《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。     

63例高级别胶质瘤中IDH1和TERT突变状态的预后价值

目的:探讨异柠檬酸脱氢酶-1（IDH1）和端粒酶逆转录酶（TERT）启动子突变对高级别胶质瘤患者的预后价值。方法:选取2014年9月至2017年6月于我院行手术切除且术后病理提示为高级别胶质瘤的患者63例（WHO Ⅲ级27例，Ⅳ级36例），完善临床资料、随访资料、分子检测结果。应用Sanger测序法检测样本中IDH1和TERT启动子突变情况，根据结果将患者分为不同亚组，通过比较其生存期的差异，分析基因突变与患者预后的关系。结果:63例高级别胶质瘤中，IDH1突变型和野生型患者的中位生存期分别为24和10个月，差异有统计学意义（P＜0.01）；TERT突变型和野生型的中位生存期无明显差异（P＞0.05）。IDH1突变为高级别胶质瘤患者预后良好的因素，TERT突变不能单独提示预后，二者联合分析提示:IDH1突变／TERT突变组预后最好，IDH1野生／TERT突变组预后最差，IDH1突变／TERT野生组预后稍好于IDH1野生／TERT野生组，四组间预后有明显差异。结论:IDH1突变的高级别胶质瘤患者有较好的临床预后，在此基础上，TERT启动子突变检测有助于进一步划分其预后分层。     

Feasibility of establishing cerebral ischemia models by using aerocyst-blocking bilateral ascending pharyngeal artery of piglets Imaging assessment

BACKGROUND: The cerebral ischemia and ischemia/reperfusion animal models are used to simulate the human cerebrovascular diseases is one of the popular topics of neurological science recently. To study the pathophysiology, pathogenesis, prophylaxis and treatment of ischemic cerebrovascular diseases and to establish the ideal animal model that is the most similar to the human cerebral ischemia, are the topics that the people generally cared about. OBJECTIVE: To evaluate the effects of aerocyst-blocking bilateral ascending pharyngeal artery on the establishment of cerebral ischemia models by using digital subtraction angiography (DSA), magnetic resonance diffusion-weighted imaging (DWI) and magnetic resonance perfusion-weighted imaging (PWI). DESIGN: Repetitive measure animal experiment. SETTING: Zhongshan Hospital Affiliated to Dalian University. MATERIALS: The experiment was carried out in the Animal Laboratory (Provincial Laboratory), Zhongshan Hospital of Dalian Univeristy from January to May 2006. A total of 14 domestic piglets, of 6 months old, weighing 12–15 kg, of either gender, were selected from Animal Experimental Center, Dalian University. Multistar T.O.P digital subtraction angiography machine was provided by Siemens Company, German. METHODS: Aerocyst-blocking bilateral ascending pharyngeal artery was used to establish cerebral ischemia models. And then, Multistar T.O.P. DSA was used for imaging of cerebral vessels before blocking, during blocking and at 0.5 and 2 hours after ischemia perfusion. GE Signa 1.5 T supraconduction magnetic resonance imaging was used for DWI examination; in addition, PWI was used based on focal sites and areas. Otherwise, magnetic resonance imaging (MRI) was used to detect signal changes of T1WI and T2WI in ischemic areas. MAIN OUTCOME MEASURES: Analytic results of DSA, DWI, PWI and MRI. RESULTS: All 14 experimental piglets were involved in the final analysis. ① DSA: The blood flow of bilateral ascending pharyngeal arteries and its branch were blocked at blocking phase, which restored 0.5 and 2 hours after reperfusion. ② DWI and PWI: There were no observable abnormalities in PWI and DWI at pre-blocking. Abnormal increased signals were found on both DWI and PWI at during and post-blocking. There were reduction in ADC and rCBF and delay in rTTP at all time points except pre-blocking. ③ MRI: There were no abnormal signals observable at any time of pre- and post-blocking in T1WI and T2WI. CONCLUSION: It is feasible to establish this kind of animal experimental models, and it can simulate the ischemic state; meanwhile, the existence and extent can be showed directly by DSA, DWI, and PWI.     

二羧乙基锗倍半氧化物的抗大鼠实验性胃溃疡作用及其作用机理研究

二羧乙基锗倍半氧物(Dicarboxyethyl GermaniumSesquioxide,DEG)是人工合成的有机锗化合物。它能对抗Shay幽门结扎性溃疡的形成,使胃液中PGE_2含量增加,胃蛋白酶活性和游离酸度明显降低。DEG还能对抗消炎痛型,五肽胃泌素型和酒精型溃疡的形成,促进醋酸型溃疡的愈合,但对应激型和利血平型溃疡无对抗作用。DEG的主细胞分泌功能比对照组明显减弱。实验结果表明,DEG的抗溃疡作用可能与增加胃内PGE_2含量、抑制胃液分泌和促进蛋白质合成有关。     

