陈宝田教授创小乌桂汤治疗顽固性痹证

小乌桂汤由陈宝田教授所创立,该方由《千金要方》的小续命汤、《金匮要略》的乌头汤和桂枝芍药知母汤三个经方的合方加减,主要用于治疗顽固性痹证,具有疏风通络,散寒除湿,益气养血的作用.陈宝田教授认为,顽固性痹证多因风寒湿邪阻滞经络肢体关节,且邪实甚重,非一般之剂能除之.临证治疗类风湿性关节炎及强直性脊柱炎,加全蝎以加强通络止痛之力;多发性动脉炎加黄连解毒汤,以增清热解毒之功;退行性骨关节病及年老病久、体质虚弱明显者,加独活寄生汤以补肝肾,强筋骨;寒盛者,加大辛温药量;化热者则减辛温药量,并加大黄芩、知母、白芍之用量.     

Role of hemodynamics in initiation/growth of intracranial aneurysms

Background

Intracranial aneurysm (IA) is a disease of the vascular wall resulting in abnormal enlargement of the vessel lumen. It is a common pathology with a prevalence of 2%‐3% in the adult population. IAs are mostly small, quiescent and asymptomatic; yet, upon rupture, severe brain damage or even death is frequently encountered. In addition to clinical factors, hemodynamic forces, mainly wall shear stress (WSS), have been associated with the initiation of IAs and possibly with their risk of rupture. However, the mechanism by which WSS contributes to aneurysm growth and rupture is not completely understood.

Design

PubMed and Ovid MEDLINE databases were searched. In addition, key review articles were screened for relevant original publications.

Results

Current knowledge about the relation between WSS and IA has been obtained from both computational fluid dynamic studies in patients and experimental models of IA formation and growth. It is increasingly recognized that a high wall shear stress (gradient) participates to IA formation and that both low and high WSS can drive IA growth. Primary cilia (PC) play an important role as mechanosensors as patients with polycystic kidney disease, which is characterized by the absence or dysfunction of PC, have increased risk to develop IAs as well as increased risk of rupture.

Conclusion

Wall shear stress is a key player in IA initiation and progression. It is involved in vascular wall remodelling and inflammation, processes underlying aneurysm pathophysiology.     

Toward understanding early Earth evolution: Prescription for approach from terrestrial noble gas and light element records in lunar soils

Because of the almost total lack of geological record on the Earth''s surface before 4 billion years ago, the history of the Earth during this period is still enigmatic. Here we describe a practical approach to tackle the formidable problems caused by this lack. We propose that examinations of lunar soils for light elements such as He, N, O, Ne, and Ar would shed a new light on this dark age in the Earth''s history and resolve three of the most fundamental questions in earth science: the onset time of the geomagnetic field, the appearance of an oxygen atmosphere, and the secular variation of an Earth–Moon dynamical system.     

Effect of fluid shear stress on the internalization of kidney-targeted delivery systems in renal tubular epithelial cells

Renal tubular epithelial cells (RTECs) are important target cells for the development of kidney-targeted drug delivery systems. Under physiological conditions, RTECs are under constant fluid shear stress (FSS) from original urine in the renal tubule and respond to changes of FSS by altering their morphology and receptor expression patterns, which may affect reabsorption and cellular uptake. Using a microfluidic system, controlled shear stress was applied to proximal tubule epithelial cell line HK-2. Next, 2-glucosamine, bovine serum albumin, and albumin nanoparticles were selected as representative carriers to perform cell uptake studies in HK-2 cells using the microfluidic platform system with controlled FSS. FSS is proven to impact the morphology of HK-2 cells and upregulate the levels of megalin and clathrin, which then led to enhanced cellular uptake efficiencies of energy-driven carrier systems such as macromolecular and albumin nanoparticles in HK-2 cells. To further investigate the effects of FSS on endocytic behavior mediated by related receptors, a mice model of acute kidney injury with reduced fluid shear stress was established. Consistent with in vitro findings, in vivo studies have also shown reduced fluid shear stress down-regulated the levels of megalin receptors, thereby reducing the renal distribution of albumin nanoparticles.     

