[目的]观察壮医毛桃土参方联合药线点灸治疗老年轻度认知障碍(MCI)的临床疗效.[方法]将100例MCI患者随机分为治疗组及对照组各50例,治疗组予壮医毛桃土参方联合药线点灸治疗,对照组予口服壮医毛桃土参方治疗.两组分别于治疗前1d及治疗30d后采用蒙特利尔认知量表(MoCA)、日常生活活动能力量表(ADL)、韦氏记忆量表(DSR)对患者进行评估,并测定患者血清同型半胱氨酸(Hcy)、超氧化物歧化酶(SOD)、丙二醛(MDA)含量.[结果]治疗后,两组患者MoCA、ADL、DSR评分均较治疗前改善(P<0.05),且治疗组改善程度优于对照组(P<0.05).两组患者血清Hcy、SOD、MDA含量均有不同程度改善(P<0.05),且治疗组改善程度优于对照组(P<0.05).[结论]壮医毛桃土参方联合药线点灸能调节老年轻度认知障碍患者血清Hcy、SOD、MDA水平,改善患者认知水平及记忆力,提高生活质量,值得临床推广.

AbstractBackground and purposeThe heterogeneous, complex condition known as ischemic stroke (IS) is brought on by the interaction of a number of risk factors and genetic variables. The association between C‐reactive protein (CRP) gene polymorphisms and IS has, however, been the subject of inconsistent findings. Therefore, we conducted a meta‐analysis to comprehensively address possible associations of CRP genes with the risk of IS.MethodsA comprehensive literature search for all the published articles was performed in electronic databases including PubMed, EMBASE, Cochrane Library, and Google Scholar from January 1, 1950 to June 30, 2022. Odds ratio (OR) with 95% Confidence interval (CIs) along with fixed/random effect models were used to calculate summary estimates.ResultsTwelve case‐control studies totalling 3880 IS cases and 5233 controls were included for the association of CRP gene polymorphisms (rs1800947, rs1130864, rs3093059, rs2794521, and rs1205). Across all genotyping models, we discovered that rs1130864, rs3093059, rs2794521, and rs1205SNPs were not substantially related to IS risk. A trend for significant association for rs1800947 under dominant (OR = 1.19; 95% CI = 0.97 to 1.48), recessive (OR = 1.49; 95% CI = 0.71 to 3.14) and allelic model (OR = 1.21; 95% CI = 0.99 to 1.48) was observed. However, protective association for rs1130864 under dominant (OR = 0.80; 95% CI = 0.70 to 0.91) and rs3093059 under allelic model (OR = 0.18; 95% CI = 0.14 to 0.22) was found.ConclusionOur thorough study revealed that the CRP gene variants rs1800947, rs1130864, rs3093059, rs2794521, and rs1205 could not be related to the risk of ischemic stroke. However, additional research must focus on the rs1800947 polymorphisms in a particular group.

Owing to its intricate pathophysiology, cerebral stroke is a serious medical condition caused by interruption or obstruction of blood supply (blockage of vasculature) to the brain tissues which results in diminished supply of essential nutrients and oxygen (hypoxia) and ultimate necrosis of neuronal tissues. A prompt risks assessment and immediate rational therapeutic plan with proficient neuroprotection play critically important role in the effective management of this neuronal emergency. Various conventional medications are being used for treatment of acute ischemic cerebral stroke but fibrinolytic agents, alone or in combination with other agents are considered the mainstay. These clot-busting agents effectively restore blood supply (reperfusion) to ischemic regions of the brain; however, their clinical significance is hampered due to various factors such as short plasma half-life, limited distribution to brain tissues due to the presence of highly efficient physiological barrier, blood brain barrier (BBB), and lacking of target-specific delivery to the ischemic brain regions. To alleviate these issues, various types of nanomedicines such as polymeric nanoparticles (NPs), liposomes, nanoemulsion, micelles and dendrimers have been designed and evaluated. The implication of these newer therapies (nanomedicines) have revolutionized the therapeutic outcomes by improving the plasma half-life, permeation across BBB, efficient distribution to ischemic cerebral tissues and neuroprotection. Furthermore, the adaptation of some diverse techniques including PEGylation, tethering of targeting ligands on the surfaces of nanomedicines, and pH responsive features have also been pondered. The implication of these emerging adaptations have shown remarkable potential in maximizing the targeting efficiency of drugs to ischemic brain tissues, simultaneous delivery of drugs and imaging agents (for early prognosis as well as monitoring of therapy), and therapeutic outcomes such as long-term neuroprotection.

