换个角度看"推门课"

“推门课”即学校领导、教研员不预先打招呼而直接进入教室听课的一种教研管理方式。简单来看，这种听课方式确有不“人性”之处。以至遭到部分领导和教师的强烈反对。但若换一种思路，从教研管理的角度来看“推门课”，也许会“推”出不同结论。     

中医"中风"概念的演变

中风是临床常见病证,历代医家在长期临床实践中积累了丰富的经验,留下了大量的文献.从这些文献来看,历代医家对中风,尤其是中风概念的认识并不统一,在不同时期,中风一词的内涵并不相同,而是经历了外感病、真中、类中,再到脑卒中这样一个逐渐演变的过程.     

中医"中风"概念的演变

中风是临床常见病证,历代医家在长期临床实践中积累了丰富的经验,留下了大量的文献.从这些文献来看,历代医家对中风,尤其是中风概念的认识并不统一,在不同时期,中风一词的内涵并不相同,而是经历了外感病、真中、类中,再到脑卒中这样一个逐渐演变的过程.     

中医"中风"概念的演变

中风是临床常见病证,历代医家在长期临床实践中积累了丰富的经验,留下了大量的文献.从这些文献来看,历代医家对中风,尤其是中风概念的认识并不统一,在不同时期,中风一词的内涵并不相同,而是经历了外感病、真中、类中,再到脑卒中这样一个逐渐演变的过程.     

中医"中风"概念的演变

中风是临床常见病证,历代医家在长期临床实践中积累了丰富的经验,留下了大量的文献.从这些文献来看,历代医家对中风,尤其是中风概念的认识并不统一,在不同时期,中风一词的内涵并不相同,而是经历了外感病、真中、类中,再到脑卒中这样一个逐渐演变的过程.     

中医"中风"概念的演变

中风是临床常见病证,历代医家在长期临床实践中积累了丰富的经验,留下了大量的文献.从这些文献来看,历代医家对中风,尤其是中风概念的认识并不统一,在不同时期,中风一词的内涵并不相同,而是经历了外感病、真中、类中,再到脑卒中这样一个逐渐演变的过程.     

中医"中风"概念的演变

中风是临床常见病证,历代医家在长期临床实践中积累了丰富的经验,留下了大量的文献.从这些文献来看,历代医家对中风,尤其是中风概念的认识并不统一,在不同时期,中风一词的内涵并不相同,而是经历了外感病、真中、类中,再到脑卒中这样一个逐渐演变的过程.     

把高血脂"吃"下来

随着人民生活水平的不断提高，很多人体内脂肪过多，胆固醇过剩，形成高脂血症，进而引发动脉硬化和心脑血管病。不少中老年朋友一提到血脂（血总胆固醇、甘油三酯、低密度脂蛋白胆固醇）增高，常常流露出“谈虎色变”的恐慌，以致饮食无所适从，一味戒荤断油，失去了应有的一些生活乐趣。很多高血脂症是“吃”出来的，然而，在饮食上通过合理选择、巧妙搭配，保证你会在大饱口福的同时。也可把高血脂“吃”下来。     

牢记七绝招避免"吃错药"

药店好像菜市场一样，药品种类繁多，顾客自行挑选购买。药店又绝不像菜市场，因为其中出售的治病救人的药物而非白菜萝卜，顾客购药也不能完全随心所欲，有时需要出示处方。此时如何在药店购药，如何安全科学服药才能让自己驱除病痛、收获健康是一门学问。专家指出，安全用药、合理用药需要做到正确挑选药物、科学服用药物。     

米非司酮终止"早早孕"40例的效果分析

米非司酮联合米索前列醇用于终止早孕，是较好的药物流产方法，但这一配伍方案使用的前提，是B超能够确定宫腔内孕囊。如何有效的处理B超能够确定宫腔内孕囊或者异位妊娠包块之前的更早期的妊娠，是值得临床探讨的课题。我们对这部分患者，采用米非司酮进行催经止孕，收到了较好的效果。     

艾滋病的“四维论治”

