和中平逆方治疗肝胃郁热型反流性食管炎临床研究

目的:观察和中平逆方治疗肝胃郁热型反流性食管炎的临床疗效。方法:选择60例经内镜检查及中医辨证确诊为肝胃郁热型的反流性食管炎患者,分为中药治疗组、西药对照组,每组各30例,均以8周为一疗程,疗程结束后进行疗效比较。结果:两组临床症状疗效,治疗组总有效率为96.67%,对照组为96.66%,两组比较无显著性差异(P>0.05);内镜疗效,治疗组总有效率为73.33%,对照组为73.33%,两组比较无显著性差异(P>0.05);肝胃郁热证候疗效,治疗组总有效率为96.67%,对照组为76.67%,两组比较有显著性差异(P<0.05)。结论:1.和中平逆方对反流性食管炎的症状、食管黏膜炎症改善均有明显疗效;2.和中平逆方对肝胃郁热型反流性食管炎中医证候的改善优于奥美拉唑肠溶胶囊。     

益坤宁对围绝经期大鼠卵巢细胞凋亡率及caspase-3表达的影响

目的:研究中药益坤宁(yikunning,YKN)对围绝经期大鼠卵巢细胞凋亡率及凋亡相关基因caspase-3基因表达的影响,探讨益坤宁治疗围绝经期综合征的作用机理。方法:选用30只自然衰老的围绝经期雌性大鼠,随机分为中药益坤宁实验组、围绝经期对照组和利维爱(livial)对照组,另选10只青年雌性大鼠作为青年对照组。连续灌胃处理4周后,采用原位脱氧核糖核苷酸末端转移酶介导的缺口末端标记(TUNEL)法检测大鼠卵巢细胞凋亡率,采用逆转录-聚合酶链反应(RT-PCR)和蛋白印迹(Western blot)检测大鼠卵巢中caspase-3 mRNA和蛋白表达。结果:益坤宁组大鼠卵巢细胞凋亡率显著低于围绝经期对照组(P0.01);益坤宁组大鼠卵巢中caspase-3 mRNA和蛋白表达低于围绝经期对照组,高于青年对照组,差异有统计学意义(P0.01)。结论:中药益坤宁通过降低围绝经期大鼠卵巢细胞凋亡率,下调卵巢中凋亡相关基因caspase-3的表达,从而延缓卵巢衰老,这可能是其治疗围绝经期综合征的分子机制之一。     

自制益肾消痛丸联合中药塌渍治疗膝骨性关节炎临床疗效观察

目的:观察自制益肾消痛丸联合中药塌渍治疗膝骨性关节炎(KOA)的疗效。方法:将64例膝骨性关节炎患者随机分为治疗组(n=32),对照组(n=32),对照组采用西药内服,治疗组采用益肾消痛丸联合中药塌渍,两组疗程15天,比较两组疗效。结果:治疗组和对照组均能缓解膝骨性关节炎疼痛。治疗组总有效率90.6%,对照组总有效率68.75%,两组有显著差异(P0.001)。结论 :自制益肾消痛丸联合中药塌渍治疗早中期膝骨性关节炎疗效满意,值得推广。     

银丹心脑通软胶囊治疗老年室性期前收缩的临床观察

目的观察银丹心脑通软胶囊治疗老年室性期前收缩的临床疗效。方法将164例老年室性期前收缩患者随机分为两组,对照组82例给予盐酸普罗帕酮片口服,每次150mg,每天3次;治疗组82例,给予银丹心脑通软胶囊,每次3粒,每天3次。两组均用药4周为1个疗程。观察两组临床症状和24h心电图改善情况及副作用。结果两组的临床症状改善率分别为92%和69.5%,治疗组明显优于对照组,差异有统计学意义（P〈0.05）;24h动态心电图改善率分别为92%和80.5%,两组比较无统计学意义（P〉0.05）;对照组的不良反应明显高于治疗组（P〈0.05）。结论银丹心脑通软胶囊治疗老年室性期前收缩的疗效与普罗帕酮相近,但临床症状改善优于普罗帕酮,而且副作用比普罗帕酮小。     

