Objective: Hemifacial spasm (HFS) is a kind of motor disorder, and the striatum plays a significant role in motor function. The purpose of this study was to explore the alterations of the cortical-striatal network in HFS using resting-state functional magnetic resonance imaging (fMRI). Methods: The fMRI data of 30 adult patients with primary unilateral HFS (15 left-side and 15 right-side) and 30 healthy controls were collected. Six subregions of the striatum in each hemisphere were selected for functional connectivity (FC) analysis. One-sample t-test was used to analyze the intragroup FC of the HFS group and the control group. Two-sample t-test was used to compare the difference of FC between the two groups. The correlation between the abnormal FC and severity of HFS was evaluated by using the Spearman correlation analysis. Results: Compared with the controls, the striatal subregions had altered FC with motor and orbitofrontal cortex in patients with HFS. The altered FC between striatal subregions and motor cortex was correlated with the spasm severity in patients with HFS. Conclusion: The FC of the cortical-striatal network was altered in primary HFS, and these alterations were correlated with the severity of HFS. This study indicated that the cortical-striatal network may play different roles in the underlying pathological mechanism of HFS.

目的 探索温肾健脾方对脾肾阳虚证腹泻型肠易激综合征(IBS-D)大鼠肠组织蛋白组学的影响.方法 50只雄性SD大鼠随机分为健康对照组(N组)、模型组(M组)、温肾健脾方中剂量组(ZZ组)、温肾健脾方高剂量组(ZG组)和匹维溴铵西药组(W组)5组,每组10只.后4组参考前期研究制备脾肾阳虚证IBS-D大鼠模型;N组全过程正常饲养,无造模干预及治疗,ZZ组、ZG组和W组给予相应治疗2周.采用TMT蛋白组学技术,对其结肠组织进行生物信息学、互作网络和重点差异蛋白表达情况的动态变化分析.结果 共筛选出M/N组有主要差异的蛋白共405个;通过DAVID网站对这些差异蛋白进行功能分析(P<0.05)发现它们的主要功能包括蛋白质参与的生物学过程、分子功能和细胞定位3个方面;经KEGG分析发现他们涉及的主要生物学通路为代谢途径、氧化磷酸化、核糖体、阿尔茨海默病、亨廷顿病和剪接体通路;ZZ组和W组共同回归的蛋白有65个,占到ZZ组回归蛋白的82.28％.结论 温肾健脾方通过参与3组生物学功能、6个生物学通路干预了脾肾阳虚证IBS-D大鼠肠组织蛋白的表达,同时在干预蛋白表达的机制上与匹维溴铵作用机制高度相似.

OBJECTIVE:Neurovascular coupling enables rapid adaptation of cerebral blood flow (CBF) to support neuronal activity. Modern techniques enable the simultaneous recording of neuronal activities and hemodynamic parameters. However, the causal relationship between electrical brain activity and CBF is still unclarified. In this study, we investigated the causal relationship between surface electroencephalogram (EEG) and cerebral blood flow velocity (FV) from transcranial Doppler using Granger causality (GC) analysis. APPROACH:Twenty simultaneous recordings of EEG and FV from 17 acute ischemic stroke patients were studied. Each patient had simultaneous, continuous monitoring of EEG and bilateral FVs in either the middle cerebral arteries or posterior cerebral arteries. The causal interactions between FV (0.006-0.4 Hz) and EEG (delta, theta, alpha, beta and gamma bands) were investigated through GC index (GCI). In order to make the GCIs comparable, the proportion of GCI (PGCI) values where G-causality is statistically significant were calculated. Scores on the NIH Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) for neurologic disability were recorded respectively at discharge. Patients were divided into a deceased (mRS = 6) and a survival group (mRS = 1 to 5), and a favorable (mRS: 1 to 2) and unfavorable outcome group (mRS: 3 ~ 6). MAIN RESULTS:This study identified a causal relationship from EEG→FV, indicating EEG contained information that can be used for FV prediction. PGCI was negatively related with mRS (p < 0.05), indicating that stronger causalities between EEG and FV exist in patients with better outcome. The NIHSS was negatively related with the asymmetry of the two-side PGCI, calculated as the difference between the lesional side and non-lesional side PGCI. SIGNIFICANCE:A causal relationship from EEG→FV may exist in patients with ischemic stroke. The strength of G-causality may be related to stroke severity at discharge.

