老年多器官功能障碍综合征(MODSE)是老年危重症患者死亡的重要病因,常表现为心、肺、肾等主要脏器的衰竭,中医药在辨证论治及整体观念思想的指导下,对于MODSE的治疗有一定的优势,五苓升陷汤为升陷汤与五苓散的合方,具有益气升陷、温阳利水的作用,现介绍五苓升陷汤治疗MODSE心肾衰竭验案1例并文献回顾.

THIS ARTICLE WAS WITHDRAWN BY THE PUBLISHER IN NOVEMBER 2020

A mechanically-tunable random laser based on a waveguide-plasmonic scheme has been investigated. This laser can be constructed by spin coating a solution of polydimethylsiloxane doped with the rhodamine 6G organic dye and silver nanowires onto a silicone rubber slab. The excellent overlap of the plasmon resonance peak of the silver nanowires with both the pump wavelength and the photoluminescence spectrum provides the low threshold and tuning properties of the random laser. The random laser wavelength can be tuned from 558 to 565 nm by stretching the soft substrate, which causes reorientation and breakage of the silver nanowires. The polarization state of the random laser can also be changed from random polarization to partial polarization by stretching. The laser performance remains unchanged after the stretching and restoration experiments. These results not only enable easy realization of an ultrathin flexible plasmonic random laser but also provide insights into the mechanisms of three-dimensional plasmonic feedback random lasers.

Growing evidence suggests that miR-150-5p has an important role in regulating genesis of various types of cancer. However, the roles and the underlying mechanisms of miR-150-5p in development of colorectal cancer (CRC) remain largely unknown. Transwell chambers were used to analyze effects on cell migration and invasion by miR-150-5p. Quantitative real-time PCR (qRT-PCR), Western blotting and dual-luciferase 3' UTR reporter assay were carried out to identify the target genes of miR-150-5p. In our research, miR-150-5p suppressed CRC cell migration and invasion, and MUC4 was identified as a direct target gene. Its effects were partly blocked by re-expression of MUC4. In conclusiomn, miR-150-5p may suppress CRC metastasis through directly targeting MUC4, highlighting its potential as a novel agent for the treatment of CRC metastasis.

Colorectal cancer (CRC) is one of the leading causes of cancer related deaths worldwide (Jemal et al., 2009). Although improved treatment strategies involving surgery, chemoand radio-therapy have increased the overall survival rates in early stages, metastasis and relapse are still the main cause of CRC death. Over the past few years, a large number of miRNAs have been discovered to be correlated with tumor pathogenesis and progression, and miR-150 is one of the most widely researched miRNAs in various kinds of cancer (Lin et al., 2008; Wu et al., 2010; Watanabe et al., 2011). However, there are few researches about miR150-5p in CRC was reported. Previous studies shown that miR-150-5p was low expressed in CRC tissues (Ma et al., 2012; Pizzini et al., 2013), and patients whose tumors had low miR-150-5p expression had shorter survival and a worse response to adjuvant chemotherapy than patients whose tumors had high miRNA expression (Ma et al., 2012), which indicated that miR-150-5p might act as a tumor suppressor gene in CRC. However, the role of miR-150-5p in CRC and its possible mechanism of the action remain to be further explored. MUC4 is a high-molecular weight glycoprotein that belongs to the family of membrane bound mucins (Chaturvedi et al., 2008), which is expressed by epithelial cells in normal respiratory, gastrointestinal and genital tracts (Audie et al., 1993). In cancers originating from these epithelial cells MUC4 is frequently over-expressed

A number of studies have examined the association between interleukin-6 (IL-6) rs1800796 polymorphism and risk of lung cancer but revealed inconsistent results. The aim of this study was to clarify the association between IL-6 rs1800796 polymorphism and risk of lung cancer.

