ETHNOPHARMACOLOGICAL RELEVANCE:Niuhuang Jiedu (NHJD) is a Chinese medicine prescription containing realgar (As2S2), which is neurotoxic, and seven other traditional Chinese medicines (TCMs). However, whether the multiple TCMs contained in NHJD can mitigate the neurotoxicity of realgar is yet to be elucidated. AIM OF THE STUDY:This study aimed to investigate the effect of NHJD on realgar-induced neurotoxicity and elucidate its underlying mechanisms. MATERIAL AND METHODS:Caenorhabditis elegans was treated with realgar suspension (1-8 mg/mL) for 48 h. Transgenic nematode strains labeled with green fluorescent protein were used to evaluate neuronal structural damage. Locomotion and perception behaviors were assessed by measuring head thrashes, body bends, and chemotaxis. Oxidative stress was determined by detecting reactive oxygen species (ROS), lipofuscin, and glutathione-S-transferase-4 (GST-4) levels. Subsequently, a quantitative reverse transcription-polymerase chain reaction was employed to analyze gene expression associated with oxidative stress, whereas the role of the p38 MAPK pathway was investigated using KU25 nematodes. Finally, arsenic species in the nematodes were estimated using high-performance liquid chromatography-atomic fluorescence spectrometry. Data analysis was performed using analysis of variance or rank tests with SPSS 26.0. RESULTS:Treatment of nematodes with 8 mg/mL realgar resulted in significant damage to dopaminergic and GABAergic neurons, impaired locomotor and perceptual behavior (at 4-8 mg/mL), and induced oxidative damage (at 2-8 mg/mL). A neuron-defective model was established using 8 mg/mL realgar to gauge the effects of NHJD on realgar-induced damage. The findings indicated that NHJD, containing the same dose of realgar, significantly alleviated neuronal damage and neurobehavioral impairment and increased ROS, lipofuscin, and GST-4 levels. In addition, NHJD reduced the expressions of oxidative stress-related genes (gst-4, skn-1, gcs-1, gss-1, ctl-2, ctl-3, and sod-1) compared with realgar alone. Nonetheless, significant differences in skn-1 expression, neurobehavior, ROS, or lipofuscin levels were not observed between the realgar and NHJD groups in KU25 nematodes. Moreover, arsenic methylation metabolites were not identified in the nematodes. CONCLUSIONS:The multiple TCMs contained in NHJD effectively mitigated realgar-induced dopaminergic and GABAergic neurotoxicity in nematodes, and pmk-1 may play a crucial role in NHJD's alleviating realgar-induced neurotoxicity via the p38 MAPK signaling pathway.

Ethnopharmacological relevance: Realgar (As2S2 or As4S4) is a traditional Chinese medicine (TCM) containing arsenic. Existing studies have shown that it has genotoxicity under long-term use with large doses. Niuhuang Jiedu (NHJD) is a Chinese medicine prescription containing realgar and seven other TCMs. Whether the multiple TCMs combination in NHJD can reduce the genotoxicity induced by realgar in equivalent doses is still unknown. Aim of the study: To research the effect of NHJD on realgar's genotoxicity and the possible mechanism involved based on the arsenic methylation metabolic pathway. Material and methods: Six groups (control, realgar (0.8 g/kg), NHJD (12.48 g/kg), as well as Glycyrrhiza uralensis Fisch (GU), Scutellaria baicalensis Georg (SB), Rheum palmatum L (RP) plus equivalent doses of realgar, respectively) were set up. ICR mice were intragastric administered for 12 weeks. First, genotoxicology tests were conducted to evaluate the effect of NHJD, GU, SB, and RP on reducing realgar's genotoxicity. The inorganic arsenic (iAs), dimethyl arsenic acid (DMA), and monomethyl arsenic acid (MMA) were determined by HPLC-AFS, and the iAs%, MMA%, DMA%, primary methylation index (PMI), etc. Were calculated. Meanwhile, the S-adenosyl methionine (SAM) and arsenate reductase (ARR) levels, the arsenic (+3)methyltransferase (As3MT), purine-nucleoside phosphorylase (PNP), glutathione S-transfer omega1 (GSTO1) gene expression were detected, aimed to explore the possible alleviation mechanisms of NHJD. Results: The combination of multiple TCMs in NHJD decreased the levels of MN parts per thousand, SPA%, and DNA damage caused by realgar, with similar effects observed when SB, RP, and GU were used separately with realgar. Notably, the iAs% significantly decreased, while DMA% and PMI notably increased in the NHJD and realgar + SB (or RP) groups compared to the realgar-only group (P < 0.05). Increases in SAM and ARR levels were observed across various groups, but only the ARR increase in the NHJD group was statistically significant. Moreover, significant increases in As3MT mRNA and GSTO1 mRNA were noted in the NHJD group, and PNP mRNA levels significantly rose in the realgar + SB group. Conclusions: This study revealed that NHJD could attenuate the genotoxic effects of realgar. The botanicals SB, RP, and GU within NHJD may be key contributors to this effect. Enhancements in arsenic methylation capabilities through increased levels of SAM and ARR and elevated gene expressions of As3MT, PNP, and GSTO1 suggest potential mechanisms behind these findings.

