卜献春治疗糖尿病下肢动脉闭塞症经验

介绍卜献春教授治疗糖尿病下肢动脉闭塞症的经验。卜教授认为本病因虚致瘀、脉络瘀阻为主要病机,补虚通络为治疗原则,临床提倡分期论治,善用黄芪桂枝五物汤加减治疗糖尿病下肢动脉闭塞症,临床疗效肯定。     

穴位注射治疗下肢动脉硬化性闭塞症的探索与实践

我科从2006年2月至2014年5月期间采用香丹注射液穴位注射治疗下肢动脉硬化性闭塞症（PAD）43例,均取得了满意的临床疗效,现总结如下。1对下肢动脉硬化性闭塞症的认识1．1概述下肢动脉硬化性闭塞症多见于髂总动脉、股浅动脉和胭动脉,是动脉粥样硬化病变累及周围动脉并引起慢性闭塞的一种疾病。由于动脉粥样硬化斑块、动脉中层变形和继发性血栓形成,逐渐产生管腔狭窄或闭塞,造成患肢缺血。随着社会整体生活水平的提高和人口的老龄化,发病率逐年提高。     

血管成像在诊断下肢动脉闭塞性疾病中的价值

[探讨]多排螺旋CT血管成像（MDCT）对下肢动脉闭塞性疾病的诊断价值。方法：对32例临床疑下肢动脉闭塞性疾病的病人采用MDCT成像检查,利用多种重建技术做图像后处理来显示下肢动脉粥样硬化狭窄等下肢动脉闭塞性疾病的形态学改变。[结果]：奉组32例全部检查成功,螺旋MDCT发现30支狭窄或闭塞的血管中15支轻度狭窄,8支中度狭窄,6支重度狭窄,1支闭塞,显示下肢动脉主干狭窄和闭塞的符合率达100％。[结论]：MDCT方法具有安全、方便、准确、无创等特点,是下肢动脉闭塞性疾病较理想的影像学检查手段。     

温阳通络针刺法治疗下肢动脉硬化闭塞症初探

下肢动脉硬化闭塞症（lower extremity atherosclerotic occlusive disease,LEAOD）是血管外科常见病,属于下肢缺血性疾病,是以下肢大中动脉狭窄、闭塞和血栓形成为病理基础的肢体缺血综合征,以患肢末端发冷、麻木及间歇性跛行、静息性疼痛为主要表现,严重者伴有坏死感染。其发病率随年龄增大而增加。目前,国内外下肢动脉硬化闭塞症的发病呈逐年上升的趋势,其发病率在60岁以下人群中为3％,70岁以上人群中则增至20％以上,男性多于女性。严重的并发症是导致本病临床治疗效果欠佳和死亡率高的主要原因之一。     

加味六藤水陆蛇仙汤治疗糖尿病下肢动脉闭塞症初期患者32例

我们运用加味六藤水陆蛇仙汤治疗糖尿病下肢动脉闭塞症初期患者32例,现报告如下。1临床资料1.1诊断标准2型糖尿病按照1999年WHO糖尿病专家委员会确定的诊断标准[1],糖尿病下肢动脉闭塞症初     

补阳还五汤加减治疗早期糖尿病下肢动脉硬化闭塞症30例

目的:观察补阳还五汤加减治疗早期糖尿病下肢动脉硬化闭塞症的临床疗效。方法:采用补阳还五汤加减治疗30例本病早期患者,以10天为1个疗程,连续治疗3个疗程。观察治疗前后临床症状、下肢动脉超声多普勒血流动力学指标。结果:显效7例,有效18例,无效5例,总有效率83.3%。结论:补阳还五汤加减治疗早期糖尿病下肢动脉硬化闭塞症,有较好的疗效,可明显改善临床症状。     

分期静脉动脉化治疗下肢动脉闭塞症

目的探讨分期静脉动脉化手术对广泛性下肢动脉闭塞症的疗效。方法对有慢性缺血表现的11条下肢行Doppler超声与DSA和踝肱指数测定,确诊为广泛性下肢动脉闭塞症。然后用分期静脉动脉化手术对所有患肢进行治疗。结果术后近期1条截肢。10条患肢随访6~36个月,症状消失,疗效理想,术后Doppler超声与MRA复查可见动脉血向缺血肢体灌注。结论静脉动脉化治疗广泛性下肢动脉闭塞症疗效确切,已为治疗该病的一种较成熟的术式。     

