武连仲教授治疗坐骨神经痛经验

全国名中医天津中医药大学第一附属医院针灸科武连仲教授用多年的临床经验总结概括出针刺的理、法、方、穴、术，其创立的"通经止痛"针刺疗法在临床中疗效佳，武老在治疗坐骨神经痛时，取足太阳膀胱经和足少阳胆经具有走窜针感的经穴为主穴，其配伍精确，组方严密，手法独特，可供临床参考。本文将武老运用"痛经止痛"针刺法治疗坐骨神经痛的经验从"理、法、方、穴、术"方面做浅述。     

从"醒脑开窍"针刺疗法探讨国医大师石学敏院士对中医脑病的贡献

"醒脑开窍"针刺疗法是我国著名中医药学家和教育家、中国工程院院士、国医大师、石学敏中医发展基金会理事长石学敏教授于1972年为治疗中风病创立的针刺疗法。该疗法临床应用已达40余年，在中风病等多种疾病治疗中确实显示出其卓越的疗效。通过大量的临床观察和基础实验研究，对机体多系统疾病均有良好的调节作用。该疗法不仅限于中风病的应用，一切脑性麻痹或瘫痪(如小儿脑瘫、一氧化碳中毒和脑外伤后等)；严重的疼痛(如神经痛、内脏痛、创伤痛和癌瘤痛等)；精神疾病(如癫狂痫、抑郁症、百合病和癔病等)；还有部分其他系统(如尿崩症、遗尿和二便失控等疾病)均有非常好的疗效。从脑主神明的认识；"醒脑开窍"针刺疗法的提出与确立；创立中风病机新理论等方面，并探讨中国工程院院士、国医大师石学敏教授对中医脑病的新贡献。     

医学生志愿服务新机制的创新探索

医学生是志愿服务的重要群体之一。本文通过对医学生志愿服务现状、存在问题等深入分析,探索新的志愿服务方向与实施策略。通过实践逐步形成了包括招募、培训、管理、评估和激励机制在内的完整运行机制,在确保志愿服务工作健康可持续发展的同时,为医学生了解临床工作提供宝贵机会,有利于他们专业知识的学习巩固,更好地培养崇高医德。     

腹腔镜胆总管探查术与内镜下十二指肠乳头括约肌切开术治疗胆总管结石的临床对照研究

目的:比较腹腔镜胆总管探查术(LCBDE)与内镜下十二指肠乳头括约肌切开术(EST)治疗胆总管结石的临床效果。方法:回顾性分析2012年11月—2014年3月收治的210例胆总管结石患者资料,按手术方式分为LCBDE组(116例)和EST组(94例),对比两组相关临床指标。结果:两组手术成功率差异无统计学意义(99.1%vs.95.74%,P=0.175),但LCBDE组一期治愈率高于EST组(97.4%vs.90.4%,P=0.038);两组残余结石率、平均住院时间与住院费用均无统计学差异(均P0.05),但EST组一期治疗后9例残余结石患者行第2次EST治疗,6例残余结石患者行第3次EST治疗;首次EST失败的患者,其住院时间与花费明显增加;LCBDE组围手术期总并发症以及远期并发症发生率均明显低于EST组(均P0.05),差异主要来源于EST相关并发症。结论:LCBDE治疗胆总管结石一期治愈率高于EST,且并发症率低于EST组,能保留十二指肠乳头括约肌的生理功能,可同时实施腹腔镜胆囊切除术处理胆囊病变。因此,在多数情况下,应首先考虑LCBDE。     

高职《中药鉴定学》教学模式的思考与探索

中药鉴定学是中药学及相关专业的一门专业课,课程知识多且零碎,内容却极其枯燥,怎样提高学生的学习兴趣,提高中药鉴定学的教学质量,使所学药材更加易学易认,调动学生的积极性,是大家不断研究和商讨的课题.审视当前中药鉴定学的教学活动,笔者对其理论教学、实验教学内容和教学模式进行思考与探索.     