目的 评价潜在类别模型在出血性中风辨证分类研究中对于潜在证候类型探索的效果.方法 利用R软件poLCA包,采用潜在类别模型对 480 例出血性中风患者的 62 条证候要素信息进行建模分析,筛选合适的适配模型,提取各潜在类别中包括的证候要素,定义各潜在类别的证候类型,并对患者进行分类预测.结果 通过比较选择了潜在类别数为 3 的模型,将 62 条证候要素汇聚成了中脏腑脱证、中脏腑闭证之中脏、中脏腑闭证之中腑 3 个潜在证候类型,并通过预测将 480 名患者分别归到 3 个亚组,人数分别为 237、165、78 人.结论 潜在类别模型可以探索出血性中风的潜在证候分类,分类结果符合中医理论,在出血性中风辨证分类研究中,可将其分类结果作为参考.

Curriculum ideology and politics is an important measure of the current ideological and political education mode reform in colleges and universities,and also a glorious mission given to college teachers in the new era.There are rich ideological and political elements in the Preventive Medicine course for TCM Major.Teachers should take"building morality and cultivating talents"as the fundamental starting point,look for the touch point of ideological and political education,and exert the function of recessive moral cultivation of the course.This paper summarizes the typical ideological and political elements in the Preventive Medicine course for TCM Major,and reflects how to improve the actual effect of ideological and political education in Preventive Medicine course from improving teachers'own ideological and political quality,establishing curriculum ideology and politics goals,exploring diversified ideological and political teaching methods and attaching importance to the effect evaluation of curriculum ideology and politics.The objective is to provide reference for improving the ideological and political education of Preventive Medicine course and lay a foundation for cultivating outstanding TCM talents.

Ethnopharmacological relevance: Niu Huang Jie Du prescription (NHJD) is a traditional Chinese medicine (TCM) widely used in patients suffering from excessive inner fire toxin (Huo Du Nei Sheng) syndrome, such as sore throat, gingival swelling, and pain, mouth and tongue sores, etc. This formula contains realgar (As4S4) which is one of the 28 toxic medicinal materials promulgated by the Chinese Ministry of Health. Many studies reported its toxicity on the liver and kidney, and the detoxification effect of NHJD. However, its detoxification mechanism is still unclear. Aim of the study: To clarify the detoxification mechanism of NHJD to realgar, this study evaluated the detoxi-fication effect of NHJD on realgar exposure in mice, and analyzed differences in mRNA expression profiles in liver tissues and associated functional predictions. Material and methods: ICR mice were administered with NHJD, realgar, and CMC-Na as blank control for 12 weeks, respectively. Liver injury was evaluated by histopathologic examination and liver mRNA gene were sequenced by Illumina. Differentially expressed gene, functionally enrichment and protein association network analysis were conducted.Results: 43 genes were screened out, among which 15 genes in the realgar group were decreased, but the extent of the decline has been restored in the NHJD group. The remaining 28 genes have exactly the opposite trends. Functional module analysis revealed that those detoxification function-related genes were primarily for positive regulation of glutathione metabolism, P450 on the metabolism of exogenous compounds, oxidative stress and immune-related, etc.Conclusions: The results indicated that realgar mainly causes liver damage by changing the common enzymes of drug metabolism, especially the expression of genes related to CYPs, GSTs family, oxidative stress, and com-plement immunity, while the TCM prescription NHJD has a regulatory effect on the abnormal expression of corresponding genes. Our results will provide some clues for the detoxification mechanism of arsenic-containing TCM prescriptions.

