基于病因病机分析各省市新型冠状病毒肺炎的中医药防治

新型冠状病毒肺炎属于中医学“疫病”范畴。疫情爆发以来,全国各省市卫生行政管理部门坚持中西医结合原则,陆续制定了各省市的中医药防治方案,三因制宜,分期分型辨证并不断完善。笔者全面收集并整理相关信息,基于病因病机分析了各省市中医药防治方案,认为此次疫病是外感疫气,病位主要在肺卫,病邪主要表现为“毒、湿、热、虚、寒”。此“毒”即为疫气,武汉遇暖冬,非其时而有其气而发疫,一气一病,播散流行,治疫必先治毒;“湿”邪之地在南北方各占一半,东西部均有,在南方源于季节和地域,在北方可由寒挟杂,治疗均应祛湿;“热”主要见于南方,为南方常见的病邪,亦可因湿毒入里,湿郁化热,而在北方热与湿同现,主要是因湿毒入里,湿郁化热,治热均以清为主;“虚”则主要在北方,北方冬季多寒,易伤正致虚,或邪正交争激烈,伤阳伤阴致虚,宜祛邪为标,扶正为本;“寒”见于北方和南方山区,寒气过甚,易伤阳伤正,故尤其要注重预防,且以补正气为主。中医防疫治疫应三因制宜,重视预防,与时俱进。     

Stage line diagram: An age‐conditional reference diagram for tracking development

This paper presents a method for calculating stage line diagrams, a novel type of reference diagram useful for tracking developmental processes over time. Potential fields of applications include: dentistry (tooth eruption), oncology (tumor grading, cancer staging), virology (HIV infection and disease staging), psychology (stages of cognitive development), human development (pubertal stages) and chronic diseases (stages of dementia). Transition probabilities between successive stages are modeled as smoothly varying functions of age. Age‐conditional references are calculated from the modeled probabilities by the mid‐P value. It is possible to eliminate the influence of age by calculating standard deviation scores (SDS). The method is applied to the empirical data to produce reference charts on secondary sexual maturation. The mean of the empirical SDS in the reference population is close to zero, whereas the variance depends on age. The stage line diagram provides quick insight into both status (in SDS) and tempo (in SDS/year) of development of an individual child. Other measures (e.g. height SDS, body mass index SDS) from the same child can be added to the chart. Diagrams for sexual maturation are available as a web application at http://vps.stefvanbuuren.nl/puberty . The stage line diagram expresses status and tempo of discrete changes on a continuous scale. Wider application of these measures scores opens up new analytic possibilities. Copyright © 2009 John Wiley & Sons, Ltd.     

Stage-related increase in the proportion of apoptotic germ cells and altered frequencies of stages in the spermatogenic cycle following gestational, lactational, and direct exposure of male rats to p-nonylphenol.

The cumulative effects of environmental toxicants, for example, the alkylphenol, para-nonylphenol (p-NP) are of concern. Our previous study showed that p-NP reduced several testicular morphometric parameters, including sperm counts. The present study reexamined material collected in that study to determine the mechanistic basis of p-NP action on spermatogenic development in the offspring. Seven-day pregnant Sprague-Dawley rats were treated with vehicle or 100 or 250 mg/kg p-NP through gestation, lactation and afterward directly to all male offspring until 10 weeks of age. Both doses of p-NP significantly (P < 0.02) increased the number of germ cells with in situ end-labeled fragmented DNA (TUNEL positive) by 1.9-fold and 1.7-fold, respectively, and specifically in stages XII-XIV and I-III. TUNEL-labeling was, however, selective, and excluded labeling of basal cells with apoptotic morphology. Cleaved caspase-3 immunohistochemistry strongly labeled basal cells (spermatogonia and early spermatocytes) with condensed marginated chromatin but not degenerate germ cells lacking definitive nuclear material found throughout the epithelium. Only the caspase index (ratio of number of caspase positive to number of degenerate cells) of the 100-mg/kg p-NP group was significantly (p < 0.05) threefold greater than controls. Whereas both doses and either 250 or 100 mg/kg treatment alone significantly (p < 0.002) reduced the frequencies (duration) of stages I-III, VII-VIII, and late VIII-IX (spermiating and recently spermiated tubules), respectively, both doses significantly (p < 0.002) increased the frequencies of stages IV-VI and all stages containing late-stage spermatocytes (XII-XIII) and meiotic cell divisions (XIV). Thus, p-NP, an environmentally persistent xenoestrogen, insidiously alters the spermatogenic cycle and spermatogenic process in male offspring.     