现代教学法与传统教学相结合在心血管临床教学工作中的实践与探索

目的:探讨现代教学法与传统教学相结合在心血管临床教学工作中的实践与探索。方法:选择本院心血管科室2012年6月-2013年3月的实习生180名,分为传统教学组、现代教学组和结合教学组。观察三组的临床教学效果。结果:结合教育组平日成绩及笔试考核均无一人在60分以下,其平均成绩高于高于传统教学组25%,高于现代教学组15%。而笔试成绩高于其他两组10%和5%。结论:现代教学法与传统教学相结合对心血管临床教学有明显的效果,有利于实习医生对相关疾病的掌握,值得在本院各科室进行推广。     

Developmental outcomes of children with congenital diaphragmatic hernia: A multicenter prospective study

Purpose

To determine developmental outcomes and associated factors in patients with congenital diaphragmatic hernia (CDH) at 2 years of age.

Methods

This is a multicenter prospective study of a CDH birth cohort. Clinical and socioeconomic data were collected. Bayley Scales of Infant Development (BSID-III) and Vineland Adaptive Behavior Scales (VABS-II) were performed at 2 years of age.

Results

BSID-III and VABS-II assessments were completed on 48 and 49 children, respectively. The BSID-III mean cognitive, language, and motor scores were significantly below the norm mean with average scores of 93 ± 15, 95 ± 16, and 95 ± 11. Ten percent (5/47) scored more than 2 standard deviations below the norm on one or more domains. VABS-II scores were similar to BSID-III scores with mean communication, daily living skills, social, motor, adaptive behavior scores of 97 ± 14, 94 ± 16, 93 ± 13, 97 ± 10, and 94 ± 14. For the BSID-III, supplemental oxygen at 28 days, a prenatal diagnosis, need for extracorporeal membrane oxygenation (ECMO) and exclusive tube feeds at time of discharge were associated with lower scores. At 2 years of age, history of hospital readmission and need for tube feeds were associated with lower scores. Lower socioeconomic status correlated with lower developmental scores when adjusted for significant health factors.

Conclusion

CDH patients on average have lower developmental scores at 2 years of age compared to the norm. A need for ECMO, oxygen at 28 days of life, ongoing health issues and lower socioeconomic status are factors associated with developmental delays.     

数字人体经络信息获取的多光谱探测技术研究

本文首先阐述了数字人体的多光谱探测技术的国内外研究现状和意义;然后讨论了数字人体经络信息获取的多光谱探测技术的研究内容、研究目标、拟采取的研究方法、技术路线,人体经络系统物质流、信息流探测获取的实验方案及可行性分析等;为数字人体经络的信息获取提供了技术方法.     

我院开展远程会诊的实践与探索

远程会诊在我国的发展经历多个时期,作为实现分级诊疗和发展远程医疗的有力手段已在全国各级医院得到广泛应用。国内开展远程会诊的竞争激烈,并且出现受众需求个性化、缴费流程不合理、学科覆盖不全面的问题。中国人民解放军总医院在扩充远程会诊专家团队、优化远程缴费路径和加强资源融合等方面进行了实践和探索。作者总结了远程会诊的发展和新形势、分析远程会诊实践中出现的问题,在探索远程会诊实践的基础上提出了关注远程早期筛查、常规检测、诊断后转诊等建议,进一步思考和展望,促进了远程会诊服务能力的进一步提升。     

Laparoscopic hepatic left lateral Iobectomy combined with fiber choledochoscopic exploration of the common bile duct and traditional open operation

AIM:To investigate the possibilities and advantages of laparoscopic hepatic left lateral Iobectomy combined with fiber choledochoscopic exploration of the common bile duct compaired with traditional open operation.METHODS:Laparoscopic hepatic left lateral Iobectomy combined with fiber choledochoscopic exploration of the common bile duct and traditional open operation were performed in two groups of patients who had gallstones in the left lobe of liver and in the common bile duct.The hospitalization time,hospitalization costs,operation time,operative complications and post-operative liver functions of the two groups of patients were studied.RESULTS:The operation time and post-operative liver functions of the two groups of patients had no significant differences,while the hospitalization time,hospitalization costs and operative complications of the laparoscopic hepatic left lateral Iobectomy combined with fiber choledochoscopic exploration in the common bile duct group were significantly lower than those in the traditional open operation group.CONCLUSION:For patients with gallstones in the left lobe of liver and in the common bile duct,laparoscopic hepatic left lateral Iobectomy combined with fiber choledochoscopic exploration of the common bile duct can significantly shorten the hospitalization time,reduce the hospitalization costs and the post-operative complications,without prolonging the operation time and bringing about more liver function damages compared with traditional open operation.This kind of operation has more advantages than traditional open operation.