从新型冠状病毒肺炎的寒疫病机探析清肺排毒汤的组方机制

在《新型冠状病毒肺炎诊疗方案(试行第六版)》中推荐的清肺排毒汤,临床观察疗效显著。笔者拟探讨新型冠状病毒肺炎(COVID-19)的寒疫病机以及清肺排毒汤的方药组成机制,认为该方能疏解表里、通调三焦,具有宣肺行气、透邪解毒、润燥化湿、逐水泻热的功效,切合COVID-19寒、燥、湿的病机特点,且能有效的针对症状进行治疗,应推广全国各地广泛使用以遏制疫情蔓延。     

A proposed mechanism for central centrifugal cicatricial alopecia

Central centrifugal cicatricial alopecia (CCCA) has an unknown mechanism. Analyzing other scarring diseases (lichen planopilaris, fibrotic kidney disease and scleroderma) may help to clarify the mechanism of scarring in CCCA. These diseases were chosen for comparison due to either their location of disease (skin or scalp specifically), or prominence in patients of African descent. Genetics, possible triggers, an autoimmune lymphocytic response, and epithelial to mesenchymal transition are potentially involved. Possible common pathways in scarring diseases and a better understanding of the CCCA mechanism will lead to further research into the pathogenesis and potential treatments of CCCA.     

Communication research in the context of te whare tapa whā model of health

Abstract

Purpose: Te whare tapa whā represents a Māori view of health and wellness in four dimensions: taha wairua (spiritual health), taha hinengaro (mental health), taha tinana (physical health) and taha whānau (family health). This model of health focuses on indigenous Māori in Aotearoa/New Zealand but has relevance for all people. Speech-language pathologists, including those not familiar with this model, recognise that all four dimensions are needed to support health and wellbeing. Taha wairua includes the importance of culture and heritage to personal identity, an area that speech-language pathology (SLP) recognises as key to clinical competency. Taha hinengaro includes the need to express thoughts and feelings, another area particularly salient to SLP. The other two dimensions taha tinana (physical health) and taha whānau (family health) are arguably more familiar in the day-to-day work of speech-language pathologists.

Method: Two broad strands of research are examined within this model of health exploring the challenges faced by vulnerable populations namely: (1) two community based groups (a Choir and a Gavel Club) for people with acquired neurological conditions such as stroke and Parkinson’s disease, and (2) diagnosis and management of hearing loss and auditory processing disorder.

Result: Community based groups, explored through the CeleBRation Choir and the Gavel Club, highlighted the application of all aspects of te whare tapa whā to the experiences of people with neurological conditions participating in these community therapies. In the area of hearing loss and auditory processing disorder, gaps across all four dimensions of taha wairua, taha hinengaro, taha tinana and taha whānau were identified in the available literature and in examination of clinical provision for participants.

Conclusion: Te whare tapa whā provides a framework to consider all the elements that contribute to people living well while experiencing communication challenges within their whānau (extended family). This approach relies on strong partnerships between clinicians, extended family, researchers, communities, organisations and other professionals. Clinicians and researchers are encouraged to consider how their beliefs, practices and impact could improve through consideration of Indigenous health models such as te whare tapa whā.     

科技期刊嵌入的多重复合科技创新生态系统研究

【目的】 深入探究科技期刊和科技创新生态系统的关系,为科技期刊响应国家号召,高质量、可持续地服务科技创新提供参考。【方法】 基于生态隐喻和模型构建法,构造出科技期刊嵌入的多重复合科技创新生态系统模型,理顺期刊创新运作机制和复合系统构建路径。【结果】 科技期刊被嵌入科技创新生态系统后,形成身兼二任的次生生态,不仅是创新成果作者与多种科技创新主体的接口,而且上下联通不同层级创新生态圈,还衍生出动态自调节、协同共生、交互作用机制。【结论】 科技期刊强力嵌入并高效发挥主观能动性,为科技期刊服务国家科技创新提供全新理论和实践动力,并丰富科技创新生态系统层次、内涵。     

