仝小林运用茯苓、生白术、泽泻利脾湿经验

茯苓、生白术、泽泻是仝小林院士临床常用的利脾湿三味小方.仝小林认为,现今多种疾病以脾虚湿困为基本病机.茯苓可利水渗湿,常用剂量为9～120 g;生白术可健脾燥湿,常用剂量为9～90 g;泽泻渗湿化浊,常用剂量为15～30g.利脾湿三味小方用于代谢性疾病、内分泌、消化系统疾病等有脾湿之证.     

Fournier's gangrene: Report of thirty-three cases and a review of the literature

Background: Fournier’s gangrene (FG) is an extensive fulminant infection of the genitals, perineum or the abdominal wall. The aim of this study is to share our experience with the management of this difficult infectious disease. Methods: Thirty‐three male patients were admitted to our clinic with the diagnosis of FG between February 1988 and December 2003. The patient’s age, etiology and predisposing factors, microbiological findings, duration of hospital stay, treatment, and outcome were analyzed. The patients were divided into two groups. The first 21 patients (Group I) were treated with broad‐spectrum triple antimicrobial therapy, broad debridement, exhaustive cleaning, and then they underwent split‐thickness skin grafts or delayed closure as needed. The other 12 patients (Group II) were treated with unprocessed honey (20–50 mL daily) and broad‐spectrum triple antimicrobial therapy without debridement. Their wounds were cleaned with saline and then dressed with topical unprocessed honey. The wounds were inspected daily and the honey was reapplied after cleaning with normal saline. Then, the patients’ scrotum and penis were covered with their own new scrotal skin. Results: The mean age of the patients was 53.9 ± 9.56 years (range = 23–71). The source of the gangrene was urinary in 23 patients, cutaneous in seven patients, and perirectal in three patients. The predisposing factors included diabetes mellitus for 11 patients, alcoholism for 10 patients, malnutrition for nine patients, and medical immunosuppression (chemotherapy, steroids, malignancy) for three patients. The mean duration of hospital stay was 41 ± 10.459 (range = 14–54) days. Two patients in Group I died from severe sepsis. The clinical and cosmetic results were better in Group II than Group I. Conclusions: Necrotizing fasciitis of the perineum and genitalia is a severe condition with a high morbidity and mortality. Traditionally, good management is based on aggressive debridement, broad‐spectrum antibiotics, and intensive supportive care but unprocessed honey might revolutionize the treatment of this dreadful disease by reducing its cost, morbidity, and mortality.     

Associations between unprocessed red and processed meat,poultry, seafood and egg intake and the risk of prostate cancer: A pooled analysis of 15 prospective cohort studies

Reports relating meat intake to prostate cancer risk are inconsistent. Associations between these dietary factors and prostate cancer were examined in a consortium of 15 cohort studies. During follow‐up, 52,683 incident prostate cancer cases, including 4,924 advanced cases, were identified among 842,149 men. Cox proportional hazard models were used to calculate study‐specific relative risks (RR) and then pooled using random effects models. Results do not support a substantial effect of total red, unprocessed red and processed meat for all prostate cancer outcomes, except for a modest positive association for tumors identified as advanced stage at diagnosis (advanced(r)). For seafood, no substantial effect was observed for prostate cancer regardless of stage or grade. Poultry intake was inversely associated with risk of advanced and fatal cancers (pooled multivariable RR [MVRR], 95% confidence interval, comparing ≥45 vs. <5 g/day: advanced 0.83, 0.70–0.99; trend test p value 0.29), fatal, 0.69, 0.59–0.82, trend test p value 0.16). Participants who ate ≥25 versus <5 g/day of eggs (1 egg ～ 50 g) had a significant 14% increased risk of advanced and fatal cancers (advanced 1.14, 1.01–1.28, trend test p value 0.01; fatal 1.14, 1.00–1.30, trend test p value 0.01). When associations were analyzed separately by geographical region (North America vs. other continents), positive associations between unprocessed red meat and egg intake, and inverse associations between poultry intake and advanced, advanced(r) and fatal cancers were limited to North American studies. However, differences were only statistically significant for eggs. Observed differences in associations by geographical region warrant further investigation.     

六神曲生品与炒制品的消化酶活力及胃肠动力比较

目的比较六神曲生品和炒制品在消化酶活力和促进胃肠动力方面的差异,为临床合理应用六神曲提供实验依据。方法淀粉酶活力应用碘量法测定,蛋白酶活力应用福林-酚试剂比色法测定;采用小鼠小肠推进实验方法评价六神曲生品和炒制品对胃肠蠕动的影响。结果六神曲生品的淀粉酶活力为（164．49±5．11）U·g^-1,炒制后活力明显下降（P〈0．01）,为（19．86±0．65）U·g^-1;六神曲生品的蛋白酶活力为（15．37±1．92）U·g^-1,炒制后活力增强（P〈0．01）,为（22．74±0．96）U·g^-1;六神曲生品和炒制品均能改善病理模型小鼠小肠的推进功能（P〈0．05）,且生品优于炒制品（P〈0．05）。结论六神曲生品和炒制品均含有淀粉酶、蛋白酶成分和促进胃肠动力效应;六神曲生品中淀粉酶活力较高,而炒制后蛋白酶活力明显增高,临床可依据消化不良类型而分别合理使用。     

六神曲的发酵菌种分离及纯种发酵考察

目的:筛选优势菌种,探索纯种发酵对六神曲发酵炮制品质量的影响.方法:采用微生物菌种分离方法,从实验室自制和同仁堂购买的六神曲中筛选菌种,采用部分霉菌进行六神曲纯种发酵后淀粉酶及蛋白酶活力测定.淀粉酶活力测定依据碘-淀粉比色法,蛋白酶活力测定采用Folin试剂法.结果:筛选出12株霉菌,黄曲霉能显著提高六神曲淀粉酶和蛋白酶的活力,自制六神曲中分离的杂色曲霉产蛋白酶活力最高,其次为同仁堂分离的肉色曲霉和伞枝犁头霉,其余各组产蛋白酶活力明显低于传统自然发酵组.结论:六神曲原材料中不含淀粉酶、蛋白酶,纯种发酵能稳定提高六神曲发酵炮制品的质量.     

