陈大舜教授治疗不寐医案七则

论文从七个不同病案论述陈大舜教授治疗不寐的临床诊治经验,其临床效果明显.七则医案:心火胃热,心肾不交致不寐,治以清热泻火,交通心肾,方用导赤散合交泰丸加减;肝阴亏虚,虚热内扰致不寐,治以柔肝凉血,清热除烦,方用酸枣仁汤合天麻钩藤饮加减;胆胃不和,痰热上扰致不寐,治以清胆和胃,养血安神,方用黄连温胆汤合酸枣仁汤加减;肺阴虚兼痰瘀互结致不寐,治以养阴安神,化痰散瘀,方用沙参麦冬汤、半夏白术天麻汤合二至丸加减;肝郁化火,气滞血瘀致不寐,治以疏肝解郁,清热化瘀,方用丹栀逍遥散加减;气阴两虚,虚火上扰致不寐,治以养阴益胃,清热除烦,方用益胃汤合酸枣仁汤加减;脾肾两虚,虚火扰心致不寐,治以交通心肾,养心安神,方用交泰丸合黄连阿胶汤加减.     

产后盆底训练对预防女性早期盆底功能障碍的价值研究

目的：了解产后盆底训练对预防女性早期盆底障碍的临床价值。方法：住院分娩的产妇240名分成研究组（118例）和观察组（122例）。研究组产后42d采用法国PHENIX盆底肌肉康复系统进行盆底肌肉训练,对照组进行一般产后随访,两组分别以产后42d及产后3、6个月进行随访,项目包括测定盆底肌肉张力及问卷调查尿失禁的发生情况,并进行POP～Q分度评估。结果：研究组产后3、6个月阴道静息压、阴道收缩压及阴道收缩持续时问均高于对照组,差异有高度统计学意义（P〈0．01）;研究组产后3、6个月尿失禁的发生率低于对照组,两组比较差异均有统计学意义（均P〈0．05）。两组产后3、6个月随访期间无脏器Ⅲ度脱垂情况发生。结论：产后早期盆底训练可减少尿失禁的发生,改善盆腔脏器脱垂,值得临床推广应用。     

肝胆与脏腑气化关系探讨

肝胆在脏腑气化功能中起着重要作用。主要表现在五个方面;肝升肺降、治节有权,木敷心和、血运畅达,木疏土达、纳运如常,木和肾充、开合自如,木气疏调、三焦司职。     

从藏象学说再论湿疹病因病机简

湿疹是多种因素引起的一种具有明显渗出倾向的皮肤炎症性疾病,是皮肤科常见病,其病因复杂,皮损的表现也多种多样,容易反复。随着社会的工业化进程,人们生活方式的改变,及环境污染等因素的影响,湿疹的发病呈逐年上升的趋势。中医治疗湿疹有数千年的历史,针对湿疹的不同病期,采用中药内服、外用治疗疗效好,复发率低。对于湿疹的病因、病机各医家进行了论述,对其病因主要围绕着风、湿、热邪进行论述,对湿疹发病过程中涉及的脏腑,有从心论述的,有从脾论述的,也有从心、脾、肺、肝等方面论述的,认识不一。为进一步了解湿疹的病因、病机,该文从中医藏象学说的角度,分析五脏与湿疹发病的关系,更好的从病因、病机方面认识、治疗湿疹。     

The many weak instruments problem and Mendelian randomization

Instrumental variable estimates of causal effects can be biased when using many instruments that are only weakly associated with the exposure. We describe several techniques to reduce this bias and estimate corrected standard errors. We present our findings using a simulation study and an empirical application. For the latter, we estimate the effect of height on lung function, using genetic variants as instruments for height. Our simulation study demonstrates that, using many weak individual variants, two‐stage least squares (2SLS) is biased, whereas the limited information maximum likelihood (LIML) and the continuously updating estimator (CUE) are unbiased and have accurate rejection frequencies when standard errors are corrected for the presence of many weak instruments. Our illustrative empirical example uses data on 3631 children from England. We used 180 genetic variants as instruments and compared conventional ordinary least squares estimates with results for the 2SLS, LIML, and CUE instrumental variable estimators using the individual height variants. We further compare these with instrumental variable estimates using an unweighted or weighted allele score as single instruments. In conclusion, the allele scores and CUE gave consistent estimates of the causal effect. In our empirical example, estimates using the allele score were more efficient. CUE with corrected standard errors, however, provides a useful additional statistical tool in applications with many weak instruments. The CUE may be preferred over an allele score if the population weights for the allele score are unknown or when the causal effects of multiple risk factors are estimated jointly. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.     

徐宜厚脏腑辨证治疗白塞病经验

白塞病是以血管炎为病理基础的多系统疾病,使用主要的系统药物激素治疗存在减量或停药难的现状。徐宜厚教授将本病定位于肝、脾、肾,以脏腑寒热虚实辨证为思路遣方用药,不但解决了激素减量难的问题,且使病情缓解期显著延长。     

Weak Localization in Polycrystalline Tin Dioxide Films

The electrical and magnetotransport properties of nanocrystalline tin dioxide films were studied in the temperature range of 4–300 K and in magnetic fields up to 8 T. SnO_2−δ films were fabricated by reactive direct current (DC) magnetron sputtering of a tin target with following 2 stage temperature annealing of synthesized samples. The nanocrystalline rutile structure of films was confirmed by X-ray diffraction analysis. The temperature dependences of the resistance R(T) and the negative magnetoresistance (MR) were explained within the frame of a model, taking into account quantum corrections to the classical Drude conductivity. Extracted from the R(T) and R(B) dependences electron dephasing length values indicate the 3D character of the weak localization (WL) in our samples.     

An optimal control problem with nonlocal conditions for the weakly nonlinear hyperbolic equation

Some problems in physics and engineering may be effectively described in terms of nonlocal problems for differential equations. These nonlocal conditions show that some data on the boundary cannot be measured, and therefore some averaged data of the problem are given. In the present paper, necessary conditions of optimality in the optimal control problem are derived for hyperbolic equations with nonlocal boundary conditions. Copyright © 2012 John Wiley & Sons, Ltd.     

HPV16 E6E7癌蛋白通过TWEAK/Fn14信号途径对细胞增殖和凋亡的影响

目的:探讨HPV16 E6E7对TWEAK/Fn14信号途径及细胞增殖和凋亡的影响。方法:制备表达HPV16 E6E7的逆转录病毒,感染原代角质形成细胞。用流式细胞仪分析可诱导纤维母细胞生长因子14(Fn14)表达,Real-time RT-PCR和Western blot法检测调解活化正常T细胞表达和分泌的趋化因子(RANTES)、单核细胞趋化蛋白-1(MCP-1)、干扰素-γ诱导蛋白10水平(IP10)和肿瘤坏死因子(TNF)受体相关因子(TRAF2)表达,生物化学法检测Ras GTpase活性,TUNEL检测细胞的凋亡,MTT法检测细胞增殖。结果:表达HPV16 E6E7的逆转录病毒感染角质形成细胞后,Fn14高表达,RANTES、MCP-1、IP10和TRAF2表达增加,Ras GTpase活性升高。与未感染表达HPV16 E6E7逆转录病毒的细胞比较,表达E6E7感染的角质形成细胞对TNF-α刺激不敏感,细胞增殖显著增加(P0.05)。结论:表达HPV16 E6E7细胞激活TWEAK/Fn14信号途径,从而上调RANTES和TRAF2表达,导致细胞增殖,这可能是高危型HPV的一个致病机制。