Intestinal flora always maintains a dynamic balance in the health human body, and it is interdependent, inhibitory and ompetitive with the body. With the increasingly progressive level of medicine and biotechnology, more and more studies have found that the effect traditional Chinese medicine on the treatment of multisystem diseases is related to adjustment of the imbalance of intestinal flora. This paper summarizes the studies on the impact of traditional Chinese medicine on intestinal flora in recent years. It is found that traditional Chinese medicine plays an important role in multisystem diseases through improving the abundance and evenness of intestinal flora, affecting metabolic pathways and metabolites, and regulating the intestinal mucosal barrier.

目的 探讨不同程度心力衰竭合并贫血患者的病因及合并疾病特点.方法 选取首都医科大学附属北京安贞医院2018年1月至2020年12月收治的2180例心力衰竭合并贫血患者.根据纽约心脏病协会心功能分级将患者分为轻度心力衰竭组(Ⅰ～Ⅱ级,999例)和重度心力衰竭组(Ⅲ～Ⅳ级,1181例).记录患者年龄、性别、合并疾病及引起心力衰竭的主要病因.采用二元Logistic回归模型分析心力衰竭合并贫血患者发展为重度心力衰竭的危险因素.结果 二元Logistic回归分析结果显示年龄≥60岁(比值比=2.210,95％置信区间:1.826～2.675)、肺部感染(比值比=2.318,95％置信区间:1.717～3.111)、肾脏病(比值比=1.646,95％置信区间:1.312～2.065)、消化道出血(比值比=1.620,95％置信区间:1.044～2.515)、原发性心肌病(比值比=4.665,95％置信区间:2.504～8.694)是心力衰竭合并贫血患者发展为重度心力衰竭的危险因素(均P<0.05).结论 年龄≥60岁、肺部感染、肾脏病、消化道出血以及原发性心肌病是心力衰竭合并贫血患者发展为重度心力衰竭的危险因素.

目的 探讨心功能不全合并贫血患者发生急性心肌梗死的相关疾病因素.方法 选取2018年1月至2020年12月于首都医科大学附属北京安贞医院住院的心功能不全合并贫血患者3 040例,根据是否发生急性心肌梗死分为急性心肌梗死组(322例)和非急性心肌梗死组(2 718例).比较2组患者年龄、性别、合并疾病等临床资料,分析患者发生急性心肌梗死的疾病因素.结果 急性心肌梗死组年龄、合并糖尿病、高血压、高脂血症、肾脏病、消化道出血比例均高于非急性心肌梗死组[(68±12)岁比(59±15)岁、53.1％(171/322)比24.5％(666/2 718)、70.5％(227/322)比53.5％(1 454/2 718)、59.6％(192/322)比26.0％(706/2 718)、58.7％(189/322)比30.1％(817/2 718)、15.2％(49/322)比5.5％(149/2 718)],合并心房颤动、瓣膜病比例均低于非急性心肌梗死组[14.6％(47/322)比19.4％(527/2 718)、27.0％(87/322)比54.5％(1 480/2 718)],差异均有统计学意义(均P＜0.10).Logistic回归分析结果显示,年龄≥60岁、合并糖尿病、高脂血症、肾脏病、消化道出血是心功能不全合并贫血患者发生急性心肌梗死的独立危险因素(均P＜0.05).结论 在心功能不全合并贫血患者中,年龄≥60岁患者合并有糖尿病、高脂血症、肾脏病、消化道出血时更容易发生急性心肌梗死.

心血管疾病是导致全球性死亡的主要病因[1],截止到2030年约有2330万例死于心血管疾病,冠心病是最主要的心血管疾病之一,其发病率呈上升趋势[2],因此冠心病诊疗长期以来一直是学者们重点关注内容.传统诊疗冠心病方案的提高依赖于大型随机对照试验的严格对比和发现,更新效率较低.数据挖掘技术可解决这一问题,具有时间短、效率高的作用.该技术通过对大量电子病历数据进行整理、分析,辅助冠心病的诊疗[3-4].数据挖掘技术主要包括两大类算法:监督学习算法和无监督学习算法.监督学习主要通过已有的训练样本去训练得到一个最优模型,常见的有监督学习算法:决策树、神经网络、支持向量机、线性回归、KNN、朴素贝叶斯、随机森林等算法;无监督学习是在没有标签的数据里面发现潜在一些结构的方式,主要的无监督学习算法主要有聚类、降维、关联规则分析等算法.本文将对这两大类算法在冠心病诊疗中的应用进展进行归纳整理.

Objective To analyze the effect of Xuezhikang on the markers of the serum lipid levels of cholesterol synthesis and absorption in early menopausal women with hypercholesterolemia, and preliminarily explore its lipid-lowering mechanism. Methods A total of 90 early menopausal women with hypercholesterolemia were enrolled from December, 2014 to May, 2016 from Beijing Anzhen Hospital, Capital Medical University, who were randomly allocated to receive Xuezhikang (1200 mg/d, orally) or atorvastatin (10 mg/d, orally) according to a random number table. Serum levels of some related biomarkers, including cholesterol synthesis markers (squalene, dihydrocholesterol, dehydrocholesterol, and lathosterol), and absorption markers (campesterol, stigmasterol, and sitosterol) as well as safety indices were obtained at baseline and after 8 weeks of the intervention. Results Eight weeks after treatment, both Xuezhikang and atorvastatin significantly reduced the levels of total cholesterol, triglycerides, low density cholesterol compared to baseline (all P<0.01). Xuezhikang significantly reduced the levels of squalene, dehydrocholesterol and lathosterol compared to baseline (all P<0.01), but atorvastatin only significantly reduced the level of squalene (P<0.01), compared to baseline. All cholesterol absorption markers showed no significant differences before and after treatment (P>0.05), however, a more obvious downward trend was shown in the Xuezhikang group. In addition, all the safety indices showed no significant differences between the two groups. Although the creatinekinase level in the Xuezhikang group was significantly higher, it remained within the safe range. Conclusions Xuezhikang may have more comprehensive effects on the markers of cholesterol synthesis and metabolism in early menopausal women with hypercholesterolemia through ergosterol and flavonoids in its "natural polypill."

三七作为我国传统中药,因其具有活血化瘀的功效,在治疗心血管疾病方面疗效显著,且随着现代中药提取技术的提高,三七提取物极大程度地提高了其作用功效.整理近几年国内外关于三七提取物(主要成分为三七总皂苷)在治疗心血管疾病(冠心病、高血压、心力衰竭、心律失常)时的作用机制、临床应用效果及可能的不良反应等文献,并对所查阅的相关文献进行相应的剖析、归纳及总结.本文结论为三七提取物三七总皂苷及其有效成分对治疗心血管疾病有明确疗效,尤其是在冠心病、高血压、心力衰竭、心律失常或多种疾病同时合并存在时,三七提取物三七总皂苷可起到使用单一药物而发挥多种药效的作用,同时减轻患者经济及精神压力,提高患者生活质量.