Fe-Cu-Zn-Mo同位素示踪氧化还原过程

非传统稳定同位素（Fe-Cu-Zn-Mo）理论与数据相结合提高了科研工作者对地质体系氧化还原过程的理解。本文对这一相对较新的领域进行了综述,包括与氧化还原过程相关的同位素分馏理论和实验约束、时空尺度下的氧逸度以及同位素示踪氧化还原过程。稳定同位素理论预测,Fe-Cu-Zn-Mo同位素应该对氧化还原状态的变化能够做出响应。结果表明,Fe同位素作为岩浆过程、表生过程、俯冲带流体性质"氧逸度计"应用前景广阔;Cu同位素在岩浆、热液、陆地系统可以很好地示踪氧化还原过程;Zn同位素由于络合过程分馏已经被用在许多不同环境中作为含硫/碳流体迁移的敏感示踪剂;Mo同位素作为古氧逸度计可有效重建古海洋-大气氧化还原状态。     

Provenance of Conglomerate and Sandstone from Early Permian Shoushangou Formation in Xi Ujimqin, Inner Mongolia: Implications for Understanding Paleo-Asian Ocean Subduction

During the Late Carboniferous to Early Permian, a rift was formed by post-collisional extension after ocean closure or an island arc-related basin formed by Paleo-Asian Ocean (PAO) subduction in the Xi Ujimqin area. Nevertheless, the closure time of the PAO is still under debate. Thus, to identify the origin of the PAO, the geochemistry and U-Pb age of zircons were analyzed for the extra-large deep marine, polymict clastic boulders and sandstones in the Shoushangou Formation within the basin. The analyses revealed magmatic activity and tectonic evolution. The conglomerates include megaclasts of granite (298.8 ± 9.1?Ma) and granodiorite porphyry (297.1 ± 3.1?Ma), which were deposited by muddy debris flow. Results of this study demonstrated that the boulders of granitoids have the geochemistry of typical I-type granite, characterized by low Zr + Nb + Ce + Y and low Ga/Al values. The granitoid boulders were formed in island arc setting, indicating the presence of arc magmatism in the area that is composed of the Late Carboniferous to Early Permian subduction-related granitoid in southern Xi Ujimqin. Multiple diagrams for determining sedimentary provenance using major and trace elements indicate that Shoushangou sediments originated from continental island arc-related felsic rocks. Detrital zircon U-Pb age cluster of 330–280?Ma was obtained, indicating input from granite, ophiolite, Xilin Gol complex, and Carboniferous sources to the south. The basin was geographically developed behind the arc during the Early Permian period because the outcropped intrusive rocks in the Late Carboniferous to Early Permian form a volcanic arc. The comprehensive analyses of source areas suggest that Shoushangou sediments developed in a backarc basin in response to the northward subduction of the PAO. The backarc basin and intrusive rocks, in addition to previously published Late Carboniferous to Early Permian magmatic rocks of arc unit in Xilin Gol, confirm the presence of an Early Permian trench-arc-basin system in the region, represented by the Baolidao arc and Xi Ujimqin backarc basin. This study highlights the importance and potential of combined geochemical and geochronological studies of conglomerates and sandstone for reconstructing the geodynamic setting of a basin.     

中药治疗急性扁桃体炎临床疗效的Meta分析

目的:系统评价中药治疗急性扁桃体炎的临床疗效。方法:计算机检索中国知网（CNKI）、中国生物医学文献服务系统（SinoMed）、万方数据（WANFANG DATA）、维普中文科技期刊数据库（VIP）、医药学文献资料库（Embase）、PubMed、Cochrane Library、Web of Science等数据库,检索时间为自建库至2023年6月10日,搜集有关中药治疗青少年及成人急性扁桃体炎的临床随机对照试验（RCT）,采用Cochrane偏倚风险工具评估所纳入的文献,采用Rev Man 5.3软件进行Meta分析。结果：共纳入文献11篇,患者880例。Meta分析结果显示,治疗组的总有效率［OR=3.37,95%CI(2.27,5.00),P＜0.00001］、咽痛评分［MD=-0.48,95%CI(-0.81,-0.15),P=0.004］、扁桃体肿大评分［MD=-0.45,95%CI(-0.75,-0.16),P=0.003］、热退时间［SMD=-1.01,95%CI(-1.72,-0.31),P=0.005］、咽痛改善时间［SMD=-1.59,95%CI(-2.24,-0.94),P＜0.00001］、扁桃体充血缓解时间［SMD=-1.10,95%CI(-1.55,-0.65),P＜0.00001］、并发症发生情况［OR=0.21,95%CI(0.10,0.44),P＜0.0001］均优于对照组。结论：中药治疗青少年及成人急性扁桃体炎疗效确切,并发症少。     

