属性层次模型在中医证候诊断中的应用

目的:研究一种综合考虑专家主观经验和机器学习客观规则的中医证候诊断模型。方法:基于属性层次分析模型,提出了一种可以应用于中医证候识别的方法,并编程实现了智能系统。系统融合中、西医多个特征构建决策属性,集成中医专家主观经验和机器学习客观规则联合辨证,实现了离散属性测度、相对属性权和合成属性权的计算方法。结果:构建了中医证候诊断系统,针对肝硬化样本病例学习辨证规则,并识别新样本的证候。结论:通过中医肝硬化数据进行系统的实例验证研究,表明该系统所得辨证结果与临床诊断吻合较好。     

属性层次模型在中医证候诊断中的应用

目的：研究一种综合考虑专家主观经验和机器学习客观规则的中医证候诊断模型。方法：基于属性层次分析模型,提出了一种可以应用于中医证候识别的方法,并编程实现了智能系统。系统融合中、西医多个特征构建决策属性,集成中医专家主观经验和机器学习客观规则联合辨证,实现了离散属性测度、相对属性权和合成属性权的计算方法。结果：构建了中医证候诊断系统,针对肝硬化样本病例学习辨证规则,并识别新样本的证候。结论：通过中医肝硬化数据进行系统的实例验证研究,表明该系统所得辨证结果与临床诊断吻合较好。     

证候空间和方剂空间的数学结构

本文考察了中医理、法、方、药原理,给出了证候空间和方剂空间的数学结构,以利于中医现代化和中医临床中应用电子计算机诊疗技术。     

胃溃疡中医证候动物模型研究进展

胃溃疡是一种常见的消化系统疾病,中医药治疗该病效果显著,但其治疗机制至今尚未明确。建立一套科学客观的胃溃疡中医证候动物模型及模型评价体系,对促进中医药在此领域的发展以及进一步的研究具有重大意义。笔者对近10年中医药治疗胃溃疡相关文献进行整理,总结和分析了胃溃疡中医证候动物模型的制作与评价方法,对肝胃不和证、脾胃湿热证、胃络瘀阻证、脾胃虚寒证、胃阴不足证、肝郁脾虚证等动物模型的制作方法进行总结,发现目前的胃溃疡动物模型存在中医辨证分型不够统一、造模思路与证型局限、造模方法标准不一、模型病证结合不紧密、模型评价体系不规范等问题,并提出模型改进意见,以期为此领域的研究提供参考。     

两种高血压大鼠模型证候特征差异性的研究

目的探讨两种经典高血压实验动物模型的证候特征,以便更好地考察降压中药疗效及作用机理。方法选择自发性高血压大鼠和肾性高血压大鼠两种经典常用动物模型,从宏观表征和行为学的角度,对二者的证候特征及其差异性进行辨析比较。结果自发性高血压大鼠在14～18周龄,基本符合高血压中医辨证分型中肝火上炎证型的表现;两肾一夹型肾性高血压大鼠在术后4～8周,基本符合高血压中医辨证分型中阴虚阳亢证型的表现。结论两种高血压动物模型的中医证候特征不同,在进行降压中药的疗效评价和作用机理实验研究时,可以考虑有针对性地选用。     

益气安神膏对心脾两虚型失眠患者睡眠质量及中医证候疗效的影响

目的:观察益气安神膏对心脾两虚型失眠患者睡眠质量及中医症候疗效的影响,为膏方应用于失眠调理提供理论依据。方法:选取2016年10月至2017年10月来广州中医药大学第一附属医院就诊的70例心脾两虚型失眠患者作为研究对象,按照就诊顺序,由电脑产生随机数字,根据数字奇偶性分为对照组(35例)和试验组(35例)。在认知行为治疗(CBT-I)干预基础上,试验组予口服益气安神膏1匙(约15g)/次,每日2次,对照组予口服归脾丸10丸/次,每日3次,4周为1疗程,两组均连续服用8周2疗程。采用匹兹堡睡眠质量指数量表(PSQI)、中医证候评分量表评分评估睡眠质量及中医证候疗效。结果:试验组总有效率为94.3%(治愈2例,有效31例),高于对照组的77.1%(治愈1例,有效26例),差异有统计学意义(P0.05)。治疗前,两组PSQI评分差异无统计学意义(P0.05);治疗后,试验组得分(8.1±2.8)分,对照组得分(10.4±3.8)分,前者明显低于后者,差异具有统计学意义(P0.05)。中医证候疗效方面,相较于对照组,试验组疗效更佳,差异有统计学意义(P0.05)。结论:益气安神膏在改善睡眠质量及中医证候疗效方面均优于归脾丸,其临床疗效明显,服用方便,可适用于临床慢性失眠患者的调理。     

