王琦教授应用枳术丸治疗功能型便秘的经验探讨

对于名方的应用,主要学习其制方思想,临证时既能执守,又能圆通,明其理而活其法。徐大椿在《兰台轨范·序》中言:"一病必有主方,一病必有主药。"王琦教授临床常以主病主方思想治疗疾病,针对性强,疗效显著。文章以枳术丸治疗功能性便秘为例,试论王琦教授主病主方学术思想和临床经验。     

《伤寒论》教学灵魂在“活”字——赴新加坡教学体会

<正>在快乐中学习,从学习中找到快乐,是学习的最佳境界。本人于2011年4月赴新加坡中医学院讲授《伤寒论》,一月的教学,时时处于快乐之中,书本"活",老师"活",同学"活",整一个"活生生"、"活泼泼"。现将心得与同道分享。1鲜活的案例此次赴新加坡,我们带去了广州中医药大学伤寒论病区拍摄的临床教学查房视频,包括查房与讨论两部分。病案介绍电子版打印后交同学,人手一册,让其预习。一般安排在每次教学近尾时,进行视频案例讨论。首先针对病案提出辨治思路;观看查房视频后进行讨论;随后观看讨论     

Longterm follow‐up of diode laser transscleral cyclophotocoagulation in the treatment of refractory glaucoma

Purpose: This prospective study was conducted to evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation (TDLCP) in advanced refractory glaucoma. Methods: A total of 124 eyes in 121 patients with advanced glaucoma refractory to medical treatment were treated consecutively with TDLCP. Success was defined as final intraocular pressure (IOP) of 5?21 mmHg in eyes with visual acuity (VA) of more than hand movements (HM) and relief of pain in eyes with VA of HM or less, including blind eyes. Results: Mean patient age was 65.6 ± 17.1 years (range 14–91 years). Mean follow‐up was 17 ± 14.6 months (range 3–42 months). Mean pretreatment IOP was 29.9 ± 8.4 mmHg (range 17–58 mmHg) and IOP at last follow‐up was 20.8 ± 8 mmHg (range 6–45 mmHg) (p < 0.001). The number of laser applications (mean 9.2 ± 2.8, range 4–15) and maximal laser power (mean 2.01 ± 0.22 mW, range 1.3–3.0 mW) were not associated with lower postoperative IOP. Intraocular pressure of ≤ 21 mmHg was recorded in 63.0% of eyes at the last follow‐up visit. Overall, 28 (21.7%) eyes required at least one retreatment. No phthisis bulbi or persistent hypotonia developed. Conclusions: TDLCP is an effective and safe method for the treatment of advanced refractory glaucoma, although repeated treatments are often necessary.     

三波长肝储备功能检测系统的设计

背景：术前评估肝脏储备功能可以让医生得到充分的肝脏信息,从而制定下一步的治疗计划。吲哚青绿排泄试验因为其具有简单、创伤少等优点,被证明是一种有效的预测患者肝储备功能的方法。 目的：设计基于吲哚青绿排泄法的便携式肝储备功能测试系统。 方法：依据组织对红外光吸收的不同以及脉动选择不同波长LED,选择ARM9平台,设计外围硬件以及探头,并在Window CE系统下设计系统的软件程序,进行整机效果验证。 结果与结论：便携式肝储备功能测试系统可以无创、实时的提供吲哚青绿15 min滞留率以及血氧饱和度等人体信息,系统采用三波长LED照射手指,并利用光电传感器采集透过手指的光强,软件方面采用数字滤波器及自学习阈值法去除干扰信号。实验证明该系统信号可靠、稳定,效果良好,具有实用性。     

