从原创思维看中医学的传承与发展

中医药之所以能够长期存在并经久不衰,在于其防治疾病的有效性。中医的的理论思维都源于中国古代哲学思维,当时占统治地位的哲学思想如精气学说、阴阳学说和五行学说都很好地融入中医的原创思维中。中医药工作者应在继承优良经验的基础上,运用现代科学技术诠释之,从而达到新的认识,创建出新的理论为现代临床服务,这样也许对中医能有科学性的认识,从而使得中医踏上可持续的发展之路。     

293篇医学研究生论文的发表时滞分析

目的了解研究生论文的发表时滞,以指导研究生的论文管理.方法选取《医学研究生学报》2005-2006年见刊的研究生论文293篇,按照论文种类的不同分为论著类229篇,综述类45篇;293篇中基金论文184篇,非基金论文109篇.分别计算其各阶段的时滞数据.结果293篇论文的总体见刊时滞为(234.7±116.9)d,其中审稿周期为(57.0±36.8)d,编辑周期为(109.4±96.4)d,待刊周期为(68.3±59.3)d.论著类的见刊时滞为(224.2±7.4)d,明显小于综述类的(272.9±19.3)d,P＜0.05;基金论文的见刊时滞为(211.9±7.6)d,明显小于非基金论文的(273.3±12.4)d,P＜0.01.结论研究生论文普遍周期过长,尤其是综述类论文和(或)非基金论文;研究生作者应根据论文种类的不同把握投稿时间.     

云南永胜县总管田村钉螺分布调查——河边田钉螺原始分布状态初步报告

云南省永胜县总管田村是1981年才发现的血吸虫病较小流行区。该村的钉嫘主要分布在河边田,在历史上河边田从未灭过螺,其钉螺的分布情况纯属原始分布状态。我们对河边田的钉螺分布状态进行了详细地调查,证实了河边田的钉螺原始分布状态呈孤立、分散的岛状分布。其状况与大理福星村的钉螺分布状态一致。     

高速涡轮牙钻及微创拔牙刀在阻生智齿拔除术中的应用效果

目的 探究高速涡轮牙钻及微创拔牙刀在阻生智齿拔除术中的应用效果。方法 选取2016年12月至2017年12月行阻生智齿拔除术的患者70例，根据拔牙方法将患者分为对照组（35例）与微创组（35例），对照组采取常规拔牙方法，微创组采取高速涡轮牙钻及微创拔牙刀拔牙。比较两组的手术指标（拔牙完整性、张口受限度、肿胀度、手术时间）、疼痛程度、并发症发生情况和术后生活质量（心理职能、生理功能、躯体疼痛、活力）。结果 微创组患者的拔牙完整性、张口受限度、肿胀度、手术时间4项手术指标均优于对照组（P均<0.05）。微创组和对照组患者治疗前的疼痛视觉模拟量表（VAS）评分差异无统计学意义（P>0.05），治疗后微创组VAS评分较对照组下降（P<0.05）。微创组并发症总发生率为11.43%（4/35），低于对照组[34.29%（12/35），P<0.05]。微创组术后3个月的心理职能等生活质量各项评分均高于对照组（P均<0.05）。结论 阻生智齿拔除术中应用高速涡轮牙钻及微创拔牙刀可有效提高治疗效果、减少并发症发生。     

肠复康肛滴治疗胸腹部术后肠麻痹86例临床观察

目的观察肠复康肛滴液治疗胸腹部术后肠麻痹的临床疗效。方法选择胸腹部术后肠麻痹患者146例,随机分为治疗组86例,对照组60例;治疗组用肠复康肛滴,对照组用新斯的明、吗丁啉分别肌注和口服。结果治疗组在促进患者肠鸣音出现时间、复常时间及肛门排气、排便出现时间等方面,明显优于对照组(P<0.01);治疗组在腹胀、呕吐、腹痛等肠麻痹症状的起效时间、消失时间及3d内症状消除率等方面亦明显优于对照组(P<0.05或0.01)。结论肠复康肛滴对胸腹部术后肠麻痹具有良好的治疗作用,其临床疗效优于新斯的明及吗丁啉。     

猫运动区青霉素诱发致痫灶手术治疗方法实验研究 第Ⅰ部分:行为学和电生理学变化

目的 :从行为学和电生理学观察上 ,探讨射频或激光技术在治疗致痫灶位于功能区的癫痫的可行性、安全性和有效性。比较致痫灶皮层不同切开形状对手术效果的影响。方法 :建立家猫运动区青霉素局灶性癫痫模型 ,给予不同的手术技术干预 ,通过电生理学和行为学观察 ,比较射频、激光技术和横切刀技术在控制癫痫发作方面的手术效果 ;通过观察术后一周的行为的变化 ,比较三种处理因素在功能保护方面的差异。通过皮层切开不同的形状 ,比较形状对手术效果的影响。结果 :在控制癫痫发作方面 ,射频或激光技术与传统的横切刀技术相比 ,统计学比较无显著性差异 (P >0 0 5 ) ;在功能保护方面 ,三者也无差异 ;皮层切开的形状对癫痫发作的控制 ,统计学比较无显著性差异 (P >0 0 5 )。结论 :行为学和电生理学观察 ,射频和激光技术在治疗功能区癫痫是可行的 ,其手术效果是安全、有效的     

