《素问玄机原病式》学术思想探讨

《素问玄机原病式》一书，发挥《内经》病机学说，弥补了原“病机十九条”过于简略之不足，创造性地继承和发展了《内经》理论，特别是首倡“六气皆从火化”之说；关于“相火”的论述，则为后世相火理论的形成奠定了基础；它还总结了温热病的治疗原则，对后世温病学派的形成产生了重要影响。     

急救护理潜在的法律问题及对策

随着医学科学和法制观念的普及，患者保护自己就医权利的意识越来越强，特别是护理工作，由于其技术性、服务性、复杂性都很强，容易发生医疗纠纷。面对护理工作中潜在的法律问题，如何应用有效手段保护医务工作者的权益，实现安全医疗已成为一个突出问题。根据急诊的特点，护理工作中采取防范措施已成为保证医疗安全很重要的环节。     

谈医务人员的医德导向问题

随着历史的变革,人们的道德取向发生了变化。面对商品经济大潮的冲击,医务工作者应树立什么样的医德观,塑造什么样的医护形象,对此,认为一是应加强医德导向,二是增强医德意识,三是坚持医德评价,以提高遵守社会主义医德规律的自觉性     

Investigation of validity of closed questions in a survey of British South Asian and white populations

Objectives. The paper concerns the validity of closed-format questions in an interview-based population survey and focuses on a comparison of South Asian and white respondents. Method. A two-part interview consisting of open, respondent-centred questions followed by closed questions taken from a large-scale interview-based health survey was carried out with 15 persons from white and 14 from South Asian communities resident in the UK. Interviewees’ views of their stays in hospital was the focus. Results. The two-part interview was found to provide a broadly satisfactory method for the investigation of validity although a limitation was recognised. Twenty-nine per cent of the variation in response to a closed question on ‘overall satisfaction’ was predictable from views expressed in the open interview. The views of both groups, as expressed in the open interview, were inadequately represented by the closed questions. This appeared to be especially true for the South Asian sample. The validity of the closed question appeared greater for white than for South Asian interviewees. Conclusions. It is concluded that when designing and piloting health surveys consideration should be given to members of all communities to be included in the survey.     

《素问》王冰注使用祖本探讨

根据王冰序,王冰在整理《素问》时使用了不同的版本,但并未说明以何本作祖本。根据对王冰序、《素问》新校正等提供的有关材料进行的分析,认为王冰所用祖本虽源自梁代传本,但不是全元起本,似应是张公秘本;今存《素问》中有些篇文结构应是祖本旧貌;祖本与全元起本、《针灸甲乙经》及《太素》应属不同传本系统。     

对完善《医院处方点评管理规范(试行)》的思索

目的:为完善《医院处方点评管理规范(试行)》(简称《规范》)提供参考。方法:采用描述性分析方法,联系《规范》,结合自身的工作实践,就《规范》总则、处方点评的实施、处方点评的结果、处方点评工作表4个方面提出问题和建议。结果:《规范》应分类、分级细化;处方点评的部分监测指标抽样方法、医嘱点评和处方点评结果的判定标准有待进一步详实;处方点评工作表建议增加"性别"和"反馈方式"监测项,删除"是否合理"项,将"处方日期"项调整到表外,并差异化调整"药品通用名数"监测项,同时建议更改处方点评工作表附注中对"A"和"G"的定义。结论:《规范》需不断完善和细化,以提高其科学性和规范性。     

N-Acetylcysteine Rinse for Thick Secretion and Mucositis of Head and Neck Chemoradiotherapy (Alliance MC13C2): A Double-Blind Randomized Clinical Trial

ObjectiveTo determine whether N-acetylcysteine rinse was safe and could improve thickened secretions and dry mouth during and after radiotherapy.Patients and MethodsWe designed a prospective pilot double-blind, placebo-controlled randomized clinical trial (Alliance MC13C2). Adult patients (age ≥18 years) were enrolled if they underwent chemoradiotherapy (≥60 Gy). Patients initiated testing rinse within 3 days of starting radiotherapy. With swish-and-spit, they received 10% N-acetylcysteine (2500 mg daily) or placebo rinse solution 5 times daily during radiotherapy and 2 weeks postradiotherapy. The primary aim was to evaluate N-acetylcysteine in improvement of saliva viscosity with the Groningen Radiotherapy-Induced Xerostomia questionnaire. Secondary aims included evaluating xerostomia improvement by the same questionnaire and with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Head and Neck-35 Questions survey and adverse-event profiles. The type I error rate was 20%.ResultsThirty-two patients undergoing chemoradiotherapy were enrolled. Baseline characteristics were balanced for placebo (n=17) and N-acetylcysteine (n=15). N-acetylcysteine was better for improving sticky saliva (area under curve, P=.12). Scores of multiple secondary end points favored N-acetylcysteine, including sticky saliva daytime (P=.04), daytime and total xerostomia (both P=.02), pain (P=.18), and trouble with social eating (P=.15). Repeated measures models confirmed the findings. Taste was a major dissatisifer for N-acetylcysteine rinse; however, both testing rinses were safe and well tolerated overall.ConclusionOur pilot data showed that N-acetylcysteine rinse was safe and provided strong evidence of potential efficacy for improving thickened saliva and xerostomia by patient-reported outcome. A confirmatory phase 3 trial is required.Trial Registrationclinicaltrials.gov Identifier: NCT02123511     

吴崐著作版本考

吴崐是新安医学名家之一.1584年,吴崐撰成《医方考》6卷.1594年,撰成《素问吴注》24卷.1618年,撰成《针方六集》6卷,由程标捐资刊刻.吴崐尚撰有《脉语》2卷,成书年代不详.《医方考》有明刊本、日本及朝鲜刊本、旧抄本、现代版本4类版本.《吴注素问》有明清刊本、日本刊本、旧抄本、影印本、现代版本5类版本.《针方六集》有明刊本、抄本、影印本及现代版本4类版本.《脉语》多与《医方考》合刊,除部分现代版本未附《脉语》之外,《脉语》的版本大致同于《医方考》.     

《素问释义》注释特点的研究

<素问释义>由张琦注于道光九年,是清代一部较为重要的校注本.该书注解简洁,部分注文精辟且有新意,对国内外的<内经>研究均产生了一定影响.通过对<素问释义>注文进行研究,认为张琦注释<素问>的特点主要可概括为批判地继承前人注文;以阐释医理为主;酌加按语;注有详略;评议篇文;文义未详者,存疑待考或仅提出倾向性意见等六个方面.