“肾虚络瘀，肾络癥瘕”病机观与肾间质纤维化中自噬不足的相关性

肾间质纤维化（RIF）是由多种病因导致慢性肾脏疾病的主要病理特征,结合中医“络病学说”“癥瘕理论”与现代医学肾脏病理特征,“肾虚络瘀,肾络癥瘕”是RIF的主要病机,正气亏虚,累及肾气,肾虚气化不利,痰热瘀毒等实邪阻滞肾络,相互胶结,形成癥瘕,积聚于肾络导致了RIF。自噬是细胞体内将受损或衰老的细胞器、变性的蛋白质等代谢产物进行降解与重吸收的过程,自噬参与了RIF发生的诸多环节,与RIF发生发展关系密切,将自噬与中医学结合研究发现,机体内生痰热瘀毒等实邪的代谢与自噬降解和重吸收功能相关,自噬在一定程度上是消除痰热瘀毒等实邪的方式,正气不足,累及肾气,肾虚气化不利,自噬功能不足,会引起痰热瘀毒等实邪累积,瘀阻肾络则易形成肾络癥瘕造成RIF,肾虚络瘀是自噬不足的基础,肾络癥瘕是自噬不足的微观病理表现,自噬不足与肾络癥瘕形成具有相同的病机演变,该文就RIF“肾虚络瘀,肾络癥瘕”病机,结合RIF-自噬病理机制,深入探讨“肾虚络瘀-自噬不足-肾络癥瘕”在RIF的相关性,全面诠释“肾虚络瘀,肾络癥瘕”病机的科学内涵,以期从中医理论阐述自噬在RIF中的作用研究奠定基础,为RIF的治疗及其机制研究提供新...     

微型钢板内固定配合中药熏洗治疗掌指骨骨折76例

目的：观察微型钢板内固定配合中药熏洗治疗掌指骨骨折的临床疗效。方法：76例患者均采用微型钢板内固定配合中药熏洗。结果：经治疗后,按TAM标准评定功能：优56例,良7例,优良率82．9％。结论：微型钢板内固定配合中药熏洗治疗掌指骨骨折疗效较好。     

STR-PCR方法检测贵州小型香猪遗传变异性的研究

目的 准确分析贵州小型香猪种群遗传变异及近交程度。方法 采用１０对短串联重复序列（ＳＴＲ）引物,对贵州小型香猪个体进行ＰＣＲ检测。结果 在检测到的８８个有效等位基因型中,纯合基因型５０个,占５５．７％。个体平均杂合率为０．４０８１,位点平均杂合率为０．５５６２。结论 贵州小型香猪具有一定遗传稳定性,符合封闭群动物遗传学特征。     

小型猪痰瘀互结证冠心病“痰、毒、瘀”病机演变规律的实验研究

目的：探讨小型猪痰瘀互结证冠心病病机演变的规律。方法：将18只中国小型猪随机分为正常对照组,模型组,丹蒌片组,每组6只。除正常对照组外,其他各组高脂饲料喂养 2周后,采用介入技术球囊损伤冠状动脉左前降支内皮,继续高脂饲料喂养8周,制备小型猪痰瘀互结证冠心病模型。于0周（实验前）、高脂2周（术前或给药前）、高脂6周（给药后4周）、高脂10周（给药后8周）,分别观察各组动物体重指数（BMI）、血液流变性参数、血脂水平、血清炎症因子水平的动态变化,并在实验结束时观察肝脏甘油三酯（TG）和总胆固醇（TC）水平及冠状动脉组织病理改变。结果：与对照组比较,模型组自第2周起至实验结束,血清TC,TG,LDL-C及VLDL-C水平均升高（P<0.01）,5 s^-1和60 s^-1切变率下的全血黏度均明显增加（P<0.05或P<0.01）;第6周时BMI和血清TNF-α水平均明显升高;第10周时BMI及血清hs-CRP,IL-6,TNF-α水平均明显升高,同时冠脉管腔狭窄率、内膜厚度,及内膜厚度/中膜厚度比值均明显增加（P<0.05或P<0.01）;肝脏TC和TG水平明显升高（P<0.01）。与模型组比较,丹蒌片组的冠状动脉病变程度明显减轻,其内膜厚度、管腔狭窄率,及内膜厚度/中膜厚度比值均明显减少（P<0.01）,BMI,血清TC,TG,LDL-C,VLDL-C,肝脏TC,TG,以及血清hs-CRP,IL-6,TNF-α水平亦均明显降低（P<0.05或P<0.01）,5 s^-1和60 s^-1切变率下的全血黏度均明显降低（P<0.05）。结论：痰浊、邪毒、瘀血三者的相互影响促进动脉粥样硬化（AS）斑块的发生和发展,是痰瘀互结证冠心病的关键病机所在。     

