目的 通过近红外脑功能成像技术(fNIRS),检测针刺治疗对非器质性失眠症患者进行情绪面孔识别时大脑含氧血红蛋白(oxy-Hb)浓度的变化的影响.方法 招募非器质性失眠症患者30例作为治疗组,健康志愿者32例作为对照组.治疗组予2周针刺治疗,对照组不予针刺治疗,两组于治疗前后分别检测进行情绪面孔识别时大脑oxy-Hb浓度的变化.结果 非器质性失眠症患者治疗前,在注视负性情绪面孔时oxy-Hb浓度高于对照组,在注视中性情绪面孔时oxy-Hb浓度低于对照组(P<0.05);经治疗后,治疗组患者额叶、顶叶皮层的oxy-Hb浓度在注视负性情绪面孔时低于治疗前,在注视中性情绪面孔时高于治疗前(P<0.05);非器质性失眠症患者治疗后在注视中性情绪面孔时oxy-Hb浓度高于对照组(P<0.05),在注视负性情绪面孔时oxy-Hb浓度差异无统计学意义(P>0.05).结论 失眠患者oxy-Hb浓度经针刺治疗后发生相应变化,主要表现在额顶叶皮层,说明针刺治疗可以调整失眠患者脑功能状态,改善失眠患者的情绪识别,2周治疗周期即可以得到改善.

腰椎间盘突出症(LDH)是临床常见的腰痛原因,也是针灸治疗的优势病种.传统针灸治疗LDH取穴思路为腰背部足太阳经及腰夹脊局部取穴配合下肢远端取穴,对缓解疼痛有一定效果,但对改善活动受限,防止腰痛反复发作效果不佳.文章浅析通过"少阳"选穴治疗LDH所导致的腰痛及腰部活动障碍,并试从传统中医及现代医学理论方面对"少阳"论治LDH进行探讨,旨在为LDH的治疗提供新的思路.

目的:探讨超重肥胖高血压患者证型特点及其与血流动力学参数的相关性.方法:选择中日友好医院心脏科门诊及住院部初发的原发性高血压患者213例,分为正常体重组(76例)和超重肥胖组(137例),收集患者的基本资料及实验室指标、血流动力学参数及中医临床症状等,分析超重肥胖高血压患者的证型特点及其与血流动力学的关系.结果:超重肥胖高血压患者的证型分布与正常体重组有显著差异,其构成依次为痰瘀互结证(43.10％)、肝火亢盛证(28.50％)、阴虚阳亢证(16.10％)、阴阳两虚证(12.40％).超重肥胖组患者每分钟输出量(CO)、心指数(CI)、总外周阻力指数(SVRI)、胸液含量(TFC)显著高于正常体重组(P＜0.05),超重肥胖组中痰瘀互结证SVRI、主动脉硬化指数(AS)显著高于非痰瘀互结证(P＜0.01),痰瘀互结证与SVRI(r=0.433)、AS(r=0.173)、TFC(r=0.268)正相关(P＜0.05),与 CO、CI无相关关系.结论:痰瘀互结证是超重肥胖高血压患者主要证型,超重肥胖高血压患者更易出现动脉硬化.

目的 探讨高血压合并阻塞性睡眠呼吸暂停综合征(OSAS)患者证型特点与血流动力学的关系.方法 选取2021年3-10月在中日友好医院心脏科住院的初发高血压患者214例,将患者按照是否合并OSAS分为单纯高血压组(118例)和高血压合并OSAS组(96例).收集患者的基本资料及实验室指标、血流动力学指标及中医临床证型资料.分析高血压合并OSAS患者的证型特点及其与血流动力学的关系.结果 高血压合并OSAS组男性比例、体重指数、舒张压水平高于单纯高血压组,高密度脂蛋白胆固醇水平低于单纯高血压组,差异均有统计学意义(均P＜0.05).单纯高血压组中医证型构成为肝火亢盛证(69例,58.5％)、痰瘀互结证(18例,15.3％)、阴虚阳亢证(16例,13.6％)、阴阳两虚证(15例,12.7％);高血压合并OSAS组中医证型构成为痰瘀互结证(58例,60.4％)、肝火亢盛证(17例,17.7％)、阴虚阳亢证(14例,14.6％)、阴阳两虚证(7例,7.3％).痰瘀互结证在高血压合并OSAS患者中占主导地位.高血压合并OSAS组外周血管阻力指数(SVRI)、主动脉硬化指数(AS)高于单纯高血压组,差异均有统计学意义(均P＜0.05).高血压合并OSAS组患者中,痰瘀互结证患者SVRI、AS均高于非痰瘀互结证患者,差异均有统计学意义(均P＜0.001).高血压合并OSAS组患者痰瘀互结证与SVRI、AS呈正相关(r = 0.401,P＜0.001;r = 0.378,P = 0.001).结论 痰瘀互结证是高血压合并OSAS患者的主要证型,血流动力学方面表现为"高阻"模式,可能与血管损伤有关.

