德国柏林Pflgewerk养老机构学习见闻分享

2019年9—12月,笔者参与了苏州大学与德国柏林Pflgewerk养老机构针对失能老年人居家照护课程研发与智慧化养老的交流项目,在学习与交流期间,德国完善的居家照护体系,先进适老辅具的研发与运用,系统规范的照护员培训课程,浓厚的人文关怀气氛与多学科团队合作的安宁疗护中心令笔者印象深刻。本文结合学习交流活动的亲身经历,...     

The altering in sensory sensitivity: a current issue of female breast surgery

Breast surgery is an important treatment for women with malignant breast diseases. In addition to breast appearance, the integrity of breast function is increasing in patients with breast diseases. As the basis of breast physiological function, breast skin sensitivity is important to the quality of life of patients after surgery. Breast skin sensitivity gives the patient a “real” breast feeling. The sensory recovery after breast surgery has also become one of the important goals of breast surgery. In this review, we aim to discuss the research progress on recovery of breast skin sensitivity after different treatment modalities for breast disease.     

Catechins as a Potential Dietary Supplementation in Prevention of Comorbidities Linked with Down Syndrome

Plant-derived polyphenols flavonoids are increasingly being recognized for their medicinal potential. These bioactive compounds derived from plants are gaining more interest in ameliorating adverse health risks because of their low toxicity and few side effects. Among them, therapeutic approaches demonstrated the efficacy of catechins, a major group of flavonoids, in reverting several aspects of Down syndrome, the most common genomic disorder that causes intellectual disability. Down syndrome is characterized by increased incidence of developing Alzheimer’s disease, obesity, and subsequent metabolic disorders. In this focused review, we examine the main effects of catechins on comorbidities linked with Down syndrome. We also provide evidence of catechin effects on DYRK1A, a dosage-sensitive gene encoding a protein kinase involved in brain defects and metabolic disease associated with Down syndrome.     

Deer antler based active ingredients have protective effects on LPS/d-GalN-induced acute liver injury in mice through MAPK and NF-κB signalling pathways

ContextDeer antler based active ingredients are known to have certain anti-inflammatory and antioxidant activities. However, its potential hepatoprotective effect remains unclear.ObjectiveThis article reports the hepatoprotective effect of protein components in deer antler bases (R1) on lipopolysaccharide/d-galactosamine (LPS/d-GalN)-induced acute liver injury (ALI) in mice, and explores its possible mechanism.Materials and methodsThe four separated and purified protein components of deer antler bases were screened and verified by the RAW264.7 cell inflammation model. In the in vivo experiment of LPS/d-GalN-induced ALI in mice, ALT, AST, SOD, CAT, GSH and MDA were detected. The liver histopathology was analysed, the COX-2 and iNOS proteins were analysed by immunohistochemistry, and 4-HNE was analysed by immunofluorescence staining. In addition, the effects on the MAPK pathway and NF-κB/IκB-α pathway in liver proteins were explored.ResultsWith isolated RA protein fraction pre-treated RAW264.7 cells, NO production decreased by 35.3% compared with the model group. The experimental results of ALI in mice induced by LPS/d-GalN show that R1 protein components can protect mice from ALI through anti-inflammatory and anti-oxidative stress effects and reduce liver pathological damage in mice. The results also indicate that the R1 protein component may protect the liver by inhibiting the activation of the MAPK pathway and the NF-κB/IκB-α pathway induced by LPS/d-GalN.ConclusionsThe separated and purified R1 protein component of deer antler base has a good protective effect on LPS/d-GalN-induced liver injury, and may become a potential material for protecting against liver injury.     

益肾蠲痹法治疗系统性红斑狼疮临床报道

目的:研究益肾蠲痹法治疗系统性红斑狼疮的疗效.方法:本研究应用"益肾蠲痹法"对54例曾用激素或免疫抑制剂治疗系统性红斑狼疮,因副作用而改用益肾蠲痹法治疗3年以上的患者,观察治疗前后临床疗效、症状积分、激素剂量、血沉、C反应蛋白、ENA系列等指标变化.结果:54例系统性红斑狼疮患者治疗后的症状积分显著下降,ESR、CRP明显下降;激素用量逐渐撤减至停服,ENA系列指标阴转率最高达96.3%.结论:益肾蠲痹法对难治性系统性红斑狼疮,具有疗效高、毒副作用小、症状及实验室指标改善明显等理想疗效,是一种易于推广使用、具有良好产业化前景的治疗方法.     