发光二极管照射对高糖培养的视网膜神经元凋亡的光生物调节作用及其机制

背景 研究糖尿病视网膜病变(DR)的发病机制及防治具有重要的临床意义.近年来随着生物医学光子学研究的发展,国际上利用光生物调节进行疾病防治的研究越来越受到重视,但关于光生物调节对DR的防治作用研究鲜见报道. 目的 探讨光生物调节对高糖环境下视网膜神经元凋亡的抑制作用及其机制,为光生物调节在DR治疗方面的应用提供依据.方法 采用免疫磁珠分离法分离Wistar大鼠视网膜神经元并进行传代培养,采用Nissl染色法对培养的细胞进行鉴定.将培养的细胞分为正常对照组、高糖模型组和高糖+发光二极管(LED)组,正常对照组细胞采用Neurobasal培养基进行培养,高糖模型组细胞在Neurobasal培养基中添加25 mmol/L葡萄糖,高糖+LED组细胞造模后48 h在培养箱中用LED红光光源进行照射,光源波长为620 nm,最大功率为1W,中心光辐射照度为6.67 mW/cm2.光源置于细胞上方2 cm处,光斑直径为2.0cm,使光斑完全覆盖1个培养孔,每次连续照射300 s,12h后重复照射1次,共照射3次.培养后48 h采用流式细胞仪测定各组细胞凋亡情况;采用激光扫描共焦显微镜观察各组细胞内Ca2+浓度变化;Western blot法检测各组细胞中磷酸化丝氨酸-苏氨酸激酶(p-AKT)蛋白的相对表达量.结果 培养后2～3d,倒置显微镜下可见细胞呈多边形和椭圆形,可见细胞核及核仁.培养后5～7d神经元突起增多,经Nissl染色后细胞质呈蓝紫色,神经元与神经胶质细胞的比例达91％.正常对照组、高糖模型组和高糖+LED组细胞凋亡率分别为(7.634_±3.176)％、(33.642±9.315)％和(23.914±6.375)％,其中高糖模型组和高糖+LED组细胞凋亡率均明显高于正常对照组,高糖+ LED组细胞凋亡率明显低于高糖模型组,差异均有统计学意义(均P＜0.0l).激光扫描共焦显微镜下可见高糖模型组和高糖+LED组细胞中Ca2+荧光像素值均明显高于正常对照组,高糖+LED组细胞中Ca2+荧光像素值明显低于高糖模型组,差异均有统计学意义(均P＜0.05).Westen blot法检测显示正常对照组、高糖模型组和高糖+LED组细胞中p-AKT蛋白相对表达量分别为10.34±3.18、2.16±0.46和7.15±1.72,高糖+LED组细胞中p-AKT蛋白相对表达量明显低于高糖模型组,差异有统计学意义(P＜0.05).结论 高糖环境抑制抗凋亡的PI3K/AKT通路活性并影响视网膜神经元钙稳态,导致细胞凋亡.低强度LED光照射可激活PI3K/AKT通路,减少高糖引起的细胞凋亡.     

基于视觉生理指标的发光二极管光健康影响

伴随发光二极管（LED）产业的快速发展,LED光健康研究成为未来产业发展的重点。笔者在介绍目前国内外LED光健康领域的研究进展和标准化动态的同时,详细介绍了基于视觉生理指标的LED光健康影响研究的体系框架以及研究进展。     

Nanotechnology-based therapies for the prevention and treatment of Streptococcus mutans-derived dental caries

BackgroundDental caries results from long-term acid production when sugar is metabolized by a bacterial biofilm, resulting in a loss of calcium and phosphate from the enamel. Streptococcus mutans is a type of acid-producing bacteria and a virulent contributor to oral biofilms. Conventional treatment options, such as cefazolin and ampicillin, have significant levels of bacterial resistance. Other topical agents, such as fluoride, tend to be washed away by saliva, resulting in low therapeutic efficacy.HighlightThis review aims to highlight the solubility issues that plague poorly water-soluble therapeutic agents, various novel polymeric, and lipid-based nanotechnology systems that aim to improve the retention of therapeutic agents in the oral cavity.ConclusionIn this review, different formulation types demonstrated improved therapeutic outcomes by enhancing drug solubility, promoting penetration into the deep layers of the biofilm, facilitating prolonged residence time in the buccal cavity, and reducing the emergence of drug-resistant phenotypes. These formulations have a strong potential to give new life to therapeutic agents that have limited physicochemical characteristics.     

