“散膏”是多个腺体的总称

目的：认识《难经》记录中＂,散膏＂所指的解剖学实体。方法：考证《难经》的相关记录,结合对《黄帝内经》有关人体解剖的认识,考证＂散膏＂的词义。结论：＂散膏＂是多个腺体的总称。     

《难经》命门脏器实质新论

命门之名 ,始见于《内经》 ,但最早将命门作为内脏的记载 ,则是《难经》[1 ] 。而《内》、《难》二者所记述的命门 ,乃名同实异[2 ] 。近人徐氏依据《内经》“命门者 ,目也”(《灵枢·根结》)的记载提出为免与《难经》发生混乱 ,《内经》所言之“命门”宜改为“明门”[3] 。鉴于古今医家对《难经》命门脏器实质认识颇不一致。笔者从中西医结合角度 ,探讨如下。1 .“命门”在解剖结构上相当于肾上腺笔者认为 ,考证“命门”的解剖结构实质 ,首先必须以最早将“命门”作为内脏记载的《难经》为依据。而归纳《难经》对命门的记述主要有 :《难经…     

《圣济总录》“虚劳门”医论考

通过对《圣济总录》"虚劳门"医论的考证,发现《圣济总录》"虚劳门"的医论主要来源于《内经》《难经》《诸病源候论》《千金要方》《外台秘要》《太平圣惠方》等文献,然而《圣济总录》又绝非直接的照搬,而是更多地融入了北宋医学对疾病的最新认识,如对疾病发生机制的清晰分析,对疾病临床症状的详细描述,特别是按照寒热虚实辨证分型,使疾病的证型更加复杂等,充分体现了北宋时期医学理论的进步。     

《难经文字考》管窥

日本江户后期学者伊藤凤山《难经文字考》（写本）就《难经》的８１个问题作了考证。作者运用清儒文字训诂知识，引证中国古代典籍的注释及训诂专著，发表了一些独到见解，纠正了历代注家的若干误训，对于正确理解《难经》原文有所裨益。     

ДX11538a：俄藏敦煌古抄本《难经》残卷

《难经》由唐初杨玄操整理为定本流传至今,杨氏整理之前的旧本历来无由得见.但俄藏敦煌残卷ДX11538a,考证当为《难经》古传旧本片段.与传世本相比,该本排列无序,文字参差,但却在一定程度反映了古本《难经》的旧貌,且有优于传世本之处,对今人研究《难经》有一定价值.     

论滑寿对《内经》、《难经》研究的贡献

滑寿,字伯仁,一字伯休,晚号樱宁生。元末明初著名医家,著有《十四经发挥》、《诊家枢要》、《读素问钞》、《难经本义》等医学著作,为中医学的发展作出了巨大贡献。《十四经发挥》为针灸学著作,《诊家枢要》则是脉诊专著。《读素问钞》是分类整理、择要类编《素问》之作,开节要类编《素问》之先河。《难经本义》则考证《难经》条文出处,详加点校,求其本义,使《难经》医理彰显于世,成为注释《难经》的典范之作。本文通过对《读素问钞》和《难经本义》两书的分析探讨,论述了滑寿对《内经》、《难经》研究的贡献。     

三焦名实考

三焦为六腑之一,无可非议;然而《难经》的“有名无形”,致使三焦“有无”之争成为历代医家千年探索而未能休止的课题。三焦名实问题的考证,应当从以下4个方面分别来讨论。1三焦之诸家争鸣自从《难经》提出三焦“有名无形”之说后,关于三焦的争论,基本有以下五类论说,即:区域说,     

