Clinical observation on the effect of Chinese medicine-“TCM formula” intervention on recurrence and metastasis of triple negative breast cancer

ObjectiveThis study used a prospective cohort study to observe the effect of triple-negative breast cancer on the 2-year disease-free survival rate with or without “TCM formula”.MethodsFrom November 1 st, 2016, the first patient was enrolled in the cohort study. A total of 356 patients were enrolled on January 30, 2019. Among them, 154 cases were followed up for 2 years. During the follow-up, there were 6 cases of shedding, so 6 cases were affected. A total of 148 cases were included in the analysis, including 73 in the exposed group and 75 in the non-exposed group. The exposed group was given “TCM formula” on the basis of standardized treatment, and the non-exposed group was treated with simple triple-negative breast cancer. The two groups visited each of the three months. The interview included safety examination (hematology and imaging). The endpoint was the difference in 2-year invasive disease-free survival between the exposed and non-exposed groups and the safety of the “TCM formula”.ResultsThere were 6 cases of shedding during the experiment and the shedding rate was 3.9 %. The 2-year rate of invasive disease-free survival in the exposed team was 88.7 % and the non-exposed group was 82.5 %. Logistic multivariate regression analysis predicted that “TCM formula” could reduce the disease-related recurrence and metastasis rate by 11 % (OR = 0.89, 95 % CI 0.37−0.956, P＜0.05). Through K–M survival analysis, TNBC patients with age ≤35 years and regional lymph node stage N1 may be the benefit group of “TCM formula”(P＜0.05). During the study, the incidence of total adverse events was 8.2 % in the exposed group, mainly manifested as stomach discomfort, diarrhea, and hepatocyte damage.Conclusion1. In the exposed group, the two-year rate of invasive disease-free survival increased by 6.2 % compared with the non-exposed group(P＞0.05). 2. According to K–M survival analysis, TNBC patients with age ≤35 years and regional lymph node metastasis to N1 may be potential beneficiaries of “TCM formula”. 3. “TCM Formula” is safe and tolerable to most patients.     

《针灸大成》关于气海穴临床应用的文献研究

目的:通过检索《针灸大成》中与气海穴治疗作用相关的文献条文,总结气海穴在治疗各系统疾病中运用频次较高的疾病及其配穴规律,为临床针灸对气海穴的使用提供理论支持。方法:以《中华医典》(第五版)中《针灸大成》作为文献检索来源,将气海穴及气海穴的别称“脖胦”“下肓”“丹田”“肓之原”“肓原”“下言”和“气泽”为检索词,用计算机检索工具及人工检索相结合的方法检索符合要求的文献条文,通过建立本研究的数据库,频次分析、条形统计图比较分析等方法,总结出气海穴在治疗各系统疾病中的运用频次及其配穴规律。结果:在《针灸大成》所涉及的条文中,气海穴尤善治疗内科疾病,在治疗内科疾病中排名前3位的是脾胃系病症、气血津液疾病、肾系病症和妇科疾病,气海穴配穴习惯为上下配穴法,同名经配穴法,以及前后配穴法,其中主要为前后配穴法和同名经配穴法。结论:气海穴《针灸大成》中单穴应用占比最高,而在气海穴众多配穴中,运用了本经配穴法、上下配穴法、前后配穴法,配穴归经主要来自任脉和足太阳膀胱经。同名经配穴法,同气相求,可增加疗效;与气海穴配伍较多的足太阳膀胱经以背腧穴为主,此为前后配穴法,亦称腹背阴阳配穴法,腹部为阴,腰背为阳,前后配穴法可起到“从阳引阴”亦可“从阴引阳”的作用,以达到调节阴阳,调和脏法,调畅经络的目的。     

中药复方配伍的研究方法及其进展

中药复方是由2味或2味以上中药遵循中医理论组合而成的方剂。多味中药在合适的剂量配比之下,协同发挥作用,实现中医的整体调节治疗。研究中药复方的配伍对推动中药现代化发展、新药开发以及临床应用有着重要意义。近年来,研究者们在传统的"七情和合"与"君臣佐使"的基础上,运用新技术和新方法对中药复方的成分、药效活性和药代动力学性质等进行了研究,从不同角度探讨了中药复方配伍的科学内涵。同时,多种数理方法和模型的建立、网络药理学和数据挖掘方法的发展与应用,也对中药复方配伍研究提供了很大帮助。研究方法的发展虽促进了中药复方配伍的科学研究,但还需进一步建立适合中药复方配伍复杂关系的研究方法,以阐明中药复方及其成分/组分配伍的内在规律,进而构建新的现代中药复方,这也是目前中药复方配伍研究的重点任务。     

基于“中医传承辅助平台”软件挖掘年莉教授治疗糖尿病肾病的用药规律

[目的] 采用"中医传承辅助平台"软件，探讨年莉教授治疗糖尿病肾病的用药规律。[方法] 将2016年11月-2019年4月年莉教授治疗糖尿病肾病的中药处方信息输入中医传承辅助平台系统，采用频次分析、组方规律分析方法挖掘、探讨年莉教授治疗糖尿病肾病的临床用药特点。[结果] 对年莉教授治疗糖尿病肾病158首处方进行分析，涉及中药207味，使用频次在前10位的药物分别为白芍、川芎、当归、半夏、刺蒺藜、丹参、泽泻、牛膝、厚朴，白术获得9组药对、3组核心药物组合。[结论] 年莉教授治疗糖尿病肾病经验丰富，高频药物的配伍体现了年莉教授多采用平肝疏肝，补血养阴，活血化瘀的治疗原则。期望能为临床治疗和药物研发提供参考，并为糖尿病肾病在泰国的治疗提供新的理念和借鉴。     