Endovenous ablation of truncal veins

The latest techniques for endovenous occlusion using RF ablation catheters or endoluminal laser targeting water are our preferred methods to treat saphenous related varicose veins. Our clinical experience with endovenous techniques in more than 1000 patients shows a high degree of success with minimal side effects, most of which can be prevented or minimized with use of tumescent anesthesia. Tumescent anesthesia is critical to the safety of endovenous techniques. Within the next 5 years, these minimally invasive endovenous ablative procedures involving saphenous trunks should have virtually replaced open surgical strippings. More than 100,000 patients already have been treated worldwide.     

An integrated strategy based on UPLC–DAD–QTOF-MS for metabolism and pharmacokinetic studies of herbal medicines: Tibetan “Snow Lotus” herb (Saussurea laniceps), a case study

Ethnopharmacological relevance

Saussurea laniceps Hand.-Mazz. (SL) has long been used under the herbal name Tibetan “Snow Lotus” for the treatment of rheumatoid arthritis, stomachache and dysmenorrhea in Tibetan folk medicine. Since herbal medicine (HM) is a synergistical system with multiple components, both of the metabolism and pharmacokinetic studies of HM are interdependent. This study aimed to develop an integrated strategy based on the UPLC–DAD–QTOF-MS technique for metabolism and pharmacokinetic studies of HM.

Material and methods

SL was used here as a test herb to verify the feasibility of the proposed strategy. SL was administered to rats, then, the blood plasma, urine and feces were analyzed to determine the metabolic profiles. Using our strategy, umbelliferone and scopoletin were evaluated to be the key bioactive components. Their pharmacokinetic parameters were measured and biotransformation pathways were elucidated.

Results

After oral administration of SL to rats, 17 components in blood, 10 components in urine and 2 components in feces were identified and characterized using our UPLC–DAD–QTOF-MS method. Umbelliferone, scopoletin and their metabolites were found to be the major components involved in the metabolism process. Literature reports also suggest that umbelliferone and scopoletin are responsible for the therapeutic effects of SL, thus these two components were selected as the active markers for pharmacokinetic study. In the test of validity, the established method presented good linearity with R²>0.99. The relative standard deviation value was below 13.9% for precision, and recovery studies for accuracy were found to be within the range 91.8–112.5%.

Conclusion

The present strategy offers, simultaneously, precision in quantitative analysis (metabolism study) and accuracy in quantitative analysis (pharmacokinetic study) with greater efficiency and less costs, which is therefore reliably used for integrated metabolism and pharmacokinetic studies of HM.     

Optical recordings reveal the differential distribution of glutamatergic transmission in the cochlear and vestibular nuclei in the newborn mouse brainstem

Objective Using optical imaging in brainstem slices, we studied evoked responses in the mouse cochlear (CN) and vestibular (VN) nuclei. Methods The use of optical imaging allowed us to visualize the.spa-tiotemporal patterns of excitatory propagation in the CN and VN. Optical recordings can differentiate excitatory propagation in the ventral CN(VCN) from that in the dorsal CN(DCN). Furthermore, we assessed the relative dis-tribution of NMDA and non-NMDA receptors in these regions using the glutamate antagonists APV (NMDA recep-tor antagonist) and CNQX (non-NMDA receptor antagonist) in mouse brainstem slices during postnatal days 1 to 3. Results The average sensitivity to APV was 99.1% in the VCN, 76.0% in the DCN and 64.9% in the VN. The average sensitivity to CNQX was 0.9% in the VCN, 24.0% in the DCN and 35.1% in the VN. These results indi-cate that the effect of APV dominated in the VCN, while both APV and CNQX were effective antagonists in the DCN and VN. In the VN, the distribution of APV-and CNQX-sensitive cells was almost completely uniform. However, in the DCN the distribution of APV- and CNQX-sensitive cells was highly complex. The area that was more sensitive to CNQX was located in the superficial layer of the DCN while the area with a higher sensitivity to APV was located progressively in the deep layer. Conclusion This optical recording data suggests that there is a differential distribution of NMDA and non-NMDA receptor mediated neurotransmission in the VCN, DCN and VN.