In Memory of Our Editorial Board Member Prof. WANG Bao-en

Prof.Prof.WANG Bao-en,China＇s famous internal medicine experts,medical educator,member of the Editorial Board of Chinese Journal of Integrative Medicine,passed away at the age of 88 on October 11,2014 in Beijing.Prof.Wang was born on February 13,1926 and graduated from Peking University School of Medicine in July1948.After graduation he worked in the First Hospital of Peking University,Beijing Third Hospital,     

中国神经外科的领航者——2008年度国家最高科学技术奖获得者王忠诚院士介绍

2009年1月9日上午10时,在中国北京人民大会堂,由中共中央总书记、国家主席、中央军委主席胡锦涛将2008年度国家最高科学技术奖之一授予首都医科大学神经外科学院院长、附属北京天坛医院名誉院长、北京市神经外科研究所所长王忠诚院士,以表彰他在神经外科领域所做出的杰出贡献。本文简要介绍王忠诚院士的经历、主要贡献及其意义。     

中国神经外科的领航者——2008年度国家最高科学技术奖获得者王忠诚院士介绍

2009年1月9日上午10时,在中国北京人民大会堂,由中共中央总书记、国家主席、中央军委主席胡锦涛将2008年度国家最高科学技术奖之一授予首都医科大学神经外科学院院长、附属北京天坛医院名誉院长、北京市神经外科研究所所长王忠诚院士,以表彰他在神经外科领域所做出的杰出贡献。本文简要介绍王忠诚院士的经历、主要贡献及其意义。     

浅谈成永明主任运用岭南无痛蜂针疗法治疗慢性疲劳综合征经验

文章总结成永明主任运用岭南无痛蜂针疗法治疗慢性疲劳综合征(CFS)的临床经验.通过查阅并复习相关中医文献、跟师临证、整理医案等方式,从成永明主任治疗CFS的理论基础、针法特点、选穴特点等方面总结分析成永明主任临床经验.成永明主任认为在岭南独特气候、人文环境中,CFS具有明显地域特征,基于经典理论"湿胜阳微",CFS应从...     

论《验方新编》的学术成就

《验方新编》作者鲍相璈,字云韶,清代善化（湖南长沙）人。约生活于道光至咸丰年间,曾任职广西省武宣县。鲍氏自幼爱好医药之学,心存济世救人之情,自谓：“余幼时,见人有良方,秘而不传世,心窃鄙之。因立愿广求,不遗余力,或见于古今之载籍。或得之戚友之传闻．皆手录之。久之,荟萃甚富,各门俱备,乃删其不甚经验及数方相同与贵药不能力致者。     

导师责任制在临床护理教学中的应用效果

目的 探讨导师责任制在临床护理教学中的应用效果.方法 自2010年7月~2011年4月,我们将243名护生随机分为实施组和对照组,实施组127名,对照组116名.对照组采用传统带教模式,实施组采用导师制教学模式.结果 实施组护生的理论、操作考核成绩明显高于对照组(P<0.01);问卷调查护生及护理教研室对老师的评价,实施组均高于对照组(P<0.05).结论 在护理临床教学中实施导师责任制教学管理方法提高了临床护士老师的带教水平及综合素质,促进了教学质量的提高.     

医学遗传学在中国公共卫生事业中发挥重要作用--北京2004医学遗传学国际学术研讨会报告

The International Conference of Medical Genetics 2004 (ICMG2004) was held at Peking University Health Science Center on July 14 - 18, 2004. This conference is a part of the series that have been organized by the North American Associationof Chinese Medical Geneticists (NAACMG）and the Chinese Medical Genetics Association (CMGA) and was initialized by the year of 2000 at-Naniing-(ICMG2000 NanJing).     

