高效液相色谱法测定复方生地合剂中绿原酸的含量

目的：建立复方生地合剂中绿原酸含量测定的高效液相色谱法。方法色谱柱（250 mm±4.6 mm,5μm）,流动相：乙腈-0.4%磷酸溶液（10：90）,流速1 mL·min-1,柱温30℃,检测波长327 nm。结果绿原酸在0.0624-4.68μg范围内线性关系良好。R=0.9999,平均回收率为100.7%,RSD=1.7%（n=6）。结论该方法操作简便,重复性高,可用于复方生地合剂的质量控制。     

针药结合治疗多发性硬化临床研究

目的：观察针药结合治疗多发性硬化（MS）的临床疗效。方法：将60例MS患者随机分为针药组（32例）和西药组（28例）;针药组给予针灸和首乌益髓汤治疗,西药组给予巴氯芬片口服,疗程6个月。观察两组治疗前后中医临床症状评分、神经功能障碍评分（EDSS）、生活质量（QOL）评分等变化。结果：治疗后针药组中医临床症状积分和总积分较治疗前显著降低（P〈0.01）,且针药组积分低于西药组（P〈0.01）。治疗后两组EDSS评分、Barthel指数评分、QOL评分有不同程度改善（P〈0.01）,针药组优于西药组（P〈0.01）。结论：针药结合可改善MS患者临床症状,提高生活质量。     

手捻针干预重症抑郁障碍共病失眠:证据来自多导睡眠图及血清生物标志物

ObjectiveThis study is conducted to determine effects of manual acupuncture (MA) in patients with a diagnosis of major depressive disorder (MDD) and comorbid insomnia.MethodsA total of 67 participants who met the inclusion criteria were randomly enrolled in a two-arm randomized, placebo controlled, patients-blind trial and allocated to a real-MA group (patients = 34) and a sham-MA group (patients = 33). Patients in the real-MA group were treated on ‘Five-shen acupoints’, including Sìshéncōng (四神聪 EX-HN 1), Shéntíng (神庭 GV 24), Shéndào (神道 GV 11), bilateral Běnshén (本神 GB 13), and bilateral Shénmén (神门 HT 7). Though being punctured on the same acupoints, patients in the sham-MA group were treated by a placebo acupuncture approach (Streitberger Placebo-needle). Each group received corresponding interventions every other day, three times a week for total eight weeks. Both polysomnography (PSG) and testing of serum biological markers such as neuropeptide Y (NPY) and substance P (SP) were performed at pre- and post-treatment. Additionally, the global scores of Pittsburgh sleep quality index (PSQI) and the global scores of 17-items Hamilton Depression Rating Scale (HAMD17) were used for assessing the subjective sleep and emotion experience of patients, respectively. Meanwhile, adverse effects were monitored and recorded.ResultsAfter eight-week treatment, the global scores of PSQI and global scores of HAMD17 declined significantly (both P < 0.05) in the real-MA group but not in the sham-MA group (both P > 0.05). According to the parameters of PSG, striking decline were observed in sleep latency (SL) and wake after sleep onset (WASO) and striking climb were observed in total sleep time (TST) and sleep efficiency (SE) in the real-MA group after treatment (P < 0.05, respectively) but not in the sham-MA group (P > 0.05, respectively). Additionally, there were no significant differences in awakening times (ATs) and rapid eyes movement sleep latency (REM-SL) in both two groups after treatment (both P > 0.05). Meanwhile, the expression of NPY increased significantly and the expression of SP decreased significantly in the real-MA group after interventions (both P < 0.05) while those indicators only slightly fluctuated in the sham-MA group (P > 0.05). No serious adverse event was reported in either real- or sham- MA group.Conclusion(1) MA may be a potential alternative therapy for improving MDD and comorbid insomnia (particularly in extending total sleep time and shortening wake-up duration and sleep latency) via upregulating the expression of NPY and downregulating the expression of SP; more importantly, this efficacy of acupuncture can not be replaced by sham-acupuncture acting on the same acupoints with the same treatment frequency. (2) There is insufficient evidence to prove that MA can effectively reduce the number of arousals.     

