赵建军教授对于癫痫擅从肝、脾论治,认为癫痫发生的主要原因在于肝的生理功能失常,包括肝郁气滞、肝血亏虚、肝风内动、肝阳上亢等方面,主张以疏肝理气、柔肝养血、平肝潜阳、重镇安神为治疗原则;癫痫的发生发展,与脾密切相关,脾胃虚弱,则运化无力,水湿不化,日久蕴结为痰,痰蒙清窍,神机失常,发为本病,因而主张以健脾化痰为治疗原则.

国家名老中医赵建军教授从事中医脑病的研究近40年,对治疗失眠颇有心得,从心肝、脾胃、心肾的关系论治,结合临证经验提出"祛火以心、肝为先,平衡阴阳以交通心肾为要,治痰以脾、胃为重"之论,运用黄连温胆汤、柴胡疏肝散、交泰丸加减治疗失眠,临床疗效肯定.

目的 观察芒针透刺联合毫针针刺治疗中风后吞咽障碍的临床疗效,并观察对血氧饱和度、吞咽功能及其营养状况的影响.方法 将57例中风后吞咽障碍患者随机分为针刺组(18例)、康复组(20例)和药物组(19例).3组均采用基础治疗,药物组予以单唾液酸四己糖神经节苷脂(GM1)静滴;康复组采用常规吞咽康复治疗;针刺组采用芒针透刺联合毫针针刺.观察3组治疗前、治疗2周后、治疗后及治疗后6个月随访洼田饮水试验前后脉冲血氧饱和度、标准吞咽功能评价量表(SSA)评分、血清白蛋白和前白蛋白的水平变化,并比较3组临床疗效.结果 3组治疗2周后、治疗后及随访,洼田饮水试验前后脉冲血氧饱和度下降值和SSA评分均降低(P<0.05),且针刺组低于康复组及药物组(P<0.05);3组治疗后及随访,血清白蛋白及前白蛋白水平均上升(P<0.05),且针刺组高于康复组及药物组(P<0.05).针刺组总有效率为94.4％,高于康复组及药物组的90.0％和84.2％(P<0.05).结论 在基础治疗基础上,芒针透刺联合毫针针刺可有效改善中风后吞咽障碍患者的吞咽功能和营养状况.

目的 观察通督调神针刺法治疗肝肾亏虚型血管性痴呆(VD)的临床疗效.方法 将50例肝肾亏虚型VD患者随机分为治疗组和对照组,每组25例.治疗组采用通督调神针刺法配合常规针刺治疗,对照组仅采用常规针刺治疗.观察两组治疗前后各项量表[简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活能力量表(ADL)]评分及血清同型半胱氨酸(Hcy)水平的变化情况,并比较两组临床疗效.结果 治疗组总有效率为92.0％,明显高于对照组的68.0％,两组比较差异具有统计学意义(P<0.05).两组治疗后MMSE、MoCA评分均较同组治疗前显著上升,ADL评分和Hcy水平均较同组治疗前显著降低,差异均具有统计学意义(P<0.05).治疗组治疗后各项量表评分及Hcy水平与对照组比较,差异均具有统计学意义(P<0.05).结论 通督调神针刺法能更有效地提高肝肾亏虚型VD患者的认知水平及生活质量,可降低患者血清Hcy水平.

目的:基于网络药理学方法探讨中药配伍"柴胡-石菖蒲"的有效活性成分,探讨该药对配伍同疾病的相关通路和关键靶点,明确治疗癫痫的作用机制.方法:利用中药系统药理学数据库与分析平台检索中草药柴胡、石菖蒲的有效活性成分及靶点,在GeneCards数据库中查找癫痫疾病相关的基因靶点,通过String数据库建立蛋白质相互作用网络,在Metascape软件中对核心靶点进行基因本体论(GO)功能富集分析和京都基因与基因组百科全书(KEGG)通路富集分析.结果:获得柴胡的有效成分56种,石菖蒲的有效成分28种,药物靶点285个,疾病靶点1523个,筛选得到潜在药物治疗靶点71个.GO功能富集分析结果表明主要可能与对激素的反应、细胞对氮化合物的反应、细胞群增殖的负调控等有关.KEGG信号通路富集分析结果表明主要与癌症通路、缺氧诱导因子(Hypoxia Inducible Factor,HIF)-1信号通路及白细胞介素(Interleukin,IL)-17信号等通路相关.结论:柴胡-石菖蒲药对能通过多种有效活性成分、多种途径、多种靶点起到控制癫痫的作用.

