扑热息痛片致药疹1例

1 基本资料 患者,男,27岁,因头痛自服一片扑热息痛(0.3 g/片),约3 h后出现局部皮肤瘙痒难耐而就诊.查体:体温37 ℃,脉搏82次/min,呼吸20次/min,血压125/80 mm Hg.口唇红斑,下唇红斑上有2 cm×3 cm范围成片簇集血疱;双手虎口周围有4 cm×4 cm红斑,左手红斑上有0.5 cm×1cm血疱1个;左脚拇趾第一节趾骨背面有2 cm×4 cm红斑,右脚根部有3 cm×4 cm红斑.     

Efficacy of Getong Tongluo Capsule(葛酮通络胶嚢)for Convalescent-Phase of Ischemic Stroke and Primary Hypertension:A Multicenter,Randomized,Double-Blind,Controlled Trial

Objective:To evaluate whether the efficacy of Getong Tongluo Capsule(葛酮通络胶囊,GTC,consisted of total flavone of Radix Puerariae)on improving patients'quality of life and lowering blood pressure are superior to the extract of Ginkgo biloba(EGB)for patients with convalescent-phase ischemic stroke and primary hypertension.Methods:This randomized,positive-drug-and placebo-controlled,double-blind trial was conducted from September 2015 to October 2017.Totally 477 eligible patients from 18 hospitals in China were randomly assigned in a 2:1:1 ratio to the following interventions,twice a day for 12 weeks:(1)GTC 250 mg plus EGB-matching placebo 40 mg(237 cases,GTC group),(2)EGB 40 mg plus GTC-matching placebo 250 mg(120 cases,EGB group)or(3)GTC-matching placebo 250 mg plus EGB-matching placebo 40 mg(120 cases,placebo group).Moreover,all patients were orally administered aspirin enteric-coated tablets 100 mg,once a day fo r 12 weeks.The primary outcome was the Barthel Index(Bl).The secondary outcomes included the control rate of blood pressure and National Institutes of Health Stroke Scale(NIHSS)scores.The incidence and severity of adverse events(AEs)were calculated and assessed.Results:The Bl relative independence rates,the clinical recovery rates of NIHSS,and the total effective rates of NIHSS in the GTC and EGB groups were significantly higher than the placebo group at 12 weeks after treatment(P<0.05),and no statistical significance was found between the GTC and EGB groups(P>0.05).The control rate of blood pressure in the GTC group was significantly higher than the EGB and placebo groups at 12,18 and 24 weeks after treatment(P<0.01).There were no statistically significant differences in the incidences of AEs,adverse drug reactions,or serious AEs among the 3 groups(P>0.05).Conclusion:GTC exhibited significant efficacy in improving patients'quality of life as well as neurological function and controlling hypertension.     

抗震救灾中的传染病防治工作原则

人类的历史教训证明,包括大地震在内的严重自然灾害,对地域生态环境和人类居住条件造成极大的破坏,对灾区人员的健康造成沉重的打击.在这种情况下,发生重大传染病流行的风险将会显著增加.汶川大地震发生后,搜寻生还者,抢救伤病员是抗震救灾第一阶段的重点.     

A Bibliometrics Analysis on Academic Influence of Chinese Journal of Integrated Traditional and Western Medicine

Objective:To illustrate the academic influence of Chinese Journal of Integrated Traditional and Western medicine,and provide suggestions for further development of the Journal.Methods:Taking the China National Knowledge Infrastructure(CNKI)database as main source and the Chinese Science Citation Database(CSCD)as reference,the researchers retrieved the related data of the Journal such as its publication quantity,citations,fund projects,authors,institutions and regions from 1981 to 2018,analyzed these data by means of bibliometrics and information visualization with EXCEL,SPSS,VISIO,MATLAB and other softwares.Results:Through the analysis of the main indicators,the relevant indicators of the Journal’s academic influence revealed the developing trend of the Journal.Cardiovascular and cerebrovascular diseases,endocrine,digestive system,pharmacological research of Chinese medicine and gynecology,as the hot topics in the discipline and academic,were clarified.Conclusions:All indicators show that the Journal is a high-quality journal reflecting the excellent achievements in the field of integrated Chinese and Western medicine in China.Through further analysis of relevant indicators,the authors put forward some specific suggestions on how to run the Journal well.     

考试制度管理与改革之我见

分析目前考试制度存在的主要问题有命题、复习题、补考制度等方面的弊端,提出考试制度的改革要在加强"三风"建设、做好试题的编审工作、建立完善的考试管理制度、严肃补考纪律等方面下工夫,让严肃的考风带动良好的学风,从而提高教学质量.     

