中医综合治疗寒凝血瘀型原发性痛经40例

目的:观察中医综合治疗寒凝血瘀型原发性痛经的临床疗效。方法:选取寒凝血瘀型原发性痛经患者80例,按照随机数字表法分为治疗组和对照组,每组40例。对照组给予布洛芬缓释胶囊口服治疗,治疗组给予自拟中药内服配合穴位贴敷、红外线照射治疗。结果:治疗组有效率为92.5%,对照组有效率为82.5%,治疗组优于对照组(P0.05);治疗组治疗后症状积分优于对照组(P0.05);治疗组复发率低于对照组(P0.01)。结论:中医综合治疗寒凝血瘀型原发性痛经疗效显著。     

中西医结合治疗毛细支气管炎研究进展

对于小儿毛细支气管炎,西医多采用免疫预防治疗、支持治疗和药物治疗三种。支持治疗主要有:氧疗、吸痰、物理治疗、补液及高渗盐水雾化等;药物治疗主要包括了支气管扩张剂、肾上腺素、糖皮质激素、白三烯受体拮抗剂、抗病毒及抗生素等;免疫预防治疗包括静脉注射免疫球蛋白与帕利珠单抗等;中医多采用辨证论治、中成药口服、中药静脉制剂、中药雾化吸入、穴位贴敷及中药灌肠等疗法,但缺少单独的中医治法临床研究,临床方面多以西医常规治疗联合中医药治法控制病情,并且取得了较好的临床疗效。尽管对毛细支气管炎的治疗已经取得很大的进展,多种治疗方案的应用也提高了治愈率,但仍缺少一套完整的中西医结合预防与治疗标准。     

中医食疗配合中药内服治疗虚寒型胃溃疡18例

目的:观察中医食疗配合中药内服治疗虚寒型胃溃疡的临床效果。方法:选取本院2012年5月—2013年6月治疗的虚寒型胃溃疡患者36例,按照随机数字表法将36例患者分为观察组和对照组,每组18例。对照组给予中药内服治疗,观察组在对照组治疗的基础上给予中医食疗辅助治疗。结果:观察组有效率为94.44%,对照组有效率为66.67%,观察组优于对照组(P0.05);两组不良反应比较,差异无统计学意义(P0.05)。结论:中医食疗配合中药内服治疗虚寒型胃溃疡疗效明显。     

金砖国家艾滋病抗病毒治疗药物保障策略及启示

随着艾滋病免费抗病毒治疗政策的推行,免费治疗人数的增加,药品治疗费用的攀升,金砖五国的艾滋病抗病毒药物保障均面临巨大挑战。为此,金砖五国推出了一系列政策以促进药物国产化和压低进口药品价格。本文对金砖国家艾滋病流行及防治情况、防艾药物的生产供给情况及药物保障政策进行分析,并提出启示与建议:(1)建立艾滋病抗病毒治疗药物统筹协调机制;(2)减少药品专利许可,增加国产药物仿制的可能;(3)与原研企业谈判获得自愿许可或技术转让加快药物国产化进程;(4)利用反垄断法获得药品自愿许可促进药品国产化;(5)必要时启动强制许可实现药品国产化;(6)寻求多种谈判筹码降低进口药品价格;(7)加强非政府组织自身能力建设。     

“单独二胎”政策下陕西省部分家庭生育意愿及其影响因素调查

“单独二胎”政策从提出到推行,一直是全社会的焦点,围绕这一政策合理与否,各方也提出了各种观点。通过对未达适婚年龄的独生子女、已达适婚年龄的独生子女和已达适婚年龄的非独生子女3类人群的调查,分别了解了他们对于“单独二胎”政策的认识和看法,继而从3个角度对政策的普及前景及影响因素进行统计分析。从结果看,由于政策尚在初始普及阶段,出于许多现实因素的限制和考量,符合要求的年轻夫妇生育意愿并不是很积极,若想进一步普及推行此政策,尚有许多问题需要解决。     

