OBJECTIVES:To explore the effect and mechanism of acupuncture at "Feishu" (BL 13) and "Dingchuan" (EX-B 1), and "Kongzui" (LU 6) and "Yuji" (LU 10) for relaxing the airway smooth muscle in the rats during acute asthma attack and compare the effect among the two pairs of acupoints and the acupoints combination.METHODS:Forty SD male rats with SPF grade were randomly divided into a blank group, a model group, a pair-point A group (acupuncture at "Feishu" [BL 13] and "Dingchuan" [EX-B 1]), a pair-point B group (acupuncture at "Kongzui" [LU 6] and "Yuji" [LU 10]) and a point combination group (acupuncture at "Feishu" [BL 13] , "Dingchuan" [EX-B 1], "Kongzui" [LU 6] and "Yuji" [LU 10]), with 8 rats in each group. Except the rats in the blank group, the model of acute asthma attack was induced by ovalbumin (OVA) combined with aluminum hydroxide gel in the rest groups. Started on the 15th day of modeling, except in the blank group and the model group, acupuncture was delivered in the other groups, 30 min in each intervention, once daily, for 14 days. In each group, the latent period of asthma inducing was measured; the lung resistance (LR) and dynamic lung compliance (Cdyn) were determined using lung function detector; the levels of endothelin-1 (ET-1), tumor necrosis factor-α (TNF-α), cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) in serum and bronchoalveolar lavage fluid (BALF) were measured by ELISA; with Masson staining and electron microscopy adopted, the morphology and ultrastructure of airway smooth muscle of the rats were observed; the mRNA and protein expressions of ET-1 and beta-2 adrenergic receptor (β2-AR) were detected by quantitative real-time fluorescence and Western blot, respectively.RESULTS:Compared with the blank group, the latent period of asthma inducing was shortened (P<0.05), RL increased and Cdyn decreased (P<0.05) with the different concentrations of methacholine (0.025 mg/kg, 0.05 mg/kg, 0.1 mg/kg, 0.2 mg/kg) in the model group. In the pair-point A group, the pair-point B group and the point combination group, the latent period of asthma inducing was prolonged (P<0.05), RL decreased and Cdyn increased (P<0.05) with different concentrations of methacholine when compared with those in the model group; and the latent period of asthma inducing in the point combination group was longer than that in the pair-point A group (P<0.05). Compared with the blank group, the levels of ET-1, TNF-α and cGMP in the serum and BALF were elevated (P<0.05), and those of cAMP reduced (P<0.05) in the model group. The levels of ET-1, TNF-α and cGMP in the serum and BALF were reduced (P<0.05), and those of cAMP elevated (P<0.05) in the pair-point A group, the pair-point B group and the point combination group when compared with those in the model group. In the blank group, the lung tissue was normal structurally. In the model group, the collagen fibers were proliferated increasingly, the smooth muscle was thickened, the mitochondria were swollen, and their cristae disrupted and reduced massively. In the pair-point B group, the collagen fibers were proliferated, the smooth muscle was thicker compared with that in the blank group, the mitochondria were mildly swollen and their cristae disrupted partially. In the pair-point A group and the point combination group, the lung tissue changes were obviously alleviated in comparison with the model group, the mitochondria were slightly swollen and their cristae disrupted occasionally. Compared with the blank group, the mRNA and protein expression of ET-1 increased and that of β2-AR decreased in the lung tissue of the model group (P<0.05). In the pair-point A group, the pair-point B group and the point combination group, the mRNA and protein expression of ET-1 was reduced and that of β2-AR elevated in the lung tissue when compared with those in the model group (P<0.05). In comparison with the pair-point A group, the mRNA expression of β2-AR was elevated in the point combination group (P<0.05). When compared with the pair-point B group, the mRNA expression of β2-AR increased, the protein expression of ET-1 decreased (P<0.05) in the point combination group.CONCLUSIONS:Acupuncture at "Feishu" (BL 13) and "Dingchuan" (EX-B 1), "Kongzui" (LU 6) and "Yuji" (LU 10), two pairs of acupoints relieves the airway smooth muscle spasm in the rats during acute asthma attack, which may be related to inhibiting the mRNA and protein expression of ET-1 to reduce the excretion of ET-1 and TNF-α; while enhancing the mRNA and protein expression of β2-AR to balance the levels of cAMP and cGMP. The effect is optimal when acupuncture is delivered at two pairs of acupoints simultaneously.

