IntroductionOvarian cancer (OC) is the malignant tumor with the highest mortality among gynecological cancers. Chemotherapy resistance is a major obstacle to OC therapy. Circular RNAs (circRNAs) play crucial roles in cancer development and chemoresistance. However, the role and potential mechanism of has-circ-001567 (circ-VPS13C) in chemoresistance of OC remain unknown.Material and methodsThe levels of circ-VPS13C, miR-106b-5p and 14-3-3 zeta (YWHAZ) were detected by quantitative real-time polymerase chain reaction (qRT-PCR) or western blot assay. Cell Counting Kit-8 (CCK-8) assay was used to assess cell viability and calculate the half inhibition concentration (IC50) of cisplatin (DDP). The levels of autophagy-related markers were measured by western blot assay. Cell apoptosis and migration were evaluated by flow cytometry and transwell assay, respectively. The binding relationship between miR-106b-5p and circ-VPS13C or YWHAZ was confirmed by dual-luciferase reporter assay. Xenograft assay was performed to explore the role of circ-VPS13C in vivo.ResultsCirc-VPS13C and YWHAZ were up-regulated, while miR-106b-5p was down-regulated in DDP-resistant OC tissues and cells. Knockdown of circ-VPS13C enhanced DDP sensitivity by repressing autophagy in DDP-resistant cells. Circ-VPS13C increased DDP resistance via sponging miR-106b-5p. Moreover, miR-106b-5p directly targeted YWHAZ. Up-regulation of YWHAZ alleviated the decrease in DDP resistance caused by circ-VPS13C depletion. In addition, circ-VPS13C silencing decreased DDP resistance in vivo.ConclusionsCirc-VPS13C knockdown enhanced DDP sensitivity of OC through modulation of autophagy via the miR-106b-5p/YWHAZ axis, providing a new biomarker for improving the efficacy of OC chemotherapy.

本文通过梳理古今文献,对麻黄破癥坚积聚功效进行整理和挖掘,总结临床和基础研究证据,分析中医机理和临床应用价值.麻黄的破癥坚积聚功效在历代本草、方剂、医家论述等著作中均有记载,历代多有医家推崇此功效.麻黄破癥坚积聚功效的机理在于以"通""温"二性调一身气血为作用基础,围绕内虚外实的病因及气血运行不畅的病机来发挥作用.临床可见妇科、肿瘤科、外科等各科的案例报道和名家经验总结.现代实验表明,麻黄的提取物具有抗凝血、抑制肿瘤新生血管形成、降低脑组织出血后继发性损伤等功效,以阳和汤、麻黄附子细辛汤为首含有麻黄的方剂也可显著抑制以肿瘤为代表的"癥坚积聚".由此可见,麻黄的破癥坚积聚功效具有明确的典籍记载、临床报道和实验证据,应当进一步扩大麻黄破癥坚积聚的临床应用.

笔者结合《伤寒论·辨脉法》第29条,从脉证等对此分析,认为《金匮要略·水气病脉证并治》中记载的"大气一转,其气乃散""大气"当为脾胃之气,"其气"为脾之精气.又从病位、方药等方面再证此观点,并示仲景转气之法,为临床运用提供理论依据.

目的 观察止眩方气雾给药预防晕动症的疗效,并通过网络药理学预测其作用机制.方法 提前给药预防晕动症昆明小鼠模型,利用行为学实验和晕反应指数探究止眩方的疗效.利用中药系统药理学数据库与分析平台(TCMSP)和文献挖掘获取止眩方有效成分和靶点,运用Cytoscape 3.7.1软件构建"药对-化合物-通路-疾病"网络和蛋白相互作用(PPI)网络.在Metascape数据库中对靶点进行京都基因和基因组百科全书(KEGG)分析.结果 旷场实验、高架十字迷宫实验结果均显示雾化组小鼠活跃度高于模型组,且雾化高浓度组的晕反应指数相比于模型组明显降低(P＜0.05).止眩方有130个靶点与晕动症相互作用.关键靶点作用于丝裂原活化蛋白激酶(MAPK)、磷脂酰肌醇3-激酶(PI3K)-丝氨酸/苏氨酸激酶(Akt)等193条信号通路.结论 雾化给予止眩方能够预防小鼠晕动症,疗效明确,且止眩方预防晕动症具有多成分、多靶点、多通路的作用特点,为后续研究奠定基础.

