避孕失败补救措施导致月经病及证候分布规律的研究

目的对避孕失败补救措施(普通人流、无痛人流，药物流产)后妇女月经进行调查，探讨其所致月经病病种分布情况及所致月经病的中医证候分布规律，为中医药较规范治疗避孕失败补救措施导致的月经病提供辨证理论依据，以提高其治愈率，发挥中医药的治疗优势。方法制定调查表，对避孕失败补救措施后妇女第3、6月的月经进行随访，填写月经情况及中医症状，进行病种及中医证候分析，统计月经病病种及中医证候的分布规律。结果①调查377例，第3月、第6月随访，发生月经病者分别占18.83%、11.94%；第6月总恢复率为36.62%。于普通人流、无痛人流、药物流产致月经病的病种中以月经过少比例最高，第3月分别为35%、39.29%、26.09%，第6月别为30.00%、28.57%、17.39%；③三种流产致月经病中医证型主要有肝肾阴虚、肝郁血瘀、气血两虚、心脾两虚四型，其中以肝肾阴虚最多(普通人流50%、无痛人流46.43%、药流39.13%)。结论①普通人流、无痛人流、药流均可导致多种月经病，单病种中以月经过少比例最高，其次是月经后期。②普通人流、无痛人流、药物流产导致月经病的中医证候分布一致，以肝肾阴虚最多，其次是肝郁血瘀，再其次是气血两虚及心脾两虚。     

原发性肾病综合征中医证候荟萃分析

目的研究原发性肾病综合征的中医证候分布,总结其主要的证候类型。方法通过计算机检索国内1997-2010年关于中医药治疗原发性肾病综合征的文献,运用随机对照试验表对文献进行评估,采用JADAD治疗评分表对文献进行评价,将符合标准的文献运用加权百分率法进行荟萃分析。结果共有9篇文献入选本研究,得到701例病人15种证型,其中主要的证型为脾肾阳虚型（29.5%）、肝肾阴虚型（16.7%）、阴虚湿热型（13.8%）。结论脾肾阳虚、肝肾阴虚、阴虚湿热为原发性肾病综合征的主要证型。     

求证紧张型头痛与风湿头痛全等的研究

目的研究紧张型头痛与中医风湿头痛的对等关系。方法从理论和临床两个方面论证：①理论研究：734例头痛患者的中医舌脉调查及138例TTH患者中医证型的分布情况;②临床研究：随机选取2007年3月至2010年10月在广州南方医科大学南方医院中医科头痛专科门诊就诊的TTH患者138例,将此138名患者随机分为头痛新1号组、羌活胜湿汤组、盐酸乙哌立松片组各46例,分别给予头痛新1号方、羌活胜湿汤方、盐酸乙哌立松片治疗,疗程3个月。结果 734例头痛患者,按8型分证,仅舌脉而论,573例为舌质暗红或者红,苔薄白,脉缓或弦缓;138例TTH患者中医证型分布如下：风湿头痛101例（73.18%）,风湿兼血瘀头痛26例（18.84%）,风湿兼肝阳上亢头痛11例（7.98%）。临床治疗：头痛新1号组总有效率为93.4%,羌活胜湿汤组总有效率为76.0%,西药组为65.3%,头痛新1号组疗效明显优于两对照组。结论中医头痛的分型是症状学诊断与中医的舌脉没有明显相关性,TTH属于中医的风湿头痛范畴,TTH的两个亚型分别对应于风湿兼血瘀头痛、风湿兼肝阳上亢头痛,临床上也进一步论证TTH的中医治疗当以祛风、活血、除湿立法,兼以养肝、平肝、安神之法疗效更佳。     

52例COVID-19患者出院后核酸复检阳性的中医证型分析

目的探讨孝感地区普通型COVID-19出院后核酸复检阳性患者中医四诊信息、中医证型分布规律,为总结经验及制定科学、高效的救治方案提供依据。方法收集分析来自湖北省孝感市第一人民医院收治的52例普通型COVID-19患者出院后核酸复检阳性的临床资料,主要包括患者基本信息、基础疾病、中医四诊信息、中医证型分布规律。结果 52例普通型COVID-19患者出院后核酸复检阳性以及临床表现异常者共22例(42.31%),主要表现为咳嗽17例(32.69%),其次还有便秘、胸闷、腹泻、纳差、乏力、气促等症状。舌质主要为暗红(50.00%),其次为舌质淡红、舌质红。舌苔主要为黄腻(53.85%),其次为白腻、薄白、薄黄、少苔。临床证型分属为湿毒郁肺证24例(46.15%),其次为寒湿阻肺证、肺脾气虚证、气阴两虚证。结论普通型COVID-19患者出院后核酸复检阳性根据辨证主要为湿毒郁肺型,"湿""毒"为主要致病因素,治宜以祛湿为则。     

中医辨治肛门湿疹210临床观察

目的：探索中药治疗肛门湿疹的疗效。方法们通过中医辨证，把210例肛门湿疹患者随机分为湿热下注、血虚风燥、血热夹湿和湿热虫毒四种证型，分别以消风散加减治疗，观察其有效率。结果以消风散加减治疗肛门湿疹有效率达90%左右。结论加减消风散治疗肛门湿疹有较好疗效。     

糖尿病夹湿证与HP感染的关系探讨

糖尿病的中医诊断与分型历来多有争议,有人从证候辨证角度,根据临床表现,遵循八纲、脏腑、气血分为:①热盛证;②阴虚证;③气虚证;④阳虚证;⑤夹湿证;⑥夹淤证[1]。其中夹湿证主因之一为脾胃不和,湿热内蕴引起。证见脘腹胀痛、纳呆呕恶、或嗳气呃逆,神疲倦怠等,苔厚腻,质淡红,脉滑弱。现代医学诊断将其列为胃或肠之炎症、溃疡、甚至是癌症前兆。为探讨糖尿病夹湿证脾胃不和、湿热内蕴与胃或十二指肠炎症之间的关系,现将本院检测的14C-尿素呼气试验HP测定结果分析报告如下。1对象和方法1·1对象病例选择为2003年12月~2004年4月在门诊与住院…     

