桃仁的本草考证

对中药的本草考证,是推动经典名方开发与上市的前期工作。查阅现代文献发现,近年对桃仁的研究大多集中在药理成分、药代动力学、医案等方面,鲜有从古籍文献出发对桃仁的基原、炮制、性味归经及功效主治等方面进行研究。经考证发现,桃仁的常用名有"桃仁""桃核仁",产地较广;从品种而言,桃仁的植物来源古今变化不大,清代以前,桃仁的植物来源为山桃或毛桃的种子,近代以来桃或山桃的种子成为主流,不同著作关于桃仁植物来源的拉丁学名有所不同,笔者认为桃Amygdalus persica,山桃A. davidiana拉丁学名较为合理。桃仁行血,宜连皮、尖,生用;桃仁润燥,宜去皮、尖,炒黄。桃核承气汤和桃红四物汤原方中桃仁的炮制方法应当皆为"去皮、尖,炒黄",身痛逐瘀汤中桃仁的炮制方法则应为"连皮、尖,生用"。桃仁主治闭经、瘕邪、小虫、胸痹、咳喘、便秘等多个病证,血虚者、血燥者、孕妇等群体慎用或勿用。现代临床应用仅是对古籍记载的部分继承,提示桃仁还有许多功效可供考证研究,值得进一步深入挖掘以扩大临床应用。古籍关于桃仁的性味归经、品质评定与现代《中华人民共和国药典》内容较一致。因桃仁外观与杏仁相似,尤以粉碎后难以区分,需耗费大量时间和财力予以鉴别,建议医疗机构采购桃仁时尽量采购未经粉碎的桃仁,药房根据临床需求再进行加工炮制。     

经典名方达原饮的关键信息考证

达原饮是治疗湿邪伏于膜原证的代表方,首载于《温疫论》,为明代医家吴又可创制的治疫名方,在新型冠状病毒肺炎湿邪郁肺证的治疗中亦发挥重要作用。该文基于“中华医典（V5.0）”软件及“中医古籍数据库”“国医典藏”数据库,以“达原饮”“达原散”为检索词进行检索,对古籍原文进行标引整理、统计分析及考证,对“达原饮”从组成剂量、药味基原炮制、功能主治、制法服法及现代基础研究与临床应用等方面进行古今文献收集与分析,以期为达原饮的现代开发与临床应用提供文献参考依据。结果发现组成上,多数医籍依照原方药物组成,部分医籍在“芍药”“草果”两味药的记载有区别;剂量上,总体变化不大,差异主要见于“草果”一味药;炮制上,历代文献记载本方组成药味均未明确特殊炮制要求,建议生品入药;制服法上,历代医籍大多遵原书,部分医籍记载以生姜为引,部分医籍在煎煮水量及服药时间上有变化;功效主治上,原书记载达原饮“使邪气溃败,速离膜原”,后历代医籍记载治疗疾病包括“瘟疫”“疫疟”“温疫”“时疫”等,主治主要围绕“疫病”,以邪伏膜原为病机,以发热为表现的各类疾病;临床应用上,古代医家多以“发热”“舌上白苔如积粉”为本方应用的重要指征,现代医家将达原饮广泛运用于发热及消化、呼吸、泌尿、内分泌等多个系统疾病及皮肤病、儿科疾病,同时对流感,严重急性呼吸综合征（SARS）,禽流感等流行性传染病具有确切疗效。     

