玉屏风颗粒结合咳喘方穴位敷贴治疗小儿哮喘缓解期临床研究

目的观察玉屏风颗粒结合中药咳喘方穴位敷贴治疗小儿哮喘缓解期的临床疗效。方法选取湖北省荆州市中医院儿科门诊支气管哮喘缓解期患儿110例,随机分为对照组55例和观察组55例。对照组给予辅舒酮吸入治疗,观察组给予玉屏风颗粒结合中药咳喘方穴位敷贴治疗,治疗3个月评估临床疗效、呼出一氮化氮(FeNO)分值的变化及药物不良反应,比较两组患者治疗前后1年中的哮喘发作次数、急诊次数和住院次数。结果治疗后,观察组总有效率为96.36%,显著优于对照组的83.64%(P0.05);FeNO分值较对照组显著下降(P0.01);1年内患儿哮喘发作次数、急诊次数、住院次数均明显低于对照组(P均0.01)。结论玉屏风颗粒结合中药咳喘方穴位敷贴治疗小儿哮喘缓解期能有效控制气道炎症,减少疾病的复发,临床疗效显著。     

保儿宁联合布地奈德同步治疗小儿变应性鼻炎合并哮喘的疗效分析

目的探讨保儿宁联合布地奈德同步治疗小儿变应性鼻炎合并哮喘的临床疗效。方法选取变应性鼻炎合并哮喘患儿86例,随机分为观察组和对照组,各43例,对照组患儿给予布地奈德气雾剂经鼻吸入,观察组在对照组基础上给予保儿宁颗粒。观察两组患儿治疗前后鼻炎及哮喘症状并进行严重程度评分。结果治疗前两组患儿鼻炎及哮喘症状评分差异无统计学意义(P>0.05),治疗后观察组患儿鼻炎及哮喘症状评分均明显低于对照组(P<0.05)。结论保儿宁颗粒联合布地奈德同步治疗小儿变应性鼻炎合并哮喘具有良好的疗效,不良反应较少,值得临床推广应用。     

氯雷他定对儿童支气管哮喘并变应性鼻炎的防治作用及其机制的研究

目的探讨小剂量吸入激素的基础上联合应用氯雷他定对儿童支气管哮喘并变应性鼻炎的防治作用及其机制。方法将62例支气管哮喘并变应性鼻炎患儿分为氯雷他定组(32例)和对照组(30例),在丙酸氟替卡松气雾剂治疗基础上分别加用氯雷他定和安慰剂治疗3个月。记录患儿的哮喘症状评分、变应性鼻炎发作时间、感冒样症状发作次数、喘鸣发作次数、β2-受体激动剂的用量,并测定血清可溶性细胞间黏附分子(sICAM-1)浓度。结果两组患儿治疗后的哮喘症状、变应性鼻炎发作时间、哮喘发作次数、感冒样症状发作次数、β2-受体激动剂用量间差异均有统计学意义(P<0.05);治疗前两组患儿的血清sICAM-1浓度间差异无统计学意义(P>0.05),而治疗后血清sICAM I-1浓度间差异有统计学意义(P<0.05)。结论在小剂量吸入激素的基础上联合应用氯雷他定能显著改善支气管哮喘并变应性鼻炎患儿的症状,降低血清sICAM-1浓度可能是其机制之一。     

丙酸氟替卡松鼻喷雾剂(辅舒良)联合丹溪玉屏风颗粒治疗儿童变态反应性鼻炎的疗效观察

目的探讨丙酸氟替卡松鼻喷雾剂(辅舒良)联合丹溪玉屏风颗粒治疗儿童变态反应性鼻炎的疗效。方法将符合儿童变态反应性鼻炎的98名患儿随机分成二组各49例。对照组单用丙酸氟替卡松鼻喷雾剂(辅舒良),治疗组在单用丙酸氟替卡松鼻喷雾剂(辅舒良)的基础上联合丹溪玉屏风颗粒治疗。结果治疗组有效率为95.9%,对照组有效率为83.7%,治疗组优于对照组(P0.05)。结论丙酸氟替卡松鼻喷雾剂(辅舒良)联合丹溪玉屏风颗粒治疗儿童变态反应性鼻炎效果更好。     

