信息技术支持下的探究学习模式在中医诊断学《肝腑辨证》课中的应用

文章介绍了信息技术支持下探究式学习模式具有信息性、实践动手能力、学习资源丰富、培养学生的沟通能力、改变学习思维等特点,并通过中医诊断学《肝腑辨证》课程具体探讨了如何应用这一学习模式进行中医课程的教学。从条件的准备、探究问题的提出和具体教学过程的实践都进行了详细的介绍和分析,说明了应用探究式学习模式进行中医教学的特点,为进一步推广应用这一学习模式提供有益的见解。     

跖骨颈微创截骨结合中医正骨八法矫正拇外翻畸形

目的:探讨第一跖骨颈内侧截骨、术中配合正骨八法治疗脚拇趾外翻畸形的疗效。方法:2005年3月—2009年6月,采用跖骨颈微创截骨结合中医正骨八法治疗32例(46足)拇外翻患者,男9例,女23例,年龄35～79岁,平均55岁,病程6个月～10年,患者术前主要症状表现为拇外翻畸形、拇囊炎,穿鞋及行走时疼痛明显。手术前后均摄双足负重正侧位X线片,测量拇外翻角,第1、2跖骨间夹角及近侧关节固角以判定畸形程度,并采用足部疾患治疗效果AOFAS评分以评价其临床疗效。结果:随访时限为24～57个月,平均38个月。术后骨愈合满意,无延迟愈合及不愈合情况,术后足部持续疼痛2例。术后2年与术前相比,患者的拇外翻角,第1、2跖骨间夹角及近侧关节固角平均矫正11.7°、3.5°和9.7°,AOFAS评分提升33.8分。结论:跖骨微创截骨手术结合中医正骨八法是治疗拇趾外翻畸形的一种较好的、疗效可靠的手术方式。     

Immigrant health,place effect and regional disparities in Canada

The paper addresses a critically important area in Canadian immigration and health from both a social and a spatial perspective. It employs multilevel and contextual approaches to examine the social determinants of immigrant health as well as the place effects on self-reported health at a regional and neighborhood scale. The data come from the raw microdata file of the 2005-10 Canadian Community Health Survey (a random national health survey) and the publicly available Canadian Marginalization index based on the 2006 Census. Three populations are compared: Canadian-born, overall foreign-born, and Chinese immigrants. The results suggest various degrees of association between self-reported health, individual and lifestyle behavioral characteristics, and neighborhood material deprivation and ethnic concentration in census tracts. These factors contribute differently to the reported health of Chinese immigrants, Canada's largest recent immigrant group. A healthy immigrant effect is partially evident in the overall foreign-born population, but appears to be relatively weak in Chinese immigrants. For all groups, neighborhood deprivation moderately increases the likelihood of reporting poor health. Ethnic concentration negatively affects self-rated health, with the exception of the slight protective effect of Chinese-specific ethnic density in census tracts. The multilevel models reveal significant area inequalities across Census Metropolitan Areas/Census Agglomerations in risk of reporting unhealthy status, with greater magnitude in the foreign-born population. The vast regional variations in health among Chinese immigrants should be interpreted carefully due to the group's heavy concentration in large cities. The study contributes to the literature on ethnicity and health by systematically incorporating neighborhood contextual effects in modeling the social determinants of immigrant health status. It fills a gap in the literature on neighborhoods and health by focusing on ethnically disparate groups rather than on the general population. By revealing regional disparities in health, the paper adds a spatial perspective to the work on immigrant health.     

民国中西药学汇通代表作《汉药新觉》考略

郭若定《汉药新觉》为民国时期中西药学汇通的代表作,其上集曾被民国时期北平杂志《明日医药》连载,并刊有单行本.续集内容由其家属收藏,全书完整本于2010年由上海科学技术文献出版社出版,载药208种,以单味中药为主,并收部分复方药及西药.该书中西药学汇通思想,体现在3个方面：中西药物,兼收并蓄;衷中参西,继承创新;中西合参,旨在汇通.     

基于置信规则库的慢性萎缩性胃炎陈永灿辨证经验挖掘

[目的] 根据名老中医陈永灿(下称陈氏)诊治慢性萎缩性胃炎(chronic atrophic gastritis，CAG)的临床资料和诊疗方案，挖掘基于置信规则库(belief rule base，BRB)的CAG辨证经验。[方法] 对症候信息进行编码，将症候“有、无”分别赋值为“1、0”，以此建立CAG中医症候信息数据库。将编码后的信息作为CAG辅助诊断模型的输入特征，通过BRB挖掘症候信息与证素之间的关系，利用证据推理(evidence reasoning，ER)融合算法对输入特征进行激活处理并输出结果，最后根据输出的证素结果结合临床实际得到证型。[结果] 在收集到的572例CAG病例数据集上对CAG辅助诊断模型进行训练及测试，证实该模型准确率达到79.07%，优于传统的支持向量机(support vector machine，SVM)算法；由预测结果得到的证型主要为脾虚气滞型、寒热错杂型、肝胃郁热型。[结论] CAG辅助诊断模型在实际临床运用中具有可行性，表明人工智能技术有助于名老中医经验的传承和传播。     

