黄明河辨治脾胃病临床经验

黄明河主任从事中医脾胃病临床工作近60年,在长期的临床实践中积累了丰富的临床经验,并且逐渐形成了鲜明的个人诊治特色。其临床经验不但丰富了脾胃病的现代中医诊疗内容,而且为后学者提供了很好的学习方法。①以中医脏象学说为导向,重视各脏、腑的生理、病理特点,临床以脏腑辨证为主要手段,具体到脾胃病,临证时对脾、胃二脏分别辨证,使证型更加细化;②重视肾阳在脾胃病治疗中发挥的关键作用,一旦发现肾阳虚弱的端倪,及早着手温补肾阳,可起到事半功倍的效果;③宏观与微观辨证相结合治疗脾胃病,积极使用现代诊疗仪器,参考胃、肠镜检查结果、病理检查结果等,进行胃、肠病变的微观辨证,同时与中医传统望、闻、问、切宏观辨证相结合,提高了诊治的精准度。     

磁声电导率检测系统设计及其线性扫频理论验证

临床研究证实病灶组织的早期诊断能显著降低患癌风险,由于磁声电成像具有高分辨率和高对比度优势,因而有望成为一种新的检测方法。本文采用模块化设计思维,设计并实现了一款低成本、数字化磁声电导率检测系统,并提出线性调频连续波激励洛伦兹力电阻抗检测理论,通过0.5%NaCl均匀仿体实验,清晰获得与实际物理尺寸一致的均匀仿体电导率曲线,验证了线性扫频理论应用在本系统是准确且可行的。同时,1 000μs线性扫频时宽所获得分辨率优于500μs和1 500μs,提示线性扫频时宽是影响电导率分辨率的重要因素。通过对不同浓度NaCl均匀仿体的实验,得到了相同结论,证明了本系统的可重复测量性。     

Weak D in the Tunisian population

BackgroundMore than 90 weak D types have been discovered to date. As there are no published data on the frequencies of weak D types in the Tunisian population, the aim of this study was to determine the composition of weak D alleles in our population.ResultsAmong the D+ donor cohort, weak D type 4 was the most prevalent allele (n=33, 1.2%) followed by weak D type 2 (n=6, 0.17%), weak D type 1 (n=4, 0.11%), and weak D type 5 (n=1, 0.28%) and weak D type 11 (n=1, 0.28%). RHD sequencing identified a weak D type 4.0 allele in all 19 samples tested. Among the D− pool, comprising 223 samples, we detected one sample with weak D type 4.0 associated with a C+c+E−e+ phenotype which had been missed by routine serological methods.DiscussionWeak D type 4.0 appears to be the most prevalent weak D in our population. However, all samples must be sequenced in order to determine the exact subtype of weak D type 4, since weak D type 4.2 has considerable clinical importance, being associated with anti-D alloimmunisation. One case of weak D type 4 associated with dCe in trans had been missed by serology, so quality control of serological tests should be developed in our country.     

Molecular characterization of weak D phenotypes by site-directed mutagenesis and expression of mutant Rh-green fluorescence protein fusions in K562 cells

BACKGROUND AND OBJECTIVES: Mutations detected in 161 weak D samples from Caucasians have been classified into 16 types. Because flow cytometry using monoclonal anti-D antibodies (mAbs) has shown that weak D red cells display type-specific antigen density, these mutations in transmembranous regions have been assigned weak D phenotypes. The present study attempts to confirm or refute this assignment. MATERIALS AND METHODS: We amplified DNA from four Japanese weak D samples using the polymerase chain reaction (PCR), and directly sequenced the amplified DNA. Using site-directed mutagenesis, we constructed three vectors expressing mutant RHDs-- G212C, V270G (weak D type 1) and G358A (type 2)--in K562 cells. The expression of RhD antigens was examined by flow cytometry using mAbs. RESULTS: A new mutation resulting in a conversion at amino acid residue 212 (Gly to Cys) was detected in a Japanese weak D sample. K562 cells transduced with mutant RhD cDNA reacted weakly in a type-specific manner with mAbs. CONCLUSIONS: The mutations--G212C (new weak D type), V270G (weak D type 1) and G358A (type 2)-- in transmembranous regions had obvious effects on the D epitopes recognized by mAbs. The results of this study provide direct evidence that these mutations can account for weak D phenotypes.     