目的:通过在不同语境下提取脏腑图和解剖图语义信息的变化和差异,考察中医脏腑概念的认知加工特点.方法:实验a、b分别采用图词匹配范式和图词整合范式,记录中医相关专业学生进行脏器概念匹配及脏腑术语整合加工的行为学和脑电数据.结果:图片呈现后引起的400 ms事件相关电位负波(N400)差异有统计学意义,实验a中脏腑图在前额、额区更负(P<0.05),实验b中解剖图在前颞区更负(P<0.01).词语呈现后诱发的晚期正成分(LPC)差异有统计学意义,由实验a前额、额、额中央、中央的脏腑图更正(P<0.05),到实验b左、右前额和右额区的脏腑图更正(P<0.05)和右侧顶区的解剖图更正(P<0.01).结论:由熟悉度导致的图片语义信息加工差异变小,脏腑术语的上下文语境对解剖图提取语义信息的抑制效应更明显.与脏腑图相比,解剖图具有整合相应概念的优势,但中医脏腑概念与2种图片,尤其是解剖图并未形成对应表征关系,中医相关专业学生对脏腑概念的加工缺乏对应的心理图像,脏腑概念更类似于抽象概念.

目的:从认知神经科学角度探讨中医脏腑句与西医器官句在大脑认知加工的差异.方法:应用事件相关电位技术,采用尾词范式和句义正确性判断任务,记录并分析中医脏腑句与西医器官句加工的行为学和脑电数据.结果:中医脏腑句与对应的西医器官句在行为学结果上无显著差异,但在事件相关电位研究结果中,相关电极点的中医脏腑句引发的400 ms事件相关电位负波(N400)与600 ms事件相关电位正波(P600)波幅值均小于对应的西医器官句(P<0.05).右额叶与右颞叶位置主要呈现N400波幅差异,P600波幅差异主要集中在左中央区与左侧顶区.结论:中医句相对西医句消耗更少的认知资源,更有加工优势.大脑右半球与中医脏腑句加工前期的预期与提取密切相关,大脑左半球与中医脏腑句加工后期的整合与反思有关.

目的:应用事件相关电位技术探索中医学习时间不同的医学生对医学命题加工的差异.方法:采用尾词范式与句义正确性判断任务,分别以中医相关专业研究生和大二生作为研究对象,提取并分析被试者在理解判断中医、西医命题时产生的行为学和脑电数据.应用重复测量方差分析对早期左前负成分(ELAN)、200 ms事件相关电位正波(P200)、400 ms事件相关电位负波(N400)、晚期正成分(LPC)时间窗的结果数据进行统计.结果:在N400时间窗,大二生比研究生诱发了更负的波幅,组别主效应呈边缘显著[F(1,27)=4.01,P=0.06,η2=0.13];在LPC时间窗,组别与命题类型的交互作用显著[F(2,54)=3.57,P=0.04,η2=0.12],大二生内,中医命题比西医命题诱发了更大的晚期正成分(P=0.01).研究生内,中西医命题间未发现显著差异(P=0.27).结论:拥有不同中医学习时间的学生对中西医命题的理解过程存在差异,随着知识水平的增高,中医学生可能不再关注中医学本身的隐喻特质,倾向于将中医抽象概念进行西医命题的具体化加工,促使中西医概念的理解呈现更多相通之处.

目的:应用事件相关电位技术,捕捉大脑判断中、西医命题时产生的脑电成分,探索不同医学命题理解过程的脑神经机制,为中西医的思维差异提供认知神经科学层面的研究证据.方法:采用尾词范式与句义正确性判断任务,采集中医相关专业研究生在理解中医、西医命题时产生的脑电数据.应用重复测量方差分析对早期左前负成分(ELAN)、200 ms事件相关电位正波(P200)、400 ms事件相关电位负波(N400)、600 ms事件相关电位正波(P600)时间窗的结果数据进行统计.结果:在ELAN、P200时间窗,中西医命题的波幅差异不显著(P>0.05);在N400时间窗,西医命题比中医命题诱发了更负的波幅(P=0.04);在P600时间窗,中医命题比西医命题诱发了更正的波幅(P=0.01).结论:在命题加工的前期词汇识别阶段,西医命题比中医存在更显著的具体性效应;在后期语义整合阶段,中医命题比西医涉及更多的整合加工,可能反映了中医语言的隐喻映射加工进程.