关于两个哲学问题的解决

绝对真理与相对真理、矛盾同一性和斗争性相对与绝对的问题,在马克思主义认识论的教学和研究中,一直没有解决。要解决这两个问题,首先应从列宁解决这两个问题的思路着手。马克思主义经典作家包括列宁在内,都没有在客观真理的意义上承认绝对真理,任何客观真理都只能是相对真理,而不能既是相对真理又是绝对真理。“同一性是相对的,斗争性是绝对的”命题,是列宁在比较辩证法和形而上学两种发展现以后提出的,是为了划清两种发展观的界限,而不能把同一性和斗争性与有条件和无条件或静止与运动简单对照起来理解。     

肿瘤坏死因子相关激活蛋白、CD4+/CD8+、IL-4与儿童细菌性社区获得性肺炎经典炎症标志物的关系研究

目的探讨肿瘤坏死因子相关激活蛋白(CD40L)、CD4+/CD8+、白细胞介素-4(IL-4)与儿童细菌性社区获得性肺炎(CAP)经典炎症标志物的关系及预测抗菌治疗效果的效能。方法选取300例儿童细菌性CAP患儿,均给予化痰、止咳、平喘及抗感染治疗, 其中43例治疗无效(观察组)及257例治疗有效(对照组),比较2组治疗前白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)及CD40L、CD4+/CD8+、IL-4,采用Pearson分析CD40L、CD4+/CD8+、IL-4与经典炎症标志物的关系及CD40L、CD4+/CD8+、IL-4之间的关系,采用logistic回归方程分析CD40L、CD4+/CD8+、IL-4与治疗无效的关系,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析CD40L、CD4+/CD8+、IL-4预测抗菌治疗效果的效能。结果观察组WBC、CRP、PCT、CD40L、IL-4水平均高于对照组(P < 0.01),CD4+/CD8+低于对照组(P < 0.01);CD40L与WBC、CRP、PCT均呈正相关(r=0.720、0.433、0.832,P < 0.01),CD4+/CD8+与WBC、CRP、PCT呈负相关(r=-0.709、-0.449、-0.698,P < 0.01),IL-4与WBC、CRP、PCT呈正相关(r=0.889、0.760、0.723,P < 0.01);CD40L、CD4+/CD8+、IL-4均与治疗无效的相关性具有统计学意义(P < 0.01);CD40L与CD4+/CD8+呈负相关(r=-0.776,P < 0.01),与IL-4呈正相关(r=0.554,P < 0.01);CD4+/CD8+与IL-4呈负相关(r=-0.538,P < 0.01);单一指标中IL-4预测抗菌治疗效果的AUC最大为0.805,各指标联合预测抗菌治疗效果的AUC为0.867,敏感度达79.07%,大于任一单一指标(P < 0.01)。结论CD40L、IL-4、CD4+/CD8+与经典炎症标志物存在一定相关性,可在一定程度上反映细菌性CAP患儿病情程度,治疗期间进行动态监测可及早预测疗效,为细菌性CAP患儿后续治疗提供参考依据。     

The physician as a locus of authority,responsibility, and operational control of medical systems

Physicians are commonly being excluded from meaningful participation in the planning, implementation, and operation of automated medical systems in hospitals. The authors advocate a rapid shift toward greater physician involvement in such systems, arguing that such a shift is desirable, feasible, and also inevitable. After reviewing the organization of information systems in hospitals, the authors describe the manner in which physician control of medical systems adds to the worth of such systems by enhancing the quality and efficiency of health care delivery. The proposed information system management role of physicians is characterized in terms of authority, responsibility, and operational control. Finally, advice is offered from an organizational perspective for establishing a physician as the hospital Medical Information Director.     

MH134-88体外细胞系的建立及其生物学特性的研究

MH134-88是将用四氯化碳诱发成功的C_3H/HeN系小鼠的腹水型肝癌株(MH134)经极限稀释及克隆化方法在体外培养,连续传代而建成的一个纯度较高的小鼠肝癌细胞系。MH134呈悬浮培养,生长迅速,特性稳定,迄今已传200余代。本文对其生物学特性进行了较系统的观察与研究。支原体检测阴性,具有较大推广应用的价值。     

《外诊法》对《黄帝内经》理论的解读方法撷英

《外诊法》辑集了包括《黄帝内经》《难经》《伤寒论》等23种医学著作中关于诊法的内容,其中《黄帝内经》占一半以上。该书在众多医家中选择了张志聪等人的注解,体现了对《黄帝内经》理论的独特解读方法,即:在选文方面初具规模和系统,内容简要精辟;注文的质量较高,解读重在实用;在诊法方面,诊察由外及内,汲取了《黄帝内经》的精华,奠定了后世关于四诊研究的基础。     

