2023年(癸卯年)运气推演及疾病防治探微

基于五运六气理论,从五运、六气、客主加临等方面分析2023年运气特点,发现2023年火运不及,上半年凉燥,下半年多热。从运气相合的角度分析应以气为主,运次之。由六气而言,初之气需注意健脾利湿,辅以疏肝;二之气应泻南补北,滋水涵木;三之气宜疏利少阳;四之气需温肾健脾清心;五之气应条达肝胆,兼清肺;六之气清心补肾。     

LQB和qLQB模型的创建及在放射性肺损伤中的初步研究

目的 基于LQ模型建立LQB和qLQB模型,初步评估其放射性肺损伤中的有效性。方法 随机抽取45例胸部肿瘤患者资料,在医科达Precise 2.12 TPS上为每例患者设计计划,用定性LQB和LKB模型分别对计划优选结果进行评估。在定性LQB模型基础上建立定量LQB模型(qLQB模型),用qLQB模型计算上述优选计划的放射性肺损伤值,并将放射性肺损伤值与LKB模型计算的NTCP值进行配对t检验。结果 定性LQB和LKB模型对计划评估的吻合率为96%。qLQB模型计算的肺损伤值与LKB模型计算的NTCP值相近(P=0.412)。结论 LQB和qLQB模型在优选计划和评估放射性肺损伤方面与LKB模型有很好的一致性。     

口腔修复门诊老年病人心理特点分析及对策

老年患者占口腔修复科临床接诊病人的很大部分，本文从医学伦理学角度入手对门诊老年病人心理状态进行分析，探讨相应对策，以寻求临床上医患更好地合作。作者的建议主要包括：(1)提高医师自身综合素质。(2)尊重、爱护老年患者，满足老年患者的合理要求。(3)治疗过程中应树立高度的道德责任感与正确的伦理道德观。     

Single nucleotide polymorphisms in the D-loop region of mitochondrial DNA and age-at-onset of patients with chronic kidney disease

Background The mitochondrial displacement loop （D-loop） accumulates mutations and single nucleotide polymorphisms （SNPs） at a higher frequency than other regions of mitochondrial DNA （mtDNA）.We previously identified disease riskassociated SNPs in the D-loop of chronic kidney disease （CKD） patients; in this study,we investigated the association of age-at-onset and D-loop SNPs in CKD patients.Methods The D-loop region of mtDNA was sequenced in 119 CKD patients attending the Fourth Hospital of Hebei Medical University between 2002 and 2008.The age-at-onset curve of the CKD patients was calculated using the KaplanMeier method at each SNP site,and compared using the log-rank test.Results The mean age of 119 CKD patients was （55.6±14.2） years,and 56.3% were males.The mean estimated glomerular filtration rate （eGFR） was （81.2±12.4） ml·min^-1·1.73 m^-2,with 79.8% （n=95） of patients having an eGFR 〈60 ml·min^-1·1.73 m^-2.All participants had an eGFR 〉30 ml·min^-1·1.73 m^-2.The age-at-onset for CKD patients who smoked was significantly lower than that of non-smoking CKD patients.The SNP sites of nucleotides 150C/T were identified for their association with age-at-onset using the log-rank test.The age-at-onset of patients with the minor allele T genotype was significantly lower than that of patients with the C genotype at the 150 SNP site （P=0.010）.Conclusions Genetic polymorphisms in the D-loop appear to be predictive markers for age-at-onset in CKD patients.Accordingly,the analysis of genetic polymorphisms in the mitochondrial D-loop may help identify CKD patient subgroups at high risk of early onset disease.     

地黄饮子对脑缺血后大鼠海马BDNF的影响

目的研究地黄饮子对大鼠持续性脑缺血后海马内脑源性神经营养因子(BDNF)的影响.方法用线栓法建立大鼠脑缺血模型,以免疫组化技术显示地黄饮子在缺血后对海马区BDNF的影响.结果在大鼠脑缺血区有BDNF阳性神经元表达,缺血组和给药组海马区神经元随缺血时间的延长,存活细胞数目均逐渐减少,而给药组存活的神经细胞数目较缺血组多.结论地黄饮子可通过促进BDNF表达,抑制细胞死亡,促进脑缺血后海马神经元的存活和修复.     

