张敬华从肝论治脑梗死急性期高血压经验介绍

介绍张敬华从肝论治脑梗死急性期高血压病的临床经验。张敬华认为，脑梗死急性期高血压属中医中风、脉胀范畴，其病机总属脏腑阴阳失调，气血逆乱。提出从肝论治脑梗死急性期高血压，治疗上有以下方法：以疏肝为要，兼通腑气；以平肝为主，佐以化痰；以清肝为用，辅以祛瘀；以补肝为本，兼顾补肾。     

子宫内膜异位症腹腔镜术后药物辅助治疗的临床分析

目的:探讨子宫内膜异位症腹腔镜术后配合使用孕三烯酮、米非司酮及中药治疗的疗效.方法:回顾2005年1月～2007年1月199例卵巢子宫内膜异位囊肿经腹腔镜手术后患者随机分为4组:子宫内膜异位症腹腔镜术后配合使用孕三烯酮、米非司酮及中药治疗与未用药组的疗效比较.随访1年,比较4组疗效及不良反应.结果:子宫内膜异位症腹腔镜术后配合使用孕三烯酮、米非司酮、中药治疗之间的疗效差异无显著性,而未用药组的疗效与前3组的疗效相比差异有显著性.结论:子宫内膜异位症腹腔镜术后加用药物是必要的,术后辅以孕三烯酮、米非司酮、中药治疗能有效地控制临床症状,延迟病灶复发时间,降低复发率,近期疗效较满意,远期疗效需要进一步观察.     

Effects of Fuscoporia obliqua on Postprandial Glucose Excursion and Endothelial Dysfunction in Type 2 Diabetic Patients

Postprandial hyperglycemia has been reported to elicit endothelial dysfunction and provoke future cardiovascular complications. A reduction of postprandial blood glucose levels by the glucosidase inhibitor Fuscoporia obliqua was associated with a risk reduction of cardiovascular complications, but the effects of Fuscoporia obliqua on endothelial function have never been elucidated. This study is aimed to assess the efficacy of Fuscoporia obliqua on postprandial metabolic parameters and endothelial function in type 2 diabetic patients. Postprandial peak glucose (14.47±1.27 vs. 8.50±0.53 mmol/liter), plasma glucose excursion (PPGE), and change in the area under the curve (AUC) glucose after a single loading of test meal (total 450 kcal; protein 15.3%; fat 32.3%; carbohydrate 51.4%) were significantly higher in the diet-treated type 2 diabetic patients (n=14) than the age- and sex-matched controls (n=12). The peak forearm blood flow response and total reactive hyperemic flow (flow debt repayment) during reactive hyperemia, indices of resistance artery endothelial function on strain-gauge plethysmography, were unchanged before and after meal loading in the controls. But those of the diabetics were significantly decreased 120 and 240 min after the test meal. A prior administration of Fuscoporia obliqua decreased postprandial peak glucose, PPGE, and AUC glucose. The peak forearm blood flow and flow debt repayment were inversely well correlated with peak glucose, PPGE, and AUC glucose, but not with AUC insulin or the other lipid parameters. Even a single loading of the test meal was shown to impair the endothelial function in type 2 diabetic patients, and the postprandial endothelial dysfunction was improved by a prior use of Fuscoporia obliqua. Fuscoporia obliqua might reduce macrovascular complication by avoiding endothelial injury in postprandial hyperglycemic status.     

Effects of static magnetic field on human umbilical vessel endothelial cell

Objective： To investigate the effects of static magnetic field（SMF） on the viability, adhesion molecule expression of human umbilical vessel endothelial cell. Methods： Magnetic flux intensity was 0. 1 mT, 1 mT, 10 mT. Cell viability and proliferation were measured with ^3H-TdR and MTT methods; and apoptosis of human umbilical vein endothelial cell （HUVEC） was studied by flow cytometry and transmission electric microscopy. ELISA was used to measure the expression of ICAM-1 and VCAM-1 on endothelium. Results： 0.1 mT SMF had no effects on the growth of HUVEC, however, SMF of 1 mT, 10 mT attenuated growth of HUVEC. 10 mT static magnetic field could induce apoptosis and necrosis of HUVEC. 10 mT SMF enhanced the expression of ICAM-1 and VCAM-1 on endothelium. Conclusion： The effect of SMF depends on the intensity of SMF. 10 mT SMF has adverse effects on human umbilical vessel endothelial cell.     