建立审因、辨病、辨证与对症四维论治的诊疗思路与研究方向,应对艾滋病的复杂性,构成艾滋病完整的诊疗体系。具体包括:以病机为靶点开展辨病论治;以病因为靶点开展审因论治;以主症、相关病症为靶点开展对症治疗;以证候为靶点开展辨证论治。四维论治不是将四者混为一谈,而是从病因、病机、证候、并发症等不同角度进行的全面认知,追求理论和临床上的系统化、一体化,也就是追求综合性诊疗。四维论治并不是否定四者的独立性,而是从病因、病机、证候、并发症等不同的角度进行具体认知,追求理论与临床的规范化、具体化,也就是要进行精准诊疗。走出"证候""辨证论治"作为艾滋病唯一研究方向的误区,是学术进步之必须。     

卫生部门和医院如何迎接入世

论述了卫生部门和医院应在转变职能和工作方法,提高参与国际竞争能力方面做好入世准备,主动适应WTO,同时要转变观念、按照世贸组织的规则和政府承诺来主动应对加入世贸。此外,还介绍了我国开放医疗服务的承诺与政策;以及我国和各国卫生服务的开放情况,并对医院迎接入世提出三点建议。     

"There they go again"--hCG and weight loss

Dr. Albrink's review of information available in 1969 did not allow her to determine a physiologic basis for the use of hCG or any proof of immediate or long term benefit. Subsequent discoveries and clinical studies only support her impressions. Despite these facts, this form of therapy has achieved a resurgence in popularity. The difference today is that patients no longer have to rely on health care providers to prescribe their medications since internet sites allow them to obtain medications "on line". This has potential adverse ramifications when we consider that the initial use of gonadotropins derived from the human pituitary was discontinued due to the iatrogenic transmission of Creutzfeld-Jakob disease. It is thought that the disease is transmitted by an abnormal protein called prion protein. Subclinical forms of the disease exist and the prions could potentially be transmitted in urine. No cases or transmission via urine have been reported and reputable sources of hCG would appear to be safe, but products from countries with greater risk have the potential for contamination. The increased demand for hCG from reputable sources has led to shortages and increased expense for the legitimate uses of hCG in treatment of endocrine disorders and infertility. Obesity and the adverse impact on health has become a priority in public health policies for the state of West Virginia and for our nation as a whole. The benefit of longevity in the practice of medicine is that one is given the opportunity to observe attempts to "reinvent the wheel" where medical practices that have been previously disproven are reintroduced. Fineberg and Hiatt state this more eloquently when they said: "What is unacceptable is to persist in demonstrably ineffective practices either because we fail to collect systematic information about the effects of our actions or because we establish and respond to inappropriate incentives." Systematic information has been obtained and has shown lack of evidence for the benefit of this therapy. The alternative explanation for the persistence and promotion of this treatment is unacceptable.     

"鼻腔矫正术"治疗鼻中隔偏曲的疗效评价

2003～2004年83例(166侧)鼻中隔偏曲男性患者在我院接受手术治疗,其中接受鼻中隔黏膜下切除术者38例,接受鼻中隔黏膜下切除加单或双侧下鼻甲部分切除术者45例.术前及术后6个月应用Eccovision型声反射鼻测量计对以上患者进行测试,评价手术疗效.结果发现鼻中隔黏膜下切除加做单或双侧下鼻甲部分切除术患者鼻腔总容积明显大于鼻中隔黏膜下切除术患者,而单纯行鼻中隔黏膜下切除术患者的疗效欠佳且不稳定.因此,笔者推荐对于合并慢性肥厚性鼻炎的鼻中隔偏曲患者应施行鼻中隔黏膜下切除加做单或双侧下鼻甲部分切除术,为简化命名并规范此类手术,建议将此手术命名为"鼻腔矫正术",并建议进一步建立和完善此手术的手术适应证和手术原则.     

齐伟基于“辨构论治”理念诊疗鹅足滑囊炎经验

"辨构论治"理论是在中医理论指导下,洞悉机械性颈肩腰腿痛的发病机制,找到损伤结构、失衡结构及失衡原因,并予以对标、对本、对因治疗的一种诊疗模式,包括辨构诊断和调衡治疗两方面。辨构诊断即从病之标、本、因找到疾病的损伤结构、失衡结构、失衡原因。调衡治疗即针对病之标、本、因予以针对性治疗。鹅足滑囊炎的损伤结构与失衡结构相比,治疗损伤结构是标,而治疗失衡结构是本。鹅足滑囊炎的失衡结构与失衡原因相比,失衡结构是标,而失衡原因是本。在临床实践中,应遵循"急则治标,缓则治本""治病求因"的中医治疗原则。在辨证论治的基础上做到"辨构论治",辨别鹅足滑囊炎的损伤结构、失衡结构、失衡原因,做到标本兼治,治病求本。     

