目的 观察贝母瓜蒌散对慢性阻塞性肺疾病(COPD)模型大鼠肺组织中p38MAPK信号通路和肿瘤相关因子受体因子MIP-T3的影响.方法 将40只SD雄性大鼠随机分为正常组、模型组、地塞米松组及贝母瓜蒌散组,每组10只;采用脂多糖(LPS)气管滴入加烟熏法制造COPD大鼠模型,为期30 d.从造模第8天开始,地塞米松组给予地塞米松注射液腹腔注射(2 mg/kg),贝母瓜蒌散组给予贝母瓜蒌散灌胃(20 ml/kg),1次/d,连续22 d,模型组予0.9% 生理盐水灌胃(20 ml/kg).Western印迹检测p38MAPK蛋白和MIP-T3蛋白的表达水平.结果 与正常组比较,模型组大鼠肺组织p38MAPK和MIP-T3的表达明显升高(P<0.05);与模型组比较,地塞米松组和贝母瓜蒌散组可降低大鼠肺组织中p38MAPK和MIP-T3的表达(P<0.05);而地塞米松组和贝母瓜萎散组p38MAPK和MIP-T3的表达无明显差异(P>0.05).结论 贝母瓜蒌散有抑制p38MAPK和MIP-T3表达的作用.

“5+3”背景下的中医住院医师规范化培训工作刚刚起步,面临着学生认可度低、基地设施不足、管理考核制度不完善、学生临床能力较差等问题.全文从如何认识规培重要性、培训医院资质要求、规培医师待遇、强化医患沟通、理论与临床并重、完善考核制度等方面探讨怎样通过住院医师规范化培训培养大批高水平、高素质的中医临床医师.

目的:观察贝母瓜蒌散对慢性阻塞性肺疾病(COPD)大鼠肺组织中血管紧张素Ⅱ(AngⅡ)表达的影响,初步探讨贝母瓜蒌散对肺组织的保护作用及其机制.方法:将30只SD大鼠随机分为正常组、模型组和贝母瓜蒌散组,每组10只.正常组大鼠常规喂养,其余2组大鼠采用脂多糖(LPS)器官滴入加烟熏法,建立大鼠COPD模型.在造模第8天,正常组和模型组大鼠灌胃给予生理盐水(20 mL· kg-1),贝母瓜蒌散组大鼠灌胃给予贝母瓜蒌散(20mL· kg-1),每天1次,连续22 d.采用免疫组织化学法和免疫印记方法观察各组大鼠肺组织中AngⅡ表达情况.结果:与正常组比较,模型组大鼠出现了喘、咳嗽、气急、精神萎靡、吐痰流涎和毛发牙齿发黄等症状和体征.与正常组比较,模型组大鼠肺组织中AngⅡ的表达水平明显增加(P＜0.05);与模型组比较,贝母瓜蒌散组大鼠肺组织中AngⅡ表达水平减少(P＜0.05).结论:贝母瓜蒌散能抵抗AngⅡ诱导的细胞炎症反应,明显改善COPD大鼠喘咳和气急等症状.

Objective:To investigate the changes of leukotriene B4(LTB4)、15-hydroxyeicosatetraenoic acid(15-HETE)in lung of an animal model with chronic obstructive pulmonary disease(COPD),and the effects of ipratropium.Methods:Thirty-six male Wistar rats were randomized into three groups,Group A(normal controls,group B(COPD),group C(smoking+ipratropium),with 12 rats in each group.Group C receiving inhaling ipratropium 0.025%10ml and once a day for 23 days.Pulmonary functions of the rats were assessed, concen-trations of LTB4 15-HETE in lung tissue were measured by RP-HPLC.Results:The lung functions of FEV0.3/FVC%in COPD rats declined obviously(P0.001),While LTB4、15-HETE concentrations in lung tissue and lung functions of Ri、Re increased significantly as compared with the normal controls(P0.001,P0.05).Treatment with ipratropium Obviousely increased the levels of LTB4 and 15-HETE in lung tissue of the COPD rat(sP0.001).However ipratropium had little effect on FEV0.3/FVC%、Ri and Re(P0.05). Conclusion:Our results suggest that LTB4 and 15-HETE are involved in airway inflammation in COPD.Ipratropium is effective in decreasing the levels of LTB4 and 15-HETE in lung tissue of COPD rats,and attenuating inflammatory changes of airways.

文章对高等中医教育临床基础学科的基本概念和学科特性进行了论述。认为中医临床基础学科建设具有其合理性、地位和作用。认为中医临床基础学科的核心是辨证论治理论体系的研究和方药运用规律的探索,提出中医临床基础学科的发展方向是完善学科体系,重视文献资料的积累和整理,适应医学发展的需要。

小柴胡汤是张仲景<伤寒论>和解表里的主方,谓"伤寒五、六日,中风,往来寒热,胸胁苦满,嘿嘿不欲饮食,心烦喜呕,或胸中烦而不呕,或渴,或腹中痛,或胁下痞硬,或心下悸,小便不利,或不渴,身有微热,或咳者,小柴胡汤主之".笔者用其治疗多种疾病,疗效较好,介绍如下.

笔者与重庆市名老中医、原壁山县人民医院刘伯枢先生探讨男性不育症的治疗,用五味子衍宗丸加淫羊霍、巴戟天、仙茅治疗肾阳虚型男性不育症,疗效较好,介绍如下.