Objective To understand the relevant circumstances and issues of clinical ventilator application of hospitals upper than or equal to second-class in China' s northwest. It provides a reference for developing a long-term training program for local ventilator operators. Methods Trainees(all from Northwest of China) were collected from Non-invasive ventilator training courses which is hold by department of pulmonary and critical care medicine,Xijing Hospital in December,2012. We adopt the form of the questionnaire in this survey. Results Finally,81 qualified questionnaires were collected. Respondents were composed of upper first-class hospital(45. 5%),middle first-class hospital(11. 3%),upper second-class hospital(39. 5%)and middle second-class hospital(3. 7%). ① Operator of Adjusting ventilator: Doctors take on this work(70%); Nurses take on this work(1. 2%). Both of doctors and nurses take this work(24. 6%);② Knowledge of mechanical ventilation(MV) : The purpose of using MV only to meet the families' request(14. 8%); doctors thought using MV just could retard the disease in short-term,but in long-term,it is meaningless(38. 2%); doctors thought MV was expensive,and the overall results was so poor(20. 9%);doctors thought using MV increased the opportunity of breathing pain(4. 9%); doctors thought use the breathing machines in early time,can improve the patients' condition(80. 2%); ③ Complication of using Non-invasive ventilation(according to the experience of the respondents,from high to low) : the incidence followed by expectoration unfavorable(70. 3%); abdominal distension(58%); aspiration(25. 9%); facial pressure ulcers(24. 7%); unstable blood pressure(8. 6%); pneumothorax(12. 3%); ④ Sedation of using Non-invasive ventilation: 8. 6% routinely given sedation,11. 1% for most of the time sedation,25. 9%occasionally sedation,38. 3% never. ⑤ The confusion of non-invasive ventilator: operator was not clear about the structure and principle of the ventilator(61. 7%); operator was not grasp the exact indications and timing of using non-invasive ventilator(67. 9%); operator was not sure of the parameter adjustment(75. 3%); operator was unclear of the non-invasive ventilation principle of carbon dioxide emitted(53. 1%). Conclusions Most of the ventilator operators of hospitals upper than or equal to second-class of China' s Northwest regions could recognize the important role of ventilator in respiratory failure curing,but they lack of the knowledge about the structure and principle of the ventilator,parameter adjustment and so on. And there were higher level of complications during the non-invasive ventilation clinically. The information will provide an important reference of the ventilator operator training program development locally.

OBJECTIVE To explore the application of PDCA cycle management mode in continuous quality improvement of the central sterile supply department and further strengthen the central sterile supply quality management so as to ensure zero defect of the sterile supplies.METHODS The quality control management team was established,the PDCA cycle management responsibility system was implemented,the PDCA cycle management approach was employed to set up the key points of the quality control,the PDCA cycle improvement program was developed to constantly improve the systems;the PDCA group was implemented the PDCA cycle management mode in Nov 2011,while the control group was not implemented the PDCA cycle management mode from Nov 2010to Oct 2011,there were 96pieces of data in each group,then the satisfaction rate was compared between the two groups.RESULTS After the implementation of the PDCA cycle management mode,the satisfaction rate of the clinical departments was 97.9%in the PDCA group,significantly higher than 91.7% of the control group,the difference was significant(P0.05);the qualified rates of the hand hinge,monitoring of disinfectant concentration,cleaning and disinfection of surgical equipments,cleaning and disinfection of pipelines,rust removal,sterile supplies of the PDCA group were respectively 99.0%,95.5%,98.0%,97.5%,97.0%,and 100.0%,significantly higher than those of the control group(P0.05).CONCLUSION Through the application of PDCA cycle management model and the implementation of comprehensively continuous quality improvement,the overall quality of the CSSD staff,service quality,and quality of the sterile supplies have been substantially improved.

The detection of circulating tumor cells (CTCs) has received great attention. MicroRNA-21 (miR-21) plays crucial roles in carcinogenesis and is considered as one of the most studied oncomiRNAs. We determined if miR-21 could be used a marker for the detection of CTCs in gastric cancer patients. Peripheral blood samples were collected from 53 preoperative patients with gastric cancer and 20 healthy volunteers. Real-time reverse transcription-polymerase chain reaction was used to detect the level of miR-21. Receiver operator characteristic curves (ROC) were constructed. Patients with gastric cancer display a significantly higher level of miR-21 in peripheral blood than those from controls. The miR-21 level was associated with the tumor node metastasis (TNM) stage, tumor size and tissue categories. The area under ROC curve was up to 0.853 ± 0.086. This study highlights the potential of the detection of miR-21 in peripheral blood as a novel tool for monitoring CTCs in gastric cancer patients.