Bloodletting Puncture at Hand Twelve Jing-Well Points Relieves Brain Edema after Severe Traumatic Brain Injury in Rats via Inhibiting MAPK Signaling Pathway

Objective:To investigate whether blood-brain barrier(BBB)served a key role in the edema-relief effect of bloodletting puncture at hand twelve Jing-well points(HTWP)in traumatic brain injury(TBI)and the potential molecular signaling pathways.Methods:Adult male Sprague-Dawley rats were assigned to the shamoperated(sham),TBI,and bloodletting puncture(bloodletting)groups(n=24 per group)using a randomized number table.The TBI model rats were induced by cortical contusion and then bloodletting puncture were performed at HTWP twice a day for 2 days.The neurological function and cerebral edema were evaluated by modified neurological severity score(mNSS),cerebral water content,magnetic resonance imaging and hematoxylin and eosin staining.Cerebral blood flow was measured by laser speckles.The protein levels of aquaporin 4(AQP4),matrix metalloproteinases 9(MMP9)and mitogen-activated protein kinase pathway(MAPK)signaling were detected by immunofluorescence staining and Western blot.Results:Compared with TBI group,bloodletting puncture improved neurological function at 24 and 48 h,alleviated cerebral edema at 48 h,and reduced the permeability of BBB induced by TBI(all P<0.05).The AQP4 and MMP9 which would disrupt the integrity of BBB were downregulated by bloodletting puncture(P<0.05 or P<0.01).In addition,the extracellular signal-regulated kinase(ERK)and p38 signaling pathways were inhibited by bloodletting puncture(P<0.05).Conclusions:Bloodletting puncture at HTWP might play a significant role in protecting BBB through regulating the expressions of MMP9 and AQP4 as well as corresponding regulatory upstream ERK and p38 signaling pathways.Therefore,bloodletting puncture at HTWP may be a promising therapeutic strategy for TBI-induced cerebral edema.     

国际心肺移植新进展——2006年第26届国际心肺移植协会年会报道

2006年4月5日至4月8日第26届国际心肺移植协会(ISHLT)年会在西班牙马德里隆重召开,来自全世界从事心肺移植的专家,包括心外科、胸外科、心内科、呼吸科、麻醉科、ICU、病理科、供体协调等从事基础及临床研究等相关科室的专家共2 000多人参加了此次盛会.     

Vogt-小柳-原田综合征误诊1例报告

1临床资料 患者,男,29岁.入院前10d双眼视力突然下降,伴轻微头痛,曾就诊于其他医院,经眼科常规检查及眼部B超检查,诊断为原发性视网膜脱离,用药不详,因治疗效果不佳,于2002年10月18日来本院就诊.入院时自诉头痛明显,全身状况不佳,视力:右眼指数/1 m,左眼指数/1 m,双眼轻度睫状充血,角膜后可见细小点状沉着物,房水闪辉阳性,瞳孔呈药物性散大,直径5.5 mm,晶体不混浊,玻璃体可见条状混浊,眼压正常.     

格林巴利综合征伴一过性高血糖性酮症酸中毒一例

1病例患者,女,49岁。10日前出现中上腹不适,伴恶心呕吐,并开始出现尿量减少,全身浮肿,四肢无力,双手不能持物,双下肢不能站立,当时无咖啡样     

婴幼儿游泳探讨

游泳是人类生活中最自然的生理活动和本能之一。不仅人类，哺乳动物也常有游泳行为，是生活中自然形成和掌握的一种本能。我们认为人和动物一样，生来就具有适应环境的能力。很多动物，无论大小都有游泳本领，不用谁来教，在水中通过多种姿势和划水方法，他们都会把鼻子露出水面，往岸上游。可是人类这种本能后来泯灭了。我们认为社会就是大海，人生就如在大海中游泳，从小让孩子在水中学会挣扎，锻炼拼搏精神，促进胎儿到婴幼儿神经及各脏器的持续发育，使生长的过程得到进一步、更高质量的发展，这对他们一生的好处都是不可估量的。     

BORG WARNER ALPHA 76系列电动病床电路原理及维护

文章对BORG WARNER ALPHA 76系列电动病床的电路控制原理进行了比较详细地介绍。     

中性点不接地系统接地故障的探讨

中性点不接地系统的接地故障是变配电系统中比较常见的故障现象,对于故障的处理快慢,也决定着以故障现象转变的事故的可能性大小,所以,对这种故障发生及处理过程必须安全、严谨、高效、准确。     