DEVELOPING AN OPERATIONAL DECISION RULE FOR IDENTIFYING THE FATAL CASE DOCUMENTS AT RISK OF BEING RETURNED THROUGH MATHEMATICAL MODELLING

Incomplete or inaccurately filled fatal case documents are often returned to the hospital by higher headquarters, causing delay in the completion of procedural formalities. A mathematical model was developed to identify those fatal case documents which are at an increased risk of being returned so that the corrective action may be taken a priori. The data was subjected to a multiple logistic regression analysis. Diagnostic test characteristics were worked out and a Receiver Operating Curve analysis was done to find out optimum operating points on the slope, and the following mathematical rule was developed:7.06=1 (if age > 50 years) − 4.5 (if age <= 12 years) + 9.88 (if serving person) + 2.75 (if ex-serviceman) + 4.5 (if dependent son or daughter) + 6.38 (if time lag > 10 days).This rule carries a sensitivity of 53 per cent and specificity of 75 per cent.KEYWORDS: Mathematical model, Medical documents, Operations research     

组织工程心脏瓣膜体外脉动反应器的初步研制

目的:探讨自行研制的体外脉动反应器应用于组织工程心脏瓣膜应力预适应的可行性.方法:根据流体力学原理,采用特殊材料自行设计制作了体外脉动反应器和预适应应力培养系统;将生物瓣置于反应器中运转,观察生物瓣的工作状态和系统的稳定性.以脱细胞猪主动脉瓣作支架,新生牛主动脉内皮细胞作种子细胞构建组织工程心脏瓣叶,静态培养4 d后,置入反应器内进行预适应处理24 h(流量由30 ml/min调至400 ml/min,频率30次/min),观察内皮细胞残留情况,并与静态培养的瓣膜相比较.结果:预适应应力培养系统能产生搏动性液体流,生物瓣正常工作,运转7 d,系统状态稳定.静态培养成功构建组织工程心脏瓣膜,内皮细胞与瓣叶支架黏附紧密,沿瓣叶表面形成单层细胞层,生长状态良好;动态培养的瓣叶内皮细胞部分被冲刷脱落,但仍有少部分细胞(6.26％)残留黏附.结论:自行设计和构建的体外脉动反应器基本能模拟体内心脏瓣膜的血流动力学,用于组织工程心脏瓣膜预适应研究具有可行性.     

The new Italian law on assisted reproduction technology (Law 40/2004)

The Italian parliament passed the law on assisted reproduction after a heated debate. The promulgation of this law (Law 40/2004) is the end point of a long and troubled journey that has seen many bills come and go, all of which have failed. The law consists of a whole set of regulations that will have a great impact on health and on society in general. The law is against many of the technical practices of assisted reproduction; several such practices are banned. This paper outlines ethical and medicolegal issues arising in connection with the law. The law states that no more than three embryos must be created at any one time and all the embryos created must be transferred together even if the couple does not need all the embryos. Embryo cryopreservation is also forbidden, as is assisted reproductive technology (ART), which uses a third party in any way, and the screening of embryos for genetic defects.     

改良FLAG方案治疗难治性急性髓细胞白血病的初步分析

OBJECTIVE: To evaluate the therapeutic effect of modified FLAG regimen in the management of refractory acute myeloid leukemia (AML). METHODS: Sixteen patients with refractory AML were divided into two groups. In modified FLAG regimen group (n=10), the patients received fludarabine (Flu, 50 mg/d, VDx5 d) and Ara-c (200 mg/d, VDx5 or 7 d). The regimen for classic FLAG group (n=6) consisted of Flu (50 mg/d, VDx5d), Ara-C (500 or 1,000 mg/d, VDx5d) and G-CSF (300 microg/d, x5 d, subcutaneously injected 4-6 hours before chemotherapy). Each patient received subcutaneous G-CSF (300 microg/d) when the white blood cell count was lower than 1.0x10(9)/L till the condition was corrected. RESULTS: The total complete remission(CR) rate of the 16 patients was 50% (8/16). Seven patients in modified group achieved CR (70%) and only one of the classic group did (17%, P<0.05). Episodes of infections were lower in modified group than in the classic group (50% vs 83%). CONCLUSION: Modified FLAG regimen is more likely than classic FLAG regimen to achieve CR and reduce infections in patients with refractory AML.     