Objective Parkinson’s disease (PD) is one of the most common neurodegenerative diseases. This study aims to screen specific modules and key genes related to PD. Methods Gene expression profile data GSE6613 and GSE22491 were downloaded from the Gene Expression Omnibus database. The significantly differentially expressed genes (DEGs) in different datasets were screened, followed by gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. The Weighted Gene Co-expression Network Analysis (WGCNA) was used to screen disease-related modules that are significantly stable across datasets. The protein–protein interaction network was constructed using the DEGs in the stable module obtained and preservation modules. Finally, the hub genes directly related to PD were screened. Results A total of 179 DEGs with the same significant difference direction were screened. The enrichment analysis of GO and KEGG pathways showed that 20 significantly related GO biological processes and 9 KEGG signaling pathways were screened. A total of three highly conservative modules were detected in the WGCNA network. Finally, three significant PD-related KEGG pathways screened from the Comparative Toxicogenomics Database were identified, including neuroactive ligand–receptor interaction (CRHR2, CTSG, GRIN1, GRIN2D, LPAR4 and P2RX3), amyotrophic lateral sclerosis (BCL2, GRIN1 and GRIN2D) and alcoholism (CAMKK2, GRIN1, GRIN2D and SLC18A2). Key genes, such as SLC18A2, GRIN1 and GRIN2D, may be potential candidate genes for PD progression. Conclusions Our findings indicate that SLC18A2, GRIN1 and GRIN2D may play an important role in the pathogenesis of PD.

目的 探讨鹿茸提取物对血管性痴呆(VD)大鼠海马的保护作用.方法 健康Wistar大鼠以两血管阻断法(2-VO)复制VD模型,造模成功后随机分为模型组、盐酸多奈哌齐组、高浓度鹿茸组、中浓度鹿茸组、低浓度鹿茸组,每组10只.另选取10只健康大鼠只分离颈总动脉,不结扎者为假手术组.假手术组、模型组灌服蒸馏水,盐酸多奈哌齐组灌服0.45mg/(kg·d)盐酸多奈哌齐溶液,高、中、低浓度鹿茸组分别以20,10,5 mL/(kg·d)灌胃鹿茸提取物,给药30d后,水迷宫检测各组大鼠法行为学;HE染色检测大鼠海马神经元病理结构;免疫组化及Western Blot检测海马组织钙调蛋白(CaM)、钙调蛋白激酶Ⅱ (CaMKⅡ)蛋白表达情况.结果 与假手术组比较,模型组大鼠空间学习记忆能力与探索能力下降,表现为逃避潜伏期明显延长,穿越原平台次数及在原平台象限停留时均明显减少(P＜0.05),海马病理结构明显受损,海马CaM蛋白表达水平上调,CaMKⅡ蛋白表达水平下调(P＜0.05,P＜0.01);与模型组比较,高、中浓度鹿茸组大鼠空间学习记忆能力与探索能力明显改善,表现为逃避潜伏期明显缩短,穿越原平台次数及在原平台停留时间均明显增加(P＜0.05),海马CaM蛋白表达水平明显下调、CaMKⅡ蛋白表达水平明显上调(P ＜0.05,P＜0.01).结论 鹿茸提取物可干预大鼠海马CaM、CaMKⅡ蛋白表达,保护大鼠海马神经元,改善VD大鼠学习与记忆能力.

随着社会时代的不断发展和进步,人们常处于快节奏、压力大的氛围之中,赖以"蓄能"的睡眠无法得到满足,越来越多的人患有失眠证,失眠甚至成为困扰着现代社会人们身心健康的头号疾病.导师赵建军教授为吉林省名中医,第六批全国名老中医药专家学术经验继承指导教师,从事中医药治疗脑血管系统疾病研究近40年,中医历史悠久,在治疗失眠方面具有较多的临证经验,辨证精准,功效显著,强调临床规范化治疗的同时,针对不同个体注重辨证施治,身心兼顾,充分发挥出中医的整体调节及辨证论治优势.

