病理学融合实验教学的思考与实践

为提高病理学实验教学质量,加强学生理论联系实际的能力,开展以分析临床病理案例和整合基础医学知识为主要教学方式的病理学融合实验教学改革;促进学生形成以器官病理改变为核心的＂正常形态→正常功能→病理变化→功能变化→发病机制→临床表现＂整体知识体系,并掌握横向联系的学习方法;最终达到提高教学质量的目的.     

研究性学习法在预防医学实验教学中的应用

主要阐述将研究性学习法运用于预防医学实验教学的具体过程及教学效果。学生通过提出课题→文献查阅与设计实验→点评设计→实施实验→实验总结→结果评价等环节参与课题研究,自行归纳总结,变被动学习为主动学习。实验操作能力、观察能力、逻辑思维能力、实际解决问题能力以及综合分析能力得到提高,可为创新型人才的培养提供参考。     

规范门诊导医实习带教程序的探讨

门诊导医实习是培养学生运用专业理论知识为患者提供导诊、分诊、咨询服务,帮助患者解决实际问题,并在实践中进一步充实和提高专业能力的过程,是对临床护理知识的检验和有效的补充。根据临床实习大纲,结合门诊工作特点,科学制定门诊导医实习评价标准,按照层级带教责任制,依照门诊导医实习评价标准,采用入科教育→综合素质培养→教学小讲座→实习效果评价→出科考核→回访座谈征求意见等规范带教程序,培养学生综合素质及沟通协调能力。通过对教与学效果评价,建立良好评价、评教机制,提高门诊导医带教质量。     

用系统学的模型方法探讨脏腑的根据

以祖先进化的历史为框架(模型),把进化中各类祖先适应的地质(五行)、气象和产生的组织器官等元素,“往框架中放,各就各位,最后全局就豁然呈现出来了”,即五脏六腑是人的六种脊椎动物祖先(原始有头类→鱼类→两栖类→爬行类→哺乳类→人类),适应一定生态系统依次产生的六个机能系统(肝→心→脾→肺→肾→心包)。     

血浆粘度六因素线性逐步回归分析

本文对39例对象的血浆粘度(Y)及其六个血浆成分——白蛋白(x_1)、球蛋白(x_2),纤维蛋白原(x_3)、胆固醇(x_4)、甘油三酯(x_5)和β脂蛋白(x_6)进行了测定,并对Y和x_1～x_6进行了六元回归,还对这六个因子产生血浆粘度的贡献作了排列,依次为x_2→x_3→x_6→x_4→x_5→x_1。继之以不同的F值的界限,进行了逐步回归,选取其主要因子和剔除其次要因子,从其复相关系数、标准估计误差、方差分析并在实际应用中加以检验,最后获得的三元方程式:Y=0.59453+3.23404·10~(-4)x_2+5.15788·10~(-4)x_3+5.14465.10~(-4)x_6是与实际相符合的较为理想的方程式。这一方程在理论上反映了与血浆粘度形成有关的主要化学成分,以及粘度与其主要化学成分间的定量关系;在临床上对于诊治高粘血浆症有一定的指导意义。     

纸印法检查扁平足时踩脚印方法的研究

<正> 目前一般采用纸印法检查平足,作者比较了四种不同的踩脚印方法,发现踩脚印方法不同,扁平足检出率也不相同,足弓横径也不相同。通过研究,认为双足齐踩法最可靠,这种方法为:高凳坐位→双足→齐踩上试纸→缓慢站起→再坐下→双脚离开试纸→再坐下→双脚抬起离开试纸。     

西安市急性病毒性肝炎最佳筛选策略探讨

目的探讨西安市急性病毒性肝炎病原学筛选最优策略。方法系统综述、成本效果分析。结果13条分型策略中,成人组以HAV→HBV→HEV→HCV诊断费用最低,费用为14989．02元／千病例．成本效果比（CER）为17．72。儿童组以HAV→HBV→HCV→HEV诊断费用最低,费用为9463．33元／千病例,成本效果比（CER）为9．81。总人口以策略HAV→HBV→HEV→HCV最经济,诊断费用为13570．89元／千病例,成本效果比（CER）15．47。灵敏度分析显示甲肝发病增加以策略HCV→HBV→HCV→HEV为最佳诊断策略,如果甲肝发病为原来的1／4以下及乙肝增加3倍以上以策略HBV—HAV—HCV—HEV为最佳策略。丙肝、戊肝发病率的变化对结果无影响。结论西安市目前现行急性病毒性肝炎筛选方法（甲、乙、丙、戊型肝炎同时检测）的成本最高,HAV→HBV→HEV→HCV策略可以完成筛选任务,也最经济。     

急性心肌梗塞舌象变化规律分析

急性心肌梗塞 ,舌苔由薄→腻→黄→黑为逆 ;由黑→黄→腻→薄为顺。薄白苔多见于急性心肌梗塞的早期或恢复期 ,舌象的变化 ,反应病情的轻重 ,预示证候转机。     

我国急性病毒性肝炎最佳分型诊断路径探讨

目的 探讨急性病毒性肝炎病原学分型诊断最佳路径。方法 系统综述、成本效果分析。结果 根据我国历史文献,用系统综述方法分析我国急性病毒性肝炎构成比,十二条分型路径中以HBV→HAV→HEV→HCV诊断费用最低,13403.44元/千病例,成本效果比（CER）为1384,其次为HBV→HAV→HCV→HEV,HAV→HBV→HEV→HCV和HAV→HBV→HCV→HEV。结论 目前我国现行急性病毒性肝炎分型诊断方法（甲、乙、丙、戊型肝炎同时检测）的成本最高,散发季节以HBV→HAV→HEV→HCV的诊断路径最为经济,基本可以完成分型诊断任务,而在甲型肝炎出现爆发时以路径HAV→HBV→HEV→HCV最经济。     

急性病毒性肝炎最佳诊断策略的成本效益分析

目的：探讨急性病毒性肝炎病原学分形诊断最优策略。方法：收集中国生物医学（CBMD）1987／1999的所有相关献,进行系统综述、成本效益和灵敏度分析。结果：以HAV→HBV→HEV→HCV分型策略进行分型诊断的成本效益比（CER）17．9,HAV→HBV→HCV→HEV分型策略的CER为18．7,HBV→HAV→HCV→HEV CER为19．0,其余策略均大于20。年龄和试剂盒价格对分型策略影响不大。但如果乙肝病例占总病例的48．3％时,策略HBV→HAV→HEV→HCV的CER（15．1）最低。结论：甲、乙丙、戊型肝炎同时检测成本较高,策略HAV→HBV→HEV→HCV是最佳策略,但乙型肝炎病例占48．3％以上时,策略HBV→HAV→HEV→HCV为最佳。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…