经典名方济川煎的古代文献考证

济川煎出自《景岳全书》（明·张景岳）,是国家中医药管理局2018年公布的《古代经典名方目录（第一批）》中的经典名方之一。笔者采用文献计量学方法,收集了相关古籍数据43条,涉及中医典籍26部,系统地梳理了济川煎的历史源流、主治病证、组成及方义衍变、剂量、炮制、煎服方法等,为经典名方的研发和临床应用提供了古代文献证据支持。归纳分析发现济川煎历代主治病证有所扩展,除原方记载的虚秘、产后便秘、气瘕之外,此方还可用于燥结、血瘕、阴结、小儿大便闭结、目病及肺（肠）。其方证的适应人群从成人、产妇扩展到了小儿,病证范围也从内科、妇产科延展到了儿科、五官科等。虽然历代医家记载了济川煎加减方,但当归、牛膝、肉苁蓉、泽泻、升麻、枳壳的配伍组成、相对恒定,煎服法也多沿用了水煎,食前服;同时,清医家对其进行了大量的方义论述,但鲜有争议。     

经典名方中茯苓的本草考证

通过查阅历代本草、医籍等古代资料,结合中国知网、万方等数据库收录的现代文献,对《古代经典名方目录（第一批）》中方剂涉及的茯苓药材的基原、产地与品质、采收期、加工炮制方法、栽培技术等方面进行全面梳理与考证,为包含茯苓药材的经典名方品种开发与研究提供参考。经考证可知,古代茯苓入药的基原应为多孔菌科茯苓Poria cocos的干燥菌核。其产地在我国分布广泛,主产于安徽、湖北、河南、云南,以云南所产品质较佳,安徽、湖北产量较大。茯苓古今品质评价结论基本一致,均以块大、质重、皮薄多皱、断面白色细腻者为佳。采收期多为阴历八月,初加工经历古代阴干到现代“发汗”后阴干的演变;茯苓从古至今炮制方法主要为切制,可将其加工成“茯苓块”和“茯苓片”。栽培技术经历了“野生茯苓-活体松根接种-段木接种”的演化过程,目前茯苓主要以人工段木栽培为主,技术方法成熟、产量丰富,可以满足经典名方的研发需求。     

Serological relationship between a novel ovine pestivirus and classical swine fever virus

The genus Pestivirus comprises globally distributed members of the family Flaviviridae, which cause severe losses in livestock. The most common species of the genus are bovine viral diarrhoea virus type 1 (BVDV‐1) and type 2 (BVDV‐2), classical swine fever virus (CSFV) and border disease virus (BDV). Recently, a novel ovine pestivirus was repeatedly detected in aborted lamb foetuses on a farm located in the Brescia Province (Italy). Complete genome characterization of this isolate showed that it was highly divergent from known pestivirus species and that it was genetically closely related to CSFV. The aim of this study was to determine the serological relatedness between the identified novel pestivirus and BVDV, BDV and CSFV selected strains for which homologous serum was available, by antigenic characterization performed using cross‐neutralization assays. The serological relatedness was expressed as the coefficient of antigenic similarity (R). Both field and specific antisera raised against the ovine pestivirus neutralized the CSFV reference strain Diepholz with titres significantly higher than those specific for the BDV and BVDV strains. Furthermore, the calculated R values clearly indicated that the novel ovine pestivirus is antigenically more related to CSFV than to ruminant pestiviruses, in agreement with the results of the genomic analysis. This would have severe consequences on CSFV serology in the event of a switch to porcine hosts with implications for CSFV surveillance and porcine health management.     

B-cell memory in malaria: Myths and realities

B-cell and antibody responses to Plasmodium spp., the parasite that causes malaria, are critical for control of parasitemia and associated immunopathology. Antibodies also provide protection to reinfection. Long-lasting B-cell memory has been shown to occur in response to Plasmodium spp. in experimental model infections, and in human malaria. However, there are reports that antibody responses to several malaria antigens in young children living with malaria are not similarly long-lived, suggesting a dysfunction in the maintenance of circulating antibodies. Some studies attribute this to the expansion of atypical memory B cells (AMB), which express multiple inhibitory receptors and activation markers, and are hyporesponsive to B-cell receptor (BCR) restimulation in vitro. AMB are also expanded in other chronic infections such as tuberculosis, hepatitis B and C, and HIV, as well as in autoimmunity and old age, highlighting the importance of understanding their role in immunity. Whether AMB are dysfunctional remains controversial, as there are also studies in other infections showing that AMB can produce isotype-switched antibodies and in mouse can contribute to protection against infection. In light of these controversies, we review the most recent literature on either side of the debate and challenge some of the currently held views regarding B-cell responses to Plasmodium infections.     

