醒脑灌肠液药理作用分析

简版：醒脑灌肠液为崔应麟教授所创，临床上常用于治疗出血性中风急性期，有良效。笔者根据传统中医学理论并结合现代化科研成果，对其进行方解并对其单味药药理作用予以分析。……     

外泌体miRNA对慢性肾脏病诊断价值的Meta分析北大核心

目的:通过Meta分析评价外泌体miRNA对慢性肾脏病的诊断意义。方法:计算机检索万方数据库、中国知网、中国生物医学文献数据库、维普网、Web of Science、Cochrane Library、PubMed、Embase建库至2022年5月公开发表的关于外泌体miRNA诊断慢性肾脏病的临床研究。文章经筛选、提取资料后通过Review Manager 5.3中诊断试验质量评价表2对其进行质量评估。Meta-disc 1.4软件分析纳入文献的阈值/非阈值效应异质性,计算灵敏度、特异性、阳性似然比、阴性似然比、曲线下面积及诊断比值比。StataMP 16.0软件分析敏感性、异质性及发表偏倚。结果:共计纳入6篇文献,Meta分析结果显示:Spearman相关系数为-0.603(P=0.038<0.05),该研究存在阈值效应;诊断比值比Cochran-Q为67.85(P<0.01),表明该研究存在非阈值效应引起的异质性,采用随机效应模型合并效应量。合并灵敏度为0.81(0.78-0.84),合并特异性为0.81(0.76-0.85),合并阳性似然比为3.32(1.98-5.57),合并阴性似然比为0.30(0.19-0.48),合并曲线下面积为0.8401,Q指数=0.7719,合并诊断比值比为12.20(4.74-31.42)。此次研究纳入文献有1篇较强敏感性且存在发表偏倚(P=0.01<0.05)。结论:外泌体miRNA表达水平对慢性肾脏病的诊断具有重要的价值和意义。然而,由于纳入研究较少且具有异质性,需要更多的临床研究来找出诊断慢性肾脏病的最佳外泌体miRNA。     

石冠卿治疗脑病常用药对经验介绍

正药对是指临床上经常使用的2种药物相互配合运用,可以起到协同作用、提升疗效,或者制约作用、降低毒性。《黄帝内经》中的半夏秫米汤被认为是最早的药对应用,对后世药对的发展产生了深远影响。研究药对对于深入挖掘方剂的组方原则及发挥方药的最佳疗效有巨大优势。石冠卿教授(1918-1999)是全国首批名老中医药学术经验继承人导师,全     

崔应麟从湿论治杂病验案举隅

嗜睡、眩晕、口干三案,病虽不同,但病理因素都责之湿。或阳虚阴盛,痰湿阻滞,清阳不升,脑窍失充,心神失养导致嗜睡;或痰湿阻滞,郁久化火,木郁风动,肝风挟痰火上扰清窍而致眩晕;或脾阳虚衰,水湿内生,津不上承导致口干。崔应麟教授紧扣病机,皆从湿论治,分别给予瓜蒌薤白半夏汤加减以温补心阳,燥湿化痰;半夏白术天麻汤合桂枝加龙骨牡蛎汤加减以温化痰湿,镇肝熄风;五苓散加减以温阳健脾化湿。辨证准确,选方得当,效如桴鼓,值得临床学习。     

