活血通络法治疗类风湿关节炎临床疗效的Meta分析

目的:运用Meta分析对中医活血通络法治疗类风湿关节炎(RA)临床疗效的有效性进行评估。方法:检索并筛选出2000—2013年国内发表的符合纳入标准的相关文献,进行Jadad评分及采用Cochrane协作网提供的Rev Man 5.2软件进行统计分析。予漏斗图法进行发表性偏倚分析。结果:筛选出符合纳入标准的文献10篇,Jadad评分高质量文献2篇,低质量文献8篇。Meta分析显示,中医药(包括中西医结合)治疗组与西药对照组对疾病疗效对比的结果[OR=3.58,95%CI(2.37,5.42),Z=6.03,P<0.000 01];单纯中医药治疗组与西药对照组对疾病疗效对比的结果[OR=4.66,95%CI(2.38,9.14),Z=4.48,P<0.000 01]。漏斗图法提示Meta分析具有可信性。结论:中医活血通络法可改善RA患者的临床症状,对RA的治疗有效。     

MUC1 expression in primary and metastatic pancreatic cancer cells for in vitro treatment by (213)Bi-C595 radioimmunoconjugate

Control of micrometastatic pancreatic cancer remains a major objective in pancreatic cancer treatment. The overexpression of MUC1 mucin plays an important role in cancer metastasis. The aim of this study was to detect the expression of MUC1 in human primary tumour tissues and three pancreatic cancer cell lines (CAPAN-1, CFPAC-1 and PANC-1), and target MUC1-positive cancer cells in vitro using (213)Bi-C595 alpha-immunoconjugate (AIC). The expression of MUC1 on pancreatic tumour tissues and cancer cell lines was performed by immunohistochemistry and further confirmed by confocal microscope and flow cytometry analysis on the cell surface. Cytotoxicity of (213)Bi-C595 was tested by MTS assay. Apoptosis was documented using TUNEL assay. Overexpression of MUC1 was found in approximately 90% of tested tumour samples and the three pancreatic cancer cell lines. (213)Bi-C595 is specifically cytotoxic to pancreatic cancer cells in a concentration-dependent fashion. These results suggest that overexpression of MUC1 in pancreatic cancer is a useful target, and that the novel (213)Bi-C595 AIC selectively targets pancreatic cancer cells in vitro. (213)Bi-C595 may be a useful agent for the treatment of micrometastases or minimal residual disease (MRD) in pancreatic cancer patients with overexpression of MUC1 antigen.     

以肺间质病变为首发表现的原发性干燥综合征一则

原发性干燥综合征是一个主要累及外分泌腺体的慢性炎症性自身免疫病。干燥综合征患者比较典型的临床表现为口眼干燥,但往往疾病早期并不是以口眼干燥为首发症状,而是以系统损害为首发症状,本文将介绍一例以肺间质病变为首发症状的原发性干燥综合征。     

推拿配合中药足浴熏洗治疗膝骨性关节炎的临床研究

目的 评价推拿配合中药足浴熏洗治疗膝骨性关节炎（knee osteoarthritis,KOA）的临床疗效,并观察治疗前后Lysholm膝关节功能评分(Lysholm knee score,LKSS)的变化。方法 将61例轻中度KOA患者随机分成两组,治疗组推拿配合中药足浴熏洗治疗,对照组口服美洛昔康治疗,两组均治疗20天（次）,于治疗前、治疗10天（次）、治疗结束及结束后1个月评定LKSS评分。结果 （1）治疗组临床控制13例,显效11例,有效6例,无效 1例,对照组分别为5、11、10、4例,治疗组疗效优于对照组(P<0.05)。（2）LKSS:两组治疗结束LKSS均高于治疗前, 差异有统计学意义(P<0.01);治疗10天（次）后治疗组LKSS低于对照组,但差异无统计学意义(P>0.05);治疗结束后治疗组LKSS高于对照组(P<0.05)。（3） 随访1个月需要重新接受治疗病例数及随访LKSS与治疗结束时LKSS的差值,治疗组均低于对照组(P<0.01)。结论 推拿配合中药足浴熏洗治疗KOA有较好的临床疗效。     

