论强化中医思维是中医学术发展的关键

中医学在历史的发展中曾经取得过辉煌的成就,为中华民族的繁衍昌盛和世界人民的健康做出了巨大的贡献。然而在近百年来中医学术却发展缓慢,且临床阵地日渐萎缩。其中原因,有学者认为是因为中医学是不符合近代科学原理及西医学诊治标准,中医学欲要发展必须要现代化或者西医化。笔者认为,中西医是医学中两种不同流派:西医学是微观分析医学,突出器质性变化,强调机器诊断,辨病论治;而中医学是宏观整体医学,突出功能性变化,强调四诊合参,辨证论治。中医学术发展缓慢主要是中医思维方法的弱化或丧失,而建立和强化中医思维是中医学术的发展的关键。…     

Calculation of magnetic field-induced current densities for humans from EAS countertop activation/deactivation devices that use ferromagnetic cores

Compliance testing of electronic article surveillance (EAS) devices requires that induced current densities in central nervous system (CNS) tissues, i.e. brain and the spinal cord, be less than the prescribed safety limits. Even though ferromagnetic cores are mostly used for activation/deactivation of embedded magnetic tags, assumed equivalent air-core coils with guessed increased number of ampere turns have always been used to calculate the magnetic fields for the proximal region to which a customer is exposed. We show that at low frequencies up to several kilohertz, duality of electric and magnetic circuits may be exploited such that the shaped high reluctance core is modelled as though it was a higher conductivity electric circuit of the corresponding shape. The proposed procedure is tested by examples of two magnetic cores typical of countertop activation/deactivation devices. The equivalent exposure magnetic fields obtained from the dual electric fields are shown to be in excellent agreement (within +/-5%) with those measured for these ferromagnetic EAS devices. The previously proposed impedance method is then used to calculate the induced current densities for a 1.974 x 1.974 x 2.93 mm resolution anatomic model of a human. For the two considered EAS systems using excitation currents of 5000 A turns at 200 Hz, the maximum 1 cm2 area-averaged induced current densities in the CNS tissues are calculated and found to be less than the ICNIRP safety limits.     

7β-N~2-芳基三嗪酰胺基苯乙酰胺基-3-亚甲基杂环头孢烯酸衍生物的合成及其抗菌活性

设计合成了１０个７βＮ２芳基三嗪酰胺基苯乙酰胺基３亚甲基杂环头孢烯酸衍生物及其二钠盐,均为未见文献报道的新化合物,其结构经元素分析数据及光谱分析证实．体外抑菌试验结果表明：化合物（Ⅱ１）,（Ⅱ２）和（Ⅱ３）活性较强,对所选用的１９种菌株均有一定的活性,多数化合物的ＭＩＣ值为８ｍｇ／Ｌ,具有一定的广谱抗菌特征     

丹红注射液联合甘利欣治疗慢性乙型肝炎肝纤维化的临床研究

目的探讨丹红注射液联合甘利欣注射液治疗慢性乙型肝炎肝纤维化的临床疗效。方法选取192例慢性乙型肝炎肝纤维化患者,随机分为治疗组110例,对照组82例,治疗组用丹红注射液联合甘利欣注射液治疗,对照组单用甘利欣注射液。观察疗程结束前后患者血清透明质酸（HA）、血清Ⅲ型前胶原（PC-Ⅲ）、层粘蛋白（LN）、Ⅳ型胶原（Ⅳ-C）、肝功能指标变化及临床疗效。结果治疗组血清肝纤维化指标、肝功能指标下降明显,而白蛋白有明显升高,与对照组相比有显著性差异（P〈0.05或P〈0.01）。结论丹红注射液联合甘利欣注射液治疗慢性乙型肝炎,可有效减轻和延缓肝纤维化的发生与发展,对肝纤维化指标和肝功能有明显改善作用。     

