应用脱钙骨基质和硫酸钙颗粒治疗骨缺损的初期结果

目的探讨使用骨移植替代物脱钙骨基质（DBM）和硫酸钙颗粒（OSTEOSET）治疗骨缺损的疗效。方法对同期手术治疗的52例骨缺损患者的缺损处,分别于术后第1、4、8周及3、6、12个月进行随访并摄X线片直至骨缺损愈合。统计分析患者的临床资料、X线片辅助分析骨缺损修复程度和并发症。结果随访8-12个月,植骨术后6、12个月分别有95%和99%患者的骨缺损显示有明显的新骨形成,修复水平为60%-100%。并发症为3例（5.77%）,经换药后治愈,未发生骨缺损不愈合。结论DBM和OSTEOSET在骨愈合早期可加速骨缺损的修复,并可作为新鲜自体髂骨的替代物。     

磷酸钙骨水泥强化椎弓根螺钉对骨质疏松性椎体骨折的临床意义

目的 :评价磷酸钙骨水泥 (calciumphosphatecement ,CPC)强化和修复椎弓根螺钉的生物力学效果。方法 :6具新鲜老人骨质疏松的脊柱标本 ,从T11～L4 共 36个椎体 ,随机选取其中 32个 ,分为 4组 ,每组 8个。A组 :随机选择一侧椎弓根放置直径为 6 .5mm的椎弓根螺钉 ,另一侧以直径为 3.5mm的钻头导孔。向两侧椎弓根孔道注入配制好的磷酸钙骨水泥 (CPC) 3～ 5ml ,体温下 ( 37℃ )放置 2 4h后 ,再行前述拔出实验。B组 :应用PMMA进行修复和强化 ,作为对照 ,操作方法同A组。C组 :植入椎弓根螺钉 ,添加或不添加CPC ,进行周期抗屈实验。D组 :相同方法 ,应用PMMA作为对照。结果 :CPC骨水泥强化组和修复组拔出力明显高于对照组 ,差异有显著性意义 (P <0 .0 5)。结论 :在植入椎弓根螺钉时添加具有生物活性的磷酸钙 (CPC)骨水泥可显著提高其初始稳定性     

Vertebral plate regeneration induced by radiation-sterilized allogeneic bone sheets in sheep

Objective： To evaluate the effects and mechanism of radiation-sterilized allogeneic bone sheets in inducing vertebral plate regeneration after laminectomy in sheep. Methods ： Twelve adult male sheep （ aged 1.5 years and weighing 27 kg on average ） provided by China Institute for Radiation Protection underwent L3-4 and L4-5 laminectomy. Then they were randomly divided into two groups： Group A （n =6） and Group B （n =6）. The operated sites of L4-5 in Group A and L3-4 in Group B were covered by ＂ H-shaped＂ freeze-drying and radiationsterilized allogeneic bone sheets （ the experimental segments）, while the operated sites of L3-4 in Group A and L4-5 in Group B were uncovered as the self controls （ the control segments ）. The regeneration process of the vertebral plate and the adhesion degree of the dura were observed at 4,8,12,16,20 and 24 weeks after operation. X- ray and CT scan were performed in both segments of 1.34 and L4-5 at 4 and 24 weeks after operation. Results： In the experimental segments, the bone sheets were located in the anatomical site of vertebral plate, and no lumbar spinal stenosis or compression of the dura was observed. The bone sheets were absorbed gradually and fused well with the regenerated vertebral plate. While in the control segments, the regeneration of vertebral plate was not completed yet, the scar was inserted into the spinal canal, compressing the dura and the spinal cord, and the epidural area almost disappeared. Compared with the control segments, the dura adhesion degree in the experimental regenerated segments was much milder （ P 〈 0. 01 ）, the internal volume of the vertebral canal had no obvious change and the shape of the dura sack remained well without obvious compression. Conclusions： Freeze-drying and radiation-sterlilized allogeneic bone sheets are ideal materials for extradural laminoplasty due to their good biocompatibility, biomechanical characteristics and osteogenic ability. They can effectively reduce formation of post-laminectomy scars, prevent recurrence of post-lamlnectomy spinal stenosis, and induce regeneration of vertebral plates.     

桂枝茯苓胶囊配合药物流产的临床观察

目的 探讨桂枝茯苓胶囊配合药物流产的临床疗效。方法将选择药物流产的早孕者随机分为两组，对照组和试验组各150例，对照组给予米非司酮＋米索前列醇；而试验组给予米非司酮＋桂枝茯苓胶囊＋米索前列醇。观察两组胚囊排出时间，胚囊排出前阴道流血量，胚囊排出后阴道流血量、流血时间、清宫率及转经时间。结果 与对照组比较，试验组胚囊排出时间短，胚囊排出后阴道流血量少，阴道流血时间短，清宫率低，且服药期间腹痛反应轻，差异有显著性（P〈0．05）。而在胚囊排出前阴道流血量及药流后转经时间方面，试验组与对照组无显著差异（P〉0．05）。结论 桂枝茯苓胶囊配合药物流产是经济、安全、有效的终止早孕的方法。     