H1阻滞剂联用小剂量氨茶碱对过敏性鼻炎合并哮喘的防治作用

目的　观察在小剂量氨茶碱联合H1 阻滞剂对过敏性鼻炎合并变应性哮喘的防治作用。方法　将 3 5例过敏性鼻炎合并轻中度变应性哮喘患者分为酮替芬与氨茶碱治疗组 ( 18例 )和对照组安慰剂 ( 17例 ) ,进行 3个月的治疗 ,比较两组 7项观察指标。结果　观察组治疗前后每周哮喘状态计分、鼻炎发作时间 (天 )、每月伤风次数、按需吸入 β2 受体激动剂 (喷 )、最大呼吸流量(PEF)、日内平均变异率 ( % )、血清嗜酸性粒细胞 ( % ) 6项指标与对照组比较均有非常显著性差异 (均P <0 .0 1) ,但血清IgE含量两组无显著性差异 (P >0 .0 5 )。结论　在小剂量氨茶碱的基础上联合应用H1阻滞剂可显著提高对过敏性鼻炎合并变应性哮喘的防治效果。     

舒利迭治疗儿童哮喘的临床疗效观察

目的观察舒利迭治疗儿童哮喘的临床疗效。方法76例中度哮喘患儿随机分为观察组和对照组,分别应用舒利迭和辅舒酮吸入治疗1年,观察两组患儿哮喘急性发作次数及治疗前后肺功能(FEV1预计值%)的变化。结果舒利迭组哮喘急性发作次数明显少于辅舒酮组;两组均可提高FEV1预计值%,改善肺功能,但舒利迭组明显优于辅舒酮组。结论舒利迭治疗儿童哮喘的临床疗效较好。     

培元生金方联合天灸治疗儿童哮喘并变应性鼻炎效果观察

【目的】观察培元生金方联合天灸治疗儿童哮喘并变应性鼻炎的效果。【方法】将92例缓解期儿童哮喘并变应性鼻炎患儿随机分为治疗组和对照组各46例。2组病例均给予面罩式储物罐吸入丙酸氟替卡松气雾剂,在此基础上,治疗组加用中药培元生金方口服,并予天灸疗法治疗,对照组只加用天灸疗法治疗。观察2组中医证候、鼻炎症状体征评分及哮喘发作次数。【结果】治疗组的中医证候疗效、变应性鼻炎临床疗效优于对照组,哮喘发作次数少于对照组,2组比较差异均有统计学意义(P0.05)。【结论】培元生金方联合天灸治疗缓解期儿童哮喘并变应性鼻炎的效果良好,可明显改善患儿的中医证候,缓解变应性鼻炎的症状、体征,减少哮喘急性发作次数。     

糖皮质激素联合辅舒良及顺尔宁治疗哮喘合并中重度过敏性鼻炎

目的：对比吸入型糖皮质激素联合辅舒良及顺尔宁与吸入型糖皮质激素联合辅舒良治疗哮喘合并中重度持续性过敏性鼻炎的临床疗效。方法：将2011年1月至2013年1月广州医科大学第一附属医院收治的55例哮喘合并中重度持续性过敏性鼻炎患者作为研究对象,对照组使用吸入型糖皮质激素联合辅舒良治疗(20例),治疗组使用吸入型糖皮质激素联合辅舒良及顺尔宁联合治疗(35例)。治疗前及治疗后3个月,检测患者肺功能并进行病情症状及体征记分,并比较临床疗效。结果：观察组和对照组治疗后3个月肺功能指标第1秒用力呼气量占预计值百分比( FEV1％)、最大呼气中期流速占预计值百分比( MMEF％)与治疗前比较,差异均有统计学意义( P<0.05)。观察组治疗后MMEF％与对照组比较,差异有统计学意义( P<0.05)。治疗后3个月,患者过敏性鼻炎的喷嚏、流涕次数、鼻堵、鼻痒等症状均明显好转,其中观察组总有效率高于对照组( P<0.05)。结论：吸入型糖皮质激素联合辅舒良及顺尔宁能更有效控制患者支气管哮喘及中重度持续性过敏性鼻炎的临床症状,并显著提高肺功能。     