青少年近视发病率逐年升高,已成为世界关注的疾病之一.目前,中医药与壮医药治疗近视的方法不尽相同,但在减轻患儿痛苦、改善视功能、提高患儿生活质量方面均具有丰富的临床实践经验.文章将近年来有关中医药与壮医药的研究成果加以阐述,以期为今后更好地开展青少年近视的防治工作提供参考.

青少年抑郁症是一种较为常见的精神类疾病,发病率逐年升高,严重威胁青少年的身心健康和生命安全.青少年抑郁症的预防、早期筛查、诊断及治疗在临床实践中具有重要意义.本文从青少年抑郁症的发病机制、预防和治疗等方面对其研究进展作一综述,以期为临床防治提供参考.

Bronchial asthma (asthma for short) is a common chronic respiratory disease inchildren, which has adverse effects on children's physical and mental health. Nuclear factor κB (NF-κB) signaling pathway is an important transcription factor in airway inflammation, and plays an important role in airway inflammation and airway remodeling in asthma. Clinical studies have found that traditional Chinese medicine has positive effects in the treatment of asthma. Hence, this paper aims to review the literatures on the treatment of asthma through traditional Chinese medicine compound and single herbs and extracts by regulating the NF-κB signaling pathway for nearly a decade. It is found that traditional Chinese medicine can inhibit airway inflammation, relieve airway smooth muscle spasm and reduce airway resistance through the regulation of NF-κB signaling pathway, so as to play a key role in the treatment of asthma, and provide a scientific basis for the treatment of asthma with traditional Chinese medicine.

小儿厌食症是指儿童较长时期食欲减退,以厌恶进食、食量减少甚至拒绝进食为临床特征的一种病症.城市儿童发病率较高,其中以1～6岁儿童最为多见[1].其一般预后较好,若病情迁延,长期不愈则易发生睡眠障碍,甚至影响患儿生长发育,转为疳证.本文就中医外治法在小儿厌食症中的临床应用近况进行综述.

目的:建立金樱根基原之一的粉团蔷薇根质量控制标准.方法:性状、显微、TLC法进行定性鉴别;根据2020年版《中华人民共和国药典》方法进行检查和浸出物测定;UPLC测定粉团蔷薇根中构莓苷F1、阿江榄仁亭、野蔷薇苷含量,并以UPLC建立指纹图谱.结果:所建立的显微鉴别、薄层色谱法、UPLC含量测定和指纹图谱方法稳定可行.药材水分、总灰分及浸出物含量:水分不得过13.87％,总灰分不得过8.72％,浸出物不得少于5.08％;11个批次粉团蔷薇根中所测构莓苷F1、阿江榄仁亭、野蔷薇苷含量范围分别是0.44～12.45、0.32～3.79、1.10～8.08 mg·g-1,暂定本品按干燥品计算,含构莓苷F1不得少于0.35 mg·g-1,含阿江榄仁亭不得少于0.26 mg·g-1,含野蔷薇苷不得少于0.88 mg·g-1;同时测定了11批粉团蔷薇根药材的指纹图谱并建立了共有模式,标定共有峰15个,指认了其中的构莓苷F1、阿江榄仁亭、野蔷薇苷、蔷薇酸、委陵菜酸5个成分.结论:该研究所建方法专属性强,可从整体上对粉团蔷薇根进行鉴别和质量控制,也为最终制定金樱根药材质量标准打下基础.

