中西结合,共战新冠肺炎

2019年12月,湖北武汉地区出现了一种不明原因的肺炎,后经病原检测证实该肺炎是新型冠状病毒2019-nCoV感染所致。2020年1月中旬开始向全国各地迅速蔓延,截止到2020年2月27日24时,全国累计报告确诊病例78824例,累计死亡病例2788例。自疫情发生后,国家卫生健康委员会组织专家不断总结分析,连续更新发布新型冠状病毒肺炎(NCP)的诊疗方案共六版,并不断加大对中医中药治疗新冠病毒性肺炎的推荐力度;国家及各省市中医药管理部门、医疗机构积极组织中医专家投入到NCP的救治中去,包括浙江在内的很多省市中医参与率在90%以上。在武汉建立的方舱医院,中医药大规模介入,并由张伯礼院士、刘清泉教授等国内顶尖中医专家亲自指导。     

Pretreatment with scutellaria baicalensis stem-leaf total flavonoid prevents cerebral ischemia- reperfusion injury

Pretreatment with scutellaria baicalensis stem-leaf total flavonoid has protective effects against ischemia and attenuates myocardial ischemia-reperfusion injury. In this study, rats were given scutellaria baicalensis stem-leaf total flavonoid intragastrically at 50, 100, and 200 mg/kg per day for 7 days before focal cerebral ischemia-reperfusion injury models were established using the suture method. We then determined the protective effects of scutellaria baicalensis stem-leaf total flavon- oid pretreatment on focal cerebral ischemia-reperfusion injury. Results showed that neurological deficit scores increased, infarct volumes enlarged, apoptosis increased and Bcl-2 and Bax protein expression were upregulated at 24 hours after reperfusion. Pretreatment with scutellaria baicalensis stem-leaf total flavonoid at any dose lowered the neurological deficit scores, reduced the infarct volume, prevented apoptosis in hippocampal cells, attenuated neuronal and blood-brain barrier damage and upregulated Bcl-2 protein expression but inhibited Bax protein expression. Doses of 100 and 200 mg/kg were the most efficacious. Our findings indicate that pretreatment with scutel- laria baicalensis stem-leaf total flavonoid at 100 and 200 mg/kg can improve the neurological func- tions and have preventive and protective roles after focal cerebral ischemia-reperfusion injury.     

Treatment of epilepsy in China Formal or informal？

Antiepileptic drugs are the preferred treatment approach for epileptic patients. However, informal treatment is important for intractable epilepsy. In this study, 500 epileptic patients were recruited from the General Hospital of Beijing Military Area Command of Chinese PLA during the period of October 2009 to January 2012. These involved patients that had been medically treated for at least 1 year. Information on the initial treatment and changes to treatment regimens for each patient was collected through questionnaires. The survey results showed that 52.3% of the epileptic patients searched for treatment after the first seizure, and the mean numbers of seizures was 12.8; 59.8% of the epileptic patients were diagnosed at the first visit, and the mean onset time was 17 months after the first seizure. After diagnosis, patients were treated for an average of 20 days, and the median time was 1 day. Formal anti-epileptic drugs were selected as the first treatment regimen by 67.8% of patients, and 77.5% of these drugs were monotherapies. The mean and median numbers of seizure were respectively 36.9 and 3.0 times before the first regimen was changed. The regimen was changed within the first 6 months by 46.6% of patients, and after the first and second years of treatment, the proportions increased to 54.0% and 71.8%, respectively. In total, 78.5% of the regi- mens were changed to informal treatments. The informal treatment of epilepsy in China is common, being initiated by either patients or physicians. Enhancing epileptic treatment services in hospital, improving physicians＇ professional quality, and strengthening health propaganda may promote the normalization of drug treatment of epilepsy in China.     

“之乐”杯医学有奖征文

昨天我们疑惑于单纯控制传统危险因素不能完全阻止动脉粥样硬化的发展,易损斑块是临床事件的元凶;今天我们发现：氧化应激在动脉粥样硬化发生、发展及斑块破裂过程中产生了重要作用,抗氧化应激治疗已成为动脉粥样硬化}生疾病治疗的明确而且关键的靶点,并取得POSITIVE、PROPENSITYANALYSIS两个重要循证证据,为了更好地探索抗氧化应激治疗在卒中患者中的获益,完善缺血性卒中的治疗方案,《中国卒中杂志》与诺美（国际）有限公司联合举办“之乐”杯医学有奖征文活动。     