慢性心力衰竭中医证候的研究进展

慢性心力衰竭是大多数心血管疾病的最终转归,也是最主要的死亡原因之一。本文主要探讨中医对慢性心力衰竭证候的认识,从病因病机、证候分布规律、临床动态分期3个方面对慢性心衰的证候研究现状做一简要的综述,分析证候内部及证候之间的组合特点,为临床研究提供依据,推动相关证型的标准化、规范化进程。     

踝肱指数与糖尿病周围神经病变及中医证候积分的相关性

目的：探讨踝肱指数（ABI）与糖尿病周围神经病变及中医证候积分的相关性。方法：选取我院内分泌科收治辩证以气阴两虚 为证型的糖尿病患者66 例，根据踝肱指数实验将患者分为ABI降低组（0.9>ABI>0.5）和ABI 正常组(1.4>ABI>0.9)。记录患者神 经病变症状尼龙丝检查以及中医症候评分，分析ABI与糖尿病周围神经病变及中医证候积分的相关性。结果：ABI降低组的糖尿 病周围神经病变的患病率高于ABI正常组（P<0.05）。ABI 降低组发麻、针刺感症状的发生率高于ABI 正常组，且有统计学差异 （P<0.05）。ABI降低组10 g尼龙丝检查异常者多于ABI正常组，差异显著（P<0.05）。ABI降低组的感觉振动阈值高于ABI正常组 （P<0.05）。ABI数值与中医证候积分呈负向直线相关（P<0.05）。结论：糖尿病患者ABI数值与糖尿病周围神经病变和中医证候积 分具有相关性。     

加味消痞汤对脾虚痰瘀型高脂血症患者血脂水平及中医证候症状的影响

目的:探讨加味消痞汤治疗脾虚痰瘀型高脂血症(HL)的临床疗效,并探讨其对血脂水平及中医证候症状的影响。方法:选择2018年8月~2019年12月我院收治的脾虚痰瘀型HL患者96例,按照随机数字表法将其分为观察组50例和对照组46例,观察组采用加味消痞汤治疗,对照组采用血脂康胶囊治疗。比较两组患者临床疗效、治疗前后血脂变化、中医证候积分变化及药物治疗期间不良反应发生情况。结果:观察组患者治疗总有效率94.00%显著高于对照组78.26%,差异具有统计学意义(P<0.05)。治疗后两组患者总胆固醇(TC)、甘油三脂(TG)以及低密度脂蛋白胆固醇(LDL-C)水平较治疗前明显下降(P<0.05),而高密度脂蛋白胆固醇(HDL-C)水平显著升高(P<0.05),且治疗后观察组患者TC、TG以及LDL-C水平低于对照组,HDL-C水平高于对照组(P<0.05)。两组患者治疗后中医证候总积分均明显低于治疗前,且观察组低于对照组(P<0.05)。两组患者治疗前后肝肾功能、血尿常规均无明显异常,且治疗期间两组患者均未发生药物相关不良反应。结论:加味消痞汤治疗脾虚痰瘀型HL患者,临床疗效确切,能够有效降低患者血脂水平,且患者临床症状改善明显,用药安全,值得临床推广应用。     