小儿哮喘发病率逐年升高,已成为世界关注的疾病之一.目前,哮喘急性期的西医一线用药以糖皮质激素为主,且存在无法忽视的副作用.中医药治疗哮喘疗效卓然,不良反应小,治疗方式多样且可多法联用.文章通过检索相关文献,从中医内治法、外治法以及临床观察三个方面,对近5年来中医药治疗小儿哮喘急性期的相关文献作一梳理,为未来深入研究小儿哮喘急性期的防治提供参考.

肺炎支原体是社区获得性肺炎常见病原,多见于学龄前期及青年,但在婴幼儿中亦不少见.小儿支原体肺炎发病无明显季节性,常年均可出现,占小儿肺炎的10％～20％.其临床表现在各年龄段有差异,年长儿童较易出现长期高热、肺部影像学改变,容易并发肺炎衣原体感染,年幼儿童容易出现喘息、气促及肺部干啰音、肺部斑片状阴影,并发病毒感染[1].近年来我国儿童肺炎支原体肺炎(mycoplas?ma pneumoniae pneumonia,MPP)发病率日趋上升[2],而中医药治疗该病取得了较大进展,现将近年来中医药治疗小儿肺炎支原体肺炎进展综述如下.

"培土生金法"又称补脾益肺法,是根据五行相生关系和脏腑相关理论而定的治法.小儿为稚阴稚阳之体,脏腑功能常不足,常见肺脏易感外邪而生肺系疾病.故本文根据小儿肺脏的生理病理特点,结合中医药膳食疗文化特色,探讨基于"培土生金法"药膳食疗在小儿肺系疾病应用的重要性,并在治未病理念指导下列举其常见的小儿药膳食疗方,为小儿药膳食疗在临床上提供指导.

目的 采用星点设计-响应面法优选小儿益肺健脾煎膏剂提取工艺.方法 以加水倍数、提取时间为考察因素,橙皮苷含量与干膏率的总评"归一值"为考察指标,进行二因素五水平试验,并分别作多元线性回归及二项式拟合,用所得效应面对结果 进行预测分析.结果最佳提取工艺条件为:21倍量水,煎煮2次,每次212 min,总评"归一值"为0.83630,与预测值相比较,偏差率为-16.531％(在-20.000％内).结论 优选的提取工艺简便、稳定,具有较好、可靠的预测性.

目的 筛选与儿童哮喘发病相关的关键微小核糖核酸(miRNA)、信使核糖核酸(mRNA).方法 从高通量基因表达数据库(GEO)数据库获取哮喘儿童miRNA芯片数据集GSE25230,利用GEO2R筛选出差异表达miR?NA;对差异表达miRNA进行转录因子预测、下游靶基因预测;利用GEO数据库获取哮喘儿童mRNA芯片数据集GSE63142,同时使用GEO2R筛选出差异表达mRNA,并对差异表达mRNA进行KEGG、GO功能富集分析;将差异表达miRNA预测靶基因与差异表达mRNA取交集获得目标基因,最后构建哮喘儿童发病潜在miRNA-mRNA调控网络,进一步筛选出关键miRNA、mRNA.结果 共筛选出34个上调miRNA与35个下调miRNA,其转录因子主要有EGR1、SP1、SP4、RREB1、TFAP4.共筛选出68个上调差异表达mRNA与48个下调差异表达mRNA,KEGG富集结果显示差异表达mRNA主要涉及白介素17信号通路、神经活性配体—受体相互作用、趋化因子信号通路、肾素—血管紧张素系统等;GO功能富集分析显示,差异表达mRNA功能主要富集在细胞外基质、丝裂原激活蛋白激酶、细胞外间隙以及胞外区等生物学过程中.哮喘儿童发病潜在miRNA-mRNA网络Degree值排名前3的关键miRNA分别为hsa-miR-30c-5p、hsa-miR-181a-5p、hsa-miR-335-5p,关键mRNA分别为CXCL2、KIT、MUC5B.结论 筛选出与儿童哮喘发病相关的关键miRNA分别是hsa-miR-30c-5p、hsa-miR-181a-5p、hsa-miR-335-5p,关键mRNA分别是CX?CL2、KIT、MUC5B.

