目的 运用网络药理学方法及分子对接技术探讨黄芪-半夏"药对治疗非小细胞肺癌(NSCLC)的作用机制.方法 通过文献查找及 TCMSP 数据库筛选"黄芪-半夏"药对主要成分及作用靶点,在 GeneCards、PharmGKB、DrugBank、OMIM数据库获取 NSCLC相关靶点,利用 Cytoscape软件分别构建"中药-成分-靶点""中药-成分-靶点-疾病"相互作用网络;运用 STRING数据库构建蛋白互作网络,并根据拓扑学参数筛选"黄芪-半夏"药对治疗NSCLC的关键靶点;对关键靶点进行GO功能富集和KEGG通路分析,并构建"成分-靶点-通路"网络图,运用Auto Dock Vina 1.1.2 将得到的主要活性成分与关键靶点进行分子对接,运用PyMOL软件进行结果可视化.结果 共获得"黄芪-半夏"药对有效成分33 个,作用于227 个潜在靶点,NSCLC靶点1253 个,拓扑分析得到关键靶点97 个,其中度值≥中位数的靶点有48 个,包括TP53、AKT1、CASP3、JUN等.GO功能富集分析得到生物过程主要涉及细胞因子介导的信号通路,基因表达的正向调控,RNA聚合酶Ⅱ启动子转录的正调控;KEGG通路富集分析主要包括Pathways in cancer通路、肿瘤坏死因子信号通路、PI3K-Akt通路等,分子对接结果显示,"黄芪-半夏"药对主要活性化合物与5 个核心靶点的结合能力皆良好.结论"黄芪-半夏"药对可能通过槲皮素、山奈酚、黄芩素等主要活性成分,作用于TP53、AKT1、CASP3、JUN、VEGFA等相关靶点,干预Pathways in cancer、肿瘤坏死因子、PI3K-Akt等信号通路,协同产生调控肿瘤细胞周期、介导肿瘤细胞凋亡、抑制其增殖分化及转移等来防治NSCLC.

目的:分析郝万山教授治疗抑郁症的组方用药规律.方法:筛选 2015 年 5 月至 2020 年 1 月郝教授于北京中医药大学国医堂诊治的抑郁症病例,依据标准录入相关数据,应用中医传承辅助平台(V3.0)及SPSS 25.0,通过分析用药频次、四气五味、关联规则及聚类分析总结郝教授治疗抑郁症的组方用药规律.结果:筛选出符合标准的 495 个处方,涉及中药 170 味;中药频次前 3 位为陈皮、党参、石菖蒲;药性与药味以温、平及甘、辛、苦为主;高频药物组合前 3 位为"党参+陈皮""陈皮+石菖蒲""党参+石菖蒲";分析得到 30个药物组合关联规则;聚类分析得出 4 个核心聚类处方;常用经方有逍遥散,定志小丸等.结论:郝教授治疗抑郁症多从扶正气、宁心神、解郁结、化痰饮论治.

Objective: To explore the relationship between platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) and prognosis of lung cancer patients before cold ablation. Methods: Retrospectively analyze the case data of primary lung cancer patients who underwent cryoablation of lung argon helium knife in our hospital from January 2012 to March 2018. PLR and NLR were calculated based on the blood routine data of the patients within 1 week before the operation. value. The patients were followed up. The deadline for follow-up was June 2021. The survival curve (ROC curve) was drawn according to the patient's survival prognosis, and the Youden index was calculated to determine the optimal cutoff value of PLR and NLR, and grouped based on this analysis. The correlation between pre-PLR level and NLR level with clinicopathological characteristics and prognostic survival time of patients with primary lung cancer. Results: The best cut-off point was calculated according to the ROC curve and divided into high PLR group (PLR≥155.72, n=127) and low PLR group (＜155.72, n=87); high NLR group (≥2.91, n=120) and Low NLR group (<2.91, n=94); preoperative high PLR, high NLR group pT, pN, pM and TNM staging compared with low value group, the difference was statistically significant (P<0.05); Cox multivariate Analysis shows that high PLR, high NLR, high pT staging, high pM staging, and high TNM staging are independent risk factors affecting postoperative survival; the postoperative survival rate of the high-level PLRNLR group was significantly lower than that of the other groups, and the difference was statistically significant. significance. Conclusion: The significant increase of NLR and PLT before operation in patients with primary lung cancer is associated with poor prognosis; the combination of the two has potential clinical application value in assessing the survival of patients after surgery.