益气活血法治疗下肢动脉硬化闭塞症37例

<正>动脉硬化闭塞症(ASO)是动脉粥样硬化病变引起的慢性动脉狭窄或闭塞性疾病,可导致下肢间歇性跛行、溃疡、足部或足趾的感染性或坏疽。笔者应用本院自制通脉灵胶囊治疗本病37例,取得了较满意的疗效。现总结如下。     

持续动脉灌注溶栓治疗下肢动脉闭塞症伴急性血栓形成

目的探讨持续动脉灌注溶栓治疗下肢动脉闭塞症伴急性血栓形成的效果。方法选择经彩超及动脉造影确诊的12例下肢动脉闭塞症伴急性血栓形成患者,采用动脉插管至血栓部位,行持续动脉灌注溶栓治疗2~5 d。结果9例患者患肢被挽救,3例患肢被截肢。结论持续动脉灌注溶栓对治疗下肢动脉闭塞伴血栓形成是有效的。     

系统化家庭随访对下肢动脉闭塞症支架植入术后患者治疗依从性的影响

目的探究系统化家庭随访对下肢动脉闭塞症支架植入术后患者治疗依从性的影响。方法随机抽取于该院2015年5月-2016年8月进行下肢动脉闭塞症支架植入术后出院患者136例,按数字表法随机分为观察组和对照组各68例,对照组则进行常规护理以及出院指导,对观察组在对照组的基础上进行系统化家庭随访护理。1年后对两组患者的术后治疗依从性以及复发率等进行比较。结果两组患者的术后治疗依从性比较,观察组明显优于对照组,差异有统计学意义(P0.05)。结论系统化家庭随访能够有效的提高下肢动脉闭塞症支架植入术后患者治疗依从性。     

徐振晔“以通为用”治疗晚期恶性肿瘤经验

徐振哗教授从事肿瘤临床工作三十余年,经验丰富;认为晚期恶性肿瘤患者正气明显衰退,治疗当“以通为用”。笔者跟师临诊,获益良多,现将其“以通为用”治疗晚期恶性肿瘤的临床经验总结介绍如下。     

Effects of feeding tyrosine and phenylalanine on the accumulation of phenylethanoid glycosides to Cistanche deserticola cell suspension culture

AIM： To investigate the effects of feeding phenylalanine （Phe） and tyrosine （Tyr） on the accumulation of total phenolic compounds and four phenylethanoid glycosides （PeGs） to a cell suspension culture of the parasitic plant Cistanche deserticola.METHOD： A cell suspension culture of C. deserticola was established and precursors of different concentrations were fed. In each group, the cell was sampled at the 24^th day after inoculation. The content of total phenolic compounds and four PeGs compounds were determined using the Folin-Ciocalteu method and an HPLC method, respectively.RESULTS： In the Phe fed cells, the maximum PeGs yield was achieved when Phe was fed at 1.5 mmol·L^-1 and the yield reached 1.13 times the control cell concentration. In the Tyr fed cells, the maximum yield of PeGs was 1.60 times of control when 0.75 mmol·L^-1 Tyr was fed to the cells. Furthermore, it was found that the salidroside yield was 4.01 times of control group when 5 mmol·L^-1 Tyr was fed.CONCLUSION： Tyr is a better precursor for PeGs accumulation compared with Phe, and the rate limiting enzymes might be involved in the Tyr branch.     

DT-13, a saponin of dwarf lilyturf tuber,exhibits anti-cancer activity by down-regulating C-C chemokine receptor type 5 and vascular endothelial growth factor in MDA-MB-435 cells简

AIM： To investigate the anticancer activity of DT-13 under normoxia and determine the underlying mechanisms of action. METHODS： MDA-MB-435 cell proliferation, migration, and adhesion were performed to assess the anticancer activity of DT-13, a saponin from Ophiopogonjaponicus, in vitro. In addition, the effects of DT-13 on tumor growth and metastasis in vivo were evaluated by orthotopic implantation of MDA-MB-435 cells into nude mice; mRNA levels of vascular endothelial growth factor （VEGF）, C-C chemokine receptor type 5 （CCR5） and hypoxia-inducible factor 1a （HIF-1a） were evaluated by real-time quantitative PCR; and CCR5 protein levels were detected by Western blot assay. RESULTS： At 0.01 to 1 umol·L -1, DT-13 inhibited MDA-MB-435 cell proliferation, migration, and adhesion significantly in vitro. DT-13 reduced VEGF and CCR5 mRNAs, and decreased CCR5 protein expression by down-regulating HIF-1 a. In addition, DT-13 inhibited MDA-MB-435 cell lung metastasis, and restricted tumor growth slightly in vivo. CONCLUSION： DT-13 inhibited MDA-MB-435 cell proliferation, adhesion, and migration in vitro, and lung metastasis in vivo by reducing VEGF, CCR5, and HIF-la expression.     