Rheological studies on the solubilization by the surfactant SDS of complexes between three acidic polysaccharides and an organic base chloride

Developments in the solubilization of complexes between the cationic polymer, poly(hexamethylenebiguanidinium chloride) (PHMBH⁺Cl^-) and acidic polysaccharides are reported. It was discovered that the anionic detergent sodium dodecyl sulphate (SDS) is an excellent solubilizer for these complexes, enabling several multi-component systems to be studied. SDS itself was shown to interact with PHMBH⁺CL^- to form a highly viscous solution. Maximum viscosity was obtained with a SDS : PHMBH⁺CL^- molar ratio of 15.6. SDS : PHMBH⁺Cl^- at this ratio served as a good solubilizer for the acidic polysaccharides (sodium alginate, sodium carboxymethyl cellulose, and xanthan), forming highly viscous fluids. The effect of temperature on the viscosity of these solutions was also examined.     

剪切波弹性成像诊断腮腺占位性病变的应用价值

目的:通过剪切波弹性成像(shear wave elastrography,SWE)获得鉴别腮腺良恶性病变及良性亚组分型的杨氏模量值,并分析其诊断价值。方法:选取2019年6月至2020年1月以腮腺占位性病变住院的74例患者(76个结节),对所有患者的腮腺病变在术前或穿刺活检之前进行SWE技术检查,获得相应的杨氏模量值,并与组织学检查结果进行比较和分析。结果:在76个结节中,良性病变69例,恶性病变7例。良性病变中多形性腺瘤(pleomorphic adenoma,PA)占37.6%(26例),单形性腺瘤(monomorphic adenoma,MA)占30.0%(23例),淋巴结占21.7%(15例)。所有腮腺肿瘤杨氏模量最大值及平均值均高于腮腺内淋巴结,差异均有统计学意义(P<0.05)。PA与MA比较杨氏模量最大值及平均值差异有统计学意义(P<0.05)。腮腺恶性病变与良性病变比较,杨氏模量最大值及平均值差异有统计学意义(P<0.05),但是恶性病变与良性病变各亚组之间比较,除淋巴结组之外,杨氏模量最大值及平均值差异均无统计学意义(P>0.05)。结论:SWE技术虽然在鉴别腮腺良恶性肿瘤之间没有达到预期效果,但在良性亚组(PA与MA、淋巴结与其他腮腺肿瘤)之间有重要的诊断意义。     

The Immediate Effects of Foam Rolling and Stretching on Iliotibial Band Stiffness: A Randomized Controlled Trial

BackgroundIliotibial Band Syndrome (ITBS) is a common clinical condition likely caused by abnormal compressive forces to the iliotibial band (ITB). Stretching interventions are common in ITBS treatment and may predominantly affect tensor fascia latae (TFL). Another ITBS treatment is foam rolling, which may more directly affect the ITB. Shear wave ultrasound elastography (SWUE) measures real-time soft tissue stiffness, allowing tissue changes to be measured and compared.PurposeTo examine effects of foam rolling and iliotibial complex stretching on ITB stiffness at 0˚ and 10˚ of hip adduction and hip adduction passive range of motion (PROM).Study DesignRandomized controlled trial.MethodsData from 11 males (age = 30.5 ± 9.0 years, Body Mass Index (BMI) = 27.8 ± 4.0) and 19 females (age = 23.5 ± 4.9, BMI = 23.2 ± 2.1) were analyzed for this study. Subjects were randomly assigned to one of three groups: control, stretching, and foam rolling. Shear wave ultrasound elastography measurements included ITB Young’s modulus at the mid-thigh, the distal femur and the TFL muscle belly. ITB-to-femur depth was measured at mid-thigh level. Hip adduction PROM was measured from digital images taken during the movement.ResultsNo significant interactions or main effects were found for group or time differences in ITB Young’s modulus at the three measured locations. The ITB stiffness at the mid-thigh and distal femur increased with 10° adduction, but TFL stiffness did not increase. A main effect for adduction PROM was observed, where PROM increased 0.8˚ post-treatment (p = 0.02).ConclusionA single episode of stretching and foam rolling does not affect short-term ITB stiffness. The lack of ITB stiffness changes may be from an inadequate intervention stimulus or indicate that the interventions have no impact on ITB stiffness.Levels of Evidence1b