《古本难经阐注》之“古本”系宋元时期吴澄校定本考

[目的]考察清代丁锦《古本难经阐注》一书中所称"古本"的真实性。[方法]寻找《古本难经阐注》与《难经阐注》经文顺序所蕴含的规律,与传世文献中相关记载进行对比研究,确定《古本难经阐注》所称"古本"的真实性。[结果]《古本难经阐注》所称"古本",实为宋元时期经学大家吴澄所校定本《难经》,丁锦在吴澄的基础上删去序文及篇名,并篡改吴氏所分六篇为四卷,才形成了《古本难经阐注》一书。[结论]吴澄作为经学大家,以经学之力校定《难经》,其校定文字等内容不仅资为《难经》校勘的参考,更是作为《难经》的古传本,为《难经》研究提供了版本依据,故其价值不仅高于明清注本之上,更可直追吕广、杨玄操二氏,对《难经》的辑复、校勘等工作都将具有十分重要的意义。     

《难经正义》之中西医汇通论脏腑

《难经正义》是叶霖对《难经》的注疏,是书辨论精切,考证详审,分析全面,说理清澈。当时西医已传入中国,叶氏参西医之说,阐中医之理,尤其是书中所述脏腑部分,杂采西说引证,为中西医结合之先河。     

谈滑寿对《难经》注释的贡献

滑寿将《难经》加以注释,成《难经本义》,此书成为后世研读《难经》者必备的参考书。滑氏对《难经》的字词、名物、病因病理均进行了注释,认为《难经》为解《素问》之经,采用考之《灵》《素》,以探其源的方法进行注释;旁引前人之注释,许多书今已佚,故保存了大量的文献资料;对有关问题提出己见,明确"独取寸口"之说源于《难经》,指出其决五脏六腑死生吉凶的意义。《难经本义》言简意赅,语言明白晓畅,于《难经》之学的普及功莫大矣。     

Local Research Ethics Committees can audit ethical standards in research.

OBJECTIVES: To show that a Local Research Ethics Committee (LREC) can carry out an audit of ethical standards in research. To find out if a researcher met certain ethical standards in recruiting subjects for clinical trials and in obtaining their consent. DESIGN: Postal questionnaire. SETTING: Clinical research by one doctor during one year. SUBJECTS: Eleven patients entered in clinical trials. MAIN OUTCOME MEASURES: Success in ethics committee obtaining data. Achievement of ethical standards in recruitment of subjects and in obtaining consent. RESULTS: The audit was successfully carried out and standards were partly met. CONCLUSIONS: Local Research Ethics Committees can carry out audits of the conduct of research projects which they have approved. Provision for possible audits can be made at the time of application to the committee. Our committee thought the ethical standards in the research which we audited were acceptable.     

Hyperbaric oxygen for stroke treatment

ABSTRACT: This is an editorial for the inauguration of the Medical Gas Research and addresses a particular issue of using hyperbaric oxygen for stroke treatment.     

Scientific misconduct from the perspective of research coordinators: a national survey

OBJECTIVE: To report results from a national survey of coordinators and managers of clinical research studies in the US on their perceptions of and experiences with scientific misconduct. METHODS: Data were collected using the Scientific Misconduct Questionnaire-Revised. Eligible responses were received from 1645 of 5302 (31%) surveys sent to members of the Association of Clinical Research Professionals and to subscribers of Research Practitioner, published by the Center for Clinical Research Practice, between February 2004 and January 2005. Findings: Overall, the perceived frequency of misconduct was low. Differences were noted between workplaces with regard to perceived pressures on investigators and research coordinators, and on the effectiveness of the regulatory environment in reducing misconduct. First-hand experience with an incident of misconduct was reported by 18% of respondents. Those with first-hand knowledge of misconduct were more likely to report working in an academic medical setting, and to report that a typical research coordinator would probably do nothing if aware that a principal investigator or research staff member was involved in an incident of misconduct. CONCLUSION: These findings expand the knowledge on scientific misconduct by adding new information from the perspective of research coordinators. The findings provide some data supporting the influence of workplace climate on misconduct and also on the perceived effectiveness of institutional policies to reduce scientific misconduct.     

