《金匮要略》肺系病证辨治思路及特点探析

对<金匮要略>肺系病证的辨治思路及特点进行了分析,指出其证候表现以肺气壅滞属实者为多;治疗时注重区分标本缓急,在病证发作期以祛邪治标为先要;方药随证情而立,善用小青龙汤化裁进退;用药以辛温为主,喜择麻黄、石膏等药组方.     

土茯苓离体快繁研究

以土茯苓Smilax glabra Roxb根状茎侧芽的生长锥为外植体,以MS、3/2MS、B5和改良H等培养基为基本培养基,附加不同浓度的植物生长调节剂进行离体培养研究.结果表明:外植体在MS 6-BA 1.0 mg/L NAA 0.1 mg/L培养基上芽的萌动速度较快;萌动芽在MS 6-BA 1.0 mg/L NAA 0.1 mg/L 10%CM(椰子汁)培养基上丛生芽诱导和增殖的效果最佳;3/2MS 6-BA 0.05 mg/L 4%蔗糖培养基的壮苗效果较好;H NAA 0.5 mg/L培养基的生根率可达94%以上;以沙和泥炭土各1/2为基质移栽试管苗,成活率达到95%以上.     

安神调经针法治疗月经后期探析

心身疾病是当今医学亟待解决的课题.临床上大量月经后期的患者其发病与心理社会因素密切相关,属心身疾病的范畴.据此,笔者提出了月经调节的中医"心脑-肾气-天癸-冲任-胞宫轴"的新模式,并认为它与现代医学"大脑皮层-下丘脑-垂体-卵巢-子宫生殖轴"的神经内分泌调节系统极为相似.在此基础上创立了一套安神调经疗法.通过调整心脑功能,从而调节下丘脑-垂体-性腺轴,促进卵泡发育,治疗月经后期.并以此为突破点,为心身疾病引起的各种妇科病的针灸治疗提供了一种新方法、新思路.     

黄精多糖对新生大鼠大脑皮层神经细胞缺氧性凋亡的影响

目的:探讨黄精多糖对体外培养的新生大鼠大脑皮层神经细胞缺氧性凋亡的保护作用.方法:采用"Neurobasal加B27 Supplement"体外培养新生大鼠大脑皮层神经细胞,使用Hoechst 33342荧光染色、免疫细胞化学染色观察黄精多糖对缺氧复氧性神经细胞凋亡的保护作用.结果:缺氧前加入500μg/ml～1.5mg/ml的黄精多糖能显著地降低缺氧复氧培养诱导的神经细胞凋亡率,增加缺氧的神经细胞Bcl-2蛋白的表达,减少Bax蛋白的表达,提高Bcl-2/Bax比值.而缺氧12h后加入黄精多糖则无明显的抗凋亡作用.结论:缺氧前加入黄精多糖可以通过上调缺氧神经细胞Bcl-2表达、下调Bax表达和提高Bcl-2/Bax的比值以避免缺氧的神经细胞凋亡.     

增液承气汤临床举隅

增液承气汤是清代名医吴鞠通在<温病条辨>中治疗阳明腑实证因下后不通而设的方剂.用药玄参30g,生地24g,麦冬24g,大黄9g,芒硝4.5g.其方有滋阴攻下的作用.笔者用于治疗因阳明腑实引起的疾病,取得满意疗效.     

The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer.

AIM: Serum tumour markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and CA242 were investigated to evaluate the values of single and combined test in the diagnosis and prognosis of pancreatic cancer. METHODS: Pre-operative serum CEA, CA19-9 and CA242 were measured in 105 pancreatic cancers, 70 non-pancreatic malignancies and 30 benign pancreatic diseases. RESULTS: The sensitivity of CA19-9 alone was the highest in pancreatic cancer patients (80%), but the specificity was significantly lower than that of CEA and CA242 (P<0.01). The combination of CEA and CA242 could increase the specificity to 92%. In serum CA242 positive patients, the survival time was remarkably shorter than that of patients with negative result (P<0.01). The survival time in patients with more than two markers positive expression of CEA, CA19-9 and CA242 was obviously shorter than that of only one or no marker positive expression (P<0.05). CONCLUSION: The diagnostic rate of CA19-9 in pancreatic cancer is better than that of CEA and CA242. Combined detection of CEA and CA242 can improve the diagnostic specificity obviously. High levels of serum markers are associated with advanced stage of the disease. Patients with two or three markers positive expression of CEA, CA19-9, and CA242 simultaneously had a shorter survival time.     

Paclitaxel-based chemoradiotherapy in localized gastric carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome.

