电针“肺俞”穴对慢性阻塞性肺疾病大鼠迷走神经放电的影响

目的 观察电针“肺俞”穴对慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD)大鼠迷走神经放电的影响,初步探讨针刺治疗COPD的作用机制。方法 随机将40只SD大鼠分为正常组、正常电针组、模型组、模型电针组,后两组以香烟烟熏结合脂多糖气管滴注法复制COPD模型。观察各组大鼠支气管肺泡灌洗液(bronchoalveolar lavage fluid, BALF)和血浆中乙酰胆碱（acetylcholine, ACh）的含量,并取正常电针组、模型电针组大鼠的“肺俞”穴进行即刻电针治疗,观察电针前后大鼠迷走神经放电情况。结果 与电针前比较,正常电针组和模型电针组大鼠电针后颈部左侧迷走神经放电频率、面积和幅度均显著增加（P<0.05） 模型电针组大鼠电针前后颈部左侧迷走神经放电频率、面积和幅度差值显著大于正常电针组（P<0.05）。ACh在外周血浆中含量变化为：模型组显著高于正常组（P<0.05）,模型电针组显著高于正常电针组但显著低于模型组（P<0.05）。ACh在BALF中含量变化为：正常电针组显著高于正常组（P<0.05）,模型电针组显著高于正常电针组和模型组（P<0.05）。结论 电针“肺俞”穴可使COPD大鼠迷走神经放电增强,并促进肺局部ACh递质的释放。     

大黄泄浊颗粒保留灌肠对非透析慢性肾病湿热证患者血清结缔组织生长因子及肝细胞生长因子的影响

目的观察非透析慢性肾病湿热证患者血清结缔组织生长因子(connective tissue growth factor,CTGF)和肝细胞生长因子(hepatocyte growth factor,HGF)水平及大黄泄浊颗粒保留灌肠对其干预作用。方法将63例非透析慢性肾病3~4期湿热证患者随机分为治疗组32例和对照组31例,并设正常组20例。治疗组和对照组均给予基础治疗,治疗组加用大黄泄浊颗粒保留灌肠,每日1次,疗程8周。观察两组临床疗效、血尿素氮(blood urea nitrogen,BUN)、血清肌酐(serum creatinine,SCr),以及治疗前后血清CTGF、HGF,并与正常组进行比较。结果治疗组临床疗效和中医证候疗效均显著优于对照组(P0.05)。治疗后治疗组BUN较治疗前显著降低(P0.05),SCr呈降低趋势(P0.05);对照组治疗后BUN较治疗前呈降低趋势(P0.05),SCr较治疗前显著升高(P0.05)。治疗组和对照组治疗前CTGF、HGF水平显著高于正常组(P0.05);治疗后治疗组和对照组血清CTGF、HGF水平均显著降低(P0.05);治疗组治疗后HGF和CTGF下降值大于对照组,差异无统计学意义(P0.05)。结论大黄泄浊颗粒保留灌肠改善非透析慢性肾病湿热证患者的机制与降低血清CTGF、HGF水平有关。     

肺气虚证浅探

The main functions of the pulmonary Qi are controlling the defensive energy, in charge of vital energy and regulatory functions of the lung. Deficiency of the pulmonary Qi shows advance graduslly decrese of superficial resistance, disturbances of the respiratory function and regulatory functions of the lungs. So lined with integration of traditional Chinese medicine theory and clinical practice, the syndrome of deficiency of the pulmonary Qi are divided into three degrees: slight, medium and serious.     

Academic Achievement and the Self-Image of Adolescents with Diabetes Mellitus Type-1 and Rheumatoid Arthritis

A total of 69 adolescents, 21 with diabetes mellitus type-1 (DM), 24 with rheumatoid arthritis (RA), and 24 controls matched for sex, age, social background, and living environment, were compared by means of their school grades and the Offer Self-Image Questionnaire. The ages of the children at the time of the diagnosis of the disease and its subsequent duration were the same in the DM and the RA groups. Results show that the academic achievement of adolescents with DM who are well balanced and adolescents with RA with mild or moderate symptoms are equal to those of their healthy peers. In the OSIQ scales there were no statistically significant differences between the groups. In the groups of controls, there were more significant correlations between the OSIQ scores and the school grades than those with the DM or RA adolescents. The direction was positive. The correlations of the 3 groups did not differ significantly from each other. In case of adolescents with various kinds of chronic diseases, it is important to support their motivation for learning and planning the future.Medical doctor, specializes in child and adolescent psychiatry. Since gaining her PhD at the University of Turku in 1987, she has also specialized in hospital administration and adolescent psychotherapy. Since 1982, she has been the senior doctor of the Child Psychiatric Clinic of Satakunta Hospital District. Currently she is the head of the Adolescent Psychiatry Clinic, Turku University Hospital. She has trained both child psychiatrists and adolescent psychiatrists. During the years 1990–1992 she has participated as a postdoctoral fellow in the Clinical Research Training Program for Adolescents sponsored by the NIMH.Experienced Psychologist and Researcher. She received her PhD in neuropsychology at the University of Turku. She is currently a clinical psychologist at the Adolescent Psychiatry Unit of Turku University Central Hospital. She is an expert on neuropsychological test methods and also responsible for teaching their application.     

Pulmonary interstitial emphysema in live birth determination: radiographic and gross pathologic features

Pulmonary interstitial emphysema (PIE) has previously been reported as a useful finding in the determination of live birth in cases where the birth and death were not attended. Herein, we present the radiographic and gross pathologic features of PIE in such a case. In this instance, in addition to parenchymal interstitial emphysema, there were subpleural air collections and a pneumothorax.     