张闻东教授认为血管性痴呆的发病与髓减脑消、神机失养密切相关,辨证以肝肾亏虚、脾胃虚弱为主,可兼夹痰、瘀蒙蔽心神,其病位在脑.在治疗方面善用井穴醒脑益智,针药结合固本培元、化痰开窍、活血通络.

目的:观察三通三调针刺法治疗脑卒中后肢体痉挛的效果.方法:将脑卒中后合并肢体痉挛的60例患者随机分为三通三调针刺组和普通针刺组各30例,分别采用三通三调针刺法和普通针刺法治疗,2周为单个疗程,治疗4个疗程,观察2组治疗前后临床痉挛指数(CSI)、改良Ashworth量表(MAS)的变化,评价其疗效.结果:三通三调针刺组总有效率为97％,普通针刺组总有效率为93％,前者高于后者(P<0.05).治疗后,2组的CSI、MAS评分较治疗前降低(P<0.05),且三通三调针刺组的CSI、MAS评分低于普通针刺组(P<0.05).结论:三通三调针刺法治疗脑卒中后肢体痉挛疗效明显.

任继学教授认为中风病机为虚风上冲,挟营阴上扰于脑.中焦虚满态及下焦失藏态为中风病风险人群的中医状态,痰火内郁态及肝阳上亢态为中风高危人群的中医状态.按此理论体系.中风高危人群治疗原则为行气解郁、清泻痰火,平肝潜阳、降气泻火.在调护时须注重脾胃的调养和生活方式的调控.

目的 观察艾灸治疗卒中相关失眠的临床疗效.方法 将56例卒中相关失眠患者采用随机数字表法分为治疗组和对照组,各28例.治疗组予温和灸治疗,取穴百会、涌泉;对照组予艾司唑仑片口服.治疗4周后,比较2组的临床疗效以及治疗前后匹兹堡睡眠质量指数(PSQI)7个因子评分和总分,汉密尔顿焦虑量表(HAMA)评分,5-羟色胺(5-HT)、乙酰胆碱(ACh)、去甲肾上腺素(NA)等神经递质的活动信号检测值.治疗后随访3个月,比较2组随访前后PSQI评分中睡眠质量、日间功能障碍2个因子评分.结果 对照组总有效率为85.7％(24/28),治疗组为93.9％(26/28),2组比较差异无统计学意义(P＞0.05);治疗后,除催眠药物评分外,2组PSQI 6个因子评分和总分及HAMA评分均明显降低,与同组治疗前比较差异有统计学意义(P＜0.05),且治疗后治疗组PSQI总分及睡眠时间、睡眠障碍2个因子评分明显低于对照组,差异均有统计学意义(P＜0.05);治疗后2组5-HT、ACh、NA活动信号检测值均明显升高,与同组治疗前比较差异有统计学意义(P＜0.01),但2组治疗后比较差异均无统计学意义(P＞0.05);随访后治疗组PSQI评分中睡眠障碍、日间功能障碍2个因子评分均明显降低,与同组随访前比较差异有统计学意义(P＜0.05),随访后治疗组2个因子评分明显低于对照组,2组比较差异均有统计学意义(P＜0.05).结论 艾灸能明显改善卒中相关失眠患者的失眠、焦虑症状,有效调节卒中相关失眠患者的5-HT、Ach、NA等神经递质的活动信号检测值;对比西药,艾灸的优势体现在对卒中相关失眠患者的睡眠时间、睡眠障碍两方面的有效调节,此外对患者的睡眠质量、日间功能障碍亦具有更显著的长期疗效.