目的:了解医教协同背景下江苏省临床医学硕士专业学位研究生的专业认同及满意度情况,为后续的教学与管理工作提供参考.方法:对533名江苏省临床医学硕士专业学位研究生进行问卷调查,对数据进行描述统计、差异性检验和多重线性回归分析.结果:临床医学硕士专业学位研究生对于医教协同培养模式的平均满意度为(3.46±0.70);其中90.7％的人认可该培养模式,61.3％的人愿意参与该计划;医教协同培养模式的认同度、所属医院与经济补贴是影响满意度的因素(P<0.05).结论:江苏省临床医学硕士专业学位研究生对医教协同培养模式的满意度处于中等偏上水平,在课程设置、上课时间安排、科室轮转安排、经济补贴等方面有待进一步完善.

Background Nowadays, acute intracerebral hemorrhage stroke (AICH) still causes higher mortality. Liangxue Tongyu Formula (LXTYF), originating from a traditional Chinese medicine (TCM) prescription, is widely used as auxiliary treatment for AICH. Objective To dig into the multicomponent, multitarget, and multipathway mechanism of LXTYF on treating AICH via network pharmacology and RNA-seq. Methods Network pharmacology analysis was used by ingredient collection, target exploration and prediction, network construction, and Gene Ontology (GO) and KEGG analysis, with the Cytoscape software and ClusterProfiler package in R. The RNA-seq data of the AICH-rats were analyzed for differential expression and functional enrichments. Herb-Compound-Target-Pathway (H-C-T-P) network was shown to clarify the mechanism of LXTYF for AICH. Results 76 active ingredients (quercetin, Alanine, kaempferol, etc.) of LXTYF and 376 putative targets to alleviate AICH (PTGS2, PTGS1, ESR1, etc.) were successfully identified. The protein-protein interaction (PPI) network indicated the important role of STAT3. The functional enrichment of GO and KEGG pathway showed that LXTYF is most likely to influence MAPK and PI3K-Akt signaling pathways for AICH treatment. From the RNA-seq of AICH-rats, 583 differential mRNAs were identified and 14 of them were consistent with the putative targets of LXTYF for AICH treatment. The KEGG pathway enrichment also implied that the MAPK signaling pathway was the most correlated one among all the related signaling pathways. Many important targets with expression changes of LXTYF for AICH treatment and their related pathways are great markers of antioxidation, anti-inflammatory, antiapoptosis, and lowering blood pressure, which indicated that LXTYF may play mutiroles in the mechanisms for AICH treatment. Conclusion The LXTYF attenuates AICH partially by antioxidation, anti-inflammatory, and antiapoptosis and lowers blood pressure roles through regulating the targets involved MAPK, calcium, apoptosis, and TNF signaling pathway, which provide notable clues for further experimental validation.

