卫生法学专业人文社会医学的实践教学探讨

为适应我国卫生事业的发展需求,围绕如何培养具备人文精神的高素质卫生法学人才,从树立人文学科实践教学意识出发,在积极完善人文社会医学课程的实践教学设计和实践教学体系的同时,努力提升卫生法学师资队伍的实践教学和人文素养教育能力,以期为我国的社会主义卫生事业培养出优秀的接班人。     

Acute kidney injury and the critically ill

Acute renal failure is commonly encountered in the intensive care unit. It is associated with considerable morbidity and mortality. There are many possible aetiologies in the critically ill, including nephrotoxic agents, hypovolaemia and sepsis. While many classification systems for acute renal failure exist, the RIFLE (Risk, Injury, Failure, Loss, End-stage) criteria and the Acute Kidney Injury Network (AKIN) criteria are the most commonly utilized. Many supportive therapies are employed to minimize the degree of renal injury once recognized, such as fluid resuscitation, maintenance of an adequate mean arterial pressure (with the use of vasopressors in persistent hypotension despite fluid and treatment of the underlying aetiology). However, if renal failure becomes established, then renal replacement therapy (RRT) may be needed to maintain homeostasis. While there are no clear guidelines with respect to the ideal mode or timing of RRT, we will discuss pros and cons of the various options.     

中西医结合治疗眼眶骨折致眼眶瘀肿及眶下神经知觉障碍临床观察

目的 :观察早期运用中西医结合疗法治疗眼眶骨折致眼眶瘀肿及眶下神经知觉障碍的临床疗效。方法 :将76例(82眼)眶骨骨折患者按随机数字表法分为对照组和治疗组各38例(41眼)。对照组予抗生素、地塞米松静脉滴注,B族维生素及甲钴胺片口服,并对症治疗;治疗组在对照组的基础上辨证运用自拟经验方眼眶骨折1号方、眼眶骨折2号方。观察两组治疗后眼眶瘀肿及眶下神经知觉障碍改善情况,综合评价疗效。结果:治疗组软组织肿胀、眼睑瘀血、结膜下瘀血平均消退时间均短于对照组,差异有统计学意义(P<0.05)。眶下神经知觉障碍改善情况,治疗组显效6例,有效12例,无效0例,总有效率100%;对照组显效2例,有效12例,无效6例,总有效率70%;治疗组疗效明显优于对照组,差异有统计学意义(P<0.05)。结论:早期运用中西医结合疗法治疗眶骨骨折安全、有效,能加快眶周软组织损伤修复,缩短眼眶瘀肿消退时间,改善眶下神经知觉障碍。与单纯西医治疗比较,中西医结合疗法能缩短疗程、提高临床疗效。     

中西医结合治疗对原发性高血压患者血压及生存质量改善的临床观察

目的:观察中西医结合治疗对原发性高血压(肝肾阴虚证)患者血压及生存质量的改善情况。方法:采用随机、对照方法,将120例原发性高血压患者分为观察组和对照组各60例,对照组用硝苯地平缓释片治疗,观察组在对照组西药的基础上,加用中药汤剂治疗,疗程为3个月,观察治疗前后患者临床表现、血压水平及生存质量改善情况。结果:治疗后,观察组在中医证候疗效、血压水平、生存质量躯体健康、躯体角色功能、躯体疼痛、总体健康、活力、社会功能、心理健康方面均明显优于对照组,差异具有统计学意义(P<0.05),治疗后两组情绪角色功能方面差异无统计学意义(P>0.05)。结论:与单纯西药相比,中西医结合治疗原发性高血压在临床表现、血压水平、生存质量改善情况均有明显优势。     

中西医结合治疗口腔扁平苔藓的临床疗效观察

目的观察中西医结合治疗口腔扁平苔藓的临床效果。方法选取从2012年1月-2013年1月我院口腔科收治的40例口腔扁平苔藓患者，按就诊顺序随机分为对照组和治疗组各20例。对照组患者注射卡介菌多糖进行治疗，实验组患者在对照组基础上结合中药方剂进行治疗。结果治疗前，2组患者的疼痛评分比较，差异无统计学意义（t=0．151，P〉0．05）。采用不同方式治疗后，2组患者的疼痛评分比较，差异有统计学意义（t=9．631，P〈0．05）；对照组的总有效率为85．0％，实验组的总有效率为95．0％，实验组明显优于对照组，差异有统计学意义（P〈0．05）。结论采取中西医结合治疗口腔扁平苔藓，能使患者的疼痛情况得到缓解，有助于治疗效果的提升，具有临床应用及推广价值。     

中医外治法在高血压病治疗中的应用

高血压病是世界性常见病和多发病，是我国脑卒中和冠心病的主要致病因素，传统西医治疗有明显副作用，中医外治法在高血压病治疗护理方面效果良好，无毒副作用，价格低廉，患者易于接受，便于推广。     

Potential advantages of a combination of Chinese Medicine and bone marrow mesenchymal stem cell transplantation for removing blood stasis and stimulating neogenesis during ischemic stroke treatment

Combined treatment of ischemic stroke with Chinese medicine and exogenous bone marrow mesenchymal stem cell(BMSC) transplantation may improve the removal of blood stasis and stimulation of neogenesis.Chinese medicines that remove blood stasis not only promote blood circulation but also calm the endopathic wind,remove heat,resolve phlegm,remove toxic substances and strengthen body resistance.The medicinal targeting effect of Chinese medicine can promote the homing of BMSCs,and the synergistic therapeutic effects of drugs can contribute to BMSC differentiation.As such,exogenous BMSC transplantation has potential advantages for neogenesis.Chinese medicines and exogenous BMSCs provide complementary functions for the removal of blood stasis and stimulation of neogenesis.Therefore,a combination of Chinese medicine and transplantation of exogenous BMSCs may be particularly suited to ischemic stroke treatment.     

驻景丸加减治疗甲状腺功能减退性心脏病心肾阳虚型20例

目的评价驻景丸加减治疗甲状腺功能减退性心脏病心肾阳虚型的临床疗效。方法选取甲状腺功能减退性心脏病心肾阳虚型患者40例，随机分为治疗组和对照组。治疗组给予驻景丸加减联合左甲状腺素，对照组单纯给予左甲状腺素，观察临床疗效。结果治疗组总有效率为95．00％，对照组总有效率为80．00％，治疗组优于对照组（P〈0．01）。结论驻景丸加减联合左甲状腺素疗法优于单纯西药治疗。