In the current study sophocarpine was investigated in vitro for prevention of β-amyloid induced PC12 neuronal cell damage. Exposure to β-amyloid caused a dose-dependent suppression in growth of PC12 cells with maximum reduction at 10 μM. Sophocarpine pre-treatment reversed suppressive effect of β-amyloid (10 μM) on PC12 cell growth in concentration-based manner. In sophocarpine pre-treated PC12 cells the β-amyloid mediated PGE2 level elevation was attenuated significantly at 0.25–2 μM doses. Moreover, in sophocarpine pretreated PC12 cells the β-amyloid mediated promotion of COX-2 level was also inhibited. Sophocarpine pre-treatment attenuated iNOS expression in β-amyloid exposed PC12 cells at 0.25–2 μM doses. Pre-treatment of PC12 cells with sophocarpine suppressed NO-species generation induced by β-amyloid exposure. In sophocarpine pretreated PC12 cells elevation of nuclear NF-κB expression induced by β-amyloid was significantly inhibited. In summary, sophocarpine prevents reduction of PC12 cell growth induced by β-amyloid exposure via inhibition of inflammatory processes. The preventive effect of sophocarpine on β-amyloid induced PC12 cell damage is associated with inhibition of NF-κB nuclear translocation. Therefore, sophocarpine may be used for treatment of neurological disorders like Alzheimer’s disease.

BACKGROUND:An individual's level of lower limb motor function is associated with his or her disability level after stroke, and motor improvement may lead to a better prognosis and quality of life. Data from animal models show that Qizhitongluo (QZTL) capsule facilitates recovery after focal brain injury. We aimed to validate the efficacy and safety of the QZTL capsule for promoting lower limb motor recovery in poststroke patients.METHODS:In this randomized, multicenter, double-blind, placebo- and active-controlled trial from 13 sites in China, participants with ischemic stroke and Fugl-Meyer motor scale (FMMS) scores of <95 were eligible for inclusion. Patients were randomly assigned in a 2:1:1 ratio to the QZTL group, Naoxintong (NXT) group or placebo group for 12 weeks at 15-28 days after the onset of stroke. The primary outcome was the change in the Lower Limb FMMS (FMMS-LL) score from baseline over the 12-week intervention period.RESULTS:622 participants were randomly assigned to the QZTL group (309), NXT group (159), or placebo group (154). The FMMS-LL score increased by 4.81 points (95 % CI, 4.27-5.35) in the QZTL group, by 3.77 points (95 % CI, 3.03-4.51) in the NXT group and by 3.00 points (95 % CI, 3.03-4.51) in the placebo group at week 12. The QZTL group showed significantly larger improvements compared with the placebo group at each interview from weeks 4-12 (difference, 0.89 [0.30,1.49] at week 4, P = 0.0032; difference, 1.83[1.01,2.66] at 90 days poststroke, P < 0.0001; difference, 1.81[0.88,2.74] at week 12, P = 0.0001).CONCLUSION:The QZTL capsule is an effective treatment for lower limb motor impairment. The finding indicates that the QZTL capsule may be used as a potential new strategy for stroke rehabilitation.

清代医家叶天士于《临证指南医案》首次提出"上下交损,当治其中"的治疗方法,用于治疗心肾不交的遗精.该治法突出了后天之本,中焦脾胃在疾病发生发展中的重要作用.中焦脾胃运化失常,可导致脑髓失养或毒损脑络,从而引起阿尔茨海默病的发生发展,现代医学研究认为阿尔茨海默病与肠道微生物群落失调密切相关.结合现代医学与传统医学的理论特点,进一步探究中焦脾胃与肠道微生物群落的相互关系.通过查阅文献、参考古籍医案、阿尔茨海默病用药规律分析、相关实验研究,为此法在临床上治疗阿尔茨海默病提供论据支持,为中医药防治阿尔茨海默病提供新思路,为中医药防治复杂病因病机的脑系疾病提供广泛的应用前景.

In this project, silver‑platinum (AgPt) nanoparticles were prepared by using the Crocus sativus L. plant ethanolic extract. The AgPt nanoparticles were characterized by applying the various method as ultraviolet-visible and infrared spectroscopy, electron microscopy, and X-ray diffraction analysis. The morphology structural indicated that the AgPt nanoparticles were spherical particles with diameter about 36.0 nm. The FTIR spectroscopy shows the efficient stabilization of the AgPt nanoparticles by phytoconstituents. The Ag and AgPt nanoparticles have polyphenolic content, lower than the flavonoids and proanthocyanins contents. The AgPt nanoparticles depicted the highest antioxidant properties compared to the Ag nanoparticles and ascorbic acid. The results showed that the AgPt nanoparticles had a high antioxidant properties. In addition, the AgPt nanoparticles demonstrated the substantial antimicrobial and cytotoxic activities against pathogenic microbes and MCF-7 breast cancer cell line. The environmental chemistry analysis depicts that methyl orange can be degraded from water by catalytic degradation process with sodium borohydride. The AgPt nanoparticles were prosperous in catalytic degrading methyl orange following a first order kinetic model.

