朱南孙调经助孕经验

朱南孙教授治疗不孕症,强调"首辨虚实",因人制宜,重在求本,虚则补之,实则泻之。对于虚证,先补益其虚,气血安和,再调经助孕;对于实证先予祛邪,邪去正复再予调补助孕。对于婚久不孕,经行错后,畏寒肢冷,纳呆便溏之脾肾阳虚者,先治以温肾健脾,养血调经,待脾胃调和,再施以温肾助孕法治疗。朱老提出欲求嗣,必先调经,调经者,重在调周,调周者,必兼养卵促卵。行经期,以通为主,以活血调经之品促进经血通畅,慎用寒凉药以防滞其经水。经后期,经水已泻,胞宫阴血亏虚逐渐至盛,以滋阴养血,补益冲任为主,常予四物汤、二至丸化裁。不孕症患者性善忧思急躁,心神失养,阴虚阳亢,无以营养冲任胞宫,不能成孕,故而疏肝解郁,宁神定志亦为调经助孕之要领。     

胡国华运用“通”“养”法治疗产后身痛经验

胡国华教授秉承海派中医朱氏妇科的学术观点,认为产后身痛的根本病机是产后多虚,邪气入里所致,常运用朱氏妇科"通、涩、清、养"四法中的"通""养"二法论治本病。患者产后气血亏虚,百脉空虚,筋脉失养即本虚,此时又因外邪入侵,产褥期风寒湿邪乘虚而入即标实,针对产褥期特殊的生理病理以及气血亏虚、外邪内侵的发病机制,胡国华教授提出益气养血,通络止痛法。胡国华教授用药灵活,精而不杂,善用药对,丝丝入扣,强调疾病有其共性,但亦须重视个体的动态变化,还非常重视患者心理调摄,除言语劝导外可根据临床症状酌加疏肝宁心之品,临床往往取得良好的治疗效果。     

腹膜后囊性黑色素性神经鞘瘤一例报道并文献复习

探讨腹膜后囊性黑色素性神经鞘瘤的临床病理特征,以提高对该肿瘤的诊治水平。方法 赣南医学院第一附属医院肿瘤外科2014-03-17收治1例腹膜后囊性黑色素性神经鞘瘤患者,总结其临床资料、影像学表现、病理特征,并结合国内外文献进行综合分析。结果 患者,男,47岁,因左侧后腰部疼痛就诊,增强CT扫描发现左侧腰大肌旁肿瘤,与左侧肾脏关系密切,外科手术切除;巨检：肿瘤为囊性,大小15.0 cm×10.0 cm×10.0 cm,其内见大量咖啡样黏稠液体,囊壁厚1.0 cm,部分外壁与左侧肾脏周围组织粘连;镜下：囊壁内肿瘤细胞较少,被纤维组织分隔成结节状,肿瘤细胞呈梭形及上皮样,胞质内见大量黑色素沉积。免疫组织化学标记：HMB45、Melan-A、S100、CD57、波形蛋白（Vimentin）均为（+）,细胞外胶原基膜Ⅳ型胶原（CollagenⅣ）（+）,Ki-67约4%（+）。病理诊断：（腹膜后）囊性黑色素性神经鞘瘤（经典型）。结论 囊性黑色素性神经鞘瘤是少见的具有神经鞘细胞特征及黑色素细胞分化的软组织肿瘤,囊性者罕见,有潜在恶性生物学行为,需长期随访。     

丙泊酚干预脊髓损伤模型脊髓水肿及后肢电生理的变化

BACKGROUND: A large number of studies have verified that propofol could effectively reduce secondary nerve injury by improving microenvironment of spinal cord injury. OBJECTIVE: To study the effects of propofol on spinal cord edema and electrophysiology of the hind limb in rats with spinal cord injury. METHODS: Rat models of acute spinal cord injury were established by using the modified Allen method. A total of 40 rat models were randomly divided into spinal cord injury group and propofol group (n=20). Rats in the propofol group were injected with propofol through the caudal vein. The spinal cords of an additional 20 rats were exposed in the sham surgery group. Motor function was evaluated using BBB score and inclined plate test before modeling, 1, 3 days, 1-4 weeks after modeling. Neuronal apoptosis was detected after spinal cord injury using TUNEL assay at 72 hours after modeling. AQP4/9, matrix metalloproteinases 9/2 mRNA and protein expressions were measured using RT-PCR and western blot assay. At 4 weeks after modeling, pathological changes of the spinal cord were observed using immunohistochemistry and hematoxylin-eosin staining. Neurophysiological recovery was analyzed using motor evoked potentials and somatosensory evoked potentials. RESULTS AND CONCLUSION: (1) At 1-4 weeks after modeling, BBB score and inclined plate test score were higher in the propofol group than in the spinal cord injury group (P < 0.05), but lower than in the sham surgery group (P < 0.05). (2) The number of apoptotic cells was significantly more in the spinal cord injury group than in the propofol group (P < 0.05). No apoptotic cells were found in the sham surgery group. (3) At 72 hours after spinal cord injury, AQP4/9 and matrix metalloproteinases 9/2 mRNA and protein expression was higher in the propofol group than in the sham surgery group (P < 0.05). AQP4/9 and matrix metalloproteinases 9/2 mRNA and protein expression was significantly reduced in the propofol group (P < 0.05). (4) At 4 weeks after modeling, the spinal cord was loose, and the cavity was small. Partial neuronal necrosis could be seen. The degree of nerve fiber density in the propofol group was between the sham surgery group and spinal cord injury group. (5) Motor evoked potentials and somatosensory evoked potentials were obviously recovered, the latency was short, amplitude was increased in the propofol group, which showed significant differences as compared with the sham surgery group and the spinal cord injury group (P < 0.05). Results suggested that propofol can reduce apoptosis in rat neurons after spinal cord injury, reduce spinal cord edema-related gene expression, and improve electrophysiological function and limb motor function.       

