Effect of diltiazem, a calcium antagonist, on myocardial ischemia

In line with studies on the metabolism of the ischemic myocardium, the effectiveness of diltiazem hydrochloride, a potent calcium antagonist, in reducing the effects of ischemia was evaluated. Nonischemic and ischemic tissue samples were examined in two groups of dogs—Group I, dogs receiving no drug and killed after 60 minutes of regional ischemia, and Group II, dogs given diltiazem after 10 minutes of ischemia and killed 50 minutes later. Administration of diltiazem proved beneficial in several ways: The decrease in adenosine-5′-triphosphate in the ischemic region was halved, inhibition of anaerobic glycolysis was reduced, tissue levels of lactic acid and free fatty acids were lowered and the contractility of glycerinated heart muscle fibers was improved. However, administration of the drug did not influence mitochondrial function. Mitochondrial oxygen consumption and respiratory control were reduced by equal amounts in both groups, as was mitochondrial calcium ion binding. These observations demonstrate that diltiazem is capable of minimizing the consequences of acute ischemia, although the beneficial effects do not extend to all aspects of myocardial metabolism.     

Lipid metabolism in perfused human and dog coronary arteries.

The paper represents a summary of our studies in which in vitro perfusion of human and animal coronary vessels was carried out. Formation and uptake of lipids in perfused human coronary arteries were studied under a vairety of experimental conditions, including exposure to carbon monoxide. The effect of collagenase on lipid synthesis and transport in carotid arteries of dogs was also studied. Human plasma with hydrogen-3-labeled cholesterol and carbon-14-acetate was used to perfuse human blood vessels. Autologous plasma was employed. Inhibition of cholesterol uptake was accomplished by the addition of 7-ketocholesterol (concentrations of 0.005 to 1 mum/ml) to the perfusate. Both atherosclerotic and normal human coronary arteries incorporated 14C-acetate into lipids but failed to synthesize either cholesterol of cholesterol esters. Similar results were obtained in human saphenous veins perfused at arterial pressure. Cholesterol uptake from the perfusion fluid was demonstrated in atherosclerotic and normal human coronary arteries as well as in human saphenous veins. Carbon monoxide increased permeability of the arterial wall to cholesterol uptake. In dog arteries exposed to collagenase marked increases in cholesterol uptake were found, but total lipid synthesis was reduced; the relative synthesis individual lipids remained unchanged. The addition of 7-ketocholesterol to the perfusate reduced cholesterol uptake by the vessel by 90 percent. Inhibition of cholesterol uptake was present in all species and was not due to oxidation of cholesterol to 7-detocholesterol in the perfusate. The results illustrate that human coronary arteries as well as human saphenous veins synthesize lipids but not cholesterol. Cholesterol flux into the artery is augmented by carbon monoxide and collagenase. The data also show that active inhibition of cholesterol uptake in the arterial wall can be accomplished by competitive inhibition with 7-ketocholesterol.     

温针灸、浮针及针刺治疗膝骨性关节炎临床研究

目的:研究温针灸、浮针及针刺治疗膝骨性关节炎(KOA)的临床疗效。方法:选取80例KOA患者为对象,采用随机数字法将其分为对照组(n=40)和观察组(n=40),对照组给予金骨莲胶囊联合塞来昔布胶囊治疗,观察组给予温针灸、浮针及针刺治疗,比较两组临床疗效、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、膝关节功能(KSS)评分、血清炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]水平及不良反应发生率。结果:观察组治疗有效率高于对照组(95.00%与77.50%)(P<0.05); 治疗后观察组疼痛、僵硬及日常活动评分均显著低于对照组(P<0.05); 治疗后观察组KSS评分高于对照组(P<0.05); 治疗后观察组血清CRP、TNF-α、IL-6水平均低于对照组(P<0.05); 观察组不良反应发生率0%低于对照组12.50%(P<0.05)。结论:温针灸、浮针及针刺治疗KOA临床疗效显著,可缓解临床症状,提高膝关节功能评分,降低炎性因子水平,且安全性较高。     

On the Passivity of Hysteretic Systems with Double Hysteretic Loops

The Bouc–Wen hysteresis model is widely employed to mathematically represent the dynamical behavior of several physical devices, materials and systems such as magnetorheological dampers, lanthanide zirconium or aluminum oxides, mechanical structures or biomedical systems. However, these mathematical models must account for different properties such as the bounded-input bounded-output stability, asymptotic motion, thermodynamic admissibility or passivity in order to be physically consistent with the systems they represent. The passivity of a system is related to energy dissipation. More precisely, a system is passive if it does not generate energy but only dissipates it. The objective of this paper is to prove that two different double-loop Bouc–Wen models are passive under a particular set of model parameters.     

