自拟安神定魂汤治疗失眠60例临床体会

失眠中医称＂不寐＂或＂不得眠＂、＂不得卧＂、＂目不瞑＂,是临床最常见的一种疾病。中医治疗失眠有一定的优势,笔者从2007年到2011年用自拟安神定魂汤在门诊对90例失眠患者进行了临床观察,取得满意疗效,现总结如下。     

中医“治未病”模式在妇幼保健院中的应用

中医＂治未病＂理论源于中医古医籍《黄帝内经》,包括＂未病先防＂、＂既病防变＂、＂瘥后防复＂3个方面。笔者在临床实践中,把中医＂治未病＂理念引入医疗活动中,在保持现代医学＂诊断＂、＂治病＂优势的同时,加入了中医＂治未病＂内容,发现中医＂治未病＂模式在妇幼保健院运用有广泛的社会效益以及良好前景。     

中医在社区医疗服务体系中的作用

中医是我国传统文化精华与瑰宝[1],在中国两千年历史中发挥着主要作用.以＂阴阳五行＂为理论基础,以＂望闻问切＂为诊疗手段,以＂整体观＂为指导思想.随着时代进步与我国现代化发展,中医学不断为现代人所重视并发展壮大.将中医融入社区医疗服务中,完善社区医疗服务体系,不仅是社会需要,更是中医之责任.     

老年创伤性“肩关节假性脱位”现象分析及中医治疗临床观察

目的分析老年创伤性＂肩关节假性脱位＂现象;观察中医手段治疗老年创伤性＂肩关节假性脱位＂疗效。方法所有患者均采用中医诊治手段。结果老年创伤性＂肩关节假性脱位＂系创伤性肩关节不稳,中医治疗费用低、创伤小、疗效显著,安全可靠。避免了手术创伤。     

擦净传统中医的尘埃——专访中华药王科技集团董事长张延德

用＂疗效＂为中医正名＂随着全球工业化进程的不断深入,世界的生态环境日趋恶化,人类的疾病出现了很多新病种。2003年‘非典’疾病和近两年‘禽流感’、H1N1等新病种在全球范围或局部地区肆虐的时候,中医药发挥出的巨大实用疗效价值,让人们不得不从疾病、健康需要的角度重新评估、看待、认识中医。＂     

全国名老中医治病经验谈系列——龚志贤治腹胀——三宜汤

龚志贤1907年生于重庆,中医内科专家。建国后,历任卫生部中医司科长,北京医院中医科主任,重庆市中医研究所研究员、所长,中华全国中医学会理事、四川分会副会长。组成:广藿香、厚朴、苏梗、苍术、茯苓、前胡各12克,广木香、清半夏、生姜、黄芩各9克。     

河南南阳：“四个带动”破解中医药发展瓶颈

本刊讯（本刊记者 王伟 特约记者 齐祖宏 杨俊涛 樊新生）为认真贯彻落实南阳市委全会提出的＂项目带动＂、＂品牌带动＂、＂创新带动＂、＂服务带动＂发展战略,实现中医事业快速发展,河南省南阳市中医管理局结合当地实际,认真梳理,制定出切实可行的奋斗目标。     

观斑识健康

中医诊病讲究望闻问切,这之中＂望＂居首位,很多人觉得中医神奇也在于此,可以不开口就能基本判断出毛病在哪里,其实这只是因为人生病前后会在身体的某一部位出现特有的体征,而中医总结了很多经验,通过＂望＂就能判断出大致问题所在。本文就来说说脸上的斑点。     

中医对石淋的认识探讨

本文主要探讨祖国医学对＂淋证＂中＂石淋＂的认识,从中医角度分析其主要的病因病机,总结历代医家对该病进行辨证论治与治疗的用药特点,为中医临床提供充分的理论指导。     

传统中医文化与社会主义核心价值体系建设

作为中国传统文化的瑰宝,中医文化以其蕴涵的价值观念、伦理道德、人文精神与哲学思想在现代仍具有重要的价值。中医文化所遵循与倡导的＂天人合一＂的哲学思想、＂大医精诚＂的伦理道德、＂以人为本＂的人文精神,对于如何理解和建设社会主义核心价值体系有较好的借鉴意义。     

Prenatal nicotine exposure enhances the susceptibility to metabolic syndrome in adult offspring rats fed high-fat diet via alteration of HPA axis-associated neuroendocrine metabolic programming