目的:检测并比较雄黄与四种甲基化代谢物(MMAⅢ、DMAⅢ、MMAⅤ及DMAⅤ)遗传毒性大小.方法:以CHL细胞为研究对象,对雄黄浸出液和四种甲基化代谢物开展细胞毒性试验确定各自的IC50;各物质统一以1/4 IC50 为剂量标准,开展染色体畸变实验、微核实验、单细胞凝胶电泳实验,进行遗传毒性的检测与比较.结果:各物质在1/4 IC50 给药剂量下,雄黄浸出液染色体畸变率为7.5％,MMAⅢ和DMAⅢ畸变率分别是10％和14％,而MMAⅤ和DMAⅤ畸变率在5％～10％之间;雄黄浸出液与四种甲基化代谢物均能引起CHL细胞微核率增加,且除雄黄浸出液外,四种甲基化代谢物与空白对照组比较差异均有统计学意义(P＜0.01);各物质均能引起CHL细胞的彗星尾长、Olive尾距、尾DNA％增加(P＜0.05),且MMAⅢ和DMAⅢ组的上述三个观察指标较雄黄浸出液组明显升高(P＜0.05).结论:雄黄浸出液的遗传毒性明显低于MMAⅢ和DMAⅢ,但与MMAⅤ和DMAⅤ相比未见显著差异.

The alkaline comet assay has been widely used to determine genotoxicity in human populations exposed to arsenic. The sample sizes of earlier studies were usually small, and inconsistent results were found. Meta-analyses can merge the results of multiple studies of the same type and increase the credibility of the conclusion by increasing the sample size. Thus, to investigate the monitoring effect of alkaline comet assay on genotoxicity for arsenic exposed population, meta-analyses were performed. Thirteen studies were found to meet the inclusion criteria and were included in this study; of them, twelve articles were of medium quality (15-20 points), only one study was of high quality (21-27 points). Meta-analyses showed that the overall estimates of Mean Ratio (MR, defined as the mean value of the response in the exposed group divided by that in the reference group) were 2.81 (95 % confidence interval (CI) 1.93-4.10); 2.37(95 % CI, 1.73-3.26), and 1.69(95 %CI, 1.29-2.20) for comet tail length, % tail DNA, and tail moment, respectively. This shows that the level of DNA damage in arsenic exposed population is significantly higher than that in control populations. A meta-analysis of the correlation coefficients showed that the overall estimate was 0.52 (95 %CI, 0.48-0.56, P<0.05) with all correlation coefficients included, but it changed to 0.24 (95 %CI, 0.17-0.28, P<0.05) when two abnormal correlation coefficients were excluded, suggesting there was a positive correlation between arsenic load in vivo and DNA damage, but the overall estimate value of coefficients was unstable. Therefore, we conclude that the alkaline comet assay can be used as an effective genotoxic biomonitoring tool for arsenic-exposed populations. However, more and higherquality studies are still needed to verify its actual application value.

"课程思政"是当前高等教学中加强大学生思想政治教育的主要途径之一.本文通过探索中医院校"预防医学"课程思政的建设,从教学内容、教学方法、教学团队建设、考核方式四个方面论述了专业知识传授和思政教育育人的有机融合,在教学中实施"知识传授"与"价值引领"同向同行,培养德术兼备的"卓越医生".

目的:系统评价雄黄及其复方治疗骨髓增生异常综合征(MDS)的临床疗效及安全性.方法:全面检索雄黄及其复方治疗MDS的研究文献,筛选合格文献,采用Stata10.0软件对纳入文献中的数据进行系统分析与评价.结果:共纳入5篇完全随机对照研究,Meta分析结果显示,试验组的总有效率明显高于对照组pRR=1.19,95％ CI (1.05,1.35),P=0.01],但完全缓解率两组间未见有明显差异.纳入17篇单组率研究,Meta分析结果显示,合并后雄黄及其复方治疗MDS的总有效率为86.0％[95％ CI (0.82,0.89),P=0.000];完全缓解率为7.0％[95％CI(0.04,0.09),P=0.000];不良反应率为4.0％[95％CI(0.01,0.06),P=0.001].结论:雄黄及其复方治疗MDS,具有较好的疗效和较低的不良反应率,可以作为MDS治疗的有效替代治疗药物.但此证据尚需高质量的临床研究进一步证实.

