基于阴阳学说探讨巨噬细胞极化在心力衰竭炎症中的作用

炎症是心力衰竭(以下简称"心衰")的关键致病特征,其过表达可致心肌肥大、凋亡及纤维化,加重心衰的进程。巨噬细胞是人体重要的免疫细胞,具有高度异质性,参与炎症反应及维持心脏稳态。巨噬细胞极化是一个动态过程,在不同微环境的刺激下,巨噬细胞可极化2个亚群:经典激活的M1型和替代激活的M2型,两者相互拮抗。当巨噬细胞极化为促炎表型M1为主时,启动炎症反应;以抗炎表型M2为主时,发挥抑制心衰炎症、修复组织作用。同时,在心衰发展的不同阶段,M1和M2之间可相互转化,这与中医学说的阴阳制约、平衡和转化内涵相似。基于此,笔者拟通过阴阳理论来阐明M1与M2型巨噬细胞之间的关系,提出临床防治心衰应重视微观和宏观的炎症反应,调控巨噬细胞极化,使"抗炎"和"促炎"达到平衡,这与中医理论中调节机体阴阳平衡相一致,可为心衰的中医药治疗提供新靶点和新方向。     

血府逐瘀汤诱导内皮祖细胞对心肌缺血模型大鼠缺血区血管新生的影响

目的 观察血府逐瘀汤诱导内皮祖细胞(EPCs)对心肌缺血模型大鼠缺血区血管新生的影响,探讨其作用机制.方法 采用结扎冠状动脉左前降支方法 制备急性心肌缺血模型.实验大鼠随机分为正常组、假手术组、模型组、他汀组和血府逐瘀汤低、中、高剂量组.造模后将荧光标记的EPCs尾静脉注射植入模型大鼠体内,成模后灌胃给药,给药第3日和...     

中医诊断实训虚拟仿真课程的构建探索

中医诊断实训课程对于培养学生的操作技能、辨证思维起到积极作用,有助于开拓学生思路.由于诸多因素的影响,医学实践教学的质量难以提高,因此可使学生直观、形象地模拟各种实践操作过程的虚拟仿真技术受到青睐,但中医学领域应用还处于起步阶段.通过建立中医诊法技能和辨证思维的实践虚拟仿真,以及探索中医诊法生理、病理学理论的实验虚拟仿...     

侧支血管造影在脾破裂动脉栓塞术中的应用价值

目的 探讨侧支血管造影在脾破裂出血脾动脉栓塞中的重要性.方法 回顾性分析2018年1月～2021年1月52例脾破裂出血行脾动脉栓塞术的临床资料,术中同时行胃左动脉、胰十二指肠上动脉、膈肌动脉等周围血管造影,观察有无侧支血管开放,并栓塞侧支供血动脉.结果 52例中9例(17.3％)侧支血管开放参与脾脏供血.术后脾脏出血均...     

超选择性肾动脉栓塞治疗肾穿刺活检术后出血

目的探讨明胶海绵条超选择性肾动脉栓塞术治疗肾穿刺活检出血的疗效,评价其对近期肾功能的影响。方法回顾性分析2016年5月~2018年12月12例肾动脉栓塞治疗肾穿刺活检出血的资料,使用自备明胶海绵条进行超选择性肾动脉栓塞。结果12例出血全部得到控制,术后1周复查血肌酐较术前无明显变化(P>0.05)。结论采用超选择性肾动脉明胶海绵条栓塞治疗肾穿刺活检出血,即时止血效果显著,对肾功能影响小。     

龙葵氯仿提取物对肾透明细胞癌的干预作用研究

目的:探究龙葵氯仿提取物对肾透明细胞癌(CCRCC)细胞增殖和凋亡能力的影响,明确其在CCRCC中作用机制。方法:同步设空白组、顺铂组、龙葵组、抑制剂组、顺铂联合抑制剂组、龙葵联合抑制剂组采用CCK-8法检测CCRCC细胞系的增殖情况,运用AV/PI染色联合流式细胞术检测细胞的凋亡情况,Western Blot法定量检测PI3K/AKT信号通路关键元件的蛋白表达和磷酸化水平。结果:与空白组比较,各组对786-O的增殖均有抑制作用,均能促进细胞凋亡,其中以顺铂联合抑制剂组和龙葵联合抑制剂组最为突出。与空白组比较,各组均能调控PI3K/AKT信号通路,其中龙葵组的p-AKT表达下调最为显著。结论:龙葵氯仿提取物对CCRCC有较好的干预作用,其可能机制与抑制PI3K/AKT信号通路活化有关。     