穴位贴敷联合中药足浴治疗痰浊上蒙型眩晕的效果

目的 观察穴位贴敷联合中药足浴治疗痰浊上蒙型眩晕的效果。方法 将2021年7月至2022年6月在我院治疗的112例痰浊上蒙型眩晕患者随机分为对照组与观察组,每组56例。对照组采用西药治疗,观察组在对照组的治疗基础上采用穴位贴敷及中药足浴治疗。观察比较两组的临床疗效以及中医证候积分、血流动力学、眩晕障碍量表(DHI)评分、活动平衡信心量表(ABC)评分改善情况。结果 观察组的临床总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的主证、次证、兼证及舌苔脉象等中医证候积分比较,差异无统计学意义(均P>0.05);治疗后,观察组各项指标中医证候积分均明显低于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组患者的平均血流速度(Vm)、基底动脉血流速度(BA)、右侧椎动脉血流速度(RVA)、左侧椎动脉血流速度(LVA)比较,差异均无统计学意义(均P>0.05);治疗后,观察组的Vm、BA、RVA及RVA指标水平均高于对照组,差异均有统计学意义(均P<0.05)。两组患者治疗前的DHI及ABC评分比较,差异无统计学意义(均P>0...     

The Treatment of Irritable Bowel Syndrome with Hypnotherapy

Previous research from the United Kingdom has shown hypnotherapy to be effective in the treatment of irritable bowel syndrome (IBS). The current study provides a systematic replication of this work in the United States. Six matched pairs of IBS patients were randomly assigned to either a gut-directed hypnotherapy (n=6) or to a symptom monitoring wait-list control condition (n=6) in a multiple baseline across subjects design. Those assigned to the control condition were later crossed over to the treatment condition. Subjects were matched on concurrent psychiatric diagnoses, susceptibility to hypnosis, and various demographic features. On a composite measure of primary IBS symptoms, treatment was superior (p=.016) to symptom monitoring. Results from the entire treated sample (n=11; one subject was removed from analysis) indicate that the individual symptoms of abdominal pain, constipation, and flatulence improved significantly. State and trait anxiety scores were also seen to decrease significantly. Results at the 2-month follow-up point indicated good maintenance of treatment gains. No significant correlation was found between initial susceptibility to hypnosis and treatment gain. A positive relationship was found between the incidence of psychiatric diagnosis and overall level of improvement.     

泼尼松龙致不同品系小鼠药源性证候的比较

目的研究糖皮质激素药物作用于不同品系小鼠后肾上腺皮质功能抑制程度及其诱导药源性证候的差异性。方法选用ICR、BALB/c、C57BL/6J、KM和裸小鼠5种小鼠为实验对象,采用泼尼松龙进行干预。每种小鼠16只,其中正常对照组8只,泼尼松龙组8只。以0.5 mg/(kg·d)泼尼松龙连续灌胃14 d,每日观测小鼠体重,在给药第14天,运用小鼠辨证论治实验方法学检测小鼠中医四诊信息,次日处死小鼠,取脾、胸腺称重并计算脏器指数;运用ELISA检测血清皮质酮和ACTH含量;采用实时荧光定量PCR技术检测肾上腺Star、Cyp11a1、Cyp21a1、Cyp11b1、Cyp11b2基因表达;运用Western blot方法检测肾上腺LDLR、SRBI、StAR蛋白表达。结果与各自对照组比较:1)0.5 mg/(kg·d)泼尼松龙给药后第7天起ICR小鼠体重显著下降(P<0.01);给药后第13天起BALB/c小鼠体重显著下降(P<0.01);给药后第5天起C57BL/6J小鼠体重显著下降(P<0.01);给药后第13天裸鼠体重显著下降(P<0.05)。2)泼尼松龙导致ICR小鼠抓力显著下降以及躯干平均温度显著降低(P<0.05)。3)泼尼松龙导致ICR小鼠和裸鼠脾重量显著下降(P<0.01)以及裸鼠脾指数下降(P<0.05),泼尼松龙导致ICR、C57BL/6J和KM小鼠胸腺重量和胸腺指数均显著下降(P<0.01)。4)泼尼松龙显著导致BALB/c与KM小鼠血清皮质酮下降(P<0.05),也显著引起BALB/c小鼠血清促肾上腺皮质激素(ACTH)含量下降(P<0.01)。5)泼尼松龙显著下调ICR小鼠肾上腺Cyp21a1基因表达(P<0.05),下调C57BL/6J小鼠Star基因表达(P<0.01),下调KM小鼠Cyp11a1、Cyp21a1基因表达(P<0.01),下调裸鼠Star与Cyp21a1基因表达(P<0.05);且泼尼松龙抑制ICR小鼠肾上腺LDLR蛋白表达以及KM小鼠肾上腺StAR蛋白表达。结论泼尼松龙造成的小鼠药源性虚证主要表现为"气虚",涉及中医"肾藏象"与"脾藏象",其物质基础以肾上腺皮质类固醇激素合成酶分子表达被抑制以及垂体-肾上腺皮质轴功能被抑制为主;开展糖皮质激素药源性虚证研究建议首选ICR小鼠。     