Recellularizing of human acellular dermal matrices imaged by high‐definition optical coherence tomography

High‐definition optical coherence tomography (HD‐OCT) permits real‐time 3D imaging of the impact of selected agents on human skin allografts. The real‐time 3D HD‐OCT assessment of (i) the impact on morphological and cellular characteristics of the processing of human acellular dermal matrices (HADMs) and (ii) repopulation of HADMs in vitro by human fibroblasts and remodelling of the extracellular matrix by these cells. Four different skin decellularization methods, Dispase II/Triton X‐100, Dispase II/SDS (sodium dodecyl sulphate), NaCl/Triton X‐100 and NaCl/SDS, were analysed by HD‐OCT. HD‐OCT features of epidermal removal, dermo‐epidermal junction (DEJ) integrity, cellularity and dermal architecture were correlated with reflectance confocal microscopy (RCM), histopathology and immunohistochemistry. Human adult dermal fibroblasts were in vitro seeded on the NaCl/Triton X‐100 processed HADMs, cultured up to 19 days and evaluated by HD‐OCT in comparison with MTT proliferation test and histology. Epidermis was effectively removed by all treatments. DEJ was best preserved after NaCl/Triton X‐100 treatment. Dispase II/SDS treatment seemed to remove all cellular debris in comparison with NaCl/Triton X‐100 but disturbed the DEJ severely. The dermal micro‐architectural structure and vascular spaces of (sub)papillary dermis were best preserved with the NaCl/Triton X‐100. The impact on the 3D structure and vascular holes was detrimental with Dispase II/SDS. Elastic fibre fragmentation was only observed after Dispase II incubation. HD‐OCT showed that NaCl/Triton X‐100 processed matrices permitted in vitro repopulation by human dermal fibroblasts (confirmed by MTT test and histology) and underwent remodelling upon increasing incubation time. Care must be taken in choosing the appropriate processing steps to maintain selected properties of the extracellular matrix in HADMs. Processing HADMs with NaCl/Triton X‐100 permits in vitro the proliferation and remodelling activity of human dermal fibroblasts. HD‐OCT provides unique real‐time and non‐invasive 3D imaging of tissue‐engineered skin constructs and complementary morphological and cytological information.     

INAUGURAL ARTICLE by a Recently Elected Academy Member:Lexical shifts,substantive changes,and continuity in State of the Union discourse, 1790–2014

This study reveals that the entry into World War I in 1917 indexed the decisive transition to the modern period in American political consciousness, ushering in new objects of political discourse, a more rapid pace of change of those objects, and a fundamental reframing of the main tasks of governance. We develop a strategy for identifying meaningful categories in textual corpora that span long historic durées, where terms, concepts, and language use changes. Our approach is able to account for the fluidity of discursive categories over time, and to analyze their continuity by identifying the discursive stream as the object of interest.When did modern political discourse emerge in the United States? What is distinctive of basic understandings of the tasks of governance today, in contrast to those that organized the politics of an earlier period? Can the origins of contemporary political understandings be located in the discourse of the past? The annual State of the Union address (hereafter, SoU), in which the US president reports broadly on the progress and challenges of his administration, provides a singular standpoint from which to address the evolution of the tasks of governance. It can thus be used to investigate old questions like those above using network-based text analysis strategies.This study reveals that the entry into World War I (WWI) in 1917 indexed the decisive transition to the modern period in American political consciousness, ushering in new objects of political discourse, a more rapid pace of change of those objects, and a fundamental reframing of the main tasks of governance. At the same time, this study demonstrates that discourse distinctive to modern politics, although it later crystalized around the liberal welfare state, in fact emerged before the transition to the modern period.We offer a unique view of American political history, which tracks the articulation of the major tasks of governance in American political and social discourse. To do so, we develop a strategy for identifying meaningful categories in textual corpora that span long historic durées. We are able to account for the fluidity of discursive categories over time, and to analyze their continuity by identifying the discursive stream as the object of interest. The methodological approach developed in this article can be used to meaningfully analyze texts produced over very long historical periods, where terms, concepts, and language use changes—to our knowledge, a problem not satisfactorily solved.     