Investigation of hHB genes in a predigree of congenital monilethrix

Objective： To investigate the gene polymorphism in a pedigree of congenital monilethrix. Methods： Genomic DNA of affected members, the normal members of the pedigree and 50 unrelated normal members who came from different regions were extracted with a whole blood genomic DNA extraction kit and used as a template for the polymerase chain reaction （PCR）-mediated amplification of hHB1 and hHB6 genes. Results： In the pedigree, DNA analysis of patients and normal persons revealed C（447th） in exonl of hHB1 gene and the 52th codon was CCA encoding arginine. But it was a heteropeak of O or C in 50 unrelated normal members, which encodes glycine or arginine. It showed that this change was a single nucleotide polymorphisms （SNP）. Conclusion： A genetic heterogeneity of monilethrix exists in Chinese population. SNP which can result in the change of amino acid sequence is found in a pedigree of congenital monilethrix, and a genetic heterogeneity of monilethrix existed in Chinese population.     

Application of posterior Moss-Miami transpedicular system for the treatment of adolescent idiopathic scoliosis

Objective： To determine the effectiveness of posterior Moss-Miami transpedicular system for the treatment of adolescent idiopathic scoliosis in 24 patients with a 2-year minimum follow-up. Methods： 24 patients who underwent operations between September 2002 and November 2003 were evaluated for curve correction, spinal balance, and complications. Age at surgery averaged 13.8 years （range from 10 to 20）. The spinal deformities were evaluated by Cobb method with anteroposterior and lateral bending radiographs. All patients were right thoracic curves. Posterior instrumentation （Moss-Miami transpedicular system） was used. The transpedicular screws were placed between T2 and L2. All the patients were assessed both clinically and radiographically. Follow-up averaged 2.8 years. Results： There was an average correction of 72% of the primary curve （pre-operation standing average 54 degrees （range from 40 to 67 degrees）, post-operation average 15.2 degrees （range from 2 to 27 degrees）, at last examination average 16.1 degrees （range from 2 to 30 degrees）. Infection and neurological complications were not noted. No major complications were observed. Conclusions： Frontal and sagittal thoracic curve correction of thoracic scoliosis can be satisfactorily obtained using Moss Miami transpedicular instrumentation. It seems that control of the three columns of the spine by the transpedicular screws offers sufficient apical translation and coronal realignment.     

Thirty Cases of Obsession Treated by Point-Stimulation and with Small Dose of Chlorimipramine

Objective: To investigate the clinical therapeutic effects of point-stimulation for obsession. Methods: Sixty cases of obsession were divided into two groups: a control group of 30 cases treated with chlorimipramine (Ch1), and a treatment group of 30 cases treated by point-stimulation (PS) plus chlorimipramine (PS Chl). The therapeutic effects and side-effect were evaluated according to the criteria set in Yale-Brown Obsession Scale (Y-BOCS), Hamilton's depression scale (HAMD), brief psychiatric rating scale (BPRS) and treatment emergent symptom scale (TESS). Results: The cure rate and markedly effective rate were respectively 26.7% and 56.6% in the control group, and 43.3% and 50% in the treatment group, suggesting that the therapeutic effect in the treatment group was better than that in the control group. The incidence of adverse side-effects was 73.33% in the control group and 46.67% in the treatment group, with a significant difference between the two groups (P<0.05). Conclusion: Point-stimulation plus small dose of chlorimipramine was superior to the simple chlorimipramine treatment, indicating that the combined method was more effective and safe for obsession with less side effects.