葛根素对油酸致大鼠急性肺损伤组织中核因子-κB表达的影响

摘 要 目的:观察核因子 κB（NF-κB）在油酸致大鼠急性肺损伤时肺组织中的表达变化,探讨葛根素对急性肺损伤的保护作用及其可能机制。方法: 24只大鼠随机分为3组：对照组（Control）、油酸组（OA）、葛根素预处理组（Pue）。Control组大鼠尾静脉注射生理盐水0.1 ml·kg^-1;OA组大鼠尾静脉注射油酸0.1 ml·kg^-1;Pue组大鼠在注射油酸前30 min腹腔注射葛根素30 mg·kg^-1。光镜下观察肺组织病理形态学改变,免疫组织化学染色技术观察NF-κB在肺组织中的表达变化。结果 Pue组较OA组肺组织损伤情况明显减轻。OA组肺组织NF-κB的阳性表达（0.39±0.07）与Conrtol组（0.12±0.04）相比显著增加（P<0.05）;应用葛根素后肺组织NF-κB的阳性表达（0.24±0.05）明显减少,但仍高于Conrtol组（P<0.05）。结论 葛根素可能通过抑制NF-κB的表达减轻急性肺损伤时肺组织的炎症反应。     

方宝华主任医师调治癫痫病经验

方宝华,主任医师,上海中医药大学客座教授.早年毕业于上海中医专门学校,深受孟河丁氏学派熏陶,并承丁济万先生亲授内科诸病,深得其奥妙.从医六十余载,学验俱丰,饮誉沪上.     

Exploring the mechanism of Buyang Huanwu decoction in the treatment of lumbar disc herniation based on network pharmacology and molecular docking

Buyang Huanwu decoction (BYHWD), as one of the traditional Chinese medicine formulas, is widely used in the clinical treatment of lumbar disc herniation (LDH) with curative effect. It has the characteristics of multi-component, multi-target, and mutual synergy, but the mechanism of action is often unclear. It needs some research to explore the molecular mechanism of BYHWD in the treatment of LDH based on network pharmacology and molecular docking. Screen the active compounds of BYHWD and predict drug-related gene/protein targets, which could determine the specific target of BYHWD in the treatment of LDH. Construct the “Drugs-Compounds-Targets” network and search for the core targets. Use Gene Ontology functional enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, and molecular docking verification to explore the possible molecular mechanism. Eighty-two effective compounds and 666 targets of BYHWD, 187 targets for LDH treatment, and 20 core candidate targets were excavated. A total of 3414 entries were identified by Gene Ontology enrichment analysis, 173 related signal pathways were identified by Kyoto Encyclopedia of Genes and Genomes enrichment analysis, and 5 core compounds were identified by molecular docking, which had a good affinity with core genes STAT3, JUN, AKT1, MAPK1, RELA, and PIK3CA. BYHWD may play the role of analgesic and improving function by synergistic anti-inflammatory and analgesic compounds, regulating cell metabolic differentiation, regulating immunity, and anticoagulation. BYHWD in the treatment of LDH may play a role in analgesia and improve function through multiple signaling pathways, including PI3K-Akt, mitogen-activated protein kinase, tumor necrosis factor, and interleukin-17. The PI3K-Akt signaling may be one of the key mechanisms.     

糖尿病大鼠早期视网膜神经节细胞凋亡机制的探讨

目的：探讨糖尿病大鼠模型早期视网膜神经节细胞(retinal ganglion cells,RGCs)凋亡的机制。

方法：SD大鼠60只,随机分为对照组(CON)及糖尿病组(DM),糖尿病组一次性腹腔注射1% STZ诱发糖尿病鼠模型,两组于第4,8,12wk分别行HE、透射电镜及TUNEL法检测RGCs的凋亡情况,并应用激光共聚焦显微镜检测RGCs内钙离子浓度的变化。

结果：糖尿病组第8wk开始出现RGCs数量减少、细胞排列紊乱的病理改变,第12wk更为明显。糖尿病组透射电镜下可见第4wk时RGCs出现线粒体肿胀; 第8wk时RGCs内肿胀的线粒体更为明显、数目增多,染色质边集于核膜周边,部分细胞体积缩小、细胞器减少; 第12wk时出现RGCs体积变小,甚至出现细胞核断裂。TUNEL阳性RGCs最早于糖尿病组第4wk时出现,随病程延长凋亡的阳性细胞逐渐增多,凋亡指数与同期对照组相比,差异有统计学意义(P<0.01)。糖尿病组第8,12wk时RGCs内钙离子浓度明显高于同期对照组,差异显著(P<0.01); 糖尿病组第8wk与第12wk比较,升高差异亦有统计学意义(P<0.05)。

结论：糖尿病早期出现了视网膜神经节细胞的凋亡,其机制可能与细胞内钙离子浓度升高有关。