基于“证治代谢组学”假说探讨中药（单体/复方）药效物质基础的研究思路与实践＊

中药(单体/复方)药效物质基础研究是中医药现代研究的关键问题之一。然而,目前运用的生化和分子生物学方法很难诠释其多靶点、整体性和动态性的整合调节作用。课题组提出的"证治代谢组学"假说理论指出,不同的证候存在"证相关代谢谱群"和"证相关生物标志物",这可能是中药药效物质基础所在,辨证论治后偏离的代谢网络功能呈现回归趋势。基于"证治代谢组学"假说开展中药(单体/复方)药效物质基础研究,这将为阐释中药(单体/复方)防病治病和养生保健的科学内涵及其对疾病个体的整合调节作用提供新的思路。本文以冠心病为研究载体、气阴虚血瘀证为切入点、活血保心丸为干预措施,就该研究思路的内涵与总体模式、提出的背景与依据、实践的方式与可行性、创新与特色及其研究意义等进行了简要介绍。     

Enhancing positive perceptions of aging by savoring life lessons

Objectives: This study examined the effects of savoring valuable life lessons on perceptions of aging and on well-being among older adults.

Method: A total of 303 adults (mean age = 68.12 years) were randomly assigned to one of three experimental conditions: savoring life lessons (n = 95), reflecting on negative aspects of aging (n = 129), or untreated-control condition (n = 79). Participants in the savoring condition wrote about a valuable lesson they had learned in growing older, whereas participants in the negative-aging condition wrote about physical losses they had experienced in aging.

Results: After controlling for baseline happiness, health, gender, and age, participants who savored valuable life lessons reported greater positive perceptions of aging and life satisfaction, compared to participants in the negative-aging and untreated-control conditions. There were no differences across conditions in negative perceptions of aging or in anxiety.

Conclusion: These findings suggest that savoring valuable life lessons could be an effective addition to psychoeducational programs designed to improve perceptions of aging.     

Contextualizing the lived experience of quality of life for persons with spinal cord injury: A mixed-methods application of the response shift model

Objective: The objective of this study was to gain greater insight into individuals’ quality of life (QOL) definitions, appraisals, and adaptations following spinal cord injury (SCI).

Design: A mixed-methods design, applying the Schwartz and Sprangers response shift (RS) model. RS is a cognitive process wherein, in response to a change in health status, individuals change internal standards, values, or conceptualization of QOL

Setting: Community-dwelling participants who receive medical treatment at a major Midwestern medical system and nearby Veterans’ Affairs hospital.

Participants: A purposive sample of participants with SCI (N?=?40) completed semi-structured interviews and accompanying quantitative measures.

Interventions: Not applicable.

Outcome Measures: Qualitative data were analyzed using content analysis to identify themes. Analysis of variance were performed to detect differences based on themes and QOL, well-being, and demographic and injury characteristics.

Results: Four RS themes were identified, capturing the range of participant perceptions of QOL. The themes ranged from complete RS, indicating active engagement in maintaining QOL, to awareness and comparisons redefining QOL, to a relative lack of RS. Average QOL ratings differed as a function of response shift themes. PROMIS Global Health, Anxiety, and Depression also differed as a function of RS themes.

Conclusion: The RS model contextualizes differences in QOL definitions, appraisals, and adaptations in a way standardized QOL measures alone do not.     

院方归龙汤加味治疗消渴脱疽探讨

[目的]探讨院方归龙汤加味治疗消渴脱疽的作用及其相关机制。[方法] 查阅分析古今相关文献，并结合临床实践，基于陈实功的《外科正宗》一书中治疗阴疽的四法“疏稼土、通地脉、助根本、回阳气”，对消渴脱疽的病因病机及院方归龙汤加味治疗消渴脱疽进行分析，并列举验案一则加以佐证。[结果] 根据文献研究及实践经验，笔者认为消渴脱疽的病机为阳气亏虚、气血失养、经脉闭阻，故临床上遵从陈实功的阴疽治疗四法“疏稼土、通地脉、助根本、回阳气”，在归龙汤基础上进行加减:加白术、陈皮健脾益气、燥湿利水，此为疏稼土；加黄芪补气升阳、通脉行滞、敛疮生肌，此为助根本；加附子助阳行气，此为回阳气。所举验案，诊断为消渴脱疽，证属阳虚血瘀，符合归龙汤加味方之病机，治之而获良效。[结论]归龙汤加味充分体现了《外科正宗》中脱疽治疗四法，治疗消渴脱疽临床疗效良好，值得临床推广应用。     

Mindfulness to regulate emotions: The Mindfulness and Emotional Intelligence Program (PINEP) and its adaptation to a virtual learning platform

The present study examines the effect of the Mindfulness and Emotional Intelligence Program (PINEP), adapted to the virtual learning platform Moodle where participants receive Mindfulness training in 12 sessions lasting an hour and a half. The sample consists of 89 people, assigned randomly to a control group on the waiting list and to an experimental group that undertakes the training. The results indicate that the participants who completed PINEP showed improvement in the variables of health, empathy and mindfulness, in comparison with the participants of the group on the waiting list.     

Structural brain differences in emotional processing and regulation areas between male batterers and other criminals: A preliminary study

Poor emotion processing is thought to influence violent behaviors among male batterers in abusive relationships. Nevertheless, little is known about the neural mechanisms of emotion processing in this population. With the objective of better understanding brain structure and its relation to emotion processing in male batterers, the present study compares the cortical grey matter thickness of male batterers to that of other criminals in brain areas related to emotion. Differences among these brain areas were also compared to an emotional perception task. An MRI study and an emotional perception assessment was conducted with 21 male batterers and 20 men convicted of crimes other than Intimate Partner Violence (IPV). Results demonstrated that batterers’ had significantly thinner cortices in prefrontal (orbitofrontal), midline (anterior and posterior cingulate) and limbic (insula, parahipocampal) brain regions. The thickness of the dorsal posterior cingulate cortex in the batterer group correlated with scores on the emotional perception task. These findings shed light on a neuroscientific approach to analyzing violent behavior perpetrated by male batterers, leading to a better understanding of the underlying mechanisms involved in IPV.     

Effects of age,gender and menstrual cycle on platelet function assessed by impedance aggregometry

Platelets are needed to prevent or arrest bleeding and aggregate at the site of injury upon vascular damage. Platelets express receptors for estrogens which might affect the function of the platelets and their hemostatic ability. The aim was to identify possible differences in platelet function related to age, gender, and phases of the menstrual cycle by use of impedance aggregometry with Multiplate. In the first part of the study, platelet function was assessed in 60 healthy individuals (30 men and 30 women) in each of three age groups (20–25, 40–45, and 60–65 years). In the second part of the study, the platelet function was analyzed on four occasions during the menstrual cycle in women without oral contraceptives (OCs) (n = 17) and compared to 19 women on OCs and 18 men of similar age (20–40 years). For the women on OCs, aggregation was analyzed once during the tablet-free week and once late during the period with OCs. The men were sampled once. Women of younger age (<45 years) had significantly higher agonist-induced aggregation response than both men and post-menopausal women (60–65 years). The agonist-induced aggregation response did not differ between phases of the menstrual cycle or OC use. The results suggest that estradiol and/or progesterone affect spontaneous aggregation since it was found to be lowest in the mid-luteal phase. Spontaneous aggregation was significantly lower in women on OCs than in both men and women without OCs. Our findings indicate that fertile age is associated with higher aggregation response capacity of the platelets, possibly to prevent excessive bleeding during menstruation, but this response capacity is not altered during the menstrual cycle or by use of OCs.