指纹图谱结合一测多评法评价拟草果质量的研究

目的建立拟草果Amomumparatsao-ko药材的质量评价方法。方法以鼠李柠檬素为参照峰确定共有峰,建立拟草果的HPLC指纹图谱;以鼠李柠檬素为内标,确定鼠李素、3,5-二羟基-7,4’-二甲氧基黄酮的相对校正因子并计算含量,实现一测多评。同时采用外标法测定3种成分的含量,比较计算值和实测值的差异。结果建立了拟草果的HPLC指纹图谱,10批样品相似度均在0.9以上;以鼠李柠檬素为内标建立的鼠李素、3,5-二羟基-7,4’-二甲氧基黄酮的相对校正因子分别为1.300、0.885,重现性良好,10批拟草果样品一测多评法计算值与实测值无显著差异。结论建立的HPLC指纹图谱和一测多评法可用于拟草果的质量评价。     

MicroRNA-155 promotes neointimal hyperplasia through smooth muscle-like cell-derived RANTES in arteriovenous fistulas

Objective

Arteriovenous fistula (AVF) suffers from a high number of failures caused by insufficient outward remodeling and venous neointimal hyperplasia formation. The aim was to investigate the exact mechanism by which microRNA-155 (miR-155) in the outflow vein of AVF is regulated.

Hyper-Inflammatory Response Involves in Cardiac Injury Among Patients With Coronavirus Disease 2019

BackgroundInflammation can facilitate development of coronavirus disease 2019 (COVID-19) and cardiac injury is associated with worse clinical outcomes. However, data are relatively scarce on the association between hyper-inflammatory response and cardiac injury among COVID-19 patients.MethodsThe study was designed based on severe and critically ill patients with COVID-19. Information on clinical characteristics and laboratory examinations was collected from the electronic medical records and analyzed.ResultsThere were 32.4% (n = 107) of patients with cardiac injury. The median age was 67 years, and 48.8% (n = 161) of patients were men. Hypertension was the most common in 161 (48.8%) patients, followed by diabetes (16.7%, n = 55) and coronary heart disease (13.3%, n = 44). Compared to cases without cardiac injury, those with cardiac injury were older, had higher proportions of coronary heart disease, and leukocyte counts, significantly elevated concentrations of N-terminal pro-B-Type natriuretic peptide, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF)-α, interleukin-2 receptor (IL-2R), IL-6, and IL-8, but lower lymphocyte counts. A significant positive correlation was observed between high-sensitivity troponin I and inflammatory cytokines. Logistic regression analysis showed that hs-CRP, TNF-α and IL-6 were independent risk factors for cardiac injury.ConclusionsCardiac injury was associated with elevated levels of inflammatory cytokines among severe and critically ill patients with COVID-19, suggesting that hyper-inflammatory response may involve in cardiac injury.     

夏芩颗粒降压作用机理研究

夏芩颗粒是金东明教授治疗高血压病肝火亢盛证的经验方,肝藏血,主疏泄,木气条达则血脉通畅,肝参与了心主血脉。肝气不舒,最易化火,肝火上炎,是导致血压升高的最常见情志因素。夏芩颗粒由夏枯草、黄芩、泽泻、牛膝、淫羊藿组方,既能清肝泻上炎之火、降肝经气血上逆,又能引火（血）下行利于祛邪,还能防苦寒伤正。各药均有不同程度的降压作用。     

夏桂成从“心-肾-子宫轴”学说论治早发性卵巢功能不全经验

夏桂成教授认为,早发性卵巢功能不全(POI)是心-肾-子宫轴功能发生紊乱、心肾不交所致。本病虽病在肾阴亏虚,癸水早竭,但与心关系密切。发病多因患者长期精神紧张导致心神不宁,心火上炎,心血营阴暗耗,久之使肾阴愈亏,不能生精化髓充养心神,恶性循环而发本病。应结合月经周期节律调节法,从心肾论治,首重治心,清心火、滋心阴,使心火先降,"心静"才能"肾实",心肾相交,使早竭之天癸重生,重新建立心-肾-子宫轴的阴阳平衡,恢复正常生殖内分泌,经候如常而治本。     

