滋阴潜阳法对肾性高血压大鼠神经免疫调节的影响

目的：观察滋阴潜阳法对二肾一夹肾性高血压模型大鼠(2K1C—RHR)的治疗作用及神经免疫调节，从神经免疫调节角度探讨滋阴潜阳法的作用机制。方法：复制2K1C—RHR模型，用滋阴潜阳中药治疗5周后，用放射免疫法测定血管紧张素Ⅱ(AngⅡ)、神经肽(NPY)、神经降压素(NT)及白细胞介素(IL4)含量。结果：滋阴潜阳法明显降低模型大鼠血中AngⅡ、NPY、IL-4含量，而升高NT含量。结论：滋阴潜阳法能明显调节肾性高血压大鼠AngⅡ、NPY、IL-4、NT含量，其神经免疫调节可能是其发挥治疗作用的机制之一。     

Death Due to Coronary Artery Insufficiency Following Blunt Trauma to the Chest

There have been numerous reports of sudden cardiac death following blunt trauma to the chest, but there is lack of such references in forensic literature. It is the court of law which makes decision about trauma precipitating natural events. The forensic pathologist is scientifically trained in the medical field and would be in a better position to give clear picture about the victim's general status at the time of death, exact nature and severity of the illness he is suffering from if any. He can also assess the nature and severity of injuries sustained, and thus, his opinion as to the possible role played by the traumatic event in bringing about the death is valuable. This paper will discuss the mechanism of cardiac injury or possible cardiac injury and sudden death of an apparently healthy 36‐year‐old male following blunt chest trauma sustained during alleged assault by his neighbor.     

Ochronosis Presenting as Methemoglobinemia

Ochronosis is the blue‐gray discoloration of collagen‐containing tissues due to homogentisic acid (HGA) deposition, secondary to endogenous alkaptonuria or exogenous enzyme inhibition. In renal disease, accumulation of HGA in serum can cause methemoglobinemia. A 60‐year‐old woman with renal disease and anemia presented with 3 days of weakness and months of gray skin discoloration. Her hemoglobin was 8.1g/dl with 24.5% methemoglobin. Despite treatment with methylene blue, exchange transfusion, and continuous renal replacement therapy, the patient died. Autopsy revealed gray discoloration and ochronotic pigment in the ribs and cartilage. Based on these findings, the patient was diagnosed with ochronosis, suggestive of alkaptonuria, complicated by methemoglobinemia. The differential diagnosis for blue‐gray skin discoloration includes argyria, methemoglobinemia, and ochronosis. This patient's clinical and autopsy findings suggested alkaptonuria complicated by methemoglobinemia due to progressive renal dysfunction. Development of methemoglobinemia in the setting of chronic skin discoloration and renal failure should prompt consideration of alkaptonuria.     

补肾益精法治疗远端肾小管酸中毒致低钾血症31例

目的 观察补肾益精法治疗远端肾小管酸中毒（distal renal tubular acidosis,dRTA）致低钾血症的疗效。方法 将62例dRTA患者随机分为观察组31例和对照组31例,对照组仅给予常规西医补钾治疗,观察组加用补肾益精中药进行综合治疗。比较两组的临床疗效及血清钾浓度的变化。结果 两组临床疗效的分布比较,差异具有统计学意义（P<0.05）,观察组临床疗效显著优于对照组;随着治疗时间延长,两组血钾浓度均较前一时点显著升高（P<0.05）;治疗48 h和72 h后,观察组血钾浓度显著高于对照组（P<0.05）。结论 补肾益精法联合西医补钾治疗能提高dRTA致低钾血症患者血钾水平,提高临床疗效。     

自拟益肾泄浊方治疗慢性肾衰竭疗效观察

目的 观察益肾泄浊方口服配合西医常规疗法治疗慢性肾衰竭（chronic kidney failure,CRF）的临床疗效。方法 将60例CRF住院患者随机分成对照组和治疗组,每组30例。在接受西医常规治疗的基础上,治疗组患者口服益肾泄浊方,对照组患者口服金水宝胶囊,两组疗程均为8周。〖JP2〗治疗前后分别检测两组患者血清肌酐（serum creatinine, SCr）、血尿素氮（blood urea nitrogen, BUN）、估算的肾小球滤过率（estimated glomerular filtration rate, eGFR）、血清白蛋白（albumin, ALB）和血红蛋白（hemoglobin, Hb）水平,观察并比较两组临床疗效和中医证候疗效。结果 治疗组临床疗效和中医证候疗效均明显优于对照组（P<0.05）。与治疗前比较,两组治疗后SCr均显著降低（P<0.05）,eGFR和ALB均显著升高（P<0.05）。治疗组治疗后SCr降低值显著大于对照组（P<0.05）,ALB和Hb升高值显著大于对照组（P<0.05）。结论 自拟益肾泄浊方口服配合西医常规治疗有利于改善CRF患者的肾功能,缓解临床症状,提高其治疗效果。     

