半夏白术天麻汤治疗眩晕高血压病举隅

高血压病是我国发病率较高的疾病之一,西医治疗以长期服用降压药物为主要治疗方式,但常因依从性差的原因导致血压控制不佳,而用中医辨证治疗对于首次发现高血压的患者,可明显有效地降低高血压的发病率。高血压病在中医学中属"眩晕",在临床中常常会用半夏白术天麻汤来治疗眩晕,本文通过跟师医案及临床收集介绍半夏白术天麻汤治疗高血压眩晕临证方药的运用。     

“Real life” polycyclic aromatic hydrocarbon (PAH) mixtures modulate hCG,hPL and hPLGF levels and disrupt the physiological ratio of MMP-2 to MMP-9 and VEGF expression in human placenta cell lines

Using JEG-3 and BeWo cells, we examined the effect of “real life” mixtures of polycyclic aromatic hydrocarbons (PAHs), at doses reported in maternal blood (Mix I) and in placental tissue (Mix II), on human chorionic gonadotropin (hCG), placental lactogen (hPL) and placental growth factor (hPLGF) secretion, protein expression and immunolocalization. Additionally, the action of PAH mixtures on basal and hormone-stimulated matrix metalloproteinase-2 (MMP-2), MMP-9 and vascular endothelial growth factor (VEGF) protein expression was evaluated. Under basal conditions, the PAH mixtures increased hCG and decreased hPLGF levels in both cell lines, while hPL expression was stimulated in JEG-3 and inhibited in BeWo. There was no effect on the MMP-2/MMP-9 ratio or VEGF expression. In hormone-stimulated cells, PAH mixtures changed the MMP-2/MMP-9 ratio in JEG-3 cells in favor of MMP-9, while in BeWo MMP-2 was favored. The effect on VEGF expression was cell specific and dependent on the mixture. In hCG-treated cells, only Mix II inhibited VEGF expression in JEG-3 cells. Neither PAH mixtures affected this protein in BeWo cells. In hPL-treated cells, Mix I had a stimulatory effect in JEG-3 cells, while Mix II exerted an inhibitory effect in BeWo cells. In hPLGF-treated cells, Mix II decreased in JEG-3 cells, but in BeWo cells, both mixtures increased VEGF expression. Considering that the evaluated protein hormones play crucial roles in angiogenesis and neovascularization in the placenta, “real life” PAH mixtures by disrupting protein hormones levels, the MMP-2/MMP-9 ratio and VEGF expression can lead to insufficiency and many pregnancy-related disorders.     

祛寒逐风合剂联合西医常规疗法治疗膝骨关节炎风寒痹阻证临床研究

目的观察祛寒逐风合剂联合西医常规疗法对膝骨关节炎风寒痹阻证的临床疗效,以及对关节症状及相关实验室指标的影响。方法采用随机数字表法将94例膝骨关节炎风寒痹阻证患者分为观察组和对照组各47例。对照组采用常规药物疗法+康复训练,观察组在对照组基础上予祛寒逐风合剂,每次50m L,每日3次,口服。2组均连续治疗2周。比较2组临床疗效,观察2组治疗前后美国西大略湖和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟评分法(VAS)评分、压痛指数、中医症状评分,白细胞介素(IL)-1β、IL-6、血管内皮生长因子(VEGF)、肿瘤坏死因子(TNF)-α、骨钙素、抗酒石酸盐酸性磷酸酶异构体(TRACP)-5b、骨特异性碱性磷酸酶(BALP)、纤维蛋白原、红细胞沉降率和红细胞聚集指数,对2组进行安全性评价。结果观察组总有效率为89.36%(42/47),对照组为74.47%(35/47),观察组明显优于对照组(P<0.05)。与本组治疗前比较,2组治疗后WOMAC评分、VAS评分、压痛指数、中医症状评分明显下降(P<0.05);2组治疗后比较,观察组WOMAC评分、VAS评分、压痛指数、中医症状评分明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后IL-1β、IL-6、TNF-α、VEGF、TRACP-5b水平明显下降,骨钙素、BALP水平明显升高(P<0.05);2组治疗后比较,观察组IL-1β、IL-6、TNF-α、VEGF、TRACP-5b水平明显低于对照组,骨钙素、BALP水平明显高于对照组(P<0.05)。与本组治疗前比较,观察组治疗后纤维蛋白原、红细胞沉降率、红细胞聚集指数明显下降(P<0.05);2组治疗后比较,观察组血液流变学各项指标明显低于对照组(P<0.05)。2组均未发生不良反应。结论祛寒逐风合剂联合西医常规疗法治疗膝骨关节炎风寒痹阻证患者疗效较好,可明显改善关节症状及相关实验室指标。     

壮精合剂治疗围绝经期综合征58例

目的:探讨壮精合剂治疗围绝经期综合征的临床疗效。方法:选取符合围绝经期综合征诊断标准的病人58例,应用壮精合剂加减口服治疗1~2个月。结果:显效31例占53.4%;有效23例占39.7%;无效4例占6.9%,总有效率为93%。结论:壮精合剂治疗围绝经期综合征能收到良好的临床疗效。     

A mixture of experts network structure for modelling Doppler ultrasound blood flow signals