Mild Preoperative Systolic Dysfunction Associated With the Use of Intraoperative Vasopressors but Not Postoperative Survival in Liver Transplantation

BackgroundMild left ventricular systolic dysfunction (LVSD) is common in patients waiting for liver transplantation (LT), but its impact on intraoperative management and survival is poorly understood. In this study, we investigated if mild pretransplant LVSD was associated with the use of intraoperative vasopressors and 1-year survival after LT.MethodsAfter institutional review board approval, preoperative echocardiographic and perioperative data of adult patients undergoing LT between January 2006 and October 2013 were reviewed. Patients with or without mild LVSD were compared using the t test or Pearson’s χ² test. Independent risk factors were identified using multivariate logistic regression.ResultsOf 1055 adult patients, 11 (1.0%) had mild LVSD. Preoperative variables were similar between the 2 groups except for age and preoperative vasopressor use. Intraoperatively, a greater portion of patients with LVSD required vasopressors following anesthesia induction (71.4% vs 20.5%), immediately after reperfusion (100% vs 62.1%), and at the end of the transplant (100% vs 38.5%) compared with patients without LVSD (all P < .05). Multivariate logistic analysis showed that LVSD was an independent risk factor (odds ratio, 4.7; 95% CI 1.0–21.3; P = .043) for increased requirement of intraoperative vasopressor along with other risk factors, including encephalopathy, preoperative pressors, male sex, high model for end-stage liver disease score, and long cold ischemia time. Patients with mild LVSD had similar 1-year survival rates compared with non-LVSD patients.ConclusionsPatients with mild preoperative LVSD, with proper intraoperative management, could undergo LT surgery and had comparable 1-year survival. Patients with mild preoperative LVSD alone should not be excluded from LT.     

夏桂成教授从心论治闭经的学术思想探讨

国医大师夏桂成教授治疗闭经重在从心论治,认为闭经的发生与心关系密切,心-肾-子宫轴在月经来潮及其周期性演变中具有重要作用。若心脾失调、心气闭塞等致心气不下,胞脉闭阻,可致经闭不行。根据月经周期与调周法理论,虽闭经日久,但患者仍处于经后期,阴长癸水失调,或合并他因难以阴长至重,重阴至阳转化失常,不能进入经间排卵期顺利排出卵子,导致经闭不行,故治疗以经后期为重。此期是治疗的奠基时期,强调宁心安神,静能生水。在经后期滋阴补肾基础上加入清心安神或镇降安神的药物,同时配合对患者的情志疏解和人文关怀。      

何若苹教授治疗带下病经验浅析

[目的]探讨何若苹教授治疗带下病的临证经验.[方法]从病因病机、治则治法方面论述何教授治疗带下病的学术观点和临床经验,对其基本方药配伍及常用加减化裁的特色予以总结.[结果]何老师分别以固肾止带、补脾疏肝、滋阴清热、清热利湿为主要治法治疗肾阳虚、脾虚肝郁、心肾不交及湿热下注型的带下病,临床疗效佳.[结论]何老师认为,带下之病,临床单证少见,杂证颇多,故辨证乃临床遣方用药之精髓,此认识值得我们深入学习和体会.     

夏军教授治疗糖尿病合并高血压经验

糖尿病合并高血压疾病属于中医"眩晕""头痛"等范畴,对心血管系统有极强的危害性,被称为同源性疾病。其病机特点是本虚标实、虚实夹杂,以阴虚为本,阳亢为标,而肝肾亏虚是主因。糖尿病合并高血压疾病在临床上,有糖尿病发病在先,高血压发病在后;或高血压在先,糖尿病在后;或两者发病时间顺序不明显。夏军教授是北京市名中医,从事中医临床40余载,对多种临床疑难病症见解独到,尤其是对心血管病、糖尿病的治疗更是得心应手,治疗糖尿病合并心血管病经验独特。夏教授认为,糖尿病合并高血压,阴虚是基本病机,无论糖尿病和高血压发病时间上孰先孰后,纠正阴虚是二者共同的着眼点,以平益肝肾,使其阴平阳秘为治疗该病的重要环节。