目的 探究SD大鼠随年龄增长其前列腺发生自发性增生的情况,为选定用于自发性良性前列腺增生模型SD大鼠的适宜鼠龄提供依据.方法 选用4、8、12月龄雄性SD大鼠各6只,取材后计算其前列腺指数、睾丸指数、肝脏指数、肾脏指数、脾指数及胸腺指数;用ELISA检测血清中双氢睾酮(dihydrotestosterone,DHT)、睾酮(testosterone,T)、胰岛素样生长因子(insulin-like growth factor-1,IGF-1)、表皮生长因子(epidermal growth factor,EGF)、B 细胞淋巴瘤因子2(B-cell lymphoma factor 2,BCL-2)、凋亡因子(BCL-2 associated X,BAX)的表达量和前列腺组织中超氧化物歧化酶(superoxide dismutase,SOD)及丙二醛(malondi-aldehyde,MDA)的含量;观察前列腺组织病理学切片,对比各组增生情况.结果 12月龄组大鼠的前列腺指数显著高于4月龄组且较8月龄组有升高趋势,8月龄组和12月龄组大鼠的睾丸指数显著低于4月龄组,各组间肝脏指数、肾脏指数和脾指数的差异无统计学意义,8月龄组和12月龄组大鼠的胸腺指数显著低于4月龄组;8月龄组和12月龄组大鼠EGF和BAX的表达量均与4月龄组有显著性差异,趋向病理状态,DHT、BCL-2和MDA的表达量随年龄增长有趋向病理状态的趋势,SOD的表达量有降低趋势;光镜下观察到随年龄增长前列腺组织逐渐出现增生.结论 SD大鼠随年龄增长前列腺会发生一定程度的自发性增生,建立自发性良性前列腺增生模型的适宜鼠龄应在12月龄以后.

目的 利用超高效液相色谱-线性离子阱-串联静电场轨道阱质谱(UHPLC-LTQ-Orbitrap MSn)对苦碟子药材醇提物不同洗脱部位的化学成分进行分析鉴定.方法 采用Acquity UHPLC BEH C18色谱柱(2.1 mm×100 mm,1.7μm),以乙腈(A)-0.1％甲酸-水溶液(B)为流动相进行梯度洗脱,在负离子模式下,分别对苦碟子药材醇提物经大孔吸附树脂分离的30％、50％、70％和95％乙醇洗脱部位进行数据采集.根据高分辨质谱提供的准分子离子峰和多级质谱碎片,获取目标化合物的精确分子量和结构信息,并结合保留时间、ClogP值、对照品分析、参考文献等相关数据对化合物进行鉴别.结果 分别在30％、50％、70％和95％乙醇洗脱部位中鉴定出36、56、33和15个化合物,包括核苷类、黄酮类、有机酸类、倍半萜内酯类、三萜类、苯丙素类等共80个化学成分,其中5个为共有成分,分别为木犀草素、芹菜素、木犀草素-7-O-β-D-葡萄糖苷、芹菜素-7-O-β-D-葡萄糖苷和七叶内酯.结论 该研究较为全面地表征了苦碟子药材醇提物的化学成分基础,并分析了其不同洗脱部位化学成分的差异,为进一步阐明苦碟子的药效物质基础提供了科学依据.

目的:基于额叶氧合血红蛋白(oxy-Hb)变化探讨针刺对不同年龄失眠患者的影响.方法:纳入失眠症患者30例,予2周针刺治疗,并于治疗前后在识别情绪面孔的任务态试验下进行近红外脑功能成像检测,应用SPSS 22.0统计软件,分别统计青年组(180.05);中年组在属于"阳"的负性情绪面孔条件下额叶的oxy-Hb浓度下降(P<0.05),属于"阴"的中性面孔条件下oxy-Hb浓度升高(P<0.05);老年组只在属于"阴"的中性面孔条件下出现oxy-Hb浓度升高(P<0.05).结论:针刺后额叶oxy-Hb的变化佐证了中医之"年四十而阴气自半"和关于失眠"阳气盛则瞋目,阴气盛则瞑目"的理论.