Background: Alzheimer’s disease (AD) has affected numerous elderly individuals worldwide. Panax notoginseng has been shown to ameliorate AD symptoms, and notoginsenoside R2 is a key saponin identified in this plant. Purpose: In the current study, we aimed to explore whether notoginsenoside R2 could improve the prognosis of AD. Methods: Herein, primary rat cortical neurons were isolated and they were treated with amyloid beta-peptide (A β ) 25–35 oligomers. Cellular apoptosis was examined via flow cytometry and Western blotting. miR-27a and SOX8 mRNA expression levels were quantified by quantitative reverse transcription-polymerase chain reaction. Furthermore, the interaction between miR-27a and SOX8 was investigated by utilizing a dual-luciferase reporter assay. Finally, an AD mouse model was established to validate the in vitro findings. Results: Notoginsenoside R2 alleviated A β 25-35-triggered neuronal apoptosis and inflammation. During this process, miR-27a expression was decreased by notoginsenoside R2, and miR-27a negatively modulated SOX8 expression. Furthermore, activation of SOX8 upregulated β -catenin expression, thus suppressing apoptosis and neuroinflammation. Conclusions: Our animal experiments revealed that notoginsenoside R2 enhanced the cognitive function of AD mice and inhibited neuronal apoptosis. Notoginsenoside R2 ameliorated AD symptoms by reducing neuronal apoptosis and inflammation, thus suggesting a novel direction for AD pharmacotherapy. Keywords Notoginsenoside R2 , Alzheimer’s disease , miR-27a , SOX8

Introduction We aimed to determine the effects of Zhuyu Annao (ZYAN) prescription on hippocampal neuronal apoptosis and cognitive disorder (CD) in ischemic brain injury (IBI). Material and methods The improved Rice-Vannucci method was used to prepare a rat model of IBI. Rats in the ZYAN prescription group were intragastrically administered 12.50 g/kg of ZYAN prescription 4 h after modeling; rats in the mock surgical group (MSG) and model group (MG) were administered an intraperitoneal injection of the same volume of normal saline twice daily. Results Compared with MG, the area of cerebral infarction, pathological changes, neuron apoptosis index, and neurodeficit score were significantly reduced in the ZYAN prescription group (P < 0.05). Morris water maze test showed that in the ZYAN prescription group, incubation period was significantly shortened and the number of platform crossings was significantly increased (P < 0.05). Furthermore, the rats in the ZYAN prescription group showed significantly reduced protein and mRNA expressions of cleaved caspase-3, Bax, p-53, and p38 mitogen-activated protein kinase (MAPK) in the hippocampus, whereas the protein and mRNA expressions of Bcl-2 were significantly increased (P < 0.05). Conclusions ZYAN prescription reduced the area of cerebral infarction, attenuated neuronal apoptosis, and alleviated CD in the rats with IBI. The beneficial effect of ZYAN prescription in IBI may be mediated via the inhibition of the p38 MAPK signaling pathway and caspase-3 cascade reaction.

Background: Alzheimer’s disease (AD) has affected numerous elderly individuals worldwide. Panax notoginseng has been shown to ameliorate AD symptoms, and notoginsenoside R2 is a key saponin identified in this plant. Purpose: In the current study, we aimed to explore whether notoginsenoside R2 could improve the prognosis of AD. Methods: Herein, primary rat cortical neurons were isolated and they were treated with amyloid beta-peptide (A β) 25–35 oligomers. Cellular apoptosis was examined via flow cytometry and Western blotting. miR-27a and SOX8 mRNA expression levels were quantified by quantitative reverse transcription-polymerase chain reaction. Furthermore, the interaction between miR-27a and SOX8 was investigated by utilizing a dual-luciferase reporter assay. Finally, an AD mouse model was established to validate the in vitro findings. Results: Notoginsenoside R2 alleviated A β25-35-triggered neuronal apoptosis and inflammation. During this process, miR-27a expression was decreased by notoginsenoside R2, and miR-27a negatively modulated SOX8 expression. Furthermore, activation of SOX8 upregulated β-catenin expression, thus suppressing apoptosis and neuroinflammation. Conclusions: Our animal experiments revealed that notoginsenoside R2 enhanced the cognitive function of AD mice and inhibited neuronal apoptosis. Notoginsenoside R2 ameliorated AD symptoms by reducing neuronal apoptosis and inflammation, thus suggesting a novel direction for AD pharmacotherapy.

