奇经八脉纵横交错循行于十二经脉之间,是经络学说的重要组成部分,现据其循行分布规律、生理功能特性和主治病症特点,与现代医学划分的人体八大系统的相关性进行初步探索,推导总结每条奇经联系密切的人体系统,以期为奇经八脉的研究及临床应用提供现代科学理论支撑,促进奇经八脉理论及临床研究的发展.

灸是中华民族的瑰宝,应用广泛且疗效明确,但起效的普适性作用原理仍未系统揭示.笔者系统分析了损伤相关分子在针刺起效初始环节发挥的重要作用,创新性地发现针刺作为一种机械性刺激可造成穴位局部的微损伤,激活并上调穴位局部多个损伤相关分子,包括高迁移率族蛋白、三磷酸腺苷和热休克蛋白等,特异性调节效应器官部位损伤相关分子水平,促进机体自我修复而达到治疗目的,揭示了针刺通过损伤相关分子启动和发挥针效的作用实质,为针刺的普适性作用原理提供科学依据.

Recently, the role of inhibitory antibodies to programmed cell death 1 receptor and programmed cell death ligand 1 in clinical treatment trials of malignant tumors has been recognized. But such drugs can cause some adverse reactions, and the immune-related adverse events, especially thyroid dysfunction, are paid more and more attention. Application of 99Tc mO 4- SPECT imaging in 2 patients with elevated thyroid function after tumor immunotherapy was reported.

Multiple myeloma (MM) is a malignant disease of clonal plasma cell hyperplasia, which occurs mostly in the elderly. The incidence of MM ranks second in hematological malignancies and is currently on the rise in China year by year. 18F-fluorodeoxyglucose (FDG) PET/CT imaging can provide information on the proliferation and metabolism of malignant tumors at the molecular level. Existing studies have proved that 18F-FDG PET/CT is of great significance in the diagnosis, staging, monitoring of efficacy and prognostic evaluation of MM. This paper reviews the research progress of 18F-FDG PET/CT imaging in the diagnosis and treatment of MM.

目的:探索药物的结构特征参数在预测药物与辅料相互作用中的规律.方法:采用两室渗透模型测定不同性质的21种药物的透膜速度,考察辅料对药物渗透的阻滞作用.通过计算药物的分子大小、电荷和形状相关的特征参数,考察药物特征参数与辅料相互作用的相关性.结果:根据12 h时9种辅料对21个药物渗透速度的影响,得到辅料对药物的阻滞率,将药物分为5类.第1类药物的阻滞率小于-25％,辅料表现出加速渗透作用;第2类药物对辅料不敏感,此类药物除非极性可及表面积(ASA_P)与偶极矩(dipole)参数外都与其他药物存在显著差异(Z=-0.704、-0.503,P=0.534、0.669);第3类药物对表面活性剂敏感,此类药物的重原子数量(a_heavy)、分子范德华体积(vol)、正电荷可及表面积(ASA+)参数的差异显著(Z=-1.965、-2.211、-2.111,P=0.047、0.024、0.035);第4类对表面活性剂和崩解剂敏感,此类药物参数的差异不显著;第5类药物对多类辅料敏感,此类药物的负电荷可及表面积(ASA-)、ASA_P、dipole等参数的差异显著(Z=-2.836、-2.611、-2.462,P=0.003、0.007、0.012).结论:分子大小、极性、形状指标能够较好预测药物与辅料相互作用关系.

Objective:To investigate the application of 99Tc m-diethylene-triaminepentaaccetic acid ( 99Tc m-DTPA) dynamic renal imaging in evaluating the compensatory function of healthy kidneys in patients with unilateral hydronephrosis. Methods:A total of 257 cases of unilateral hydronephrosis admitted to the Second Hospital of Tianjin Medical University from January 2016 to July 2019 were retrospectively analyzed. They included 149 males and 108 females, aged 12~87 (52.84±14.23) years. All patients underwent 99Tc m-DTPA renal dynamic imaging, and their glomerular filtration rate (GFR) was counted using the Gates method. They were also grouped in accordance with the degree of hydronephrosis, the degree of renal impairment, gender, age, and etiology. The GFR compensation rate (%) of the uninfected kidney in different groups was calculated. The GFR of both kidneys was compared using independent sample t-test. The influencing factors of the compensatory ability were analyzed using the Mann-Whitney U and Kruskal-Wallis tests. Results:The GFR of the affected kidney was (28.60±15.13) mL/min, while that of the contralateral kidney was (63.17±15.74) mL/min, and the total GFR was (92.94±24.46) mL/min. The GFR of the affected kidney was significantly lower than that of the contralateral kidney ( t=25.39, P<0.001). Varying degrees of compensatory increase were observed in the GFR of the uninfected kidney, the GFR compensation rate was 9.54% (-5.94%, 26.45%). Statistically significant differences were also found in the GFR compensation rate of the contralateral kidney among patients of different ages and degrees of hydronephrosis ( χ2 =47.32, 12.71, both P<0.01). No statistically significant difference was found in the GFR compensation rate of the contralateral kidney among patients with different degrees of renal damage on the affected side, the location of hydronephrosis, the location of the stones, and gender ( χ 2=4.34, Z=-0.51, -1.62, -1.41, all P>0.05). Conclusion:Using renal dynamic imaging to study the factors affecting the compensatory ability of the contralateral kidney in patients with unilateral hydronephrosis could further provide a basis for the diagnosis, treatment, and prognostic evaluation of these patients.

目的:总结重症肌无力的发病特点,中医辨证,诊疗经验。方法:选择天津中医药大学第一附属医院重症肌无力患者1例给与服用补中益气汤加减并与针灸治疗。结果:经治疗12周后患者基本痊愈,未见副作用。结论:对于重症肌无力,中医药早期参与治疗有重要意义。

<正>患者,女,44岁,2010年11月25日初诊。患者2年前发现甲状腺肿大。甲状腺彩超提示:甲状腺弥漫性肿大伴多发低回声结节,考虑结节性甲状腺肿。来诊时见:神情,精神可,自觉心悸,恶寒,双颈前肿大,可触及肿物2个,质稍硬,边缘清晰,无压痛,皮肤色如常,可随吞咽动物上下移动,口苦咽干,有痰不易咳出,纳差,睡眠可,二便正常。舌体胖大,苔略腻,质