脊柱的功能 人体脊柱上端托举着头颅,下端联结髋骨并借此连着下肢,中段附着肋骨,形成胸腹腔和盆腔的后壁,在上中段处伸展出上肢.脊柱周围附着有许多肌肉,护持一条纵行脊管内有脊髓,脊柱两侧走行着众多的神经血管.

To explore the potential target and mechanism of action of Coix seed in the treatment of pneumonia by means of network pharmacology and molecular docking. To construct the potential protein interaction network and “component-target” network diagram, GO and KEGG enrichment analysis were performed, then molecular docking was used for verification. In coix seed, 7 effective components and 144 corresponding potential targets were obtained by screening with OB ≥ 30% and DL ≥ 0.18% as thresholds. A total of 5014 pneumonia related targets were obtained, and 90 common targets were obtained.151 nodes and 251 edges were read in the “component-target” visual network diagram. A total of 19 signal pathways with significant differences were obtained by KEGG enrichment analysis. The molecular docking showed that the compounds in Coix seed had higher binding energy with the key proteins that caused pneumonia. This study preliminarily explored the potential action mechanism of coix seed in treating pneumonia by multiple channels and multiple targets, providing scientific basis for clinical application and in-depth study of this decoction piece.

Purpose Through the method of network pharmacology, the active components and targets of Shenqi Wan (SQW) were excavated, the relationship with novel Coronavirus pneumonia (COVID-19) was discussed, and the possible mechanism of SQW in the treatment of COVID-19 was revealed from the aspects of multicomponents, multitargets, and multipathways. Methods Firstly, the active components of SQW were screened from traditional Chinese medicine systems pharmacology database and analysis platform and the 2020 edition of Chinese Pharmacopeia, and the related targets of the components were obtained. Then the disease targets related to COVID-19 were screened from GeneCards and Online Mendelian Inheritance in Man. Venny was used to map the relationship between component-target and disease-target, and String was used to analyze the interaction of common targets. The network was constructed and analyzed by Cytoscape, the function of Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) genes was enriched by Metascape, and the molecular docking was verified by CB-Dock. Results Finally, 45 active components of SQW were obtained, and 72 potential targets were related to COVID-19, angiotensin-converting enzyme 2 (ACE2), interleukin (IL)-6, nitric oxide synthase (NOS3) and, C-reactive protein (CRP),may be the key targets. GO enrichment of 1715 projects, such as lipopolysaccharide stress response, active oxygen metabolism, positive regulation of cell migration, and other GO enrichment. About 136 KEGG pathways, tumor necrosis factor signaling pathway, IL-17 signaling pathway, hypoxia-inducible factor 1-alpha signaling pathway were obtained. Molecular docking showed that kaempferol, quercetin, luteolin, astragaloside, calyx isoflavone glucoside, matrine, and other COVID-19-related targets such as ACE2, chymotrypsin-like protease (3CLpro), papain-like protease (PLpro), prostaglandin-endoperoxide synthase 2 (PTGS2) have good binding ability. Conclusion According to the above results, it is suggested that SQW may play a role in the treatment of COVID-19 by directly or indirectly combining kaempferol, quercetin, and luteolin with ACE2, 3CLpro, PLpro, and PTGS2 to regulate multiple biological functions and signaling pathways.

目的 探讨麦粒灸联合揿针治疗急性期周围性面瘫的临床疗效.方法 将60例急性期周围性面瘫患者随机分为对照组和观察组,每组各30例.对照组采用单纯揿针治疗,观察组在对照组治疗的基础上加用麦粒灸,治疗4周后采用House-Brackmann(H-B)面神经功能分级评估两组患者治疗前后面神经功能及临床疗效,并于治疗后1周、1个月、3个月随访.结果 治疗后,对照组与观察组的总有效率分别为76.67％和93.33％,观察组总有效率明显高于对照组,差异有统计学意义(P<0.05).两组患者治疗前H-B面神经功能分级评分比较,差异无统计学意义(P>0.05);治疗后1周、1个月和3个月两组患者H-B面神经功能分级评分均较治疗前下降,且观察组在治疗后1周、1个月和3个月下降程度明显优于对照组,差异有统计学意义(P<0.05).结论 麦粒灸联合揿针治疗急性期周围性面瘫效果较好,能有效改善患者面神经功能.