Change in infection control practices and awareness of hospital medical staff in the aftermath of SARS

Severe Acute Respiratory Syndrome (SARS) epidemic illustrated the crucial role of infection surveillance and control measures in the combat of any highly transmissible disease. We conducted an interview survey of 121 medical staff 145 doctors, 46 staff nurses and 30 medical assistants) in a state hospital in Malaysia three months after the end of SARS epidemic (from October to December 2003). Staff was grouped according to those directly involved in the care of suspected SARS patients [S+ group n=41] and those who were not [S- group; n=80]. On hand washing following sneezing, coughing and touching patients, the proportions of medical staff that reported an increase after the SARS crisis were 22.3%, 16.5% and 45.5% respectively. On wearing masks, gloves, and aprons when meeting potentially infectious patients, the proportions that reported an increase were 39.7%, 47.1% and 32.2% respectively. Significantly more staff in S+ than S- group reported these increases. Sixty percent of staff was aware of changes in hospital infection control policies after SARS; 93.4% was aware of notifying procedures, and 81.8% was aware of whom to notify in the hospital. Regarding infection isolation ward, Infectious Control Nurse and Infection Control Committee Chairman in the hospital, the proportions of staff that could correctly name them were 39.7%, 38.3% and 15.7% respectively. Significantly more in S+ than S- group could do so. However, more than half the staff claimed ignorance on the knowledge of infection isolation ward (56.2%), Infection Control Nurse (57.9%) and Chairman (65.3%). Our findings demonstrated that SARS crisis had some positive impact on the infection control practices and awareness of medical staff especially on those with direct SARS involvement. Implications for future control of infectious diseases are obvious.     

应用体液免疫、生化指标建立生物学年龄回归方程的预测价值

[目的]应用体液免疫、生化指标中的衰老指标,利用判别分析和回归分析建立生物学年龄的回归方程,并观察其预测价值。[方法]实验对象为健康体检者(男性67例,女性62例),日历年龄30～98岁。将整体实验对象按照5岁年龄段分成13组,分别测定其血清中免疫球蛋白IGG、IGA、IGM、补体C3、C4及生化常规指标。分析以上指标与年龄之间的相关性,利用衰老指标建立回归方程。[结果]IGG、IGA、CRE、UA、GLU、球蛋白与年龄正相关,ALB和A/G与年龄负相关,P均<0.05。利用衰老指标通过判别分析得到各个组别的判别分析函数,同时通过回归分析得到生物学年龄的回归方程为YBA=0.553×年龄+0.003×IGG+0.015×IGA+0.570×GLU-3.434×A/G-0.862×ALB+60.578。[结论]根据衰老指标所得到的生物学年龄的回归方程可以作为评价健康水平或判断人体老化度的参考数据。     

黄孟君教授论治脾胃病的临床经验

黄孟君，湖南长沙人，湖南中医药大学第一附属医院脾胃病专家，从事医疗、教学工作40余年，善长使用升降理论治疗内科杂病，尤其是脾胃病方面，每每能起病沉疴。笔者有幸师从黄老学习，在跟师门诊临证的一年半里，中医临床技能得到了很大的提高，特别是脾胃病方面，感悟颇深。现将黄师运用升降理论治疗临床常见脾胃病的经验总结如下，以飨同道。     

谭新华教授辨治精囊炎经验

谭新华,教授,主任医师,博士研究生导师,享受国务院政府特殊津贴专家,湖南省名中医,全国首批、第三批老中医药专家学术经验继承工作指导老师。从事中医医疗、教学、科研工作50余年。治学重理论与实践结合,衷中参西;倡笃学务实,法古纳新;医德高尚、医术精湛,擅长外科疑难杂病的诊治,尤其对男科疾病的中医药诊治有较深研究和造诣。精囊炎是男性较常见的感染性疾病之一,病因病机复杂,缠绵难愈,谭师对于精囊炎的诊疗,疗效卓著,现将其诊疗经验介绍如下。