Aim： Prenatal nicotine exposure （PNE） alters the hypothalamic-pituitary-adrenocortical （HPA） axis-associated neuroendocrine metabolic programming in intrauterine growth retardation offspring rats. In this study we aimed to clarify the susceptibility to metabolic diseases of PNE offspring rats fed a high-fat diet. Methods： Maternal Wistar rats were injected with nicotine （1.0 mg/kg, sc） twice per day from gestational day 11 until full-term delivery, and all pups were fed a high-fat diet after weaning and exposed to unpredictable chronic stress （UCS） during postnatal weeks 18-20. Blood samples were collected before and after chronic stress, and serum ACTH, corticosterone, glucose, insulin, total cholesterol, triglyceride and free fatty acids levels were measured. The hypothalamus, pituitary gland and liver were dissected for histological studies. Results： UCS significantly increased the serum ACTH, corticosterone and insulin levels as well as the insulin resistant index without changing the serum glucose, total cholesterol, triglyceride and free fatty acids levels in adult offspring rats without PNE. The body weight of PNE offspring rats presented a typical ＂catch-up＂ growth pattern. PNE not only aggravated the UCS-induced changes in the HPA axis programmed alteration （caused further increases in the serum ACTH and corticosterone levels）, but also significantly changed the glucose and lipid metabolism after UCS （caused further increases in the serum glucose level and insulin resistant index, and decrease in the serum free fatty acids）. The effects of PNE on the above indexes after UCS showed gender differences. Pathological studies revealed that PNE led to plenty of lipid droplets in multiple organs. Conclusion： PNE enhances not only the HPA axis, but also the susceptibility to metabolic diseases in adult offspring rats fed a high-fat diet after UCS in a gender-specific manner and enhances the susceptibility to metabolic diseases in adult offspring rats fed a high-fat diet.     

Hsp90 inhibitor BILBO21 enhances triptolide-induced apoptosis of human T-cell acute lymphoblastic leukemia cells in vitro mainly by disrupting p53- MDM2 balance

Aim： To investigate the effects of BILBO21, an inhibitor of heat shock protein 90 （Hsp90） alone or in combination with triptolide （TPL） on T-cell acute lymphoblastic leukemia （T-ALL） and the mechanisms of action. Methods： Human T-ALL cells line Molt-4 was examined. The cell viability was measured using M]-I- assay. Apoptotic cells were studied with Hoechst 33258 staining. Cell apoptosis and cell cycle were analyzed using flow cytometry with Annexin V/PI staining and PI staining, respectively. The levels of multiple proteins, including Akt, p65, CDK4/6, p18, Bcl-2 family proteins, MDM2, and p53, were examined with Western blotting. The level of MDM2 mRNA was determined using RT-PCR. Results： Treatment of Molt-4 cells with BILBO21 （50-800 nmol/L） inhibited the cell growth in a dose-dependent manner （the IC~ovalue was 384.6 and 301.8 nmol/L, respectively, at 48 and 72 h）. BILBO21 dose-dependently induced Go/G1 phase arrest, followed by apoptosis of Molt-4 cells. Furthermore, BILBO21 increased the expression of p18, decreased the expression of CDK4/6, and activated the caspase pathway in Molt-4 cells. Moreover, BILBO21 （50-400 nmol/L） dose-dependently decreased the phospho-MDM2 and total MDM2 protein levels, but slightly increased the phospho-p53 and total p53 protein levels, whereas TPL （5-40 nmol/L） dose- dependently enhanced p53 activation without affecting MDM2 levels. Co-treatment with BILBO21 and TPL showed synergic inhibition on Molt-4 cell growth. The co-treatment disrupted p53-MDM2 balance, thus markedly enhanced p53 activation. In addition, the co-treatment increased the expression of Bak and Bim, followed by increased activation of caspase-9. Conclusion： The combination of BILBO21 and TPL may provide a novel strategy for treating T-ALL by overcoming multiple mechanisms of apoptosis resistance.     

Stereoselective binding of doxazosin enantiomers to plasma proteins from rats,dogs and humans in vitro

Aim： （＋）Doxazosin is a long-lasting inhibitor of a1-adrenoceptors that is widely used to treat benign prostatic hyperplasia and lower urinary tract symptoms. In this study we investigated the stereoselective binding of doxazosin enantiomers to the plasma proteins of rats, dogs and humans in vitro. Methods： Human, dog and rat plasma were prepared. Equilibrium dialysis was used to determine the plasma protein binding of each enantiomer in vitro. Chiral HPLC with fluorescence detection was used to measure the drug concentrations on each side of the dialysis membrane bag. Results： Both the enantiomers were highly bound to the plasma proteins of rats, dogs and humans [（-）doxazosin： 89.4%-94.3%; （＋）doxazosin： 90.9%-95.4%]. （＋）Doxazosin exhibited significantly higher protein binding capacities than （-）doxazosin in all the three species, and the difference in the bound concentration （Cb） between the two enantiomers was enhanced as their concentrations were increased. Although the percentage of the plasma protein binding in the dog plasma was significantly lower than that in the human plasma at 400 and 800 ng/mL, the corrected percentage of plasma protein binding was dog〉human〉rat. Conclusion： （-）Doxazosin and （＋）doxazosin show stereoselective plasma protein binding with a significant species difference among rats, dogs and humans.     

