黄芪活血功效及现代药理学研究进展

黄芪始载于《神农本草经》,有补气升阳、益卫固表,利水消肿,托毒生肌之效。被誉为补气健脾之要药,临床上常用于气虚乏力、脾虚泄泻等疾病,已为医者所熟知。近年来,研究学者围绕其补气、健脾、利水功效机制已有较全面的认识。然陶弘景在《本草经集注》首载黄芪"逐五脏间恶血",表明本品兼有活血作用。目前,对于本品活血作用机制阐释,中医常基于"补气活血""气行血行"理论进行论证,但并不等同于本品无活血作用。通过梳理历代本草文献中对黄芪的记载,发现其活血作用应用广泛。综合传统方剂与现代方剂中有关其活血作用的应用,本品在方中行活血通络、活血利水、活血扶正作用,尤能体现其活血作用。且现代药理学研究在有关瘀血病理指标的分子机制中,黄芪有很好的调控作用,表明黄芪有活血作用,但未深入探究,存在研究价值。该文从历代文献对黄芪活血功效的论述、黄芪活血作用的临床应用及现代药理学研究深入探讨其活血作用机制,以期扩展黄芪的临床应用范围,为临床治疗提供理论指导。     

基于现代医学诊疗模式的非小细胞肺癌中医证型梳理与浅析

肺癌为中国常见的呼吸道恶性肿瘤，其发病率及病死率常年占据中国恶性肿瘤首位，随着现代分子生物学研究进展，综合治疗使得肺癌患者的生存时间明显延长。基于西医的综合治疗方案，中国中西医结合的综合治疗因中医独特的辨证观和整体观在提高疗效、改善患者生活质量、减轻不良反应、延长生存期方面发挥着积极的作用，因此基于现代医学诊疗方案下患者的证型研究尤为重要。文章将梳理非小细胞肺癌（NSCLC）患者现代医学诊疗模式下的中医证型，以此指导今后中西医结合的综合治疗，从而更好地提高非小细胞肺癌患者的生存及生活质量。     

慢性难愈性创面的治疗研究进展

慢性难愈性创面(Chronic Refractory Wounds，CRW)成为外科创面治疗的棘手问题，给患者生理心理和经济造成了极大的负担，CRW发生发展的最终转归因临床上治疗方法呈现多样化，临床上对慢性创面的治疗方法呈现多样化，现就中医和现代医学对慢性创面的治疗作一综述。     

康复理念结合针灸推拿对小儿发育迟缓的康复效果

目的分析在小儿发育迟缓的治疗中应用针灸推拿结合现代康复理念对患儿康复效果的影响。方法按照随机数字表法将2017年2月—2019年2月本院收治的88例发育迟缓患儿进行分组调查,分别为对照组(针灸推拿治疗)和试验组(现代康复理念结合针灸推拿治疗),每组各包含患者44例,比较两组患者的康复效果。结果两组患者治疗前的肢体活动能力量表(GMFM)和日常生活能力(Barthel)量表评分差异不具有统计学意义(P>0.05);对照组患儿治疗后的GMFM和Barthel评分相较于试验组明显更低(P<0.05)。结论现代康复理念结合针灸推拿能够有效改善小儿发育迟缓患者的预后,对于提高患儿康复速度和生活能力具有重要意义,疗效确切。     

Late Pleistocene age and archaeological context for the hominin calvaria from GvJm-22 (Lukenya Hill,Kenya)

Kenya National Museums Lukenya Hill Hominid 1 (KNM-LH 1) is a Homo sapiens partial calvaria from site GvJm-22 at Lukenya Hill, Kenya, associated with Later Stone Age (LSA) archaeological deposits. KNM-LH 1 is securely dated to the Late Pleistocene, and samples a time and region important for understanding the origins of modern human diversity. A revised chronology based on 26 accelerator mass spectrometry radiocarbon dates on ostrich eggshells indicates an age range of 23,576–22,887 y B.P. for KNM-LH 1, confirming prior attribution to the Last Glacial Maximum. Additional dates extend the maximum age for archaeological deposits at GvJm-22 to >46,000 y B.P. (>46 kya). These dates are consistent with new analyses identifying both Middle Stone Age and LSA lithic technologies at the site, making GvJm-22 a rare eastern African record of major human behavioral shifts during the Late Pleistocene. Comparative morphometric analyses of the KNM-LH 1 cranium document the temporal and spatial complexity of early modern human morphological variability. Features of cranial shape distinguish KNM-LH 1 and other Middle and Late Pleistocene African fossils from crania of recent Africans and samples from Holocene LSA and European Upper Paleolithic sites.For Late Pleistocene African populations of modern humans, the constellation of behavioral changes encapsulated in the transition from the Middle Stone Age (MSA) to the Later Stone Age (LSA) ∼70–20 kya represents a series of some of the most pronounced changes in the archaeological record before the adoption of domesticated animals and plants and the use of ceramics for cooking and storage. It is among LSA sites that the strongest parallels with ethnographic and historic foragers are observed. Typical archaeological signatures include lithic technologies focused on the production of microliths (small flakes, blades, and bladelets with one edge blunted or “backed”) from bipolar, single-, and opposed-platform cores; an increased use of ground-stone tools; and implements made of wood and bone. These new technologies occur with the appearance of material correlates of social identity and networks of long-distance exchange, including ostrich eggshell (OES) beads, ochre, and nonlocal stone raw material, as well as increased dietary breadth, all consistent with larger, more dense, or more interconnected populations (1–9).This same interval of ∼70–20 kya witnessed a number of human dispersals across Africa, with eastern Africa host to one or more candidate populations for the expansion of Homo sapiens out of Africa (10–15). However, the eastern African hominin fossil record for this interval is extremely sparse and poorly dated, and it consists largely of isolated teeth or highly fragmentary crania and postcrania (16–18). Here, we reassess the age and context of the Kenya National Museums Lukenya Hill Hominid 1 (KNM-LH 1) partial calvaria from site GvJm-22 at Lukenya Hill, Kenya, the only eastern African fossil hominin from a Last Glacial Maximum [LGM; 19–26.4 kya (19)] LSA archaeological context. We construct a revised accelerator mass spectrometry (AMS) radiocarbon chronology built on 26 new dates on OES fragments. The revised chronology confirms the LGM age of KNM-LH 1 and expands the maximum age of the site to beyond the limits of the radiocarbon method. Increased radiometric age is consistent with new technological analyses that demonstrate previously unrecognized MSA elements that indicate assemblages spanning the MSA/LSA transition from deposits underlying KNM-LH 1. Morphometric analyses using a robust comparative dataset demonstrate the variability among African Late Pleistocene hominins, including candidate populations for out-of-Africa dispersals. They indicate that KNM-LH 1 is distinct from (i) modern Africans, (ii) H. sapiens from Holocene LSA sites, and (iii) European Upper Paleolithic modern humans, suggesting that it may sample a now extinct lineage.     

