董建华的学术思想

董建华先生，北京中医药大学教授、博士生导师、中国工程院院士，是国内外知名的中医专家。董建华教授行医六十余载，治验丰富，疗效卓著，形成了独到的学术思想。本文从四个方面论述其学术观点，即辨证思想、通降学说、胃热学说、气机理论     

丹酚酸组分中各代表性成分药效贡献率的评价及其油水分配系数的整合表征

该实验利用人脐静脉内皮细胞氧化损伤实验、家兔体外凝血4项实验和大鼠心肌缺血实验相结合的方法比较了丹酚酸组分中3个代表性成分的药效活性的差异,并利用CRITIC权重法评价代表性成分的药效贡献率;结果得到丹酚酸组分中代表性成分丹酚酸B、迷迭香酸、丹参素的贡献率分别为28.85%,30.11%,41.04%。采用摇瓶法测定了丹酚酸组分在水以及不同p H缓冲液中的油水分配系数,进一步以质量权重系数和药效贡献率相结合的方法整合表征了该组分整体的油水分配系数,结果表明丹酚酸组分在正辛醇-水/p H 1.2的盐酸溶液/p H 2.0,2.5,5.0,5.8,6.8,7.4,7.8的磷酸盐缓冲液中表观油水分配系数0.32,1.06,0.89,0.98,0.90,0.13,0.02,0.20,0.56。该实验为组分整体性质的表征提供了一定的参考。     

基于肿瘤能量代谢失衡探讨扶正解毒法在慢性结肠炎“炎癌转化”分期干预中的应用

慢性结肠炎在一定情况下可发生癌转化。慢性结肠炎“炎癌转化”是在线粒体能量代谢损伤、有氧糖酵解代谢上调的机制下,肠道上皮细胞代谢失衡,促使炎症微环境向肿瘤微环境转化的过程。认为由正气虚损而致太阴经、阳明经的寒热分离是结肠炎癌转化的触发机制,由邪毒鸱张诱发的气机升降失调是打破促瘤抑瘤平衡,进而邪聚成瘤的关键。临床治疗上应在中医恒动观理论指导下分清慢性结肠炎炎癌转化的不同阶段,灵活把握扶正与解毒的主次,改善肠道炎性环境,调节异常能量代谢,以延缓恶化时间,截断炎癌转化的进程。     

低能量小光斑氩激光光凝治疗糖尿病性视网膜病变的疗效观察

目的观察低能量小光斑氩激光全视网膜光凝治疗糖尿病性视网膜病变的临床疗效和光凝引起的不良反应。方法对2003年来我院就诊的糖尿病性视网膜病变患者13例(20只眼)行低能量、小光斑氩激光光凝治疗,观察疗效及术后并发症。结果术后3个月视力提高3只眼(15％),视力不变13只眼(65％),视力下降 4只眼(20％)。经FFA证实光凝有效者15只眼(75％),光凝无效者5只眼(25％)。结论低能量小光斑氩激光全视网膜光凝治疗糖尿病性视网膜病变既能取得良好的效果,又能减少光凝对视网膜的付损伤。     

超微细粉小复方等对大鼠心肌缺血/再灌注损伤能量代谢的影响研究

目的:观察具有益气活血通痹作用的中药超微细粉小复方对大鼠心肌缺血/再灌注损伤的影响。方法:63只大鼠随机分假手术组(Sham)、模型组(Model)、中粉组(Z)、超微细粉组(X)、煎剂组(J)、麝香保心丸组(SX)等7组,灌胃14天,冠脉结扎60min联合Langendroff灌流120min复制心肌缺血/再灌注模型,采用生化方法检测各组大鼠心肌Na+-K+-ATPase、Ca2+-Mg2+-ATPase、FFA含量。结果:与模型组相比,益气活血通痹小复方各组均能降低心肌FFA含量(P<0.01),其中以中粉组、超微细粉组效果最佳。中粉组、超微细粉组能升高心肌Na+-K+-ATPase含量、Ca2+-Mg2+-ATPase含量(P<0.01),煎剂组能升高Ca2+-Mg2+-ATPase含量(P<0.05)。结论:益气活血通痹小复方可能通过改善心肌能量代谢减轻心肌缺血/再灌注损伤,以中粉组、超微细粉组效果最佳。     

Study on modified shengmai yin injection for prevention and treatment of brain impairment in endotoxin shock rats

Objective:To examine the effects of modified Shenmai Yin on invigorating vital energy, promoting blood flow, and protection against neural impairment in an endotoxin-induced shock rat model. Methods: Ninety-six SD rats were randomly divided into four groups: sham operation (saline 20 ml/kg), shock model (lipopolysaccharide, LPS, 8 mg/kg), Reformed Shengmai Yin (加味生脉饮 Pulse-activating Decoction) (LPS 8 mg/kg + reformed Shengmai Yin Injection 10 ml/kg), and dexamethasone (LPS 8 mg/kg + dexamethasone 5 mg/kg) groups. Each group was subdivided into 1 h, 2 h, 3 h, and 6 h time points for observation. The carotid artery was separated and connected with a biological functional system to monitor mean arterial pressure (MAP). Brain water levels, malonaldehyde (MDA) content, and superoxide dismutase (SOD) activity were also determined. Results: In the shock model group, MAP was progressively decreased after injection of LPS, brain water and MDA contents were increased, brain SOD activity was decreased, and capillary vessel edema in brain tissue was also observed. All these parameters were improved significantly in both treatment groups, although the effects were more marked with Shengmai Yin than with dexamethasone. Conclusion: Modified Shengmai Yin exhibits strong anti-shock and neuroprotective effects against Endotoxininduced shock.     

