中医应有独自的医疗事故界定标准

中医学拥有自身的特色、优势和发展规律,正因为中医具有此特殊性,所以从论述建立中医医疗事故界定标准的价值、作用和意义出发,来论证建立中医医疗事故界定标准的必要性才有根据。然后在进一步论述建立中医医疗事故界定标准的合理性、可能性和可行性的基础上,归结出中医应有独自的医疗事故界定标准。     

基于化学成分与肠道菌群探讨消癌解毒方中黄连-乌梅药对的配伍机制

目的 探讨黄连-乌梅药对与消癌解毒方水煎液中部分生物碱类成分的含量差异,并比较药对与全方对小鼠肠道菌群的影响。方法 采用Extend-C₁₈(100 mm×2.1 mm,1.8 μm)色谱柱,以0.1%甲酸水（A）-乙腈（B）进行梯度洗脱,流速0.3 mL/min,柱温35 ℃,进样量2 μL;离子化模式为电喷雾离子化（ESI）,以正离子模式检测,开展方法学验证和含量测定研究。按照给药不同将小鼠分为正常组、全方高浓度组、全方低浓度组、药对高浓度组和药对低浓度组,连续灌胃给药7 d,每组分别收集粪便样本,进行16S rRNA基因测序。结果 建立的含量测定方法在一定浓度范围内线性关系良好,方法学验证结果均符合相关要求,木兰花碱与非洲防己碱在黄连、药对以及全方中的含量分别为:(4.433±0.133)(8.905±0.154) mg/g,（3.545±0.033）（9.170±0.051） mg/g,（5.287±0.038）（13.861±0.690） mg/g。全方组和药对组中拟杆菌门Bacteroides的丰度均高于正常组,而全方组和药对组中厚壁菌门Firmicutes的丰度均低于正常组。药对高浓度组中的疣微菌门Verrucomicrobia和变形菌门Proteobacteria的丰度高于其他组。结论 液质联用方法和相关参数简便、可靠,可用于有关成分的含量检测。与单味药中含量相比,经过药对配伍后,非洲防己碱含量增加,而木兰花碱含量则略有降低;经过全方配伍后,2种成分的含量均增加。此外,肠道菌群实验表明无论是药对还是全方在给药后,会不同程度地影响肠道菌群内部占比改变,其可能对调节肠道系统平衡,具有一定帮助作用,从而为进一步阐释黄连-乌梅在消癌解毒方中配伍机制提供了参考和依据。      

探讨用整体观和系统论指导高等中医药院校教育的发展

系统思想是科学发展观方法论的具体体现,而整体观与系统论正是指导中医辨证施治的基本理念和思维方法.通过科学发展观的深入学习,结合中医药工作的实践以及若干文件与文献的参阅,提出以整体观和系统论指导高等中医药院校教育的发展,并就若干问题做出思考.     

精神障碍者的依法诊疗与权利保护

2012年10月26日第十一届全国人民代表大会常务委员会第二十九次会议表决通过了《中华人民共和国精神卫生法》 (以下简称《精神卫生法》).这部孕育了27年的法律终于诞生. 全法七章八十五条,其中最核心的内容为以下四点: (1)坚持预防为主,预防与治疗、康复相结合的方针,减少精神障碍的发生,提高治疗、康复水平; (2)切实保障精神障碍者的合法权益,保障其人格尊严和人身安全不受侵犯,严格设置非自愿住院治疗的条件和程序.     

“被精神病”相关问题的法学思考

<正>近两年,有关"被精神病"问题被一些媒体炒得沸沸扬扬,吸引了社会关注的眼球。在国务院报请全国人大常委会审议的《中华人民共和国精神卫生法(草案)》中,也针对防止"被精神病"的发生做出了专门的规定。在现实生活中,针对     

参白解毒方抑制HCT116细胞增殖的药效及机制

目的 探讨参白解毒方（SBJDF）抑制结直肠癌（CRC）细胞HCT116增殖的药效及机制。方法 利用参白解毒方（0、0.25、0.5、1、2、4 g·L^-1）处理HCT116细胞48 h，噻唑蓝（MTT）比色法检测参白解毒方对HCT116细胞活力的影响，分别设置空白组、参白解毒方（1、2、4 g·L^-1）组，倒置显微镜观察参白解毒方对HCT116细胞形态的影响，克隆形成实验观察参白解毒方对HCT116细胞增殖能力的影响，JC-1探针检测参白解毒方对HCT116细胞线粒体膜电位（Δψm）的影响，流式细胞仪检测HCT116细胞周期分布和细胞凋亡率，蛋白免疫印迹法（Western blot）分析参白解毒方对细胞周期，抗凋亡以及核转录因子-κB（NF-κB）信号通路相关蛋白的影响。结果 参白解毒方有效抑制HCT116细胞活力，引起细胞形态改变，呈浓度依赖性；与空白组比较，参白解毒方（1、2、4 g·L^-1）组克隆形成率均明显下降（P<0.05，P<0.01），参白解毒方（2、4 g·L^-1）组诱导HCT116细胞发生G₀/G₁期阻滞（P<0.05，P<0.01）。与空白组比较，参白解毒方（1、2、4 g·L^-1）组周期蛋白D₁（CyclinD₁）表达明显下降（P<0.05，P<0.01），参白解毒方（2、4 g·L^-1）组细胞周期蛋白A₂（CyclinA₂），周期蛋白依赖性激酶4（CDK4）蛋白表达明显下降（P<0.05，P<0.01），参白解毒方（4 g·L^-1）组周期蛋白依赖性激酶1（CDK1）表达显著下降（P<0.01）。与空白组比较，参白解毒方（2、4 g·L^-1）组课诱导HCT116细胞凋亡，并下调抗凋亡相关蛋白B淋巴细胞瘤-2（Bcl-2）、Bcl-2相关xl蛋白（Bcl-xl）表达（P<0.05，P<0.01），降低HCT116细胞线粒体膜电位；与空白组比较，参白解毒方（2、4 g·L^-1）组可下调NF-κB信号通路相关蛋白IκB激酶α（IKKα）、NF-κB抑制蛋白α（IκBα）、磷酸化p65蛋白（p-p65）的表达（P<0.05，P<0.01）。结论 参白解毒方有效抑制HCT116细胞增殖，其机制可能通过抑制HCT116细胞NF-κB信号通路的激活，引起细胞周期阻滞，诱导细胞凋亡。     

