基于中医古籍文献的升降散应用溯源及探析

通过对中医古籍中有关升降散论述的文献梳理,全面探讨其内涵。本方是在大黄、僵蚕为雏形的基础上增加蝉蜕、姜黄而成方,几经易名,终在杨璿《伤寒瘟疫条辨》中为后人所熟知。本方广泛用于治疗瘟疫,以丸剂、散剂为主,方便携带,便于服用;重用大黄旨在祛邪、逐秽;应用时视人之体质强弱和量其毒之轻重而判断用药多寡,并辅以米酒、生蜜等以顾护正气。杨璿将其由治疗“热疫”的专方扩展为治疗“表里三焦大热”的通用方剂,扩大了本方治疗疾病范围。     

Stress Testing Versus CT Angiography in Patients With Diabetes and Suspected Coronary Artery Disease

Background

The optimal noninvasive test (NIT) for patients with diabetes and stable symptoms of coronary artery disease (CAD) is unknown.

螺旋CT及CAD技术在人工关节定制设计中的应用研究

随着生物医用材料研制和医学的迅速发展，以及生活水平、医疗保健、康复水平的提高，人们对自身组织、器官及骨骼缺损的修复和置换方面的要求日益提高，尤其对人造骨骼和人工关节的需求越来越广泛。由于计算机断层成像技术CT（computed tomography）已经成为显示和研究人体内部结构非常有用的手段，将计算机辅助设计技术CAD（Computer aided design）和计算机辅助工程CAE（Computer aided Engineering）等相关技术应用于人造骨骼和内置假体的设计，不仅可以提高产品的设计质量，同时，结合CT和计算机三维重建方法，     

CAD基因原核表达载体的构建及表达产物的活性鉴定

目的构建pCool—GST—ICAD／CAD的表达载体，并存大肠杆菌BL21（DE3）中表达具有生物学活性的CAD核酸酶？方法用PCR扩增CAD基因，将扩增产物克隆入pCool—GST—ICAD载体中构建出pCool—GST—ICAD／CAD表达载体。经酶切和电泳鉴定正确后，在大肠杆菌BL21（DE3）中诱导表达，表达产物经亲和层析、离子交换层析及凝胶过滤等方法分离纯化。最后用SDS—PAGE和DNA降解实验进行鉴定。结果构建了pCool—GST—ICAD／CAD原核表达载体，重组载体转化后表达出毫克级水平的GST—ICAD／CAD蛋白复合体。经分离纯化后得到纯度很好的CAD—ICAD篮白复合体，在SDS—PAGE电泳上旱现清晰的两条蛋白带。经DNA降解实验证明纯化所得的CAD蛋白具有非特异性降解DNA的核酸酶作用。结论成功制备了具有生物学活性的CAD核酸酶，为进一步研究细胞凋亡的作用机制提供了有效的制剂。     

前扣带束的应用解剖定位

为了提高立体定向扣带束毁损术的疗效,本文对30例(60侧)成人正常脑标本探索在大脑原点前、扣带束毁损术最佳靶点的位置、坐标值及其毗邻关系。研究结果认为最佳手术部位应选择在原点前12mm处,该束高度为4.40±4.20mm、宽度为6.60±3.06mm、中心点距x轴的坐标值为6.30±2.20mm、该处扣带束的最低点与侧脑室前角的最高点间的距离为4.00±3.40mm,供临床参考。     

A solitary plasmacytoma of donor origin arising 14 years after kidney allotransplantation

Summary Allotransplantation of solid organs transfers passenger leucocytes which may give rise to a state of persistent microchimaerism. In this report we describe the case of a patient who developed a solitary plasmacytoma in a transplanted kidney more than 10 years after allografting. The diagnosis was established on the basis of the presence of a monoclonal IgG kappa peak in the serum, and light chain proteinuria, the plasmacytoid features of tumour cells including cell surface expression of IgG, kappa light chains, CD20, CD38 and CD56, the absence of lytic bone lesions and a normal bone marrow biopsy, and the disappearance of the monoclonal IgG peak after graft nephrectomy. A donor origin of the tumour was established by HLA DNA typing of tumour, tumour-free kidney tissue, and peripheral blood leucocytes, respectively.     

Is it time to reconsider initial antibiotic treatment strategies for severe urinary tract infections in Europe?

Until recently, most reported cases of bacteraemia caused by multidrug-resistant strains of Enterobacteriacae producing an extended-spectrum beta-lactamase (ESBL) in Europe have been nosocomial in origin. However, increasing numbers of reports of community-acquired bacteraemia and urinary tract infection caused by ESBL-producing microorganisms suggest that the geographical origin of patients should be taken into account as a risk-factor for possible ESBL production. Early identification of patients at high-risk of infection with ESBL-producing microorganisms, based on their geographical origin and travel history, should help to optimise initial antibiotic treatment strategies for severe urinary tract infections in Europe.     

Duplicated origin of right vertebral artery with rudimentary and accessory left vertebral arteries

Summary We observed a rare cerebrovascular anomaly in a patient with brain-stem infarction. Two right vertebral arteries arose from the subclavian artery and communicated directly with each other under the transverse foramen of the fourth cervical vertebra. The left vertebral artery consisted of a rudimentary artery that arose from the left subclavian artery, ran through the transverse foramen of the sixth cervical vertebra and then tapered down to disappear at the fourth/fifth cervical vertebrae, plus a second, accessory artery that arose from a branch of the left thyrocervical trunk, ran through the transverse foramen of the fifth cervical vertebra and tapered off to disappear at the first/second cervical vertebrae.