目的:评价中药治疗卒中后认知障碍(PSCI)的疗效与安全性.方法:计算机检索中国知网数据库,万方数据库,维普数据库,中国生物医学文献数据库,PubMed,The Cochrane library和ClinicalTrials.gov共7个数据库,纳入中药治疗PSCI的随机对照试验(RCT).使用Cochrane偏倚风险评估工具对纳入研究的方法学质量进行评价,并对纳入研究进行描述性分析,应用RevMan 5.3软件进行Meta定量分析.结果:共纳入16项RCT,1 296例受试者,干预组649例,对照组647例.研究结果显示中药联合西药组和中药组干预在改善PSCI患者蒙特利尔认知评估量表,简易精神状态检查量表,Barthel指数评定量表,日常生活能力量表,中国脑卒中临床神经功能缺损程度评分量表和美国国立卫生研究院卒中量表的评分上均优于西药组,且未见严重的不良反应.结论:中药在改善PSCI患者的认知功能水平方面具有潜在优势,对改善日常生活能力及神经功能缺损症状也有一定疗效,并未观察到严重不良事件.本文纳入研究的方法学质量不高,建议后续开展高质量的RCT来研究中药治疗PSCI的疗效和安全性,为该疾病的临床诊疗提供决策依据.

目的 探讨急性缺血性脑卒中后认知障碍的中医证候要素,为临床早期干预提供辨证论治依据.方法 纳入多中心协作收集的急性缺血性脑卒中后认知障碍患者331例,采用“中医症状、舌脉象观察表”进行四诊信息采集,内容含40项临床症状、20项舌象及10种脉象.对受试者的70项四诊信息采用因子分析方法进行证候要素提取,并统计证候要素分布特点.结果 40项临床症状中出现频率位于前5位的为乏力(44.71％)、言语謇涩(41.99％)、失眠(41.39％)、夜尿频多(35.95％)、神疲(35.35％).舌色以舌暗出现频率最高,占53.47％;苔色以苔白最为常见,占66.77％;苔质以苔薄最多,占48.94％.脉弦出现频率最高,占65.86％,其次为脉滑、脉沉.经因子分析后共得出6个证候要素,其中气虚比例最高(43.20％),其次为痰(23.56％)、血瘀(16.31％)、火(8.46％)、阴虚(5.44％)、阳虚(3.02％),病位以肾、脾、肝多为常见.结论 急性缺血性脑卒中后认知障碍中医证候要素以气虚为主,肾脾亏虚、痰瘀互结可能是脑卒中急性期出现认知障碍的重要病理因素.

目的:比较情境模拟教学法及虚实结合的情境教学法在脑病科临床带教中的效果.方法:试验组学生随机分成研究组(n=20)与对照组(n=20).对情境模拟教学法及虚实结合两种教学模式教学效果进行评价,评价方法为两组学生对教学法的评价及对两组学生进行OSCE考核和理论考试.结果:对两组学生在学习兴趣、理论水平、培养医患沟通技巧、临床操作能力、综合处置能力5个方面的评价进行比较,研究组明显优于对照组;教师对学生的评价结果显示研究组学生理论考试成绩及OSCE考核成绩均高于对照组.结论:提示模拟情境结合实际情境训练可明显提高学生的临床综合学习能力.

张闻东认为脑中风的病因病机为元气虚衰,痰、瘀、毒阻于脉络,元神失司.在诊治脑中风方面以"通调"为原则,灵活运用"通督脉调元神"以醒脑开窍、"通三焦调脏腑"以培元泄浊、"通气街调经络"以舒筋活络的"三通三调"针刺法,标本同治,虚实并理,整体辨治,以复脑之功能.