The Importance of Venous Return in Starling‐Like Control of Rotary Ventricular Assist Devices

Rotary ventricular assist devices (VADs) are less sensitive to preload than the healthy heart, resulting in inadequate flow regulation in response to changes in patient cardiac demand. Starling‐like physiological controllers (SLCs) have been developed to automatically regulate VAD flow based on ventricular preload. An SLC consists of a cardiac response curve (CRC) which imposes a nonlinear relationship between VAD flow and ventricular preload, and a venous return line (VRL) which determines the return path of the controller. This study investigates the importance of a physiological VRL in SLC of dual rotary blood pumps for biventricular support. Two experiments were conducted on a physical mock circulation loop (MCL); the first compared an SLC with an angled physiological VRL (SLC‐P) against an SLC with a vertical VRL (SLC‐V). The second experiment quantified the benefit of a dynamic VRL, represented by a series of specific VRLs, which could adapt to different circulatory states including changes in pulmonary (PVR) and systemic (SVR) vascular resistance versus a fixed physiological VRL which was calculated at rest. In both sets of experiments, the transient controller responses were evaluated through reductions in preload caused by the removal of fluid from the MCL. The SLC‐P produced no overshoot or oscillations following step changes in preload, whereas SLC‐V produced 0.4 L/min (12.5%) overshoot for both left and right VADs. Additionally, the SLC‐V had increased settling time and reduced controller stability as evidenced by transient controller oscillations. The transient results comparing the specific and standard VRLs demonstrated that specific VRL rise times were improved by between 1.2 and 4.7 s ( = 3.05 s), while specific VRL settling times were improved by between 2.8 and 16.1 seconds ( = 8.38 s) over the standard VRL. This suggests only a minor improvement in controller response time from a dynamic VRL compared to the fixed VRL. These results indicate that the use of a fixed physiologically representative VRL is adequate over a wide variety of physiological conditions.     

工作相关肌肉骨骼疾患与人体工效学负荷研究进展

工作相关肌肉骨骼疾患(WMSDs)是常见的慢性非传染性疾病。WMSDs已成为影响工人健康、降低工人生命质量和造成经济损失的重要因素,可见于多个行业、工种。本文对WMSDs流行现状及人体工效学负荷相关研究进行综述,以期找到职业人群保护的可行方法。     

Metabolism and pharmacokinetics studies of allyl methyl disulfide in rats

1. Allyl methyl disulfide (AMDS) is one of the main compounds in garlic, whereas its metabolism has not been studied yet.

2. In this work, we first identified the metabolites of AMDS in rat erythrocytes and rats using GC–MS. The transformation mechanism study among different metabolites was then conducted. The apparent kinetics of AMDS in rat erythrocytes and pharmacokinetics of AMDS by oral administration in rats were also studied.

3. The metabolic pathway study showed that AMDS was mainly metabolized in rats to allyl methyl sulfoxide (AMSO) and allyl methyl sulfone (AMSO₂) through mechanisms of reduction, methylation and oxidation. The transformation mechanism study indicated that AMDS was firstly reduced to allyl mercaptan (AM) in rat erythrocytes, and then methylated to allyl methyl sulfide (AMS) by S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH), and finally oxidized to AMSO and AMSO₂ by liver microsomes. The half-life of AMDS in rat erythrocytes was 6.285?±?0.014?min while the half-lives of its active metabolites AMSO and AMSO₂ in vivo were 18.17 and 17.50?h, respectively. Also, the large AUCs of the two active metabolites were observed, indicating potential applications of AMDS for certain pharmacological effects.