广东省政府应对人感染禽流感防控政策变迁分析

人感染禽流感是我国高发的重大动物传染病疫情,造成了巨大的生命财产损失,政府积极出台防控政策以有效应对不断进化的疫情。本文以渐进决策模式为主线,借鉴多源流理论中问题、政治、政策三个影响因素以及"问题之窗"等分析理念,对广东省政府应对人感染禽流感防控政策变迁的过程进行分析。通过分析发现政府应对人感染禽流感防控政策变迁是一个渐进的过程,且变迁过程中政治因素起决定性作用。     

Food deserts in Korea? A GIS analysis of food consumption patterns at sub-district level in Seoul using the KNHANES 2008-2012 data

BACKGROUND/OBJECTIVESThe concept of "food deserts" has been widely used in Western countries as a framework to identify areas with constrained access to fresh and nutritious foods, providing guidelines for targeted nutrition and public health programs. Unlike the vast amount of literature on food deserts in a Western context, only a few studies have addressed the concept in an East Asian context, and none of them have investigated spatial patterns of unhealthy food consumption from a South Korean perspective.SUBJECTS/METHODSWe first evaluated the applicability of food deserts in a Korean setting and identified four Korean-specific unhealthy food consumption indicators, including insufficient food consumption due to financial difficulty, limited consumption of fruits and vegetables, excessive consumption of junk food, and excessive consumption of instant noodles. The KNHANES 2008-2012 data in Seoul were analyzed with stratified sampling weights to understand the trends and basic characteristics of these eating patterns in each category. GIS analyses were then conducted for the data spatially aggregated at the sub-district level in order to create maps identifying areas of concern regarding each of these indicators and their combinations.RESULTSDespite significant reduction in the rate of food insufficiency due to financial difficulty, the rates of excessive consumption of unhealthy foods (junk food and instant noodles) as well as limited consumption of fruits and vegetables have increased or remained high. These patterns tend to be found among relatively younger and more educated groups, regardless of income status.CONCLUSIONSA GIS-based analysis demonstrated several hotspots as potential "food deserts" tailored to the Korean context based on the observed spatial patterns of undesirable food consumption. These findings could be used as a guide to prioritize areas for targeted intervention programs to facilitate healthy food consumption behaviors and thus improve nutrition and food-related health outcomes.     

Update on NHANES Dietary Data: Focus on Collection,Release, Analytical Considerations,and Uses to Inform Public Policy

NHANES is the cornerstone for national nutrition monitoring to inform nutrition and health policy. Nutritional assessment in NHANES is described with a focus on dietary data collection, analysis, and uses in nutrition monitoring. NHANES has been collecting thorough data on diet, nutritional status, and chronic disease in cross-sectional surveys with nationally representative samples since the early 1970s. Continuous data collection began in 1999 with public data release in 2-y cycles on ∼10,000 participants. In 2002, the Continuing Survey of Food Intakes by Individuals and the NHANES dietary component were merged, forming a consolidated dietary data collection known as What We Eat in America; since then, 24-h recalls have been collected on 2 d using the USDA’s Automated Multiple-Pass Method. Detailed and targeted food-frequency questionnaires have been collected in some NHANES cycles. Dietary supplement use data have been collected (in detail since 2007) so that total nutrient intakes can be described for the population. The continuous NHANES can adapt its content to address emerging public health needs and reflect federal priorities. Changes in data collection methods are made after expert input and validation/crossover studies. NHANES dietary data are used to describe intake of foods, nutrients, food groups, and dietary patterns by the US population and large sociodemographic groups to plan and evaluate nutrition programs and policies. Usual dietary intake distributions can be estimated after adjusting for day-to-day variation. NHANES remains open and flexible to incorporate improvements while maintaining data quality and providing timely data to track the nation’s nutrition and health status. In summary, NHANES collects dietary data in the context of its broad, multipurpose goals; the strengths and limitations of these data are also discussed in this review.     