产程中应用杜冷丁对产程及新生儿的影响

目的　观察杜冷丁对产程及新生儿的影响。方法　将 16 0例初产妇随机分为观察组和对照组 ,各 80例 ,观察组在宫口开大 1.2cm时杜冷丁 10 0mg肌肉注射 ,对照组未用药。结果　第一产程用药组与对照组相比明显缩短 ,有显著差异 (P <0 .0 5 ) ,第二、三产程无差异 (P >0 .0 5 ) ,对新生儿影响、产后 2小时内出血量及新生儿体重两组无差异 (P >0 .0 5 )。结论　产程中应用杜冷丁可减轻产妇疼痛 ,缩短第一产程 ,不增加新生儿窒息 ,值得推广应用     

腹腔镜胆囊切除术开展初期质量控制的临床研究

目的探讨如何控制腹腔镜胆囊切除术（LC）开展初期的并发症及中转率。方法制定八条质量控制措施，总结分析568例LC临床资料。结果并发症6例，仅占1．2％，中转手术8例，中转率仅1．6％。结论在开展LC初期只要加强质量控制，完全可以避开高并发症、高中转率这种所谓的自然规律。     

Diversity in Clinical Psychology

Clinical psychology is not as diverse as society, and the generalizability of clinical psychology to diverse groups has largely been untested. Some progress has been made in increasing the number of ethnic minorities receiving PhD degrees in clinical psychology and in increasing ethnic minority representation in clinical trials. Nevertheless, clinical psychologists and clinical psychology research are not diverse. A stages of change model may be useful in motivating clinical psychologists to diversify. A future scenario involving inertia and a second involving change are offered.     

Renewal of the membrane complex of Schistosoma mansoni is closely associated with lipid metabolism

Metabolic pathways leading to lipid biosynthesis in four different developmental stages of Schistosoma mansoni were explored and quantified by incubation in the presence of labeled precursors in a chemically defined medium. At the schistosomulum stage and in male, female, or paired worms, glycerol and oleate incorporation into neutral lipids, mainly in the form of triacylglycerols, was greater than into phospholipids, whereas in 11-and 15-day-old worms, synthesis mainly led to phospholipids. Incorporation into phospholipids was recovered largely in phosphatidylcholine, and distribution into other phospholipids depended on the developmental stage. Incorporation of choline and ethanolamine into their respective phospholipids represented up to 15% of the parasitic phospholipid content. The formation of phosphatidylcholine by phosphatidylethanolamine methylation occurred mainly in the immature parasitic stages. Inositol incorporation was also measurable, whereas [14C]serine incorporation was low or undetectable. Addition of 1-palmitoyl-2-[14C]oleyl phosphatidylcholine revealed a very high uptake of this phospholipid by the immature stages but further metabolism was not detectable. In contrast, adult S. mansoni were completely unable to take up or absorb this exogenous phospholipid. The most striking aspect of this study was the relatively high metabolic activity in 11-day-old worms and the lower but sustained activity on day 15 and at the schistosomulum stage. By comparison, biosynthetic activity in adult S. mansoni, on which research studies have been focused until now, was very low. We also discuss the participation of lipid metabolism in the constant renewal of the membrane complex which is essential to parasitism by S. mansoni.     

Sleep and memory consolidation: The role of electrophysiological neuroimaging

Summary Memory consolidation involves a complex series of molecular, cellular and network-level processes that take place on time scales from millisecond to months. Evidence from a wide range of experimental observations supports the hypothesis that parts of these processes occur during sleep when the brain is not engaged in processing and encoding incoming information. Indeed, sleep seems to be favorable for brain plasticity. Experience-dependent cortical plasticity observed during sleep has been hypothesized to be part of the global process of memory consolidation. Thus, studying task-dependent, regionally specific reactivation of neuronal assemblies during posttraining sleep may make important contributions to elucidating the role of sleep in memory trace processing. A new methodology – low-resolution brain electromagnetic tomography (LORETA) – offers the possibility of localizing electrical activity produced by cortical neuronal generators under normal (undisturbed) sleeping conditions. The high time resolution of brain electrical data can be exploited to produce neuroimages for specific EEG spectral frequency bands (e.g. delta, theta, or spindle bands). This makes it possible to investigate, dependent on the type of memory, when – in which sleep stages (S2 sleep, SWS, REM sleep) – and where – in which cortical brain regions (primary sensory cortex, higher association cortex) – experience-dependent reactivation occurs.     

TNF inhibits malaria hepatic stages in vitro via synthesis of IL-6

We examined the capacity of murine recombinant tumor necrosis factor (rmTNF) to induce an inhibitory effect at the hepatic stage on malaria induced by Plasmodium yoelii sporozoites. When injected three times, 1.0 micrograms of rmTNF was found to protect 78% of mice against a sporozoite challenge. In contrast, whatever the dose and the schedule of administration, no inhibition was observed when purified hepatocyte cultures were infected with P. yoelii. The addition of non-parenchymal hepatic cells to hepatocyte cultures restored the capacity of TNF to modulate hepatic stage development, leading to up to 44% inhibition. Antibodies to interleukin 6 reversed the anti-parasite activity in the co-culture system.