OBJECTIVE To explore the effect of moxa-cone moxibustion at "Feishu" (BL13) and "Zhongfu" (LU1) on the contents of related inflammatory factors in serum and bronchoalveolar lavage fluid (BALF), and the expression of phosphatidy-linositol-3-kinase (PI3K), retinoic acid related orphan receptor γt (RORγt) and fork/wing helix transcription factor 3 (Foxp3) in lung tissue in asthma mice. METHODS Sixty male Balb/c mice were divided into normal, model, LY294002 (an inhibitor of PI3K, LY), electroacupuncture (EA) and moxa-cone moxibustion (moxibustion) groups (n=12 in each group). The asthma model was established by intraperitoneal injection of ovalbumin sensitization. The mice in the LY group were injected with LY 294002 (7.5 mg/kg) via the tail vein. EA or moxa-cone moxibustion was applied at BL13 and LU1 in the EA or moxibustion group once daily for 2 weeks. The levels of immunoglobulin E (IgE), interleukin-4 (IL-4) and interferon-γ (IFN-γ) in serum and BALF were detected by enzyme-linked immunosorbent assay. The expressions of PI3K, RORγt and Foxp3 in lung tissue were detected by real-time fluorescent quantitative polymerase chain reaction (QRT PCR) and immunohistochemistry. RESULTS Compared with the normal group, the levels of IgE and IL-4 in serum and BALF, the expressions of PI3K and RORγt mRNA and protein in lung tissue were significantly increased (P<0.01), while the levels of IFN-γ, and the expressions of Foxp3 mRNA and protein were significantly reduced (P<0.01) in the model group. Compared with the model group, the levels of IgE and IL-4 in serum and BALF, the expressions of PI3K and RORγt mRNA and protein in lung tissue were significantly decreased (P<0.01, P<0.05), and the levels of IFN-γ in serum and BALF, the expressions of Foxp3 mRNA and protein in lung tissue were significantly increased (P<0.01) in the LY, EA and moxibustion groups. CONCLUSION Moxa cone moxibustion at Shu- and Mu-acupoints of the lung meridian can reduce airway inflammatory reaction and control asthma attacks in asthma mice, which is closely related to its effects in regulating the expressions of RORγt and Foxp3 through PI3K signaling pathway.

研究生教育肩负着高层次人才培养和创新创造的重要使命,是国家发展、社会进步的重要基石.中医学作为医学类高等教育改革的三大主体之一,完善中医住院医师规范化培训的实施及寻找合适的中医硕士专业学位研究生临床能力的培养模式显得愈发重要.文章结合中医硕士专业学位研究生的培养现状,分析广西中医药大学在中医硕士专业学位研究生临床能力培养过程中存在的主要问题,以及为提高中医硕士专业学位研究生临床实践能力所采取的一系列改革措施,提出未来的应对策略,旨在进一步提升中医硕士专业学位研究生的临床实践能力,提高培养质量,为探寻适合中医特色的人才培养制度、促进中医硕士专业学位研究生培养与规培并轨的有效衔接提供改革思路.

