口服降糖药和胰岛素对眼表治疗的影响（英文）

目的：描述和对比口服降糖药（OAD）和胰岛素治疗2型糖尿病患者眼表的效果。方法：在安卡拉卫生部培训和研究医院就诊的20例40眼口服降糖药患者,20例40眼胰岛素治疗患者,对照组的10例非糖尿病人作为研究对象。对所有患者进行常规眼科检查,Schirmer试验,泪膜破裂时间分析和结膜印迹细胞学分析.比较三组的泪液功能参数,杯状细胞密度和鳞状上皮化生等级。记录视网膜病变及眼表疾病之间的关系。结果：口服降糖药患者泪膜破裂时间值明显低于其他组（P〈0.05）。三组的杯状细胞密度和鳞状上皮化生等级相近。上皮细胞稍大,呈现更多的多边形的眼的中位数级为1级,并且嗜酸性染色胞浆和杯状细胞数量减少。视网膜病变与眼表疾病不相关。结论：口服降糖药患者的角膜前泪膜稳定性比其他组差。各组的印迹细胞学分析结果相似。     

药物化学探究性实验教学模式的探索

药物化学实验教学是药物化学课程的重要组成部分。传统的验证性实验教学方法和教学内容存在较大的缺陷,而探究性实验教学模式突出了学生在实验中的自主性,可以有效地弥补验证性实验教学的不足。实践证明,药物化学探究性实验教学模式不仅提高了学生的学习热情和主动性,同时还培养了学生的自学能力、创新思维和创新能力。     

Use of hybrid chitosan membranes and human mesenchymal stem cells from the Wharton jelly of umbilical cord for promoting nerve regeneration in an axonotmesis rat model

Many studies have been dedicated to the development of scaffolds for improving post-traumatic nerve regeneration. The goal of this study was to assess the effect on nerve regeneration, associating a hybrid chitosan membrane with non-differentiated human mesenchymal stem cells isolated from Wharton’s jelly of umbilical cord, in peripheral nerve reconstruction after crush injury. Chromosome analysis on human mesenchymal stem cell line from Wharton’s jelly was carried out and no structural alterations were found in metaphase. Chitosan membranes were previously tested in vitro, to assess their ability in supporting human mesenchymal stem cell survival, expansion, and differentiation. For the in vivo testing, Sasco Sprague adult rats were divided in 4 groups of 6 or 7 animals each:Group 1, sciatic axonotmesis injury without any other intervention (Group 1-Crush); Group 2, the axonotmesis lesion of 3 mm was infiltrated with a suspension of 1 250-1 500 human mesenchymal stem cells (total volume of 50 μL) (Group 2-CrushCell); Group 3, axonotmesis lesion of 3 mm was enwrapped with a chitosan type III membrane covered with a monolayer of non-differentiated human mesenchymal stem cells (Group 3-CrushChitIIICell) and Group 4, axonotmesis lesion of 3 mm was enwrapped with a chitosan type III membrane (Group 4-CrushChitIII). Motor and sensory functional recovery was evaluated throughout a healing period of 12 weeks using sciatic functional index, static sciatic index, extensor postural thrust, and withdrawal reflex latency. Stereological analysis was carried out on regenerated nerve fibers. Results showed that infiltration of human mesenchymal stem cells, or the combination of chitosan membrane enwrapment and human mesenchymal stem cell enrichment after nerve crush injury provide a slight advantage to post-traumatic nerve regeneration. Results obtained with chitosan type III membrane alone confirmed that they significantly improve post-traumatic axonal regrowth and may represent a very promising clinical tool in peripheral nerve reconstructive surgery. Yet, umbilical cord human mesenchymal stem cells, that can be expanded in culture and induced toform several different types of cells, may prove, in future experiments, to be a new source of cells for cell therapy, including targets such as peripheral nerve and muscle.     

