张从正治疗闭经、崩漏浅析

张从正认为闭经及崩漏的病因为气血、津液之运行失常,气血、津液运行不畅所形成的瘀血、痰湿、胞脉闭阻均为心火的病理表现;经水出诸肾,不论是瘀血、痰湿之湿邪,还是精血亏虚之虚证均与肾密切相关。因此临床治疗闭经、崩漏以清心火,益肾水为大法,针对不同的证候给予不同的治法及方药,以达到扶正祛邪的目的。     

清热凉血化瘀方口服联合灌肠治疗婴儿肝炎综合征的临床研究

目的观察清热凉血化瘀方口服联合灌肠治疗婴儿肝炎综合征的临床疗效。方法选取婴儿肝炎综合征患儿72例，随机分为口服联合灌肠组37例和单纯口服组35例，在2组患者均给予常规治疗的基础上，口服联合灌肠组应用清热凉血化瘀方口服联合灌肠治疗，单纯口服组则给予清热凉血化瘀方。观察2组患儿治疗前后血清血红蛋白、氨基酸等各相关指标的水平变化，比较疗效、病程、症状恢复时间差异。结果2组患儿治疗后各项血清指标较治疗前均明显下降，且口服联合灌肠组下降更明显（P〈0．05）；口服联合灌肠组的病程明显比单纯口服组短，症状改善时间也更少（P〈0．05）；口服联合灌肠组疗效明显优于单纯口服组（P〈0．05）。结论清热凉血化瘀方口服联合灌肠治疗婴儿肝炎综合征能够明显改善婴儿肝炎综合征的症状及各项血清指标水平，较大的缩短病程，提升治愈率，疗效显著，值得临床推广应用。     

Quantitative assessment of optical clearing methods on formalin-fixed human lymphoid tissue

Rising interest in three-dimensional volume imaging of biological tissues for diagnostic and research purposes, calls for appropriate optical clearing methods as an indispensable requirement for high-resolution imaging on a cellular level. In recent years, many clearing protocols have emerged, though most of them focus on murine central nervous tissue. Peripheral organs or tissues of human origin have only been investigated sparsely. Therefore, we tested eight established clearing methods (BABB, Ce3D, CUBIC, ECi, ChemScale, ChemScaleQQ5, SeeDB2 and PACT) on formaldehyde-fixed human tonsils. This application-oriented taxonomy can help researchers restrict the space of their survey on clearing techniques for lymphatic tissue as it provides information on each method in regard to its efficacy, clearing speed, preservation of fluorescence labelling, toxicity, expenditure and monetary costs. We found that all of the applied clearing protocols could render the sample tissues transparent. Ce3D and PACT achieved the highest degrees of tissue transparency. Since it requires less preparing and processing time and is lower in toxicity, we recommend Ce3D for the clearing of human lymphoid tissue.     

基于数据挖掘徐雯清心泻脾法治疗小儿手足口病用药规律分析

目的:应用中医传承辅助系统软件分析徐雯教授清心泻脾法治疗小儿手足口病的用药规律。方法:收集、整理徐雯教授治疗小儿手足口病的处方,将处方录入中医传承辅助系统(V2.5),采用关联规则、聚类分析等数据挖掘方法分析其治疗小儿手足口病用药规律。结果:通过对102首治疗小儿手足口病方剂所含药物的频次统计得出常用药物14味,通过药物之间的关联规则分析得到使用频次较高的药对16组;通过熵层次聚类分析算法发现26个关联系数较高的潜在药对及13个新处方。结论:通过中医传承辅助平台揭示其清心泻脾法治疗小儿手足口病的用药规律,即多选用清热、解毒、利湿、疏风、透疹之品进行组方,统计分析结果与专家临床辨证论治心得基本吻合。     

杭州地区26家医疗卫生机构2010-2012年清热类中成药基本药物使用分析

目的:了解杭州地区清热类中成药基本药物的使用情况和趋势,促进合理用药。方法:统计杭州地区26家医疗卫生机构2010-2012年清热类中成药基本药物的相关数据,应用限定日剂量分析法,从使用频度、金额排序等方面对相关药物使用状况进行分析。结果:清热类中成药基本药物销售金额呈逐年上升趋势;一清胶囊、茵栀黄颗粒、板蓝根颗粒、双黄连口服液连续3年用药频度排序居前列;该类药物的日用药金额大多在10元以下,价格基本合理。结论:杭州地区清热类中成药基本药物使用基本合理,符合我国当前药品消耗总趋势。     

不同年龄段女性复发性尿路感染的临床分析

目的:观察不同年龄段女性复发性尿路感染的临床特点,评价单用抗生素或联合中药治疗的疗效。方法:观察女性复发性尿路感染患者156例,其中育龄期组90例,更年期和老年期组66例。所有患者予以抗生素治疗,部分患者同时联用清热利湿复方中药治疗。观察治疗前后临床症状、体征和实验室检查结果,药物治疗结束后观察随访半年。结果:更年期和老年期女性较育龄期女性复发性尿路感染症状不典型,随访期复发率高。联合中药治疗能显著减少复发率,改善症状。结论:临床医生在诊治女性复发性尿路感染时应该考虑不同年龄段的临床特点,合理选择诊疗方案。     

