miRNA在阿尔茨海默病发病机制中作用的研究进展

阿尔茨海默病(AD)是一种发病率较高的神经退行性疾病,可严重影响患者及家属的生活质量。miRNA可通过调控AD中淀粉样蛋白前体(APP)、β-分泌酶1(BACE1)、tau等生物标志物的表达和神经炎症相关的胶质细胞的激活影响AD的发病机制。本文综述近年来miRNA在AD发病机制中作用的研究,为进一步探索miRNA对AD诊断及治疗的策略提供依据和思路。     

马耳他针灸发展现状

总结针灸在马耳他发展的现状及立法情况,为"一带一路"政策下,中医针灸在较高层面上进行规范化的推广,并进入良性发展的轨道提供政策参考。以作者在马耳他大学中医中心工作经历为背景,以实地调研为主要工作方法,结合检索Pub Med、荷兰医学文摘数据库(Embase)、中国期刊全文数据库(CNKI)、维普(VIP)和万方数据库,搜集与马耳他针灸发展相关的文献资料进行综述。结果表明:针灸在马耳他应用已30余年,江苏省和上海市中医机构分别与当地政府、大学合作开展了针灸医疗与教学合作。马耳他在国家医疗保健法中包含有替代医学法章节,其中有针灸医师管理条例。中国与马耳他合作建成的两所医疗中心,为中医针灸在马耳他的发展打下了坚实的基础,有望在中医临床、教学、科研等方面开展更高层次的合作与交流。     

针灸及其血清对荷瘤小鼠CD4~+CD25~+Treg细胞体外增殖的影响

目的:观察针灸治疗对H_(22)荷瘤小鼠CD4~+CD25~+Treg细胞(CD4~+CD25~+regulatory T cells)体外增殖的影响和针灸血清刺激下的CD4~+CD25~+Treg细胞的体外增殖变化,探讨针灸及其血清对荷瘤小鼠免疫调节细胞的干预作用。方法:48只小鼠随机分为电针治疗组、艾灸治疗组、肿瘤对照组、正常对照组。采用H_(22)肿瘤细胞移植性实体瘤模型,电针和艾灸"大椎"治疗后,磁珠分离CD4~+CD25~+Treg细胞,氚标记胸腺嘧啶核苷掺入法观察不同组小鼠CD4~+CD25~+Treg细胞体外增殖能力和针灸血清对CD4~+CD25~+ Treg细胞体外增殖的影响。结果:肿瘤对照组CD4~+CD25~+Treg细胞增殖水平比正常对照组明显增高(P<0.05);电针治疗组和艾灸治疗组CD4~+CD25~+Treg细胞增殖水平与肿瘤对照组比较均明显降低(P<0.01)。电针治疗组和艾灸治疗组1:1、1:8稀释度血清刺激正常小鼠CD4~+CD25~+Treg细胞体外增殖,较正常对照、肿瘤对照组血清显著增高(P<0.05),各组1:16、1:32稀释度血清对Treg细胞作用的差别无统计学意义(P>0.05)。结论:针灸治疗能下调荷瘤小鼠CD4~+CD25~+Treg细胞体外增殖能力。不同浓度针灸血清体外刺激CD4~+CD25~+Treg细胞增殖表现出不一致的效应。     

"乳癌术后方"对乳腺癌患者生活质量影响的临床研究

为评价“乳癌术后方”对 35 8例乳腺癌患者生活质量的影响。采用欧洲癌症治疗研究组织生活质量核心量表E ORTCQLQ -C30 ,对 35 8例乳腺癌患者运用“乳癌术后方”治疗前后分别进行问卷调查 ,并设对照组 96例。结果“乳癌术后方”治疗 6个月 ,临床症状明显改善 ,与对照组比较 ,P <0 0 5 ;患者生理功能、情感功能、认识功能等都有不同程度的提高 ;生活质量总评价各项治疗前后有明显改变 ,与对照组比较 ,P <0 0 5。提示该方能明显提高乳腺癌患者的生活质量 ,有很好的临床应用价值。     