《内经》“求属”内涵初探

《内经》病机“求属”的基本内涵可概括为 :从脏腑经络所属部位和功能特点来归类病候 ,求其病位所属 ;从自然气候的六气特点来归类病候 ,求病性所属 ;从邪正虚实来求其属 ;从气血引起的气机失常求其属 ;从疾病的转化传变求属 ;用阴阳总括病机求属。临床以此指导审因辨证 ,可提高辨证的准确性 ,有利于确定恰当的治疗原则。     

温病辨病论治内涵的系统诠释

明清时期形成发展起来的温病学说，因为创立了以卫气营血和三焦辨证为核心的温病辨证纲领，被认为完善和补充了中医学的辨证论治体系，是对中医学的重大发展。     

岩黄连总碱下调miR-223表达调控人牙龈成纤维细胞增殖与凋亡的分子机制研究

目的:探讨岩黄连总碱对牙龈卟啉单胞菌脂多糖(Pg-LPS)诱导的人牙龈成纤维细胞增殖与凋亡的影响及其可能作用机制。方法:体外培养人牙龈成纤维细胞,分为对照组(NC组)、Pg-LPS组、5μg/ml岩黄连总碱+Pg-LPS组、10μg/ml岩黄连总碱+Pg-LPS组、20μg/ml岩黄连总碱+Pg-LPS组、miR-NC+Pg-LPS组、miR-223+Pg-LPS组、anti-miR-NC+Pg-LPS组、anti-miR-223+Pg-LPS组、20μg/ml岩黄连总碱+Pg-LPS+miR-NC组、20μg/ml岩黄连总碱+Pg-LPS+miR-223组。采用EDU、流式细胞术分别检测细胞增殖与凋亡;RT-qPCR法检测miR-223的表达量;ELISA法检测白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)水平;Western blot检测剪切的半胱天冬氨酸蛋白酶3(Cleaved-caspase-3)、pro-caspase-3、磷脂酰肌醇-3-激酶(PI3K)/蛋白激酶B(AKT)蛋白表达。结果:岩黄连总碱(5、10、20μg/ml)和下调miR-223表达可显著...     

中医理论中的认识论特点及哲学反思

中医基础理论中的认识论特点可概括为:阴阳对立统一的整体观念是中医基础理论主要的组成部分和思想方法。阴阳的概念具有普遍性和特殊性涵义。阴阳斗争性的朴素辩证法思想,是《内经》动态平衡思想的精华。阴阳学说近似地把握了宇宙万物的统一性和整体性,反映了事物间的矛盾制约关系,为中医学整体把握人体的理论体系的建立奠定了基础,也是中医学能走在其他传统医学前列的重要原因之一。但是,中医理论缓慢发展的原因在于认知模式的泛化性,多层次的整合思维缺乏逻辑性,重功能轻实体的决定论缺点,传统的实用观使理论和实践脱节。中医理论要发展必须更新思维模式,跳出传统整合认识的框框,吸收系统思维方式,借鉴现代科学方法,将宏观和微观相结合,完善思维方式,促进理论发展。     

Pi (Spleen)-Deficiency Syndrome in Tumor Microenvironment Is the Pivotal Pathogenesis of Colorectal Cancer Immune Escape

Cancer immunoediting consists of three sequential phases: elimination, equilibrium, and escape. For colorectal adenoma-carcinoma sequence, the adenoma dysplastic progression may represent an equilibrium phase and the cancer stage as escape phase. Immune system eliminates transformed enterocytes by destroying them at first, sculpts them at the same time and selects the variants subsequently that are no longer recognized and insensitive to immune effectors, and finally induces immunosuppressive state within the tumor microenvironment that facilitates immune escape and tumor outgrowth. Immunosuppression and inflammation are the two crucial features of Pi(Spleen)-deficiency. Classic quotations, immune evidence and clinical observations suggest that Spleen(but not other organs) deficiency is the key pathogenesis of colorectal cancer(CRC) microenvironment. Weakness of old age, immunosuppressive cytokines from chronic inflammation, tumor-derived immunosuppressive factors and surrendered immune cells—regulatory T cells, myeloid-derived suppressor cells and tumor associated macrophages(TAMs) constitutes CRC microenvironment of Pi-deficiency. Furthermore, excess in superficiality, such as phlegm stagnation, blood stasis and toxin accumulation are induced by chronic inflammation on the basis of asthenia in origin, an immunosuppressive state. Great masters of Chinese medicine emphasize that strengthen Pi is the chief therapeutic principle for CRC which receives good therapeutic effects. So, Pi-deficiency based syndrome is the pivotal pathogenesis of tumor microenvironment. The immunosuppressive microenvironment facilitates immune escape which play an important role in the transition from adenoma to adenocarcinoma. There are some signs that strengthen Pi based treatment has potential capacity to ameliorate tumor environment. It might be a novel starting point to explore the mechanism of strengthen Pi based therapy in the prevention and treatment of CRC through regulation of tumor environment and immunoediting.