Background As a traditional Chinese medicine (TCM) prescription for acute stroke, Liangxue Tongyu formula (LXTYF) was widely used as auxiliary treatment measure in some clinical practice. This study aimed to evaluate the clinical efficacy and safety of LXTYF combined western conventional medicine (WCM) with WCM only for acute intracerebral hemorrhage (ICH). Methods We systematically searched PubMed, Embase, Cochrane Library, CMB (Chinese biomedicine database), CNKI (China National Knowledge Infrastructure), WanFang, and VIP until August 2019 to confirm relevant randomized controlled trials (RCTs) compared the combination of LXTYF and WCM with WCM alone for the treatment of acute ICH. Two investigators independently assessed the risk of bias, and extracted and analyzed the data from the identified studies using RevMan 5.3.0 software following Cochrane's standard and PRISMA guidelines. The herbal compositions of LXTYF were also assessed. Results 15 RCTs were identified, totally recruiting 1648 patients with acute intracerebral hemorrhage. Compared with the WCM alone, the combination therapy of LXTYF with WCM could improve the clinical effective rate (RR, 1.21; 95% CI, 1.15-1.25, P < 0.05) and ADL score (MD, 18.09; 95% CI, 12.11-24.07; P < 0.05), and reduce syndrome scores of the TCM (MD, -4.11; 95% CI, -4.69 to -3.53; P < 0.05) and the Glasgow outcome score(GOS) (MD=0.43, 95%CI: 0.06 to 0.79, P=0.02) Moreover, there was no sufficient evidence to indicate the adverse effects would increase compared with WCM alone. Conclusion Based on current evidence, we concluded that the combined therapy had some benefits in treating acute intracerebral hemorrhage. However, considering the potential biases and limitations of our study, additional large, high-quality RCTs are required in the future to confirm or refute the effects of LFTYF combined with WCM in acute stroke.

The micronucleus (MN) assay has been used to determine the potential genotoxic effects in human populations exposed to arsenic. Some of these studies found an increase in MN frequency among exposed individuals, but others found no increase or inconclusive results. Thus, the main purpose of this current study was to investigate whether MN can be used as a biomarker for the arsenic exposure, as well as whether or not the different cell types that have been used to monitor MN frequency differ in their sensitivity to upon arsenic exposure. A systematic literature review was conducted followed by a meta-analysis. The review identified 25 useful studies with data from 3232 exposed individuals (15 studies assaying lymphocytes, 16 assaying buccal cells, and 9 assaying urothelial cells), with 18 studies measuring drinking water exposure, 5 measuring occupational exposure, one measuring coal burning, and one measuring dietary exposure. The meta-analysis indicated that the overall estimates of Mean Ratio (MR, defined as the mean value of the response in the exposed group divided by the mean value of the response in the reference group) were 2.95 (95% confidence interval (CI): 2.00 to 4.35), 2.36 (95% CI: 1.77 to 3.15), and 2.82 (95% CI: 1.86 to 4.28) for MN assays conducted with lymphocytes, buccal cells, and urothelial cells in the MN assay, respectively. Subgroup analysis showed that when the exposure method was drinking water, the MN frequencies increased significantly in lymphocytes (MR = 3.59, 95% CI: 2.30 to 5.60), in buccal cells (MR = 2.35, 95% CI: 1.76 to 3.15), and in urothelial cells (MR = 3.16, 95% CI: 2.02 to 4.97). However, when the exposure method was the occupational setting or others, the MN detection using the three types of cells did not find significant differences between groups. Subgroup analysis also showed that lymphocyte MN frequencies increased significantly in both routine-culture MN assays (MR = 2.88, 95% CI: 1.15 to 7.24) and cytokinesis-block MN assays (MR = 2.89, 95% CI: 1.84 to 4.55). The performance of the MN assay with different types of cells was also compared, but no significant differences were found. Therefore, our analysis indicates that MN can be used as an effective biomarker for monitoring arsenic-exposed populations, and that MN assays conducted with lymphocytes, buccal cells, and urothelial cells do not differ in their ability to detect the genetic damage from arsenic.