目的 探讨温脾通络开窍方对阿尔兹海默症(AD)模型大鼠海马区病变的影响及其相关的分子机制.方法 脑立体定位注射药物诱导方法建立SD大鼠AD模型;给予模型动物低(4 g/kg),中(8 g/kg),高(16 g/kg)剂量的温脾通络开窍方(灌胃);模型动物给予石杉碱甲做阳性对照组;假手术组及模型对照组动物给予相同体积的双蒸水.术后3周开始给药.给药3周后取动物脑海马区组织,HE染色观察各组动物脑海马CA3区病理变化;免疫印迹(Western blot)检测TNFα/ROS/JNK的蛋白表达.结果 HE结果显示与假手术组相比,AD组大鼠海马CA3区组织结构及细胞形态及细胞变性发生显著变化;AD海马组织中TNFα/ROS/JNK蛋白表达显著上调;温脾通络开窍方显著改善AD大鼠海马CA3区细胞变性和组织结构的改变;显著降低AD诱导的TNFα/ROS/JNK蛋白表达上调.温脾通络开窍方对AD大鼠海马区病变的改善及蛋白分子的作用呈剂量依赖性,高剂量的温脾通络开窍方与石杉碱甲作用相当.结论 温脾通络开窍方通过抑制TNF-α/ROS/JNK分子改善阿尔兹海默症大鼠海马区病变.

Cerebral ischemia is the most common cause of hippocampal neuronal death and the most prevalent cause of stroke with high mortality rate. Ferroptosis has been suggested to affect the role of hippocampal neurons. This study explores the influence of lentivirus infection-induced ferritin overexpression in hippocampal neuronal injury and death through simulations in August Copenhagen Irish rat models. Twenty-four-hour cerebral ischemia-reperfusion injury was induced in the rats after 90-min middle cerebral artery occlusion (MCAO). Ferritin overexpression was induced through lentivirus infection. The Morris Water Maze (MWM) test and tau hyperphosphorylation test were performed on hippocampal neurons to establish a MCAO model. The effect of ferritin overexpression on hippocampal neuronal death was evaluated using hematoxylin-eosin staining and annexin V/propidium iodide flow cytometry. The MWM test revealed that MCAO modeling decreased the cognitive and locomotor capacity of the rats, whereas ferritin overexpression partially reversed the effect of MCAO. In addition, the hyperphosphorylation of tau caused by MCAO was reduced by ferritin. Pathogenic changes, impaired viability, increased apoptosis, and elevated caspase-9 cleavage in hippocampal neurons were clearly recovered by ferritin. Moreover, robust reactive oxygen species production and glutathione consumption, which was induced by MCAO modeling, were ameliorated by ferritin. Furthermore, two key modulators of ferroptosis, p53 and SLC7A11, were demonstrated to be upregulated by MCAO modeling and downregulated by ferritin. Ferritin reduction is essential for cerebral ischemia-induced hippocampal neuronal ferroptosis mediated via p53 and SLC7A11.

目的 探讨温脾通络开窍方对通过NF-κB通路对阿尔兹海默症(AD)模型大鼠的认知功能的影响及机制.方法 药物诱导方法建立SD大鼠AD模型;术后3周灌胃给予低(4g/kg),中(8g/kg),高(16/kg)剂量的温脾通络开窍方(灌胃);给药3周.水迷宫记录动物的学习、记忆行为;免疫印迹(Western blot)检测海马组织中NF-κB通路分子IKK-α/β,NIK,NF-κB p65和NF-κB p50的含量.结果 水迷宫实验结果显示温脾通络开窍方能够改善AD大鼠的空间记忆及行为异常;降低AD动物海马组织IKK-α/β,NIK,NF-κB p65和NF-κB p50表达量;作用呈剂量依赖性.结论 温脾通络开窍方可能通过抑制NF-κB通路分子改善阿尔兹海默症大鼠的认知功能.