肝郁脾虚证模型大鼠血流变及TXB_2、PGFla的变化（英文）

目的：探查中医肝郁脾虚证模型的血流变及相关调节因子的状态。方法：采用慢性束缚应激＋过度疲劳＋饮食失节法建立大鼠肝郁脾虚证模型,测定大鼠造模三周、自然恢复一周时的血流变和血浆TXB2、PGF1a。结果：与正常组相比,模型组大鼠造模三周150/s、38/s、10/s、5/s切变率下的全血粘度、还原粘度均显著升高（P〈0.001）,红细胞聚集指数显著降低（P〈0.001）,红细胞压积显著升高（P〈0.01）,红细胞变形指数无显著性差异（P〉0.05）;血浆TXB2显著升高（P〈0.001）,6-keto-PGF1a显著降低（P〈0.05）,TXB2/PGF1a显著升高（P〈0.01）;模型组大鼠第四周150/s、38/s、10/s、5/s切变率下的全血粘度、还原粘度仍显著升高（P〈0.001或P〈0.01）;红细胞聚集指数显著降低（P〈0.001）;红细胞压积与变形指数无显著性差异（P〉0.05）;血浆TXB2和TXB2/PGF1a显著降低（P〈0.05）,6-keto-PGF1a显著升高（P〈0.05）。结论：肝郁脾虚证大鼠存在血液高粘和血栓易形成状态,恢复期血液高粘同时伴有扩血管因素的加强。提示肝郁脾虚证有血流变的异常和血浆TXB2-PGI2的平衡失调,主要涉及到血小板和血浆因素的参与。     

肝郁脾虚证模型大鼠血流变及TXB2、PGFla的变化

目的:探查中医肝郁脾虚证模型的血流变及相关调节因子的状态。方法:采用慢性束缚应激+过度疲劳+饮食失节法建立大鼠肝郁脾虚证模型,测定大鼠造模三周、自然恢复一周时的血流变和血浆TXB2、PGF1a。结果:与正常组相比,模型组大鼠造模三周150/s、38/s、10/s、5/s切变率下的全血粘度、还原粘度均显著升高(P<0.001),红细胞聚集指数显著降低(P<0.001),红细胞压积显著升高(P<0.01),红细胞变形指数无显著性差异(P>0.05);血浆TXB2显著升高(P<0.001),6-keto-PGF1a显著降低(P<0.05),TXB2/PGF1a显著升高(P<0.01);模型组大鼠第四周150/s、38/s、10/s、5/s切变率下的全血粘度、还原粘度仍显著升高(P<0.001或P<0.01);红细胞聚集指数显著降低(P<0.001);红细胞压积与变形指数无显著性差异(P>0.05);血浆TXB2和TXB2/PGF1a显著降低(P<0.05),6-keto-PGF1a显著升高(P<0.05)。结论:肝郁脾虚证大鼠存在血液高粘和血栓易形成状态,恢复期血液高粘同时伴有扩血管因素的加强。提示肝郁脾虚证有血流...     

Individual differences in boldness positively correlate with heart rate in orb-weaving spiders of genus Larinioides

Recent years have seen a dramatic increase in the number of studies devoted to consistent individual differences in behavior, termed ＂behavioral syndromes＂ or animal ＂personality＂. In particular, ecologists and evolutionary biologists alike seek to explore the functional consequences of individuals＇ personalities and explanations for their general maintenance. Understand ing the mechanistic underpinnings to personality is arguably key to a deeper understanding of their functional consequences and maintenance. In particular, consistent individual differences in metabolic rate have been proposed as a general explanation for the maintenance of consistent individual differences in boldness, aggressiveness, and activity level. In this paper we explore whether consistent individual differences in boldness are associated with heat rate, a proxy for metabolic rate, in two species of orbweaving spider： Larinioides cornutus and L. patagiatus. We first documented consistent individual differences in boldness in L. cornutus but not L. patagiatus, as estimated by individuals＇ latency to resume movement following an aversive stimulus. We also measured individuals＇ heart rate twice in a separate situation. We then tested for an association between individuals＇ boldness and their heart rate during these two events. We found that increased boldness was associated with increased heart. Thus, indi viduals that resumed movement quickly following an aversive stimulus also exhibited faster heart rates. Our studies provide fur ther evidence that consistent individual differences in key physiological attributes, like metabolic rate, might be a general mecha nism underlying consistent individual differences in behavior .     