孟鲁司特钠联合玉屏风颗粒治疗48例轻度持续性变应性鼻炎的疗效

目的：探讨孟鲁司特钠联合玉屏风颗粒治疗轻度持续性变应性鼻炎的疗效。方法：将78例轻度持续性变应性鼻炎的患者随机分为2组。治疗组48例应用孟鲁司特钠联合玉屏风颗粒治疗3个月,对照组30组例单用孟鲁司特钠治疗3个月,进行症状及体征记分比较,评价治疗轻度持续性变应性鼻炎的临床疗效。结果：治疗组的临床总有效率达87.5％,优于对照组66.7％,两组比较,差异有统计学意义（P〈0.05）。治疗过程均未发生不良反应。结论：孟鲁司特钠联合口服玉屏风颗粒对轻度持续性变应性鼻炎临床疗效好、未见不良反应。     

酮替芬联合舒利迭治疗哮喘合并变应性鼻炎的疗效观察

目的观察酮替芬联合舒利迭治疗支气管哮喘合并变应性鼻炎的临床疗效。方法 62例支气管哮喘合并变应性鼻炎随机分为两组,观察组32例口服酮替芬1mg,每天2次,对照组30例口服孟鲁司特钠10mg每天1次,两组同时吸入舒利迭50/250μg,每天2次,治疗时间12周。结果两组治疗后与治疗前的哮喘控制测试评分(ACT)和FEV1和PEF、变应性鼻炎的症状评分比较差异有统计学意义(P<0.01),观察组与对照组的ACT比较差异有统计学意义(P<0.05),变应性鼻炎的症状评分,观察组与对照组比较差异有统计学意义(P<0.05)。结论酮替芬联合舒利迭治疗哮喘合并变应性鼻炎时在改善FEV1和PEF方面不差于孟鲁司特钠联合舒利迭,在提高ACT和改善变应性鼻炎的症状评分方面好于孟鲁司特钠联合舒利迭。     

益智健脑颗粒联合针灸对阿尔茨海默病大鼠学习记忆的影响

目的观察益智健脑颗粒联合针灸对阿尔茨海默病（Alzheimers disease,AD）大鼠学习记忆的影响。方法将大鼠随机分为假手术组（A组）、模型组（B组）、针灸组（C组）、益智＋针灸组（D组）各10只,B、C、D 3组分别以海马CA1区注射β淀粉样蛋白25-35（Aβ25-35）造模,A组注射等量的双蒸水,各组分别治疗20 d后行Morris水迷宫试验,观察大鼠学习记忆能力变化。结果B组较A组的平均潜伏期明显延长,差异具有统计学意义（P〈0.05）;与B组比较,C组、D组的平均潜伏期明显缩短,过台次数增多,差异具有统计学意义（P〈0.05,P〈0.01）;与C组比较,D组的潜伏期缩短,过台次数增多,差异具有统计学意义（P〈0.05）。结论益智健脑颗粒联合针灸能够提高Aβ25-35介导的AD模型大鼠的学习记忆能力。     

Liuwei Dihuang,a traditional Chinese herbal formula,suppresses chronic inflammation and oxidative stress in obese rats

OBJECTIVE： To investigate the anti-inflammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang （LWDH）, a traditional Chinese herbal formula, in obese rats. METHODS： After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived （OP-CD） rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water （n=12 rats per group）. Twelve obese-resistant-CD （OR-CD） rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacrifice and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters. RESULTS： After 9 weeks of treatment, LWDH lowered serum C-reactive protein （CRP） and tumour necrosis factor-α （TNF-α） levels. Serum interleukin-6 （IL-6） levels showed a tendency towards reduction, but were not significantly different from the OP-CD control. Liver superoxide dismutase （SOD） activity was increased in response to all three doses of LWDH, while the levels of reduced （GSH） and oxidized glutathione （GSSG） and thiobarbituric acid reactive substances （TBARS） were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inflammatory and oxidative stress biomarkers and circulating adiponectin levels. CONCLUSION： The results show, for the first time, the anti-inflammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OP-JOP-CD rat model as     

程丑夫教授论治情志病验案举隅

程丑夫是国家级名老中医,湖南中医药大学第一附属医院主任医师、教授、博士生导师,享受政府特殊津贴专家,出身于中医世家,从医40余年,经验丰富,对于内科系统及疑难杂症的治疗颇有心得,笔者有幸跟师学习,聆听教诲,受益匪浅,现将程师论治情志病的经典验案略陈一二。1思虑伤脾案患者肖某,女,27岁。初诊：2014年5月20日。半年前因婚变后出现忧心忡忡,多思多虑,近1月来反复腹部胀满,刻诊：腹胀,食后为甚,呃逆,无反酸,通气后可减轻,无腹痛,不欲食,夜寐不安,二便调。舌红苔厚白腻,脉弦,BP：110／70mmHg。     