IBDV感染鸡免疫器官淋巴细胞中细胞凋亡调控蛋白的动态表达

用鸡传染性腔上囊病病毒(IBDV)SNJ93株、BC6/85株、B87株感染SPF鸡后观察免疫器官淋巴细胞中Bcl 2和Bax蛋白的分布定位和动态变化。结果,B87株接种组的腔上囊、脾、胸腺淋巴细胞中这两种蛋白在各检测时间均为阴性反应;SNJ93与BC6/85攻毒组胸腺淋巴细胞中这两种蛋白呈现阴性反应,SNJ93攻毒组腔上囊和脾淋巴细胞在48h即开始出现Bcl 2和Bax阳性反应,腔上囊淋巴细胞内这两种蛋白在感染后72、96、120h呈现明显的强阳性反应,以后开始降低,脾淋巴细胞中这两种蛋白在感染后72、96h出现强阳性反应;BC6/85攻毒组腔上囊淋巴细胞中只在96、120h出现阳性反应,脾淋巴细胞中只在96h呈现阳性反应。用免疫组化法检测Bax和Bcl 2,有可能为IBDV毒力划分增添新的依据。     

Myxoid heart disease: A review with special emphasis on sudden cardiac death

Myxoid heart disease (MHD), more commonly known as mitral valve prolapse, is a very common caridac abnormality affecting 5–10% of the general population. This article reviews the history, symptoms, physical findings, pathology, associated conditions and complications of this entity. Special emphasis is given to sudden cardiac death, which occurs as a result of acute heart failure or due to a fatal arrhythmia. Theories regarding the origin of the arrhythmias are discussed. Once the origin is known, those at risk for this devastating complication can be identified and perhaps a preventative therapeutic regimen developed.     

肝豆汤改良方对TX小鼠脑组织XIAP、Caspase- 9和Caspase- 3蛋白及其mRNA表达的影响

目的 探究肝豆汤改良方抑制肝豆状核变性（Wilsons disease,WD）脑神经细胞凋亡的分子机制。方法 选取1月龄TX小鼠120只,随机分为TX模型组(40只)、肝豆汤改良方组（40只）、丁苯酞组（20只）,另选DL小鼠40只作为正常组;每组再分成2组,各20只,分别予以生理盐水、肝豆汤改良方、丁苯酞灌胃2个月和4个月。分别采用免疫组织化学法和Western blot法检测小鼠脑组织中X- 连锁凋亡抑制蛋白（X- linked inhibitor of apoptosis,XIAP）、胱冬肽酶- 9（Caspase- 9）及胱冬肽酶- 3（Caspase- 3）蛋白表达水平,采用RT- PCR技术检测小鼠脑组织中XIAP、Caspase- 9及Caspase- 3 mRNA表达水平。结果 免疫组织化学检测显示,肝豆汤改良方组XIAP表达水平较同月龄模型组明显增多,Caspase- 9和Caspase- 3表达水平较同月龄模型组下降,5月龄和3月龄肝豆汤改良方组XIAP和Caspase- 3表达水平有所差异。Western blot检测结果显示,月龄因素对脑组织XIAP、Caspase- 9、Caspase- 3蛋白表达水平的主效应均无统计学意义（P>0.05）;月龄因素和分组因素对3种蛋白表达水平的交互作用均无统计学意义（P>0.05）;对于同月龄小鼠,模型组脑组织XIAP表达水平显著低于正常组（P<0.05）,Caspase- 9和Caspase- 3蛋白表达水平显著高于正常组（P<0.05）;肝豆汤改良方组XIAP表达水平显著高于模型组（P<0.05）,Caspase- 9和Caspase- 3蛋白表达水平显著低于模型组（P<0.05）。RT- PCR检测结果显示,月龄因素对小鼠脑组织XIAP mRNA表达水平的主效应无统计学意义（P>0.05）,但对Caspase- 9、Caspase- 3 mRNA表达水平的主效应具有统计学意义（P<0.05）;月龄因素和分组因素对XIAP、Caspase- 9、Caspase- 3 mRNA表达水平的交互作用均无统计学意义（P>0.05）。对于相同月龄小鼠,模型组脑组织XIAP mRNA表达水平显著低于正常组（P<0.05）,而Caspase- 9、Caspase- 3 mRNA表达水平显著高于正常组（P<0.05）;与模型组比较,丁苯酞组和肝豆汤改良方组XIAP mRNA表达水平显著升高（P<0.05）,Caspase- 9和Caspase- 3 mRNA表达水平显著降低（P<0.05）。结论 肝豆汤改良方通过上调XIAP蛋白及其mRNA的表达,下调Caspase- 9、Caspase- 3蛋白及其mRNA在脑组织中的表达,减轻铜沉积对神经细胞的氧化应激损伤,从而抑制神经细胞的凋亡。     

肾上腺结核猝死的法医学鉴定

通过两例肾上腺结核猝死的案例观察发现：肾上腺和肾上腺以外器官的结核病变均表现为不典型的慢性陈旧性的病理学特征。提示在法医学鉴定中,对患过结核病和“不明死因”猝死尸体剖验时肾上腺的组织病理学检验尤为重要     

我国医疗保障法律制度相关问题研究

目前,我国全民医保体系已初步形成,但仍面临医疗保障互助共济功能尚未充分发挥,医疗保障法律制度立法层级较低,应急医疗保障法律制度欠缺,大病保障制度的法律归属不明晰,医疗保障法律制度衔接存在障碍等问题。因此,应在坚持医疗保障立法的社会连带理念、明确法律体系建设目标的基础上,加快提高立法层次,建立统一的应急医疗救助法律制度,明确重大疾病保险的法律属性,完善多层次的医疗保障法律制度体系。