魏稼教授的飞针手法与临床应用

魏稼教授师承徐少廷的飞针法,并融入古代“凤凰展翅”与“饿马摇铃”补泻法的临床经验。根据明代杨继洲《针灸大成》载,前者属于捻转泻法,而后者则属于捻转加提插补法。“凤凰展翅”泻法操作重点是：二指夹持针柄,朝一个方向一捻一放4-8次,如瑞鸟展翅状;“饿马摇铃”补法的操作要点是：二指持针柄缓慢轻微摇摆50次,如饿马无力之状。文中附有治验病例。论证了以此法治疗三叉神经痛,胆石症合并胆囊炎,支气管哮喘等均有满意疗效。     

开放性手术治疗肾输尿管结石的体会

1987年至2006年我院采用开放手术治疗肾输尿管结石102例(122)次,肾结石残石率11%,无手术死亡。概述了胸膜损伤的预防及处理体会,讨论了肾脏切口和取石术式以及降低残石率、取石中肾内出血的处理及输尿管切开取石术后输尿管狭窄的预防措施等问题。     

从中医药治疗肾炎现代临床研究文献探讨肾炎中医四诊信息的规律性

目的:利用中医药治疗肾炎现代临床研究文献探讨肾炎中医四诊信息的规律性。方法:收集整理中医药治疗肾炎现代临床研究文献,采用频数分析与聚类分析的方法,分析文献中四诊信息的规律性。结果:从现代医学角度分析,肾炎四诊信息可以分为四类:疾病诊断相关症状或体征、疾病诊断相关症状或体征的中医特征性描述、疾病诊断不太相关的全身症状或体征、疾病诊断无关的舌脉象。症状出现频率高的是疾病诊断相关症状。运用聚类分析将这28项症状和舌脉象聚类为2类,能分别代表中医气阴两虚、外感风邪和气阴两虚、外感风寒证候类型。若将这28项症状和舌脉象聚为10类,则分别代表中医治疗慢性胃炎辨证过程中证候分类的常见症状或舌脉象的组合。结论:从统计学角度出发,肾炎现代文献中的中医四诊信息具有规律性,同时该规律性与中医学辨证理论一致。     

Correlation between hair selenium concentration and gastric cancer

Objective: To investigate the correlation between hair selenium (Se) level and gastric cancer. Methods: Atomic fluorescence spectrophotometer(AFS) was used to detect the Se level in hair. Results: The Se concentration in patients with gastric cancer ranged from 0.25 to 2.33μg/g(0.825±0.51μg/g), and that of health individuals ranged from 4.23 to 9.21μg/g(6.29±1.68μg/g). The results showed that the Se concentration in the patients' hair was significantly lower than that in controls (P＜0.01).Conclusion: There is a correlation between hair concentration and gastric cancer.     

防御性医疗行为现状及测量方法综述

在我国医患关系较为紧张的宏观环境下,防御性医疗成为医疗费用上涨的重要原因。本研究综述了防御性医疗行为的国内外现状及测量方法,为我国防御性医疗行为研究的开展提供借鉴。研究指出,目前我国医生中存在防御性医疗行为的比例较高,且国内相关实证研究较为缺乏,研究范围较小,测量指标不够全面。防御性医疗行为的测量方法主要包括医生自评、基于诊疗规范的客观评判、临床情景调查以及基于真实世界数据的分析,可根据实际情况选择适宜方法或将其结合运用。     

消化内镜常见故障的分析及避免方法

本文介绍了消化内镜应用中几种常见故障的原因及避免方法。     

《辅行诀》抄本寻踪

《辅行诀五脏用药法要》原藏敦煌藏经洞，1908年为法国伯希和盗掠，守洞道士王圆篆在为伯希和装箱时暗藏之，1918年售予河北省威县张僵南，僵南传其嫡孙大昌，毁于1966年“文革”初，“文革”期间张大昌将抄写本寄赠中国中医研究院，中国中医研究院加以整理，于1975年打印35本内部交流（简称“中研本”），继而王雪苔先生两次亲访张大昌，收集到两个抄本，经整理收录于1988年江西科学技术出版社《敦煌古医籍考释》（简称“考释本”）；二十世纪九十年代中国中医研究院中国医史文献研究所派王淑民先生陶广正先生再访张大昌，收集到3个抄本，经整理收录于1998年江苏古籍出版社的《敦煌医药文献辑校》（简称“辑校本”）。今仍有大昌弟子抄本传世。     

《针灸学》头针疗法的记忆教学法

为方便学生记忆，笔者将头穴按纵线10条和斜线4条分类，参照穴线分区和腧穴定位，对定位以及主治进行比较和归纳，总结出一些简便易记的特征。本法将有助于中医系学生和未系统学习过针灸学的医务人员尽快掌握和应用头针疗法。     

Ethical concerns about non-active conditions in smoking cessation trials and methods to decrease such concerns

Many have questioned whether it is ethical to assign participants in a research trial to a non-active control condition (e.g., a placebo or attention-only control) when (a) the disorder under study is serious, (b) validated treatment is available, and (c) harm may occur if treatment is not given. This ethical concern may apply to studies of controlled trials of treatments for drug dependence. The current paper examines this concern for trials of nicotine dependence because there are multiple validated treatments available. The major harm from assignment to a non-active condition in such a trial could occur if failure to quit discourages smokers from trying to quit again. Whether this harm actually occurs is unclear. Potential harms from non-active conditions may be mitigated by (a) provision of more explicit information in the consent process, (b) inclusion of only those who have failed optimal treatment, (c) provision of validated treatment via a different modality, (d) tests of the new treatment as an add-on to standard treatment, (e) use of dose–response design, (f) use of unequal randomization designs, (g) use of stopping rules, (h) provision of optimal therapy to those who fail during the study, or (i) comparison of the experimental treatment vs. standard treatment. Empirical research to inform ethical analysis of non-active conditions in drug abuse research is suggested.     

小血管套叠吻合法在临床上的应用

介绍一种改良的直径为2.0mm左右的小血管吻合方法——4针套叠吻合法,顺血流方向套入,其套入的深度与血管直径相等,只需缝合4针,此法简易、快速、可靠。报道3例游离前臂皮瓣和肩胛皮瓣移植小血管采用4针套叠吻合方法获得成功。