补肾活血方对PCOS大鼠模型卵巢中PAI-1mRNA表达的影响

目的探讨补肾活血方对大鼠PCOS模型卵巢局部纤溶酶原激活物抑制因子-1（PAI—1mRNA）表达的影响。方法选用未成年24d龄SD雌性大鼠60只,随机分为模型组、克罗米酚组、补肾活血方高剂量组、补肾活血方低剂量组、正常对照组5组。用Bogovich法建立大鼠多囊卵巢病理模型。以克罗米酚为对照。用原位杂交法观察补肾活血方对多囊卵巢大鼠局部PAI—1mRNA的影响。结果模型组卵巢局部PAI—1mRNA存在卵泡膜间质细胞显著增高,用补肾活血方高、低剂量与克罗米酚药后,卵巢局部PAI-1mRNA的表达明显降低．差异具有统计学意义（P〈0．05、P〈0．01）。补肾活血方高剂量组与克罗米酚组比较,差异具有显著统计学意义（P〈0．01）;低荆量组与克罗米酚组比较差异无统计学意义（P〉0．05）,补肾活血方高、低剂量组比较,低剂量组卵泡膜间质细胞上PAI-1的基因表达增高更明显,但二者差异无统计学意义（P〉0．05）。结论PAI-1mRNA可能与多囊卵巢综合征的发病机制有关。以补肾活血立法的补肾活血方能降低多囊卵巢大鼠局部PAI—1mRNA的显著增高表达．降低PAI—1mRNA卵巢局部的作用。提示补肾活血方可能通过PAI—1mRNA途径促进卵巢排卵的机制。     

表皮生长因子受体酪氨酸激酶抑制剂在非小细胞肺癌应用的瓶颈——获得性耐药

以表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI）分子靶向治疗研究为肇始,转化性研究使基础实验和临床实践间的鸿沟迅速填平,改变着人们认识治疗肺癌的视角。无可否认,EGFR-TKI上市后极大地延伸了肿瘤学家治疗肺癌的手段,但不管从临床经验、临床研究数据、分子生物学层面还是文献计量学的角度,     

UniPron is A Fully Effective Non-hormonal Reversible Contraceptive in Baboon Model （Papio Anubis）

Objective To determine the safety and efficacy of UniPron as a reversible contraceptive.
Methods Vaginal swabs were obtained before and after UniPron administration, cultured onto appropriate culture media and bacteria identification was done based on type of media used, Gram stain reactions, colony morphology and biochemical tests. Vaginal biopsy tissues were processed using paraffin wax method, stained with hematoxylin and eosin and examined under light microscopy to determine the effect of the product on vaginal tissues. The effect of UniPron on sperm was examined by mixing the product with electroejaculated spermatozoa in vitro at different concentrations. For efficacy studies, male baboons of proven fertility were mated with UniPron treated or untreated females of proven fertility during the fertile stages.
Results All the five females （100%） that were treated with UniPron did not conceive and they regained total fertility when the treatment was stopped while all the controls conceived. At a concentration of 40%, UniPron completely immobilized spermatozoa in an in-vitro system. UniPron mechanism of action was by lowering the vaginal pH and on application in baboon, the pH was lowered for at least 3 h after which it went back to normal.
Conclusions As we plan for a study to test UniPron as a microbicide to prevent STIs including HIV, our current study has established that this novel product is effective in contraception and harmless to vaginal tissues and vaginal microbial flora in a baboon model （Papio anubis）.     