Where and what is the paralaminar nucleus? A review on a unique and frequently overlooked area of the primate amygdala

The primate amygdala is composed of multiple subnuclei that play distinct roles in amygdala function. While some nuclei have been areas of focused investigation, others remain virtually unknown. One of the more obscure regions of the amygdala is the paralaminar nucleus (PL). The PL in humans and non-human primates is relatively expanded compared to lower species. Long considered to be part of the basal nucleus, the PL has several interesting features that make it unique. These features include a dense concentration of small cells, high concentrations of receptors for corticotropin releasing hormone and benzodiazepines, and dense innervation of serotonergic fibers. More recently, high concentrations of immature-appearing cells have been noted in the primate PL, suggesting special mechanisms of neural plasticity. Following a brief overview of amygdala structure and function, this review will provide an introduction to the history, embryology, anatomical connectivity, immunohistochemical and cytoarchitectural properties of the PL. Our conclusion is that the PL is a unique subregion of the amygdala that may yield important clues about the normal growth and function of the amygdala, particularly in higher species.     

《临证指南医案》痹证用药特点分析

目的探讨《临证指南医案》痹证用药特点。方法 运用数据挖掘技术统计药物使用频次、性味归经并进行关联规则、聚类、复杂网络分析等。结果 筛选出83首处方,共涉及中药125味，使用频次前5位依次为桂枝、茯苓、白术、当归、苦杏仁，功效类别以补虚药为主，性味以甘温最多，归经主要涉及肺、脾、肝、心、肾、胃；关联规则得到10对常见组合，高频中药聚为4类，复杂网络分析得到1个核心组合。结论 叶氏常从络病角度治痹，或通、或补、或通补皆施，重视肺脾，注重调和气血营卫，擅长通补奇经治法。     

壮医药治疗痹证研究概况

壮医药是中国医药学宝库的组成部分,具有明显的民族性、地域性和传统性,其疗法包括：药物内服、壮药外敷、药线点灸、针挑疗法、药罐疗法、壮药熏洗等。痹证是由于风、寒、湿、热等外邪侵袭人体,闭阻经络,气血运行不畅所导致的,相当于现代医学的风湿性疾患。该文就近十多年来壮医药治疗痹证的研究进行综述,为壮医药治疗痹证的进一步研究提供依据。     

双水平正压通气治疗慢性阻塞性肺疾病伴呼吸衰竭临床疗效分析

目的评价双水平正压通气（BWAP）治疗慢性阻塞性肺疾病呼吸衰竭患者的疗效。方法76例慢性阻塞性肺疾病急性加重期（ArCOPD）合并Ⅱ型呼吸衰竭患者,分为治疗组41例和对照组35例,两组均给予常规药物治疗,治疗组同时给予BIPAP呼吸初进行无创机梆两气治疗,对两组患者心率、呼吸频率、血气分析进行比较。结果呼吸机治疗组患者心率、呼吸频率、血气分析的改善情况优于常规治疗组,两组比较差异有统计学意义（P〈0.05）。结论BIPAP无创通气对AECOPD伴Ⅱ型呼吸衰竭治疗效果肯定,且是一种并发症、不是反应少的机械通气技术。     

从补气论治消渴合并痹证

文章通过对消渴合并痹证各方面的阐述,论证从补气角度治疗该病证的优势及意义。以阐述消渴合并痹证的临床表现及危害为基础,展开论述该病证的病因病机,从而得出结论,该病为虚实夹杂,本虚标实之证。进而论述其基本发病机理为气阴两虚,痰浊瘀血闭阻脉络。引出中医治疗该病证的基本治疗思路为益气养阴,活血化瘀。各代医家应用补气药物占临床应用上的比重及各项研究中治疗该病证中补气药物的频次,从而突出补气药物应用于临床上的意义。得出结论应用补气药物治疗消渴合并痹证具有优势及发展前景。