路波以辛开苦降法治疗非酒精性脂肪肝胃热脾困证临床经验

随着我国经济的发展和人民生活水平的提高,非酒精性脂肪性肝病(NAFLD)、2型糖尿病、代谢综合征等与胰岛素抵抗相关的代谢性疾病的发病率逐年增加,并互为危险因素,常相继或同时发病。陕西省名中医路波主任医师长期从事代谢性疾病的中西医治疗与预防,提出饮食不节导致痰郁脾虚进而内生瘀血、浊热,终致寒热虚实错杂为NAFLD基本病机,病位涉及肝、脾、胃。其针对NAFLD最常见证型胃热脾困证,立"辛开苦降"法为治则,方用"运脾化浊颗粒",达邪去郁开、瘀散热清之效,临床疗效确切。     

杨小红从肾虚膀胱热论治老年女性泌尿系感染经验介绍

杨小红教授是广州中医药大学硕士研究生导师,广州中医药大学第一附属医院主任医师,师从全国名老中医陈镜合,从事临床、教学、科研工作三十余年,在治疗泌尿系统疾病方面经验丰富,疗效显著。笔者跟师学习3年余,现将杨教授治疗老年女性泌尿系感染经验总结如下。     

肿瘤从痰从脾论治的体会

中晚期肿瘤患者多为虚实夹杂、本虚标实之重症,笔者在临床中体会到,其虚可以辨证为气血阴阳及五脏之虚,但应以调治脾虚为主,其实证可以表现为气滞、痰凝、血瘀等,但应以治痰为主,在病因病机上及诊治上,始终抓住痰与脾这两个核心。下面就此论述一下。痰、脾与肿瘤发病的关系朱丹     

CLINICAL AND DIAGNOSTIC FEATURES OF SCHISTOSOMIASIS JAPONICA A REVIEW OF 200 CASES

Schistosomiasis'' japonica is one of the most important parasitic diseases in China. Ever since its dscovery in this eountry (j) its inCidenee、and extent Of enilemiCity haVe bec0删：e inCreaSlngIy evident With imprOvement Of diagnoStiC methodS and a8 a reSUlt Of inVeStiga- 戗On8 made by VariOU8 W0rkerS. It iS Well knOWn that reglonS watered by the Yan或ze RiVer were rampant w托h this di8ea8e. The vast areas of endemlelty lnclude not only the territories im!mediately traversed by the main stream and its lnnumerable tributarie8 but also districts adjaeent to the mammoth bodies of water such as Great Lake（太湖）,Poyanghu t都防湖），and Tung七inghu（洞庭湖）． Thus Kiangsu（江袜），、Chekiang 【浙江），Anhwei（安徽），Kiangsi（江西），Hupeh（湖北）and Hunan （湖南） are the proVinees of high endemicity. Rampaney of the infeStation dOes nOt, hoWever, COnfine to reglOnS of tbe Central and lOWer YangtZe Valley aS eaSeS Of SChiStOSOmiaSiS have been reCOrded il土the central plains Of Szechuan(四J”) (2—4)and sou¨thwest parC of Chin可ihcluding Kwangsi（魔西）(5)and Yunnan（雷南）（艿。8）．     

二陈汤合桃红四物汤加减治疗痤疮63例体会

痤疮是青春期常见、多发的皮肤疾患，中医称之为“肺风粉刺”、“面粉渣”等。其主要表现为粉刺、丘疹、脓疱、结节、囊肿及瘢痕。由于本病好发于面部，易反复发作，缠绵难愈，严重影响患者的美容，部分患者可能因此而发生心理障碍，甚至有相当一部分患者会因为病情较重或处理不当形成凹陷性或增生性瘢痕，严重影响患者的生活质量。近年来，随着人们生活水平的提高，痤疮成为目前患者和医务工作者关注的疾病之一。从2006年至今笔者跟随导师运用中医药治疗了63例患者，其中在用二陈汤合桃红四物汤加减治疗痤疮之痰湿瘀滞证病例，治疗后取得满意疗效，现介绍如下。     