锰离子滴眼液局部应用对眼前节组织的毒性作用

背景 锰离子滴眼液用于活体视觉传导通路的示踪观察方法已有研究,但锰离子局部点眼对眼前节组织的毒性作用尚无深入研究. 目的 研究不同质量浓度锰离子滴眼液对兔眼眼前节组织的毒性作用.方法 选取32只清洁级新西兰白兔,按照随机数字表法随机分为1.00 mol/L MnCl2组、0.50 mol/LMnCl2组、0.25 mol/L MnCl2组以及对照组,每组8只.采用抽签法随机选择动物一侧眼为实验眼,按照分组情况分别用1.00、0.50、0.25 mol/L锰离子滴眼液及生理盐水各1滴点于结膜囊中,分别于点眼后2h及1、3、7、14、21和28 d时在裂隙灯显微镜下观察眼局部刺激反应;用角膜荧光素染色法观察角膜上皮损伤情况并进行评分;采用角膜内皮镜观察角膜内皮细胞密度(ECD)和角膜厚度,并于点眼后3、7、14、28 d行苏木精-伊红染色,检查结膜、角膜、小梁网及睫状体的组织病理学变化.结果 1.00 mol/L MnCl2组和0.50 mol/L MnCl2组兔眼均出现睑结膜充血、水肿及大量分泌物等刺激症状,1.00 mol/L MnCl2组兔眼于点眼后1d刺激反应最强,点眼后7d反应消失;0.50 mol/L MnCl2组兔眼眼表刺激反应程度轻于1.00 mol/L MnCl2组,持续到点眼后3 d;0.25 mol/L MnCl2组兔眼点眼后未见明显的眼表刺激反应.点眼后2h、1d、3d及7d,各组兔眼角膜上皮荧光素染色评分总体比较差异均有统计学意义(x2=17.350、19.200、12.200、10.140,均P＜0.05).各组兔眼点眼后不同时间点ECD总体比较差异无统计学意义(F分组=0.38,P＞0.05;F时间=1.79,P＞0.05).各组兔眼点眼后不同时间点角膜厚度总体比较差异有统计学意义(F分组=18.22,P＜0.05;F时间=116.75,P＜0.05)点眼后2h～3d,1.00 mol/L MnCl2组兔眼角膜厚度值明显增加,但点眼后7～28 d,各组兔眼角膜厚度值接近,点眼后2h～14d角膜厚度值均明显高于点眼后28 d,0.50 mol/L MnCl2组兔点眼后2h～1d角膜厚度值明显高于点眼后28 d,差异均有统计学意义(均P＜0.05).组织病理学检查结果显示,1.00 mol/L MnCl2组兔眼于点眼后3d和7d可见结膜、小梁网和睫状体的炎性细胞浸润及角膜基质水肿,0.50 mol/L MnCl2组于点眼后3d可见结膜炎性细胞浸润,但角膜、小梁网和睫状体组织未见明显异常,而0.25 mol/L MnCl2组兔眼点眼后结膜、角膜、小梁网和睫状体均未见明显异常.结论 1.00 mol/L锰离子滴眼液对兔眼眼前节有明显毒性作用,0.50 mol/L锰离子滴眼液的毒性则明显降低,0.25 mol/L锰离子滴眼液对兔眼眼前节无明显的毒性作用.     

基于中医传承辅助系统的毕荣修教授治疗激素性股骨头坏死处方规律探析

目的:分析毕荣修教授门诊及病房治疗激素性股骨头缺血性坏死(SANFH)方剂的处方规律。方法:收集并严格筛选毕荣修教授治疗SANFH的方剂,使用中医传承辅助系统(v2.5)软件进行逐一录入并进行数据处理,对筛选出的治疗SANFH的方剂,进行处方规律分析。结果:筛选出符合要求的61首治疗SANFH的处方,确定了处方中药物出现的常用药物和4味核心药物以及6首新处方等。结论:治疗SANFH应以补养肝肾、活血化瘀为主要治法,并根据不同兼证,酌情配伍具有行气止痛、益气养阴、接骨续筋等功效的药物,以达到标本同治的目的。中医传承辅助系统对于分析名中医处方用药规律具有科学性、实用性,能够客观全面地总结分析名中医的临证经验,对于中医药的传承与发展具有重大意义。