巨噬细胞极化在心肌纤维化中的作用及Notch信号通路相关研究

巨噬细胞是一类免疫功能多样且具有高度异质性的细胞群体,在不同微环境的刺激下,可极化为两个亚群:M1型和M2型,且在心肌纤维化发展不同阶段其极化表型及功能存在显著差异。即在心肌纤维化早期,M1型比例升高以促进炎症进展;在心肌纤维化后期,M2型比例升高以缓解心肌纤维化。Notch信号通路可调控巨噬细胞极化,与心肌纤维化的发展有关,尤其是在心肌梗死、心力衰竭等心血管疾病中。故阻断Notch信号通路有利于调控巨噬细胞极化,进而有助于抑制或逆转心肌纤维化进程。     

Clinical observation on the correlation between moxibustion sensation and distance of moxa stick

Objective

To explore the correlation between moxibustion sensation and distance of moxa stick and provide reference for clinical practice.

Methods

A total of 16 healthy volunteers aged 18-35 years old in college were recruited and given mild moxibustion at Shousanli (LI 10), Zusanli (ST 36), Shenshu (BL 23) and Tianshu (ST 25) with moxa stick, and the occurrence and frequency of moxibustion sensation were recorded at distances of 5 cm, 4 cm, 3 cm and 2 cm. Mild moxibustion scale was used to count the score.

Results

Warm was the main moxibustion sensation, burning pain and soreness decreased with the rise of distance; for the same acupoint, score of mild moxibustion scale increased with the decrease of distance; score ranged between 5.5 and 6.5 at distance 3 cm, which was the most comfortable distance for volunteers.

Conclusion

The distance of 3 cm is the most comfortable distance in mild moxibustion

     

Influence of different-distance mild moxibustion at Zusanli (ST 36) on functional brain imaging in healthy population

Objective

To explore the beneficial regulatory effect of mild moxibustion from different distances at Zusanli (ST 36) of healthy population on the functions of temperature-related brain regions.

Methods

In 20 recruited healthy subjects, the change of the temperature-related brain regions induced by mild moxibustion from different distances at Zusanli (ST 36) was observed by functional magnetic resonance imaging (fMRI).

Results

In comparison of the values in amplitude of low-frequency fluctuation (fALFF) during and before moxibustion, it has been found that in moxibustion of 2 cm distance, fALFF value increased in the brain regions of the left anterior cingulated cortex and lateral surrounding cerebral regions, and fALFF value decreased in the cerebral regions of the peripheral cortex of the calcarine fissure; in moxibustion of 3 cm distance, fALFF value increased in the brain regions of the right and medial side and paracingulated gyrus, and fALFF value decreased in the cerebral zone of the left middle temporal gyrus; in moxibustion of 4 cm distance, fALFF value increased in the brain regions of the right and medial and paracingulated gyrus; and in moxibustion of 5 cm distance, fALFF value increased in the brain regions of the left hippocampus. In comparison of the value of regional homogeneity (ReHo), it has been found that in moxibustion of 2 cm distance, ReHo value increased in the cerebral zone of the posterior lobe of the right cerebellum, and ReHo value decreased in the cerebral zone of the right occipital lobe; in moxibustion of 3 cm distance, ReHo value increased in the brain regions of the left cerebellar posterior lobe and left frontal lobe, and ReHo value decreased in the cerebral zone of the right inferior temporal gyrus; in moxibustion of 4 cm distance, ReHo value increased in the brain regions of the right superior frontal gyrus and ReHo value decreased in the brain regions of the right parietal lobe and angular gyrus; in moxibustion of 5 cm distance, ReHo value increased in the cerebral zone of the right frontal lobe and ReHo value decreased in the cerebral zone of the right brainstem.

Conclusion

In moxibustion of 3 cm distance, the changes in the brain regions basically conform to the transmission route of body trunk temperature.

     

穴位注射鹿瓜多肽注射液配合中药熏蒸治疗类风湿性关节炎42例临床观察

目的：观察穴位注射鹿瓜多肽注射液配合中药熏蒸治疗类风湿性关节炎的疗效。方法：42例类风湿性关节炎患者采用穴位注射鹿瓜多肽注射液配合自拟蠲痹熏洗方中药熏洗治疗,观察疗效。结果：临床缓解11例（26．2％）,显效16例（38．1％）,有效12例（28．6％）,无效3例（7．1％）,总有效率为92．9％。结论：穴位注射鹿瓜多肽注射液配合中熏蒸治疗类风湿性关节炎疗效好．无不良反应,投资少,简便易行,值得临床推广。