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。     

中药治疗创伤后应激障碍的研究进展

创伤后应激障碍(PTSD)是指突发性、威胁性或灾难性生活事件导致个体延迟出现和长期持续存在的精神障碍,其临床表现以再度体验创伤为特征,并伴有情绪的易激惹和回避行为。PTSD的发生不仅伴随着行为学指标异常,机制研究表明还表现出神经生物学指标异常。PTSD的发生机制研究多集中在神经内分泌系统、中枢神经系统和免疫系统等方面,主要表现为应激激素、促炎细胞因子、神经递质、神经保护因子的水平异常。中药因其具有多靶点、多成分和多途径的特点,在治疗PTSD方面表现出了许多优势。当前研究表明,多种中药能够改善PTSD模型中动物行为异常、逆转神经生物学指标。其中很多中药复方已经应用于临床并且具有很好的疗效,因此中药治疗PTSD具有广阔的应用前景。但是,尚未有PTSD的专属治疗药物,且尚未完全厘清PTSD的机制。故本文对当前中药治疗PTSD的研究进行综述,并且从治疗的中药种类、作用机制、动物模型等角度,重点阐述PTSD的发生与治疗进展,以期为PTSD的治疗提供参考。     

The role of immunosuppressive agents in the management of severe and refractory immune‐related adverse events

The advent of immune checkpoint inhibitors has improved survival in some types of cancer and brought promising prospects to cancer immunotherapy. Despite their clinical benefits, significant off‐target toxicities resulting from the immune system activation have been observed, namely immune‐related adverse events (irAEs), which pose to clinicians a new challenge of optimal management. With steroids being the mainstay of current management of irAEs, immunosuppressive agents are especially indicated for severe or steroid‐refractory cases, based on current immunopathophysiological knowledge and on extrapolations of treatment options for primary autoimmune disorders. This review focuses on the status and recent clinical progress of immunosuppressive agents in the management of severe and steroid‐refractory irAEs.     

Helicobacter pylori CagA oncoprotein interacts with SHIP2 to increase its delivery into gastric epithelial cells

Chronic infection with Helicobacter pylori cagA‐positive strains is causally associated with the development of gastric diseases, most notably gastric cancer. The cagA‐encoded CagA protein, which is injected into gastric epithelial cells by bacterial type IV secretion, undergoes tyrosine phosphorylation at the Glu‐Pro‐Ile‐Tyr‐Ala (EPIYA) segments (EPIYA‐A, EPIYA‐B, EPIYA‐C, and EPIYA‐D), which are present in various numbers and combinations in its C‐terminal polymorphic region, thereby enabling CagA to promiscuously interact with SH2 domain‐containing host cell proteins, including the prooncogenic SH2 domain‐containing protein tyrosine phosphatase 2 (SHP2). Perturbation of host protein functions by aberrant complex formation with CagA has been considered to contribute to the development of gastric cancer. Here we show that SHIP2, an SH2 domain‐containing phosphatidylinositol 5′‐phosphatase, is a hitherto undiscovered CagA‐binding host protein. Similar to SHP2, SHIP2 binds to the Western CagA‐specific EPIYA‐C segment or East Asian CagA‐specific EPIYA‐D segment through the SH2 domain in a tyrosine phosphorylation‐dependent manner. In contrast to the case of SHP2, however, SHIP2 binds more strongly to EPIYA‐C than to EPIYA‐D. Interaction with CagA tethers SHIP2 to the plasma membrane, where it mediates production of phosphatidylinositol 3,4‐diphosphate [PI(3,4)P₂]. The CagA‐SHIP2 interaction also potentiates the morphogenetic activity of CagA, which is caused by CagA‐deregulated SHP2. This study indicates that initially delivered CagA interacts with SHIP2 and thereby strengthens H. pylori‐host cell attachment by altering membrane phosphatidylinositol compositions, which potentiates subsequent delivery of CagA that binds to and thereby deregulates the prooncogenic phosphatase SHP2.     

米非司酮联合宫瘤消胶囊对子宫肌瘤治疗效果

目的分析米非司酮和宫瘤消胶囊的联合应用对子宫肌瘤的临床治疗效果。方法本研究对象为80例子宫肌瘤患者,收治时间均在2017年3月—2018年3月期间。将上述子宫肌瘤患者随机分成两组,各40例。给予对照组患者口服米非司酮进行治疗,研究组患者在上述治疗的基础上增加宫瘤消胶囊口服治疗,记录2组患者治疗效果,性激素水平及子宫体积及肿瘤体积变化。结果(1)研究组患者的总体有效率显著高于对照组;(2)研究组患者的P、E2、LH及FSH均显著低于对照组;(3)研究组患者子宫体积及肿瘤体积均显著低于对照组。结论米非司酮片和宫瘤消胶囊的联合治疗对子宫肌瘤患者的治疗效果较显著。