胃食管反流病的常用方剂及药对规律

目的 总结胃食管反流病(GERD)的常用方剂及药对规律.方法 检索1994-2014年中医药治疗GERD的相关文献,提取辨证分型、用药等信息,建立Microsoft Excel 2003数据库,采用Crosstabs方法分析各证型、方剂、药对出现频次.结果 共纳入文献350篇,常见6种基本证型,依次为肝胃不和证、脾虚湿热证、肝胃郁热证、痰气交阻证、中虚气逆证、脾胃虚寒证;共使用方剂109个,中药143种.GERD肝胃不和证治疗以柴胡疏肝散为主;脾虚湿热证以半夏泻心汤居多;肝胃郁热证常用左金丸;痰气交阻证以半夏厚朴汤为主;中虚气逆证以旋覆代赭汤为主;脾胃虚寒证黄芪建中汤多见.文献中高频使用的药对组合是半夏-黄连、黄芩-黄连、芍药-甘草、柴胡-白芍等共19对.结论 中医药治疗GERD重视辨证论治的思想,多在主方、主药的基础上,综合考虑本证型病机特点,适当配伍其他类药物,或使其兼顾病机更加广泛,提高主药治疗效果,或防止主药作用太过,佐制其潜在副作用.     

体验式学习在护理本科生早期接触临床中的应用研究

目的:探讨体验式学习在护理本科生早期接触临床中的应用效果。方法:选取我校2011级152名护理本科生作为研究对象,在南京医科大学第一附属医院早期接触临床,进行为期20周的体验式学习,应用关怀能力量表、护患沟通能力量表、健康教育能力量表进行评估,比较体验式学习前后护生护理能力的变化。结果:护生临床关怀能力、护患沟通能力及健康教育能力均得到明显提高,与体验式学习前比较差异有统计学意义(P0.05,P0.01)。结论:应用早期接触临床的体验式学习方法,能提高护理本科生的护理能力,为进入临床实习打好基础。     

在新护士岗前培训中应用体验式教学的意义研究

目的探索体验式教学法运用于岗前培训的意义。方法采用质性研究中的深入访谈法,对8名参加岗前培训的新护士进行面对面、半结构式深入访谈,访谈后用NVivo 7软件进行分析。结果本研究分析出3个主题,分别是:体验式教学法现运用于各类护理教学课程并能达到教学目的;岗前培训中新护士的体验感受包括,患者需要得到身心的关怀,临床护理需要精湛的护理操作技术和创新;体验式教学能引导新护士正确进行职业生涯规划。结论体验式教学运用于岗前培训能培养新护士"以患者为中心"的护理理念,引导新护士提高业务技术水平和护理创新的意识,引导新护士正确进行职业生涯规划,在临床护理教学过程中值得推广。     

Congruence Couple Therapy for Pathological Gambling

Couple therapy models for pathological gambling are limited. Congruence Couple Therapy is an integrative, humanistic, systems model that addresses intrapsychic, interpersonal, intergenerational, and universal–spiritual disconnections of pathological gamblers and their spouses to shift towards congruence. Specifically, CCT’s theoretical foundations, main constructs, and treatment interventions are illustrated in a progression of six clinical phases. Promise of CCT’s systemic conceptualization and interventions for pathological gambling and future directions in its continuing evolution are discussed.     

国医大师周信有运用对药治疗慢性胃炎

国医大师周信有治疗慢性胃炎常用对药:白术、鸡内金伍用,白术益气健脾主升,脾气升则运化有权,鸡内金健胃消食主降,胃气降则收纳有功,二药相伍,有利于脾胃升降纳运功能的恢复;陈皮、砂仁伍用,陈皮长于燥湿健脾,砂仁善于化湿醒脾,一燥一化,使湿邪除而脾运;黄连、半夏伍用,半夏辛、温,功能健脾燥湿、消痞散结,又可化痰降逆,黄连苦、寒,苦能燥湿,寒能泻热,二药相伍,可调脾胃气机升降;延胡索、白芷伍用,延胡索活血散瘀、行气止痛,白芷温胃散寒,延胡索、白芷相伍,共达活血、行气以止痛之效。     

Supervision: the process of life-long learning in social and educational professions

The supervision process represents one of the possible processes of life-long learning and development of an adult. This paper presents a developmental-educational model of supervision. It is a specific learning developmental and supportive method of professional reflection and counselling used in social and educational settings in Slovenia. Different concepts that explain learning and acquiring competence in the process of supervision are discussed. Special emphasis is given to the process of experiential learning (Kolb), learning within the zone of proximal development (Vygotsky) and the process of mental adaptation leading to new cognition (Piaget).     

The Next Wave: Confexting

Radiology conferences enable participants the opportunity to ask experts questions through question and answer (Q and A) sessions or individually. Given the time limitations and intimidating circumstances, we incorporated conference text messaging (confexting) as a method of increasing interactivity between the audience and speakers. During a 5-day radiology conference, text messaging was utilized for anonymous interactivity between the audience and speakers during Q and A sessions. There were 324 text messages; 76 of these were either follow-up statements or questions related to earlier text messages. Forty-two questions were submitted via paper notes. There was a general trend of an increasing number of text messages and a decreasing number of paper notes. The anonymous text messaging system was found to be an effective method for interactivity between the audience and the speakers. The questions and answers could be presented in a PowerPoint format at the formal Q and A sessions. Questions texted to the authors during their talks could be immediately answered or addressed in subsequent talks. Although difficult for some individuals to embrace technology, confexting allows for interactivity and prompts discussion. Confexting is an effective method for interactivity between the audience and speakers not previously utilized in a conference setting. The anonymity and asynchronous communication enable conference participants to submit more questions than in the traditional setting. The speakers may be able to explain more thoroughly difficult concepts more thoroughly with additional slides at Q and A sessions or may immediately answer texted questions during their talks.     

孙丽平教授运用对药辨治小儿咳嗽临证荟萃

阐述了孙丽平教授治疗小儿咳嗽临床常用的8组对药,即前胡与白前、紫菀与款冬花、苦杏仁与桃仁、橘红与桔梗、瓜蒌与冬瓜子、地龙与僵蚕、川贝母与浙贝母、沙参与麦冬的配伍特点及临床应用心得,并列举其临证经典医案,结合中药学理论和现代药理学研究,总结分析孙教授运用对药治疗小儿咳嗽的学术经验及用药思路。孙教授认为小儿体属稚阳,其咳多起肺虚实之热,主以清热护肺,次以运脾滋阴,主次同疗,则阴阳平矣,强调小儿咳嗽用药,应以辨别个体体质差异为基础,提倡对药组方"肺脾同治、气血通调、阴阳平补"的用药理念。附案例1则,以资验证。