用于肠道检查的微小机器人内窥镜系统

对传统的内窥镜系统和主动式机器人内窥镜系统的差别作了比较,又对机器人内窥镜系统的工作环境——人体肠道内部的状况作了详细讨论,由此提出了对主动式机器人内窥镜系统的设计要求。介绍了一种基于蚯蚓运动原理的主动式微小机器人内窥镜系统,对微小机器人机体的构造及其驱动原理作了分析。同时,提出了一种微小机器人机体介入人体肠道的方法:用锥形导引管引导,将微小机器人送入肠道,避免了由肛门括约肌的收缩引起的机器人机体卡住或损坏。     

猪原位肝移植的麻醉及管理

目的：采用杂种猪模拟原位肝移植的麻醉及管理。方法：对实验猪行经口气管内插管静吸复合全身麻醉。结果：猪的气管插管术与人体相比有其自身特点。实验猪对氯胺酮基础麻醉有较大的耐受量。转流开始时和新肝期开始时血流动力学有较大的改变。结论：对实验猪进行肌松或非肌松气管内插管是可行的。对血流动力学改变的处理应以预防为主。精确计算失血量并及时进行输血输液和维持适当的麻醉深度，对预防和纠正失血性休克有根重要作用。若麻醉处理得当，术中严重的心律失常是完全可能避免的。     

冠状动脉内多普勒超声评价猪急性冠状动脉闭塞侧支循环状态及影响因素

目的评价猪急性闭塞冠状动脉侧支循环状态及硝酸甘油和酚妥拉明对其的影响。方法使用冠状动脉内多普勒超声测定14头小型家猪正常状态及急性闭塞后左回旋支的血流频谱,并观察冠状动脉内应用硝酸甘油和酚妥拉明对其的影响。结果急性闭塞10min时回旋支远端的平均峰值流速(APV)明显低于正常(0.97±1.05cm/s比25.78±4.36cm/s,P<0.01),应用硝酸甘油和酚妥拉明后梗死相关血管变为反向或双向血流,APV绝对值(8.32±1.53cm/s和8.54±2.15cm/s)较用药前明显增加(P<0.01);闭塞后90min时及重复应用上述两药后APV分别为0.99±1.14cm/s、9.02±1.47cm/s和8.95±2.36cm/s,闭塞90min较闭塞即刻差异无统计学意义,用两药后APV值差异无统计学意义(P均>0.05)。结论猪急性冠状动脉闭塞时侧支循环自身建立不足,硝酸甘油和酚妥拉明均可明显增加冠状动脉侧支循环血流。     

The thalamic nucleus submedius and ventrolateral orbital cortex are involved in nociceptive modulation: A novel pain modulation pathway

Recently, a series of studies have given rise to and provided evidence for the hypothesis that the nucleus submedius (Sm) in the medial thalamus is involved in modulation of nociception. The Sm, ventrolateral orbital cortex (VLO) and the periaqueductal gray (PAG) constitute a pain modulatory pathway, activation of which leads to activation of the PAG–brainstem descending inhibitory system and depression of the nociceptive inputs in the spinal cord and trigeminal nucleus. Other studies have indicated that the Sm–VLO–PAG pathway plays an important role in the analgesia induced by electroacupuncture stimulation of the acupuncture point (acupoint) for exciting small diameter fiber (A-δ and C group) afferents. Opioid peptides, serotonin, dopamine, glutamate and their related receptors are involved in Sm- and/or VLO-mediated descending antinociception, and a GABAergic disinhibitory mechanism participates in mediating the antinociception induced by activation of μ-opioid receptors, serotonin 1_A receptors, and dopamine D₂-like receptors. This review describes these findings, which provide important new insights into the roles of the thalamus and cerebral cortex in descending pain modulation.     

Repigmentation after autologous miniature punch grafting in segmental vitiligo in North Indian patients.

Segmental vitiligo is rather refractory to medical treatment. The paucity of literature on the results of autologous miniature punch grafting in segmental vitiligo in dark-skinned patients led us to conduct such a study in 15 dark-skinned patients of North Indian origin to observe the repigmentation response to this technique at different sites. The age range was 16-42 years (mean 23.08 years). There were four males and eleven females (M:F ratio being 1:2.75) who had the disease for 3-15 years. After autologous miniature punch grafting, a remarkable repigmentation was obtained in 12 (80%) cases with 90% to 100% improvement. About 40-60% repigmentation was observed within 3-6 months in the majority (66.6%) of cases and near total to total repigmentation was observed within 2 years. The maximum pigment spread was observed over the face (cheeks) and neck, and the minimum pigment spread was observed over the left arm and right upper eyelid. Complications were minimal. The present study demonstrates that autologous miniature punch grafting is a safe and easy technique, that produces good cosmetic results in the unsightly depigmenting lesions of segmental vitiligo, especially on the face and exposed areas, even in dark-skinned races if patients are selected carefully. This can be of great benefit to patients who are psychologically disturbed by their disease.