WHO西太区与“世界中医药学会联合会”中医名词术语国际标准比较研究：精、神、气、血、津、液部分

精、神、气、血、津、液是中医理论中6个非常重要的概念，有关术语在《WHO西太区传统医学国际标准名词术语》中一共收录了59条，“世界中医药学会联合会”（以下简称世中联）《中医基本名词术语中英对照国际标准》中收录了58条。血、津、液的内涵较为具体，有一定的物质基础，理解并不困难。翻译上虽有差异，但亦不难统一。精、神、     

Mechanical tests on the reconstructed anterior cruciate ligament fixed with allogenetic cortical bone cross-pin on the femoral side

Background Anterior cruciate ligament reconstruction （ACLR） has developed dramatically in the last century.Now,ACLR has become a reliable and productive procedure.Patients feel satisfied in 〉90% cases.The aim of this study was to evaluate the feasibility of allogenetic cortical bone cross-pin （ACBCP） used as a clinical fixation method in anterior cruciate ligament reconstruction on the femoral side based on biomechanical tests in vitro.Methods The specimens were provided by the bone banks of the First Affiliated Hospital of People＇s Liberation Army of General Hospital from September 2011 to June 2012.Fresh deep frozen human allogenetic cortical bone was machined into cross-pins which is 4.0 mm in diameter and 75.0 mm in length.Biomechanical parameters compared with Rigidfix were collected while cross-pins were tested in double-shear test.The load-to-failure test and cycling test were carried out in a goat model to reconstruct anterior cruciate ligament with Achilles tendon autograft on the femoral side fixed by human 4.0 mm ACBCP and 3.3 mm Rigidfix served as control.Maximum failure load,yield load,and stiffness of fixation in single load-to-failure test were compared between the two groups.Cycle-specific stiffness and displacement at cycles 1,30,200,400,and 1 000 were also compared in between.Results In double-shear test both maximum failed load and yield load of 4.0 mm humanACBCP were （1 236.998±201.940） N.Maximum failed load and yield load of Rigidfix were （807.929±110.511） N and （592.483±58.821） N.The differences of maximum failed load and yield load were significant between ACBCP and Rigidfix,P 〈0.05.The shear strength of ACBCP and Rigidfix were （49.243±8.039） MPa and （34.637±3.439） MPa,respectively,P 〈0.05.In the load-to-failure test ex vivo,yield load and maximum failed load of ACBCP fixation complexity （（867.104±132.856）N,（1 032.243±196.281） N） were higher than those of Rigidfix （（640.935±42.836） N,（800.568±64.890） N,P 〈0.05）.However,s     

中医疗法治疗运动性疲劳的研究进展

随着竞技体育的发展，运动员经常承受着大负荷、超强度的体力训练，因此极易产生运动性疲劳。疲劳的出现使肌内压增高，局部缺血，造成氧化代谢、H^＋排出率与pH值降低，血乳酸增高，从而影响肌纤维神经传导速度和肌内收缩力量，减弱了肌肉保护能力。致使较多的冲击力传到骨骼上，故易导致疲劳骨折的发生,严重影响了运动员的训练和比赛成绩，对运动员身心产生不必要的伤害。运动性疲劳消除手段的研究一直是竞技体育工作和运动医学关注和研究的焦点。     

Effects of tacrolimus and cyclosporine treatment on metabolic syndrome and cardiovascular risk factors after renal transplantation: a meta-analysis

Background The therapeutic success of renal transplantation has been largely attributable to the development of effective and balanced immunosuppressive treatment regimens.This study provides a meta-analysis of a series of randomized controlled trials that compared the effects of tacrolimus and cyclosporine on metabolic syndrome （MetS） and cardiovascular risk factors after renal transplantation.Methods We searched various electronic databases and bibliographies,including MEDLINE,the Cochrane Central Register of Controlled Trials,and EMBASE,for relevant studies published prior to October 2012.Results Our meta-analysis included five randomized controlled trials that examined a total of 923 patients.The tacrolimus group and the cyclosporine group exhibited no significant differences in MetS incidence after renal transplantation; risk ratio （RR）：1.06,95％ confidence interval （C/）：0.73-1.55,P=0.76.Cyclosporine treatment was associated with a higher incidence of hyperlipidemia （RR：0.50,95％ CI：0.39-0.64,P ＜0.01）.Although there were no statistically significant differences,cyclosporine treatment was associated with a higher incidence of hypertension （RR：0.91,95％ CI：0.83-1.00,P=0.06） after renal transplantation compared to tacrolimus treatment,and tacrolimus treatment was associated with a higher incidence of diabetes after renal transplantation （RR：1.79,95％ CI：0.98-3.27,P=0.06） compared to cyclosporine treatment.Conclusions Compared to tacrolimus treatment,cyclosporine treatment was associated with a higher incidence of hyperlipidemia.Future large-scale studies are expected to be conducted to further confirm our findings.