《杂病治例》补校举隅

参校其他医学文献对《杂病治例》原文中10处由于误、脱、不明的文字问题进行校勘、补正,并分别做了理由说明。     

实施护理专案提高外周静脉留置针固定正确率

目的:探讨实施护理专案对提高外周静脉留置针固定正确率的效果。方法:调查分析2018年3月382例大妇科外周静脉留置针患者中固定不正确的情况,建立护理专案小组,开展“提高外周静脉留置针固定正确率”的护理专案改善活动,按专案的步骤进行要因分析、确定真因、制定对策并组织实施,观察2018年9月402例使用外周静脉留置针的患者,比较专案活动实施前后留置针固定的正确率。结果:外周留置针固定正确率由专案改善活动前的62.30%提高到86.32%(P<0.05)。结论:通过实施护理专案,可提高外周静脉留置针固定的正确率。     

Medial frontal negativities predict performance improvements during motor sequence but not motor adaptation learning

Alterations in our environment require us to learn or alter motor skills to remain efficient. Also, damage or injury may require the relearning of motor skills. Two types have been identified: movement adaptation and motor sequence learning. Doyon et al. (2003, Distinct contribution of the cortico‐striatal and cortico‐cerebellar systems to motor skill learning. Neuropsychologia, 41(3), 252‐262) proposed a model to explain the neural mechanisms related to adaptation (cortico‐cerebellar) and motor sequence learning (cortico‐striatum) tasks. We hypothesized that medial frontal negativities (MFNs), event‐related electrocortical responses including the error‐related negativity (ERN) and correct‐response‐related negativity (CRN), would be trait biomarkers for skill in motor sequence learning due to their relationship with striatal neural generators in a network involving the anterior cingulate and possibly the supplementary motor area. We examined 36 participants' improvement in a motor adaptation and a motor sequence learning task and measured MFNs elicited in a separate Spatial Stroop (conflict) task. We found both ERN and CRN strongly predicted performance improvement in the sequential motor task but not in the adaptation task, supporting this aspect of the Doyon model. Interestingly, the CRN accounted for additional unique variance over the variance shared with the ERN suggesting an expansion of the model.     

Does It Really Matter What Volume to Exhale Before Using Asthma Inhalation Devices?

Correct use of inhalation devices is one essential component of optimal management of asthma. Several longstanding controversies regarding specific steps to correct use of metered dose inhalers (MDI) include the lung volume when the MDI should be actuated. As a primary objective, literature was reviewed examining this one step in MDI use. Results from six of nine investigations support the need to gently exhale either to functional residual capacity (FRC) or residual volume (RV) before MDI actuation. Literature is also summarized regarding the need to exhale to FRC or RV before inhaling from MDI plus valved holding chambers or other extension devices and from dry powder inhalers. Numerous studies indicate that many patients as well as health care professionals either do not know or forget to exhale to RV or FRC before inhaling asthma medications. Both patients and health care professionals need education to help ensure correct use of MDI and other asthma inhalation devices, including instruction to first exhale gently to RV or FRC before inhaling the medication.     

Impact of corrected sinus node recovery time in predicting recurrence in patients with paroxysmal atrial fibrillation

ObjectiveAtrial fibrillation (AF) and sinus node dysfunction (SND) have common underlying pathophysiological mechanisms. As an index of SND, corrected sinus node recovery time (CSNRT) may also reflect atrial function. The aim of the present study was to determine whether CSNRT predicts AF recurrence in patients undergoing AF ablation.MethodsConsecutive patients with paroxysmal atrial fibrillation (PAF) who underwent radiofrequency catheter ablation between January 2017 and December 2018 were enrolled. Clinical data, CSNRT, and other electrophysiology indices were collected and analysed between patients with or without AF recurrence.ResultsA total of 159 patients with PAF who underwent the same radiofrequency catheter ablation procedure were enrolled, including 25 patients with SND. During the one-year follow-up period, 22 patients experienced AF recurrence. Patients with recurrence had a significantly longer CSNRT and a larger left atrial volume index (LAVI) than patients without AF recurrence. SND (CSNRT > 550 ms) and a larger LAVI were independently associated with AF recurrence after ablation. A statistically significant CSNRT cut-off value of 550 ms predicted AF recurrence with 73% sensitivity and 85% specificity.ConclusionCSNRT and LAVI are independent predictors of PAF recurrence following ablation.     

浅谈脏腑气机

脏腑气机是对脏腑生理功能活动形式的概括,由于其生理功能各不一样,故各脏腑气机也有升降出入之不同.掌握脏腑气机,不仅对于我们更好的认识脏腑的生理功能,而且对于疾病的治疗,都有着重要的指导意义.     

牙列中线偏斜的正畸治疗

目的：探讨导致牙性、功能性牙列中线偏斜的常见原因及矫治技术。方法：采用临床检查、后前位X线片、曲面断层片和模型测量进行诊断分析,将牙列中线偏斜分为3种不同类型。然后应用颌间牵引法、带螺旋结构的双垂直曲法、逐个牙移动法、再定位咬合板等矫治方法。结果：60例牙列中线偏斜病例,依据临床分型,采用相应的治疗方法,均达到满意效果。结论：牙性、功能性牙列中线偏斜患者要根据其-临床特征、病因机制选择相应的治疗方法,才能保证矫治疗效。     

类风湿关节炎30例误治分析

[目的]简述类风湿关节炎的临床特点及误诊误治情况,吸取其中的经验教训。[方法]回顾性分析30例不合理治疗的类风湿关节炎患者临床表现及治疗经过。[结果]30例类风湿关节炎患者存在不合理使用非甾体抗炎药及糖皮质激素的情况,且未使用改变病情的抗风湿药(DMARDs);类风湿关节炎应用中西医结合治疗能达到较好疗效。[结论]类风湿关节炎是一种慢性、进展性、破坏性关节病,规范治疗有较好的疗效。     

毛泽东执政能力建设思想研究

本文作者对毛泽东党的执政能力建设思想作了分析和研究，重点阐述了毛泽东的加强民主集中制建设是提高党的执政能力的制度保障、改进领导方式和工作方法是提高党的执政能力的关键环节、从实际出发制订和实行正确的政策和策略是提高党的执政能力的重要内容等丰富思想。     

自体软骨移植和改良Abbe瓣矫正双侧唇裂鼻唇畸形

目的　利用鼻底双三角瓣 ,自体软骨移植和改良Abbe’瓣 ,Ⅱ期矫正双侧唇裂术后鼻唇畸形。方法　利用唇裂修复时贮存鼻底两个三角瓣 ,延长鼻小柱 ,并将双侧鼻翼软骨完全游离同时切取耳甲软骨 ,修整后将其移植固定鼻小柱处 ,在下唇唇红中央设计包括下唇全层和小块三角形皮肤的改良Abbe’瓣。结果　本组共施术 2 0例 ,均获Ⅰ期愈合 ,经 0 5～ 5年临床观察及随访 ,术后效果满意 ,未见鼻唇及切取软骨耳廓发育受影响。结论　利用唇裂修复时贮存鼻底的双三角瓣 ,自体耳甲软骨移植和改良Abbe’瓣行双侧唇裂Ⅱ期矫正鼻小柱过短 ,鼻尖鼻翼低平 ,上唇过紧 ,唇珠和唇弓外形差效果肯定。