抗生素联合益肾泄浊化瘀汤治疗慢性尿路感染临床研究

目的观察抗生素联合益肾泄浊化瘀汤治疗慢性尿路感染的临床疗效和安全性。方法选取2012年6月至2014年6月我院收治并确诊为慢性尿路感染患者120例,将其按照随机数字法随机分为观察组和对照组两组,每组60例;对照组采用敏感抗生素治疗,观察组在对照组基础上采用益肾泄浊化瘀汤,随症加减,两组均2周为1个疗程,给予3个疗程;观察治疗前后尿常规白细胞、尿细菌培养计数的变化,以及治疗前后慢性尿路感染综合疗效改善的情况及复发情况,并观察用药的安全性。结果两组治疗后尿白细胞定性及定量均较治疗前改善,差异均具有统计学意义(t≥12.3949,P0.05);但治疗后观察组尿白细胞定性及定量均较对照组改善更加明显(t=6.6022、11.4557,P0.01);两组尿菌培养计数均较治疗前减少(t≥11.2863,P0.05),但治疗后观察组尿菌计数较对照组减少更为明显,差异具有统计学意义(t=19.1851,P0.01);观察组治疗3个疗程后总有效率(91.7%)高于对照组(80.0%)(χ2=5.065,P0.05);随访6个月,观察组复发率(8.3%)明显低于对照组(31.7%)(χ2=10.208,P0.01)。治疗期间,两组心、肝、肾功能均正常,无明显不良反应。结论与单独服用抗生素相比,抗生素联合益肾泄浊化瘀汤治疗慢性尿路感染,能够显著降低患者的尿白细胞,使尿细菌培养转阴,且可改善患者临床症状,临床效果好复发率低,安全性高,值得临床推广。     

益坤宁对围绝经期大鼠卵巢bcl-2和bax表达的影响

目的:研究中药益坤宁(Yikunning,YKN)对围绝经期大鼠卵巢bcl-2和bax基因表达的影响,探讨益坤宁治疗围绝经期综合征的作用机制。方法:选用自然衰老的围绝经期雌性大鼠,随机分为3组(n=10):围绝经期对照组、利维爱(Livial)对照组和益坤宁组,另选10只青年雌性大鼠作为青年对照组。连续灌胃处理4周后,采用逆转录-聚合酶链反应(RT-PCR)检测大鼠卵巢中凋亡相关基因bcl-2和baxmRNA表达,采用蛋白印迹(Westernblot)检测大鼠卵巢中Bcl-2和Bax蛋白表达。结果:益坤宁组大鼠卵巢中Bcl-2、BaxmRNA及其蛋白表达高于围绝经期对照组,差异有统计学意义(P0.01);益坤宁组大鼠卵巢中Bcl-2/BaxmRNA比值和蛋白比值高于围绝经期对照组,差异有统计学意义(P0.05或P0.01)。结论:中药益坤宁通过上调围绝经期大鼠卵巢中凋亡相关基因bcl-2和bax的表达,上调Bcl-2/BaxmRNA比值和蛋白比值,从而延缓卵巢衰老,这可能是其治疗围绝经期综合征的分子机制之一。     

调理脾胃法治疗维持性血透患者营养不良的报告

目的:探讨调理脾胃法治疗维持性血透患者营养不良的效果.方法:40例维持性血透患者随机分为治疗组和对照组,两组在对症处理相同、血透相关因素一致条件下进行维持血透治疗,治疗组同时根据辨证分型服用调理脾胃中药,疗程3个月.结果:与本组治疗前相比较,治疗后的各项生化指标明显提高(P<0.01),蛋白分解率也较治疗前提高(P<0.05),SGA分级好转(P<0.01),临床常见症状体征积分随治疗时间延长呈下降趋势(P(0.05);治疗组与对照组治疗后的各项生化指标、蛋白分解率、SGA分级及临床常见症状体征积分等差异均具有显著性(P<0.05).结论:中药调理脾胃法可以改善维持性血透患者营养不良状况.     