Background: This study was performed to summarize our experience in treating acute superior mesenteric artery embolism (SMAE) by percutaneous mechanical thrombectomy (PMT). Methods: The clinical data of five patients with acute SMAE treated by PMT in our center from October 2015 to May 2018 were retrospectively analyzed. PMT was performed under local anesthesia. Access was established via the femoral artery or brachial artery. Thrombectomy was performed on the superior mesenteric artery using a 6F Rotarex catheter (Straub Medical, Wangs, Switzerland). Results: Technical success of PMT was achieved in all five patients; emboli were completely removed in three patients and partially removed in two patients. No PMT-related complications were noted after surgery. Four patients were smoothly discharged from the hospital after their symptoms were relieved. One patient still had symptoms of intestinal ischemia after the operation, and massive small intestinal necrosis was found by exploratory laparotomy. Intestinal resection was performed, and the patient died 4 months later. Conclusions: PMT by the Rotarex system is a minimally invasive, safe, and effective technique in removing SMAE. Early application of PMT can avoid intestinal necrosis.

我国结肠癌的发病率和死亡率均有逐年上升的趋势,化疗耐药(chemoresistance)是结肠癌治疗失败的主要原因,本课题对贝母素及其中药组方进行研究,发现该药物及组方与化疗药物联合使用,能有效逆转结肠癌化疗耐药,并可降低化疗药物特有的不良反应;借助了高通量代谢组学手段深入探讨贝母素及其中药组方抗肿瘤作用的分子机制,找出逆转结肠癌化疗耐药的潜在靶点;项目开发了纳米化中药投递系统,用于增加抗肿瘤中药药物的水溶性和抗肿瘤活性.本研究推进了中西医结合治疗结肠癌化疗耐药的创新发展并获得国际认可,应用本项目技术指导结肠癌化疗耐药的中西医结合临床用药和新药研发,取得较好的临床疗效和社会经济效益.

OBJECTIVES: This pilot study investigated the safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices in patients with prehepatic portal hypertension. METHODS: Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into three groups by surgery type: shunt surgery alone (Group A), shunt surgery and devascularization (Group B), and shunt surgery combined with foam sclerotherapy (Group C). Between-group differences in operation time, intraoperative blood loss, portal pressure decrease, postoperative complications, rebleeding rates, encephalopathy, mortality rates and remission of gastroesophageal varices were compared. RESULTS: Groups A, B and C had similar operation times, intraoperative bleeding, and portal pressure decrease. The remission rates of varices differed significantly (p<0.001): one patient in Group A and 6 patients in Group B had partial response, and all 9 patients in Group C had remission (2 complete, 7 partial). Two Group A patients and one Group B patient developed recurrent gastrointestinal bleeding postoperatively within 12 months. No postoperative recurrence or bleeding was observed in Group C, and no sclerotherapy-related complications were observed. CONCLUSIONS: Shunt surgery combined with foam sclerotherapy obliterates varices more effectively than shunt surgery alone does, decreasing the risk of postoperative rebleeding from residual gastroesophageal varices. This novel surgery is safe and effective with good short-term outcomes.

随着生活水平的不断提高,脂肪肝的发病率较5年前也上升了50倍,并呈现低龄化趋势.诸多疾病都与脂肪肝息息相关,万万不能小觑,它可能导致肝硬化、肝功能衰竭,甚至肝癌,而且对心血管系统、内分泌系统、免疫系统等均可造成损害,可以促使动脉粥样硬化的形成,诱发和加重高血压病、冠心病,造成脑病脂肪肝综合征,加重糖尿病、高脂血症,降低人体免疫功能.如何远离脂肪肝呢?谈到这一话题,首先要了解人体的脂肪是从哪儿来的,又要到哪里去?

