基于络病理论的辛香通络方治疗气滞血瘀型痛经的临床效果

目的 评估自拟辛香通络方治疗气滞血瘀型痛经的临床效果。方法 选取2021年12月至2022年12月收治的90例气滞血瘀型痛经患者为研究对象,随机将其分为辛香通络方组和对照组,各45例。辛香通络方组接受辛香通络方治疗,对照组接受散结镇痛胶囊治疗。比较两组的治疗效果。结果 辛香通络方组的治疗总有效率为93.33%,明显高于对照组的77.78%,差异具有统计学意义（P<0.05）。结论 辛香通络方治疗气滞血瘀型痛经效果显著,具有明显的优势。     

基于异病同治体质学说探讨益气解毒方治疗EB病毒感染相关性疾病

清·陈壬锋《石室秘录》提出同经者,同是一方,而同治数病也.流行病学研究表明在EB病毒感染相关性疾病患病人群,多为气虚型病理体质,而在此基础上发生的EB病毒感染以及续发的相关疾病,在感染人群中形成了气虚染毒病机过程,也是贯穿各相关疾病全程的共同基础病机,因此基于异病同治的治法模式,在体质学说的指导下,探讨益气解毒方治疗EB病毒感染相关疾病的可行性,为治疗EB病毒感染相关性疾病提出了新见解,以期开辟一条中医诊疗新思路.     

基于"五音疗疾"理论初探孕期女性应对新型冠状病毒肺炎的心理调适

新型冠状病毒肺炎(以下简称新冠肺炎)开始爆发以来,对人民的身心健康产生了严重危害.中医学倡导"整体观念""身心合一"的防治理念,不仅在疫情治疗上做出巨大贡献,在心理调适上也有很大应用空间.孕期女性在面对突发重大疫情时较正常人群情绪敏感,更容易产生情绪波动;运用五行音乐对孕期妇女进行心理调适可以缓解孕妇恐慌、焦虑等不良情绪.该文基于"五音疗疾"理论初探情志辨证施乐、脏腑辨证施乐、三因制宜施乐对孕期妇女进行心理调适的方案.     

基于网络药理和分子对接探究山柰酚治疗抵抗性前列腺癌的机制

目的:利用网络药理学方法和分子对接技术分析山奈酚治疗去势抵抗性前列腺癌(CRPC)的靶点,并探讨其相关分子机制。方法:从DisGeNET数据库中检索CRPC的靶点,同时,从药物靶点数据库Swiss Target Prediction数据库获取山奈酚治疗靶点,通过韦恩图工具获取靶点交集作为山奈酚抗CRPC的核心靶点,通过R studio中的“clusterProfiler”包对核心靶点进行GO和KEGG通路富集分析,预测山奈酚治疗CRPC的生物学过程和关键信号通路。结果:挖掘了山奈酚治疗CRPC的29个核心靶点：ESR1、SRC、EGFR、AKT1、PTGS2、CYP19A1、MMP9、ABCG2、ESR2、IGF1R等,主要通过调控内分泌抵抗通路、EGFR酪氨酸激酶抑制剂耐药性、蛋白聚糖在癌症、PI3K-Akt信号通路、雌激素信号通路等信号通路。结论:本研究预测了山奈酚治疗CRPC的核心靶点、生物学过程以及关键信号通路,将有助于山奈酚在去势抵抗性前列腺癌治疗中的临床应用。     

前列腺癌的诊治进展

前列腺癌(prostate cancer，PCa)在美国位于男性恶性肿瘤发病率的第一位，死亡率第二位。我国虽为前列腺癌低发地区，但近年来随着人口老龄化及生活条件的改善，其发病率逐渐升高。上海市统计数据显示，前列腺癌的发病率已从1991年的2．9／10万男性上升到目前的12．6／10万男性。本文将对前列腺癌的诊断与治疗进展作一介绍。     

基于"肾主骨"理论探讨CKD-MBD病机及其物质基础

CKD-MBD是一组由慢性肾衰竭引起的矿物质和骨代谢异常综合征.现代医学证实,CKD-MBD发生全过程与"肾虚"存在密切的关联性.该文基于历代医家对"肾主骨"理论的深刻总结,充分探讨CKD-MBD病机及其物质基础,为今后从肾论治CKD-MBD提供坚实的理论基础.     