鼻腔冲洗在鼻内镜术后的应用观察

随着功能性鼻内镜手术在临床的广泛应用，术后常出现如黏膜肿胀、术腔结痂、分泌物积聚等不良反应。为了解决上述问题，我科开展了鼻内镜术后鼻腔冲洗治疗，取得了明显效果，现总结如下。     

板蓝根醇提部位化学成分研究

目的:从板蓝根中分离化学成分。方法:板蓝根95%乙醇提取物经硅胶吸附,不同溶剂洗脱部分经硅胶柱层析反复分离纯化,测定所得化合物的理化常数和波谱数据,鉴定其化学结构。结果:从氯仿部位分得5个化合物,从正丁醇部位分得1个化合物,分别鉴定为:胆甾醇(Ⅰ)、靛蓝(Ⅱ)、靛玉红(Ⅲ)、对羟基苯甲醛(Ⅳ)、水杨酸(Ⅴ)、落叶松脂素-4,4′-2-O-β-D-二葡萄糖苷(Ⅵ)。结论:化合物Ⅰ、Ⅳ为首次从板蓝根药材中分离,具有一定的参考价值。     

几丁糖预防CO2激光声带切除术后声带粘连短期观察的实验研究

Objective To observe the effect of immediate topical application of chitosan on preventing anterior giottic stenosis (AGS) after microsurgical resection of both vocal fold with CO<,2> laser , including the anterior commissure, in a canine model. Methods Sixteen canine larynges were injured by microresecting procedure of both vocal folds with CO<,2> laser. The dogs were randomly divided into two groups, chitosan group and control group. The chitosan and isotonic sodium chloride solution(control) were used for 5 minutes immediately after surgery. One week after the initial surgery, three dogs in each group were randomly selected , ultrastructure of fibroblast were examined with transmission electronic microscope and expression of basic fibroblast growth factor(bFGF) and traansforming growth factor betal (TGF-β1) were evaluated by enzyme-linked immunosorbent assay(ELISA). Three weeks after surgery, the rest dogs' glottic web were lysed and repeatedly treated with chitosan and isotonic sodium chloride solution respectively. The glottic wound healing and AGS formation were examined every week, and all larynges were harvested and examined histologically six weeks after the initial surgery. Results Transmission electronic microscope examination of the ultrasmcture of fibroblast indicated that chitosan inhibited the proliferation of fibroblast. Chitosan increased the expression of bFGF and TGF-β1, and bFGF and TGF-β1 in chitosan group, which was significantly higher than that in control group (z = -2.887 and -2.005, P =0.002 and 0.041). Chitosan decreased the extent of AGS formation. Three weeks after the surgery, the AGS lesion in the control group affected mean 49% of the length of the vocal folds from the anterior commissure to the vocal process, while chitosan group affected mean 7%, which was significantly less than the extent of web formation in the control group, (z = - 2. 619, P = 0. 008). The grade of collagen content in chitosan group was significantly lower than that in control group (P = 0. 003). Conclusion Chitosan is effective in preventing AGS after CO<,2> laser cordectomy.     

几丁糖预防CO2激光声带切除术后声带粘连短期观察的实验研究

Objective To observe the effect of immediate topical application of chitosan on preventing anterior giottic stenosis (AGS) after microsurgical resection of both vocal fold with CO<,2> laser , including the anterior commissure, in a canine model. Methods Sixteen canine larynges were injured by microresecting procedure of both vocal folds with CO<,2> laser. The dogs were randomly divided into two groups, chitosan group and control group. The chitosan and isotonic sodium chloride solution(control) were used for 5 minutes immediately after surgery. One week after the initial surgery, three dogs in each group were randomly selected , ultrastructure of fibroblast were examined with transmission electronic microscope and expression of basic fibroblast growth factor(bFGF) and traansforming growth factor betal (TGF-β1) were evaluated by enzyme-linked immunosorbent assay(ELISA). Three weeks after surgery, the rest dogs' glottic web were lysed and repeatedly treated with chitosan and isotonic sodium chloride solution respectively. The glottic wound healing and AGS formation were examined every week, and all larynges were harvested and examined histologically six weeks after the initial surgery. Results Transmission electronic microscope examination of the ultrasmcture of fibroblast indicated that chitosan inhibited the proliferation of fibroblast. Chitosan increased the expression of bFGF and TGF-β1, and bFGF and TGF-β1 in chitosan group, which was significantly higher than that in control group (z = -2.887 and -2.005, P =0.002 and 0.041). Chitosan decreased the extent of AGS formation. Three weeks after the surgery, the AGS lesion in the control group affected mean 49% of the length of the vocal folds from the anterior commissure to the vocal process, while chitosan group affected mean 7%, which was significantly less than the extent of web formation in the control group, (z = - 2. 619, P = 0. 008). The grade of collagen content in chitosan group was significantly lower than that in control group (P = 0. 003). Conclusion Chitosan is effective in preventing AGS after CO<,2> laser cordectomy.