自噬及铁死亡相关靶点与慢性肾病肾功能损伤的进展：生物信息学分析及实验验证

BACKGROUND: Autophagy and ferroptosis play important roles in the development of chronic kidney disease, but the molecular mechanisms and gene targets related to autophagy and ferroptosis in renal tissue of chronic kidney disease are still unclear. OBJECTIVE: To screen differentially expressed genes in chronic kidney disease-related datasets based on bioinformatics, and to explore potential key biomarkers suitable for screening renal function progression in patients with chronic kidney disease. METHODS: (1) The GSE137570 dataset was obtained from GEO database to screen the differentially expressed genes by Networkanalyst database analysis. Ferroptosis and autophagy related targets were obtained by OMIM, GENECARD, FerrDb and HAMdb databases. The respective data were intersected to obtain autophagy-ferroptosis related differentially expressed genes in chronic kidney disease for parallel enrichment analysis. The STRING website was used to construct the protein-protein interaction network of differentially expressed genes, which was imported into Cytoscape software and analyzed by MCODE and Cytohubba plug-in to screen potential core targets. Enrichment analysis was performed to obtain the functions of these potential core targets. (2) In the in vitro experiment, mouse renal tubular epithelial cells were divided into two groups: the control group received no intervention, while the model group was stimulated with 5 ng/mL transforming growth factor β1 for 24 hours to induce mesenchymal transformation of renal tubular epithelial cells. Flow cytometry was used to measure the levels of reactive oxygen species and changes in mitochondrial membrane potential in the cells. RT-PCR was employed to assess ferroptosis, autophagy-related markers, and the mRNA expression of potential core targets in the cells. RESULTS AND CONCLUSION: After screening the GSE137570 dataset, a total of 480 differentially expressed genes were obtained, including 104 upregulated genes and 376 downregulated genes (log2| (FC) | > 1, P < 0.05). There were 562 ferroptosis-related targets and 1 266 autophagy-related targets obtained from the OMIM, GENECARD, FerrDb, and HAMdb databases. Intersection of differentially expressed genes with ferroptosis- and autophagy-related targets yielded 15 ferroptosis-related targets and 18 autophagy-related targets, respectively. The enrichment analysis results indicate that ferroptosis-related differentially expressed genes are primarily involved in biological processes such as sulfur amino acid metabolism, neutrophil degranulation, and ferroptosis signaling pathways. Autophagy-related differentially expressed genes are mainly enriched in biological processes such as platelet degranulation, extracellular matrix degradation, and receptor tyrosine kinase signaling. After screened by MCODE and CytoHubba, key genes were identified in the protein-protein interaction network, including CD44, ALB, TIMP1, PLG, CCL2, and DPP4. Immune infiltration analysis results indicate that immune cells such as B cells, CD4+ T cells, NK cells, and monocytes show significant differential expression in renal tissue after chronic kidney disease, and the core targets are also significantly correlated with these immune cells (P < 0.05). The results of receiver operator characteristic curve analysis further demonstrate that the pathological progression of chronic kidney disease can be effectively diagnosed by CD44, ALB, TIMP1, PLG, CCL2, and DPP4. Single-cell sequencing results show that, except for PLG, the expression of target genes in the renal tissue of mice in each model group is generally consistent with the results of this experiment. RT-PCR results demonstrate that, for the validation of autophagy and ferroptosis phenotypes, compared with the control group, the model group shows a significant decrease in mRNA expression of LC3B, Nrf2, and SLC7A11 (P < 0.05), and a significant increase in P62 mRNA expression (P < 0.05). Regarding the validation of potential core targets, compared with the control group, the model group exhibits a significant decrease in mRNA expression of ALB and PLG (P < 0.05), and a significant increase in TIMP1 and CCL2 mRNA expression (P < 0.05). Overall, these findings indicate that, through bioinformatics analysis and experimental validation, CD44, ALB, TIMP1, PLG, and CCL2 are abnormally expressed in the renal tissue of patients with chronic kidney disease, closely correlated with estimated glomerular filtration rate and tubulointerstitial fibrosis, and maybe play a predictive role in the progression of chronic kidney disease. © 2024, Chinese Journal of Tissue Engineering Research. All rights reserved.     

基于17948篇中英文文献分析近20年中医药治疗慢性肾脏病研究热点与趋势

目的 对近20年公开发表的中医药治疗慢性肾脏病的相关研究进行文献计量学分析,探索该学科领域的发展现状及趋势,预测未来研究方向。方法 计算机检索万方数据知识服务平台、中国国家知识基础设施、中国生物医学文献服务系统、维普网、Web of Science、Cochrane Library、PubMed、Embase数据库2002—2022年公开发表的关于中医药治疗慢性肾脏病的相关研究文献,经NoteExpress软件筛选后通过CiteSpace 5.8R3和VOSviewer软件对作者、机构、关键词进行共现、聚类及突现分析,绘制可视化知识图谱。结果 共纳入文献17 948篇,包括中文文献14 593篇、英文文献3 355篇,发文量逐年攀升,趋势稳定;核心作者884位,包括中文作者362位、英文作者522位,该领域已形成了以多个关键学者为中心的稳定团体,且各机构间合作密切;研究热点前期多集中于名医经验、临床观察、证候分析,后期多集中于多组学方式探究慢性肾脏病生理病理机制与药物作用机制,涉及基础学科与生物信息分析、数据挖掘、网络药理学等新兴学科。结论 中医药治疗慢性肾脏病领域研究发展态势稳定,临...     

