Sequential Therapy Based on Evolvement of Patterns: A New Model for Treatment of Alzheimer’s Disease

In order to solve the problem of long-term (>9 months) efficacy in the treatment of Alzheimer''s disease (AD) by conventional therapy (CT), a staged and multiply-targeted sequential therapy based on the evolvement of patterns (STEP) was developed. Its main innovations include: (1) the time order of evolution of patterns defined by Chinese medicine (CM) in AD was found, that is, "the orderly pattern evolution starting from Shen (Kidney) deficiency, progressing to phlegm, stasis and fire, and worsening to severe toxin as well as functional collapse"; (2) the cascade hypothesis of Shen deficiency in AD and its sequential therapy based on Shen-reinforcing was proposed, that is, "reinforcing Shen in the early stage and throughout the whole process, resolving phlegm, activating blood and purging fire in the middle stage, detoxifying and replenishing vitality to stop the collapse in the advanced stage", and through meta-analysis, clinical drug use was optimized, thus the leap from "inferential selection" to "evidence-based selection" was realized; (3) the STEP regimen combined with CT maintained cognitive and behavioral stability in AD patients for at least 12 months, with cognitive enhancement and behavioral synergy after 9 months, and cognitive benefit was superior to CT at 9, 12, 15, 18, 21, and 24 months, respectively. The 2-year cognitive improvement rate was increased by 25.64% (P=0.020) and the cognitive deterioration rate was decreased by 48.71% (P=0.000). Among them, the cognitive and functional benefits of Shen-reinforcing therapy for very early AD (350 cases) for 1 year were better than the placebo (P<0.001), and the dementia conversion rate was reduced by 8.85% (P=0.002). The behavioral symptomatic relief of patients with vascular dementia received fire-purging therapy (540 cases) was superior to those received CT (P=0.016). These data suggested that the STEP regimen has synergistic effects on CTs at least in terms of cognitive benefit, and the earlier the use, the greater the benefit will have. Therefore, the STEP regimen should be considered as one of the clinical options, particularly for the dearth of effective pharmaceutical or immunological interventions that are currently available for AD.     

a-1, 2岩藻糖基转移酶II在肺鳞癌组织中的表达及对肺鳞癌细胞增殖的影响

目的：探讨a-1，2岩藻糖基转移酶II（FUT2）在肺鳞癌中的表达情况及其对肺鳞癌细胞增殖的影响。方法：应用UALCAN数据库分析FUT2在临床肺鳞癌患者组织中的差异表达及其与肺鳞癌患者临床TNM分期、年龄及性别因素的相关性；采用瞬时转染技术，将FUT2的shRNA质粒转染进H226细胞株中构建FUT2低表达的肺鳞癌细胞模型；利用CCK-8、平板克隆及Western blot实验检测FUT2对肺鳞癌细胞的生长、单克隆细胞团形成及PCNA蛋白表达的影响。结果：FUT2在肺鳞癌尤其是肺鳞癌TNM早中期呈现高表达趋势（P＜0.05），而与年龄和性别无关。低表达FUT2可以抑制肺鳞癌细胞的生长速率和单克隆细胞团的形成数，同时，可以抑制肺鳞癌细胞PCNA蛋白的表达水平，差异均有统计学意义（P＜0.05）。结论：FUT2在肺鳞癌中高表达且促进肺鳞癌细胞的增殖能力，有望成为肺鳞癌的早期诊断指标。     

Outcomes of Early Decompressive Craniectomy Versus Conventional Medical Management After Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis

This meta-analysis examined whether early decompressive craniectomy (DC) can improve control of intracranial pressure (ICP) and mortality in patients with traumatic brain injury (TBI).Medline, Cochrane, EMBASE, and Google Scholar databases were searched until May 14, 2015, using the following terms: traumatic brain injury, refractory intracranial hypertension, high intracranial pressure, craniectomy, standard care, and medical management. Randomized controlled trials in which patients with TBI received DC and non-DC medical treatments were included.Of the 84 articles identified, 8 studies were selected for review, with 3 randomized controlled trials s having a total of 256 patients (123 DCs, 133 non-DCs) included in the meta-analysis. Patients receiving DC had a significantly greater reduction of ICP and shorter hospital stay. They also seemed to have lower odds of death than patients receiving only medical management, but the P value did not reach significance (pooled odds ratio 0.531, 95% confidence interval 0.209–1.350, Z = 1.95, P = 0.183) with respect to the effect on overall mortality; a separate analysis of 3 retrospective studies yielded a similar result.Whereas DC might effectively reduce ICP and shorten hospital stay in patients with TBI, its effect in decreasing mortality has not reached statistical significance.     