目的 观察针刺头三神联合壮医药线点灸治疗抽动秽语综合征患儿的临床疗效.方法 将62例抽动秽语综合征患儿随机分为观察组和对照组,每组31例,观察组给予针刺头三神联合壮医药线点灸治疗,对照组口服盐酸硫必利片治疗,14 d为1个疗程,治疗4个疗程.分别于治疗前后采用耶鲁抽动症整体严重程度量表(YGTSS)评价患儿病情,观察两组疗效.结果 观察组总有效率为87.1％,对照组总有效率为67.7％,观察组疗效好于对照组(P<0.05).治疗后两组患儿YGTSS的运动抽动评分、发声抽动评分、综合损伤评分及总评分均低于治疗前,并且观察组上述各评分均低于对照组(P<0.05).结论 针刺头三神联合壮医药线点灸治疗抽动秽语综合征患儿疗效好,能有效改善患儿临床症状.

Objective: It is aimed to explore the influence of scalp acupuncture (SA) on vascular dementia (VD) patients' behaviors, cognitive function (CF) and activity of daily living (ADL). Methods: 63 VD patients were selected from our hospital as objects of study and divided into experimental group (EG) (n=34) and control group (CG) (n=29) according to different treatment methods. CG was treated with conventional western medicine (CWM) and EG was treated with SA on the basis of treatment used for CG so as to compare the response rate (RR) and the mini-mental state examination (MMSE) and ADL scores before treatment and 1 month and 3 months after treatment and analyze the levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) before and after treatment. Results: (1) The RR of EG was higher than that of CG (P<0.05). (2) The MMSE scores of two groups had no statistical difference before treatment (P>0.05), and the scores of EG were much higher than those of CG 1 month and 3 months after treatment (P<0.05). (3) The ADL scores of two groups had no statistical difference before treatment (P>0.05), and the scores of EG were much higher than those of CG 1 month and 3 months after treatment (P<0.05). (4) There was no statistical difference in levels of TNF-alpha and IL-1 beta between two groups before treatment (P>0.05), and the levels of above factors in EG were lower than those in CG after treatment (P<0.05). Conclusion: SA had a good therapeutic effect on VD and could improve patients' cognitive ability (CA) and ADL and reduce the level of serum inflammatory factors (SIF), showing a definite effect.

目的:观察头穴透刺对阿尔茨海默病(Alzheimer's disease,AD)模型大鼠记忆能力及其海马区N-甲基-D天冬氨酸(N-methy-D-aspartate,NMDA)受体表达的影响,探讨头穴透刺改善AD模型大鼠学习记忆能力的机制.方法:采用链脲佐菌素侧脑室注射建立AD模型大鼠模型,随机分为空白组、假手术组、模型组、针刺组、西药组.采用Moms水迷宫实验观察大鼠的学习记忆能力,Western blot检测大鼠海马NR2A、NR2B蛋白的表达.结果:大鼠记忆能力比较:造模后,与空白组、假手术组比较,模型组、针刺组、西药组逃避潜伏期明显延长、跨越平台次数明显减少(P＜0.05).治疗后,与模型组、空白组及假手术组比较,针刺组、西药组逃避潜伏期缩短、跨越平台次数增加(P＜0.05).大鼠海马NR2A、NR2B蛋白相对表达量比较:与空白组、假手术组比较,模型组NR2A相对表达量升高明显(P＜0.05),NR2B表达降低明显(P＜0.05);与模型组比较,针刺组、西药组NR2A相对表达量明显降低(P＜0.05),NR2B相对表达量明显升高(P＜0.05),且针刺组NR2A的相对表达量低于西药组(P＜0.05),NR2B的相对表达量高于西药组(P＜0.05).结论:头穴透刺能够减少AD模型大鼠海马NR2A的表达,提高NR2B的表达,从而改善AD模型大鼠的记忆能力.

