Fitness to Stand Trial: Learning from the Ezra Pound Saga

The famous United States poet and literary figure Ezra Pound (1885–1972) was indicted for treason in the District of Columbia after being extradited from Italy for participation during the Second World War in propaganda broadcasts on behalf of the Italian dictator, Benito Mussolini. With his life at risk, he successfully pleaded that he was unfit to stand trial by reason of mental impairment. A review of the evidence given by the four psychiatrists and of the judge's charge to the jury casts doubt on the claim that the trial was politically directed to ensure that Pound was not executed. However, later diagnoses from St Elizabeths Hospital in Washington, after he was detained, suggest that his principal impairment may have been a personality disorder, perhaps with cyclothymic or bipolar traits, raising the issue of whether such a diagnosis should be sufficient for a finding of unfitness to stand trial.     

组织工程化软骨修复软骨损伤

背景:目前临床上多采用自体或异体软骨移植、软骨膜或骨膜移植、软骨细胞移植等方法进行软骨损伤修复,但均因取材局限、免疫排斥等导致效果不佳。利用组织工程的方法再造软骨,为软骨缺损的临床修复提供了新的思路与途径。目的:利用SCI数据库文献检索和深度分析功能,对于组织工程软骨的文献资料趋势进行多层次探讨分析,根据检索文献结果分析组织工程软骨的发展趋势。方法:通过计算机检索SCI数据库中2001/2010有关组织工程软骨的文献,检索词为"软骨(cartilage);组织工程(tissueengineering);软骨细胞(chondrocyte/cartilage cell);软骨组织(cartilage tissue);支架材料(scaffold materials);种子细胞(seed cell)",以文字和图表的形式进行统计和结果分析,描述其分布特征。结果与结论:SCI数据库2001-01/2010-12收录组织工程软骨相关文献总计3137篇,中国在该领域的文献产出量逐渐增多,总体呈上升趋势,Biomaterials《生物材料》杂志发表文献量最多。美国在该领域文献产出量多于其他国家,对该领域研究起到重要作用,发表文献较多的机构集中在美国的哈佛大学,莱斯大学,麻省理工学院,哥伦比亚大学,加利福尼亚大学圣地亚哥分校等。     

《金匮要略》本科教学三步曲——溯源、贯通、致用

[目的]提升《金匮要略》本科教学质量,训练及提升学生临床诊疗思维及能力。[方法]在深入分析传统教学模式的基础上,开展《金匮要略》本科教学三步曲的教学探索,进而探讨各步的要点及具体操作要素。[结果]《金匮要略》本科教学三步曲,即溯源、贯通、致用。细读深研、溯本求源,是《金匮要略》本科教学之第一步,即首要前提,要求教师讲授时回归原文原意,注重原文之间的联系;融会贯通、理论升华,是第二步,也是核心内容,这一步应重点讲授“病→脉→证→治”逐级分类循证推理之临床诊疗模式,而背诵是实现贯通的有效途径;着眼临床、学以致用,是第三步,也是最终目标,应做到“病”“证”之古今接轨。本教学模式下,学生出勤率达99%,课堂互动率95%以上,课堂原文背诵正确率93%以上,期末试卷综合分析题、案例分析题正确率达到95%以上。[结论]《金匮要略》本科教学三步曲——溯源、贯通、致用,训练提升了学生对仲景理论的综合分析运用能力,以及逐级分类诊疗决策循证推理能力,拉近了理论学习与临床应用的距离,也为《金匮要略》教学方法的探索注入新的内容。     