阿魏酸5-羟化酶（ferulate 5-hydroxylase，F5H）是苯丙烷代谢途径上的关键酶。本课题组前期转录组测序研究显示F5H基因在甘草酸生物合成过程中起负调控作用，因此本文拟克隆该基因，并从基因过表达和沉默两个方面对这一调控作用进行深入研究。本文克隆得到甘草F5H基因（GenBank注册号：MK882511）；以pCAMBIA1305.1为载体骨架，以Spe Ⅰ和Bgl Ⅱ为酶切位点，利用基因融合法构建过表达载体pCA-F5H；根据F5H第一外显子设计sgRNA序列，以pHSE401为载体骨架，以Bsa Ⅰ为酶切位点，构建CRISPR/Cas9基因编辑载体pHSE-F5H；使用电转法将pCA-F5H和pHSE-F5H分别转入发根农杆菌ATCC15834感受态细胞；以甘草胚轴为外植体材料，利用发根农杆菌介导法分别诱导F5H过表达及沉默甘草毛状根系。同时，构建野生型甘草毛状根以及携带空质粒的阴性对照甘草毛状根。利用UPLC法测定各甘草毛状根系中甘草酸的含量，结果显示F5H基因沉默甘草毛状根体系中甘草酸含量显著高于野生型和阴性对照组，而过表达F5H基因甘草毛状根系中甘草酸含量则显著低于野生型和阴性对照组。本文通过逆向遗传学策略，从基因过表达和沉默两个方面证实了F5H基因对甘草酸生物合成的负调控作用，为进一步构建甘草酸次生代谢分子调控网络奠定了基础。

To investigate the potential molecular mechanism of the combination of Platycodonis Radix and Lilii Bulbus with the homology of medicine and food in the treatment of pneumonia by means of network pharmacology and in vitro verification experiment. Under the condition of bioavailability(OB)≥30% and drug-like(DL)≥0.18, the active components of Platycodonis Radix and Lilii Bulbus were screened in TCMSP database; the prediction targets of active components were searched from TCMSP, DrugBank and other databases, and the potential targets of pneumonia were obtained through GeneCards and OMIM database. The common targets were obtained by the intersection of drug and disease targets. The PPI network of common targets was constructed by STRING 11.0, and the core targets were obtained by topological analysis. Then the core targets received GO and KEGG analysis with use of WebGestalt and Metascape. The &quot;component-target-pathway&quot; network was constructed with the help of Cytoscape 3.7.1 software, and the component-target molecular docking verification was carried out with Discovery Studio 2016 software. Finally, the core targets and pathways were preliminarily verified in vitro. In this study, 12 active components were screened, 225 drug prediction targets and 420 potential diseases targets were obtained based on data mining method, and 14 core targets were obtained by topological analysis, including TNF, MMP9, AKT1, IL4 and IL2. The enrichment results of GO and KEGG showed that &quot;Platycodonis Radix and Lilii Bulbus&quot; drug pair may regulate inflammation, cell growth and metabolism by acting on 20 key signaling pathways such as TNF and IL-17, thereby exerting anti-pneumonia effects. The results of molecular docking showed that 12 active components had good binding ability with 14 core targets. In vitro experiment results showed that the core components of &quot;Platycodonis Radix and Lilii Bulbus&quot; drug pair could inhibit the expression of MMP9 and TNF-α by regulating TNF signal pathway. This study confirmed the scientificity and reliability of the prediction results of network pharmacology, and preliminarily revealed the potential molecular mechanism of the compatibility of Platycodonis Radix and Lilii Bulbus in the treatment of pneumonia. It provides a novel insight on systematically exploring the mechanism of the compatible use of Platycodonis Radix and Lilii Bulbus, and has a certain reference value for the research, development and application of new drugs.

月经不调是妇科临床最常见的疾病,对于妇女的身心健康及孕育胎产均有影响.该病多由脏腑功能失常,气血失调,直接或间接损伤冲任,从而导致肾、天癸、冲任、胞宫之间平衡协调失常,发生月经不调.刘颖教授为北京中医药大学附属东直门医院针灸科主任医师、教授,临床经验丰富,且对针灸治疗月经不调有独到见解.现将刘颖教授的学术思想及治疗体会进行整理总结.