OBJECTIVE:To observe the effect of moxa-cone moxibustion at lung's back-shu points and front-mu points on the expression of helper T lymphocyte 17 (Th 17)/regulatory T lymphocyte (Treg) in mice with asthma, and to explore the possible mechanism of moxa-cone moxibustion on asthma. METHODS:Sixty SPF-grade healthy male Balb/c mice were randomly divided into a normal group, a model group, an LY294002 group (LY group), an electroacupuncture (EA) group and a moxibustion group, 12 mice in each group. Asthma model was replicated by using ovalbumin (OVA) sensitization. Except the mice in the normal group, all the mice were intraperitoneally injected with sensitization solution (containing 15 μg of OVA and 30 mg of aluminum hydroxide) on the 1st day, 7th day and 14th day, 0.5 mL per mice; from the 15th day, 1% OVA solution was atomized for 20 min, once a day for 2 weeks; the mice in the normal group was treated with identical operations but with 0.9% sodium chloride solution. The mice in the LY group were treated with injection of LY294002 at tail vein on the 13th day, 14th day and 15th day. At the beginning of the 15th day, The mice in the EA group were treated with EA at "Feishu" (BL 13) and "Zhongfu" (LU 1) with disperse-dense wave, frequency of 2 Hz/20 Hz, intensity of 1 mA, 15 min each time, once a day for 2 weeks. The mice in the moxibustion group was treated with moxa-cone moxibustion at "Feishu" (BL 13) and "Zhongfu" (LU 1) from the 15th day, three moxa-cones per acupoint, once a day for 2 weeks. On the 16th day, 18th day and 22nd day, the incubation period of asthma was recorded. On the 29th day, all the samples were collected. The expressions of IL-17 and IL-10 in serum and bronchoalveolar lavage fluid (BALF) were detected by ELISA method. The pathological changes of lung tissue were observed by HE staining. The percentage of Th17, Treg and Th17/Treg ratio in spleen tissue were detected by flow cytometry method. RESULTS:Compared with the normal group, the incubation period of asthma in the model group was significantly shortened (P<0.01), while that in the LY group, the EA group and the moxibustion group was longer than that in the model group (P<0.01). After the intervention, bleeding and inflammatory exudation in the lung tissue were observed in the model group, and a large number of inflammatory cell infiltration around the bronchus and alveoli was found, and extensive consolidation appeared; the pathological changes of lung tissue in the LY group, the EA group and the moxibustion group were significantly reduced, and the structure of bronchus and alveoli was basically normal, and the inflammatory exudation and inflammatory cell infiltration were significantly reduced compared with the model group; the inflammatory reaction in the moxibustion group was slightly less than that in the LY group and the EA group. Compared with the normal group, the content of IL-17 in serum and BALF, the percentage of Th17 and Th17/Treg ratio in spleen tissue in the model group after intervention were increased (P<0.01), while the content of IL-10 in serum and BALF and the percentage of Treg in spleen tissue were decreased (P<0.01, P<0.05). Compared with the model group, the contents of IL-17 in serum and BALF, Th17 percentage and Th17/Treg ratio in spleen tissue in the LY group, the EA group and the moxibustion group were significantly reduced (P<0.01, P<0.05), while the content of IL-10 in serum and BALF and the percentage of Treg in spleen tissue were increased (P<0.01, P<0.05). The above indice had no significant difference among all the intervention groups (P>0.05). CONCLUSION:The Th17/Treg is imbalanced in asthmatic body. The moxibustion at lung's back-shu points and front-mu points can control asthma by regulating Th17/Treg imbalance and restoring immune homeostasis.

咳嗽变异性哮喘(cough variant asthma,CVA)又称过敏性咳嗽,表现为反复和慢性咳嗽,常在清晨或夜间发作,运动可加重咳嗽,可无喘息症状;部分儿童最终发展为典型哮喘.西医治疗常以糖皮质激素、白三烯受体拮抗剂、抗过敏药物等坚持长期、规范、个体化治疗为主[1-2],但易复发,不易治愈.近年来,中医在小儿咳嗽变异性哮喘治疗方面取得了较大的进展,现从中医方面对该病的文献作一论述.

近年来,将现代医疗服务技术与养老保障有效结合的养老模式,逐渐兴起成为国内的新型养老典范,该模式不仅能够满足老年人的日常生活需求,亦可随时为病患及失能老年人提供医疗护理、康复等方面的特殊照料[1].随着我国老龄人群数量不断增加,社会老龄化程度加剧,"白发浪潮"已成为社会着重关注的养老热点.但是,养老资源分配不均衡、养老机构服务质量参差不齐、公共疗养普及度不高及高额养老花费等问题仍是不可避免的阻碍.当前,基于中医药事业的蓬勃壮大和"健康中国战略"的稳步健行,中医药优势与养老模式相结合将成为老龄人康养新趋势.