Topology Optimization of Piezoelectric Energy Harvesters for Enhanced Open-Circuit Voltage Subjected to Harmonic Excitations

Energy harvesting devices made of piezoelectric material are highly anticipated energy sources for power wireless sensors. Tremendous efforts have been made to improve the performance of piezoelectric energy harvesters (PEHs). Noticeably, topology optimization has shown an attractive potential to design PEHs with enhanced energy conversion efficiency. In this work, an alternative yet more practical design objective was considered, where the open-circuit voltage of PEHs is enhanced by topologically optimizing the through-thickness piezoelectric material distribution of plate-type PEHs subjected to harmonic excitations. Compared to the conventional efficiency-enhanced designs, the open-circuit voltage of PEHs can be evidently enhanced by the proposed method while with negligible sacrifice on the energy conversion efficiency. Numerical investigations show that the voltage cancellation effect due to inconsistent voltage phases can be effectively ameliorated by optimally distributed piezoelectric materials.     

Preparation and characterisation of the colistin-entrapped liposome driven by electrostatic interaction for intravenous administration

Potential use of liposome for polycationic colistin is hindered by their phospholipid membrane permeability. In this study, liposomes were modified with sodium cholesteryl sulphate (Chol-SO₄^?) for improving the colistin loading by enhancing the colistin-bilayer electrostatic attraction. We have evaluated two liposomes: colistin-entrapped liposome of Chol-SO₄^? (CCL) and coated Chol-SO₄^?/colistin complex liposome (CCCL). In comparison with CCL which formed large aggregates at Chol-SO₄^?/colistin charge ratio below 2:1, CCCL showed a smaller size less dependent on the charge ratio, probably arising from more colistin entrapped on the inner leaflet of bilayer. Both liposomes exhibited significantly increased entrapment efficiency as compared with the liposome without Chol-SO4^?. But colistin released upon dilution, implying free transfer of colistin through bilayers. Pharmacokinetics results showed the approximately four-fold increase in the plasma AUC_0–8?h for CCCL and CCL as compared with colistin solution, showing potential benefit for infectious target localisation by prolonging the systemic circulation of colistin.     

双能量CT半定量评分系统在尿酸盐结晶评估中的应用价值

目的 探讨双能量CT（DECT）半定量评分系统在痛风患者尿酸盐结晶评估中的可行性及应用价值。方法 回顾性分析2013年8月至2017年8月江苏大学附属澳洋医院39例痛风患者的足部DECT扫描结果,并对其尿酸盐结晶进行半定量评分。应用DECT定量软件测量尿酸盐结晶体积;采用组内相关系数（ICC）评估半定量评分重复性;使用Spearman相关性分析半定量评分与尿酸盐体积的相关性;同时比较半定量评分方法与定量软件测量尿酸盐体积方法所用时间。结果 39例患者共完成了73只足部扫描,其中69只足部检测到尿酸盐结晶。DECT尿酸盐结晶评分在肌腱中最高,其次为第一跖趾关节、踝/中足关节,脚趾的其他关节评分最低。2名影像医师对尿酸盐结晶的半定量分析结果一致性高,ICC为0.944。69只足部的尿酸盐结晶体积平均值为（2.69±8.84）cm³。DECT尿酸盐评分与其体积密切相关（r=0.479,P<0.001）。两名评分者使用DECT评分系统分析尿酸盐结晶所需时间分别为（68.18±15.16）秒、（74.67±16.15）秒,定量软件分析所需时间为（166.10±13.23）秒,三者之间差异有统计学意义（F=527.029,P<0.001）。结论 DECT尿酸盐结晶半定量评分系统是可行的,相比定量分析软件更省时、方便,值得推广应用。     

组胺对分化的3T3L1细胞UCP2表达的影响

目的 探索组胺对脂肪细胞能量代谢的影响及其作用机制。方法 培养3T3L1细胞，诱导分化为白色脂肪细胞，运用RT-PCR以及Western-blot技术检测组胺和苯海拉明对白色脂肪细胞中UCP2 mRNA水平和蛋白质表达水平的影响。结果 白色脂肪细胞在不同剂量组组胺的刺激下，UCP2的表达值在不同剂量组之间存在显著差异（P〈0.05），UCP2的表达水平随着组胺剂量的增加而增加，在组胺剂量为30μmol·L^-1时达到最高值；在相同剂量组胺下，观察不同时间对细胞内UCP2表达的影响，结果发现，不同时间组之间也存在显著性差异（P〈0.05），当时间为6h时，UCP2表达量达到最高；苯海拉明剂量依赖性地抑制脂肪细胞UCP2 mRNA水平和蛋白质的表达。结论 组胺可以刺激分化成熟的3T3L1细胞中UCP2的表达，其机制与激活H1受体有关。