Background Major Depression Disorder (MDD) is a common mental disease that has become one of the world's major medical diseases. Currently, the Fructus Aurantii (FA) has been widely used to treat depression. However, the active substance ingredients and potential mechanisms of the shell antidepression have not yet been clarified. Method First, we used ultraperformance liquid chromatography-quadrupole/time-of-flight tandem mass (UPLC-QTOF-MS/MS) technology to identify the chemical composition of the FA. Then, it is predicted for active ingredients, pharmaceutical disease target screening by DiscoveryStudio 2016 (DS), Metascape, and other databases, PPI network diagram, and FC core pathway. Finally, the system network pharmacology results are verified by molecular contact verification. Results Forty-six compounds in FA were identified, and twelve active ingredients were determined. Various database information, PPI network analysis of 41 intersections, and 20 core targets including DRD2, MTOR, FASP3, and PIK3P1 were integrated. Finally, the MDD treatment is indicated by molecular docking, and the most relevant potential signal pathway is the PI3K-Akt signaling pathway.

Breast cancer metastasis and recurrence accounts for vast majority of breast cancer-induced mortality. Tumor microenvironment (TME) plays an important role at each step of metastasis, evasion of immunosurveillance, and therapeutic resistance. Consequently, TME-targeting alternatives to traditional therapies focused on breast cancer cells are gaining increasing attention. These new therapies involve the use of tumor cells, and key TME components or secreted bioactive molecules as therapeutic targets, alone or in combination. Recently, TME-related nanoparticles have been developed to deliver various agents, such as bioactive ingredients extracted from natural sources or chemotherapeutic agents, genes, proteins, small interfering RNAs, and vaccines; they have shown great therapeutic potential against breast cancer metastasis. Among various types of nanoparticles, biomimetic nanovesicles are a promising means of addressing the limitations of conventional nanocarriers. This review highlights various nanoparticles related to or mediated by TME according to the key TME components responsible for metastasis. Furthermore, TME-related biomimetic nanoparticles against breast cancer metastasis have garnered attention owing to their promising efficiency, especially in payload delivery and therapeutic action. Here, we summarize recent representative studies on nanoparticles related to cancer-associated fibroblasts, extracellular matrix, endothelial cells, angiogenesis, and immune cells, as well as advanced biomimetic nanoparticles. Future challenges and opportunities in the field are also discussed.

带脉穴属足少阳胆经,是足少阳胆经与奇经八脉之带脉的交会穴.笔者整理分析古代文献中关于带脉穴的记载,发现其临床应用灵活而广泛.现以《中华医典》 (第5版)[1]中收录的1156部古籍为检索源,以"带脉"为检索词进行检索,共检索到878条文献,筛选其中与带脉穴有关的条文进行整理分析,将研究结果论述如下.

1-脱氧-D-木酮糖-5-磷酸合酶(1-deoxy-D-xylulose-5-phosphate synthase,DXS)是萜类化合物前体物质合成途径2-C-甲基-D-赤藻糖醇-4-磷酸(2-C-methyl-D-erythritol 4-phosphate,MEP)途径的第一个限速酶,在甘草次生代谢过程中发挥着重要的调控作用.本课题组在前期转录组研究中发现DXS基因表达水平与甘草的指标性成分甘草酸的含量呈负相关,因此本文拟通过毛状根培养体系,从基因过表达和沉默两方面开展研究,解析DXS基因对甘草酸生物合成的调控作用.本文克隆了甘草DXS基因(GenBank注册号:MN158121);采用基因融合法构建了过表达载体pCA-DXS;根据DXS第一外显子设计sgRNA序列,构建了 CRISPR/Cas9基因编辑载体pHSE-DXS;以甘草胚轴为外植体材料,采用发根农杆菌介导法诱导了DXS基因过表达和表达沉默的甘草毛状根体系.同时,诱导了野生型甘草毛状根及含空质粒的阴性对照毛状根.采用UPLC法测定各甘草毛状根样品中甘草酸的含量,结果显示: DXS基因沉默组毛状根样品中甘草酸含量显著高于野生型和阴性对照组,而DXS基因过表达甘草毛状根样品中甘草酸含量则显著低于野生型和阴性对照组.本文通过逆向遗传学策略,从基因过表达和沉默两个方面证实了DXS基因对甘草酸生物合成的负调控作用,为解析DXS基因在萜类化合物代谢中的作用提供了理论依据,也为进一步构建甘草酸生物合成分子调控网络奠定了基础.

头痛是针灸科常见病症及优势病种,常规以太阳、阳明、少阳、厥阴等经络辨证为主.刘颖教授认为,除此之外,应考虑太阴、少阴及督脉、任脉等奇经辨证,并总结了太阴头痛、少阴头痛、督脉头痛、任脉头痛等症的主要特征及选穴方法.针灸治疗头痛时以六经及奇经进行辨证,不仅能对症灵活选穴,提高治疗效果,也能丰富经脉辨证的内涵,具有一定临床及理论价值.