异位散结汤治疗子宫内膜异位症的临床研究

目的探讨异位散结汤治疗子宫内膜异位症的疗效。方法将122例子宫内膜异位症患者分成2组，观察组50例，采用自制中药异位散结汤口服；对照组72例口服丹那唑，疗程3个月，观察2组的疗效、复发率、副作用。结果观察组痊愈率42．0％，总有效率94．0％，与对照组22．0％，86．0％比较明显提高（P〈0．05），观察组复发率（4．4％）与对照组（21．4％）比较明显降低（P〈0．01）。结论异位散结汤治疗子宫内膜异位症疗效好，复发率低，副作用小，方法简单易行，病人易于接受，是一种安全有效的治疗方法。     

Endovascular treatment of wide-necked intracranial aneurysms using of ＂remodeling technique＂ with the HyperForm balloon

Background Aneurysms with wide-necked or a large neck/fundus ratio, especially located on an arterial bifurcation or a small artery, are challenges for interventional neuroradiologist because of the risk of coil migration or coil protrusion into the parent vessels. Our study was designed to improve the efficacy and safety of the ＂remodeling technique＂ with the HyperForm balloon for these difficult aneurysms and was confirmed by a follow-up result.
Methods From June 2004 to September 2006, forty-two patients （20 men, 22 women） with wide-necked or large neck/fundus ratio aneurysms were treated by using the ＂remodeling technique＂ with the HyperForm balloon.
Results Forty wide-necked aneurysms were successfully treated with the HyperForm balloon remodeling technique with only two failed cases. Final results consisted of total occlusion in 34 cases （80.9%）, subtotal in 4 （9.5%） and incomplete in 2 （4.8%）. One aneurysmal rupture occurred, but no clinical consequence was shown. No thromboembolic events were observed during treatment. Final angiographic follow-up time ranged from 3 to 18 months.
Conclusions The ＂remodeling technique＂ with the HyperForm balloon is a very useful tool in the treatment of wide-necked or unfavorable neck/fundus ratio intracranial aneurysms - located on an arterial bifurcation or a small artery and, especially, located on the bifurcation of a large artery and a small one. In our experience, this technique provided a safe and efficient treatment for difficult aneurvsms when the standard remodelina techniaue miaht have failed.     

The importance of "throwing money at" the problem of global health

More funding from wealthy countries is required to improve health care and the infectious disease situation in developing countries. Although progress has been made, funds for fighting AIDS, tuberculosis, and malaria remain inadequate. These treatable and preventable diseases together kill over 6 million people every year. Funds are needed to improve access to existing medicines as well as to increase research and development of drugs. The idea that "throwing money at the problem is not going to solve it" rightly holds that increased funding is not sufficient for solving the health care problems of developing countries. In order to work, funds must be spent wisely. This does not mean that increased funding is unnecessary.     

中医"治未病"说略

"治未病"是中医学先进和超前的医学思想,既是医疗保健的理想境界,也是衡量医者水平的重要标志。"未病"包括无疾之身、疾病隐而未发、发而未传三种状态;"治未病"具有三种境界,可概括为"未雨绸缪,保身长全""见微知著,救其萌芽""料在机先,阻截传变"。现代"治未病"切入点可以表达为:养生是基础,体质是根本,关注高危人群、发病先兆和干预亚健康状态是重点。中医"治未病"的意义主要体现于减轻医疗卫生负担、保障民众健康、发挥中医优势、实现中西医对话与交流等方面。     

韩树人教授谈“哮喘专主于风”

哮喘为临床的常见病、多发病,历来为医家所重视。韩树人教授在研究继承传统理论的基础上形成了自己的学术观点,提出了“哮喘专主于风”的理论。详细分析了临证时的分型特点,阐明哮喘发作程度有轻重之分,证型有寒热之别,缓解时肺脾肾各有所虚,但辨证总须与“风”紧密联系,抓住这一中心环节进行遣方用药,为临床工作提供了新的思路。