The correlation between TNF-α, IL-6 in cervical mucous during follicular development and ovulation stimulation in different protocols

Objective To investigate the correlation between TNF-α and IL-6 levels in cervical mucous during follicular development and ovulation stimulation in different protocols.Methods 36 infertile women were set up as experimental groups,divided into CC, HMG, IVF-ET group,each group consisted of 12 infertile women and 15 women with normal menstrual cycles were choiced as control group.Cervical mucous during follicular phase, luteal phase and ovulation phase were collected.TNF-α, IL-6 levels in cervical mucous were measured by radioimmunology assay (RIA).Follicular development were monitored by transvaginal ultrasonagraphy.Results (1) TNF-α levels in cervical mucous of experimental groups and control group were periodically various among the reproductive cycle.It increased during follicular phase, reached to peak during ovulation phase, and decreased during luteal phase (P＜0.05).IL-6 levels had no obvious periodical changes.(2) Compared with CC and control group, levels of TNF-α,IL-6 in HMG and IVF-ET group were significantly higher (P＜0.05).(3) Levels of TNF-α and IL-6 in cervical mucous were positively correlated with the dominant follicle diameter (r=0.261, r=0.192 respectively,P＜0.05).(4) TNF-α and IL-6 showed positive correlation in the reproductive cycle (r=0.782,P＜0.05).Conclusions (1) TNF-α level shows a cyclic change in the reproductive cycle and peaks during ovulation,whereas IL-6 level does not.(2) TNF-α and IL-6 may play a certain role in the process of follicular development and ovulation.(3)The levels of TNF-α and IL-6 are up-regulated by gonadotrophic hormone.(4) TNF-α and IL-6 may have coordination properties and participate in the same biological effects.     

Comparison of clinical outcomes of frozen-thawed blastocysts transfer in natural and hormonally controlled cycles

Objectives:To assess the clinical outcomes of frozen-thawed blastocysts transfer in natural and hormonally controlled cycles.Methods:A retrospective analysis of natural and hormonally controlled cycle for 246 frozen-thawed blastocyst transfer cycles,the clinical pregnancy rate,implantation rate,early abortion rate were compared.Results:Of the 192 hormonally controlled cycles,the cancel rate,clinical pregnancy rate per ET,implantation rate and abortion rate were 7.3%(14/192),53.9%(96/178),38.8%(131/338)and 11.5%(11/96)respectively,whereas in 54 natural cycles,these rates were 16.7%(9/54),68.9%(31/45),52.9%(45/85)and 16.1%(5/31)respectively.There was no significant difference between the two groups with regard to the clinical pregnancy and abortion rate per ET,but the cancel rate and implantation rate were higher in natural cycles.However,the pregnancy and implantation rates of patients without PCOS in hormonal control cycles(57.2%,40.9%)were similar with those in natural cycles(P>0.05).Conclusion:These findings suggested that both hormonally controlled and natural cycles had similar pregnancy outcomes in frozen-thawed blastocysts transfer.     

宫颈取材与宫颈癌及癌前病变检出率的关系初探

目的：对医院2005年全年门诊及住院病人的宫颈病理检查结果进行分析，为临床检查操作规范提供基础数据。方法：采用Excel建立数据库，转化生成SPSS13．0统计软件包数据库，进行描述性分析、检验。结果：2154例送检材料中，检出宫颈癌及癌前病变共255例，检出率11．9％，其中宫颈表面取材检出率29．0％（占所有宫颈癌及癌前病变的65．5％）；宫颈管搔刮术（ECC）检出率5％；宫颈表面＋ECC取材检出率29．1％；宫颈电环切除术（LEEP）检出率25．8％；宫颈赘生物检出率3．3％；全切子宫的检出率6．3％。宫颈表面3、6、9、12点定点、宫颈四个象限、宫颈管取材的检出率及病变程度比较，差异均无统计学意义（P〉0．05）。结论：宫颈癌及癌前病变的检出主要依靠宫颈表面活检，配合ECC、LEEP、宫颈赘生物摘除等。