Synthesis and bioassay of β-（1,4）-D-mannans as potential agents against Alzheimer＇s disease

Aim： Oligomannurarate 971 derived from a marine plant has shown neuroprotective effects. In this study we synthesized a series of truncated derivatives of the oligosaccharide, and investigated the effect of these derivatives against Aβ peptide toxicity in vitro. Methods： The sulfoxide method was applied to synthesize the derivatives. SH-SY5Y human neuroblastoma cells were treated with Aβ1-40 （2 pmol/L）, and the cell viability was detected using a CCK8 assay. Results： A series of β-（1,4）-D-mannosyl oligosaccharide, ranging from the disaccharide to the hexasaccharide, were synthesized. Addition of 10 pmol/L β-（1,4）-D-mannobiose 6, β-（1,4）-D-mannotriose 9 or β-（1,4）-D-mannotetraose 12 in SH-SY5Y cells significantly attenuated Aβ1-40-induced toxicity. The efficacies were similar to those caused by 10 pmol/L oligomannurarate 971 or alzhemed. Other oligosaccharides including oligomaltoses and oligocelluloses were less active. Conclusion： Synthetic homogeneous short chain β-（1,4）-D-mannans shows neuroprotective effect against Aβ peptide toxicity similar to that of heterogeneous oligomannurarate 971 and alzhemed.     

防风通圣颗粒联合液氮冷冻治疗神经性皮炎的疗效观察

目的:评价防风通圣颗粒联合液氮冷冻治疗神经性皮炎的临床疗效和安全性。方法:120例神经性皮炎患者分为A组、B组和C组各40例,A组患者口服防风通圣颗粒,每天2次,每次3 g,液氮冷冻治疗,每周3次,连续2周为1个疗程;B组液氮冷冻治疗,每周3次,连续2周为1个疗程;C组患者口服防风通圣颗粒,每天2次,每次3 g,连续治疗2周为1疗程。结果:A组患者治疗后基愈率为75%、显效率为20%、进步率为5%、无效率为0%,有效率为95%;B组患者治疗后基愈率为55%、显效率为20%、进步率为22.5%、无效率为2.5%,有效率为75%;C组患者治疗后基愈率为52.5%、显效率为17.5%、进步率为25%、无效率为5%,有效率为70%。A组与B组、C组疗效比较差异均有显著的统计学意义(χ2=4.8039,P0.0284;χ2=7.013 0,P=0.0081);B组与C组疗效比较差异无显著的统计学意义(χ2=0.250 8,P=0.616 5)。三组患者均无明显不良反应。结论:防风通圣颗粒联合液氮冷冻治疗神经性皮炎是安全的、有效的。     

湿热证动物模型造模方法及评价研究＊

湿热证是中医临床常见的一种证候类型，病程缠绵反复，贯穿于众多疾病的发展始终，严重影响人们的生活健康。研究人员通过建立动物模型对疾病展开更深入的探讨，目前湿热证动物模型研究较多，以中医病因病机为原理造模，方法较为成熟，操作性强，重复性好；但存在制备方法单一，制备标准模糊，研究方向和研究领域呈扎堆式发展等不足。本文通过对中国知网（CNKI）、维普（VIP）、万方、PubMed数据库建库以来有关湿热证动物模型的研究文献进行整理和分析，从温病湿热证、脏腑湿热证及病证结合湿热证的角度出发，对湿热证动物模型的制备方法以及现存优缺点进行讨论和分析，以期为湿热证动物模型的优化及临床研究提供新的思路与方法。     

乌梅丸治疗更年期崩漏的临床观察

目的探究乌梅丸治疗更年期崩漏的临床疗效。方法选择2017年3月—2019年11月收治的52例更年期崩漏患者,以随机数字表法分为治疗组和对照组,每组26例。对照组给予乙烯雌酚2 mg/d和醋酸甲羟孕酮片10 mg/d,治疗组给予乌梅丸治疗。观察2组患者治疗效果及治疗前后汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)评分变化情况。结果治疗组的治疗总有效率高于对照组(P<0.05),且治疗组治疗后的HAMA、HAMD评分均低于对照组(P<0.05)。结论乌梅丸可有效改善更年期崩漏患者的临床症状,缓解患者负面情绪,临床应用价值较高,值得推广。     

穴位按摩配合中药熏洗治疗中风半身不遂的效果观察及护理

目的：探讨穴位按摩配合中药熏洗治疗中风半身不遂的临床效果。方法将中风后半身不遂的患者84例分为两组，对照组采样常规治疗；观察组在常规治疗的基础上，采用中药熏洗配合穴位按摩治疗，2个疗程后对患者肌力、关节活动度进行对比。结果观察组肌力改善总有效率为83．3％，关节活动度改善总有效率77．15％，对照组肌力改善总有效率为58．3％，关节活动度改善总有效率55．5％，两组比较差异有显著意义（ P＜0．05）。结论穴位按摩配合中药熏洗治疗中风病半身不遂临床效果优于单纯的药物治疗。