先天性脊柱畸形是指各种原因引起的先天性椎骨发育不良,包括椎体形成不全、椎体分节障碍以及混合畸形等,严重的脊柱畸形影响脏器功能,严重影响生活质量[1-3].重度先天性脊柱畸形通常指脊柱侧弯或后凸畸形角度大于90°[4],椎体结构较正常椎体存在较大变异,给手术带来很大困难与风险.全脊椎截骨术(vertebral column resection,VCR)的出现相较于传统截骨方式大大提高了截骨的畸形矫正率,但因其手术技术难度较高、风险大、出血较多,临床应用有诸多限制.头盆环牵引的阶梯治疗可以提高手术矫形效果,并控制手术风险,减少出血量[5].为此杭州市萧山区中医院脊柱外科采用一期头盆环牵引二期截骨矫形手术的方式治疗重度先天性脊柱畸形,现报道如下.
肺癌是发病率病死率最高的恶性肿瘤之一,病因复杂,因缺乏特异的临床症状体征,肺癌多发现于中、晚期,临床治疗效果有限[1].肺癌五年生存率维持在 20％～30％,随年龄增长而升高[2].肺癌在中医学中归属于"肺积""息"等病范畴.《济生方》云:"息贲之状,在有胁下,大如覆杯,喘息奔溢,是为肺积."方秀兰教授在肺癌治疗方面经验丰富,其从肺脏特性出发,采用益气养阴之法治疗肺癌,收效甚好.本文将从方秀兰教授的门诊病例中筛选 103 例肺癌(阴虚)患者的中药治疗方案进行评估,利用数据挖掘技术进行药物频数、关联规律和聚类分析,以期总结方秀兰教授治疗肺癌学术思想与用药规律.
功能性消化不良(functional dyspepsia,FD)是指位于上腹部的一个或一组症状,主要包括上腹部疼痛或烧灼感、餐后饱胀感、早饱感、食欲不振、嗳气、恶心和呕吐等,但不能用器质性、系统性或代谢性疾病等来解释[1].
视网膜静脉阻塞(retinal vein occlusion,RVO)是全球第二大高发的视网膜血管性疾病,按照其发病部位分为视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)和视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO),发病机制复杂[1].目前抗血管内皮生长因子(vascular endothelial growth factor,VEGF)治疗是RVO一线治疗方案[2].临床发现2 例患者在接受抗VEGF治疗后出现视网膜棉绒斑短暂性增多情况,报道如下.
Objective To investigate the mechanistic action of Guanxinning in treating heart failure in a rat model of acute myocardial infarction.Methods Fifty specific pathogen-free grade male rats were selected to es-tablish a heart failure model after acute myocardial infarction by ligating the anterior descending branch of the left coronary artery.During the modeling process,five rats died and the rest of 45 rats were successfully modeled and then randomly divided into blank control,clopidogrel,and Guanxinning treatment groups(n=15 per group).After 4 weeks of gastric lavage treatments,the ultrastructural changes were assessed in the myocardium of each rat and expression of phosphatidylinositol 3-kinase(PI3K)and protein kinase B(AKT),oxidative stress factors,like the re-active oxygen species(ROS),and total cellular antioxidant capacity(T-AOC)in myocardial tissues and serum tumor necrosis factor-α and seα),transforming growth factor-β1(TGF-β1),acardiac ultrasound index[the left ventricular septal systolic thickness(IVSs),left ventricular septal diastolic thickness(IVSd),and left ventricular short axis short-ening rate(LVFS)]were analyzed using the corresponding mythologies.Results Compared with the blank control rats,the myocardial ultrastructure changes in the clopidogrel and Guanxinning-treated rats were more obvious,and the inflammatory damage to the myocardial ultrastructure in the Guanxinning group was significantly reduced.Com-pared with the blank control group,both clopidogrel and Guanxinning-treated rats showed an increase in PI3K and AKT levels in the myocardial tissues(PI3K,0.75±0.09)and 0.84±0.11 vs.0.59±0.05;AKT,0.76±0.08 and 0.91±0.13 vs.0.71±0.04;P＜0.05).Moreover,compared with the blank control,the clopidogrel and Guanxinning groups of rats had a decrease in ROS level in the myocardial tissues(28.58±2.27 and 21.43±2.18 vs.39.71±2.46;P＜0.05),but an increase in T-AOC level(0.28±0.05 and 0.35±0.09 vs.0.13±0.03 mmol/mg;P＜0.05).Compared with the blank control,the serum TNF level in the clopidogrel and Guanxinning groups was reduced(78.64±8.55 and 68.85±6.76 vs.104.85±10.89 ng/L;P＜0.05),whereas the TGF-β level was elevated(2176.39±174.39 and 2314.71±179.58 vs.1652.28±146.93 ng/L;P＜0.05).Compared with the blank control,levels of IVSs in the clopidogrel and Guanx-inning groups were decreased(3.45±0.37 and 2.74±0.31 vs.4.18±0.45 mm;P＜0.05),whereas the LVFS level was increased(40.81±2.61 and 45.82±2.71 vs.35.71±2.52%;P＜0.05).However,there was no significant difference in IVSd levels among these three groups(P＞0.05).Conclusion Guanxinning treatment was able to improve the my-ocardial ultrastructure and heart function in heart failure in a rat model of acute myocardial infarction and reduce the oxidative stress levels and inflammatory reactions.The mechanism of action may be related to activation of the P13K/AKT signaling and enhancing mitochondrial function.