贝叶斯网络在中医药领域的研究现状及展望

贝叶斯网络技术的信息处理过程与中医辨证思维相吻合,目前已广泛应用于中医证候规律探究、名老中医经验传承、中药药性研究、疾病干预措施疗效评价及现代化中医诊断技术中,将复杂多样的中医数据转变成客观、量化的标准。目前中医辅助诊疗系统已建立并不断完善,促进了临床辅助诊疗及远程医疗的发展。贝叶斯网络技术在中医药研究的诸多领域发挥着重要作用,但仍存在有待改进之处:首先,样本数据的支持力度不足,扩大样本数量、提高样本质量是进一步实现数据分析客观化的必要选择;其次,贝叶斯网络算法利用频率进行,一旦出现频率较低的症状、证候要素及证型时,算法会在变量筛选的过程中将其舍弃,从而导致信息获取不全面,影响结果的准确性,故需进一步获取更多的高质量样本,加强对精进算法的探索。随着研究的不断深入,今后亟需建立智能化的中医药诊疗系统,提供个体化的治疗处方及调理建议,以发挥中医药"未病先防,既病防变"的诊疗优势。     

中医辨治小儿遗尿的古往今来

小儿之体有别于成人,形神体用皆娇弱柔嫩,遗尿之病时有发生。余思中医传承千年而不衰,故当上下求索,于古今往来间探寻其辨治小儿遗尿之道,以明求其因而知其机,通研其理法方药,以解小儿遗尿之苦。言小儿遗尿之病总不离于肾之虚,而五脏六腑皆可相关,其机乃属三焦失司而膀胱不约,其治当以补肾固本止遗为要,寒热虚实者,则随证而治。而专方成药者常有其便利之处,临证遣方用药多可加之用之。     

脑卒中后肩关节半脱位的综合治疗

肩关节半脱位的治疗方法有:针灸疗法、推拿疗法、中药疗法、现代康复疗法等。新的治疗方法也在不断出现,大部分都是采用几种方式结合治疗。现代康复手段是治疗脑卒中后肩关节半脱位最普遍和有效的治疗手段,传统的针灸推拿疗法也有很好的疗效,治疗时要根据患者本身情况结合多种治疗手段对患者进行治疗。另外,对于脑卒中患者应注意早期预防,尽量避免半脱位的发生,一旦发现要及时治疗,以免影响上肢功能的康复。     

我们的中国梦：新医药学——四论创建新医药学

本文阐述了现代医学正面临的重大突破和挑战,提出了中医药发展需要创新性的革命,思想解放必须重视的几个观点。现在是中国科学家提出创建新医药学的最佳时机,也是中国科学家凝聚的共识。介绍了新医药学（整体系统医学）的定义和研究内容。最后提出了设立中国“新医药学发展计划”的倡议。     

藏药药性理论及其对现代藏药药性理论研究的启示

藏药药性理论是藏药学的核心,为了正确认识藏医药的科学价值,准确把握藏医药的特色优势,本文就藏医药药性理论的历史源流、藏药性味、作用靶向、功效、藏药与疾病等方面进行了探讨;并提出正确开展藏药药性理论的研究是保持和发展藏医药的前提;建议深入开展藏药药性理论的文献研究,明确和完善藏药药性理论;建议采用数据挖掘技术开展藏药药性理论的研究,阐明藏药药性的规律;建议采用系统生物学等技术进行藏药药性理论研究,阐明藏药药性的科学涵义;主张在开展藏药药性理论研究时要建立实验研究与临床研究相结合的模式,以进一步确定藏药药性理论的临床价值,从而达到保持藏药药性理论特色优势和科学认识藏药药性理论的目的。