目的 运用数据挖掘技术探析郝万山教授治疗主证失眠处方用药规律.方法 收集郝万山教授2015年5月—2020年1月期间在北京中医药大学国医堂中医门诊部的门诊病历资料,采用中医传承辅助平台(V3.0)软件分别进行频次统计分析及关联分析,剖析郝万山教授主治失眠的处方配伍规律.结果 共纳入病例697例、纳入处方696首,合计纳入药物162味,归纳核心组方为:柴胡、党参、半夏、黄芩、桂枝、甘草、陈皮、远志、石菖蒲、酸枣仁、茯苓、白芍,常用加减药物组合为:五味子+麦冬、焦神曲+焦麦芽、淡豆豉+栀子、杜仲+桑寄生、熟地+当归、荆芥+防风等.结论 郝万山教授治疗失眠患者重视疏利少阳、通畅三焦、调和胃胆,善以和枢机、解郁结、益少阳、化痰浊、宁心神、定魂魄为法,寒温并用、攻补兼施,在核心处方基础上加减以调和五脏寒热与气血阴阳.

不宁腿综合征是一种神经系统感觉障碍疾病,表现为下肢深部不适感和强烈的活动欲望,夜间症状更加明显.首都国医名师郝万山认为其和肝的功能失调密切相关,基于"肝体阴而用阳"的理论,肝具有刚柔相济的生理特点及阳用易亢、阴体易亏、体用互病的病理特点,应以调其虚实、和其逆顺为准则,选用一贯煎和芍药甘草汤滋水涵木以养肝体,四逆散加减疏肝郁、畅气机以调肝用,兼以四君子汤顾护脾胃,四妙丸清热利湿,并结合临证所见灵活加减,临床取得良效.

恶性肿瘤为有形之阴邪,生长迅速、具有阳动之性,是故体阴而用阳.微创外科的蓬勃发展为肿瘤患者的治疗提供了新的机遇与挑战,在中医"孤阳不生,独阴不长"、"坚者削之""衰其大半而止"等理论指导下的肿瘤微创外科治疗可能激活机体的免疫功能,具有新的治疗前景和意义.

目的 挖掘名老中医从瘀论治胃癌的组方规律,并基于网络药理学探讨核心药物的分子作用机制.方法 计算机检索中国知网、万方、维普数据库2000年1月1日—2019年10月1日名老中医治疗胃癌的相关文献,结合人工检索书籍的方式收集名老中医处方;采用古今医案云平台(V1.5.6)对纳入处方的常用药对、核心药物组合等进行分析;采用中药系统药理学数据库和分析平台(TCMSP)、GeneCards及在线人类孟德尔遗传数据库(OMIM)筛选药物靶点和疾病靶点相互作用的有效靶点,并将有效靶点导入String数据库得到蛋白-蛋白相互作用(PPI)网络,利用R软件对有效作用靶点进行基因本体(GO)分析及京都基因和基因组百科全书(KEGG)通路富集分析.结果 共纳入处方68首,得到8个核心药物,筛选出131个活性成分,获得62个核心药物有效作用靶点.GO功能分析集中在类固醇激素反应、对有毒物质的反应、细胞核受体活性等,KEGG分析可得主要作用通路为PI3K-Akt信号通路、细胞凋亡、MAPK信号通路、缺氧诱导因子-1(HIF-1)信号通路等.结论 本研究结果提示活血化瘀核心药物主要通过影响细胞周期、促进细胞凋亡、逆转化疗耐药性、影响血管生成对胃癌发挥作用,为后期实验研究提供了理论依据.

Using a prospective longitudinal design, differences between abstinent alcohol-dependent patients (n = 15) and abstinent healthy volunteers (n = 11) were determined with respect to their psychological functioning and alcohol consumption patterns following abstinence. Results showed no differences in alcohol consumption. In 20% of the patients and 9% of the controls more than 10% of protocols indicated alcohol intake, and in 27% of the patients and 27% of the controls less than 10% of protocols indicated alcohol intake. Total abstinence was reported by 53% of the patients and by 64% of the controls. For patients, validation of self-reported alcohol consumption was carried out via biological markers. Patients and controls differed in terms of: increased sleep, euphoria, concentration, initiative, anxiety, negative and positive craving. pessimistic thoughts, autonomic disturbances, and humour. A gradual normalization back to baseline levels was observed for some symptoms. These results suggest that affective/mood states may be unstable for alcoholics, and further, that these symptoms may be related to the protracted withdrawal syndrome or may represent residual symptomatology.

