Sequential Therapy Based on Evolvement of Patterns: A New Model for Treatment of Alzheimer’s Disease

In order to solve the problem of long-term (>9 months) efficacy in the treatment of Alzheimer''s disease (AD) by conventional therapy (CT), a staged and multiply-targeted sequential therapy based on the evolvement of patterns (STEP) was developed. Its main innovations include: (1) the time order of evolution of patterns defined by Chinese medicine (CM) in AD was found, that is, "the orderly pattern evolution starting from Shen (Kidney) deficiency, progressing to phlegm, stasis and fire, and worsening to severe toxin as well as functional collapse"; (2) the cascade hypothesis of Shen deficiency in AD and its sequential therapy based on Shen-reinforcing was proposed, that is, "reinforcing Shen in the early stage and throughout the whole process, resolving phlegm, activating blood and purging fire in the middle stage, detoxifying and replenishing vitality to stop the collapse in the advanced stage", and through meta-analysis, clinical drug use was optimized, thus the leap from "inferential selection" to "evidence-based selection" was realized; (3) the STEP regimen combined with CT maintained cognitive and behavioral stability in AD patients for at least 12 months, with cognitive enhancement and behavioral synergy after 9 months, and cognitive benefit was superior to CT at 9, 12, 15, 18, 21, and 24 months, respectively. The 2-year cognitive improvement rate was increased by 25.64% (P=0.020) and the cognitive deterioration rate was decreased by 48.71% (P=0.000). Among them, the cognitive and functional benefits of Shen-reinforcing therapy for very early AD (350 cases) for 1 year were better than the placebo (P<0.001), and the dementia conversion rate was reduced by 8.85% (P=0.002). The behavioral symptomatic relief of patients with vascular dementia received fire-purging therapy (540 cases) was superior to those received CT (P=0.016). These data suggested that the STEP regimen has synergistic effects on CTs at least in terms of cognitive benefit, and the earlier the use, the greater the benefit will have. Therefore, the STEP regimen should be considered as one of the clinical options, particularly for the dearth of effective pharmaceutical or immunological interventions that are currently available for AD.     

肝门胆管癌的动态增强CT诊断

目的评价螺旋CT对肝门胆管癌的诊断价值。方法13例肝门胆管癌行螺旋CT平扫及动态增强扫描,并与手术及病理对照分析。结果11例平扫表现为肝门区低密度软组织肿块;2例表现为肝门区胆管不规则增厚,管腔狭窄。增强扫描13例有延迟强化。结论螺旋CT扫描对肝门胆管癌的诊断具有重要意义。     

肛直肠抑制反射时门静脉血中P物质变化

目的探讨肛直肠抑制反射（RAIR）时门静脉血中P物质（SP）的变化规律及外源性内脏神经对其变化的影响。方法将实验大白鼠分为7组，其中6组先按去与不去直肠肛管外源性内脏神经支配而分为不去神经和去神经两大组，每组中又按Foley导管上气囊置入直肠腔中的位置分为2、4、6cm组；同时再设1个对照组，将Foley导管置入直肠腔中，但不注水扩张球囊。检测并比较在直肠腔内刺激后，各组门静脉血中的SP值及变化情况。结果去神经组中2、4cm组与不去神经组之间及对照组之间，门静脉血中SP值变化比较，P〉0．05，差异无统计学意义。不去神经组中的6cm组与对照组及去神经组中2cm和4cm组之间SP值比较，P〈0．01，差异有统计学意义；去神经组和不去神经组中的6cm组之间SP值比较，P〈0．01，差异有统计学意义。结论直肠腔内上部的刺激不引出RAIR可能与该部位的刺激使内括约肌兴奋性递质（SP）的释放有关；外源性内脏神经对RAIR中门静脉血的SP变化有调控作用。     

游走火罐配透刺、艾灸治疗周围性面瘫35例

周围性面瘫,多是由面神经炎引起面神经缺血、水肿导致的面肌瘫痪[1].笔者近年在沙特阿拉伯工作期间,有感于面部按摩疗法在周围性面瘫康复中的广泛应用,以面部游走火罐配合针灸疗法治疗本病35例,均取得了较好的疗效.现总结如下.     

大鼠静脉窦高压致硬膜血管变化的研究

目的探讨大鼠静脉窦高压后硬膜血管变化及其静脉窦高压在硬脑膜动静脉瘘形成中的作用。方法体重200～250g的SD雄性大鼠110只,随机分为静脉窦高压组(85只)和假手术组(25只),将静脉窦高压组85只大鼠闭塞左侧横窦和上矢状窦前1／3,并吻合右侧颈总动脉和颈外静脉,制成静脉窦高压模型。假手术组大鼠单纯解剖相应的颈部血管和硬脑膜窦,但不行吻合或闭塞。术后90d,随机取7只静脉窦高压组大鼠和5只假手术组大鼠,行硬脑膜血管明胶墨汁灌注,观察硬膜血管的状况。结果术后90d静脉窦高压组和假手术组大鼠的硬膜血管数分别为(10.7±1.5)条／mm,(10.3±0.6)条／mm,差异无显著性。在静脉窦高压组中1只大鼠有硬脑膜动静脉瘘,其形态和结构与生理性动静脉短路类似。结论大鼠静脉窦高压一段时间后,颅内硬膜血管无明显增生。颅内硬脑膜动静脉瘘的形成很可能是由动静脉间的短路发展而来。     

灰关联分析应用于因素分析时关联度指标的改进

本文指出在应用灰关联分析进行因素分析时传统的关联度计算方法的不足，并提出采用新的关联度指标来表示因素之间的关联关系，同时给出了实例介绍计算方法。     

铁路系统医院136篇口腔修复、正畸学论文的统计分析

通过对铁路系统医院１３６篇口腔修复、正畸学论文的统计分析，来评价医院口腔修复、正畸的科研水平，同时也揭示了科研工作中存在的问题。指出只有加强科研协作、扩大学术交流、增加科研投入，提高科研水平，使科研成果更趋完善。     

Angiotensin I conversion and coronary constriction by angiotensin II in ischemic and hypoxic isolated rat hearts.

Dose-response curves of angiotensin I (AI, 1.0-1000.0 pmol) and angiotensin II (AII, 1.25-1250.00 pmol) were obtained in isolated rat hearts subjected to control conditions, mild hypoxia (PO2 = 145 mm Hg), reoxygenation, ischemic (perfusion pressure = 35 mm Hg) and reperfusion. Both AI and AII caused dose-dependent coronary flow (CF) of 26 +/- 3 and 27 +/- 2%, respectively. The effects of both AI and AII were substantially attenuated during hypoxia, but were fully restored upon reoxygenation. During ischemia, the effect of AII was unaltered while the effect of AI was enhanced compared to the control (P less than 0.05). This enhancement was reversible on reperfusion. Cardiac conversion of AI, calculated from ED50 values for AI and AII, was significantly increased during ischemia (P less than 0.05). Infusion of saralasin (0.5-5.0 micrograms/min) did not increase CF in any of the groups. We conclude that (1) the coronary vasoconstrictive effect of AII is preserved in ischemia but attenuated in hypoxia and (2) cardiac conversion of AI to AII is enhanced in hearts injured by ischemia.