止血方对围绝经期异常子宫出血肝肾阴虚证患者内分泌激素水平的影响

目的分析止血方对围绝经期异常子宫出血肝肾阴虚证患者内分泌激素水平的影响。方法将93例围绝经期异常子宫出血患者随机分为对照组46例和观察组47例,对照组予以米非司酮片治疗,观察组加用自拟止血方治疗,观察比较两组患者的临床疗效以及治疗前后促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E_2)、子宫内膜厚度、控制出血时间与完全止血时间的情况。结果观察组的FSH、LH、子宫内膜厚度、控制出血时间及完全止血时间均低于对照组(P0.05)。观察组E_2水平及总有效高于对照组,差异均有统计学意义(P0.05)。结论止血方可通过补益肝肾作用调节内分泌激素水平,改善卵巢功能,其凉血止血等作用能快速控制异常子宫出血,对围绝经期异常子宫出血肝肾阴虚证患者的疗效显著,值得临床推广。     

感应电治疗股外侧皮神经炎临床观察

目的:探讨感应电治疗股外侧皮神经炎的临床疗效.方法:将符合纳入标准的股外侧皮神经炎患者88例随机分为治疗组和对照组,对照组在髂前上棘下10cm处进行肌肉注射维生素B 1100mg和B1 20.5mg治疗,治疗组用感应电治疗.结果:治疗一疗程后蚁走感、烧灼感、麻木感积分改善情况治疗组与对照组比较差异有显著性(p<0.01或<0.05),治疗二疗程后各症状积分改善情况治疗组与对照组比较差异有显著性(p<0.01或<0.05);治疗一疗程后及治疗二疗程后治疗组的临床疗效均优于对照组(p<0.01或<0.05).结论:感应电治疗股外侧皮神经炎疗效较好,值得临床推广.     

逍遥丸联合布拉氏酵母菌治疗围绝经期功能性消化不良的疗效观察

目的探讨逍遥丸联合布拉氏酵母菌治疗围绝经期功能性消化不良(MPFD)的临床疗效。方法将64例MPFD患者随机分为对照组(n=30)和观察组(n=34),对照组用布拉氏酵母菌1.0g/次,2次/d,餐后服;治疗组在对照组基础上用逍遥丸8丸/次,3次/d口服,4周为1疗程。随访6个月的复发率。结果观察组显效率为47.06%,总有效率为88.23%;对照组显效率为23.33%,总有效率为66.67%。两组比较观察组明显优于对照组(P0.05)。6个月后两组复发率比较:观察组3例(10.00%),对照组8例(40.00%),两组比较差异有统计学意义(P0.05)。结论逍遥丸联合布拉氏酵母菌对MPFD有良好的临床疗效。     

On the origin of the Hirudinea and the demise of the Oligochaeta

The phylogenetic relationships of the Clitellata were investigated with a data set of published and new complete 18S rRNA gene sequences of 51 species representing 41 families. Sequences were aligned on the basis of a secondary structure model and analysed with maximum parsimony and maximum likelihood. In contrast to the latter method, parsimony did not recover the monophyly of Clitellata. However, a close scrutiny of the data suggested a spurious attraction between some polychaetes and clitellates. As a rule, molecular trees are closely aligned with morphology-based phylogenies. Acanthobdellida and Euhirudinea were reconciled in their traditional Hirudinea clade and were included in the Oligochaeta with the Branchiobdellida via the Lumbriculidae as a possible link between the two assemblages. While the 18S gene yielded a meaningful historical signal for determining relationships within clitellates, the exact position of Hirudinea and Branchiobdellida within oligochaetes remained unresolved. The lack of phylogenetic signal is interpreted as evidence for a rapid radiation of these taxa. The placement of Clitellata within the Polychaeta remained unresolved. The biological reality of polytomies within annelids is suggested and supports the hypothesis of an extremely ancient radiation of polychaetes and emergence of clitellates.     