武汉市某医院频繁就诊多科室患者心理评估及护理干预研究

目的：探讨频繁就诊于门诊多科室患者的心理特征及护理干预措施。方法：选取60例频繁就诊于某医院门诊多科室患者（研究组）与60例在门诊单个科室就诊患者（对照组）进行抑郁自评量表（SDS）、焦虑自评量表（SAS）测评,并作相关分析。同时,对60例研究组又随机分为干预组和未干预组,每组30例,分析采取护理干预后的效果。结果：研究组SDS、SAS评分明显高于对照组（=18.15,〈0.001,=16.62,〈0.001）;其主诉多系统生理症状的出现频次也显著多于对照组;同时其躯体疾病确诊率、实验室检查阳性支持率、疗效均显著低于对照组。经过护理干预后,干预组SDS、SAS评分显著降低（=3.13,〈0.01,=4.68,〈0.01）,多系统生理症状的出现频次有明显减少。结论：频繁就诊于门诊多科室患者有明显的抑郁、焦虑情绪和多种躯体化症状,需给予积极的护理干预,提高患者对疾病的认知程度及应对能力,减轻患者的负性情绪,为积极配合诊疗创造条件。     

异体输血对手术患者免疫功能的影响及临床意义

目的：探讨并论述异体输血对患者免疫功能的影响及意义；方法：阅读关于异体输血对患者免疫功能的影响方面的文献，进行总结；结果：输血免疫研究对手术患者的预后及疾病治疗的创新都将有重要的理论与实用价值；结论：异体输血对手术患者免疫功能抑制明显，在临床中应尽量少输血，必须输血时，推荐成分输血。     

男女对性刺激反应差异的研究进展

目的：研究男女对不同视觉性刺激的差异。方法：以一些最新文献为依据进行综述。结果：在观看色情电影时大脑部位特定区域存在着明显的性别差异。结论：男女性唤起的差别与大脑活性相关，这个发现为男女性差异提供了新的解释。     

河南省医学期刊载文及引文分析

目的：对河南省医学期刊的载文及引文作定量描述。方法：用文献计量学方法对河南省１９９５年内出版的１４种医学期刊文献的１０项指标（源文量、基金资助率、出版时差、作者合著度、作者单位合著度、引文率、平均引文量、期刊引文率、外文引文率、普赖斯指数）进行统计分析。结果：河南省部分期刊如《河南医学研究》，《眼科研究》，《河南医科大学学报》，《胃肠病与肝病学杂志》的合著度，引文率，平均引文量及期刊引文率等指标已达到或接近国内先进水平；而外文引文率与国内水平有较大差距；出版时差是省内最有优势的指标项，整体居国内领先水平。结论：对各期刊文献指标定量描述的结果可为医学期刊评价提供文献计量学依据。     

Combination of bleach and flourescent microscopy: a milestone in the diagnosis of smear negative tuberculosis

BACKGROUND: The reliability of direct smear microscopy for diagnosis of tuberculosis has frequently been questioned due to low sensitivity. Treatment of sputum with sodium hypochlorite (NaOCI) has been used to increase sensitivity in many settings. However, no study has established the effect of NaOCI on fluorescent microscopy. OBJECTIVE: To establish whether NaOCI concentration method enhances positivity of fluorescent microscopy smear negative sputum for diagnosis of tuberculosis. DESIGN: A prospective study. SETTING: Mbagathi District Hospital and Centre for Respiratory Diseases Research, Kenya Medical Research Institute. RESULTS: Forty five (22%) specimens were culture positive. Fluorescent microscopy sensitivity was 28.9% and 22.2% after centrifugation and sedimentation with 3.5% NaOCI, respectively (P > 0.05). Sensitivity was 24.4% and 17.8% after centrifugation and sedimentation with 5% NaOCI, respectively (P > 0.05). Although there was no statistical significance difference between the two NaOCI concentration methods, 3.5% NaOCI with centrifugation indicated a higher yield. CONCLUSION: Use of NaOCI significantly enhances positivity of smear negative sputum for diagnosis of tuberculosis when used with fluorescent microscopy. This approach could be recommended for screening all tuberculosis suspects especially in settings with potential smear negative tuberculosis.