美国肺癌防治工作对中国的启示

据《CA：A Cancer Journal for Clinicians》杂志发布的2021年美国癌症统计报告,自1991年以来,美国癌症死亡率呈持续下降趋势,至2018总体下降31%,提示因癌症死亡人数减少了约320万。尽管一些常见癌症死亡率下降趋势放缓,但由于控烟工作有效、医疗技术水平提高、癌症筛查的普及,加速推动...     

含银医疗器械质量检验中的几点建议

含银医疗器械因没有相应的国家标准和行业标准可依，企业注册质量标准技术要求不统一，给市场监管带来不便。本文对目前含银医疗器械质量检验过程中出现的问题进行了分析，并对质量技术要求及银含量检测方法提出了相应的建议。     

Unraveling the Phase Stability and Physical Property of Modulated Martensite in Ni2Mn1.5In0.5 Alloys by First-Principles Calculations

Large magnetic field-induced strains can be achieved in modulated martensite for Ni-Mn-In alloys; however, the metastability of the modulated martensite imposes serious constraints on the ability of these alloys to serve as promising sensor and actuator materials. The phase stability, magnetic properties, and electronic structure of the modulated martensite in the Ni₂Mn_1.5In_0.5 alloy are systematically investigated. Results show that the 6M and 5M martensites are metastable and will eventually transform to the NM martensite with the lowest total energy in the Ni₂Mn_1.5In_0.5 alloy. The physical properties of the incommensurate 7M modulated martensite (7M–IC) and nanotwinned 7M martensite (7M−(52¯)2) are also calculated. The austenite (A) and 7M−(52¯)2 phases are ferromagnetic (FM), whereas the 5M, 6M, and NM martensites are ferrimagnetic (FIM), and the FM coexists with the FIM state in the 7M–IC martensite. The calculated electronic structure demonstrates that the splitting of Jahn–Teller effect and the strong Ni–Mn bonding interaction lead to the enhancement of structural stability.     

急性冠脉综合征患者冠状动脉计算机断层扫描血管成像斑块定量分析的对比研究

目的 应用冠状动脉计算机断层扫描血管成像(CCTA)斑块定量分析,比较急性冠脉综合征(ACS)和稳定性冠心病(SCAD)患者冠状动脉斑块成分与负荷特征。方法 回顾性纳入2021年1月至3月就诊于中国人民解放军总医院第一医学中心心血管内科的116例冠心病(CAD)患者的临床资料,根据患者临床诊断结果将其分为ACS组(81例)和SCAD组(35例)。2组患者均在14 d内先后接受CCTA和冠状动脉造影检查。采用CCTA斑块定量分析软件测量各类斑块成分体积及负荷、最小管腔直径和重构指数(RI)、偏心指数(EI)等影像学指标并比较分析。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、Wilcoxon检验及χ²检验。结果 ACS组患者较SCAD组患者具有更大的总斑块负荷(TPB)、非钙化成分负荷(NCPB)和脂质成分负荷(LPB),差异均有统计学意义[(60.5±11.2)%和(51.7±14.4)%,(58.9±12.0)%和(50.1±15.2)%,17.9%(11.6%,27.6%)和14.2%(7.5%,20.8%),均P<0.0...     

Inheritance and Fitness Costs of Vip3Aa19 Resistance in Mythimna separata

The “high-dose/refuge” strategy is expected to work most effectively when resistance is inherited as a functionally recessive trait and the fitness costs associated with resistance are present. In the present study, a laboratory selected Mythimna separata strain that have evolved >634.5-fold resistance to Vip3Aa19 was used to determine the mode of inheritance. To determine if fitness costs were associated with the resistance, life history parameters (larva stage, pupa stage, pupal weight, adult longevity and fecundity) of resistant (RR), -susceptible (SS) and heterozygous (R_♂S_♀ and R_♀S_♂) strains on nontoxic diet were assayed. The LC₅₀ values of R_♀S_♂ were significantly higher than that of R_♂S_♀ (254.58 μg/g vs. 14.75 μg/g), suggesting that maternal effects or sex linkage were present. The effective dominance h of F₁ offspring decreased as concentration increased, suggesting the resistance was functionally dominant at low concentration and recessive at high concentration. The analysis of observed and expected mortality of the progeny from a backcross suggested that more than one locus is involved in conferring Vip3Aa19 resistance. The results showed that significant differences in many life history traits were observed among the four insect genotypes. In short, resistance to Vip3Aa19 in M. separata was inherited as maternal and multigene and the resistance in the strain was associated with significant fitness costs. The results described here provide useful information for understanding resistance evolution and for developing resistance management strategies.