Ginsenoside 20(S)-Rg3 is identified as an active saponin monomer which derived from red ginseng and is demonstrated to play an anti-tumor role in diverse cancers. MicroRNAs (miRNAs) are important regulators in the progression of cancers, containing esophageal squamous cell carcinoma (ESCC). It was reported that microRNA 324-5p (miR-324-5p) exerted critical functions in some cancers; however, the detailed molecular mechanism of miR-324-5p mediated by 20(S)-Rg3 to suppress cell viability in ESCC has not been explored. Herein, we explored the function of 20(S)-Rg3 or miR-324-5p on ESCC cell viability by MTT assay, colony formation assay, flow cytometry analysis and western blot analysis. The binding of miR-324-5p to its target gene, proteasome activator subunit 3 (PSME3), was confirmed through RNA pull down and luciferase reporter assays. The results indicated that 20(S)-Rg3 significantly inhibited cell viability and the cell cycle and facilitated cell apoptosis. Furthermore, this effect was strengthened with the increased concentration of 20(S)-Rg3. Moreover, we found that miR-324-5p level was increased under 20(S)-Rg3 treatment. Additionally, overexpressed miR-324-5p inhibited ESCC cell viability, and downregulated miR-324-5p recovered inhibited cell viability caused by 20(S)-Rg3. Further exploration verified that miR-324-5p targeted PSME3, and PSME3 deficiency countervailed the effect of miR-324-5p inhibition on ESCC cell viability under 20(S)-Rg3 treatment. Conclusively, 20(S)-Rg3 suppresses cell viability in ESCC via mediating miR-324-5p-targeted PSME3.

炎症性肠病(inflammatory bowel disease,IBD)是一种发病原因未十分明确的慢性复发性肠道炎症性疾病,包括3种亚型:溃疡性结肠炎(ulcerative colitis,UC)、克罗恩病(Crohn's disease,CD)、未定型结肠炎(indeterminate colitis,IC)[1-2].目前IBD的发病率越来越高,其发病机制可能与基因、环境、免疫及肠道菌群相关[1].人体肠道中定植着大量的菌群、真菌、病毒,它们的失调在IBD的发病过程中可能起了非常重要的作用.

目的:研究“老十针”缓解老年晚期非小细胞肺癌(NSCLC)患者氩氦刀冷冻治疗相关疲乏的临床疗效.方法:收集自2015年6月至2018年6月期间老年晚期NSCLC接受氩氦刀冷冻治疗并出现疲乏症状患者共63例,分为针刺治疗组32例(“老十针”+基础药物治疗)和对照治疗组31例(仅予基础药物治疗),比较两组疲乏程度评分、疲乏中医症状评分和生活质量评分(KPS).结果:术后1周,针刺治疗组疲乏程度评分较对照治疗组显著降低(P＜0.05),且针刺治疗组术后1周评分比术后当天亦显著下降(P＜0.05);针刺治疗组患者体倦乏力、气短懒言、食少纳呆症状评分较对照治疗组显著降低(P＜0.05);对照治疗组术后1周KPS评分比术后当天显著降低(P＜0.05),而针刺治疗组术后1周虽有下降,但差异无统计学意义.结论:“老十针”能有效缓解老年晚期NSCLC患者氩氦刀冷冻治疗相关疲乏状态,减轻体倦乏力、气短懒言、食少纳呆症状,减少氩氦刀冷冻治疗对生活质量的影响,具有积极的临床意义.

目的 探讨合并肾细胞癌(RCC)的多原发恶性肿瘤(MPMN)的发病特点、治疗方法及预后,以提高其临床诊治水平.方法 回顾性分析9例合并RCC的MPMN患者的临床资料,并随访生存情况.结果 9例患者中,男5例,女4例,确诊时患者的年龄为43～82岁.双原发恶性肿瘤(DPMN)7例,三原发恶性肿瘤2例.合并RCC的MPMN以消化系统和呼吸系统肿瘤最为常见.9例患者的中位生存时间为25个月,2年和3年生存率分别为66.7％和22.2％.结论 对恶性肿瘤患者定期随访可以在早期发现其他原发恶性肿瘤,通过临床分析提高对合并RCC的MPMN的认识也将有助于为患者制订恰当的治疗方案.

