基于“祛邪为第一要义”从清热化湿论治新型冠状病毒肺炎

结合验案分析,基于"祛邪为第一要义"探讨新型冠状病毒肺炎从清热化湿论治的思路与方法。认为新型冠状病毒肺炎主要是属于"湿热"性质的疫病,治疗应强调清热化湿,以"祛邪为第一要义",辅以扶正。在中医祛邪与扶正理论指导下,通过宣肺平喘、通腑泻热、芳香化湿等治法,祛邪为主,肺肠合治,可以使发热减轻或消退,使大便通畅,从而截断病情进展,避免或减少危重症的发生及死亡的风险;通过清热化湿、疏肝健脾、凉血化瘀等治法,祛邪兼以扶正,肺与肝、脾合调,可以改善肝功能损伤,减少病情加重的风险;通过补气健脾等扶正治法,可以改善患者的精神和体力,促使病毒更快转阴,缩短病程,促进患者早日康复。     

基于和法的湿瘟“三护”与新型冠状病毒肺炎的治疗

新型冠状病毒肺炎归属于中医学"湿瘟"范畴,其核心病机为外感湿浊疫毒之邪伏膜原,引动少阳相火,内外相合,木火刑金,湿(毒)火上冲,而成疫毒闭肺之证。治疗以"和"法贯穿始终,"护中气、护宗气、护阴液"固本,外疏内清,寒温并用为基本治则,以宣肺达邪、清热解毒、补气养阴、活血化瘀、化湿通络等多法杂糅,共奏厥功,截断病势以救危亡。     

Comparison of Ileal Digested Production of Parental Rice and Rice Genetically Modified With Cowpeas Trypsin Inhibitor

INTRODUCTION With the rapid development of genetically modified foods in the world, the safety assessment of these novel foods is becoming the first task for governments, scientists, and consumers. At the same time, nutritional assessment is an important …     

五联疫苗与常规疫苗接种不良反应比较

目的：比较分析五联疫苗与常规疫苗接种不良反应类型及处理方法。方法：随机抽选2019年7月~2020年12月期间于本院接受预防接种儿童共120例为研究对象,经动态随机化分组为对照组60例（常规疫苗接种）、观察组60例（五联疫苗接种）,其后对观察组行二次动态随机化分组为A组（上臂三角肌预防接种）、B组（大腿前外侧肌肉预防接种）各30例。统计组间、组内预防接种后不良反应发生率及预防接种认可情况差异。结果：（1）不良反应率：经统计两组预防接种后不良反应发生情况后可知,观察组发生率低于对照组,差异显著（P＜0.05）;经对比观察组组内预防接受后不良反应情况可知,两组不良反应率对比无显著差异（P＞0.05）。（2）预防接种认可度：经组间对比后可知,观察组家属接种操作便利性、安全性及可配合性认可度均高于对照组,差异显著（P＜0.05）;经观察组组内对比后可知,A组家属接种操作便利性、安全性及可配合性认可度均高于对照组,差异显著（P＜0.05）。（3）相关性分析：经收集两组发生接种后不良反应儿童基线资料后可知,疫苗接种操作、疫苗类型、个体因素及其他因素为导致儿童预付接种不良反应的主要单因素类型,其中疫苗接种操作、个体因素均可正向预测预防接种不良反应,差异显著（P＜0.05）。结论：相较常规疫苗接种,五联疫苗接种安全性优势显著,且家属具有较高认可度,可在实际接种中经提升疫苗接种操作质量及儿童个体性安全因素分析后,经实施上臂三角肌接种后进一步提升预防接种家属认可度。     

Methylprednisolone Inhibits the Expression of Glial Fibrillary Acidic Protein and Chondroitin Sulfate Proteoglycans in Reactivated Astrocytes

创伤后的神经胶质增生导致硫酸软骨素蛋白聚糖(CSPG)的显著表达,从而抑制轴突生长和再生。甲基强地松龙(MP),一种合成的糖皮质激素,在急性脊髓损伤(SCI)的治疗中有神经保护作用和抗炎效应。但是,MP对于CSPG在活性胶质细胞中的表达的作用尚不清楚。本文用a-氨基-3-羟基-5-甲基-4-异恶唑丙酸酯(AM-PA)诱导星形胶质细胞再活化,用环噻嗪模拟SCI的兴奋性中毒刺激。AMPA治疗后,星形胶质细胞再活化的标志物-胶质纤维酸性蛋白(GFAP)、CSPG神经聚糖和磷酸盐的表达都显著上调。AMPA治疗星形胶质细胞的条件培养液强烈抑制大鼠背根神经节中神经元的轴突生长,但这种作用能被MP的预处理所逆转。此外,MP下调成年SCI大鼠中GFAP和CSPG的表达,对抗RU486的糖皮质激素受体(GR)和GR si RNA能逆转MP对GFAP和神经聚糖表达的抑制作用。这些结果提示,MP能在兴奋性中毒损伤后通过GR介导的星形胶质细胞再活化下调和GSPG表达抑制来改善神经修复,促进轴突生长。     