从心脑论治电针中风后焦虑障碍:随机对照试验

ObjectiveTo evaluate the differences in the clinical effect and the safety in the treatment of post-stroke anxiety disorder (PSAD) between electroacupuncture (EA) and paroxetine on the base of the heart-brain theory.MethodsA total of 70 patients of PSAD were randomized into an EA group and a medication group, 35 cases in each one. In the EA group, four acupoints were selected and divided into two pairs. In the Pair A, there were Băihuì (百会 GV20) and Fēngfŭ (风府 GV16). In the Pair B, there were Xīnshū (心俞 BL15) and Shénmén (神门 HT7). After acupuncture, the electroacupuncture apparatus was applied. The duration of needle retention was 20 min. EA was given three times a week, totally for 4 weeks. In the medication group, paroxetine tablets were administered orally, 10 mg daily in the first 4 days and 20 mg afterwards, totally for 4 weeks. Before and after treatment, as well as in the follow-up period, Hamilton anxiety scale (HAMA), Barthel index (BI) for daily life ability, and clinical global impression (CGI) were observed and the clinical therapeutic effect was evaluated separately.ResultsA total of 3 cases were dropped-out in the medication group. Finally, 35 cases in the EA group and 32 cases in the medication group were included in the analysis. Compared with the scores before treatment, the scores of HAMA and CGI-SI (severity of illness) were lower and the scores of BI were higher after treatment and during the follow-up in either the EA group or the medication group (all P < 0.05). Compared with the scores after treatment, the differences were not significant in HAMA and CGI-SI scores during the follow-up in either the EA group or the medication group (all P > 0.05). Compared with the medication group, BI score in the EA group was higher in the follow-up, indicating the statistical significance (P < 0.05). After treatment, CGI-SI score was different statistically between the EA group and the medication group (P < 0.05). There were 5 cases with adverse reactions in the EA group and 9 cases in the medication group.ConclusionsThe therapeutic effect of electroacupuncture on the base of heart-brain theory is similar to the oral administration of paroxetine in the treatment of post-stroke anxiety disorder. This therapy relieves anxious emotions, promotes the recovery of limb function and has less adverse reactions in the patients.     

疏肝饮对大鼠离体结肠纵行平滑肌条收缩的抑制作用

目的观察疏肝饮对大鼠离体结肠纵行平滑肌条收缩的抑制作用及其机制。方法制备大鼠离体结肠纵行平滑肌（CLSM）肌条,应用氯化卡巴胆碱（CCh）引起肌条收缩,再加入不同浓度的疏肝饮,观察疏肝饮对CLSM收缩的抑制作用,制作疏肝饮抑制收缩作用的量效反应曲线。在此基础上加入不同的抑制剂,观察这些抑制剂对疏肝饮作用量效曲线的影响。结果疏肝饮对CCh刺激后CLSM肌条的收缩具有抑制作用,这种抑制作用具有浓度依赖性。TMB-8组、4-AP组、Nifedipine组量效曲线变化与对照组相比较,上述指标均有显著性差异（P〈0.05）;而Apamin组、N-ethymaleimide组、Methylene blue组、L-NAME组量效曲线变化与对照组相比差异无统计学意义（P〉0.05）。结论疏肝饮对CCh刺激后的CLSM肌条的收缩有抑制作用,并呈浓度依赖性,这种抑制作用的信号分子机制可能与激活特异性钾通道、抑制胞外钙内流和胞内钙离子释放,使细胞内游离Ca2＋浓度降低有关。     

肝脾舒合剂治疗肝热脾虚型便秘型肠易激综合征临床观察

目的:观察肝脾舒合剂治疗肝热脾虚型便秘型肠易激综合征(C-IBS)的临床疗效。方法:将60例肝热脾虚型C-IBS患者分两组,治疗组40例予GPS合剂治疗,对照组20例予莫沙必利治疗,疗程8周。观察两组临床疗效、主要症状评分和生活质量评分变化。结果:治疗组总有效率为90.00%,对照组为60.00%,两组比较差异有显著性意义(P<0.05);治疗后两组主要症状积分均有降低(P<0.05),且治疗组低于对照组(P<0.05);两组患者生活质量均有不同程度改善(P<0.05),且治疗组改善优于对照组(P<0.05)。结论:肝脾舒合剂能改善肝热脾虚型C-IBS患者临床症状,提高其生活质量。     

Memory response to manual acupuncture in chronic insomniacs: evidence from event-related potentials

Objective

To investigate the effectiveness and safety of manual acupuncture for memory loss and sleep quality in chronic insomniacs.