基于SWE和MRI对临床显著性前列腺癌的诊断价值

目的：探究基于剪切波弹性成像（SWE）和多参数磁共振成像（mpMRI）对临床显著性前列腺癌（csPCa）的诊断价值。方法：回顾性选取2020年10月至2022年1月在延安大学附属医院泌尿外科疑诊为前列腺癌（PCa）并行超声引导下前列腺穿刺活检的患者为研究对象,共纳入患者74例。根据穿刺活检病理结果将患者分为PCa组与非PCa组,csPCa组与非PCa+临床不显著前列腺癌组（cisPCa）,其中PCa组24例,csPCa组17例。采用单因素及多因素logistic逐步回归分析筛选csPCa的独立预测因子,并通过ROC曲线比较预测概率值与各独立预测因子的诊断效能。结果：tPSA、fPSA、PSAD、PV、PIRADS、Emax差、Emean差和Emin差在PCa组与非PCa组,以及非PCa+cisPCa组与csPCa组之间的差异有统计学意义（P＜0.05）。logistic回归结果显示tPSA、PV、Emax差及PIRADS是csPCa的独立预测因子,ROC曲线结果显示logistic回归模型曲线下面积（AUC）为0.954,灵敏度为0.882,特异度为0.947,结果均优于各独立预测因子。结论：Emax差及PIRADS是csPCa的独立预测因子,与tPSA、PV联合具有较好的诊断效能。     

基于网络药理学分析黄芩素降低血压和调控炎症的作用机制

目的：探讨黄芩素对AngⅡ诱导高血压小鼠血压及血清中炎症相关因子表达的影响,并基于网络药理学进一步分析黄芩素治疗高血压的潜在作用机制。方法：利用AngⅡ皮下埋泵灌注的方式建立高血压小鼠模型,将24只C57BL/6小鼠随机分为对照组、AngⅡ组、AngⅡ+黄芩素组。黄芩素每天灌胃剂量为5 mg/（kg·d）,对照组和AngⅡ组给予等体积生理盐水灌胃,连续干预4周。利用鼠尾无创血压仪每周监测各组小鼠血压;利用Bio-plex试剂盒检测各组小鼠血清中炎症相关因子的表达。同时,运用ETCM、TCMSP数据库筛选黄芩素的作用靶点基因;再运用Disgenet、OMIM等数据库筛选高血压疾病相关的靶点基因,取两者交集,并利用KEGG进行通路富集分析。结果：AngⅡ组第1～4周的收缩压、舒张压及平均动脉压均显著高于对照组（P<0.05）;黄芩素干预2周后,能显著抑制AngⅡ诱导高血压小鼠收缩压、舒张压及平均动脉压的升高（P<0.05）;与对照组比较,AngⅡ组小鼠血清中的白介素-6(IL-6)、单核细胞趋化蛋白-1 (MCP-1)、肿瘤坏死因子-α (TNF-α)、白介素-1α (IL-1...     

The Influence of Normal Tissue Objective in the Treatment of Prostate Cancer

PurposeThe normal tissue objective (NTO) is a tool used in inverse-planned intensity-modulated radiation therapy to reduce dose spreading to the surrounding tissues. Only a few studies in the present literature are dedicated to understanding the influence of the NTO in radiation therapy planning in patients with prostate cancer or its consequences in the reduction of the dose in the surrounding healthy tissues.Material and methodsOur sample consists of 25 patients submitted to different treatment doses. Averages of plans with and without the NTO were obtained from the dose-volume histogram, and behaviours, comparisons, and quality were assessed considering homogeneity, conformity, and radiation plan indexes.ResultsWe were not able to find significant differences in the conformity index, homogeneity index, and radiation planning index between groups with and without the NTO or between treatment times. We observed a small advantage in NTO plans regarding hot spots in the central region of the planning target volume.ConclusionThe NTO is an important tool used in the optimization of plans; however, possibly due to the anatomical location of the prostate, we failed to find a significant contribution of its use in the treatment of prostate cancer. Further studies, using a larger sample and different NTO parameters, are needed to confirm our results.     

Evolution of the Treatment Paradigm for Patients with Metastatic Castration-Resistant Prostate Cancer

As recently as 2004, treatment options for men with metastatic castration-resistant prostate cancer (mCRPC) were limited, with docetaxel the only approved agent conferring a survival benefit. The therapeutic landscape is now very different, with several agents demonstrating prolonged survival since 2010. New agents for the treatment of mCRPC include sipuleucel-T, cabazitaxel, abiraterone acetate, enzalutamide and radium-223. All are now approved for use in this patient group, although the specific licensing terms vary between agents. In addition, denosumab may have utility in patients with bone metastases. A number of novel agents are also in development with promising initial results. However, because these treatment options have proliferated rapidly, there is currently a paucity of clinical evidence regarding their optimal sequencing. Selection of an appropriate treatment option should take into consideration disease characteristics, drug availability and patient choice. In summary, we discuss several new treatment options available for mCRPC and their integration into the current treatment paradigm.