《中医体质分类和判定》标准质疑

2009年中华中医药学会颁布了《中医体质分类和判定》标准,并已进入推广应用过程。考察后发现,该标准的建立未能统一执行中医体质分类标准的原则和方法;体质分类特征交叉重叠,界限不清;单一体质内部各因素之间关联性较差。故建议不宜将中医体质学说拔高到中医体质学的高度;《中医体质分类和判定》标准尚不成熟,应慎重推广应用。     

未雨绸缪,开拓生存空间——亦论中医学术发展之大势

结合对于新世纪医学发展态势的展望,就蔡定芳“变亦就,不变亦变”（上海中医药杂志,１９９９,５）一文阐述的观点,以及国内外对医学目的、医学发展的重心等问题展开讨论讨论。认为建立中医形态学,不是必要、不必要的问题,而是可能、不可能的难点：根据世纪医学重心的调整,中医学的优势将在病前、临床和病后干预的应用领域开拓生存发展的新在地。     

Choc anaphylactique dû à la succinylcholine compliqué de rhabdomyolyse

A young woman, with a contact dermatitis to nickel, experienced a life threatening anaphylaxis after induction of general anaesthesia for an emergency curettage. Hypersensitivity reaction involving IgE antibodies against succinylcholine was proven by positive skin test and radioimmunoassay detection of antibodies against succinylcholine and quaternary ammonium. After restoration of haemodynamics in a few hours, the patient had rhabdomyolysis predominant at lower left leg, which required a fasciotomy. An haemodialysis session was necessary, renal function being normalized thereafter. Several months later, the patient suffers from dysesthesia on the leg and foot. Muscular ischaemia was the consequence of the shock, the external compression due to the compression stockings probably being an additional factor.     

蔷薇红景天中红景天苷含量测定

利用高效液相色谱法测定不同采收时期的野生蔷薇红景天和经人工移栽种植后红景天中红景天苷含量。结果表明:①8月底采收的红景天根茎中红景天苷含量最高,高达1.7%,根中红景天苷含量要略低于根茎,茎和叶中含量较低;②经人工移栽种植后,红景天中红景天苷含量有所降低,其中种植在海拔894 m红景天根和根茎含量最高,分别为1.397%和1.48%。     

Profiles of traditional chinese medicine schools

Many schools of academic doctrines have emerged throughout the development history of traditional Chinese medicine(TCM) due to geographic,time,Shicheng(mentor-apprentice system) and academic diversities.Classic TCM School,Classic Formula School and Febrile Disorder School,though all lacking a clearly demonstrable or continuous Shicheng relationship,are nevertheless so classified because of their consistency in reference to the classic TCM works.Each of the Four Famous Masters of Jin and Yuan Dynasties had its distinctively different academic doctrine,resulting in the establishment of individually integrated academic schools.The emergence of the Warming and Tonifying School in late Yuan and early Ming Dynasties was realized as a means to rectify the ill effects of the cool and cold medications prevalent at the time.On the other hand,the advent of the Warm Disease School and the rise of the Confluence School embodied the close relationship carried by TCM academic schools to contemporary historical background.Looking at this development history,it is evident that the development of TCM academic schools could flourish only if it allows dissenting,yet mutually tolerant,opinions.In present medical environment where TCM and Western medicine are of equal importance,Classic TCM Schools,TCM Modernization Schools and Integrative Medicine Schools should all receive emphasis to foster development.     

In vivo measurement of compression bandage interface pressures: The first study

Compression therapy has precise technical characteristics but in vivo pressures exerted by bandages are still poorly understood.ObjectiveTo perform in vivo pressure measurements of different compression bandages bearing different technical characteristics with different application methods.MethodInterface pressure was measured on the lower limb of 20 healthy women at 3 different points (B1, C and F) using 6 compression techniques (stockings, non-elastic bandage, elastic bandages with 2 technical characteristics and 3 application methods), and in 3 positions.ResultsAll elastic compression bandages respected the principle of graduated pressure along the length of the limb (P < 0.0001), but not the non-elastic bandage. The pressures increase significantly (P < 0.0001) between the supine position and the sitting or standing position, especially with the non-elastic compression bandage. There is a marked variation in pressures between subjects for some bandages (non-elastic and elastic applied using the figure-of-eight technique). The pressure increases significantly with the number of bandage overlaps (P < 0.01).ConclusionElastic and non-elastic bandages behave differently from one another, and non-elastic bandages not appearing to comply with medical recommendations concerning graduated pressure. There is a high level of variability between subjects for some compression bandages (non-elastic and figure-of-eight methods).     

慢性病毒性肝炎血清总胆汁酸与肝组织细胞成分变化的相关性研究

目的探讨血清总胆汁酸（TBA）与慢性病毒性肝炎肝组织细胞成分变化的关系。方法对134例慢性病毒性肝炎患者做肝穿刺活检及检测血清TBA,应用病理图像分析仪以点计数法测量肝组织400倍镜视野内的主要细胞成分,测量内容包括良好肝细胞、变性肝细胞、纤维组织、脂肪细胞、淋巴细胞,计算各种组分的均数及密度。根据TBA水平的不同,将病人分成两组,比较两组病人之间五种肝组织细胞成分的差异,并使用多元线性逐步回归分析TBA升高者与肝组织细胞成分数密度的相关性。结果 （1）TBA升高组较TBA正常组的肝组织中良好肝细胞显著减少,变性肝细胞、纤维组织、脂肪细胞、淋巴细胞显著增多,差异有统计学意义（P〈0.005）。（2）TBA与变性肝细胞、肝纤维化、淋巴细胞数密度成正相关,相关系数分别为0.433、0.367、0.494,与良好肝细胞、脂肪细胞无统计学相关。结论 TBA升高与淋巴细胞数密度的相关性最密切,TBA升高可能具有间接或直接反映慢性病毒性肝炎患者肝组织的细胞免疫状态。