难治性胃食管反流病临证研究

难治性胃食管反流病是临床疑难病,症状反复,缠绵难愈,治疗棘手。中医药治疗“反酸”“吞酸”证历久源远,充分挖掘古籍,深研病机,提炼治法,发挥中医药特色,对治疗本病意义深远。     

Coronary Artery Disease Manifestations in HIV: What,How, and Why

Understanding why persons with human immunodeficiency virus (HIV) have accelerated atherosclerosis and its sequelae, including coronary artery disease (CAD) and myocardial infarction, is necessary to provide appropriate care to a large and aging population with HIV. In this review, we delineate the diverse pathophysiologies underlying HIV-associated CAD and discuss how these are implicated in the clinical manifestations of CAD among persons with HIV. Several factors contribute to HIV-associated CAD, with chronic inflammation and immune activation likely representing the primary drivers. Increased monocyte activation, inflammation, and hyperlipidemia present in chronic HIV infection also mirror the pathophysiology of plaque rupture. Furthermore, mechanisms central to plaque erosion, such as activation of toll-like receptor 2 and formation of neutrophil extracellular traps, are also abundant in HIV. In addition to inflammation and immune activation in general, persons with HIV have a higher prevalence than uninfected persons of traditional cardiovascular risk factors, including dyslipidemia, hypertension, insulin resistance, and tobacco use. Antiretroviral therapies, although clearly necessary for HIV treatment and survival, have had varied effects on CAD, but newer generation regimens have reduced cardiovascular toxicities. From a clinical standpoint, this mix of risk factors is implicated in earlier CAD among persons with HIV than uninfected persons; whether the distribution and underlying plaque content of CAD for persons with HIV differs considerably from uninfected persons has not been definitively studied. Furthermore, the role of cardiovascular risk estimators in HIV remains unclear, as does the role of traditional and emerging therapies; no trials of CAD therapies powered to detect clinical events have been completed among persons with HIV.     

基于“中医传承辅助平台”软件挖掘年莉教授治疗糖尿病肾病的用药规律

[目的] 采用"中医传承辅助平台"软件，探讨年莉教授治疗糖尿病肾病的用药规律。[方法] 将2016年11月-2019年4月年莉教授治疗糖尿病肾病的中药处方信息输入中医传承辅助平台系统，采用频次分析、组方规律分析方法挖掘、探讨年莉教授治疗糖尿病肾病的临床用药特点。[结果] 对年莉教授治疗糖尿病肾病158首处方进行分析，涉及中药207味，使用频次在前10位的药物分别为白芍、川芎、当归、半夏、刺蒺藜、丹参、泽泻、牛膝、厚朴，白术获得9组药对、3组核心药物组合。[结论] 年莉教授治疗糖尿病肾病经验丰富，高频药物的配伍体现了年莉教授多采用平肝疏肝，补血养阴，活血化瘀的治疗原则。期望能为临床治疗和药物研发提供参考，并为糖尿病肾病在泰国的治疗提供新的理念和借鉴。     

施延庆治疗震颤麻痹经验

施延庆主任中医师是全国首批500名学术经验继承的名老中医之一。施老擅长温针疗法,在治疗疑难杂病中独树一帜。历年来施老以温针治疗震颤麻痹症数十例,取得很好的疗效,今介绍于下,供同道参考。1 病因病机震颤麻痹又称帕金森病,是以进行性运动徐缓,肌肉强直及震颤为特征的病症,多发于中老年人,60岁以上的人口中可达1％,是一种较常见的神经系统变性疾病,属中医“颤振”、“痉病”等范畴。施老以中医针     

聂小圃治疗不寐经验

聂小圃(1943～),男,1968年7月毕业于江西中医学院,毕业后在江西省万年县人民医院中医科从事中医临床工作,1985年调入万年县中医院,任门诊部主任.1998年晋升为主任中医师,2002年被遴选为第三批全国中医药专家学术经验继承工作指导老师.从医近40载,临证擅长内、妇科常见病及疑难杂症的诊治,如脾胃肝胆疾病、痿证、痹证、不寐、月经不调等.     

盘龙七片治疗不稳定性冠心病心绞痛临床观察

对５８例不稳定性冠心病心绞痛患者，用盘龙七片（３８例）及复方丹参片（２０例）治疗，观察治疗前后心电图ＳＴ段，血液流变学及临床症状的变化，结果：盘龙七片组心电图ＳＴ段的缺血变化明业优于复方丹参片组（Ｐ〈０．０１），血浆粘度及纤维蛋白原下降亦明显（Ｐ〈０．０５或Ｐ〈０．０１），结论：盘龙七片虽是一种抗风湿，骨伤的中成药，但同样对治疗不稳定性冠心病心绞痛有一定的疗效。     

张琪治疗劳淋经验

张琪(1922～),男,中医世家.现任黑龙江省中医研究院研究员、主任医师,兼任黑龙江中医药大学教授、博士生导师,黑龙江省中医药学会名誉会长,中华中医药学会顾问.享受政府特殊津贴.精于仲景学说,兼通金元四大家及温病学家的学术理论,对中西汇通亦多有涉猎,尤对王清任、张锡纯的学术思想研究较为深入.善治多种疑难病症,对慢性肾脏疾病的治疗有较深造诣,为黑龙江省中医肾病重点学科带头人.主持完成了"补脾肾泻湿浊解毒活血法治疗慢性肾功能衰竭的临床与实验研究"等多项科研项目,并获省级、部级奖励.代表著作有<脉学刍议>、<临床经验集>、<张琪临证经验荟要>等,发表学术论文50余篇.     

Heparin effect on ionised calcium concentration

The effect of heparin on plasma ionised calcium was studied by adding it in increasing amounts to whole blood from 10 normal subjects. There was no significant change in ionised calcium from the addition of 1 U/ml but a significant fall of 0.02 mmol/1 when 2 U/ml were added and a progressive further fall with increasing concentrations. Heparin from three different manufacturers produced similar results. The effect of heparinisation in vivo was studied during regular haemodialysis on 10 patients with chronic renal failure. Following intravenous injection of 10000 U of heparin there was a consistent and significant fall averaging 0.03 mmol/l.