缓解视疲劳功能中药复方保健产品配方规律及特点分析

目的通过检索特殊食品信息查询平台公布的具有缓解视疲劳功能的保健食品信息资料,以及药智数据网的中成药处方数据库中眼科中成药中有保健功能的产品信息资料,为具有缓解视疲劳功能的保健产品的组方与产品开发提供依据与参考。方法运用Microsoft Excel2016软件及中医传承辅助平台对检得的产品信息进行统计,分析其配方特点。结果共收集到141个具有缓解视疲劳功能的保健食品,其中64个(45.4%)保健食品配方中含有中药类原料。使用频次≥5的中药原料有6味,累计使用145次(72%),由高到低分别是菊花、枸杞子、决明子、桑椹、熟地黄、茯苓。通过无监督的熵层次聚类得到3个新处方。非中药原料在缓解视疲劳功能的保健食品中应用较为普遍,含有外来天然植物资源的60个产品,含叶黄素及维生素类的17个。统计眼科中成药中有保健功能的产品可知,使用频次≥4的中药原料有7味,累计使用32次(29%),由高到低分别是枸杞子、决明子、菟丝子、熟地黄、菊花、五味子、车前子。通过无监督的熵层次聚类得到1个新处方。结论保健食品在中药原料的选择上与中医药理论治疗视疲劳的原则基本契合,即滋补肝肾、平肝明目。但二者在中药原料选择范围、原料配伍、剂型种类等方面有所不同。此外,还在辨证保健理论指导下,尝试探讨应用文献数据处理统计方法筛选新配方、开发新产品,为中药复方保健产品的研发开辟了新思路、新方法。     

柴苓小方对大鼠肾小球系膜细胞异常增殖的影响

目的：探讨柴苓小方对大鼠肾小球系膜细胞（GMCs）异常增殖的影响及相关机制。方法：采用脂多糖刺激系膜细胞异常增殖。MTT法检测柴苓小方对㈣异常增殖的影响；免疫细胞化学方法检测药物作用后增殖细胞核抗原（PCNA）的表达；乳酸脱氢酶释放实验检测柴苓小方的细胞毒作用。采用RT—PCR检测药物作用不同时间点细胞周期蛋白依赖性激酶抑制剂p21的表达。结果：柴苓小方可以剂量依赖性的抑制系膜细胞异常增殖并显著减少PCNA阳性细胞数而没有明显的细胞毒作用。并且柴苓小方可以显著地上调p21基因的表达（P〈0．05）。结论：柴苓小方可剂量依赖性的抑制GMC8异常增殖．其机制可能与上调p21mRNA表达有关。     

血压在前阻力血管中下降最快的原因分析

目的：解释血压在毛细血管前阻力血管中下降最快的原因。方法：利用物理模型简化复杂的心血管系统。结果：全身所有的微、小动脉段“并联”，全身所有的毛细血管段“并联”。结论：微、小动脉段的总流阻最大、使俐血压在微、小动脉中下降最快。     

Midwives in the UK: an exploratory study of providing newborn feeding support for postpartum mothers in the hospital

Our objective was to explore English midwives' views and experiences of supporting mothers with feeding their newborn baby. Grounded theory methodology was used. Data were collected using in-depth interviews from 30 midwives in the North of England. Data were analyzed using constant comparison techniques. Midwives were theoretically sampled for interview from a pool of volunteers recruited from a poster promoting the study in the clinical areas. Overall, hospital midwives felt that they did not have enough time to support mothers with feeding their neonate. To cope with these time constraints, midwives developed practices of rationing the time that they spent with mothers, and the rationing of resources available to mothers, to help them process mothers through the hospital services. These practices have important implications for the success of breastfeeding in hospitals as the practices by providers who are assigned to help breastfeeding initiation described here may inhibit the breastfeeding process.     

血清低密度脂蛋白胆固醇直接测定与Friedewald公式计算结果比较

采用聚乙烯硫酸（ＰＶＳ）沉淀法测定血清低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）值，同时应用Ｆｒｉｅｄｅｗａｌｄ公式计算ＬＤＬ－Ｃ含量，并对两法结果进行比较分析，提出当甘油三脂（ＴＧ）＜４．５２ｍｍｏｌ／Ｌ时，Ｆ公式计算法可代替ＰＶＳ法，当ＴＧ＞４．５２ｍｍｏｌ／Ｌ时，不宜用Ｆ公式计算ＬＤＬ－Ｃ的值。     

Allergen-Specific IgE Antibodies against Antigenic Components in Cow Milk and Milk Substitutes

Crossed radioimmunoelectrophoresis (CRIE) was used to study the presence of serum IgE against antigenic components of cow milk in 21 selected milk-allergic patients. The amount of each IgE specificity was estimated by a scoring system. The milk-allergic children had mainly IgE against alpha-lactalbumin, beta-lactoglobulin, albumin and immunoglobulin, the four major proteins of bovine whey, as well as IgE against three casein components. A serum pool from 1000 normal adults had IgE against the same whey protein, but in smaller amounts, and no IgE against the casein components. Eight cow milk-based formulae, commonly used for infant feeding, and goat milk were studied by the same method. It was found that six of the milk substitutes did not differ significantly from cow milk in antibody binding, but the two hydrolysed casein products, Nutramigen and Pregestimil, consisted of such small molecules that the rabbit antisera could not precipitate the hydrolysed proteins in the gels on the CRIE plates. It was therefore not possible to study their IgE binding, if any, by this method.