肝门胆管癌的动态增强CT诊断

目的评价螺旋CT对肝门胆管癌的诊断价值。方法13例肝门胆管癌行螺旋CT平扫及动态增强扫描,并与手术及病理对照分析。结果11例平扫表现为肝门区低密度软组织肿块;2例表现为肝门区胆管不规则增厚,管腔狭窄。增强扫描13例有延迟强化。结论螺旋CT扫描对肝门胆管癌的诊断具有重要意义。     

不同区域晶状体上皮细胞基因表达差异分析

【目的】比较不同区域猪晶状体上皮细胞的基因表达在转录组水平上的差异。【方法】解剖显微镜下分离晶状体前囊膜，将附着于其上的上皮细胞分为中央（直径为10．56mm）和周边两部分。分别提取两个样本的总RNAs并经PCR扩增，以Cy3和Cy5分别标记扩增的中央与周边部分的cDNA。与含7548个基因的表达谱芯片杂交，经图像分析，生物信息学处理获得基因表达在转录水平差异的相关信息。【结果】中央与周边区域的猪晶状体上皮细胞在转录组水平共鉴定出952个有效表达的基因点，其中差异表达基因261个．以中央区域为参照，周边上皮细胞mRNA上调137个，下调124个。差异表达基因主要涉及的功能有：细胞周期与凋亡、细胞骨架蛋白及细胞外基质、转录、细胞信号分子等。【结论】中央与周边区域猪晶状体上皮细胞基因表达在转录组水平上差异明显。这类差异呈明显的功能聚类。     

肛直肠抑制反射时门静脉血中P物质变化

目的探讨肛直肠抑制反射（RAIR）时门静脉血中P物质（SP）的变化规律及外源性内脏神经对其变化的影响。方法将实验大白鼠分为7组，其中6组先按去与不去直肠肛管外源性内脏神经支配而分为不去神经和去神经两大组，每组中又按Foley导管上气囊置入直肠腔中的位置分为2、4、6cm组；同时再设1个对照组，将Foley导管置入直肠腔中，但不注水扩张球囊。检测并比较在直肠腔内刺激后，各组门静脉血中的SP值及变化情况。结果去神经组中2、4cm组与不去神经组之间及对照组之间，门静脉血中SP值变化比较，P〉0．05，差异无统计学意义。不去神经组中的6cm组与对照组及去神经组中2cm和4cm组之间SP值比较，P〈0．01，差异有统计学意义；去神经组和不去神经组中的6cm组之间SP值比较，P〈0．01，差异有统计学意义。结论直肠腔内上部的刺激不引出RAIR可能与该部位的刺激使内括约肌兴奋性递质（SP）的释放有关；外源性内脏神经对RAIR中门静脉血的SP变化有调控作用。     

游走火罐配透刺、艾灸治疗周围性面瘫35例

周围性面瘫,多是由面神经炎引起面神经缺血、水肿导致的面肌瘫痪[1].笔者近年在沙特阿拉伯工作期间,有感于面部按摩疗法在周围性面瘫康复中的广泛应用,以面部游走火罐配合针灸疗法治疗本病35例,均取得了较好的疗效.现总结如下.     

灰关联分析应用于因素分析时关联度指标的改进

本文指出在应用灰关联分析进行因素分析时传统的关联度计算方法的不足，并提出采用新的关联度指标来表示因素之间的关联关系，同时给出了实例介绍计算方法。     

铁路系统医院136篇口腔修复、正畸学论文的统计分析

通过对铁路系统医院１３６篇口腔修复、正畸学论文的统计分析，来评价医院口腔修复、正畸的科研水平，同时也揭示了科研工作中存在的问题。指出只有加强科研协作、扩大学术交流、增加科研投入，提高科研水平，使科研成果更趋完善。