目的 探讨七方胃痛颗粒对人胃腺癌细胞的抑制作用及可能机制.方法 用生理盐水将七方胃痛颗粒稀释并配制成浓度为2 g/mL的七方胃痛颗粒混悬溶液,对20只SD大鼠连续灌胃5 d后获取七方胃痛颗粒含药血清.将AGS细胞分为空白对照组、顺铂组、10％含药血清组、20％含药血清组、30％含药血清组,各组细胞给予相应药物干预48 h.采用流式细胞仪检测细胞周期及凋亡情况,采用Western blot检测人表皮生长因子受体(HER)信号通路相关蛋白及其下游磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(AKT)信号通路相关蛋白的表达水平,采用实时荧光定量PCR检测上述蛋白对应基因的mRNA表达水平.结果 与空白对照组相比,20％含药血清组AGS细胞的中晚期凋亡率升高,30％含药血清组AGS细胞的中晚期凋亡率及总凋亡率升高,4个给药组AGS细胞的G0/G1期比例提高,S期比例降低(均P<0.05).与空白对照组比较,10％含药血清组AGS细胞的HER4蛋白表达水平下降,20％含药血清组AGS细胞的表皮生长因子受体(EGFR)、HER4蛋白表达水平均下降,顺铂组和30％含药血清组AGS细胞的EGFR、HER2、HER3、HER4、AKT、PI3K蛋白表达水平均下降(均P<0.05).与空白对照组比较,4个给药组AGS细胞的EGFR、HER2、HER3、HER4、PI3K、AKT的mRNA表达水平下降(均P<0.05).结论 七方胃痛颗粒能促使AGS细胞发生中晚期凋亡,使细胞周期阻滞在G0/G1期,其可能通过抑制HER信号通路及下游PI3K/AKT信号通路的激活,起到抑制AGS细胞增殖的作用.

目的 探讨ApoE基因多态性与2型糖尿病(T2DM)患者颈动脉粥样硬化斑块的相关性.方法 回顾性分析461例内科住院患者,其中T2DM组患者226例作为试验组,非T2DM组患者235例作为对照组.检测患者ApoE基因多态性,比较2组患者、血脂、颈动脉内-中膜厚度(IMT)值、颈动脉斑块厚度Crouse积分有无差异性,分析ApoE基因多态性与T2DM患者颈动脉粥样硬化斑块之间的相关性.结果 T2DM组患者BMI值、高血压病史、冠心病史、低密度脂蛋白(LDL-C)、三酰甘油(TG)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、IMT值、斑块厚度Crouse积分明显高于对照组(P<0.05),HDL-C明显低于对照组(P<0.05);2组患者3种等位基因(ε2、ε3、ε4)中,T2DM组ε4等位基因频率(10.8％)显著高于对照组(1.9％),差异有统计学意义(P<0.05),ε3等位基因频率(81.2％)显著低于对照组(91.9％)(P<0.05);T2DM合并颈动脉斑块患者3组等位基因频率比较,ε4组基因型总胆固醇(TC)、TG、LDL-C水平明显高于ε3组和ε2组(P<0.05);T2DM合并颈动脉斑块患者的年龄、BMI值、高血压史、冠心病史、中风史、LDL-C、HDL-C、HbA1c、ε4等位基因与斑块厚度Crouse积分具有明显相关性(P<0.05),且ε4组基因型存在时对应的颈动脉斑块形成风险的ROC曲线下面积为0.691.结论 T2DM患者ApoE基因多态性与血脂、颈动脉IMT值及颈动脉粥样硬化斑块形成具有明显相关性,ε4等位基因与血脂TC、TG、LDL-C水平升高相关,且对颈动脉粥样硬化斑块形成有较高的预测价值.

Objective:To analyze the differences of clinical symptoms and ultrasonic image features between benign and malignant non-mass-like breast lesions and to investigate their diagnostic values.Methods:A total of 229 non-mass-like breast lesions detected by ultrasound in 210 female patients aged (44.3±11.1) years were retrospectively analyzed in The Second Affiliated Hospital, Guangzhou University of Chinese Medicine from June 2017 to July 2019. The differences of clinical symptoms and ultrasonic image features were compared between the benign and malignant groups. The ultrasonic image features included size, orientation, cord-shaped hypoecho in the lesion, echo pattern, posterior features, calcification, associated features, and blood flow signal. Independent sample t test was used to compare the measurement data, and χ2 test or Fisher's exact probability method was used to compare the count data. Results:A total of 71 malignant lesions and 158 benign lesions were confirmed by surgery or biopsy. There were statistically significant differences in clinical symptoms, cord-shaped hypoecho in the lesion, echo pattern of lesions, calcification, associated features, and blood flow between the benign group and the malignant group (all P<0.05); in the benign group, the echo pattern of lesions was mainly type Ⅱa and Ⅴ, while in the malignant group, it was mainly type Ⅰb and Ⅱb; there were no statistically significant differences in the size, orientation, and posterior features (all P>0.05). Conclusion:There are some differences in the clinical symptoms and ultrasonic image features between benign and malignant non-mass-like breast lesions, which may be helpful to the differential diagnosis for non-mass-like breast lesions.

