心元胶囊对慢性心力衰竭心血瘀阻证患者心脏超声参数、脂质代谢及血液流变学的影响

摘要 目的：探讨心元胶囊对慢性心力衰竭（CHF）心血瘀阻证患者心脏超声参数、脂质代谢及血液流变学的影响。方法：根据随机数字表法,将我院2020年3月~2022年3月期间收治的的CHF心血瘀阻证患者120例分为对照组（常规西药治疗,n=60）和观察组（心元胶囊联合常规西药治疗,n=60）。对比两组中医疗效、心功能指标、血脂指标、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、N-末端脑钠肽前体（NT-proBNP）、血液流变学指标,并观察两组不良反应情况。结果：观察组的中医总有效率明显高于对照组（P<0.05）。两组治疗后左室射血分数升高,左室舒张末期容量、左室收缩末期容量缩小,且观察组的改善效果优于对照组（P<0.05）。两组治疗后三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）下降,高密度脂蛋白胆固醇（HDL-C）升高,且观察组的改善效果优于对照组（P<0.05）。两组治疗后CK、CK-MB、NT-proBNP下降,且观察组的改善效果优于对照组（P<0.05）。两组治疗后全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原下降,且观察组的改善效果优于对照组（P<0.05）。两组不良反应发生率对比,差异无统计学意义（P>0.05）。结论：心元胶囊治疗CHF心血瘀阻证可提高临床疗效,改善心功能,调节脂质代谢、血液流变学水平,安全有效。     

玉肤解毒膏治疗结直肠癌患者卡培他滨化疗所致手足综合征的疗效观察

摘要 目的：观察玉肤解毒膏治疗结直肠癌患者卡培他滨化疗所致手足综合征的临床疗效,为临床提供合理治疗方案。方法：选择2021年月-2022年5月湖南省肿瘤医院门诊或住院部确诊为结直肠癌行含卡培他滨方案化疗所致手足综合征患者60例。所有患者采用抛掷硬币法分为玉肤解毒膏组和尿素软膏组,各30例。玉肤解毒膏组采用玉肤解毒膏治疗;尿素软膏组采用尿素软膏治疗,2组均连续治疗21 d。观察2组手足综合征分级改善情况、临床疗效、中医证候积分、疼痛视觉模拟评分（VAS）、手足皮肤反应生活质量量（HF-QoL）评分及焦虑自评量表（SAS）评分。结果：玉肤解毒膏组在降低手足综合征分级及提高治疗总有效率上均优于尿素软膏组（P＜0.05）;治疗后2组中医证候积分、VAS评分、HF-QoL评分及SAS评分较治疗前降低（P＜0.05）,且玉肤解毒膏组均低于尿素软膏组（P＜0.05）。结论：玉肤解毒膏治疗结直肠癌患者卡培他滨化疗所致手足综合征的临床疗效确切,可有效降低患者临床分级,降低中医证候积分、缓解疼痛症状,改善患者生活质量及焦虑状况,具有一定的临床应用价值。     

游离睾酮指数联合血清GnSAF、SHBG对多囊卵巢综合征不孕患者IVF-ET治疗妊娠结局的预测价值

摘要 目的：探讨游离睾酮指数（FAI）联合血清促性腺激素平抑因子（GnSAF）、性激素结合球蛋白（SHBG）对多囊卵巢综合征（PCOS）不孕患者体外受精-胚胎移植（IVF-ET）治疗妊娠结局的预测价值。方法：选取2020年1月～2022年6月湖南省妇幼保健院生殖医学中心收治的197例PCOS不孕患者为PCOS组,根据IVF-ET治疗妊娠结局分为妊娠失败组和妊娠成功组,另选取同期68名体检健康妇女为对照组。收集PCOS不孕患者临床资料,计算FAI并检测血清GnSAF、SHBG水平。采用单因素和多因素Logistic回归分析PCOS不孕患者IVF-ET治疗妊娠结局的影响因素,采用受试者工作特征（ROC）曲线分析FAI和血清GnSAF、SHBG对PCOS不孕患者IVF-ET治疗妊娠结局的预测价值。结果：PCOS组FAI和血清GnSAF水平高于对照组,SHBG水平低于对照组（P＜0.05）。197例PCOS不孕患者IVF-ET治疗妊娠成功率为51.27%（101/197）。单因素分析显示,妊娠失败组体质指数、黄体生成素（LH）、LH/促卵泡生成素（FSH）、睾酮、抗苗勒管激素（AMH）、FAI、GnSAF高于妊娠成功组,FSH、受精率、优胚率、SHBG低于妊娠成功组（P＜0.05）。多因素Logistic回归分析显示,体质指数增加和LH、LH/FSH、AMH、FAI、GnSAF升高为PCOS不孕患者IVF-ET治疗妊娠失败的独立危险因素,SHBG升高为其独立保护因素（P＜0.05）。ROC曲线分析显示,FAI和血清GnSAF、SHBG联合预测PCOS不孕患者IVF-ET治疗妊娠结局的曲线下面积大于FAI、GnSAF、SHBG单独预测。结论：FAI和血清GnSAF、SHBG水平联合预测PCOS不孕患者IVF-ET治疗妊娠结局的价值较高。     