Objective:To explore the syndrome characteristics of TCM of functional abdominal distension based on the methods of principal component analysis and factor analysis.Methods:A total of 300 patients with functional abdominal distension were enrolled,using Excel to establish a clinical data database,the patient's gender,age and TCM syndrome scoring were recorded and stored.The SPSS statistical software was used to analyze the principal component analysis and factor analysis.Results:The principal component analysis was used to extract 11 principal components with relative independence and eigenvalues of 1.0 or more,and the cumulative contribution rate was 67.944％.The functional abdominal distension syndrome was obtained by using the factor rotation method to extract 11 factors combined with the analysis of traditional Chinese medicine theory:Excess syndrome:incoordination between liver and stomach (13.541％),intestinal excess heat (9.922％),incoordination between the liver and the spleen (6.558％),exuberance of stomach fire (6.108％),damp-heat in the stomach and intestine (5.393％),syndrome of liver-stomach heat (4.689％),phlegm retention in the middle energizer (4.251％),incoordination between the spleen and the stomach (3.666％);Deficiency syndrome:deficiency cold of spleen and stomach (7.139％);syndrome of intermingled deficiency and excess:stagnation of liver qi and spleen deficiency (3.484％),excessive dampness due to deficiency in spleen (3.194％).Conclusion:Using the methods of principal component analysis and factor analysis,the syndrome characteristics of functional abdominal distention can be analyzed more objectively and accurately.

目的 观察中药提取物贝母素乙对人结肠癌HCT-116细胞的可能作用途径.方法 取人结肠癌HCT-116细胞接种于6孔板,每孔1ml共计2000细胞,设对照组和贝母乙素组,每组3个平行标本,贝母素乙组中每孔加入贝母素乙200 μg,最终工作浓度200 μg/ml,对照组加入等体积二甲基亚砜,药物处理后72h吸出培养基,进行总RNA提取.应用基因芯片技术检测两组的差异基因表达谱,并对差异基因进行GO、KEGG富集分析和聚类分析.结果 共筛选出差异基因37个,其中显著上调基因共5个,其余为下调基因共32个(差异倍数≥2,P＜0.05).GO分析主要影响通路集中在生物学过程中的热生成调控、运动行为调控、尿嘧啶核苷代谢过程、肾上腺素能受体信号通路的调控、脂肪组织代谢的调控和G蛋白偶联受体信号通路的调控;分子功能方面的肾上腺素能受体结合活性和尿嘧啶核苷磷酸化酶活性.KEGG富集分析主要影响通路集中在药物代谢酶、嘧啶代谢、酮体合成和降解、维生素B6代谢、核糖体等方面.聚类分析结果显示,贝母素乙组相对对照组上调基因中RPL和PHLDA1两群联系较为紧密,在下调基因中UPP1与ARRDC3两群联系较为紧密.结论 贝母素乙能显著影响结肠癌HCT-116细胞中的嘧啶代谢通路,抑制其细胞增殖,促进其能量代谢.

The general situation about objective indexes of TCM patterns of chronic superificial gastritis (CSG) in recent years were reviewed from biochemical, immune and genetic aspects in the hope of providing evidence for establishing the standard of syndrome differentiation and treatment for CSG.

Objective To observe the combination treatment of Qi supplied and stagnation resolved therapy with mFOLFOX6 postoperative adjuvant chemotherapy for the stage Ⅲ colon cancer. Methods Eighty colon cancer patients with stage Ⅲ pathological diagnose were randomly assigned into control group and treatment group after radical operation of colon cancer in one month. Forty patients received the mFOL-FOX6 chemotherapy as control group. And the others received both Qi supplied and stagnation resolved tradi-tional Chinese medical therapy and mFOLFOX6 chemotherapy as treatment group. Scores of functional status after one year,Disease - free survival( DFS)after three years and the mean survival time of patients were measured. And chemotherapeutic agentsˊ side effect were observed too. Results The Karnofsky score of the treatment group was 91. 72 ± 7. 44,and it was higher than that of the control group(P ﹤ 0. 05). The 3 years DFS rate of the treatment group was 74. 99 percent,and that of the control group was 72. 26 percent. The mean survival time of two groups were 38. 81 ± 1. 71 months and 33. 45 ± 1. 93 months. There were no statis-tical differences. Compared with control group,the rates of hematologic toxicity,gastro - intestinal reaction and peripheral neurotoxicity of treatment group was lower with statistical significance. Conclusion The com-bination treatment of Qi supplied and stagnation resolved therapy with chemotherapy can reduce chemotherapy side effect and be beneficial to prolong the survival of colon cancer patients.