不同器官细胞因子在多细菌感染性炎症时的基因表达和临床意义

目的探讨肝、肺细胞因子基因表达与腹腔吞噬细胞上清液、循环血中细胞因子含量的关系,为临床诊治多细菌感染引发的炎症提供实验依据.方法将30只小鼠分为假手术对照组(sham组)和盲肠结扎组(CLP组).采用RT-PCR法检测肝脏和肺脏肿瘤坏死因子α(TNF-α)和白细胞介素10(IL-10)的基因表达情况,采用ELISA法检测腹腔巨噬细胞上清液和循环血液中相应细胞因子含量.结果CLP组的TNF-α、IL-10基因表达和腹腔巨噬细胞上清液、循环血液中的相应细胞因子含量均高于sham组.CLP后18h组与4h组比较,TNF-α在腹腔巨噬细胞上清液、循环血液中的活性均有显著性差异(P＜0.05),在肝、肺中基因表达有非常显著性差异(P＜0.01);IL-10在腹腔巨噬细胞上清液和循环血液中的含量无显著性差异,而在肝、肺中基因表达有显著性差异.结论发生多细菌感染性炎症时,肝、肺参与细胞因子的表达;血液中细胞因子含量不能完全代表组织器官内的基因表达情况;多细菌感染性炎症治疗应考虑靶器官细胞因子的表达状态.     

留置双J管病人的观察与护理

双J管又称双猪尾管，因两端卷曲，每端形似猪尾而得名。由于其支架和内引流作用，能解除输尿管炎症、水肿造成的暂时性梗阻，防止术后伤口漏尿和输尿管狭窄。同时，集合系统不与外界直接相通，可避免肾造瘘所引起的出血、感染，因无外引流管的限制和不适感，病人可早期下床活动，有利于术后康复。2004年7月-2005年2月我院先后为58例病人应用双J导管．效果良好，现报告如下。     

SODIUM EFFECTS ON THE FIBRILLATORYPROPENSITY OF NON-IONIC CONTRAST MEDIA

Removing sodium from standard ionic contrastmedia markedly increases the incidence of ventricu-lar fibrillation in patients undergoing coronary arvgiography. Newer nonionic contrast media, Iopa-midol (IOP), Iohexol (IOH) and Ioversol (IOV),contain only trace amounts of sodium. To determinewhether sodium influences the fibrillatory propen-sity of nonionic contrast media, we measured theprolongation in QT interval and performed program-med electrical stimulation with l,2 and 3 ventricularextra stimuli in 40 dogs during 4 ml intracoronaryinjections of IOP, IOH and IOV. Solutions of eachcontrast media with added NaCI at concentrations of0.225To, 0.45% and 0.970 were compared to stockcontrast media. The addition of NaCI markedlyincreased the amount of QT interval prolongationproduced by each contrast media. With IOP, theamount of QT interval prolongation was 40+11msec with standard IOP but was 58+11 msec with0.225'70 NaCI/IOP, 84+17 msec with 0.45'To NaCI/IOP, and 132+42 msec with 0.970 NaCl/IOP(P相似文献   

受体介导内吞和自噬同凋亡的关系

目的 观察刀豆素A(ConA)与小鼠腹腔巨噬细胞表面ConA受体结合、内吞、转运及巨噬细胞自噬、凋亡的形态学变化，以探讨受体介导内吞与自噬体形成和细胞凋亡之间的关系。方法 用辣根过氧化物酶(HRP)标记ConA(ConA-HRP)与小鼠腹腔巨噬细胞共孵育，不同时间取出部分巨噬细胞，制备电镜标本，观察。结果透射电镜观察表明：ConA的内吞属于受体介导内吞；形成的内吞体有泡状、管状及双层膜的线状等形式；双层膜的线状结构包裹部分胞质和细胞器，形成自噬体；自噬体与溶酶体融合，而后巨噬细胞凋亡。结论受体介导内吞和自噬同凋亡之间存在一定的关系。     

六味地黄汤对实验性糖尿病大鼠心、肝、肾组织中过氧化氢酶活性和过氧化脂质含量的影响

用四氧嘧啶诱导雄性Ｗｉｓｔａｒ大鼠为模型进行研究．结果发现，四氧嘧啶大鼠血糖明显升高，且心、肝、肾组织中过氧化氢酶活性较正常组明显降低，过氧化脂质含量在心、肝组织中明显增高，过氧化脂质与过氧化氢酶比值在心、肝、肾组织中均明显高于正常组，表明糖尿病状态下大鼠心、肝、肾组织中均自由基生成增多，氧化损伤加重．经六味地黄汤治疗后，血糖明显下降，但心、肝、肾组织中的过氧化氢酶活性无改变；而心肌中过氧化脂质含量和过氧化脂质与过氧化氢酶比值则明显降低，过氧化脂质含量和过氧化脂质与过氧化氢酶比值在肝、肾组织中无变化，表明六味地黄汤能明显清除心肌中自由基，抑制心肌中脂质过氧化，且此作用并不是通过提高过氧化氢酶活性来达到．     

神效止痛膏的镇痛作用

用二甲苯所致的急性炎症模型观察了神效止痛膏的抗急性炎症作用．用扭体法、热板法观察了神效止痛膏对小鼠的镇痛作用．结果表明，神效止痛膏有很好的镇痛作用．