Cooperation of isoforms of laminin-332 and tenascin-CL during early adhesion and spreading of immortalized human corneal epithelial cells

The repair of corneal wounds requires both epithelial cell adhesion and migration. We have studied the early adhesion process of immortalized human corneal epithelial (HCE) cells and show by field emission scanning electron microscopy (FESEM) that the cells first adhere via foot-like process to the growth substratum and later present lamellar spreading. During early adhesion indirect immunofluorescence showed that the cells codeposited laminin (Lm) -332 and the large subunit of tenascin-C (Tn-CL) as a demarcated plaque beneath the cells. Instead, unprocessed Lm-332 (alpha 3'32) was found in a wider area in cells showing lamellar spreading and was also prominently expressed in the cytoplasm of the migrating marginal cells in the in vitro wounded HCE cultures. Confocal laser scanning microscopy (CLSM) showed that the Golgi apparatus was located to the vicinity of the Lm-332/Tn-CL-containing adhesion plaque and accordingly treatment of the cells with demecolcine, dispersing the Golgi apparatus, prevented the formation of plaques. This suggests that formation of the adhesion plaque depends on a direct vectorial secretion of Lm-332 and Tn-CL to the culture substratum. Instead, cytochalasin B treatment disrupted microfilaments and arborized the cells but did not affect the deposition of Tn-CL/Lm-332 as a plaque beneath the cells. The suggestion was supported by immunoprecipitation experiments which showed that Tn-CL and Lm alpha 3' chain were found in cell-free matrices on the culture substratum of spreading cells but not at all (Tn-CL) or much less (Lm-332) in the culture medium. Quantitative cell adhesion experiments showed that HCE cells did not adhere to plain Tn-C coat and that integrin (Int) alpha(3)beta(1) mediated the adhesion of HCE cells to purified Lm-332 and to Lm-332/Tn-C while Int beta4 did not mediate adhesion to these proteins. Taken together, our data suggest that Lm-332 and Tn-CL cooperate in early adhesion process of HCE cells. Furthermore, the results show that Lm-3'32 isoform functions in the spreading of the cells beyond the early adhesion stage and appears to emerge into HCE cells starting to migrate in experimental wounds.     

不同附子炮制品四逆汤化学成分及毒性差异分析

目的 比较生附片、淡附片、阴附片、阳附片4种附子炮制品入方四逆汤化学成分以及毒性差异,为临床安全用药提供科学的依据。方法 分别以阴附片、阳附片、生附片、淡附片制备单味药以及四逆汤汤剂,经UPLC法检测汤剂中乌头碱、新乌头碱、次乌头碱、苯甲酰乌头原碱、苯甲酰新乌头原碱、苯甲酰次乌头原碱、甘草苷、甘草酸、6-姜酚含量,通过系统聚类分析（hierarchical cluster analysis,HCA）、主成分分析（pricipal component analysis,PCA）和正交偏最小二乘-判别分析（orthogonal partial least squares discriminant analysis,OPLS-DA）对4种四逆汤进行分类分析,再经急性毒性试验和长期毒性试验比较4种附子炮制品四逆汤毒性差异。结果 4种四逆汤中成分含量以及毒性大小存在显著性差异。双酯型生物碱：乌头碱、新乌头碱、次乌头碱含量及其总量高低排序为生附片四逆汤>阴附片四逆汤>阳附片四逆汤>淡附片四逆汤;单酯型生物碱：苯甲酰乌头原碱、苯甲酰新乌头原碱、苯甲酰次乌头原碱含量及其总量高低排序为...     

Streamlining the generation of an osteogenic graft by 3D culture of unprocessed bone marrow on ceramic scaffolds

Mesenchymal stromal cells are present in very low numbers in the bone marrow, necessitating their selective expansion on tissue culture plastic prior to their use in tissue-engineering applications. MSC expansion is laborious, time consuming, unphysiological and not economical, thus calling for automated bioreactor-based strategies. We and others have shown that osteogenic grafts can be cultured in bioreactors by seeding either 2D-expanded cells or by direct seeding of the mononuclear fraction of bone marrow. To further streamline this protocol, we assessed in this study the possibility of seeding the cells onto porous calcium phosphate ceramics directly from unprocessed bone marrow. Using predetermined volumes of bone marrow from multiple human donors with different nucleated cell counts, we were able to grow a confluent cell sheath on the scaffold surface in 3 weeks. Cells of stromal, endothelial and haematopoietic origin were detected, in contrast to grafts grown from 2D expanded cells, where only stromal cells could be seen. Upon implantation in nude mice, similar quantities of bone tissue were generated as compared to that obtained by using the conventional number of culture expanded cells from the same donor. We conclude that human osteogenic grafts can be efficiently prepared by direct seeding of cells from unprocessed bone marrow.     

Ultra-processed Foods and Risk of Crohn’s Disease and Ulcerative Colitis: A Prospective Cohort Study

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