Capillary blood flow in patients with dysmenorrhea treated with acupuncture

OBJECTIVE; To observe capillary blood flow at acu- points during acupuncture treatment of primary dysmenorrhea and gain new insights into its anal- gesic mechanism. METHODS： Patients with primary dysmenorrhea were enrolled and randomly assigned to a treat- ment or control group. Subjects＇ symptoms were differentiated into various Traditional Chinese Medi- cine （TCM） syndromes and treated for 10 sessions with puncturing acupuncture or self-pressing right-hand Hegu （LI 4）, adding other acupoints based on syndrome. Laser speckle was used tocompare the change in the vasomotor amplitude and perfusion of the capillaries in Hegu （LI 4） be- fore and during the treatment. Each subject was re- quired to finish the period pain symptoms observa- tion form, verbal rating scales, numerical rating scale, pain rating index, face rating scale, Zung self-rating depression scale, Zung self-rating anxi- ety scale, and numerical rating scale before and af- ter treatments. RESULTS： After 10 sessions, the symptom scores, pain index （PI）, and visual analog scale （VAS） de- creased significantly in treatment group. The vol- ume of blood flow in Hegu （LI 4） declined slightly. No significant evidence supported that needling caused capillary contraction, but the capillary vaso- motor amplitude at Hegu （LI 4） increased remark- ably. CONCLUSION： Acupuncture can increase the capil- lary blood flow, thus promoting the flow of Qi and blood in terms of TCM theory, which facilitates pain relief.     

Curative effect of Xuebijing injection on severe pulmonary contu- sion

OBJECTIVE： To investigate the curative effects of Xuebijing （XBJ） injection, a Chinese patent medi- cine, on severe pulmonary contusion （PC）. METHODS： Sixty-three patients with PC were ran- domized to conventional therapy plus XBJ injec- tion （n=33） or conventional therapy alone （n=30）. Between groups differences in corticosteroid treat- ment, immune regulation therapy, hemofiltration, infusion volume, transfusion volume and antibiotic period were measured, as were intensive care unit（ICU）-free time, ventilation time, 28-day mortality rate and incidence of ventilation-associated pneu- monia （VAP）. Serum concentrations of procalcito- nin （PCT）, tumor necrosis factor-a （TNF-a）, interleu- kin （IL）-6, and 11_-10, white blood cell （WBC） counts and percentages of human leukocyte antigen DR/ CD14＋ （HLA-DR/CD14＋） peripheral blood mononu- clear cells were compared. Markers of ventilation were determined by blood gas analysis and ventila- tor parameters. RESULTS： WBC counts and serum concentrations of PCT, TNF-a, 11.-6 and IL-10 were reduced signifi- cantly more quickly, and CD14＋ percentage was in- creased significantly earlier, in the XBJ group than in the control group （P〈0.05 each）. The level of ven- tilation and oxygenation index were ameliorated earlier in the XBJ than in the control group （P〈 0.05）. XBJ treatment significantly reduced ICU-free time, ventilation time and incidence of VAP （P〈0.05 each）, but had no effect on 28-day mortality rate （P〉0.05）. CONCLUSION： XBJ treatment can shorten ICU-free and ventilation times and reduce the incidence of VAP, improving outcomes in patients with severe PC. XBJ may act by regulating inflammation and im- munity, alleviating systemic inflammatory response syndrome induced by trauma.     

Effect of Morinda officinalis capsule on osteoporosis in ovariectomized rats

AIM： To explore the therapeutic effects ofMorinda officinalis capsules （MOP） on osteoporosis in ovariectomized rats. METHOD： Six-month-old female Sprague-Dawley rats were induced for postmenopausal osteoporosis （PMOP） by bilateral ovariectomy and divided into seven groups as follows： sham-operated group, ovariectomized （OVX） control group, OVX treated with xianlinggubao （XLGB） （270 mg·kg^-1·d^-1） , OVX treated with alendronate sodium （ALN） （3 mg·kg^-1·d^-1）, and OVX treated with Morinda officinalis capsule （MOP） of graded doses （90, 270 and 810 mg·kg^-1·d^-1） groups. Oral treatments were administered daily on the 4th week after ovariectomy and lasted for 12 weeks. The bone mineral density was evaluated by dual-energy X-ray absorptiometry. The tartrate-resistant acid phosphatase （TRAP）, alkaline phosphatase （AKP）, and osteocalcin （OC） levels in the serum and plasma were determined by standard colorimetric and enzyme immunoassays methods. Bone biomechanical properties and morphological parameters were analyzed by three-point bending test and histomorphometry respectively. RESULTS： Morinda officinalis capsules at all doses were able to significantly prevent the OVX-induced loss of bone mass due to diminishing serum AKP and TRAP levels while elevating OC level in the plasma. Morinda officinalis capsules also enhanced the bone strength and prevented the deterioration of trabecular microarchitecture. CONCLUSION： Morinda officinalis capsules possess potent anti-osteoporotic activity in OVX rats which could be an effective treatment for postmenopausal osteoporosis.     