Alzheimer’s disease (AD), the most prevalent representation of dementia, is a neurodegenerative disease resulting from the degenerative disturbance of the central nervous system. Previous studies have indicated that miR-107 is reduced in the brain neocortex of patients with AD; however, its underlying mechanism is not clear. Therefore, the objective of this study was to explore the question of whether miR-107 participates in AD development. The study confirmed that the miR-107 expression levels were dramatically decreased in patients with AD and in beta-amyloid (Aβ) (Aβ)-treated SH-SY5Y cells compared with control groups. Upregulation of miR-107 reversed the inhibitory role of Aβ on cell proliferation and viability. In addition, miR-107 upregulation also ameliorated the Aβ-induced inflammation and apoptosis of SH-SY5Y cells. Furthermore, using bioinformatic prediction, dual-luciferase reporter assay (DLRA), quantitative polymerase chain reaction (qPCR), and Western blot (WB), miR-107 was confirmed to reduce the expression level of FGF7, and it subsequently deactivated the FGFR2/PI3K/Akt pathway. Moreover, FGF7 overexpression counteracted the role of miR-107 in the viability, proliferation, inflammation, and apoptosis of Aβ-induced SH-SY5Y cells.

抽动秽语综合征(Tourette syndrome,TS),儿童期发病率较高,其特征是存在持续一年以上的多部位运动性和发声性抽搐[1].发病率为0.5～1/10万,男女发病比为2∶1～10∶1[2].在临床上,TS的病因病机较为复杂,临床诊断较为困难,而且儿童依从性较差,治疗效果较差,对青少年的身心发育造成较大的影响.有关研究显示TS的发病可能与遗传、自身免疫、环境因素、精神代谢等因素相关[3].西医治疗此病主要以氟哌啶醇、硫必利、舒必利等精神类药物,但临床不良反应较为明显.TS在中医上属于“瘛疭”“痉证”“肝风”“颤证”等范畴,相关研究表明针灸疗法治疗TS具有较为显著的疗效,不良反应小,且治疗成本较低.现将近几年来以针灸为主治疗TS文献进行归纳总结.

目的:观察针刺配合耳穴贴压、心理疗法治疗抽动秽语综合征的临床疗效.方法:将100例TS患儿随机分为观察组和对照组,每组各50例.对照组采用口服西药治疗,观察组采用针刺配合耳穴贴压、心理疗法治疗,4周为1个疗程,治疗3个疗程.观察两组耶鲁抽动程度量表(YGTSS)评分变化和不良反应.结果:观察组总有效率90％,高于对照组的74％ (P ＜0.05),治疗后观察组的YGTSS各项评分较对照组治疗后评分低(P＜0.05),观察组不良反应明显低于对照组.结论:针刺配合耳穴贴压、心理疗法治疗抽动秽语综合征疗效显著,不良反应少,值得临床推广.

为了提高中医类别临床医学专业学位研究生专业素质,随机选取广西中医药大学中医临床医学专业学位硕士研究生120人,其中A组40人用传统培养方法,B组40人用结合住院医师规范化培训培养方法,C组40人用结合住院医师规范化培训+"传承创新"培养的方法,比较三组的毕业综合评估成绩、学位论文盲审评分、医师资格考试合格情况、公开发表论文数量、就业率.三组的执业医师资格考试合格率为100％,其中C组毕业综合评估成绩、学位论文盲审评分、发表论文数量、就业率均高于A组、B组.结合住院医师规范化培训+"传承创新"培养方法值得在中医专业学位研究生培养中推广应用.