目的 应用复原挖掘的黄帝内经五音疗法治疗2型糖尿病周围神经病变患者,观察疗效并探索其机理.方法 将220例2型糖尿病周围神经病变患者随机分为对照组和治疗组各110例,在控制血糖的基础上,对照组口服甲钴胺治疗,治疗组应用黄帝内经五音疗法治疗,分别统计两组治疗前、治疗后4周、8周及12周时神经电生理、氧化应激指标的改变,及最终疗效,并进行统计学分析.结果 与治疗前相比,治疗组患者的症状改善,神经传导速度加快,SOD升高,MDA、8-OhdG下降,差异有统计学意义(P＜0.05);与对照组相比,治疗组有效率高于对照组,P＜0.05;且在SOD的升高和MDA、8-OhdG的下降方面,治疗组高于对照组,P＜0.05.结论 黄帝内经五音疗法治疗糖尿病周围神经病变,可以缓解临床症状,使神经传导速度加快,优于口服甲钴胺,其机制与提高机体的抗氧化应激能力、降低氧化应激对组织损伤相关.

Chinese medicine thinks spleen and stomach dysfunction is the main pathogenesis of reflux esophagitis,in the treatment of reflux esophagitis response to the pathogenesis of syndrome differentiation and treatment. For spleen and stomach dysfunction caused by reflux esophagitis,should give priority to with Pungent-open and bitter-down method,by adjusting the spleen and stomach qi activity lifts,restore the function of spleen and stomach,according to the condition at the same time,along with the syndrome to add or subtract,in order to improve curative effect. Pungentopen and bitter-down method can adjust the spleen and stomach function,make the qi running,so as to achieve the purpose of treating diseases. Representative formula of Pungent-open and bitter-down method is Banxia Xiexin decoction.

Through consulting relevant literature of Traditional Chinese Medicine treatment of globus hystericus for nearly ten years, phlegm-Qi stasis is the basic pathogenesis of Globus, and the pathogenesis is associated with emotion change. The treatment experience on globus hystericus are overviewed, from the internal treatment, external treatment, and treatment of inter-nal and external combination treatment. So that the traditional Chinese medicine has good curative effect in the treatment of globus hystericus. There are little Pharmacological studies of animal reports about mechanism of Chinese Medicine on globus hystericus, and it is back for further research.

反流性食管炎的中医证型分布,各医家主张不同,证型分类也不同.文献分析结果显示,反流性食管炎主要证型有9个,分别为肝胃郁热证、脾胃虚弱证、痰气交阻证、肝胃不和证、脾胃湿热证、肝郁脾虚证、气滞血瘀证、胃阴不足证、脾虚痰湿证.其中4个证型在临床上较常见,分别是肝胃郁热证、脾胃虚弱证、痰气交阻证及肝胃不和证.反流性食管炎的证型中实证居多,其发生与肝脾胃三脏密切相关.且中医证型与性别、Hp感染、体质类型等因素均有相关性.

目的 应用复原挖掘的黄帝内经五音疗法治疗脑卒中患者,观察其对肌力恢复的影响.方法 将260例脑卒中恢复期患者随机分为对照组和治疗组各130例,对照组应用药物基础治疗+康复训练,治疗组应用药物基础治疗+康复训练+《黄帝内经》五音疗法治疗,分别统计两组治疗前、治疗后2周、4周及2月时的肌力评分总和(包括手肌力、上肢肌力、下肢肌力、步行能力),并进行统计学分析.结果 治疗组在治疗后2周、4周、2月时肌力评分总和大于对照组,P＜0.05,差异有统计学意义;治疗组中医证候积分小于对照组,P＜0.05,差异有统计学意义;治疗2月时比较,治疗组愈显率(59.23％)大于对照组(40.00％),P＜0.01,差异有统计学意义.结论 黄帝内经五音疗法可促进脑卒中患者肌力康复,值得进一步研究推广.

