OBJECTIVE To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on lung function, clinical symptoms, exercise tolerance and risk of acute exacerbation in patients with chronic obstructive pulmonary disease (COPD). METHODS A total of 49 outpatients with COPD were randomly divided into TEAS group and control group by using a digital table. The clinical trials were conducted by using randomized, single-blinded and placebo-controlled method. Patients in the TEAS group were treated by TEAS of Feishu (BL13), Dingchuan (EX-B1), Zusanli (ST36) and Pishu (BL20) for 40 min, once every other day for 4 weeks, while patients in the control group were treated with placebo TEAS which the electrode plates were adhered to the same acupoints but without electrical current outputs. The treatment was conducted every 3 months in one year. In addition, patients of the two groups had no restriction on their original treatment with conventional western medicines and Chinese Materia medica. The lung function (forced expiratory volume in 1 second predicted，FEV1%, forced vital capacity predicted，FVC%) was detected using a spirometer), clinical symptom scores （CAT） for coughing, phlegm, chest tightness, climbing, family activities, out-door activities, sleeping and energy status were given. The patient's exercise tolerance was assessed using walking distance in 6 min, and the risks of acute exacerbation (times of exacerbation and hospitalization in 1 year) were recorded. RESULTS Correlative analysis showed a negative correlation between the risks of acute exacerbation and the levels of FEV1% and FVC% (P<0.01) and a positive correlation between the risks of acute exacerbation and CAT score (P<0.01). Self-comparison showed that 1 month after the treatment, the FEV1% and FVC% levels, 6MWD in the control group were significantly decreased (P<0.001, P<0.01), while the CAT score in the control group, and FEV1% and 6MWD in the TEAS group were obviously increased in comparison with their own pretreatment (P<0.05, P<0.001), but FVC% in the TEAS group and the times of exacerbation and hospitalization in the control group had no obvious changes in comparison with their own pre-treatment (P>0.05). One year (1 year) after the treatment, FEV1% and FVC% levels, 6MWD in the control group, and CAT score and times of exacerbations and hospitalization in the TEAS group were significantly decreased (P<0.001, P<0.01, P<0.05), while CAT score in the control group and 6MWD in the TEAS group were markedly increased (P<0.05, P<0.01), but FEV1% in the TEAS group and the times of exacerbation and hospitalization in the control group had no significant change compared with their own pretreatment (P>0.05). Comparison between two groups showed that after the treatment, the FEV1% (1 month) and FVC% (1 month and 1 year), 6MWD (1 month and 1 year) were significantly higher in the TEAS group than in the control group (P<0.05), while the CAT (1 month and 1 year) and times of exacerbation and hospitalization (1 year) were significantly lower in the TEAS group than in the control group (P<0.05, P<0.01, P<0.001), without significant difference in the FEV1% (1 year) level (P>0.05). CONCLUSION TEAS can improve the lung function, clinical symptoms, exercise tolerance, and reduce the risks of acute exacerbation in patients with COPD.

目的 基于TLR4/NF-κB信号通路探讨托里消毒散治疗放射性直肠炎的作用机制.方法 48只SD大鼠随机分为6组,除空白组外,其余各组均诱导造放射性直肠炎大鼠模型,造模成功后大鼠正常喂养3d后开始灌肠,空白组、模型组以2ml的0.9％生理盐水灌肠,阳性对照组以蒙脱石散(0.2 g/ml)联合地塞米松(1 mg/ml)2 ml灌肠,托里消毒散低(1 g/ml)、中(2g/ml)、高剂量(4g/ml)分别2ml灌肠,每天1次,连续10 d.处死大鼠,测直肠直径,采用HE染色考察直肠组织病理学变化;ELISA检测血清干扰素-γ(IFN-γ)、肿瘤坏死因子-o(TNF-α)、白细胞介素4(IL-4)、IL-10、表皮生长因子(EGF)水平及血清免疫球蛋白IgA、IgM、IgG含量;Western blot检测直肠TLR4、Myd88、NF-κBp65、IκBα表达;qRT-PCR检测直肠TLR4、Myd88、NF-κBp65、IL-6、IL-10 mRNA表达.结果 托里消毒散高剂量可改善直肠组织病理变化,降低直肠炎症评分(P＜0.05);托里消毒散高剂量较模型组可升高大鼠血清中EGF、IL-4、IL-10、IgA、IgM、IgG水平(P＜0.05),降低大鼠直肠组织IFN-γ、TNF-α、TLR4、Myd88、NF-κB p65、IκBα表达及TLR4、Myd88、NF-κBp65、IL-6 mRNA表达(P＜0.01).结论 托里消毒散高剂量可改善放射性直肠炎大鼠的直肠组织病理学改变,对TLR4/NF-κB信号通路相关因子及炎性细胞因子的表达均具有一定作用.