Validity of Cyriax’s Functional Examination for Diagnosing Shoulder Pain: A Diagnostic Accuracy Study

ObjectiveThe purpose of this study was to compare the diagnostic accuracy of lesion localization between Cyriax’s functional examination and ultrasonography in participants with and without shoulder pain.MethodsA total of 206 adults aged 20 years and older with or without shoulder pain were included. All participants received Cyriax’s functional examination by the first blinded physiatrist. Within a week, ultrasonography was performed by another blinded specialist. The diagnoses made by both methods, respectively, were compared finally. Sensitivity, specificity, and positive and negative predictive values were evaluated for the diagnosis of shoulder lesions between Cyriax’s functional examination and ultrasonography.ResultsThere was no significant difference between the 2 groups regarding age, sex, and body mass index. Moderate to high sensitivity (74.1%, 76.5%, and 66.7%) and high specificity (93.0%, 99.5%, and 99.0%) were in supraspinatus, subscapularis, and infraspinatus lesions, respectively. For the subacromial-subdeltoid bursitis, high sensitivity (90.4%) and moderate to high specificity (70.3%) was found. In contrast, low sensitivity (15.0%) and high specificity (100.0%) were found in the biceps lesions.ConclusionIn this study, we found that Cyriax’s functional examination had high sensitivity in detecting subacromial-subdeltoid bursitis and high specificity in rotator cuff lesion.     

中医综合疗法治疗类风湿性关节炎疗效观察

[目的]观察中医方法治疗类风湿性关节炎的疗效。[方法]将87例随机分为治疗组44例和对照组43例,治疗组予温针灸配合口服中药汤剂,对照组予口服甲氨喋呤,柳氮磺吡啶及扶他林,治疗90d后观察两组疗效及不良反应。[结果]治疗组有效率84.09%,对照组为81.40%(P>0.05)无明显差异。不良反应:治疗组22.73%明显小于对照组的53.49%。[结论]采用中医方法治疗类风湿性关节炎能取得较好的疗效,且不良反应少,费用低。     

Menstrual blood loss in healthy Chinese women

Intrauterine contraceptive devices (IUDs) are commonly used in China, but uterine bleeding is the main problem. So far, the menstrual blood loss (MBL) is based on subjective judgments by the patients, and objective quantitative data of MBL is lacking. It is necessary to determine the baseline MBL of healthy Chinese women.MBL was determined in 131 healthy women for one period, the range was 7.5–176.5 ml; the mean value was 56.3±2.8 (S.E.) ml; the median was 50.8 ml; and the central percentile limits of 80% and 90% were 20.7–95.0 ml and 13.9–120.8 ml, respectively. The amount of MBL in 92.4% of tested subjects was within 100 ml; the 95th percentile was 120.8 ml. Hematological studies were made in 25 subjects. There was a tendency for the blood iron to decrease with increasing MBL and when the MBL reached 80–100 ml, the hemoglobin and hematocrit began to decline. When MBL increased to 100–120 ml, hemoglobin and hematocrit were reduced to the lower limit of normal value.Further investigation should be made to determine if 100 ml can be used as the upper limit of normal for Chinese women.     

扁鹊及其学派传承考

郑医秦越人为扁鹊,其大致生活年代为公元前695年-公元前655年,活动地带以郑国为中心的附近六国为主,所诊虢国太子为南虢国太子。扁鹊的医学传承不是由齐国至中原,再到巴蜀之地的传承,而是在中原地带继承长桑君及周朝正统官方医学,随着文化中心东移向齐国传播,最终通过仓公的授徒实现广泛地传播。扁鹊弟子淳于意授徒后,根据所授内容的不同,使经脉医学与脏腑医学渐渐分流,张仲景之《伤寒论》应该是对阴阳、经脉医学的继承与发展,而华佗之《中藏经》应该是对五行、脏腑医学的继承与发展。仲景与华佗之前的《黄帝内经》应该是对扁鹊医学历来发展的总结之作,是对扁鹊医学的继承,而不是与扁鹊医学并驾齐驱的医学流派。     

从《理瀹骈文》谈甲状腺肿外敷用药

清代医学家吴尚先《理瀹骈文》一书开宗明义地提出内治之理,即外治之理,认为外治与内治在医理与药性上并没有区别,均是以中医基本理论为指导,明阴阳、察四时、分五行、求病机、度病情、辨病形,所异者只是饮之于内与施之于外的用药方式不同。甲状腺肿是临床常见疾病,常见的良性甲状腺疾病都具有甲状腺组织增生的共同病理基础,与中医学瘿病基本病机为气滞痰凝血瘀等有形实邪结于颈前、久而成实的认识相吻合。结合《理瀹骈文》中中医辨证之理、外治透皮吸收之理、膏可统治百病之理的思想,以化痰散结之消瘰丸为基本方,加减用药、制膏外敷,协同内治法治疗甲状腺肿,以达到增加疗效、减轻药物副作用的目的。     

由通行本《素问》编次看王冰对古籍整理的贡献

王冰编次<素问>,是在全元起本及别本的基础上进行的.通过分析全元起本<素问>、通行本<灵枢>、通行本<素问>的篇目卷次,认为全元起本<素问>及通行本<灵枢>,前后篇目内容安排杂乱,缺乏相关性.而王冰编次的通行本<素问>,内容论述集中,系统性较强,对后世影响很大,故王冰对整理中医古籍的贡献,不容置疑.