目的 探讨华蟾素注射液胸腔灌注治疗“湿热毒证”恶性胸腔积液的临床效果.方法 选取北京中医药大学东方医院2017年9月～2019年3月收治的“湿热毒证”恶性胸腔积液患者30例,采用随机数字表法将其分为治疗组和对照组,每组15例.所有患者均采用闭式胸腔穿刺引流术引尽胸腔积液,治疗组予华蟾素注射液,对照组予白介素-2胸腔灌注,每周3次,2周为1个疗程.比较两组治疗前后胸腔积液量、胸腔积液质[红细胞(RBC)、乳酸脱氢酶(LDH)、肿瘤标志物(TM)]、中医症状积分、卡氏功能状态评分(KPS)及血管内皮生长因子(VEGF)水平.结果 两组治疗后胸腔积液量情况比较差异无统计学意义(P＞ 0.05).两组治疗后RBC、TM水平比较,差异有统计学意义(P＜0.05);两组治疗后LDH水平比较,差异无统计学意义(P＞ 0.05).两组治疗后中医症状积分均低于治疗前,差异有统计学意义(P＜ 0.05).两组治疗前后KPS评分组内、组间比较,差异无统计学意义(P＞ 0.05).两组治疗前后VEGF水平组内、组间比较,差异均无统计学意义(P＞ 0.05).结论 华蟾素注射液胸腔灌注治疗“湿热毒证”恶性胸腔积液与降低胸腔积液RBC及TM的水平有关,其可能的作用机制是降低胸腔积液中VEGF表达.

目的 采用网状Meta分析方法比较冷冻消融、射频消融或微波消融单独或联合治疗原发性肺癌的疗效,为临床提供循证依据.方法 全面检索CNKI、维普、万方、the Cochrane Library、PubMed、Embase等数据库公开发表的关于冷冻消融、射频消融或微波消融治疗原发性肺癌的临床随机对照试验,检索时间为2016年1月至2020年7月,筛选出符合纳入标准的研究,按照Cochrane 5.1手册对纳入的研究进行文献质量评价与偏倚风险评估,采用ADDIS软件进行网状Meta分析与等级概率排序.结果 共纳入28项研究,2336例患者.一致性模型检验结果显示,微创消融联合化疗的疗效优于化疗或微创消融单独应用;在提高肿瘤控制率和1年生存率方面,冷冻消融、射频消融或微波消融联合或单独应用无明显差异.等级概率排序结果显示,冷冻消融联合化疗和微波消融联合化疗的疗效相近,且均有可能优于射频消融联合化疗.结论 联合疗法的疗效优于单独应用化疗或微创消融,冷冻消融和微波消融在控制肿瘤进展方面的效果更好,但在提高远期生存率方面无明显差异,但冷冻消融联合化疗有可能是更好的临床选择.

Objective To study the effects of traditional Chinese medicine (TCM) treatment on the lifetime and survival rate of elderly patients with advanced non-small cell lung cancer (NSCLC) after treated with cryoablation.Methods A total of 106 cases of elderly patients with advanced NSCLC who treated with cryoablation from January1, 2012 to June 30, 2017 were retrospectively collected. According to the post-operative treatment methods, they were divided into TCM treatment group, integrated TCM and western medicine group, and the western medicine treatment group. The primary observation indexes were survival times after operation, half-year survival rate and 1-year survival rate. Results Half-year and 1-year survival rate of the TCM treatment group was 68％ and 42％ respectively, which was higher than 44％ and 25％ in the western medicine treatment group. The survival time of the TCM treatment group was 15 months (95％ CI: 7. 58-22. 42), which was longer than 9 months (95％ CI: 4. 60-13. 40) in the western medicine treatment group. The difference was statistically significant (P < 0. 05). Comparison between the integrated TCM and western medicine group with the other 2 groups showed no statistically significant difference (P> 0. 05). The half-year survival rate was 66％ in patients who were treated with TCM, and the 1-year survival rate was 41％, which were higher than 44％ and 25％ in the patients without TCM treatment. The post-operative survival time was 15 months for patients treated with TCM (95％ CI: 11. 35-18. 65), which was longer than 9 months for patients without TCM treatment (95％ CI: 4. 60-13. 40). The difference was statistically significant (P < 0. 05). Patients who received anti-tumor therapy with western medicine showed lower post-operative survival rate and shorter post-operative survival, but the difference was not statistically significant (P> 0. 05). Conclusion TCM treatment is helpful for the prolongation of the survival time of advanced NSCLC patients after cryoablation.

目的 探讨血清钠水平与肝硬化患者Child-Pugh评分、并发症及生存期的关系.方法 收集2012年8月至2018年8月在辽宁省健康产业集团本钢总医院消化内科首次确诊为肝硬化的病例257例,根据患者入院时血清钠水平将其分为正常组和轻、中、重度低钠血症组.比较各组的Child-Pugh分级、并发症发生情况、腹腔积液量及生存期的差异.结果 4组患者Child-Pugh评分等级不同,差异有统计学意义(x 2=82.71,P＜0.001).4组患者血清钠水平与并发症发生率呈负相关,与腹腔积液严重程度呈负相关(rs=0.64,P＜0.001),与生存率呈正相关,且各组患者生存期存在统计学差异(x 2=50.12,P＜0.001).结论 血清钠水平可作为肝硬化患者病情和预后判断的指标之一.