目的:探讨C57BL6小鼠支气管肺泡干细胞(BASCSs)体外分离、鉴定及其三维培养体系的构建方法,为进一步研究BASCSs的相关特性奠定实验基础.方法:选用C57BL6成年雄鼠,完整分离肺组织,1×PBS灌洗后,经支气管分次灌注Elastase酶进行消化,以锐器切碎肺组织,加入DNA酶使细胞更好地分散开.用75μm细胞筛去除未消化的组织块,所得细胞悬液以荧光标记的CD31、CD34、CD45、SCA-1、EpCAM抗体染色,流式细胞仪分选CD31-CD34-CD45-SCA-1+EpCAM+细胞,细胞与Mlg2908细胞(小鼠肺成纤维细胞株)按(1×103):(1×106)的比例混合,以Matrigel为基质构建三维培养体系.结果:通过Elastase酶消化肺组织,每只成年小鼠可得到有核细胞总数(1.6～1.8)×107个,流式细胞技术结果显示,CD34-CD45-SCA-1+EpCAM+细胞约占EpCAM+细胞的22％;将支气管肺泡干细胞、Mlg2908细胞和Matrigel混合培养,4 d后可见克隆形成.随着培养时间延长,克隆数量逐渐减少.8 d后大部分克隆直径达50μm,形态出现分化,克隆可维持至15 d.结论:建立了一种简单、高效的分离、鉴定及三维培养小鼠BASCSs的方法.

目的通过比较本事琥珀散治疗前后子宫内膜异位症（EMs）大鼠模型血清ICAM-1、MMP-9和VEGF含量的变化,探讨本事琥珀散对EMs大鼠异位病灶形成"3A"模式中的作用机制。方法采用自体内膜移植法建立EMs大鼠模型,随机分为空白对照组、伪手术组、模型组、本事琥珀散高剂量组、本事琥珀散中剂量组、本事琥珀散低剂量组和西药对照组,给药4周后ELISA法检测EMs大鼠血清ICAM-1、MMP-9和VEGF水平。结果与空白对照组比较,模型组MMP-9含量明显降低;本事琥珀散高剂量组能够明显升高血清ICAM-1含量,以上差异均有统计学意义（P＜0.05）。结论 EMs大鼠模型血清MMP-9的变化可能来自于手术造模。手术造模对血清ICAM-1和VEGF影响不大。本事琥珀散对EMs大鼠"3A"模式各环节的影响可能并不体现在外周血中,但依然存在量效关系。

TBL 教学法(Team-Based Learning ,TBL )是一种以团队为基础 ,以学生为中心 ,使学生由被动接受知识向主动学习转变 ,培养学生团队合作能力的教学方法[1 -2] .近年来,TBL 教学法逐渐被应用于国外一些医学院校的主要课程和医学专业教育[3 ] .

将认知科学中的逻辑学、诠释学、隐喻认知和原型范畴理论等理论方法引入金匮要略的教学,利于学生完整、深刻地理解《金匮要略》中的中医语言,进而理解张仲景所要传达的疾病诊疗理念和辨证思维过程.以胸痹病为例,探讨认知科学在金匮要略等中医经典课程教学中的具体应用,能够帮助学生梳理和构建中医思维,提升中医经典课程的教学效果.

甘遂具有泻水逐饮、消肿散结的功效,《续名医类案》中记载有使用甘遂治疗疾病的医案,通过甘遂的一般概况、病证应用、炮制方法和剂型四个方面来分析和总结其在《续名医类案》中所治疗的病证和减毒增效的方法,以及从《伤寒杂病论》到《续名医类案》期间历代医家使用甘遂时的继承和发展情况,为临床使用甘遂和治疗相关病证提供思路和借鉴.

Objective: To investigate the therapeutic effect of secondary cytoreductive surgery in the patients with low grade serous ovarian cancer and to analyze the influence of the postoperative quality of life. Method: We collected the clinical data of patients with low grade serous carcinoma who underwent secondary cytoreductive surgery in our hospital from January 2003 to January 2015, and performed a retrospective analysis. We collected the basic data of patients, survival information, chemotherapy and disease related characteristics. We recorded the patient's postoperative treatment, overall survival (OS), disease-free survival (DFS) and death situation, and evaluated the quality of life of patients before and after the secondary cytoreductive surgery according to European organization for research and treatment of cancer quality of life questionair (EORTC QLQ-C30). Results: A total of 50 patients with low grade ovarian cancer were enrolled in this study. There were 39 patients (78%) with grogs residual disease (GRD) among the 50 patients. The median DFS was 57.4 months and 14.9 months respectively for patients without and with GRD. The median OS was 92.9 months and 70.4 months respectively for patients without and with GRD. The Cox multivariate regression analysis showed that the risks of survival with disease and death in patients with GRD were 3.27 and 2.04 times greater than who without GRD. The results were applied comparative t-test and showed that the postoperative quality of life was better than that preoperative in patients (P < 0.05). Conclusion: Whether the secondary cytoreductive surgery is performed thoroughly or not is closely related to the disease-free survival and overall survival of patients with low grade serous ovarian cancer. The implementation of secondary cytoreductive surgery is helpful to improve the quality of life of patients.