孙阁运用调神疏风法治疗周围性面神经麻痹急性期经验

介绍孙阁主任医师运用调神疏风法治疗周围性面神经麻痹急性期的经验。 孙师认为周围性面神经麻痹的发生与正气不足、复感风邪等因素有关,病位在面部经筋,其基本病机为经气痹阻,经筋功能失调。临床应重视调神、安神、治神,同时辅以疏风治疗,形神同治,疗效较佳。并附验案1则,以资佐证。     

中医医院癌症患者医疗服务获得感现状及影响因素分析

目的：调查在中医医院就诊的癌症患者医疗服务获得感现状、分析影响因素并探索其提升策略。方法：选取2023年1～7月在湖南中医药大学第一附属医院就诊的344 例癌症患者作为调查对象,使用一般资料调查表、医疗服务获得感评价指标量表进行调查,了解其医疗服务获得感现状,并采用多元线性回归分析相关影响因素。结果：回收有效问卷334份。癌症患者医疗服务获得感评价指标10个条目的平均认可度为95.81%。单因素分析结果显示,居住地、医保类型、学历、职业、家庭年收入、婚姻状况、疾病分期的中医医院癌症患者医疗服务获得感认可度差异有统计学意义（P<0.05）。Pearson相关分析结果显示,中医医院癌症患者的医疗服务获得感与就医便捷度、高级专家诊疗便捷度、配药便捷度、就医时间接受度、诊疗有效性等因素呈正相关。多元线性回归分析结果显示,居住地、医保类型、家庭年收入、疾病分期是中医医院癌症患者医疗服务获得感的独立影响因素。结论：中医医院癌症患者医疗服务获得感虽总体处于较高水平,但高级专家诊疗便捷度、医疗费用接受度明显低于平均水平。因此,医护人员需采取措施提高癌症患者医疗服务获得感。     

顾宁基于气血理论治疗冠心病介入术后经验

介绍顾宁教授基于气血理论治疗冠心病介入术后经验。顾教授认为,冠心病介入术后心绞痛主要病机为气虚血瘀,以气虚为本,血瘀为标,强调活血以治标,益气以固本的治疗原则,气血同调,以益气活血为主,方用补阳还五汤加减,同时,根据冠心病介入术后患者的临证特点,辨病与辨证相结合,临床疗效颇佳。并附验案2则,以资佐证。     

基于数据挖掘探析张奇文治疗癫痫的用药规

目的：基于数据挖掘技术探析全国名中医张奇文治疗癫痫的用药规律。方法：收集1998年9月1日至2019年9月30日张奇文治疗癫痫的医案,对医案中的数据进行规范化处理,构建数据库,应用古今医案云平台V2.3.5对中药使用频次、四气五味、功效归经、关联、聚类等进行分析,并总结临床经验。结果：共筛选出40首处方,中药120味。排前10位的中药分别为全蝎、蜈蚣、僵蚕、炙甘草、麦芽、山楂、钩藤、羚羊角、珍珠、牛黄,药性以平、温为主,药味主要为甘、辛、苦,主要归肝、肺、脾经,功效以通络止痛、攻毒散结、息风镇痉等为主。关联组合支持度高的组合为全蝎-蜈蚣、全蝎-僵蚕、僵蚕-蜈蚣、钩藤-全蝎、钩藤-蜈蚣。结论：张奇文治疗癫痫标本兼顾,治标重视息风,治本重视健脾。