上颌中切牙缺失牙槽嵴厚度不足的美学种植的临床研究

目的探讨上颌中切牙缺失且无明显垂直骨高度缺失患者的美学种植手术的方案设计与术后临床效果研究。方法 25例上颌中切牙缺失的患者,植入ITI种植体34颗,骨量不足者,在缺损区植入Bio-Oss人工骨粉,覆盖Bio-Gide可吸收生物膜,植入后3～6个月完成上部结构修复,术后随访6～12个月。结果 25例患者共34颗种植体稳固无松动,患者无明显不适感,短期种植成功率100%。随访期间,1例患者唇侧牙龈退缩。临床效果满意率达96%。结论上颌中切牙缺失且牙槽嵴厚度不足时,可根据牙槽嵴宽度的情况,选择不同的手术术式,同时采用引导骨再生技术来恢复牙槽嵴的丰满度,保证种植成功率,满足患者的美学要求。     

西尼罗病毒治疗方案

目前无针对西尼罗病毒的特效治疗药物。目前的治疗主要是对症和支持治疗。轻症患者呈自限性经过,但脑炎患者需积极治疗,常用措施如下。(一)一般治疗卧床休息,对病人要尽量避免不必要的刺激。保持呼吸道通畅,昏迷病人注意定时翻身、拍背、吸痰,吸氧,防止发生褥疮。注意精神、意识、生命体征以及瞳孔的变化。给足够的营养及维生素,保持水及电解质平衡。     

瘦素预处理对小鼠心肌冷/热缺血再灌注损伤的差异性

目的 研究同种小鼠腹部心脏移植模型中,瘦素预处理对心肌冷/热缺血再灌注损伤(IRI)的差异性.方法 30只雄性C57BL/6小鼠被随机分为3组:(1)心肌冷IRI组:瘦素预处理(术前30 min予腹腔注射重组瘦素,剂量为50 μg/kg.)后行同种间小鼠腹部心脏移植,供体置于4℃ UW液中保存6 h;(2)心肌热IRI组;(3)心肌缺血再灌注模型对照组(MIRI组).分别于术后6h收获标本,观察组织形态学变化,检测小鼠移植心脏及血清中性粒细胞活性,炎性细胞因子水平等.结果 心肌冷/热IRI两组对照比较,小鼠血清心肌肌钙蛋白(TnⅠ)、心肌髓过氧化物酶(MPO)活性、血清细胞炎性因子肿瘤坏死因子(TNF)-α,白介素(IL)-1 β,IL-6水平无明显差异(P＞0.05).结论 瘦素预处理虽然可以减轻心肌冷/热IRI,减轻炎症反应,但是小鼠心肌冷/热IRI之间的差异性无统计学意义.     

DCs将迎来一个免疫治疗新时代

目前对肿瘤患者采用的主要治疗手段是手术、放疗和化疗,这些方法失败后,免疫治疗给患者带来了新的希望,尤其是细胞免疫治疗已经在肿瘤治疗中取得另外令人瞩目的成效。细胞免疫治疗分为非特异(如CIK、NK等)和特异性(DC)两种,其中DCs是使用最有前景的肿瘤免疫治疗方法。它易于批量     

2012智例方程式——护肝药物在肝内胆汁淤积治疗中的最佳方案病例演讲比赛

各种肝病导致的肝内胆汁淤积给广大患者带来了巨大的痛苦和烦恼。因此,适时、合理、规范和优化地选择保肝药至关重要。由《肝脏》杂志社、《中华传染病杂志》、《医学参考报-肝脏学频道》主办,雅培中国协办的《2012智例方程式--保肝药物在肝内胆汁淤积性肝病治疗中的最佳方案病例演讲比赛》正式启动。皆在鼓励     

病原未定的急性黄疸型肝炎血清甲胎蛋白动态变化及其临床意义

临床上常有病情、病程类似病毒性肝炎,但病原学检查均为阴性,其中以急性黄疸型居多.依据西安2000年9月中华医学会传染病与寄生虫病学分会、肝病学分会联合修订的《病毒性肝炎防治方案》[1],该类病例可诊断为:急性肝炎,病原未定.甲胎蛋白是一种胚胎性球蛋白,它在良性肝病中重现机制及生物学意义至今尚不清楚.2003年2月至2006年6月,我院诊断病原未定急性黄疸型肝炎血清甲胎蛋白升高者30例,回顾分析如下.