溃疡性结肠炎是一种难于根治的消化系统疾病,其发病率逐年增高.葛根芩连汤治疗本病逐渐得到认可,本文从病因病机、药物成分、治疗机制及临床运用等方面对葛根芩连汤治疗溃疡性结肠炎的研究现状进行综述.

老年反流性食管炎(RE)是一种以反酸、烧心为主要表现的消化道功能障碍疾病,严重影响老年患者的生活质量.近年来,关于胃食管反流病的研究不断深入,使得老年RE也受到广泛关注.本文将从老年RE的发病机制、西医治疗和中医治疗等方面进行综述,以提高临床对老年RE的认识.

糖尿病胃轻瘫是糖尿病慢性并发症中较常见的并发症之一,发病率也在逐年增加.糖尿病胃轻瘫主要由糖尿病自主神经病变引起,最常见表现为便秘、上腹饱胀感和胃部不适等,严重者表现为顽固性便秘或腹泻,或便秘与腹泻交替,甚至大便失禁,致使患者的生活质量受到严重影响.本文从中医治疗、西医治疗和中西医结合治疗三个方面综述了近年来治疗糖尿病胃轻瘫的概况.

目的:研究乳腺影像学报告及数据系统(BI-RADS)分类对肉芽肿性乳腺炎(GLM)与乳腺癌鉴别诊断的价值.方法:选取在医院就诊的87例乳腺疾病患者超声图像资料,其中43例为GLM(45个病灶),44例为乳腺癌(46个病灶),应用第5版BI-RADS规范化超声词典和分类方法进行超声描述及分类诊断,分析其在GLM与乳腺癌鉴别诊断中的乳腺组织构成、病灶的大小、形状、方位、边缘、回声模式、后方回声特征、钙化以及结构扭曲、导管改变、皮肤改变、水肿和血管分布等相关特征.结果:所有病灶均经病理证实.GLM与乳腺癌在病灶的纵横比、边缘完整性、内部及后方回声、钙化、彩色血流分布以及组织扭曲、皮肤增厚、回缩改变和水肿等相关声像学特征比较,差异具有统计学意义(x2=13.580,x2=65.188,x2=17.160,x2=14.887,x2=6.131,x2=7.893,x2=6.284,x2=38.748,x2=35.708;P<0.05);乳腺组织构成、形状和导管变化比较,差异无统计学意义.BI-RADS分类对GLM和乳腺癌的诊断准确率、灵敏度、特异度、阳性预测值和阴性预测值分别为88.0％、95.7％、80.0％、83.0％和94.7％;ROC曲线下面积为0.878.结论:超声BI-RADS分类通过标准化的描述术语和风险评估分类方法,在GLM和乳腺癌良恶性鉴别诊断评估中操作简单方便、无创有效,具有较高的临床应用价值.

目的 观察吴茱萸联合小茴香封包干热外治法治疗脾胃虚寒型糖尿病胃轻瘫的疗效.方法 通过选取广西中医药大学第一附属医院2016年8月—2018年8月在内分泌科住院的脾胃虚寒型糖尿病胃轻瘫患者70例作为本次研究的研究对象,随机分为2组,对照组(n=35)和观察组(n=35).2组均给予胰岛素降糖、营养神经、改善胃动力等治疗,观察组在上述治疗的基础上同时接受场效应治疗仪进行中药封包干热外治法(吴茱萸200 g,小茴香100 g)给患者进行的腹部点穴烫疗,并观察干预前后治疗效果.结果 观察组治疗总有效率(97.14％)高于对照组(77.14％),差异有统计学意义(P<0.05);观察组治疗后上腹胀、恶心呕吐、早饱、纳差等临床症状消失时间均明显短于对照组,差异有统计学意义(P<0.05);观察组治疗后胃排空时间低于对照组,差异有统计学意义(P<0.05).结论 采用中药封包干热外治法治疗糖尿病胃轻瘫患者具有良好的治疗效果,并且能够有效缓解患者消化道临床症状,缩短患者胃排空时间.

Objective:To investigate the characteristics of Chinese medicine treatment of diabetes care benefits.Methods:33 patients with clinical diabetes by patients TCM syndrome type, according to TCM nursing care measures to implement the principle of giving emotional, living, dining, sports medicine, clinical disease nursing, health guidance and other aspects of Chinese characteristics Care methods.Results:patients care technologies compliance was 97%, for health guidance satisfaction is 100%, 93%of patients believe that the use of Nursing in nursing methods and technology can effectively relieve symptoms, the patient's health knowledge score 95.3 ± 2 (points).Conclusion:The use of Chinese medicine in signature treatments can improve clinical symptoms, control the patient's condition, improve patient grasp the extent of knowledge of the disease and improve patient care compliance and satisfaction, thereby improving the quality of life of patients.