祛风清热定痛方对偏头痛大鼠镇痛效应及内皮素1及5－羟色胺含量的影响

目的：观察祛风清热定痛方对偏头痛大鼠的镇痛效应及可能机制。方法将72只SD大鼠随机分为6组,即空白组、模型组、正天丸组和祛风清热定痛方大、中、小剂量组,每组各12只,分别予相应药液灌胃给药,连续7d。除空白组外,其余5组大鼠通过热板法测定痛阈值,然后以硝酸甘油制备偏头痛大鼠模型,放免法检测各组大鼠血浆中内皮素1（ET－1）、5－羟色胺（5－HT）含量。结果与模型组同期比较,祛风清热定痛方大、中剂量组60、120、180 min痛阈值均显著提高（P＜0．05）,祛风清热定痛方小剂量组、正天丸组120、180 min痛阈值均显著提高（P＜0．05）。与模型组比较,祛风清热定痛方大、中、小剂量组及正天丸组ET－1含量均明显降低,5－HT含量均明显增加,比较差异有统计学意义（ P＜0．05）。与正天丸组比较,祛风清热定痛方大、中剂量组ET－1含量明显降低,5－HT含量明显增加,差异有统计学意义（P＜0．05）,小剂量组ET－1和5－HT含量无统计学意义（ P＞0．05）。与祛风清热定痛方大剂量组相比,祛风清热定痛方中剂量组ET－1和5－HT含量比较差异有统计学意义（P＜0．05）,小剂量组无统计学意义（P＞0．05）。结论祛风清热定痛方具有明显的镇痛作用,其调节偏头痛模型大鼠血浆5－HT、ET－1含量可能是治疗偏头痛的机制之一。     

Analysis of regional lymph node metastases from rectal carcinoma by the clearing method

PURPOSE: It has been reported that functional outcome following low anterior resection of rectal cancer is improved by construction of a colonic J-pouch compared with straight anastomosis. Hence, we tried to justify use of the sigmoid colon in the construction of a J-pouch by the analysis of regional lymph node metastases. METHODS: A total of 182 patients underwent resection for rectal cancer. Node metastases were examined by the clearing method. According to Japanese General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus (JGR), nodes were classified into the perirectal nodes (PR-N), pericolic nodes (PC-N), central intermediate nodes (C-IM-N), central main nodes (C-M-N), lateral intermediate nodes (L-IM-N), and lateral main nodes (L-M-N). RESULTS: Metastatic rate (number of patients with node metastases/ total number of patients) of PR-N was 57.1 percent. Metastatic rate of C-IM-N was 18.7 percent and that of C-M-N was 7.1 percent. Metastatic rates of L-IM-N and L-M-N were 8.8 and 3.3 percent, respectively, and both were highest in the case of lower rectal cancer. Metastatic rate of PC-N was only 1.1 percent. The number of cases without node metastases (n(–) cases) was 78, that with only PR-N metastases (PR-N cases) was 63, that with intermediate but not main node metastases (IM-N cases) was 29, and that with main node metastases (M-N cases) was 12. Five-year survival rate after curative resection was 88.5 percent for n(–) cases, 70.9 percent for PR-N cases, 65.9 percent for IM-N cases, and 41.7 percent for M-N cases. CONCLUSIONS: In low anterior resection, high ligation of the inferior mesenteric artery and dissection of C-M-N, C-IM-N and PR-N are necessary, with the addition of the L-IM-N and L-M-N in the case of lower rectal cancer. Resection of sigmoid colon is not required, and therefore, a J-pouch can be constructed using the sigmoid colon. Nodal classification according to the JGR was predictive of case distribution and five-year survival rate.Supported, in part, by a Grant-in-Aid for Cancer Research from the Japanese Ministry of Health and Welfare and Scientific Research from the Japanese Ministry of Education, Culture and Science.     

清热化痰法对AECOPD大鼠血清中性粒细泡弹性蛋白酶水平的影响研究

初步探究清热化痰法指导下的蒌芩止嗽煎对慢性阻塞性肺病急性加重期（AECOPD）大鼠血清中性粒细胞弹性蛋白酶水平的影响。方法：建立大鼠AECOPD模型,60只AECOPD大鼠模型随机分为模型对照组（20只）、氨溴索组（20只）、蒌芩止嗽煎组（20只）,用酶联免疫吸附法（ELISA）测定AECOPD大鼠模型治疗前后血清中中性粒细胞弹性蛋白酶（NE）指标。结果：蒌芩止嗽煎组、氨溴索组治疗后与治疗前比较,NE均有明显下降（P〈0．01）。结论：清热化痰法指导下的蒌芩止嗽煎初步研究是通过降低NE水平,从而减少AECOPD大鼠模型的气道黏液高分泌,减轻气道阻塞。     

小儿豉翘清热颗粒与蒲地蓝消炎口服液联合治疗小儿上呼吸道感染疗效观察

目的：探讨小儿豉翘清热颗粒与蒲地蓝消炎口服液联合治疗小儿上呼吸道感染的临床价值及意义。方法将2010年3月至2011年9月收治的96例上呼吸道感染患儿随机分为治疗组和对照组各48例。治疗组给予小儿豉翘清热颗粒与蒲地蓝消炎口服液联合治疗;对照组仅给予蒲地蓝消炎口服液治疗。观察两组临床疗效并进行对比分析。结果治疗组总有效率（97.92%,47/48）显著高于对照组（81.25%,39/48）,差异有统计学意义（P＜0.05）。结论小儿豉翘清热颗粒与蒲地蓝消炎口服液联合治疗小儿上呼吸道感染具有疗效好、见效快、安全可靠等优点,可作为目前治疗小儿上呼吸道感染的一种首选治疗方案。