粤港地区老年单纯收缩期高血压中医证侯流行病学调查分析

目的探讨粤港地区老年单纯收缩期高血压（EISH）中医证型构成及其相关影响因素。方法以60岁以上老年单纯收缩期高血压患者为调查对象,填写“高血压中医证候调查表”收集数据,应用Epidata2．1软件建立数据库,运用SPSS13．0软件对数据进行统计分析,基本情况应用描述性统计,利用χ^2检验分析其中医证型构成与性别、年龄、病史、家族史、吸烟和饮酒史、生活习性、体重指数、合并心脑血管疾病、合并代谢疾病等因素的相关性。结果共调查EISH患者302例,其中阴虚阳亢证91例（30．1％）、阴阳两虚证51例（16．9％）、肝肾阴虚证49例（16．2％）、肝阳上亢证37例（12．3％）、痰湿壅盛证37例（12．3％）。EISH中医证型构成在不同年龄、性别、血压分级、病程、生活习惯中分布差异具有显著性（P均〈0．05）。结论EISH中医主要证型依次为阴虚阳亢证、阴阳两虚证、肝肾阴虚证、肝阳上亢证、痰湿壅盛证。年龄、性别、血压分级、病程、生活方式是EISH中医证型分布的影响因素。     

聚类分析与主成分分析在颈椎病中医证型规范化研究中的应用

背景：目前对于颈椎病的中医分型相对单一,缺乏各型颈椎病一一分型辨治的中医特色与特点。以往各型颈椎病分型主要是以个人经验总结,缺乏客观化依据,尚需数理化的方法的验证。 目的：运用聚类分析和主成分分析方法调查颈椎病中医证型的分布特点。 方法：根据颈椎病患者的临床表现设计调查表,收集575例颈椎病患者的症状、体征、舌脉等四诊信息,采用聚类分析和主成分分析法对调查表中98个常见症状进行分析。 结果与结论：聚类分析得出8类证候：湿热侵袭,痰湿阻络,气血两虚,肝肾亏虚,脾肾阳虚,血瘀气滞,寒湿痹阻,肝脾两虚。颈椎病病机复杂,虚实并见,其基本的病机是以“邪实”为主,主要表现为气滞、湿热、寒湿、痰湿,并见血瘀之邪;而正虚主要表现为阴虚、阳虚、气虚和血虚。提示聚类分析和主成分分析用于中医证型的分类研究具有一定科学性。     

痛风危险因素、体质类型与中医证型的相关研究

目的探讨痛风危险因素、体质类型与中医证型的关系。方法回顾性分析2010年1-12月就诊南方医院风湿科、中医科门诊及住院且既往发作符合1977年ACR急性痛风关节的诊断标准的42例患者的临床资料。依据《中药新药临床研究指导原则》,将入选病例分为风湿蕴热证、痰瘀痹阻证、久痹正虚证3个证型。依据王琦《中医体质分类与判定》,将纳入患者体质类型分为痰湿质、湿热质、瘀血质及其他体质。并记录患者年龄、病程、体重指数（BMI）、生化指标及合并症等临床资料,通过SPSS13.0软件分析,观察痛风危险因素、体质类型与中医证型的关系。结果①纳入患者大部分合并高脂血症（71.5%）,3种证型中痰瘀痹阻证型占患者比例最高（66.7%）,3个证型间年龄、BMI、甘油三酯（TG）差异均有统计学意义（P〈0.05）。②体质类型中痰湿质14例（33.3%）,湿热质12例（28.6%）,瘀血质9例（21.4%）,其他体质7例（16.7%）,体质类型在3种证型间的分布差异具有统计学意义（P=0.001）,其中以痰湿质最多,其次是湿热质、瘀血质,痰湿质、湿热质主要分布在风湿蕴热及痰瘀痹阻证型,瘀血质主要分布于痰瘀痹阻证型。结论痛风危险因素中BMI、TG在中医证型间存在差异,痰瘀痹阻证型是痛风的常见证型,提示控制体重、低脂饮食是防治痛风的有效措施;体质类型在中医证型分布中具有差异,对指导临床辨证、体现＂因人治宜＂、实施个体化治疗奠定基础。     

城乡抑郁症患者躯体症状表现的差异

目的:探讨抑郁症患者躯体症状的城乡差异。方法:对91例城市抑郁症患者和103例农村抑郁症患者采用躯体症状访谈表及流调中心用抑郁量表进行评定。结果:①城市组患者最常见的躯体症状为疲倦乏力(94.5%)、睡眠问题(93.4%)和心慌(78.0%);农村组患者最常见的躯体症状为疲倦乏力(94.2%)、睡眠问题(91.3%)和胸闷(77.7%)。农村组患者更易于表现出头晕和耳鸣症状。②城市患者躯体症状得分显著低于农村患者躯体症状得分。③多因素方差分析表明,居住地与教育程度对躯体症状的交互作用显著,在农村抑郁症患者中,小学以下教育程度的患者的躯体症状水平显著高于大学以上教育程度的患者,中学教育程度的患者的躯体症状水平显著高于大学以上教育程度的患者,而小学以下教育程度的患者与中学教育程度的患者的躯体症状水平差异不显著。结论:抑郁症躯体症状存在城乡差异,农村患者表现出更高的躯体症状水平。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.