喉癌甲状软骨侵犯危险因素及基于双能CT碘图喉癌体积诊断甲状软骨侵犯

目的 观察喉癌甲状软骨侵犯的危险因素,分析基于双能CT碘图肿瘤体积对喉癌甲状软骨侵犯的诊断效能。方法 回顾性分析经手术病理证实的108例喉癌患者,根据病理结果分为甲状软骨受侵犯组（49例）和未受侵犯组（59例）;对比2组基本资料及基于双能CT碘图的肿瘤体积,采用二元Logistic回归方程分析喉癌甲状软骨侵犯危险因素及其诊断喉癌甲状软骨侵犯的效能。结果 甲状软骨受侵犯组与未受侵犯组患者性别、年龄、病程及肿瘤分化程度差异均无统计学意义（P均>0.05）,喉癌分型、前联合侵犯及基于双能CT碘图的肿瘤体积差异均有统计学意义（P均<0.01）。Logistic回归分析结果显示,基于碘图的肿瘤体积（P<0.01）和前联合侵犯（P=0.03）是喉癌甲状软骨侵犯的危险因素;以肿瘤体积=3.91 cm³为临界值诊断甲状软骨侵犯的敏感度及特异度分别为93.90%及89.80%,Youden指数为0.84,AUC为0.97[95% CI（0.94,0.99）,P<0.01]。结论 基于双能CT碘图的肿瘤体积和前联合侵犯是喉癌甲状软骨侵犯的危险因素;基于双能CT碘图的肿瘤体积可用于诊断甲状软骨侵犯。     

Region-Specific Expression of Immunoregulatory Proteins on Microglia in the Healthy CNS

与中枢神经系统的空间结构高度一致,大部分的中枢神经系统疾病表现为区域性分布。虽然小胶质细胞已被公认在各种中枢神经系统疾病中发挥重要的作用,但是小胶质细胞是否表现为区域特异性目前还不清楚。因此,本研究目的是评估在健康成年小鼠的中枢神经系统的不同区域中小胶质细胞的不同表型。运用体外流式细胞仪分析CD11b,CD40,CD45,CD80,CD86,F4/80,TREM-2b,MHCII,CXCR3,CCR9以及CCR7的表面表达。这些免疫调节标记物大部分均存在于小胶质细胞上并且在表达水平上有明显的区域特异性差异。这些发现在很大程度上证实了在健康成年小鼠中枢神经系统的小胶质细胞中存在着免疫多样性。     

Platelet function analyzer (PFA)-100® closure time in the evaluation of platelet disorders and platelet function

BACKGROUND: Closure time (CT), measured by platelet function analyzer (PFA-100) device, is now available to the clinical laboratory as a possible alternative or supplement to the bleeding time test. AIM: On behalf of the Platelet Physiology Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis (ISTH-SSC), a working Group was formed to review and make recommendations on the use of the PFA-100 CT in the evaluation of platelet function within the clinical laboratory. METHODS: The Medline database was searched to review the published information on the PFA-100 CT in the evaluation of platelet disorders and platelet function. This information, and expert opinion, was used to prepare a report and generate consensus recommendations. RESULTS: Although the PFA-100 CT is abnormal in some forms of platelet disorders, the test does not have sufficient sensitivity or specificity to be used as a screening tool for platelet disorders. A role of the PFA-100 CT in therapeutic monitoring of platelet function remains to be established. CONCLUSIONS: The PFA-100 closure time should be considered optional in the evaluation of platelet disorders and function, and its use in therapeutic monitoring of platelet function is currently best restricted to research studies and prospective clinical trials.     

Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients

Summary. A variety of definitions of major bleeding have been used in published clinical studies, and this diversity adds to the difficulty in comparing data between trials and in performing meta-analyses. In the first step towards unified definitions of bleeding complications, the definition of major bleeding in non-surgical patients was discussed at the Control of Anticoagulation Subcommittee of the International Society on Thrombosis and Haemostasis. Arising from that discussion, a definition was developed that should be applicable to studies with all agents that interfere with hemostasis, including anticoagulants, platelet function inhibitors and fibrinolytic drugs. The definition and the text that follows have been reviewed and approved by the cochairs of the subcommittee and the revised version is published here. The intention is to also seek approval of this definition from the regulatory authorities.     

脑内注射脂多糖后常驻小胶质细胞死亡而中性粒细胞和单核细胞浸润成为主要炎症细胞

为了研究小胶质细胞和血中炎症细胞对脑炎症的影响,在正常和白细胞减少大鼠的黑质致密部(SNpc)、皮层和海马注射脂多糖(LPS),用特异标记来研究中性粒细胞、小胶质细胞和单核细胞的行为学。CD11b+和Iba-1+阳性细胞在正常脑和LPS注射后6h反应相似。注射后12hIba-1+细胞消失而CD11b+变成圆形。CD11b/Iba-1双阳性网状小胶质细胞在LPS注射后6h死亡。注射后12h检测到的CD11b+细胞是MPO+细胞。这些CD11b+/MPO+细胞在白细胞减少的大鼠脑内不出现,提示中性粒细胞浸润。MPO+中性粒细胞表达一氧化氮合酶(iNOS)、IL-1β、环氧合酶-2(COX-2)和单核细胞趋化蛋白-1(MCP-1),但在注射后18h死亡。在24h检测到的CD11b+细胞是浸润的单核细胞,因为这些细胞曾经是Iba-1+而且在白细胞减少的大鼠脑内不出现。而且,在LPS注射的脑内可以检测到移植的单核细胞。这些结果提示,在发生炎症的脑内,至少有一部分中性粒细胞和单核细胞被认为是活化的小胶质细胞。