On the ontogeny of the haptor and the evolution of the Monogenea

Data on the ontogeny of the posterior haptor of monogeneans were obtained from more than 150 publications and summarised. These data were plotted into diagrams showing evolutionary capacity levels based on the theory of a progressive evolution of marginal hooks, anchors and other attachment components of the posterior haptor in the Monogenea (Malmberg, 1986). 5 + 5 unhinged marginal hooks are assumed to be the most primitive monogenean haptoral condition. Thus the diagrams were founded on a 5 + 5 unhinged marginal hook evolutionary capacity level, and the evolutionary capacity levels of anchors and other haptoral attachement components were arranged according to haptoral ontogenetical sequences. In the final plotting diagram data on hosts, type of spermatozoa, oncomiracidial ciliation, sensilla pattern and protonephridial systems were also included. In this way a number of correlations were revealed. Thus, for example, the number of 5 + 5 marginal hooks correlates with the most primitive monogenean type of spermatozoon and with few sensillae, many ciliated cells and a simple protonephridial system in the oncomiracidium. On the basis of the reviewed data it is concluded that the ancient monogeneans with 5 + 5 unhinged marginal hooks were divided into two main lines, one retaining unhinged marginal hooks and the other evolving hinged marginal hooks. Both main lines have recent representatives at different marginal hook evolutionary capacity levels, i.e. monogeneans retaining a haptor with only marginal hooks. For the main line with hinged marginal hooks the name Articulon-choinea n. subclass is proposed. Members with 8 + 8 hinged marginal hooks only are here called Proanchorea n. superord. Monogeneans with unhinged marginal hooks only are here called Ananchorea n. superord. and three new families are erected for its recent members: Anonchohapteridae n. fam., Acolpentronidae n. fam. and Anacanthoridae n. fam. (with 7 + 7, 8 + 8 and 9 + 9 unhinged marginal hooks, respectively). Except for the families of Articulonchoinea (e.g. Acanthocotylidae, Gyrodactylidae, Tetraonchoididae) Bychowsky's (1957) division of the Monogenea into the Oligonchoinea and Polyonchoinea fits the proposed scheme, i.e. monogeneans with unhinged marginal hooks form one old group, the Oligonchoinea, which have 5 + 5 unhinged marginal hooks, and the other group form the Polyonchoinea, which (with the exception of the Hexabothriidae) has a greater number (7 + 7, 8 + 8 or 9 + 9) of unhinged marginal hooks. It is proposed that both these names, Oligonchoinea (sensu mihi) and Polyonchoinea (sensu mihi), will be retained on one side and Articulonchoinea placed on the other side, which reflects the early monogenean evolution. Except for the members of Ananchorea [Polyonchoinea], all members of the Oligonchoinea and Polyonchoinea have anchors, which imply that they are further evolved, i.e. have passed the 5 + 5 marginal hook evolutionary capacity level (Malmberg, 1986). There are two main types of anchors in the Monogenea: haptoral anchors, with anlages appearing in the haptor, and peduncular anchors, with anlages in the peduncle. There are two types of haptoral anchors: peripheral haptoral anchors, ontogenetically the oldest, and central haptoral anchors. Peduncular anchors, in turn, are ontogenetically younger than peripheral haptoral anchors. There may be two pairs of peduncular anchors: medial peduncular anchors, ontogentically the oldest, and lateral peduncular anchors. Only peduncular (not haptoral) anchors have anchor bars. Monogeneans with haptoral anchors are here called Mediohaptanchorea n. superord. and Laterohaptanchorea n. superord. or haptanchoreans. All oligonchoineans and the oldest polyonchoineans are haptanchoreans. Certain members of Calceostomatidae [Polyonchoinea] are the only monogeneans with both (peripheral) haptoral and peduncular anchors (one pair). These monogeneans are here called Mixanchorea n. superord. Polyonchoineans with peduncular anchors and unhinged marginal hooks are here called the Pedunculanchorea n. superord. The most primitive pedunculanchoreans have only one pair of peduncular anchors with an anchor bar, while the most advanced have both medial and lateral peduncular anchors; each pair having an anchor bar. Certain families of the Articulonchoinea, the Anchorea n. superord., also have peduncular anchors (parallel evolution): only one family, the Sundanonchidae n. fam., has both medial and lateral peduncular anchors, each anchor pair with an anchor bar. Evolutionary lines from different monogenean evolutionary capacity levels are discussed and a new system of classification for the Monogenea is proposed.In agreeing to publish this article, I recognise that its contents are controversial and contrary to generally accepted views on monogenean systematics and evolution. I have anticipated a reaction to the article by inviting senior workers in the field to comment upon it: their views will be reported in a future issue of this journal. EditorIn agreeing to publish this article, I recognise that its contents are controversial and contrary to generally accepted views on monogenean systematics and evolution. I have anticipated a reaction to the article by inviting senior workers in the field to comment upon it: their views will be reported in a future issue of this journal. Editor