“正统四象说”与“医家四象说”相关问题辨析

阴阳再分阴阳,则为“四象”。四季配“四象”分太少阴阳有两种方式：①“正统四象说”,以春为少阳,夏为太阳,秋为少阴,冬为太阴,广泛见于医家之外的各种典籍,故为“四象”说之“正统”。②“医家四象说”,以春为少阳,夏为太阳,秋为太阴,冬为少阴,仅见于医书之中。“正统四象说”和“医家四象说”,因为对阴阳的定义不同,故所观察到的阴阳变化规律有异,二者皆有道理。基于两种“四象”说,《内经》五脏与“四象”的配属方式也有两种,其中基于“正统四象说”的配属方法更为本源。     

医院智能化楼宇弱电系统设计的关键问题研究

医院智能化楼宇弱电系统设计是医院建筑工程的成败之本,系统工程项目设计的正确与否、合理与否,都将直接关系着后面整个工程的实施。弱电项目首先必须要高度重视各子系统的工程设计,系统的优劣、技术层次的高低均要通过系统设计和施工安装质量来体现,因此,弱电的工程设计是完成系统工程项目的第一步,也是非常关键的一步。     

螺旋CT对腹部空腔脏器穿孔的诊断价值

目的探讨螺旋CT在腹部空腔脏器穿孔中的诊断价值。方法回顾性分析18例腹部空腔脏器穿孔的CT表现,所有病例经临床及手术证实。结果胃、十二指肠穿孔6例,空回肠穿孔6例,结肠穿孔4例,子宫积脓自发穿孔1例,膀胱自发性破裂1例。主要CT征象有：肝上间隙积气（14例）、肝下间隙积气（8例）、肝圆韧带裂隙积气（4例）、穿孔脏器局部积气（17例）、腹腔积液（13例）、肠壁局限性增厚（9例）。结论 CT可直观地显示腹膜腔、腹膜后腔游离气体,为临床提供及时准确的诊断,并可为明确穿孔部位、病因、合并症提供较多有价值的诊断信息。     

中医经络学说对脏腑学说发展的影响

同为中医理论体系核心内容的经络学说和脏腑学说,在各自独立发展的过程中曾经相互影响。脏腑阴阳属性的认定和脏腑相合关系的确立,都与经脉学说的影响密不可分。脏腑的阴阳属性和阴阳之气的多少,起初是用“二阴二阳”来标定的。当“三阴三阳”命名了经脉,进而经脉络属了脏腑之后,才架设了脏腑与“三阴三阳”之间沟通的桥梁。在经脉表里关系和经脉脏腑络属关系的影响下,脏腑相合学说逐步成熟,《灵枢·经脉》的脏腑经络学说最终得以建立并占据了中医学术的主流地位,与之相左的其他“异说”则渐渐游弋于学术边缘而日趋湮没。     

糖尿病患者饥饿感中医病机浅识

糖尿病患者饥饿感病机有胃火炽盛、胃强脾弱、脾胃虚弱、瘀热消谷、痰热消谷等。糖尿病初期,痰热、火热之证常见,患者出现多食易饥表现,应考虑痰热消谷、火热消谷,选用白虎汤、玉女煎、消渴方等加减治疗;病程日久,火热伤阴,壮火食气,出现气阴两虚等表现,此时出现多食易饥症状,则需考虑胃强脾弱、脾胃虚弱等病机,采用半夏泻心汤、附子理中丸、参苓白术散等治疗;瘀血贯穿糖尿病始终,故在使用以上方法治疗糖尿病患者消谷易饥效果欠佳时,可考虑瘀热消谷的因素,采用桃核承气汤、白虎汤合桂枝茯苓丸治疗。糖尿病与痰湿关系密切,针对该病机引起的饥饿感,在清热的同时,还应化痰除湿。糖尿病病程日久患者,饥饿感病机复杂,宜"观其脉证,知犯何逆,随证治之"。