目的:系统评价复方黄黛片治疗急性早幼粒细胞白血病(APL)的临床疗效与安全性.方法:采用Cochrane循证医学系统评价的方法,全面检索复方黄黛片治疗APL的随机对照和半随机对照的研究文献,筛选合格的文献进行质量评价,数据采用RevMan5.3进行分析.结果:共鉴定并纳入13个临床研究,合计848例患者.与对照组相比,复方黄黛片组的死亡率[RR 0.42,95％ CI(0.25,0.71)]和复发率[RR 0.25,95％ CI(0.07,0.85)]明显降低;但无病生存率、完全缓解率、肝功能损害未见有明显改变;复方黄黛片可引起胃肠道不适反应的增加[RR 1.54,95％ CI(1.06,2.04)].结论:现有临床证据表明,复方黄黛片治疗APL可降低死亡率和复发率,但亦可能引起胃肠道不适反应增加.现有证据尚需更多大样本、高质量的随机对照研究予以证实.

将互联网+技术的现代化教学工具雨课堂,运用到理论性较强的《流行病学》的课堂教学中,以期让学生主动参与流行病学常用研究方法的设计、实施、数据分析与结果解释全过程.通过雨课堂的资料推送系统实现课前-课中-课后的强化学习,让不具备预防医学背景的中医药学生充分掌握疾病预防控制的核心理念、原理以及较高的公共卫生意义.

目的:探讨牛黄解毒片方中中药配伍能否减低雄黄的肝毒性及其与肝细胞凋亡的关系.方法:40只ICR小鼠随机分为雄黄组,牛黄解毒片全方组(7.8 g·kg-1),牛黄解毒片全方去甘草黄芩大黄组(3.8 g·kg-1),牛黄解毒片全方去雄黄组(7.3 g·kg-1)和正常组5组,雄黄组剂量设置为0.5 g·kg-1,根据《中国药典》的牛黄解毒片组方比例,设置其他给药组剂量(含等效雄黄量),各组经口给药9周,观察小鼠肝组织病理变化与氧化损伤,并应用末端转移酶标记技术(TUNEL)和免疫组化法检测肝细胞原位凋亡和凋亡相关分子Bcl-2和Bax的表达情况.结果:雄黄组小鼠肝组织出现显著水肿,且局部有坏死,而牛黄解毒片全方组及其他给药组的肝组织未见明显异常;与正常组比较,雄黄组的丙二醛(MDA)明显升高(P＜0.05);TUNEL凋亡指数,Bax表达平均吸光度A明显增加,Bcl-2表达平均A明显减少(P＜0.05);与雄黄组比较,牛黄解毒片全方组的MDA明显降低(P＜0.05),TUNEL凋亡指数,Bax表达平均A明显下降,Bcl-2表达平均A明显增加(P＜0.05);全方去甘草、黄芩、大黄后,凋亡指数较全方组增加,Bax表达亦明显增加,但Bcl-2表达无明显变化.结论:牛黄解毒片方中中药配伍可减低雄黄的肝毒性,抑制雄黄诱导的肝细胞凋亡可认为是牛黄解毒片配伍减低雄黄肝损伤的分子机制之一,抑制过程可能是通过促进Bcl-2表达而阻碍Bax表达来实现的,抑制药物与甘草、黄芩、大黄3味中药有关.