PURPOSE: Preoperative chemoradiotherapy may increase the R0 (curative) resection rate, overall survival (OS) duration, and disease-free survival (DFS) duration. We evaluated paclitaxel-based induction chemotherapy and chemoradiotherapy in patients with localized gastric or gastroesophageal adenocarcinoma to determine its feasibility, impact on the R0 resection rate, type of pathologic response, OS, and DFS. PATIENTS AND METHODS: Patients with operable, localized gastric, or gastroesophageal adenocarcinoma were eligible. Staging included endoscopic ultrasonography (EUS) and laparoscopy. Patients received two 28-day cycles of induction chemotherapy of fluorouracil, paclitaxel, and cisplatin followed by 45 Gy of radiation and concurrent fluorouracil plus paclitaxel. The cancer was restaged and surgery was attempted. Postsurgery pathologic findings and R0 resection were correlated with OS and DFS. RESULTS: Forty-one patients were enrolled. Most carcinomas were proximal (83%) and pretreatment stage EUST3 (85%). Forty patients (98%) underwent surgery, and 78% had an R0 resection. We observed a pathologic complete response (pathCR) rate of 20% and a pathologic partial response (pathPR) rate of 15% (< 10% residual cancer cells in the resected specimen). No pretreatment parameter (sex, cancer location, baseline T stage, or baseline N stage) predicted the type of postsurgery pathologic response, OS, or DFS. However, pathCR (P = .02), pathCR + pathPR (P = .006), R0 resection (P < .001), and postsurgery T and N stages (P = .01 and P < .001, respectively) were associated with OS. Same parameters were significantly correlated with DFS. Toxicity was manageable. CONCLUSION: The type of pathologic response but not pretreatment parameters was associated with OS and DFS. Efforts to increase the rate of pathologic response and better systemic cancer control are warranted.     

Polymorphisms in XPD exons 10 and 23 and bladder cancer risk.

INTRODUCTION: The nucleotide excision repair gene, xeroderma pigmentosum complementation group D (XPD), has been hypothesized to have a role in cancer risk, but results from prior molecular epidemiologic studies and genotype-phenotype analyses are conflicting. MATERIALS AND METHODS: We examined the frequency of the XPD Asp312Asn polymorphism in exon 10 and the XPD Lys751Gln polymorphism in exon 23 in 505 incident bladder cancer cases and 486 healthy controls. RESULTS: Overall, the XPD exon 10 and 23 genotypes were not associated with bladder cancer risk, after adjusting for age, sex, ethnicity, and smoking status. A gender-specific role was evident that showed an increased risk for women, but not for men, associated with the variant genotypes for both exons. For example, when the exon 23 variant allele genotypes were combined (Lys/Gln + Gln/Gln), there was an increased bladder cancer risk in women [odds ratio (OR), 1.69; 95% confidence interval (95% CI), 1.12-2.58] but not in men (OR, 0.99; 95% CI, 0.79-1.24; P(interaction) = 0.041; OR, 1.62; 95% CI, 1.02-2.58). There was also a gene-smoking interaction that showed the variant alleles for either exon or the combination of both increase the risk of bladder cancer for light and heavy smokers. For exon 23 (P(interaction) = 0.057; OR, 1.21; 95% CI, 0.99-1.47), heavy smokers (> or = 20 pack-years) who carried the exon 23 variant allele genotypes had an OR of 4.13 (95% CI, 2.53-6.73), whereas heavy smokers with the wild-type genotypes were at lower risk (OR, 3.55; 95% CI, 2.19-5.75). Moderate smokers (1-19 pack-years) with the variant allele genotypes had an OR of 1.54 (95% CI, 0.94-2.53), whereas moderate smokers with the wild-type genotypes had an OR of 1.12 (95% CI, 0.63-1.98). CONCLUSIONS: Although we did not observe main effects associated with the XPD genotypes, these results do suggest the variant allele genotypes were associated with increased bladder cancer risk in women and smokers with statistically significant interactions in the exon 23 polymorphism. Although there is biological plausibility, these novel findings for gender and smoking should be interpreted with caution upon confirmation in larger studies.     

食管癌发生发展过程中TRAIL和Survivin蛋白的表达研究

目的探讨食管癌发生发展过程中TRAIL、Survivin蛋白的表达及与食管癌病理特征的关系。方法采用免疫组化SP法对60例食管癌手术后大体标本中食管正常黏膜、单纯增生、不典型增生及浸润癌组织进行检测及分析。结果TRAIL蛋白从正常黏膜一单纯增生一不典型增生一浸润癌呈渐进性低表达，而Survivin蛋白则呈渐进性高表达。食管浸润癌组织中TRAIL蛋白的低表达与Survivin蛋白的高表达呈负相关（r=-0．480，P〈0．01）。结论TRAIL和Survivin2种蛋白参与了食管癌的发生发展，两者的表达失调导致了食管癌的发生。     

S100A4蛋白在宫颈鳞癌中的表达及意义

目的　研究S10 0A4蛋白在宫颈鳞癌组织中的表达及其临床意义。方法　应用免疫组织化学SP法检测 65例宫颈鳞癌组织和10例正常宫颈组织中S10 0A4蛋白。结果　在正常宫颈组织中S10 0A4蛋白不表达 ;在宫颈鳞癌组织中S10 0A4蛋白的表达率为3 5 .4% ( 2 3 /65 ) ;与正常宫颈组织比较 ,差异具有显著性 (P <0 .0 1)。S10 0A4蛋白在宫颈鳞癌中的表达与临床分期和淋巴结转移有关 (P <0 .0 1) ,与组织学分级无关 (P >0 .0 5 ) ;阳性细胞在血管平滑肌细胞以及淋巴细胞中亦有表达。结论　S10 0A4蛋白和宫颈鳞癌的侵袭和转移密切相关 ;S10 0A4蛋白可作为判定宫颈鳞癌临床病理特征的重要指标