介绍李世杰主任医师运用甘草泻心汤治疗癌因性疲乏的经验.李教授认为,癌因性疲乏与脾肾密不可分,主张在补中益气、健脾益肾的同时畅气机、祛外毒,治疗癌因性疲乏取得较好的临床疗效

恶性肿瘤在祖国医学中被称为“癥瘕”、“积聚”、“伏梁”等,据2018年中国癌症数据统计[1]我国恶性肿瘤估计新发病例数380.4万例,较往年呈持续增长状态.虽然现代医学近年来取得了巨大的进步,但恶性肿瘤患者的总生存率仍不尽人意.随着中医药研究的不断深入,中医药在提高恶性肿瘤的临床疗效、减轻现代医学治疗相关毒副作用、改善临床症状、提高生活质量、延长生存期限等方面发挥着越来越重要的作用[2].中医治疗肿瘤主要体现在扶正与祛邪两个方面,其具体治法包括扶正培本、补益气血、温阳、清热解毒、活血化瘀、软坚散结等[3].目前多项临床研究[4]发现合理应用温阳法治疗肿瘤临床可获得显著疗效.现将温阳抗癌相关思路和经验总结如下.

目的 探讨乳腺癌中医证型与乳腺癌的中雌激素受体(ER)、孕激素受体(PR)表达的相关性.方法 采用常规免疫组化法检测216例临床病理诊断明确及资料完整的乳腺癌组织中的ER和PR的表达,并分为ER、PR均阴性组和ER、PR均阳性组.另外,收集所有患者的临床病理特征、舌脉及脉象.结果 ER和PR均阴性组的百分比为47.2％,ER和PR均阳性组的百分比为52.7％;ER、PR均阳性组肝郁气滞证型的比例较高,差异具有统计学意义(P<0.05);结论 ER、PR均阳性与均阴性,两者中医证型存在不同,辨证论治可明显改善患者临床疗效,提高生存质量,为中医药在分子学领域开辟新道路.

目的 观察芍药汤加减方治疗急性放射性直肠炎的临床疗效.方法 将60例并发急性放射性直肠炎的盆腔及腹部肿瘤患者随机分为2组,治疗组(中药组)使用芍药汤加减方灌肠,对照组(西药组)使用康复新液100 mL+地塞米松10 mg灌肠,每天1次,2周为1个疗程,2个疗程后观察患者总体临床疗效、肠镜疗效及治疗前后患者生活质量的变化.结果 治疗组总有效率为89.9％,对照组总有效率为59.9％,组间疗效比较差异有统计学意义(P＜0.05);肠镜疗效治疗组和对照组总有效率分别为90％、60％,组间疗效比较差异具有统计学意义(P＜0.05);2组治疗前后KPS评分改变具有可比性,2组总有效率分别为73.3％、33.3％,组间比较差异有统计学意义(P＜0.05).结论 芍药汤加减方能提高急性放射性直肠炎的临床疗效、促进肠黏膜修复、改善患者生活质量.

Aim:To investigate the influence of down-regulation of G protein-coupled estrogen receptor 30 ( GPR30 ) on activation of PI3K/Akt signaling pathway in endometrial carcinoma cells and tumor tissue of nude mice .Methods:The location of GPR30, Akt and p-Akt protein in HEC-1A and Ishikawa cells was detected by immunocytochemical SP method . The expression of GPR30 in HEC-1A and Ishikawa cells was down-regulated by transfection with pGFP-V-RS-GPR30, a GPR30 antisense expression vector , and the cells transfected with pGFP-V-RS were the control; the levels of GPR30,Akt and p-Akt were detected by Western blot .The nude mice were allocated into 4 groups and inoculated the above transfected cells, and immunohistochemistry was performed to observe the changes of the expression level of p -Akt in the xenograft tis-sue.Results:Immunocytochemical SP method showed that GPR 30, Akt and p-Akt was stained as brown and yellow in cell cytoplasm of HEC-1A and Ishikawa cells.Western blot analysis showed that the expressions of GPR 30 and p-Akt were de-creased in tumor cells transfected by pGFP-V-RS-GPR30 compared with the control (P<0.05).The expression of p-Akt was decreased in the mice inoculated the tumor cells transfected by pGFP-V-RS-GPR30 .Conclusion: Down-regulation of GPR30 inhibit the activation of PI3K/Akt signaling pathway in Ishikawa and HEC-1A cells and tumor tissue of nude mice .