Citrus aurantium Xiaopi pill supplementation and consumption,and use cold and heat,as qi Xiaopi good agent,has significant effects on functional dyspepsia.

OBJECTIVE To determine the optimal timing of treating acute renal failure (ARF) patients in intensive care unit (ICU) with RIFLE (risk of renal failure, injury to the kidney, failure of kidney function, loss of kidney function and end-stage renal failure) classification using continuous renal replacement therapy (CRRT). And to evaluate the association between mortality and RIFLE classification in the same patients. METHODS Clinical data were collected from 103 ARF patients in ICU from 2000 to 2007. RESULTS The 30-days hospital mortality rate was 45.6%. The 30 days' hospital mortality rates of RIFLE-R, RIFLE-I and RIFLE-F were 25.0%, 20.0% and 57.3% respectively. CONCLUSION Survival rate of ARF patients can be manifestly elevated if CRRT is performed before RIFLE-F. The patients in RIFLE-F category have a significantly higher mortality than RIFLE-R and -I patients. The RIFLE criteria is fit for ARF classification system.

肥胖对人体健康的影响已成为全球性问题。关于肥胖的药物治疗近年来取得了较大的进展。即对其药物治疗研究作一综述,以便为今后减肥药物的深入研究提供方向。

脂肪组织的成分之一即前脂肪细胞具有分化的潜能,其分化增加可能会导致成熟脂肪细胞的数量增多,进而对肥胖的形成起到一定的作用。在此基础上提出如能通过一定的方法(如均衡饮食、增加运动、药物)抑制前脂肪细胞分化对于预防或治疗肥胖具有一定的实际意义。

报道了运用中西医结合方法治疗甲状腺功能减退性心脏病18例。西药主要用甲状腺替代疗法,中药用苓桂术甘汤加味汤剂口服,取效满意。

穴位注射法取穴:肾俞、肝俞、脾俞、心俞、三阴交、足三里、太溪、中极;药物:复方当归注射液。耳穴帖压法取穴:内生殖器、内分泌、缘中、肾、肝、卵巢、丘脑、交感。结果:有效率96.3%,证明穴位注射配合耳穴贴压能提高临床疗效。

目的:探讨温阳利水法对重症甲状腺机能减低症的治疗作用。方法:用温阳利水中药(右归饮合真武汤加减)配合甲状腺激素救治重症甲状腺机能减低症。结果:治疗4周,甲状腺功能接近正常,症状明显改善。结论:加用温阳利水中药救治重症甲状腺机能减低症,能明显缩短病程,尽早改善症状,并减少激素使用量。

Objective:To investigate the clinical effect of combined treatment of TCM and western medicine on serious hypothyroidism. Methods:40 cases of serious hypothyroidism were randomly divided into a treatment group of 22 and a control group of 18 cases. The treatment group were treated by thyroid hormone plus Chinese medicine for warming the kidney to promote diuresis.and the control group were treated by simple thyroid hormone.Improvement of main symptoms arid changes of thyroid functions were investigated.Results:The therapeutic effects of both groups were similar,the improvement of symptoms in the treatment group was significantly better than that in the control group,and the thyroid function increased in both groups(P<0.01),with the treatment group significantly superior to the control group in improvement of T_3(P<0.01).Conclusion:Combined treatment of TCM and western medicine has a satisfactory therapeutic effect on serious hypothyroidism,and can rapidly improve symptoms. shorten therapeutic course and help recover thyroid function.

慢性疲劳综合征(Chronic fatigue syndrom,CFS)是一组以慢性或反复发作的疲劳,且伴有多种精神神经症状,但无其他慢性器质性及精神性疾病的症候群.从目前国外CFS的流行病学报告看,这种疾病对社会和个人造成的负面影响不可忽视.由于现代医学目前对CFS的病因和发病机制尚不十分清楚,因此临床上缺乏有效的治疗药物.近年来,中医药学者通过发挥中医优势,探讨中医药治疗CFS的新路,从理论到临床都取得了可喜的进展,现综述如下.