冯崇廉主任应用小柴胡汤经验浅释

小柴胡汤出自《伤寒论》,是仲景为少阳伤寒而设的主方。原为治疗少阳证而设,其组方合理,疗效卓著,后世医家对其适应症有了广泛的发展,冯崇廉主任医师深刻领会方义,略有加减,在临床各科疾病的治疗方面取得了良好的疗效。     

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD): A Korean Chronic Kidney Disease Cohort

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was launched in 2011 with the support of the Korea Disease Control and Prevention Agency. The study was designed with the aim of exploring the various clinical features and characteristics of chronic kidney disease (CKD) in Koreans, and elucidating the risk factors for CKD progression and adverse outcomes of CKD. For the cohort study, nephrologists at 9 tertiary university-affiliated hospitals participated in patient recruitment and follow-up. Biostatisticians and epidemiologists also participated in the basic design and structuring of the study. From 2011 until 2016, the KNOW-CKD Phase I recruited 2238 adult patients with CKD from stages G1 to G5, who were not receiving renal replacement therapy. The KNOW-CKD Phase II recruitment was started in 2019, with an enrollment target of 1500 subjects, focused on diabetic nephropathy and hypertensive kidney diseases in patients with reduced kidney function who are presumed to be at a higher risk of adverse outcomes. As of 2021, the KNOW-CKD investigators have published articles in the fields of socioeconomics, quality of life, nutrition, physical activity, renal progression, cardiovascular disease and outcomes, anemia, mineral bone disease, serum and urine biomarkers, and international and inter-ethnic comparisons. The KNOW-CKD researchers will elaborate a prediction model for various outcomes of CKD such as the development of end-stage kidney disease, major adverse cardiovascular events, and death.     

药师在全胃肠外营养支持中的技术作用

目的：介绍和探讨药师在临床全胃肠外营养支持过程中的技术作用,以保证其临床使用的安全、有效,经济。方法：以有代表性的文献及工作实际为基础进行总结、归纳。结果：阐述了药师在全胃肠外营养支持过程中工作的必要性、基本方法和注意事项。结论：药师在全胃肠外营养支持中起到不可替代的作用。     

Efficacy of erenumab and factors predicting response after 3 months in treatment resistant chronic migraine: a clinical service evaluation

BackgroundCalcitonin gene-related peptide (CGRP) inhibitors have been developed as options for treatment of chronic and episodic migraine. We present our experience of the use of erenumab in a tertiary headache centre.MethodsThis was a prospective clinical audit of all patients commenced on erenumab following a locally agreed pathway and criteria over a consecutive period. Patients received monthly erenumab 140 mg for 3 months. Data were collected prospectively at baseline and 3 months follow up.ResultsOne hundred three patients were commenced on erenumab during the study period. Patients had tried a median of 7 previous prophylactics, including onabotulinum toxin A in 94%. At 3 months there was a reduction in median total (28 to 20, 29% reduction, p < 0.0001) and severe (15 to 5, 67% reduction, p < 0.0001) headache days. 39.8% of patients achieved at least a 30% reduction in total headache days; 61.8% of patients achieved at least a 50% reduction in severe headache days. Meeting either of these thresholds was considered a positive response, 68% of patients achieved this. Presence of daily headache pattern was negatively associated with response, (56% response vs. 90% without daily headache, p = 0.0003). There was no association between age, gender, presence of medication overuse or number of previously tried prophylactic treatments and response to erenumab. 43% of patients reported at least one adverse effect, most commonly constipation (26%); treatment was discontinued in 3 patients due to adverse effects.ConclusionsErenumab was an effective treatment for chronic migraine in this treatment resistant population over 3 months of follow up. Presence of daily headache predicted poorer response but there was still a significant positive response rate in this group.     

兔转化生长因子-β2基因的克隆及其表达的检测

目的　克隆兔转化生长因子 β2 (TGF β2 )基因 ,并获得其在兔重要脏器及角膜中的表达。方法　利用不同物种的相似序列设计相关引物 ,制备兔肝组织的RNA并逆转录 ,RT PCR技术获得TGF β2 基因蛋白编码区序列后克隆 ,RT PCR半定量及荧光定量PCR检测TGF β2 在兔重要脏器及角膜中的表达。结果　成功地克隆了兔TGF β2 的蛋白编码区序列 ,测序证实和人、大鼠及小鼠具有高度的同源性 ,含有TGF β2 的保守结构域 ,TGF β2 基因在兔心脏、肝脏、脾脏、肺脏、肾脏、肾上腺和角膜组织中均有不同程度表达。结论　利用同源序列克隆进化上保守的基因是简捷快速的方法。获得兔TGF β2 的基因有助于进一步研究其在机体重要脏器纤维化、肿瘤以及角膜疾病中的作用     

High incidence of chromosomal abnormalities in oocyte donors

Oocyte donors are chosen among phenotypically normal and fertile women who are not expected to carry any chromosomal abnormality. A high incidence of balanced structural chromosomal rearrangements has been found within oocyte donors. This result raises the question of a possible bias in their recruitment with respect to their familial background and/or personal reproductive history.     

EXPERIMENTAL HYPOALBUMINEMIA : ITS EFFECT ON THE MORPHOLOGY,FUNCTION, AND PROTEIN AND WATER CONTENT OF THE LIVER

1. Adult dogs maintained for 6 weeks upon a carrot-protein-deficient diet exhibited a progressive fall in the serum protein confined entirely to the albumin fraction. The degree of hypoalbuminemia was pronounced, i.e. a fall from 3.75 to 2.00 gm. per cent. 2. Parallel microscopic changes in the liver were observed which consisted of a gradual loss in the stainable cytoplasm producing extensive vacuolization. This vacuolization was not due to the accumulation of fat or of glycogen as shown by chemical analyses as well as by stained sections of the livers. 3. The histological changes in the livers were assumed to be due to a loss of protein inasmuch as there was a parallel fall in the protein content of the liver pari passu with the fall in the serum albumin of the blood. This assumption is made more probable by the fact that the water content of the liver increased as the protein content decreased. 4. Liver function, as measured by the excretion of iso-iodeikon, fell with the fall of the serum albumin thus indicating the production of hepatic insufficiency by the protein deficient diet. 5. These observations are discussed in relation to the question whether the liver is the site of formation or of storage of serum albumin. Certain other, particularly therapeutic, implications are also discussed, i.e. the importance of a high protein intake in patients with liver disease.     

STUDIES ON THE SEROLOGICAL TYPING OF STREPTOCOCCUS HEMOLYTICUS

The cross-reactions which interfere with satisfactory serological identification of hemolytic streptococcus are due to anticarbohydrate in the sera used for typing. This antibody can be removed easily by absorption with purified streptococcus carbohydrate, and type identification is then readily established. The serological classification of hemolytic streptococcus from throat infections contracted in New York during 1935 and 1936 showed the predominance of types 4, 13 and 22. Type 13 appeared to be the most serious in initiating rheumatic activity during this period of observation.