Mixture of experts (ME) is a modular neural network architecture for supervised learning. This paper illustrates the use of ME network structure to guide modelling Doppler ultrasound blood flow signals. Expectation-Maximization (EM) algorithm was used for training the ME so that the learning process is decoupled in a manner that fits well with the modular structure. The ophthalmic and internal carotid arterial Doppler signals were decomposed into time-frequency representations using discrete wavelet transform and statistical features were calculated to depict their distribution. The ME network structures were implemented for diagnosis of ophthalmic and internal carotid arterial disorders using the statistical features as inputs. To improve diagnostic accuracy, the outputs of expert networks were combined by a gating network simultaneously trained in order to stochastically select the expert that is performing the best at solving the problem. The ME network structure achieved accuracy rates which were higher than that of the stand-alone neural network models.     

逍遥合剂的质量标准研究

目的：建立逍遥合剂的质量标准。方法;采用TLC法对处方中的白芍、甘草进行定性鉴别;用HPLC法测定芍药苷的含量。结果：在TLC色谱中均能检出白芍、甘草、芍药苷在0．3980－1．3930μg范围内呈良好的线性关系,r=0.9999,平均回收率为98.5%,RSD=0.83%。结论：所建立的方法可准确地进行定性,定量检测可用于该制剂的质量控制。     

46例急性有机磷农药中毒死亡原因分析

目的 :探讨急性有机磷中毒 (AOPP)死亡。方法 :回顾分析 1998年至 2 0 0 0年 8月死亡病例 4 6例 ,占同期中AOPP5 0 8例的 9.0 6 %。结果 :洗胃不彻底 15例 (32 .6 % ) ,阿托品用量不足 12例(2 6 .1% ) ;中间综合征 (IMS) 7例 (15 .2 % )阿托品中毒 5例 (10 .9% ) ;混合性中毒 3例 (6 .5 % ) ,其余存在严重并发症。结论 :表明洗胃不彻底 ,阿托品用量不足及中毒、IMS、混合性中毒是AOPP死亡的主要原因。对AOPP并发的紧急凶险症状未及时控制也是其死亡原因之一。     

强心合剂对大鼠充血性心力衰竭血流动力学及心钠素的影响

目的：主要观察强心合剂对实验性大鼠充血性心力衰竭的作用及机理。方法：观察强心合剂对尾静脉注射盐酸阿霉素制备心肌病性充血性心力衰竭（CHF）大鼠模型的血流动力学,血浆心钠素等的影响,结果：强心合剂能改善CHF大鼠血流动力学各项指标,提高LVSP,＋dp/dtmax降低LVEDP－dp/dtmax,缩短T－dp/dtmax,减少血浆心钠素含量;降低肺,肝重指数,且作用效应以中药大剂量组最为明显。结论：强心合剂不仅改善实验性大鼠心脏收缩功能,而且改善舒张功能,减轻脏器充血。     

《伤寒论》治疫方用药规律分析及核心药对治疗COVID-19的作用机制研究

目的 基于数据挖掘分析《伤寒论》疫病治疗相关方剂的用药规律,并利用网络药理学分析核心药对“柴胡-黄芩”治疗新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）的作用机制。以期探讨经方治疗疫病的当代价值。方法 筛选《伤寒论》中治疗疫病的经方,利用R语言等软件对频次、性味归经、相关性、关联规则等用药规律进行分析,并运用网络药理学方法对用药规律中核心药对治疗COVID-19的机制进行探究。用Cytoscape对筛选出的成分及靶点构建“疾病-药物-成分-靶点”网络,将关键靶点导入String数据库进行蛋白相互作用（protein-protein interaction,PPI）网络分析,并在R语言中进行基因本体论（gene ontology,GO）功能分析和京都基因与基因组百科全书（Kyoto encyclopedia of genes and genomes,KEGG）通路分析。结果 纳入《伤寒论》中与疫病相关的方剂61首,共52味中药。前20味高频用药中以温性药、辛味药为主,多归脾、肺经,功效以补气药居多。“柴胡-黄芩”药对相关性最强,5个类聚方为小柴胡汤...     

通过网络药理学研究白术治疗前列腺癌的作用机制

目的:研究白术治疗前列腺癌的潜在靶点和作用机制。方法:使用公共数据库(TCMSP数据库、Genecard数据库、OMIM数据库、CTD数据库、DigSee数据库),筛选出白术的潜在活性成分及药物治疗疾病的预测靶点、前列腺癌靶点,构建成分-疾病-靶点网络图。通过生物信息学分析,包括构建蛋白质-蛋白质相互作用网络(PPI)、基因本体(GO)和京都基因和基因组百科全书(KEGG),随后进行分子对接验证研究结果。结果:筛选出白术治疗前列腺癌的7个有效活性成分及潜在的22个作用靶点,活性成分主要作用于IL-6、VEGFA、ACHE、NOS3、IL1B、PTGS2等靶点,通过调控PI3K-Akt等信号通路来达到治疗前列腺癌效果,分子对接提示白术中内酯成分与IL1B和ACHE有较好的结合。结论:本研究预测了白术治疗前列腺癌的活性成分、潜在靶点和分子机制,也揭示中药治疗恶性肿瘤的分子机制。