Objective: This study was designed to investigate the effects of modified wuhu zhuifeng san on elderly Parkinson's disease patients in terms of their motor symptoms and serum interleukin-6 (IL-1 beta), cystatin-C (Cys-C) and homocysteine (Hcy) levels. Methods: 77 elderly patients with Parkinson's disease admitted to our hospital from February 2015 to August 2017 were divided into two groups according to the treatment methods they received. The patients in the control group (the CG, n=38) were given levodopa and benserazide tablets only, but those in the observation group (the OG, n=39) were managed with modified wuhu zhuifeng san in addition to levodopa and benserazide tablets as given in the CG. Before and after the treatment, these patients' TCM symptom scores, their clinical efficacy, their unified Parkinson's disease rating scale (UPDRS) scores, their serum IL-1 beta, Cys C, and Hcy levels, and their Parkinson's disease questionnaire-39 (PDQ-39) scores were recorded. Results: (1) The OG showed lower TCM symptom scores than the CG (P<0.05). (2) The total efficiency was 94.87% in the OG (37/39), higher than the rate of 68.42% (28/38) in the CG (P<0.05). (3) The UPDRS II, UPDRS III, and UPDRS TV scores in the OG were lower than they were in the CG (P<0.05). (4) After the treatment, the IL-1 beta, Cys-C and Hcy levels in the CG were higher than they were in the OG (P<0.05). (5) Compared with the CG, the OG's PDQ-39 scores were significantly decreased after the treatment (P<0.05). Conclusion: Modified wuhu zhuifengsan is beneficial to elderly Parkinson's disease patients as it improves their motor symptoms, their IL-1 beta, Cys-C and Hcy serum levels, and their quality of life.

To explore the clinical efficacy and mechanism of the Wenfei Jiangzhuo formula in lung and kidney deficiency-type vascular dementia. The study was conducted from March 2014 to March 2016. Eighty-four patients with lung and kidney deficiency-type vascular dementia were divided into the observation (n = 44) and control (n = 40) groups. The control group received oral donepezil hydrochloride, while the observation group received the Wenfei Jiangzhuo formula. The mini-mental state examination (MMSE) score, activities of daily living (ADL) scale score, and serum superoxide dismutase (SOD) and malondialdehyde (MDA) levels were assessed before and after treatment. The MMSE and ADL scale scores in the two groups significantly improved after treatment (P < 0.05); the scores in the observation group were significantly higher than those in the control group (P < 0.05). The SOD levels in both groups significantly improved, and there was a significant difference in the MDA levels in both groups (P < 0.05). The SOD and MDA levels improved more significantly in the observation group than in the control group (P < 0.05). The Wenfei Jiangzhuo formula has a good curative effect in patients with lung and kidney deficiency-type vascular dementia and may improve MMSE and ADL scale scores and patient satisfaction.

将Mini-CEX表应用到中医临床的教学中,对中医脑病科的实习生临床教学效果进行评价,通过核心能力末期评量结果与初期整体表现的评量结果比较,有统计学意义(P<0.05),实习生对Mini-CEX表评估方法的问卷调查满意度为100％.通过Mini-CEX表的评估应用,可客观评价实习生的临床诊疗水平,有利于带教老师及时发现问题、解决问题,提高教学水平.同时,有利于激发实习生对临床实习的积极性和主动性,提高实习生的自我认知水平、临床诊疗思维及实践能力.

目的 观察头穴透刺对阿尔茨海默病(AD)大鼠学习记忆能力及海马NR1、NR2B受体mRNA表达的影响.方法 采用链脲佐菌素侧脑室注射制备大鼠痴呆模型,随机分为空白组、假手术组、模型组、针刺组、西药组.连续治疗28 d后,采用Morris水迷宫实验观察大鼠的学习记忆能力,荧光定量PCR法检测大鼠海马NR1、NR2B受体mRNA表达量.结果 大鼠学习记忆能力比较:造模后,模型组、西药组、针刺组逃避潜伏期较空白组、假手术组明显延长,跨越平台次数较空白组、假手术组明显减少,差异均有统计学意义(P<0.05).治疗后,西药组、针刺组逃避潜伏期较造模后缩短(P<0.05),跨越平台次数较造模后增加(P<0.05),且与模型组、空白组、假手术组比较差异有统计学意义(P<0.05).大鼠海马NR1、NR2B受体mRNA表达量比较:模型组NR1、NR2B受体mRNA表达较空白组、假手术组明显下降,差异均有统计学意义(P<0.05).针刺组、西药组NR1、NR2B受体mRNA的表达较模型组升高,差异均有统计学意义(P<0.05),且针刺组NR1、NR2B受体mRNA的表达量高于西药组,差异均有统计学意义(P<0.05).结论 头穴透刺能够提高AD大鼠海马NR1、NR2B受体mRNA表达量,从而改善AD大鼠的学习记忆能力.