《伤寒论》法方禁例与医源性变证的防范

《伤寒论》是一部以六经辨证体系为基础,运用四诊八钢,对疾病各阶段的辨证论治进行全面阐述的集古代医学大成之作。对《伤寒论》中立法用方有关禁忌的条文进行整理,如方药禁例中的桂枝汤禁例、栀子汤禁例、小柴胡汤禁例,治法禁例中的下法禁例、汗法禁例,从其避免医源性变证方面进行分析探索,以期对现代中医临证遣方用药起到警示作用。     

中西医结合抢救大剂量氨氯地平中毒1例

参附注射液具有益气固脱、回阳救逆功效,被列为全国中医院急诊必备急救药物,是常用于治疗各种休克等急危重症的有效药物。我科应用该药配合升压药物抢救大剂量氨氯地平中毒1例获得成功,现报道如下。1临床资料患者女性,76岁。因“嗜睡10小时”于2005年9月12日19时急诊入院。入院前10小时,患者自服苯磺酸氨氯地平片(络活喜)56片(280mg)后出现嗜睡。可以被唤醒并进食,无呕吐、抽搐及大小便失禁。入院前10min家人发现患者床旁有络活喜片空盒8个遂送入院。入院前10小时未排尿。既往有高血压病、脑梗死史。近2周每日口服氨氯地平片5mg,血压稳定。…     

自汗临证辨治浅析

“汗”为五液之一，为体内津液代谢的产物，在调节体内阴阳平衡及维持正常的生理功能方面，起着重要的作用。自汗是由于机体内部阴阳盛衰的变化，及邪气的影响所致日间汗出不止，活动后更甚的病理性汗证，在其治疗上应紧扣汗出的机理，辨证施治。     

低钾血症348例临床分析

低钾血症在急诊内科临床工作中十分常见，病因及临床表现复杂，既是一些疾病的并发症，又是一些疾病的诱因。现将我院急诊内科一年来诊断的低钾血症总结如下。     

“胃疼”不一定是“胃病”

或许我们自己或者家人都有过这样的经历:捂着肚子,痛苦地跑到医院急诊室,跟医生讲:我"胃疼",医生,给打个止痛针吧?而大多数情况下,医生会拒绝你的这个要求,医生会建议你先弄清楚是哪里痛,因为你的"胃疼"不一定是"胃病"。"胃疼"不一定是胃病"胃疼"是指在上腹部"胃"所在的区域出现疼痛。每每碰到胃疼,很多人理所当然地会认为是胃出了毛病,比如吃坏东西啦,喝冰的饮料过快啦,吃多啦之类的。但我们知道,人体是个复杂的系统,各脏器紧密相联相依,功能上往往互有影响,周围或者全身的状况都有可能反应在某个特定的器官之上。中医的"天人     

中医药治疗缺血性中风的进展

缺血性中风,发病迅速,症状严重,且常常留有后遗症,严重威胁人民的健康和生活质量。综述近5年来中医药对此病的报道,发现中医药对本病的治疗和预后有着广阔的前景和研究价值,同时对它的急性期抢救有效率也亟待提高。     

中西医结合治疗术后肠梗阻2例

笔者用中西医结合疗法治疗2例术后肠梗阻患者并获成功,报道如下。1病历简介病例1患者,男,38岁,就诊时间2009年3月29日。患者入院10天前上午9时服用止痛药后出现上腹部剧烈疼痛,伴发热、恶心、拒食。     

老年高血压病患者脉压指数与胰岛素样生长因子-1相关性研究

目的探讨老年高血压病患者脉压指数(PPI)与胰岛素样生长因子1(IGF-1)和转化生长因子-β1(TGF-β1)的关系。方法老年高血压病患者160例。同步检测血中IGF-1、TGF-β1;用超声心动图仪测定并计算左室重量指数(LVMI),计算出PPI并按照PPI高低分成正常PPI组和高PPI组。比较两组间IGF-1、TGF-β1的差异并用直线相关和多元线性回归分析PPI与其他指标的相关性。结果高PPI组血中IGF-1水平较正常PPI组高(P<0.05);PPI与血中IGF-1水平正相关(P<0.05),但非独立相关。结论老年高血压病患者PPI与血中IGF-1水平的关系受多种因素影响。     