Is Gadolinium Enhancement Predictive of the Development of Brain Atrophy in Multiple Sclerosis? A Review of the Literature

BACKGROUND AND PURPOSE: Several studies have demonstrated that brain atrophy can be detected over relatively short intervals from the earliest stages of multiple sclerosis (MS). Reviewing the published data, the authors highlight some hypothetical pathological mechanisms proposed as determinants of brain atrophy. METHODS: Using the terms multiple sclerosis, MRI (magnetic resonance imaging), and brain atrophy, 181 citations were identified. The authors considered only studies with prospective designs with natural-course MS patients and/or placebo-treated patients of therapeutic trials, in which patients underwent baseline and follow-up scans with a T1-weighted gadolinium diethylenetriamine penta-acetic acid sequence (0.1 mmol/kg body weight), and correlation analyses between Gd enhancement activity and brain atrophy progression. RESULTS: Five hundred thirty-two patients of 5 natural history studies and 5 therapeutic trial studies participated in the review process. The main observation was that in patients with a relapsing-remitting (RR) disease course, there was a correlation between Gd enhancement activity and brain atrophy progression. This correlation was not influenced by any other demographic and clinical additional data considered in the review process. CONCLUSIONS: Examination of the pathological mechanisms proposed in the reviewed studies led the authors to believe that inflammation is only in part responsible for the development of brain atrophy. This conclusion may have an implication for the strategies of tissue protection advocated in the early stages of the RR course and strengthen recent evidence indicating that anti-inflammatory immunomodulatory agents and immunosuppressive treatments, which predominantly act against the inflammatory component of disease activity, may not have similar effects on progressive tissue loss, either in RR or progressive MS.     

微卫星D8S84和D8S85在家族性热性惊厥人群相关性分析中的应用

目的：确认家族性热性惊厥与８号染色体长臂（８ｑ１３－２１）的关联；方法：用微卫星二核苷酸重复序列Ｄ８Ｓ８４和Ｄ８Ｓ８５对１３５例正常人和６３个热性惊厥家系进行聚合酶链反应－变性聚丙烯酰胺凝胶电泳（ＰＣＲ－ＰＡＧＥ）分型，结果用遗传学群体与家系计算机系统ＰＰＡＰ统计；结果：两种标志基因在中国正常人群处于Ｈａｒｄｙ－Ｗｅｉｎｂｕｒｇ平衡，并有较西方人略高的多态信息含量（ＰＩＣ），Ｄ８Ｓ８５的两种单体型频率在热性惊厥群体和普通正常人群存在显著性差异；结论：家族性热性惊厥可能与８ｑ的某些位点相关     

Utilizing a Sedation Decision Aid in Ambulatory Venous Access Device Placement: Effects on Patient Choice,Workup, and Recovery Time

This study was undertaken to determine the influence of using a sedation decision aid when selecting a sedation option for totally implantable vascular access device placement on patient choice, workup, and recovery time. An institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, retrospective study of 76 patients (aged 23-89 years, 58% female) presenting to a vascular interventional radiology department between January 2, 2017, and May 5, 2017. Patients were given a decision aid that inquired about personal values and goals, and provided information about expectations; benefits; and risks of the options, including undergoing the procedure with no sedation (local anesthetic), minimal sedation (anxiolysis with a benzodiazepine), or moderate sedation (benzodiazepine and opiate). No sedation was selected by 15 out of 76 patients (19.7%), minimal sedation was selected by 26 out of 76 patients (34.2%), and moderate sedation was selected by 34 out of 76 patients (44.7%). Postprocedure recovery time differences were significant (P?<?.001) with a mean of 17.4 minutes for no sedation, 49.3 minutes for minimal sedation, and 70.8 minutes for moderate sedation. The use of a decision aid did not slow down the process because workup times were not significantly different: 15.9 minutes for no sedation, 22.1 minutes for minimal sedation, and 18.4 minutes for moderate sedation. Patient sedation preference for totally implantable vascular access device is variable, signifying there is a role for utilizing a decision aid because it empowers a patient to select the option most aligned with his or her goals. Influence on departmental flow is notable because this does not slow down the workup and a majority of patients choose no or minimal sedation, resulting in a decreased postprocedure recovery time burden.