Methods

A total of 60 eligible participants were enrolled and randomized into either a treatment group or a control group, with 30 cases in each group. The treatment group was intervened by manual acupuncture whereas the control group was given sham acupuncture. In the two groups, the interventions were offered once every other day and three times a week, for 8 weeks in total. Before and after the treatment, Pittsburgh sleep quality index (PSQI) and eventrelated potentials (ERPs) were used to assess the patients’ sleep quality and memory, respectively. Meanwhile, adverse events were monitored and recorded.

Results

After 8-week treatment, both the treatment group and the control group showed a significant decrease in the PSQI global score (P<0.001, P<0.01), and the decrease in the treatment group was more significant than that in the control group (P<0.001). The intra-group comparisons of ERPs indicated that, the latencies of N1 and P3 were shortened and the amplitudes of N1 and P3 were increased in the treatment group after the intervention, and the differences were statistically significant (P<0.05, P<0.001); in the control group, there were no significant changes in the latency and amplitude after the treatment (P>0.05). The between-group comparisons of ERPs showed that the treatment group was more effective than the control group in shortening the latency of P3 (P<0.01).

Conclusion

Acupuncture can be a safe and effective treatment option for chronic insomnia coupled with memory impairment.

     

CCl4诱导的小鼠纤维化肝组织微小RNA差异表达谱及初步功能分析

 目的：应用微小RNA(miRNA)芯片技术研究miRNAs在四氯化碳（CCl4）诱导的小鼠纤维化肝脏中的差异表达谱,并基于基因本体论（gene ontology,GO)分析及信号转导通路分析发现差异miRNAs的主要功能。方法：实验分为正常组及模型组,皮下注射 CCl4复制小鼠肝纤维化模型;应用Agilent 小鼠 miRNA 寡核苷酸基因芯片检测各组肝脏miRNA表达谱。用随机方差模型t检验筛选2组间的差异miRNAs,并预测其靶基因。对靶基因进行GO分析及信号转导通路分析发现差异miRNAs发挥的主要功能。结果：正常组与模型组间共筛选出39个差异miRNAs,其中模型组较正常组上调的23个,下调的16个。GO分析及信号转导通路分析结果提示差异miRNAs可能调控的靶基因及其参与的生物学功能包括细胞的增殖与活化、细胞凋亡、细胞周期、细胞黏附、细胞迁移、炎症反应、转化生长因子β（TGF-β）/Smads信号转导通路、Wnt受体信号转导通路、蛋白代谢过程的调控等。GO分析发现关键的上调miRNA包括mmu-miR-322、mmu-miR-15b、mmu-miR-195、mmu-miR-200b、mmu-miR-214等,关键的下调miRNA包括mmu-miR-16、mmu-miR-130a、mmu-miR-101b、mmu-miR-30a和mmu-miR-30e等。对显著性GO与显著性信号通路所属的靶基因取交集,对网络中miRNA在网络中的调控地位进行评价,结果发现关键的上调miRNAs包括mmu-miR-200b、mmu-miR-322、mmu-miR-106b、mmu-miR-23a、mmu-miR-15b等,关键的下调miRNAs包括mmu-miR-16、mmu-miR-30e、mmu-miR-30c、mmu-miR-30a、mmu-miR-130a等。结论：纤维化肝组织miRNAs表达较正常肝组织发生明显变化;肝纤维化形成的各个环节,包括细胞的增殖与活化、细胞黏附、细胞凋亡、细胞迁移与分化、物质代谢、TGF-β信号通路等都可能受miRNAs的调控。     

体验式护理教学对提高中医专业学生人文素质的影响

目的:探讨体验式教学对中医专业医学生临床护理见习人文素质的影响。方法:选择有临床护理见习要求的一年级中医专业学生72名,随机分为2组,每组各36名,同期交叉进行为期2周的护理见习。第1周A组参与人文体验式教学、B组为传统带教式教学,第2周两组对换。学习结束予人文素质问卷测试。结果:学生普遍认为,体验式教学对提高医患交流和处理实际问题等综合能力有明显帮助;在人文关怀评分方面,体验式教学明显优于传统教学(P<0.05)。结论:体验式教学有助于培养医学生的人文素质,有效提高临床护理见习效果。