Plasma-derived mannose-binding lectin shows a direct interaction with C1-inhibitor

MBL-deficiency has been associated with an increased frequency and severity of infection, in particular in children and under immunocompromized conditions. In an open uncontrolled safety and pharmacokinetic MBL-substitution study using plasma-derived MBL (pdMBL) in MBL-deficient pediatric oncology patients, we found that despite MBL trough levels above 1.0 μg/ml MBL functionality was not efficiently restored upon ex vivo testing.     

Prognostic significance of CD20 expression and Epstein‐Barr virus (EBV) association in classical Hodgkin lymphoma in Japan: A clinicopathologic study

To investigate the clinicopathological significance of CD20 expression and Epstein‐Barr virus (EBV) association in Hodgkin and Reed–Sterberg cells of classical Hodgkin lymphoma (CHL), CD20 expression and EBV positivity (by EBER in situ hybridization) were investigated in 389 CHL patients in Japan. They included 74 CD20‐positive cases (19%) and 315 CD20‐negative cases (81%). CD20‐positive cases showed significantly older age at onset (P = 0.018) and higher association with EBV (P = 0.002). Multivariate analysis identified EBV‐positivity (but not CD20‐positivity), presence of B symptoms, thrombocytopenia, elevated serum lactate dehydrogenase and performance status >1 as poor prognostic factors for overall survival (OS). We constructed a new prognostic model with these five factors classifying patients into three groups: low risk, 0–1 adverse factor; intermediate risk, 2–3 factors; high risk, 4–5 factors. This prognostic model could stratify the prognosis of CHL patients (P < 0.0001). For 144 patients (58%) classified into the low‐risk group, the 5‐year OS was 91%. For 92 patients (37%) in the intermediate group, the 5‐year OS was 66%; for 11 patients (5%) in the high‐risk group, the 5‐year OS was 36%. In conclusion, EBV is identified as an independent poor prognostic factor for CHL patients. Therefore, examination of EBV association in CHL is recommended as routine pathologic practice especially in countries where EBV infection prevails.     

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??Abstract??Objective To explore the role of miR-125b in pediatric classical APL?? in order to seek new therapeutic strategies for drug resistant APL. Methods The target genes of miR-125b were predicted online?? validated by Dual-luciferase assay and western blot assay. MiR-125b expression levels were measured in 33 matched-pair APL samples??treated in the First Affiliated Hospital of Sun Yat-sen University and other members of South China Children APL Cooperative Group from March 2007 to September2012??at initial diagnosis and complete remission ??CR?? and in 5 relapsed patients by qRT-PCR. Proliferation and apoptosis were analyzed respectively using the RNA transfection?? MTT assay and flow cytometry. Results The expression of miR-125b was up-regulated in pediatric APL at diagnosis and relapse bone marrow samples?? but returned to normal after complete remission?? miR-125b could promote leukemic cell proliferation and inhibit cell apoptosis by regulating the expression of tumor suppressor Bak1. Remarkably??it was also found to be up-regulated in leukemic drug-resistant cells??NB4-R1??NB4-R2??HL-60/DOX???? and overexpression of exogenous miR-125b could increase their resistance to therapeutic drugs. Conclusion MiR-125b can regulate pediatric classical APL cells proliferation?? apoptosis and drug resistance by repressing BAK1 protein expression.     

杨志宏教授治疗帕金森病经验

帕金森病是一种多发于中老年的神节系统变性疾病.杨志宏教授治疗帕金森病独具特色,注重滋补肝肾以固本;在化痰祛瘀的同时,注重益气;倡导清热除湿、解毒排毒以护脑;常用解表除湿的方法治疗汗出,疗效显著.