运动和胰岛素对高血糖大鼠骨骼肌JNK和p38信号传导系统的调节作用

目的：观察运动和胰岛素对高血糖大鼠骨骼肌细胞应激激活蛋白激酶-JNK和p38信号通道活性的作用，为糖尿病的运动疗法提供分子生物学依据。方法：12周龄、体重200-230g的SD大鼠18只，腹腔内注射链脲佐菌素，建立持续高血糖模型。然后随机分为运动组、胰岛素组和对照组。运动组采用活动平板，坡度10％，速度20m／min，运动20min后取标本；胰岛素组给予皮下注射胰岛素，30min后取标本；对照组不参与运动也不给予胰岛素注射。运用化学发光法测定骨骼肌JNK和p38活性。结果：骨骼肌JNK活性在运动组分别高于对照组和胰岛素组，胰岛素组JNK活性与对照组无显著差异。骨骼肌p38活性在运动组和胰岛素组较对照组显著增高。结论：在高血糖状态下，运动使得骨骼肌JNK和p38激酶的活性增高，提示通过对JNK和p38信号转导通道的调节作用，参与了骨骼肌结构和代谢功能的适应性改变；胰岛素可以激活骨骼肌p38通道但对JNK的活性无影响，提示通过对p38的激活，改善了葡萄糖转载体的内在活性。     

动态血糖监测仪及胰岛素泵临床应用中的持续质量改进

目的探讨持续质量改进（CQI）对提高患者使用动态血糖监测系统（CGMS）、胰岛素泵（CSII）护理质量的作用。方法选择2007年4～12月305例糖尿病患者为对照组,按照常规方法在公司业务员指导下,讲授仪器的结构、工作原理和操作步骤。护士现场学习,护士长和骨干护士重点学习全部操作,然后在科室推广应用。以2008年4～12月308例糖尿病患者为观察组,以CQI理论为指导,制订内分泌专科分层次的培训计划,制定各种操作规范并由护士长全程监督控制。结果改进后护士理论、操作考核成绩比改进前显著提高（均P〈0．01）;观察组中使用CSII的患者对护士安装仪器、故障处理和观察巡视的满意度较对照组显著提高（P〈0．05,P〈0．01）;观察组使用CGMS者仪器电缆线折断、局部皮肤炎症发生率显著低于对照组（均P〈0．05）。结论持续质量改进有助于护士业务技能的提高,为糖尿病患者的治疗、监测提供保证,提高了护理质量。     

《东医宝鉴》与《万病回春》方剂内容的初步比较分析

通过比较《东医宝鉴·内景篇一》19首方剂引用《万病回春》内容与《万病回春》原文,可知许浚引用中国古代医籍并非照搬原文,而是具有自己的编撰思路。尤其是其对《万病回春》原文的删改调整,既参考了许浚自身的临床体会,也考虑到了朝鲜本土的具体情况,从而迈出了中医学在朝鲜本土化的步伐。     

c‐Jun amplification and overexpression are oncogenic in liposarcoma but not always sufficient to inhibit the adipocytic differentiation programme

Genomic amplification of c‐Jun and its upstream kinases have been implicated as a mechanism of progression from well‐differentiated to dedifferentiated liposarcoma. To further define the role of c‐Jun in liposarcoma progression, we performed immunohistochemistry for c‐Jun and its activating kinase ASK1 on a series of liposarcomas (n = 81). We correlated the results with fluorescence in situ hybridization to detect c‐Jun amplification. We also derived new cell lines from dedifferentiated liposarcomas with c‐Jun amplification. c‐Jun protein is expressed in the majority of dedifferentiated liposarcomas (91%) and their well‐differentiated components (59%), but only in the minority of pure well‐differentiated liposarcomas (27%). When c‐Jun is amplified in dedifferentiated liposarcoma, it is interspersed with amplified MDM2 on ring and giant marker chromosomes. MDM2 amplification is one of the earliest events in liposarcoma development, and these results suggest that c‐Jun was amplified at a similar time in the evolution of the tumour. In addition, shRNA to c‐Jun in c‐Jun‐amplified liposarcoma cells reduces cell number in vitro and inhibits tumour formation in vivo without an observable effect on the differentiation state of the liposarcoma cells. Thus, c‐Jun amplification is oncogenic in liposarcomas but not always sufficient for inhibition of adipocytic differentiation. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

杨继洲针灸学术思想述要

杨继洲溯源穷流,集针灸诸家之大成,师古而不泥;临证重视经络理论,提出"宁失其穴,勿失其经";总结和创新针刺手法,建立了比较规范和实用的针刺手法体系;倡导针灸药物并重,强调针灸药物综合运用,为针灸学的发展作出了重要的贡献。     

杨积武教授强心宁煎剂联合西药治疗慢性心衰临床经验

杨积武教授为辽宁中医药大学附属医院心内科主任医师,辽宁省名老中医,博士生导师,在其进40余栽的临床实践中,对心血管疾病的中西医治疗有其独特见解,杨师博览群书,深究古今文献,运用现代医学成果,坚持中西医结合,潜心研制强心宁煎剂汤药方联合西药治疗慢性心力衰竭,疗效满意,笔者不揣浅薄,现就随师所得介绍如下。