醒脑开窍针刺法联合通心络胶囊治疗83例急性脑梗死疗效观察

目的观察醒脑开窍针刺法联合通心络胶囊治疗急性脑梗死的临床疗效。方法选取2012年5月~2013年6月云梦县中医院内一科收治的急性脑梗死患者83例,随机分为治疗组（n=41）与对照组（n=42）。2组基础治疗相同,治疗组加用醒脑开窍针刺法针灸治疗及通心络胶囊口服,连续20d,比较2组患者治疗后及各组治疗前后NIHSS评分。结果治疗组治疗20d后的NIHSS评分与对照组相比,差异有统计学意义（P〈0.05）;治疗组、对照组治疗前后的NIHSS评分相比较,差异有统计学意义（P〈0.05）。结论醒脑开窍针刺法联合通心络胶囊治疗急性脑梗死能较快的促进脑梗死患者神经功能恢复,是治疗脑梗死的有效方法之一。     

针药结合治疗延髓背外侧综合征临床观察

目的：探讨针刺联合中药汤剂治疗延髓背外侧综合征的临床疗效。方法：将符合延髓背外侧综合征诊断标准的5例患者,采用醒脑开窍配合补阳还五汤进行治疗3个月。结果：1例患者共济失调、感觉障碍及吞咽困难症状完全缓解,3例患者仅遗留少许感觉障碍,1例患者仍存在病灶侧的共济失调症状。结论：针药结合治疗延髓背外侧综合征有较好的疗效。     

《方剂学》教学中的“知常”与“达变”

为了使学生能够熟练掌握《方剂学》教学大纲所要求的内容,提出"三步一扣一回头"的教学方法,使学生在学习方剂学的过程中做到知常达变的同时,提高学生学习方剂学的能力,掌握方剂学的学习方法,为学习中医学临床课程奠定坚实的基础。     

Post-traumatic Stress Disorder and Hospitalisation Syndrome as Potential Aetiologies of Unfitness to Stand Trial: The Gbagbo Decision

In Prosecutor v Laurent Gbagbo, ICC Pre-Trial Chamber, 2 November 2012 it was decided that the accused former President of the Ivory Coast was fit to stand trial. Expert opinions from a general practitioner and a psychologist were not accepted and evidence from a psychiatrist was preferred. It was determined that the evidence that the accused suffered from “hospitalisation syndrome”, PTSD and depression did not satisfy the test for unfitness to stand trial. The carefully reasoned judgment of the Pre-Trial Chamber raises important issues about the relevance of conditions that fall short of psychosis in terms of their potential to render a person unfit for trial under international criminal law or, more generally, under criminal law. While on this occasion the somewhat novel, internally contradictory and inadequately based expert opinions did not satisfy the Pre-Trial Chamber in this regard, it remains still possible that unusual conditions or combinations of conditions falling short of psychosis could result in a person's inability to participate meaningfully in the trial process.     

Three Stages to Understand Acute Pancreatitis

Objective To investigate the causes of mortality of acute pancreatitis. Methods In this study, random digits table was employed to selected 400 cases of acute pancreatitis, including 229 cases of male and 171 cases of female, the average age is 49.5 years （range from 13 years to 82 years）, 283 cases in mild acute pancreatitis, 62 cases in severe acute pancreatitis I and 55 in cases severe acute pancreatitis II. Results Of 276 cases with only local manifestation, none died. Of 69 cases with SIRS, but without organ dysfunction, also none died. Of 55 cases with organ dysfunction, 19 case died. Conclusion Organ dysfunction associated with acute pancreatitis is the leading cause of mortality of acute pancreatitis.     

莫沙比利联合多虑平治疗功能性消化不良疗效观察

目的：观察莫沙比利联合多虑平治疗功能性消化不良（FD）的疗效。方法：将112例FD患者随机分为2组，均给予莫沙比利，治疗组加用多虑平，疗程均为4周。结果：治疗组症状改善情况明显优于对照组。结论：莫沙比利联合多虑平治疗FD可显著提高疗效。     

液氮冷冻治疗骨巨细胞瘤48例报告

 本文报告48例骨巨细胞瘤,用病灶彻底刮除、液氮灌注冷冻及自身髂骨植骨治疗。经随访2年3个月～17年4个月,取得好的效果。