高压电缆线路故障行波在线定位技术的实用化研究

已开发出一种基于故障电流脉冲行波的电缆线路故障在线定位系统装置。系统可配置线路单端行波传感器作回波时间定位;可配置双端传感器作到达时间差定位;也可配置三端或多端传感器作多重时间差的多重定位。但故障在线定位装置存在两个难点：一是数据采集仅有一次机会,即在故障瞬间就必须准确地捕捉到故障行波并将其传送回信号集中处理后台;二是保证基于故障电流波形的定位精度。为此,利用球间隙放电模拟电缆接地故障在110kV电缆和同轴线电缆线路模型上进行的各种模拟故障定位实验。结果表明了在线定位装置的定位精度和可靠性已经达到了实用要求水平。定位装置已在运行线路上应用并积累经验。     

快速查找电力电缆故障浅谈

配电网电缆故障的快速查找对提高电缆故障处理速度、电力系统供电可靠性和稳定性具有决定性作用。本文分析了电缆故障发生的几种原因、故障分类、查找故障的几种实用方法以及故障点查找定位方法。电缆故障的查找和定位有多种方式和手段,本文结合实践经验,根据不同类型的故障及性质给出了较为快速、合理的检测方法和手段。     

快速查找电力电缆故障浅谈

为了能在双模态超燃冲压发动机流道方案初步论证中提供一种较快速的发动机性能计算方法,在二维N-S方程基础上,引入一维完全燃烧计算方法,提出了预估超燃冲压发动机性能的准二维计算方法。该方法能够计入激波、边界层分离等对发动机性能的影响,可在较短时间计算出整机推力、比冲性能和沿程热力学参数。通过对自由射流发动机计算,验证了此方法。并在此基础上,初步分析了燃料喷注位置和流道构型对发动机性能的影响。      

一起110kV高压电缆故障原因分析及启示

本文介绍了一起110kV高压电缆故障情况,通过对电缆故障位置进行解剖分析,分析了故障产生的原因,并提出应对措施与建议。     

Planmeca锥形束CT故障与检修

锥形束CT(Cone Beam CT,CBCT)是口腔医学重要的诊断设备,可以提供牙齿及其周围组织的准确解剖信息,为临床诊断和治疗提供决策。本文通过分析Planmeca CBCT使用中出现错误E424的1例故障案例,结合设备结构和原理,逐级排查电路部分和机械部分,分析故障原因,确定故障所在,通过调整C关节传动轴和顶部传动带位置并做校准使故障得以排除。该故障案例的讨论为CBCT的维修工作提供借鉴经验。对于此类故障,临床工程师不仅需要充分了解设备工作原理,进行理论分析和实际测试,还需要加强对技术员的使用培训和临床宣教,减少人为因素导致的故障。     

泸州医学院附属医院门诊医生工作站常见故障调查分析

目的对该院门诊医生工作站故障情况进行调查,并分析调查结果,为维护门诊医生工作站提供重要依据,也为门诊医生更好地服务患者提供保障。方法收集从2010年6月—2011年12月该院门诊医生工作站常见故障,并将门诊医生分为退休名老专家,高级职称,中级职称3类人群。将故障依据产生原因不同分为人为因素故障、软件故障、硬件故障3大类。结果本次调查时间段内故障申报共有1890次,其中软件造成的故障有456次,占故障总数24.13%,人为操作造成的故障有1362次,占故障总数72.06%,硬件造成的故障有72次,占故障总数3.81%。其中退休名老专家人为因素故障率与高级职称,中级职称人为因素故障率相比较,差异有统计学意义（P〈0.05）,退休名老专家组软件故障率、硬件故障率与高级职称组、中级职称组进行统计比较,差异无统计学意义（P〉0.05）。结论门诊医生工作站软件具有稳定的操作性及可靠性,人为因素故障率高是使用该软件的医务人员不熟练所致,可以通过加强强化培训,使医务人员更好地掌握此软件,更好地为广大患者提供方便快捷的门诊日常治疗服务。     

论医疗损害赔偿责任归责适用过错推定规则的合理性

医疗损害赔偿责任归责适用过错推定规则，在我国只有司法解释对此作了相关说明，而《民法通则》与《医疗事故处理条例》对此没有规定。世界上大部分的国家和地区在医疗损害赔偿诉讼中采用了过错推定规则，我国的社会经济、医学伦理和社会现实具有在医疗损害赔偿责任归责上适用过错拧定规则的广泛基础。因此，在医疗责任立法中采用过错原则的过错推定规则作为医疗损害赔偿责任归责的准则具有合理性。     

模拟网络故障诊断线性方法的某些理论及其应用

本文对模拟网络故障诊断的线性方法的一般原理进行了系统的论述。提出了故障定数的概念,并对故障源方程的建立、一般等效规律及其应用进行了深入讨论,给出了相应的诊断算法。