补肾密骨液对实验性骨质疏松症的影响

本文观察了中药补肾密骨液对大鼠实验性骨质疏松症的影响，并以防治骨质疏松药尼尔雌醇、丙酸睾丸素及生理盐水作为对照。结果显示，中药组与雌、雄性激素组模鼠的骨矿密度及骨质无机元素钙、镁、锰、铜含量明显高于盐水组（Ｐ＜０．０５，Ｐ＜０．０１，Ｐ＜０．００１）；空腹尿钙／肌酐、羟脯氨酸／肌酐等，诸骨吸收生化指标明显低于盐水组（Ｐ＜０．０５，Ｐ＜０．０１）．通过骨组织计量学参数值分析，表明补肾密骨液不仅能刺激衍化增生成骨细胞，产生较多的骨基质，使类骨质转变为矿化骨小梁；还能抑制破骨细胞的骨吸收活动，使模鼠的骨再建活动恢复正平衡状态。     

从《临证指南医案》管窥叶天士五运六气证治思路

文章总结探讨叶天士对五运六气学说的认识特点,发现其对运气理论具有较深研究,其对运气交接点、病机、体质、药性等方面具有独到认识。同时叶天士善于将运气理论应用于临床,对冬令藏精、开阖枢、运气脉等理论多有发挥。从运气大司天角度探讨发现,叶天士运气证治思路的形成与其所在时代运气特点关系密切。     

叶天士《临证指南医案》应用建中汤方证辨析

《临证指南医案》是记录清代医家叶天士临床经验的医案专着, 由其门人华岫云等依据叶天士临证医案整理编撰而成。书中辑录经方医案展示了叶天士的诊疗经验和思想且包括许多方症具备的案例, 反映了叶天士对张仲景建中汤的临床应用心得, 是对张仲景思想的继承和发挥。     

《临证指南医案·幼科要略》中儿科护理的思想及启示

叶天士在《临证指南医案.幼科要略》中创造性的提出了一系列儿科护理方面的独特经验。他认为:小儿易患伏气外感;小儿热病需顾护胃津;小儿暑病易耗气伤阴;小儿预后转归与体质相关。其思想对后世影响深远,值得进一步挖掘和整理。     

叶天士治疗泄泻学术思想探析

通过对叶天士《临证指南医案》的分析,深入探讨其治疗泄泻的学术思想,对于消化道疾病的防治具有一定的意义。     

叶天士《临证指南医案》论治厥证经验

叶天士以《黄帝内经》理论为指导,师法仲景,在《临证指南医案》中灵活运用脏腑辨证、奇经辨证及卫气营血辨证理论论治厥证。在脏腑辨证中重视厥阴风木,在奇经辨证中重视冲脉之气为病,在卫气营血辨证中重视火热邪气的传变,并提出"肝为刚脏"的理论,根据肝"体阴用阳"的生理特点及脏腑生化关系提出"柔肝通络""缓肝息风""潜阳益乙癸""补胃凝肝""补金柔制""益胃阴伏冲气""通补阳明"等治法,以血肉介类味厚之药填补下焦,通补奇经,选用奇经引经药入冲任脉镇冲逆之气,并重视阴液,拓宽后世论治厥证思路。     

叶天士《临证指南医案》研究进展

通过查阅近年来对叶天士《临证指南医案》的研究文献,探讨叶天士对单味药和方剂的运用规律及特点,概括叶天士对疾病的病机及分型的认识,总结叶天士临证运用的各种辨证方法,发现叶天士的临证思维是决定其临床疗效的关键。加强《临证指南医案》中医临床思维方法的研究,对更好的传承叶天士的学术思想、指导临床有重要意义。     

Gene network Analysis Defines a Subgroup of Small Cell Lung Cancer patients With Short Survival

BackgroundSmall cell lung cancer (SCLC) is an aggressive tumor, and despite its sensitivity to chemotherapy and radiotherapy, patients usually have a short survival. There are no clinically relevant predictive factors of responses to therapies, and therapeutic options are still limited.Materials and MethodsClinical data and somatic mutations of genes included in the MSK-IMPACT panel were retrieved from cBioPortal for 108 SCLCs and analyzed to identify mutated gene networks. Results were validated in an independent cohort of 54 SCLCs, whose information was also available from cBioPortal.ResultsDifferent networks were observed in tumors of short and long survivors. Degree (K) and betweenness (B) are key features that characterize a gene in its network of related mutations. By comparing their B/K ratio, 2 signatures of mutated genes were identified, describing short (IL-7R, NTRK2, HNF-1A) and long survivors (NBN, PTPN-11, IRS-1, INPP-4A, PIK-3CG, HGF, LATS-2, SMARCA-4, FLT-3, EIF-4A2, SPEN, PAX-5, SH2-D1A, ARID-1A, HOXB-13, ERCC-4, FANCA, FH, FGFR-2, MST-1R, SMAD-4, DDR-2, IGF-1R, PIK-3CB). Patients with at least 1 mutated gene of the short signature had a worse median overall survival of 8 versus 28 months (P < .001). Patients with at least 1 mutated gene of the long signature had a better median overall survival of 39 versus 20 months (P = .004). The value of the short signature was further confirmed in an independent cohort of SCLCs.ConclusionThe networks of mutated genes could help subclassify SCLCs based on their somatic mutations and aid in identifying a subset of tumors with poor prognosis.     

略论清代温病诸师的阴阳观

清代中医学最重要的进步是在温病学方面的成就。因温病是外感温热邪气,治疗上"只能作热治,不能从寒医",须要处处顾护阴液,故温病学派给人的感觉一般来说是崇尚阴柔、好用寒凉、用药轻灵等等。这其实是治疗温病本身的需要,并非温病学诸大师的一隅之偏。清代温病诸师中,叶天士、王孟英等皆主阴阳平衡观,反对景岳之"贵阳贱阴"观点,反对空谈先天阴阳,认为无补于临床。而吴鞠通则持"阳大阴小论"和"阴常有余阳常不足论",反对阴阳平衡,主"贵阳贱阴"论调。这些特点应该引起学术界重视。