党和国家一直对我国的研究生教育高度重视,近年来,国家领导人多次出席研究生教育的有关会议并做出重要指示.2013年国务院学位办启动研究生教育综合改革,改革的总体思路是:以服务需求、提高质量为主线,更加突出服务经济社会发展、更加突出创新精神和实践能力的培养、更加突出科教结合和产学结合、更加突出对外开放.2014年刘延东副总理在全国研究生教育质量工作会议上提出:提高质量、内涵发展是新时期研究生教育的核心任务.2014年独立设置中医专业硕士和博士学位,中医专业从临床医学专业中分离出来,凸显国家对中医药的重视,2015年开始中医专业硕士研究生培养与住院医师规范化培训相衔接.

开展广西壮族自治区壮瑶民族特色医养结合体系的研究,探索我区壮瑶民族特色医养结合健康服务业发展面临的问题,提出加快我区壮瑶特色的医养结合体系发展的几点建议,对助推我区产业转型升级、拉动内需增长、催生新的经济增长点和保障改善民生具有深远意义.

小儿五脏有余及不足的生理特点不是相互独立的,而是相互影响,相互作用的.小儿某一脏腑的轻微变化,很容易引起有关脏腑、甚至五脏关系的破坏,导致疾病发生.小儿药膳根据儿童五脏的生理病理特点,施用具体不同的药膳配方,不仅满足小儿的生长需求,而且借药物之性矫正机体脏腑阴阳之偏,机体的阴阳得以相对的平衡、协调,从而增强小儿机体抵御外邪侵袭的能力,预防疾病的发生,达到“未病先防”“上工治未病”的目的.另外,考虑到小儿惧怕苦味,小儿药膳可以少用药物,甚至不用药物,应多选用药食两用的中药,如山药、茯苓、枸杞、百合等.

Objective:To investigate the protective effect of Pollen Pini on oxidative damage of HepG2 cells induced by H2O2.Method:HepG2 cells were divided into normal control group,H2O2 model group and intervention group.HepG2 cells of the intervention group were pretreated with different concentrations of Pollen Pini for 12 h.Then,to produce oxidative stress,the H2O2 model group and the intervention group were treated with 400 μmol·L-1H2O2 to damage cells for 2 h.Cell viability was measured by methylthiazolyl tetrazolium (MTT) assay.To evaluate the protective effect of Pini Pollen on HepG2 cells,cell viability,intracellular reactive oxygen species (ROS),superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities,lactate dehydrogenase (LDH) and malondialdehyde (MDA) contents were detected.In addition,the expressions of key genes nuclear factor-E2-related factor 2 (Nrf2),Kelch-like epichlorohydrin-associated protein 1 (Keap 1),heme oxygenase-1 (HO-1),glutamate-cysteine ligase (GCL) in antioxidant pathway were determined by western blot.Result:MTT results showed that,compared with normal control group,the cytotoxicity of Pollen Pini groups (80,40,20,10,5 mg·L-1) were non-toxic.The contents of ROS,LDH and MDA in the H2O2 model group were significantly increased (P ＜ 0.01),while the activities of SOD and GSH-Px were significantly depressed (P ＜ 0.01).Compared with the H2O2 model group,the contents of ROS,LDH and MDA in the intervention group were significantly reduced (P ＜ 0.05,P ＜ 0.01),whereas the activities of SOD and GSH-Px were significantly increased (P ＜ 0.05,P ＜ 0.01).Western blot results indicated that pollen pini up-regulated protein expressions of Nrf2,HO-1 and GCL,but down-regulated the expression of Keap1 protein.Conclusion:The 5-20 mg·L-1 of Pollen Pini can effectively protect 400 μmol·L-1 H2O2-induced oxidative stress damage in HepG2 cells.The mechanism may be related to regulation of the activity of SOD,GSH-Px activity,ROS,LDH and MDA levels,and protein expressions of key genes Nrf2,Keap 1,HO-1,and GCL in the antioxidant pathway.