The fractal dimension approach in posture: a comparison between Down and Prader–Willi syndrome patients

The suitability of new dynamic system analysis was investigated to compare postural control in Prader-Willi syndrome (PWS) and Down syndrome (DS) patients. Time-domain, frequency-domain parameters and fractal dimension (FD) of centre of pressure (CoP) were computed in maintaining normal standing on a force platform in 20 DS and 13 PWS patients, compared to 26 obese (obese control group, OCG) and 20 healthy individuals (healthy control group, HCG). DS and PWS showed greater displacements along both directions and longer sway path (SP) parameter than HCG and OCG, with statistical differences between PWS and DS for anteroposterior displacement and SP. DS used higher frequency strategy when compared to PWS, OCG and HCG. Both DS and PWS were characterised by greater values of FD than OCG and HCG, with higher values in DS. The analyses in frequency domain and of the dynamic nature of CoP suggest that DS patients are characterised by a more complex and irregular signal than PWS patients.     

产蛋下降综合征病毒核酸J片段的确证和序列测定

产蛋下降综合征病毒核酸Ｊ片段的确证和序列测定张兹钧,胡木枝（拱北动植物检疫局,珠海５１９０２０）金由辛（中国科学院上海生物化学研究所分子生物学国家重点实验室,上海２０００３１）关键词产蛋下降综合征;Ｊ片段;ＤＮＡ片段产蛋下降综合征（ＥｇｇＤｒｏＰＳｙ...     

Prader-Willi syndrome with an unusually large 15q deletion due to an unbalanced translocation t(4;15)

Prader-Willi syndrome (PWS) is a neurobehavioral disorder caused by deletions in the 15q11-q13 region, by maternal uniparental disomy of chromosome 15 or by imprinting defects. Structural rearrangements of chromosome 15 have been described in about 5% of the patients with typical or atypical PWS phenotype. An 8-year-old boy with a clinical diagnosis of PWS, severe neurodevelopmental delay, absence of speech and mental retardation was studied by cytogenetic and molecular techniques, and an unbalanced de novo karyotype 45,XY,der(4)t(4;15)(q35;q14),-15 was detected after GTG-banding. The patient was diagnosed by SNURF-SNRPN exon 1 methylation assay, and the extent of the deletions on chromosomes 4 and 15 was investigated by microsatellite analysis of markers located in 4qter and 15q13-q14 regions. The deletion of chromosome 4q was distal to D4S1652, and that of chromosome 15 was located between D15S1043 and D15S1010. Our patient's severely affected phenotype could be due to the extent of the deletion, larger than usually seen in PWS patients, although the unbalance of the derivative chromosome 4 cannot be ruled out as another possible cause. The breakpoint was located in the subtelomeric region, very close to the telomere, a region that has been described as having the lowest gene concentrations in the human genome.     

肾综合征出血热病毒糖蛋白的提纯和鉴定

以感染肾综合征出血热病毒(HFRSV)的Vero E6细胞为材料,用免疫亲和层析结合制备聚丙烯酰胺凝胶电泳(PAGE)从感染细胞中提纯了HFRSV两种糖蛋白。先用免疫亲和层析从感染细胞的粗制抗原中获得含有四种蛋白的混合液,用[~3H]-氨基葡萄糖在感染细胞中标记病毒糖蛋白,观察到[~3H]-氨基葡萄糖只结合入78K和57K的病毒蛋白。再用制备SDS-PAGE从HFRSV混合液中提纯78K和57K两种蛋白。实验证明这两种糖蛋白均具中和抗原决定簇,57K的糖蛋白尚具血凝活性,初步鉴定表明这两种糖蛋白相当于文献报道的HFRSV G_1和G_2。