读《金匮要略校注》后

<正>《金匮要略校注》(以下称《校注》)一书,乃浙江何任先生主编,殷品之、杨百茀、刘渡舟、欧阳锜等专家审定,人民卫生出版社1990年8月出版,为卫生部、国家中医药管理局文献研究课题之一,理应给人读书以启迪,然读后使人感到颇有可商之处,为了中医药学术之发展,特根据"百家争鸣"精神,顺序摘出疑点如下,以与何任先生商     

中医的思维模式，由模糊走向清晰

<正>中医是道术并重的国学,低碳环保的国医。它所以能够做到这一点,与它所依赖的传统文化有关。传统文化的精华,是古人看待世界的方法论、世界观。有了大视野,才能有大智慧。中医认识人体,采用的比较早、比较多的方法是"取象比类"。1以象统数,取象比类相同的研究对象,可以使用不同的研究方法,有的方法可能比较     

Functional roles and clinical values of insulin-like growth factor-binding protein-5 in different types of cancers

Insulin-like growth factor-bindin g proteins (IGFBPs) are critical regulators of the mitogenic activity of insulin-like growth factors (IGFs). IGFBP5, one of these IGFBPs, has special structural features, including a nuclear transport domain, heparin-binding motif, and IGF/extracellular matrix/acid-labile subunit-binding sites. Furthermore, IGFBP5 has several functional effects on carcinogenesis and even normal cell processes, such as cell growth, death, motility, and tissue remodeling. These biological effects are sometimes related with IGF (IGF-dependent effects) and sometimes not (IGF-independent effects). The functional role of IGFBP5 is most likely determined in a cell-type and tissue-type specific manner but also depends on cell context, especially in terms of the diversity of interacting proteins and the potential for nuclear localization. Clinical findings show that IGFBP5 has the potential to be a useful clinical biomarker for predicting response to therapy and clinical outcome of cancer patients. In this review, we summarize the functional diversity and clinical importance of IGFBP5 in different types of cancers.     

Alvarado,Eskelinen,Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis scores for diagnosis of acute appendicitis

AIM:To assess the reliability and practical applicability of the widely used Alvarado,Eskelinen,Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA)scoring systems in patients with suspected acute appendicitis.METHODS:Patients admitted to our tertiary center due to suspected acute appendicitis constituted the study group.Patients were divided into two groups.appendicitis group(Group A)consisted of patients who underwent appendectomy and were histopathologically diagnosed with acute appendicitis,and non-appendicitis group(Group N-A)consisted of patients who underwent negative appendectomy and were diagnosed with pathologies other than appendicitis and patients that were followed non-operatively.The operative findings for the patients,the additional analyses from follow up of the patients and the results of those analyses were recorded using the follow-up forms.RESULTS:One hundred and thirteen patients with suspected acute appendicitis were included in the study.Of the 113 patients(62 males,51 females),the mean age was 30.2±10.1(range 18-67)years.Of the 113patients,94 patients underwent surgery,while the rest were followed non-operatively.Of the 94 patients,77patients were histopathologically diagnosed with acute appendicitis.Our study showed a sensitivity level of81%for the Alvarado system when a cut-off value of 6.5was used,a sensitivity level of 83.1%for the Ohmann system when a cut-off value of 13.75 was used,a sensitivity level of 80.5%for the Eskelinen system when a cut-off value of 63.72 was used,and a sensitivity level of 83.1%for the RIPASA system when a cut-off value of 10.25 was used.CONCLUSION:The Ohmann and RIPASA scoring systems had the highest specificity for the diagnosis of acute appendicitis.     

中医发展中一些需要思考的问题

《内经》一书构建了中医学基本理论和框架,其成书过程是和当时的社会科学、自然科学紧密关联的。南于历史原因,当时的社会科学相对比较成熟,而自然科学相对比较简朴,所以形成了中医学的重要特点——哲学、社会学思想引入、使用比较多,同时较模糊,也相对比较抽象。     

科学发展中医的核心是“天地通”

由于人们对什么是科学、中医与科学之关系的认识存在分歧,所以笼统地说"科学发展中医"带有很大的模糊性,应该首先思考几个问题,以便由模糊走向清晰。1坚持大科学观,反对科学主义科学是什么?目前没有一个标准答案,综合各家对"科学"一词的认识,可以说"科学"的基本含义     

心脏MR成像评估非心脏病人群的心舒张功能不全:基于性别研究

正目的无症状左心室(LV)舒张功能不全的评估日益受到关注。本研究旨在应用3 T心脏MR(CMR)探讨亚临床型左室舒张功能不全的患病率及不同性别患病率的差异。     

Neurochemical metabolites in the medial prefrontal cortex in bipolar disorder A proton magnetic resonance spectroscopy study

The aim of this study was to investigate proton magnetic resonance spectroscopy metabolite values in the medial prefrontal cortex of individuals with euthymic bipolar disorder. The subjects consisted of 15 patients with euthymic bipolar disorder type Ⅰ and 15 healthy controls. We performed proton magnetic resonance spectroscopy of the bilateral medial prefrontal cortex and measured levels of N-acetyl aspartate, choline and creatine. Levels of these three metabolites in the medial prefrontal cortex were found to be lower in patients with bipolar disorder compared with healthy controls. A positive correlation was found between illness duration and choline levels in the right medial prefrontal cortex. Our study suggests that during the euthymic period, there are abnormalities in cellular energy and membrane phospholipid metabolism in the medial prefrontal cortex, and that this may impair neuronal activity and integrity.     

医院感染现状及应对策略

医院感染（nosocomial infection）一词源于希腊语nosos（疾病）komeion（医疗护理）,意指由医疗护理工作引发的感染病,患者包括在医疗保健机构中接受诊疗的患者、探视者以及医务人员。这种感染在入院时不存在,也不处于潜伏期,而是发生在医院或其他医疗保健机构内。在医院获得而出院后才发病的感染及医疗保健机构工作人员的职业性感染也属于医院感染。医院感染普遍存在,我国估计每年医院感染约为500万例,