>麻痹性肠梗阻是由于腹部手术、腹腔感染或电解质紊乱后肠壁受到损伤或炎症刺激等影响而致肠功能紊乱、肠蠕动消失,肠内容物无法正常运行诱发的肠梗阻闫。近年来,随着人均寿命的增加,老年人患此病的比例逐渐增高,且往往起病急骤、进展迅速、合并症多,给治疗上带来很多难点。本文选取老年麻痹性肠梗阻患者48例进行临床观察,发现从肝郁脾虚论治疗效颇佳,现报告如下。

OBJECTIVE:Typical hemifacial spasm (HFS) commonly initiates from the orbicularis oculi muscle to the orbicularis oris muscle. Atypical HFS (AHFS) is different from typical HFS, in which the spasm of muscular orbicularis oris is the primary presenting symptom. The objective of this study was to analyze the sites of compression and the effectiveness of microvascular decompression (MVD) for AHFS.METHODS:The authors retrospectively analyzed the clinical data for 12 consecutive patients who underwent MVD for AHFS between July 2008 and July 2013.RESULTS:Postoperatively, complete remission of facial spasm was found in 10 of the 12 patients, which gradually disappeared after 2 months in 2 patients. No recurrence of spasm was observed during follow-up. Immediate postoperative facial paralysis accompanied by hearing loss occurred in 1 patient and temporary hearing loss with tinnitus in 2. All 3 patients with complications had gradual improvement during the follow-up period.CONCLUSIONS:The authors conclude that most cases of AHFS were caused by neurovascular compression on the posterior/rostral side of the facial nerve distal to the root entry zones. MVD is a safe treatment for AHFS, but the incidence of postoperative complications, such as facial paralysis and decrease in hearing, remains high.

Objective:To investigate the effects of low frequency vibroacoustic sound waves (16-160 Hz)on microcirculation and temperature of stomach meridian.Methods:The low frequency sound waves were played on the Five Shu Points of the stomach me-ridian on 30 healthy people.Then the changes of microcirculation and temperature were recorded by laser Doppler flowmetry and the effects on the points were analyzed.Results:There were different effects on the microcirculation and temperature of the stomach meridian with low different frequency acoustic waves.A1 #and A0#、A2#had peak value.And the most significant effect(P <0.05)was observed on the stomach meridian with the A1#tone (58.27 Hz)and there was significant statistical difference(P <0.01)compared with other points.A1#’s effect on the microcirculation of Neiting,Xiangu,Jiexi was significantly bigger then other points(P <0.01)and its effect on the temperature of Five Shu point had no statistical difference.Conclusion:The points of stomach meridian will selectively absorb low frequency sound waves.

目的 观察复方浙贝颗粒对人结肠癌HCT-116细胞增殖、凋亡的影响及其可能作用机制.方法 40只Wistar大鼠随机分为对照组和复方浙贝颗粒高、中、低剂量组,每组10只.复方浙贝颗粒高、中、低剂量组分别按8、4、2g/ (kg·d)灌胃,对照组给予0.1 ml/l0 g生理盐水灌胃,连续7天.于末次灌胃后1h制备各组药物血清.采用MTT法检测各组血清对人结肠癌HCT-116细胞抑制率,经流式细胞仪定量检测各组血清诱导HCT-116细胞凋亡率,Western blot方法检测各组血清对HCT-116细胞双微体-2(MDM2)、p53、p21蛋白表达的影响. 结果 复方浙贝颗粒高、中、低剂量组对HCT-116细胞增殖抑制率分别为40.00％、42.37％和29.15％,凋亡率分别为18.75％、20.00％、15.32％,均高于对照组(P＜0.05).48 h时复方浙贝颗粒高剂量组HCT-116细胞MDM2、p53、p21蛋白,复方浙贝颗粒中剂量组MDM2蛋白,复方浙贝颗粒低剂量组MDM2、p53蛋白表达均较对照组升高(P＜0.01);96h时复方浙贝颗粒各剂量组MDM2蛋白表达较本组48 h明显降低,p53蛋白表达较本组48 h明显升高(P＜0.01). 结论 复方浙贝颗粒能抑制人结肠癌HCT-116细胞增殖、促进凋亡,其作用机制可能与调节增加MDM2-p53信号通路有关.