中医综合治疗早中期慢性肾功能衰竭脾肾气虚证疗效观察

目的 观察中医综合治疗早中期慢性肾功能衰竭（chronic renal failure,CRF）脾肾气虚证临床疗效。方法 将60例CRF患者随机分为对照组和治疗组,每组30例。两组均给予西医常规治疗,治疗组患者在此基础上口服补肾健脾方配合擦背辅助治疗,对照组患者口服百令胶囊,两组疗程均为8周。比较两组患者治疗前后估算的肾小球滤过率（estimated glomerular filtration rate,eGFR）、血尿素氮（blood urea nitrogen,BUN）、血清肌酐（serum creatinine,SCr）、血红蛋白（hemoglobin,Hb）、白蛋白（albumin,ALB）的变化,评价两组临床疗效及症状改善情况。结果 与治疗前比较,两组患者治疗后SCr、BUN水平均显著下降（P<0.05）,eGFR、ALB、Hb水平均显著升高（P<0.05）。治疗组患者治疗后SCr、BUN水平下降程度以及eGFR、ALB、Hb水平上升程度较对照组更为显著（P<0.05）。两组中医证候疗效分布、临床疗效分布比较,差异均有统计学意义（P<0.05）。结论 西医常规疗法联合中医综合治疗可以显著改善CRF患者的肾功能,提高患者生存质量。     

黄枳胶囊治疗肠燥阴亏夹瘀型糖尿病性便秘30例

目的 观察黄枳胶囊治疗糖尿病性便秘的临床疗效及对患者血浆中P物质(substance P,SP)、生长抑素(somatostatin,SS)和胰高血糖素(glucagon,GC)等胃肠激素的影响.方法 将符合纳入标准的60例糖尿病性便秘患者随机分为治疗组、对照组各30例,对照组给予基础治疗联合枸缘酸莫沙必利片治疗;治疗...     

论我国服刑人员未成年子女法律保护的不足与完善

"南京饿死女童事件"引发人们对我国服刑人员未成年子女权利保护法律制度的反思。服刑人员未成年子女作为特殊的弱势群体,不仅需要物质层面的救助,更需要法律制度给予的人权保障。服刑人员未成年子女权利保护法律制度应以"儿童利益最大原则"作为理论基础,架构国家监护机制,并借助于PPP模式来探寻应然的保护路径,以期使我国服刑人员未成年子女的权利得到有效保护。     

中药保留灌肠治疗慢性肾衰66例临床观察

目的:观察中药保留灌肠治疗慢性肾衰的临床疗效。方法:将66例CRF患者随机分为灌肠组和非灌肠组,观察中药保留灌肠对临床症状及体征、尿素氮(BUN)、血肌酐(SCr)及24 h尿蛋白定量(24 h Upro)的影响。结果:治疗组总有效率明显高于对照组,治疗组临床疗效优于对照组(P<0.05)。两组BUN、SCr及24 h Upro分别得到明显的改善,差异有显著性(P<0.01);治疗组疗效明显优于对照组(P<0.01)。结论:中药保留灌肠可改善肾功能。     

双峰驼肾动脉血管分布的铸型观察

运用管道铸型技术以及扫描电镜技术对双峰驼肾动脉血管进行了系统观察。结果显示,双峰驼肾动脉在入肾门前约4~8 cm处分为背干和腹干,入肾后在肾窦内相继形成肾段动脉。左右两肾段动脉的分支分布各有特点,各段动脉分支延伸至肾的皮髓交界处,形成弓形动脉;弓形动脉是叶间动脉的延续,并不与肾表面相平行;肾血管球以及出、入球微动脉因分布区域的不同,形态结构也不尽一致。表明,双峰驼肾各段动脉分布的规律性强,段动脉分支之间没有吻合支存在;肾各部位的血管球随分布区域的不同,其形态结构也呈现一定的变化。