王氏保赤丸治疗消化系统疾病概述

王氏保赤丸系根据清代道光年间通州著名中医王胪卿祖传九世秘方配制,并由其嫡孙王绵之教授监制的纯中药制剂。该药由大黄、黄连、制天南星、川贝母等组成。方中大黄苦寒,攻积导滞,泻火凉血,行瘀通经;黄连苦寒,清热燥湿,泻火解毒;制天南星苦凉,化痰熄风定惊;川贝母苦寒,化痰止咳,清热散结。王氏     

Combinatorial effects of conception and governor vessel electroacu- puncture and human umbilical cord blood-derived mesenchymal stem cells on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion

OBJECTIVE： To investigate the combinatorial ef- fects of conception and governor vessel electroacu- puncture （EA） and human umbilical cord blood-de- rived mesenchymal stem cells （HUCB-MSCs） on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion. METHODS： With the HUCB-MSCs isolated, cultured and identified and the models of cerebral isch- emia-reperfusion established, the HUCB-MSCs of passage three were intracranially transplanted andthe EA at conception and governor vessels was ap- plied. The pathomorphologic lesion by hematoxy- lin-eosin staining and the cellular apoptosis by ter- minal deoxynucleotidyl transferase-mediated nick-end labeling method around the ischemic fo- cus were observed. RESULTS： The cultured adherent HUCB-MSCs ex- hibited a spindle shape and expressed MSC-specif- ic markers, with the cell purity and proliferation rate significantly increasing after the primary pas- sage. HE staining showed that there were no patho- logical changes observed in the sham surgery group. However, in the PBS transplantation group, degeneration and necrosis of a great number of nerve cells were seen. In both the HUCB-MSCs transplantation group and the HUCB-MSCs trans- plantation ＋ EA group, reparative changes of the pathomorphism of the tissue were found. Both combination treatment and simple MSCs treat- ment were able to improve the pathomorphorlogic lesion following cerebral ischemia and reduce the abnormal TUNEL-positive numbers, with former better than latter. CONCLUSION： HUCB-MSCs improve pathological lesions and inhibit the cellular apoptosis around the cerebral ischemic area. EA at conception and governor vessels also improve pathological lesion and inhibit the cellular apoptosis in rats treated with HUCB-MSCs transplantation, which effects were superior to that of simple HUCB-MSCs trans- plantation.     

Study on perfume stimulating olfaction with volatile oil of Acorus gramineus for treatment of the Alzheimer's disease rat

Objective：To probe into the therapeutic efect of perfume stimulating olfaction with volatile oil of Acorus Gramineus on the Alzheimer＇s disease （AD） rat. Methods： Totally 50 adult SD rats, male,weighing 300±10 g, were randomly divided into 5 groups, normal group （group A）, olfactory nerve severing model group （group B）, AD model group （group C）, AD model plus perfume stimulation group （group D）, AD model olfactory nerve severing plus perfume stimulation group （group E）, 10 rats in each group. After perfume stimulation, Morris maze test was conducted for valuating the learning and memory ability; Malondaldehyde （MDA） content, and superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px） activities in the brain, and the brain weight were detected. Results： Compared with the AD model group,the average escape latency and swimming distance in 6 days were significantly shorter than those in the group A, B, D （P〈0.01）, with no significant differences between the group C and the group E （P〉0.05）; Compared with the group A, B and D, MDA content in the group C significantly increased （P〈0.01）, and SOD and GSH-Px activities significantly decreased （P〈0.01）, and brain weight/body weight decreased significantly in the group C （P〈0.01）, with no significant differences between the group C and the group E （P〉0.05）. Conclusion： Perfume stimultating olfaction with volatile oil of Acorus Gramineus can significantly increase the learning-memory ability, decrease MDA content and increase SOD and GSH-Px activities and weight of brain in AD rats.