丙泊酚联合骨髓间充质干细胞移植对脊髓损伤大鼠后肢功能及电生理的影响

背景：研究发现,骨髓间充质干细胞具有修复神经元的作用,但单纯骨髓间充质干细胞移植对神经系统损伤的修复作用仍不理想。 目的：探讨骨髓间充质干细胞移植联合丙泊酚对脊髓损伤大鼠后肢功能和电生理的影响。 方法：80只成年的Wistar大鼠,建立脊髓损伤模型,按照随机数字表法分为4组(n=20)：骨髓间充质干细胞组、对照组、联合组、丙泊酚组。建模后6 h通过1 mL注射器经尾静脉注入骨髓间充质干细胞悬液、细胞培养液、骨髓间充质干细胞悬液+丙泊酚注射液、丙泊酚注射液。分别于造模前、造模后1,3 d与1-4周通过BBB评分、改良Tarlov评分、斜板试验进行运动功能评定。造模后4周取材用荧光显微镜观测PKH-26标记的骨髓间充质干细胞存活及分布情况,病理切片进行苏木精-伊红染色。第4周进行辣根过氧化物酶示踪分析神经纤维的再生情况,运动诱发电位和体感诱发电位分析大鼠神经电生理恢复情况。 结果与结论：①大鼠下肢运动功能评价联合组优于骨髓间充质干细胞组及丙泊酚组,骨髓间充质干细胞组和丙泊酚组优于对照组。②丙泊酚组和骨髓间充质干细胞组损伤区可见少量神经轴索样的结构,该脊髓空洞比较小,联合组可见较多的神经轴索样结构,未见脊髓空洞。对照组可见脊髓组织缺失及脊髓空洞形成,无神经轴索通过。③辣根过氧化物酶阳性神经纤维数和PKH-26阳性细胞：对照组<丙泊酚组、骨髓间充质干细胞组<联合组,各组之间差异均有显著性意义(P < 0.05)。④运动诱发电位和体感诱发电位的潜伏期：对照组>丙泊酚组、骨髓间充质干细胞组>联合组,各组之间差异均有显著性意义(P < 0.05)。⑤运动诱发电位和体感诱发电位的波幅：对照组<丙泊酚组与骨髓间充质干细胞组<联合组,各组之间差异均有显著性意义(P < 0.05)。⑥结果表明丙泊酚、骨髓间充质干细胞均能促进脊髓损伤大鼠神经突触的再生,改善大鼠电生理功能及肢体运动功能,二者联用效果更好。 中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

镇江市疾病预防控制中心资源现状与分析

2002年根据卫生体制改革要求而成立的我市疾病预防控制机构是集疾病预防与控制、卫生监测与评价、健康教育与促进为一体，为政府实施卫生技术管理和服务的卫生机构，是政府管理行为的技术支撑体，是政府实行一定福利政策的社会公益性事业单位。及时了解掌握我市疾控中心人力、物力、财力资源现状，对于进一步加强疾控队伍建设、合理配置人、财、物资源，更好地推动疾病预防控制工作向更深层次开展都具有重要意义。     

早期氟西汀干预对APP/PS1转基因痴呆模型小鼠认知功能和脑内Aβ蛋白的影响

目的观察早期氟西汀治疗对APP/PS1转基因痴呆模型小鼠认知功能和脑内β-淀粉样蛋白(Aβ)的影响。方法将20只雌雄各半2月龄的健康APP/PS1双转基因小鼠随机分为模型组(10只)和氟西汀组(10只),另选10只2月龄健康野生小鼠作为对照组。灌药4个月后,采用Y-迷宫实验、水迷宫实验观察小鼠行为学,检测小鼠脑内Aβ蛋白的水平。结果 Y-迷宫实验结果显示,对照组正确反应次数和主动回避次数均多于模型组和氟西汀组,氟西汀组正确反应次数和主动回避次数均多于模型组,差异有统计学意义(均P<0.05)。水迷宫实验结果显示,模型组同时间点逃避潜伏期长于对照组和氟西汀组,氟西汀组同时间点逃避潜伏期长于对照组,差异有统计学意义(均P<0.05);对照组原平台穿越次数多于模型组和氟西汀组,原平台象限停留时间长于模型组和氟西汀组,氟西汀组小鼠原平台穿越次数多于模型组,原平台象限停留时间长于模型组,差异有统计学意义(均P<0.05)。模型组脑内Aβ蛋白水平高于对照组和氟西汀组,氟西汀组脑内Aβ蛋白水平高于对照组,差异有统计学意义(均P<0.05)。结论早期氟西汀干预能明显改善APP/PS1转基因痴呆小鼠的学习记忆障碍,且降低其脑内Aβ蛋白的水平。     

信息技术对人们阅读行为的影响和信息表达方式的改进

在现代信息社会里，信息量急剧增加，现在全世界每天约有百亿信息单元的信息量在传递，并且每年以15～20％的速度激增。历史从未有过象今天的社会这样喧嚣而紧张，在忙碌的工作学习中，人们的阅读行为发生了显著变化。     

嗜酸性冠状动脉炎合并自发性冠状动脉夹层一例

患者女性,53岁,农民.既往体健,因突发胸痛、左侧手臂不适,在前往当地医院途中猝死.患者从发病到死亡约20 min.尸体检验见头面部、口唇及双手(足)指(趾)甲床明显发绀.主动脉始段管腔明显扩张,管壁变薄,内膜见多处脂质沉积.