目的:探讨甘草对As2O3所致的小鼠遗传毒性能否产生抑制作用.方法:ICR小鼠随机分为As2O3组、As2O3加不同剂量甘草组和阴性对照组,分别开展小鼠骨髓嗜多染红细胞微核试验和小鼠精子畸形试验,观察甘草和As2O3联合给药对小鼠微核形成率和精子畸形率的影响;同时采用原子荧光光度法,检测不同组小鼠体内肝、肾组织砷元素的含量,分析甘草配伍对砷元素在小鼠体内吸收分布的影响.结果:As2O3加7.69g/kg甘草组和As2 O3加15.38g/kg甘草组的小鼠微核形成率较单独As2O3 (4.5mg/kg,1/10 LD50)组明显降低;As2O3加1.54g/kg、7.69g/kg和15.38g/kg甘草组的小鼠精子畸形率均较单独As2 O3组明显降低;As2O3加不同剂量甘草组的小鼠肝、肾组织砷元素含量均降低,但仅As2O3加15.38g/kg甘草组差异有显著性.结论:甘草对As2O3所致的小鼠遗传毒性有抑制作用,减少As2O3在体内组织的吸收与分布可能是机制之一.

目的 探讨牛黄解毒片方中中药配伍对有毒中药雄黄是否具有减毒作用及其可能减毒药味.方法 设立牛黄解毒片全方及其不同拆方组,ICR小鼠经口给药9周后,采用彗星技术、骨髓细胞微核技术、组织病理等方法,观察牛黄解毒片方中中药配伍对有毒中药雄黄引起的遗传毒性及肝、肾组织损伤的影响.结果 与单味雄黄组比较,牛黄解毒片全方组的小鼠外周血细胞DNA损伤、骨髓嗜多染红细胞微核形成率、精子畸变率及肝、肾损伤明显减低;与全方组比较,全方中撤去甘草、黄芩、大黄三味中药后,微核形成率、精子畸变率及肝、肾组织结构未见明显改变,但DNA损伤作用明显增强,且肝细胞及肾小管上皮细胞水肿增加.结论 牛黄解毒片全方配伍对雄黄有减毒作用,减毒药味可能与甘草、黄芩、大黄有关.

BACKGROUND: Chitosan modification for magnetic iron oxide nanoparticles can improve the agglomeration and stability of magnetic iron oxide nanoparticles, and in addition, it can be used for tumor hyperthermia and gene therapy in the future.OBJECTIVE: To explore the biocompatibility of magnetic chitosan microspheres which have the potential application in tumor hyperthermia and gene therapy.METHODS: Magnetic iron oxide nanoparticles were prepared using the modified chemical precipitation.Phacoemulsification method was used to add chitosan into magnetic iron oxide nanoparticles in the preparation of magnetic chitosan microspheres. Then, the following tests were performed.(1) Cytotoxicity test: L-929 cells were cultured in 1640 medium, polyacrylamide monomer solution, 100%, 75%, 50%, 25% of magnetic chitosanmicrosphere extracts.(2) Hemolysis test: Magnetic chitosan microspheres leaching solution, saline and distilled water were added.(3) Micronucleus test: Kunming mice were intraperitoneally injected with magnetic chitosan microspheres suspension containing 5, 3.75, 2.5, 1.25 g/kg iron oxide magnetic fluid, cyclophosphamide and saline, respectively.RESULTS AND CONCLUSION: Magnetic chitosan microspheres of 200-300 nm in diameter had an increased dispersion effect. The result of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay showed that the toxicity of the material on L-929 cell lines belonged to no cytotoxicity. In the hemolysis test, the hemolysis rate of magnetic chitosan microspheres was 0.69% far less than 5%. In the micronucleus test, magnetic chitosan microspheres suspension did not cause DNA fragmentation and aneuploidy, and did not result in genetic toxicological effects produced by micronuclei. The magnetic chitosan microspheres did not appear with cacogenesis and mutagenesis. From the results, magnetic chitosan microspheres are a kind of high biocompatibility material.

疑难病治疗是医学领域的一大难题。中医和西医因各自的理论体系不同,故在疑难病的诊断和治疗等方面存在很大差别,本文对此进行了阐述,并提出中西医结合可以优势互补,提高疑难病的治疗效果。