ZHANG Zhongjing was quite ingenious in using toxic herbs,which could be reflected from the aspects of processing,concerted application,dosage,preparation,decocting,administration methods,recovery,contraindications,etc.In Treatise on Cold Pathogenic Disease,ZHANG Zhongjing reduced the toxic side effects of toxic herbs mostly by decocting earlier,decocting later,decocting longer,putting powder in after decocting,single herb decocting and then mixing,decocting pills,as well as adding honey in the process of decocting,which had important guiding significance on clinical safe medication.

通过开放式教学法、案例式教学法、问题式教学法、PBL教学法和六步教学法等教学方法在中医经典课程《金匮要略》中的运用,比较了这五种教学方法在学生接受度和教学效果方面的差异,建议将六步教学法贯穿于常规教学的始终,案例式和问题式教学法可较高频率的穿插其中,开放式和PBL教学法适当偶尔运用.

目的:通过比较本事琥珀散按行气、活血、温经功效拆方及其协同作用,对子宫内膜异位症(EMs)大鼠异位内膜基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶抑制因子-2(TIMP-2)的影响,探讨行气、活血、温经在EMs异位内膜侵袭环节的作用机制.方法:采用自体内膜移植法建立EMs大鼠模型,随机分为模型组、全方组、行气组、活血组、温经补血组、行气活血组、行气温经组、活血温经组和西药对照组,给药4周后免疫印迹(western blot)法同步检测EMs大鼠异位内膜MMP-2和TIMP-2水平.结果:与模型组比较,本事琥珀散组拆方及其协同作用各组异位内膜MMP-2和TIMP-2含量均明显降低,行气活血组异位内膜TIMP-2含量明显降低,甚至低于本事琥珀散全方组,差异具有统计学意义(P＜0.05).结论:本事琥珀散中的行气、活血、温经功效均能够独立抑制异位内膜对基底膜的侵袭,但行气活血协同作用却有利于异位内膜的侵袭生长,不利于其对EMs的治疗,须与温经药物配伍才能起到良好的治疗作用.

Objective To understand the effect of innovative entrepreneurship training activities on the nurturing ofstudents' innovative entrepreneurial ability, and to seek effective ways and methods. Methods Descriptive studiesand T-test method were used. Results There was a difference(P0.05) between the students who participated inthe training activities and those who didn't take part in such activities in all four aspects of metacognition factor,creative ability factor, psychological enduring capacity factor, and practical ability factor. Conclusion Innovativeentrepreneurship training activities have certain function of improving students' innovative entrepreneurial ability.Fundamental courses should be set up for innovative entrepreneurship training activities. Training processmanagement should be strengthened. Entrepreneurial practice platform should be constructed. These methods canhelp cultivate students' innovative entrepreneurial ability.

目的:了解江西省婺源县新型农村合作医疗制度实施的现状和满意度.方法:对调查数据采用频数分析实施现状,x2关联性分析满意度的影响因素.结果:在被调查人群中新型农村合作医疗的参与度达到90％以上,农民对新型农村合作医疗满意程度较高,了解程度一般.满意度与其了解程度度、资金公开情况、报销方式和是否报销过相关(P＜0.05).讨论:根据调查结果分析,杜绝参合前后药价不一的现象、切实提高基层医疗水平、提高参合农民的防患意识以及突破新农合地区区域性限制,可提高农民群众对该项制度的满意度.

Objective:To study the effect of Hupo Powder on IL-2 and IL-10 of rats with Qi stagnantion and blood stasis syndrome of endometriosis and discuss the mechanism.Methods:40 SD rats were divided into the blank group,Qi stagnantion and blood stasis syndrome of endometriosis group(model group),Hupo Powder group,danazol group.Results:Compared with blank group,Hupo Powder treatment group can increase the ratio of IL-2/IL-10,with significant difference(P<0.01).Compared with model group,Hupo Powder group can significantly increase the ratio of IL-2/IL-10,with significant difference(P<0.01).Conclusion:Hupo Powder can reach the treatment function through changing the Th1/Th2 immune imbalances of Qi stagnantion and blood stasis syndrome of endometriosis in rats.