修补加近侧胃迷走神经切断治疗十二指肠球部溃疡穿孔

目的探讨十二指肠球部溃疡穿孔修补加近侧胃迷走神经切断术疗效。方法将128例十二指肠球部溃疡穿孔患者分别行十二指肠球部溃疡穿孔修补加近侧胃迷走神经切断术(64例)及单纯穿孔修补术(64例)两组,对比两组疗效。结果A组术后有2例出现轻度吞咽困难,2 w后症状自动消失;6例发生腹泻,给予易蒙停2 d后症状缓解。B组7例发生腹泻,给予易蒙停等药物3 d症状消失,10例仍有术前类似的溃疡性疼痛,服用奥美拉唑加羟氨苄青霉素加灭滴灵1～2 w症状逐渐好转,均无死亡病例。两组疗效比较,差异有统计学意义(p<0.01)。结论穿孔修补加近侧胃迷走神经切断术对十二指肠溃疡穿孔的疗效明显优于单纯修补术,适合急诊手术和基层医院开展。     

注射用甲泼尼龙琥珀酸钠耳后注射治疗突发性聋

目的　探讨以耳后注射用甲泼尼龙琥珀酸钠作为突发性聋初始激素治疗的效果。方法　72例突发性聋患者随机分为两组,耳后注射组35例（耳）,给予注射用甲 泼尼龙琥珀酸钠20 mg,耳后乳突骨膜下注射,每3 d给药1次;静脉用药组37例（耳）,给予地塞米松磷酸钠注射液10 mg,静脉滴注,每日1次,3 d后减量至5 mg,继续用药3 d后停药。结果　耳后注射组痊愈16耳,显效6耳,有效4耳,无效9耳,总有效率74.3%;全身用药组痊愈17耳,显效5耳,有效4耳,无效11耳,总有效率70.3%。两组差异无统计学意义。结论　耳后注射皮质类固醇激素治疗突发性聋疗效可靠,可作为突发性聋激素治疗的初始给药方法。     

“弹簧理论”与护士压力管理

文章阐述了弹簧理论和压力的概念,说明了正、负面压力及其对工作的影响,并进一步提出对护士正面压力管理的策略以及应把握的度,为护士的压力管理提供借鉴。     

HAD方案治疗成人急性非淋巴细胞白血病临床观察

成人急性非淋巴细胞白血病５０例，作者采用ＨＡＤ方案诱导化疗，缓解后以ＨＡＤ、ＥＡ、ＭＡ或再加ＡＡ方案巩固强化。结果完全缓解（ＣＲ）４３例，ＣＲ率８６．０％。初治３８例，ＣＲ３３例（８６．８％），复治１２例，ＣＲ１０例（８３．３％）。ＣＲ４３例中３３例（７６．７％）仅用１疗程即达ＣＲ。远期疗效仍在观察中。ＨＡＤ方案毒性低，能为患者接受。取得高缓解率的原因可能与高三尖杉酯碱和柔红霉素之间的协同作用有关     

Penetratin-functionalized PEG-PLA nanoparticles for brain drug delivery

Nanoparticulate drug delivery system possesses distinct advantages for brain drug delivery. However, its amount that reach the brain is still not satisfied. Cell-penetrating peptides (CPPs), short peptides that facilitate cellular uptake of various molecular cargo, would be appropriate candidates for facilitating brain delivery of nanoparticles. However, such effect could be deprived by the rapid systemic clearance of CPPs-functionalized nanoparticles due to their positive surface charge. Penetratin (CPP with relatively low content of basic amino acids) was here functionalized to poly(ethylene glycol)-poly(lactic acid) nanoparticles (NP) to achieve desirable pharmacokinetic and biodistribution profiles for brain drug delivery. The obtained penetratin-NP showed a particle size of 100nm and zeta potential of -4.42mV. The surface conjugation of penetratin was confirmed by surface chemical compositions analysis via X-ray photo electron spectroscopy. In MDCK-MDR cell model, penetratin-NP presented enhanced cellular accumulation via both lipid raft-mediated endocytosis and direct translocation processes with the involvement of Golgi apparatus, lysosome and microtubules. In vivo pharmacokinetic and biodistribution studies showed that penetratin-NP exhibited a significantly enhanced brain uptake and reduced accumulation in the non-target tissues compared with low-molecular-weight protamine (CPP with high arginine content)-functionalized nanoparticles. These data strongly implicated that penetratin-NP might represent a promising brain-targeting drug delivery system. The findings also provided an important basis for the optimization of brain drug delivery systems via surface charge modulation.