人工股骨头置换术后翻修的相关因素分析

目的:探讨人工股骨头置换术后翻修的相关因素,了解假体体内生存情况。方法:对1995年1月～2007年1月长垣县中医院和人民医院行人工股骨头置换术后患者252例的临床资料和随访结果进行分析。结果:(1)36例进行了术后翻修,假体体内平均生存时间为113.506(95%CI:111.009～116.003)个月,3年、5年和10年翻修率分别是2.80%(95%CI:0.80%～4.76%)、4.00%(95%CI:1.65%～6.35%)和14.90%(95%CI:10.39%～19.41%),翻修原因:假体松动13例,髋臼磨损塌陷9例,假体中心性位移7例,首次手术失败3例,术后感染2例,假体柄断裂1例。(2)单因素分析显示:翻修者的身高、体重和BMI大于未翻修者,其骨质疏松、活动量过大、假体匹配欠佳、非骨水泥假体、非骨水泥固定、自锁孔未植骨的构成比高于未翻修患者。(3)多因素Cox比例风险分析显示:固定材料(HR=2.425,95%CI:1.187～4.953),自锁孔植骨(HR=0.308,95%CI:0.158～0.600),置换前BMI(HR=1.955,95%CI:1.158～3.301)和骨质疏松(HR=3.663,95%CI:1.287～10.421)是影响翻修的独立因素。结论:股骨头置换术后随时间推移需要翻修者也逐渐增多,假体松动,髋臼磨损塌陷和假体中心性位移是导致翻修主要原因。首次手术非骨水泥固定、置换前BMI和骨质疏松是术后翻修的危险因素,自锁孔植骨是保护因素。     

从象思维角度认识偏头痛的病因病机

象思维是一种贯穿于中华传统文化的重要性思维,是古代学者认识大自然万事万物所采取的独特性思维方式。其作为原创性思维被广泛应用在各个领域,对中医学的形成、发展和创新更是起着不可替代的促进作用。偏头痛作为一种慢性原发性神经血管性疾患,随着人们生活压力的增大及生活方式的改变,发病率呈逐年上升趋势,成为全球性致残率较高的疾病,严重危害着人类的生活质量和生命健康。基于对象思维的理解,从偏头痛发作过程中的临床症状特点及现代西医学研究入手,运用取象比类的手法,对偏头痛之“风象”“痰象”“瘀象”进行论述,最后立“象”以尽“意”,对偏头痛的病因病机加以概括,使读者更加形象具体地认识偏头痛的病因病机,以达到准确、快速、长久地解决患者痛苦的目的。基于象思维理论,将偏头痛之病因病机概括为风邪侵扰、顽痰阻窍、久病入络、瘀血停着,治疗时更以名中医崔应麟教授之经验方加味散偏汤化裁,临床效果显著。     

分体式髌骨爪结合丝线内固定治疗髌骨骨折临床疗效观察

目的观察分体式髌骨爪结合丝线内固定治疗髌骨骨折的临床疗效。方法对36例髌骨骨折患者采用分体式髌骨爪结合丝线内固定治疗,观察治疗效果。结果本组患者均顺利完成手术,切口Ⅰ期愈合。术后均获12个月随访。未发生感染、内固定物松脱、断裂及骨折不愈合等并发症,依据膝关节疗效评定:优良率94.44%(34/36)。结论分体式髌骨爪结合丝线内固定治疗髌骨骨折固定牢靠,术后功能恢复良好,值得临床应用。     

显微镜下与直视下超声洁治的根面情况比较研究

目的:观察比较在显微镜下与直视下超声洁治后的离体牙的根面情况。方法:选择因重度牙周炎拔除的患牙10颗,每颗牙随机一面在显微镜下进行超声洁治,另一面在直视下超声洁治,然后用亚甲蓝染色分析。选择因重度牙周炎拔除的单根牙6颗及因正畸拔除的单根牙2颗,随机分成显微镜组,直视组,未处理组和正畸牙组,于扫描电镜下观察。结果:直视组和显微镜组结石残留差异具有显著性(P<0.05),显微镜下结石去除效果较好。结论:显微镜有助于提高超声洁治的清洁效果。