王伯岳医案三则

1紫癜性肾炎刘某,男,6岁,病历号7478,患儿于1964年6月因双下肢出现紫斑,兼腹痛、泻痢、衄血,在西安某医院诊断为过敏性紫癜,后又并发肾炎,经治疗后,紫癜消失,肾炎未愈,于1964年8月29日来京治疗。查体：血压110/60 mmHg,无浮肿,咽红肿。     

美国与欧洲上市后药品安全风险管理进展概述

近10年来,美国食品药品管理局（FDA）、欧洲药品管理局（EMA）及其他相关单位,对上市后药品安全性监测日益重视,在这一领域取得了显著进展,并且制定了一系列新规定。     

朱锦善教授传授王伯岳先生经验一得

＂辛温辛凉并用,风寒风热两解＂以及＂表里双解＂的治法,是师爷王伯岳先生用于小儿外感热证的重要治法,也为广大中医儿科临床医师所效法。笔者的恩师朱锦善教授乃王伯岳先生入室弟子,深得亲传,笔者有幸忝列门墙,侍诊老师左右,老师经常在临证时传授王伯岳先生的临证经验和他自己的心得体会,深感获益。现将朱老师传承与应用王伯岳先生经验之麻杏石甘汤病案整理如下,与同道分享。     

Sodium hydrosulfide alleviates lung inflammation and cell apoptosis following resuscitated hemorrhagic shock in rats

Aim： To investigate the protective effects of hydrogen sulfide （H2S） against inflammation, oxidative stress and apoptosis in a rat model of resuscitated hemorrhagic shock. Methods： Hemorrhagic shock was induced in adult male SD rats by drawing blood from the femoral artery for 10 min. The mean arterial pressure was maintained at 35-40 mmHg for 1.5 h. After resuscitation the animals were observed for 200 min, and then killed. The lungs were harvested and bronchoalveolar lavage fluid was prepared. The levels of relevant proteins were examined using Western blotting and immunohistochemical analyses. NariS （28 pmol/kg, ip） was injected before the resuscitation. Results： Resuscitated hemorrhagic shock induced lung inflammatory responses and significantly increased the levels of inflammatory cytokines IL-6, TNF-a, and HMGB1 in bronchoalveolar lavage fluid. Furthermore, resuscitated hemorrhagic shock caused marked oxidative stress in lung tissue as shown by significant increases in the production of reactive oxygen species H202 and OH, the translocation of Nrf2, an important regulator of antioxidant expression, into nucleus, and the decrease of thioredoxin I expression. Moreover, resuscitated hemorrhagic shock markedly increased the expression of death receptor Fas and Fas-ligand and the number apoptotic cells in lung tissue, as well as the expression of pro-apoptotic proteins FADD, active-caspase 3, active-caspase 8, Bax, and decreased the expression of Bcl-2. Injection with NariS significantly attenuated these pathophysiological abnormalities induced by the resuscitated hemorrhagic shock. Conclusion： NariS administration protects rat lungs against inflammatory responses induced by resuscitated hemorrhagic shock via suppressing oxidative stress and the Fas/FasL apoptotic signaling pathway.     

人参北芪片的质量控制研究

目的建立人参北芪片的质量标准,控制制剂的质量。方法采用薄层色谱法对制剂中组成药味人参进行鉴别,采用HPLC-蒸发光散射检测法测定制剂中的黄芪甲苷,并进行方法学考察。结果人参的薄层鉴别中,斑点清晰,阴性无干扰。黄芪甲苷在0.9976～14.9640μg与峰面积呈良好的线性关系,平均回收率为98.06%,RSD为1.60%。结论建立的薄层色谱和高效液相色谱定性、定量方法可以用来控制人参北芪片的质量,方法简便可行。     

妇科止带片微生物限度检查的方法学验证研究

目的 建立妇科止带片微生物限度检查方法.方法 采用薄膜过滤法进行细菌数计数,采用平皿法进行霉菌和酵母菌计数,采用常规法进行控制菌的检查.结果 大肠埃希菌、白色念珠菌、黑曲霉菌回收率皆在80%以上;金黄色葡萄球菌、枯草芽孢杆菌回收率皆在95%以上;阴性菌对照组均无生长.结论 该法可以作为妇科止带片的微生物限度检查方法.