风市穴“垂手可得”的祛风湿穴

阅兵典礼时,挺拔的军姿是一道十分亮丽的风景线;新生入学军训时,站军姿是对意志品质的磨炼。当骄阳下,笔挺站立、双手紧贴裤缝时,一个小小的穴位正藏在中指指尖尽头处的凹陷中,这个穴位便是本期介绍的——风市穴。容易定位的风市穴风市穴出自晋代葛洪所著《肘后备急方》,书曰:“治风毒脚弱痹满上气方……次乃灸风市百壮。”归属于足少阳胆经的风市穴,因其定位别名“垂手”:取风市穴时,直立垂手、掌心贴于大腿时,中指指尖所指凹陷即为本穴。     

阿尔茨海默病中医证候诊断标准研究进展

综述近年来阿尔茨海默病(AD)中医证候分布规律研究进展,并对AD中医证候诊断标准的规范化研究进行回顾和展望。AD临床多表现为本虚标实、虚实夹杂的复杂证候。虚证可见肾虚、心虚,实证可见痰浊、血瘀等。以标准规范的证候要素为基础,具有中医特色的AD诊断标准及证候量表已使用于临床。AD的生物学研究可为中医证候微观辨证提供科学依据,同时有助于将宏观辨证和微观辨证有机结合,进而制定出与AD整个病理发展过程相适应的证候诊断标准。     

《针灸学》见习教学改革的临床实践

非针灸专业本科《针灸学》课程存在课时少、内容多、学生操作时间短等不足,而医师执业技能考试中大大增加了针灸内容的比例.为提高学生临床技能,采用调整见习时间、小班化教学、开展多元化见习考核等方法进行见习教学改革.问卷调查与学生实习表现均显示见习教学改革取得了较好的结果.     

Acupuncture for migraine:A systematic review and meta-analysis

Objective: The goal of this study is to systematically assess the effectiveness of acupuncture compared with medication for migraine.Methods: The Cochrane Library, PubMed, MEDLINE, Embase, China National Knowledge Infrastructure(CNKI), Sinomed, the Chongqing VIP full-text periodical database(VIP) and Wanfang were searched by computer to identify the randomized controlled trails comparing acupuncture with medication for migraine from the beginning of these databases to August 2018, supplementing with literature retrospective and manual searches. Review Manager 5.2 was used for statistical analysis.Results: A total of 13 trails including 1218 participants met the selection criteria.(1) The meta-analysis of 3 articles showed that acupuncture was more effective in reducing the frequency of migraine attacks(MD =-2.03; 95% CI:-2.77 to-1.30; P 0.00001) than medication.(2) The meta-analysis of three articles showed that acupuncture was more effective in reducing the number of migraine days(MD =-1.65;95% CI:-2.78 to-0.52; P= 0.004) than medication after treatment.(3) The meta-analysis of six articles showed that acupuncture was more effective in reducing VAS(MD =-1.26; 95% CI:-1.48 to-1.04;P 0.00001) after treatment.(4) The meta-analysis of two articles showed that acupuncture was more effective in reducing VAS(MD =-1.07; 95% Cl:-1.63 to-0.51; P= 0.0002) during follow-up.(5) The meta-analysis of seven articles showed that the total effective rate of acupuncture was higher than that of medication(MD=1.27; 95% Cl: 1.16 to 1.37; P 0.00001). In addition, fewer adverse effects in acupuncture groups were reported than in medication groups. Overall the quality of the evidence was low.Conclusion: The results of this meta-analysis showed that acupuncture is more effective and safer than medication for migraine. Acupuncture can be considered a treatment option for patients willing to undergo this treatment. But more high-quality studies, based on standardized, comprehensive and objective evaluation, are required to enhance the reliability of the conclusion.