论扶阳学派理论基础与核心思想

任何一个学派的形成,都有它的理论基础和核心思想,而且是维系和推进其存在与发展的基石。扶阳学派作为中医学众多学术流派之一,与其它学派一样,其理论基础无疑是《内经》的重要思想,并与《易经》、《伤寒论》等有十分密切的关系。其核心思想就是重视阳气,推崇阳气,力主阳主阴从。深入研究扶阳学派理论,对于繁荣中医学术,提高中医临床疗效,维护人民健康,促进中医药事业发展,具有重要的现实意义和深远的历史意义。     

路艺主任医师糖尿病足治验

糖尿病足是糖尿病常见的并发症,其中医病因病机主要是湿热、痰浊循经脉下行于足部,久而引起局部组织损害。路艺主任医师将糖尿病足坏疽辨为湿热蕴结及热盛伤阴两种证型,采用药物外敷法及针灸治疗有明显效果。     

腹腔镜肝切除技术的优化

目的通过动物实验优化腹腔镜肝切除中入肝血流阻断技术及肝实质离断技术。方法以10头猪为实验动物,以肝门阻断钳或可拆卸肝门阻断钳及鞘内解剖优化腹腔镜下入肝血流阻断技术;在没有任何入肝血流阻断的情况下,分别进行肝脏局部切除、左外侧叶及左内侧叶的序贯切除,肝实质离断采用超声刀、LigaSure、微波刀、双极电凝、外科夹及内镜切割闭合器完成,比较不同器械离断肝实质的效果和安全性。结果肝门阻断钳或可拆卸肝门阻断钳行入肝血流全部阻断或部分阻断后,缺血部分肝脏颜色变化明显;鞘内解剖左半肝入肝血流阻断后,左、右半肝间的缺血线明显;各种常用肝实质离断器械均有其适用范围,对其的优化使用可提高断肝效率,减少出血。结论通过动物实验优化的腹腔镜入肝血流阻断技术以及肝实质离断技术,可为腹腔镜解剖性广泛肝切除的临床应用提供依据。     

诊余医话

1懊憹证之我见 懊憹证临床较多见,常见于内科杂证中,尤以合并植物神经功能失调,或气郁化热,热郁胸间,气机升降失调之症最为多见。在主方中配合栀子豉汤,或用栀子豉汤加味疗效甚佳。笔者发现年轻中医甚至高年资医生对懊憔证几乎淡忘了,甚感漠然。     

《伤寒论》之病位研究

《伤寒论》是一部对外感病进行辨证论治的专著,但其中涉及内科杂证者甚多。如本文所及之"蓄血证"、"热入血室"证、"结胸"证、"脏结"证,既可见无外感变证中,又可于杂病中出现。这四个病证于临床中经常见到,虽然依张仲景之法论治,每获捷效,但究其所以,却不能了了。首先是这几种病的病位问题,自古迄今,无人指点明白。笔者对此谨抒自见,以"蓄血证"蓄于肠道与冲脉,以"热入血室"为热在血分,以"结胸"证为邪结胸膈胃肠,以"脏结"证为邪结在肝。     

慢性咳嗽中医药治疗再探讨

<正>钟南山院士撰文以"共同努力,提高国内慢性咳嗽的诊治水平"为题,强调"咳嗽是临床上的一种常见病,特别是胸部X线无明显异常的慢性咳嗽,约占呼吸专科门诊的20～30%,临床误诊、误治率高,给患者的工作、生活和学习带     

雷公藤多甙对哮喘豚鼠炎症的抑制作用

目的：通过哮喘豚鼠模型研究雷公藤多甙（ｔｒｉｐｔｅｒｙｇｉｕｍｐｏｌｙｇｌｙｃｏｓｉｄｅ，ＴⅡ）对哮喘豚鼠炎症的抑制作用。方法：用卵白蛋白诱发致敏豚鼠哮喘发作，同时进行ＴⅡ与地塞米松（ｄｅｘａｍｅｔｈａｓｏｎｅ，ＤＥＸ）的对照治疗，观察豚鼠支气管－肺泡灌洗液（ＢＡＬＦ）中细胞学、肺组织病理及超微结构的变化。结果：豚鼠诱发哮喘后２４ｈ和７２ｈＢＡＬＦ中炎性细胞、嗜酸细胞总数及其分类计数的结果显示，哮喘组较正常对照组明显增多，而ＴⅡ和ＤＥＸ治疗组尤其是ＴⅡ大剂量组则明显减少，与正常对照组比无显著差异（Ｐ＞０．０５），与哮喘组比有明显差异（Ｐ＜０．０５）。组织形态学也显示ＴⅡ对哮喘豚鼠迟发性哮喘反应有明显的抑制作用。结论：ＴⅡ对哮喘豚鼠炎症有明显的抑制作用。