剖宫产术后的抗凝治疗

产科手术尤其是急诊剖宫产术导致静脉血栓栓塞疾病发病率及病死率呈显著上升趋势，多表现为术后的深静脉血栓形成和肺栓塞，这不仅与手术因素相关，也与大多数合并的病理产科因素相关。术后是否常规抗凝治疗目前尚存在争议，国内亦无大规模临床研究数据支持。本文从临床角度出发，探讨如何评估产科手术后发生血栓的风险，确定抗血栓预防干预的有效时机以及合理的治疗方案。     

玳玳果黄酮降脂提取物体内组织分布规律及特征研究

目的：建立UPLC-MS/MS分析方法同时测定玳玳果黄酮降脂提取物效应组分新橙皮苷和柚皮苷在大鼠10种脏器组织中含量，分布规律及特征。方法：采用UPLC-MS/MS技术建立提取物效应组分新橙皮苷及柚皮苷在大鼠心、肝、脾、肺、肾、脑、胃、小肠、脂质、肌肉组织中的定量分析方法；大鼠给药后分别于0.33，0.67，1，4，8 h的5个时间点，分别摘取以上10种脏器组织，测定脏器组织及血液中效应组分的质量浓度，采用DAS（V 2.0）药动学软件对各样本的药物浓度-时间数据进行房室拟合，并计算不同组织效应组分的药-时曲线下面积（AUC）及平均滞留时间（MRT）。结果：所建立的UPLC-MS/MS定量分析方法具备良好的专属性、标准曲线及线性范围良好、方法准确度与精密度、定量下限均符合有关规定；玳玳果黄酮降脂提取物效应组分在血液中的分布符合一室模型，除肾脏及脑组织外，其余脏器中提取物效应组分的房室特征多为静脉注射的二室模型，柚皮苷在肾脏中的拟合结果为非静脉注射的二室模型，新橙皮苷在脑组织拟合结果为静脉注射的三室模型，给药后8 h各组织中效应组分新橙皮苷及柚皮苷AUC值大小顺序均为小肠 > 胃 > 肾 > 脂质 ≈ 脾脏 > 肺 > 肌肉 > 肝 > 心 > 脑，效应组分在各脏器中均无明显蓄积；效应组分在血液、肾脏、肝脏中的滞留时间较长，MRT均大于2 h，脂质最短，MRT不足1 h；各脏器中新橙皮苷的药-时曲线下面积约是柚皮苷的3倍，而心、肝、肾中则是3.5，2.1和3.4倍。结论：玳玳果黄酮降脂提取物效应组分在大鼠组织中分布迅速，达峰时间早于血液；效应组分在肠道内消除缓慢，给药8 h后在各脏器中的含量均显著下降且无特异的蓄积部位。研究结果揭示玳玳果黄酮降脂提取物效应组分在大鼠体内的分布特征及规律，为进一步理解玳玳果黄酮降脂提取物在体内的作用靶点及机制奠定了基础。     

Working the edges of Posthuman disability studies: theorising with disabled young people with life‐limiting impairments

This paper is built upon an assumption: that social theory can be generated through a meaningful engagement with a co‐researcher group of disabled young people. Our co‐researchers are theoretical provocateurs and theorists in their own right who, through their activism and writing, are challenging us to reconsider the meaning of life, death and disability. Their work on our funded Economic and Social Research Council (ESRC) project has enabled us to consider the promise and potential of humanist and posthuman epistemologies, theories, methodologies, interventions and activisms. The paper introduces the research, the authors of this paper (academics and co‐researchers) and then explores three layers of analysis that work the edges of posthuman thinking; sovereign and assembled selves; affects and desires; mourning and affirmation. We conclude by asserting that as a research team we are engaging with a DisHuman approach to theory and activism: one that blends the pragmatics of humanism with posthuman possibilities.     

Heterogeneity of weight loss after gastric bypass,sleeve gastrectomy,and adjustable gastric banding

Background

Laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding all lead to substantial weight loss in obese patients. Long-term weight loss can be highly variable beyond 1-year postsurgery. This study examines and compares the frequency distribution of weight loss and lack of treatment effect rates after laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding.

MicroRNA-214 promotes chronic kidney disease by disrupting mitochondrial oxidative phosphorylation

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《经穴解》学术特色及学术影响探析

《经穴解》为明末清初齐鲁针灸医家岳含珍所著,全书学术特色鲜明:从分经辨证、病候辨证、人迎寸口脉辨证三方面了阐述了经络辨证的价值,积极探讨经络与脏腑之间的联系。注重经络辨证与脏腑辨证相结合;从腧穴的主治功能、经脉循行交会与气血盛衰的关系、地理方位等多角度对书中穴名进行解释,可以窥探分析穴位的气血盛衰,提供了认知腧穴的基本思路;以“五脏互藏”理论为指导阐述腧穴主治病证,体现了其从整体辨证论治、注重经络与脏腑关联的学术特点,揭示了脏腑之间的复杂联系。该书论述全面细致,阐释深入简出,为现代针灸临床提供借鉴,促进了齐鲁医学的传承与发展。     

中西医结合诊治新型冠状病毒肺炎的几点思考

结合病案1则,探讨中西医结合诊疗新型冠状病毒肺炎的几个共性问题。认为本病患者除呼吸道表现外,消化道症状同样较为突出。早期诊断及治疗评价将肺部CT检查和病毒核酸检查综合分析;中期着重毒痰瘀,用药防肝损;晚期应肺肠同治;恢复期多健脾益肺,活血化瘀。