目的:以“护场”理论为指导,对氩氦刀不完全冷冻治疗34例非小细胞肺癌(NSCLC)进行疗效及安全性评价.方法:采用回顾性研究方法,观察34例接受不完全冷冻消融治疗的NSCLC患者的生存期及不良反应.结果:34例NSCLC患者术后6、12、18、24、30个月、36个月生存比为0.72、0.41、0.36、0.16、0.16、0.16;术后中位生存期为8.43个月,其中腺癌的中位生存期为11.87个月,鳞癌为8.1个月,大细胞癌生存期为2.4个月,差异有统计学意义(P＜0.05);Ⅲ期患者中位生存期为12.17个月,Ⅳ期为7.53个月;术后不良反应以咳嗽、咯血、发热、疼痛为主,经对症治疗后均可缓解.结论:“护场”理论指导下的不完全冷冻消融术治疗晚期NSCLC疗效确切,安全性较好.

目的 研究miR-125b靶向STAT3对胃癌细胞SGC-7901侵袭迁移能力的影响.方法 运用qPCR法检测miR-125b在胃癌及癌旁组织中的表达,运用Western blot法检测STAT3在胃癌组织及癌旁正常组织中的表达,用双荧光素酶报告基因系统检测miR-125b对STAT3转录活性的影响,用Transwell实验检测过表达miR-125b对SGC-7901细胞侵袭迁移能力的影响,用Western blot法检测过表达miR-125b后SGC-7901细胞STAT3的表达变化.结果 与癌旁正常组织比较,胃癌组织miR-125b的表达水平明显降低,STAT3蛋白表达水平明显升(P＜0.01).双荧光素酶报告基因系统检测结果显示,miR-125b可以直接调控STAT3的转录活性.过表达miR-125b后,SGC-7901细胞的侵袭和转移能力明显降低,STAT3的表达水平下调(P＜0.01).结论 miR-125b可靶向STAT3的表达调控SGC-7901细胞的侵袭迁移能力.

目的 探讨冷冻治疗术中不同冰球覆盖率对40例非小细胞肺癌患者生存期的影响,为控制ⅢB-Ⅳ期肺癌患者病情发展提供治疗策略.方法 采用回顾性研究方法,将40例非小细胞肺癌患者根据冰球覆盖率的不同分为治疗1组(冰球覆盖率<70％)、治疗2组(≥70％),记录氩氦刀术中的影像学信息、患者术后生存期以及不良反应,总结冰球覆盖率与患者生存期及安全性关系.结果 40例患者中冰球覆盖率<70％组17例,冰球覆盖率≥70％组23例,总体术后中位生存期为8.1(3.0,13.2)个月,治疗1组术后中位生存期为12.2(5.3,19.0)个月,治疗2组术后中位生存期为6.5(4.6,8.4)个月,差异无统计学意义(P>0.05);治疗2组术后及术后7天、术后14天的不良反发生率高于治疗1组.结论 部分冷冻消融能够控制疾病进展,减轻不良反应,适合晚期肺癌患者.

Objective To investigate the effect of miR-181b targeting N-myc downstream regulated gene 2 (NDRG2) on the invasion and migration of gastric cancer cell SGC-7901. Methods The expression of miR-181b in gastric cancer and adjacent tissues was detected by qPCR. The expression of NDRG2 in gastric cancer and adjacent tissues was detected by Western blot. The effect of miR-181b on the transcriptional activity of NDRG2 was determined by double luciferase reporter gene system. The transwell test was used to detect the ability of invasion and migration of SGC-7901 cells after overexpression of miR-181b. The expression of NDRG2 in SGC-7901 cells was detected by Western blot after overexpression of miR-181b. Results Compared with the normal tissues, the expression level of miR-181b in gastric cancer tissue was significantly increased, and the expression level of NDRG2 protein was significantly decreased (P＜0. 01). miR-181b could directly regulate the transcriptional activity of NDRG2. After overexpression of miR-181b, the invasion and metastasis of SGC-7901 cells increased significantly, and the expression level of NDRG2 was down-regulated (P＜0. 01). Conclusion miR-181b could regulate the invasion and migration of SGC-7901 cells by targeting NDRG2.