原发性肾病综合征合并血栓栓塞的临床研究

摘要 目的：肺栓塞及下肢深静脉血栓是影响肾病综合征(Nephrotic Syndrome,NS)预后的重要因素,但在其发生率以及治疗方面仍存在争议。本文将通过回顾性的病例研究对NS患者中血栓栓塞事件的发生率、危险因素以及是否需要早期干预等问题进行探讨。方法：收集上海交通大学医学院附属新华医院肾内科2014年1-12月诊断为原发性NS患者,并同时收集患者基本临床信息,血栓检查结果以及NS相关血液及尿液检查结果等在内的临床资料,采用多种统计方法分析血栓发生率及其危险因素,并进一步讨论NS患者的预防性抗凝措施。结果：NS患者下肢静脉血栓或肺栓塞的发生率均为15.4%,两种血栓同时发生的概率为9.6%。NS患者血栓事件的发生率与D-二聚体、血浆白蛋白、病程、病理类型呈明显相关,且具有统计学意义。结论：NS患者血栓栓塞的发生率与D-二聚体、血浆白蛋白、病程、病理类型呈显著相关,膜性肾病患者血栓栓塞发生率最高。如NS患者合并高危因素,建议定期筛查,综合评估后预防性抗凝。     

Evolutionary breakdown of distyly to homostyly is accompanied by reductions of floral scent in Primula oreodoxa

Reproductive traits that function in pollinator attraction may be reduced or lost during evolutionary transitions from outcrossing to selfing. Although floral scent plays an important role in attracting pollinators in outcrossing species, few studies have investigated associations between floral scent variation and intraspecific mating system transitions. The breakdown of distyly to homostyly represents a classic example of a shift from outcrossing to selfing and provides an opportunity to test whether floral fragrances have become reduced and/or changed in composition with increased selfing. Here, we evaluate this hypothesis by quantifying floral volatiles using gas chromatography-mass spectrometry in two distylous and four homostylous populations of Primula oreodoxa Franchet, a perennial herb from SW China. Our analysis revealed significant variation of volatile organic compounds (VOCs) among populations of P. oreodoxa. Although there was no difference in VOCs between floral morphs in distylous populations as predicted, we detected a substantial reduction in VOC emissions and the average number of scent compounds in homostylous compared with distylous populations. A total of 12 compounds, mainly monoterpenoids and sesquiterpenoids, distinguished homostylous and distylous morphs; of these, (E)-β-ocimene was the most important in contributing to the difference in volatiles, with significantly lower emissions in homostyles. Our findings support the hypothesis that the transition from outcrossing to selfing is accompanied by the loss of floral volatiles. The modification to floral fragrances in P. oreodoxa associated with mating system change might occur because high selfing rates in homostylous populations result in relaxed selection for floral attractiveness.     

Floral scent emission is the highest at the second night of anthesis in Lonicera japonica (Caprifoliaceae)

Floral color change in diverse plants has been thought to be a visual signal reflecting changes in floral rewards, promoting pollinator foraging efficiency as well as plant reproductive success. It remains unclear whether olfactory signals co-vary with floral color change. We investigated the production rhythms of floral scent and nectar associated with floral color change in Lonicera japonica. The flowers generally last 2–3 days. They are white on opening at night (N1) and become light yellow the following day (D1), yellow on the second night (N2), and golden on the second day of flowering (D2). Our measurements in the four stages indicated that nectar production decreased significantly from N1 and D1 to N2 and D2, tracking the floral color change. A total of 34 compounds were detected in floral scent and total scent emission was significantly higher in N2 than in the other three stages. The scent emission of three major compounds, Linalool, cis-3-Hexenyl tiglate, and Germacrene D was also significantly higher in N2, but the relative content of Linalool decreased gradually, cis-3-Hexenyl tiglate increased gradually, and the relative content of Germacrene D did not differ among the four measured stages. Greater scent emission by night than by day suggested a strong olfactory signal to attract nocturnal hawkmoths, the effective pollinators. However, floral scent rhythms in the four stages did not match the color change and nectar secretion, suggesting that floral color (visual) and scent (olfactory) in this species may play different roles in attracting or filtering various visitors.     

L-Tryptophan: Biochemical,nutritional and pharmacological aspects

Summary Tryptophan is important both for protein synthesis and as a precursor of niacin, serotonin and other metabolites. Tryptophan is an unusual amino acid because of the complexity of its metabolism, the variety and importance of its metabolites, the number and diversity of the diseases it is involved in, and because of its use in purified form as a pharmacological agent. This review covers the metabolism of tryptophan, its presence in the diet, the disorders associated with low tryptophan levels due to low dietary intake, malabsorption, or high rates of metabolism, the therapeutic effects of tryptophan and the side effects of tryptophan when it is used as a drug including eosinophilia myalgia syndrome.     

非线性映射和聚类分析在中风病证候分类中的应用

本文用非线性映射和聚类分析方法,给出了中风病的四个类型,为中风病的证候分类提供了分析方法和信息．     

艾滋病合并隐球菌感染17例尸检材料的临床病理学研究

在１５１例艾滋病尸检材料中发现１７例合并隐球菌感染,均经病理学确诊,患者男１５名,女２名,平均４３．６岁。１２例发生脑膜炎、肺炎和淋巴结炎各７例,尚见脾（６例）、肾（５例）等器官受累。９例为播散性感染。病变为慢性肉牙肿性,其中见有隐球菌。本文描述隐球菌性脑膜炎、肺炎等临床病理学表现,并讨论其病变特征与病理诊断问题。