶向治疗及免疫治疗已被应用于晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的一线治疗。因此,有临床试验尝试将以上两种治疗手段应用于早期可切除NSCLC患者的新辅助治疗。本文针对新辅助靶向及免疫治疗对早期可切除NSCLC患者的疗效、治疗中的潜在风险予以综述,并探讨新辅助治疗的未来发展方向。     

Tao Liu research group of Peking University School of Pharmaceutical Sciences and Mo Li research group of Peking University Third Hospital joint developed CRISPR non-natural amino acid coupling technique to improve the efficiency of precise genome editing

Tao Liu research group of Peking University School of Pharmaceutical Sciences and Mo Li research group of Peking University Third Hospital joint developed CRISPR non-natural amino acid coupling technique to improve the efficiency of precise genome editing.     

Berberine diminishes cancer cell PD-L1 expression and facilitates antitumor immunity via inhibiting the deubiquitination activity of CSN5

Programmed cell death-1 (PD-1)/programmed cell death ligand-1 (PD-L1) blocking therapy has become a major pillar of cancer immunotherapy. Compared with antibodies targeting, small-molecule checkpoint inhibitors which have favorable pharmacokinetics are urgently needed. Here we identified berberine (BBR), a proven anti-inflammation drug, as a negative regulator of PD-L1 from a set of traditional Chinese medicine (TCM) chemical monomers. BBR enhanced the sensitivity of tumour cells to co-cultured T-cells by decreasing the level of PD-L1 in cancer cells. In addition, BBR exerted its antitumor effect in Lewis tumor xenograft mice through enhancing tumor-infiltrating T-cell immunity and attenuating the activation of immunosuppressive myeloid-derived suppressor cells (MDSCs) and regulatory T-cells (Tregs). BBR triggered PD-L1 degradation through ubiquitin (Ub)/proteasome-dependent pathway. Remarkably, BBR selectively bound to the glutamic acid 76 of constitutive photomorphogenic-9 signalosome 5 (CSN5) and inhibited PD-1/PD-L1 axis through its deubiquitination activity, resulting in ubiquitination and degradation of PD-L1. Our data reveals a previously unrecognized antitumor mechanism of BBR, suggesting BBR is small-molecule immune checkpoint inhibitor for cancer treatment.     

基于德尔菲法构建呼吸与危重症医学科住院医师规范化培训出科考核指标体系

目的　根据临床需求，结合医院实际，建立一套适应呼吸与重症医学科发展的科学、系统的出科考核评价体系。方法　采用文献分析法和德尔菲法，经过两轮咨询确定指标体系，采用优序图法确定指标权重。采用SPSS 22.0统计软件进行数据分析。结果　两轮咨询专家积极系数为100%和95.65%；两次咨询群体专家权威系数平均值为0.85；两轮专家咨询的协调系数分别为0.513、0.516；最终确立一级指标5项、二级指标14项。结论　专家积极程度和协调系数好，结果可信。确立的指标体系可用于医院呼吸与危重症医学科住院医师规范化培训考核评估。