黄芪多糖诱导脐血单核细胞向树突状细胞分化中的作用

目的 观察NF-κB在黄芪多糖(APS)诱导脐血单核细胞向树突状细胞(DCs)分化过程的作用,探讨APS诱生DCs过程中的信号传导通路.方法 无菌条件下采集脐血,密度梯度离心法获得脐血单核细胞分为3组.对照组:在无药物的RPMI 1640完全培养液中培养;APS组:在含有黄芪多糖100mg/L的RPMI 1640完全培养液中培养;PDTC组:用NF-κB的抑制剂吡咯烷二硫氨基甲酸酯(PDTC)10μmol/L处理脐血单核细胞30 min后,加入含有黄芪多糖100 mg/L的RPMI 1640完全培养液中培养.培养过程中用倒置光学显微镜和透射电镜观察细胞形态变化;收集培养第12天的细胞,FCM检测细胞免疫表型;免疫荧光显微镜下观察细胞内NF-κB的激活、迁移情况.结果 (1)对照组细胞无成簇生长,培养至第12天细胞呈梭形巨噬细胞形态;黄芪多糖组细胞成簇生长,形态学由圆形逐渐变为典型的树突状细胞形态;抑制剂组细胞生长缓慢,未出现聚集现象,细胞形态学未见明显变化.(2)APS组高表达DCs特异性抗原CD80、CD83和CD86,与对照组、PDTC组比较差异有统计学意义(P<0.01),对照组与PDTC组表达相似,二者差异无统计学意义(P>0.05).(3)免疫荧光显微镜下观察NF-κB可见APS组伴有大量NF-κB荧光进入细胞核,尤以72 h显著,NF-κB激活率为(75.20±7.37)%,而对照组、PDTC组NF-κB激活率分别为(13.20±3.46)%、(8.20±1.92)%,与APS组相比,差异有统计学意义(P<0.01).结论 黄芪多糖能够诱导脐血单核细胞定向分化为DCs,NF-κB是黄芪多糖诱导脐血单核细胞向DCs分化的信号传导通路中的关键元件.

Abstract：

Objective To investigatethe role of NF-κB played in the process of the cord blood monocytes differentiating into dendritic cells(DCs)induced by astragalus polysaccharide(APS)and to explore the signal transduction pathway involved in this process.Methods Umbilica]cord blood was collected in aseptic conditions.The cord blood monocytes were obtained by density gradient centrifugation and were divided into three groups afterwards.In the control group.cells were cultivated in the RPMI 1640 complete medium.In the APS group.cells were cultivated in the RPMI 1640 complete medium containing 100 mg/L APS.In the PDTC group:cells were treated with 10 μmol/L disulfide carbamate(PDTC).NF-κB inhibitor in 30 min followed by cultivalion in the RPMI 1640 complete medium containing 100 mg/L APS.,The morphological changes were observed during the process of cultivation by the optical microscope and transmission electron microscopy.Cells were collected 12 d later and the cellular immunophenotyping was assayed by FCM.,The activation and migration of NF-κB fluorescence in the cells was examined by the immunoflouresce microscopy.Results (1)Cells in the control group grown up without cluster forformation and were found fusiform and macrophage-like in 12 d.Cells in the APS group grown up in clnstem,and morphological changes were found from the circular shape to a typical dendritic cells-like shape.Cells in the inhibitor group grown up slowly and without cluster formation,and cell morphdogy had no significant change.(2)The expression of DCs-specific antigen CD80,CD83 and CD86 in the APS group was higher than that in the control group and inhibitom group(P<0.01).The expression of those antigen in the control group and PDTC group was similar and had no statistically significance(P>0.05).(3)NF-κB fluorescence in the nuclei was examined by the immunoflourescence microscopy and was much higher in the APS group than that in khe other groups,especially in 72 h with the activation rate of NF-κB (75.20±7.37)%,while(13.20±3.46)% of PDTC group and(8.20 ±1.92)%,respectively(P<0.01).Conclusion Astragalus polysaccharide can induce the differentiation of umbilical cord blood cells into DCs,and NF-κB is the key component of the signal transduction pathway involved in this process.     

心肺复苏123例分析

2004年1月-2006年12月我院急诊科共进行心肺复苏123例,现分析如下。 1临床资料 1.1一般资料123例均为呼吸心跳骤停患者,男67例,女56例,年龄2个月-92岁,平均70岁。原发病：外伤17例,窒息10例,冠心病（无心梗证据）10例,急性心肌梗死8例,慢性阻塞性肺病5例,脑血管意外5例,其它24例,不明44例。诱因：活动后11例,进食8例,排尿3例,其它8例,无诱因93例。