运气学说结合辨证论治在崩漏治疗中的运用

崩漏为妇科疑难疾病,尤其病程长、合并器质性疾病者。更难诊治近期接诊姐妹同患崩漏一例,妹妹无合并症,以常规清热凉血止血治疗有效,姐姐合并子宫腺肌症、子宫内膜非典型增生和重度贫血,闭崩交替,出血量多势急,常规止血调经方法无效,后经辨证论治结合运气学说,攻补兼施,益气养阴、凉血化瘀止血,获效。     

基于数据挖掘《中医方剂大辞典》治疗不育症用药规律探讨

目的分析《中医方剂大辞典》中治疗不育症药物,为中医临床用药提供指导。方法统计《中医方剂大辞典》收录治疗不育症的药物,分别查出其性味归经,运用Excel、Spss 22.0、Weka 3.8、Cytoscape 3.6.1、复杂系统熵聚类等统计学方法对数据进行统计分析。结果共筛选114首治疗不育症方剂,涉及中药179味。统计出使用高频药物及其性味归经,根据高频药物的关联规则分析,得到药对配伍规则。通过熵层次聚类挖掘新处方5首。结论《中医方剂大辞典》收录治疗不育方剂组方以补肾健脾养血为要务,对于当代医家在临床上辨证施治用药有着一定的指导意义。     

从“肝肺循环轴”论治肺癌

肺癌是由正气虚损，肺气失司，气、血、痰、瘀、毒互结于肺而成。其病位主要在肺，但肝肺两脏之间有着气血相生、金木相制、流注开合为基础的轴系关系，即“肝肺循环轴”。本文基于肝肺之间密切的生理、病理关系，从“肝肺循环轴”探讨肺癌的发病机理及治疗，以期为肺癌的临床辨证论治提供新思路，文中附验案1则。     

消瘤止痛凝胶制备工艺的优化

目的优化消瘤止痛凝胶制备工艺。方法以挥发油出油率、干膏得率为评价指标,单因素试验优化挥发油提取工艺;以落新妇苷转移率、干膏得率为评价指标,正交试验优化水提工艺;以落新妇苷保留率为评价指标,单因素试验优化浓缩、干燥工艺;以黏度、外观性状、载药量、保湿性的综合评分为评价指标,AHP-CRITIC混合加权法计算权重系数。在单因素试验、正交试验基础上,通过D-Optimal设计优化处方。结果最佳提取工艺为水蒸气蒸馏法提取3 h,料液比1:20;最佳浓缩方式为在(80±5)℃、(0.07±0.01)MPa条件下减压浓缩;最佳干燥方式为在(80±5)℃、(0.06±0.01)MPa条件下减压干燥;最佳处方为挥发油、干膏、冰片总质量19.96 g(比例17:2:63),Tween-80用量0.77 g,甘油用量5.00 g,卡波姆980用量3.12 g,尼泊金乙酯用量0.40 g,三乙醇胺适量,综合评分112.63分。结论该方法稳定可靠,可用于制备消瘤止痛凝胶。     

HPLC测定蝙蝠蛾拟青霉培养物5种核苷类成分的含量

建立HPLC同时测定蝙蝠蛾拟青霉培养物中尿嘧啶、尿苷、鸟苷、腺嘌呤和腺苷5种核苷类成分含量的方法。采用Waters SunFire C18(4.6 mm×250 mm,5 μm)色谱柱;以甲醇-水为流动相,梯度洗脱,柱温30 ℃,检测波长260 nm。 结果尿嘧啶的线性范围为10.00~200.00 mg·L^-1(r=0.999 4),尿苷的线性范围为10.10~202.00 mg·L^-1(r=0.999 2),鸟苷的线性范围为10.00~200.00 mg·L^-1(r=0.999 1),腺嘌呤的线性范围为10.30~206.00 mg·L^-1(r=0.999 2),腺苷的线性范围为10.45~209.00 mg·L^-1(r=0.999 1);尿嘧啶、尿苷、鸟苷、腺嘌呤和腺苷的精密度RSD分别为0.032%,0.035%,0.039%,0.049%,0.000 80%;尿嘧啶、尿苷、鸟苷、腺嘌呤和腺苷的平均加样回收率分别为97.34%,99.10%,101.6%,98.61%,100.2%,RSD分别为1.3%,2.1%,0.96%,0.95%,1.3%。该方法灵敏度高、选择性好,线性关系及重复性好,适合于蝙蝠蛾拟青霉培养物及其提取物中核苷类成分的含量分析。     

Violence and burnout in health care emergency workers in Santiago,Chile: A survey-based cross-sectional study

Shortage of quantitative studies regarding health risks for emergency services workers is a concern for Chilean’s occupational health organizations.ObjectiveTo explore the incidence of violence and burnout in emergency services of the Metropolitan Region of Chile, and associations with workers’ characteristics and workplace conditions.MethodsA cross-sectional study was carried out from January to August 2016. A self-reported questionnaire explored about frequency and seriousness of violence episodes and about symptoms of burnout with the Maslach Burnout Inventory.ResultsOf the 565 workers participating, 71% (95% CI 66.7–74.5) said violence episodes occurred at least once a week; 71.3% (95% CI 67.3–75.0) were victims of some aggression in the previous 12 months. Patients companions, relatives or friends arose as the main aggressors and the severity of the episodes was considered slight or moderate by more than 50% of participants. Fifty-seven respondents (10.5%, CI 95% 8.1–13.5) classified as having a burnout syndrome. Having been a victim of violence was associated to high emotional exhaustion (OR_adj = 1.7, 95% CI: 1.1–2.8) and depersonalization (OR_adj = 2.0, 95% CI 1.3–3.3).ConclusionsViolence is a problem in the emergency departments of Chile’s Metropolitan Region. Burnout is also present and independently associated to violence.     

石榴果实乙酸乙酯提取物对胰岛素抵抗大鼠血糖及血脂的干预作用

目的:观察石榴果实乙酸乙酯提取物(PGFEAE)对正常大鼠及胰岛素抵抗(IR)大鼠模型血糖、血脂的干预作用,评价其改善胰岛素抵抗的药理作用。方法:高糖高脂饲料喂养加链脲佐菌素(STZ)2次ip(30 mg·kg-1)建立胰岛素抵抗大鼠模型。分别以PGFEAE 100,200,300 mg·kg-1ig干预4周后,检测空腹血糖(FBG)、空腹胰岛素水平(FINS)、胰岛素敏感指数(ISI)、血清游离脂肪酸(FFA)浓度、甘油三酯(TG)浓度。结果:与正常组相比,模型组FBG,FINS,FFA,TG水平显著上升,胰岛素(INS)水平下降(P0.05,P0.01);造模4周后,正常组与模型组大鼠FBG,FINS,TG分别为5.94,30.71,0.57mmol·L-1;13.05,42.36,1.62 mmol·L-1;给药4周后,与模型组相比,PGFEAE各剂量组均可有效降低胰岛素抵抗大鼠模型FBG,FINS,FFA,TG水平,使胰岛素抵抗大鼠模型INS水平升高(P0.05,P0.01)。结论:PGFEAE可有效改善胰岛素抵抗大鼠血糖、血脂偏高的症状,其对正常大鼠血糖、血脂无干预作用。     

七较影像学在中医院校影像诊断学典型病例教学中的应用

为了达到“培养实用型中医药人才”的培养目标,本文将比较影像学引入到中医院校影像诊断学典型病例教学中,这将有助于提高学生对影像学诊断学理论的学习,有助于学生对疾病的诊断及鉴别诊断,有助于学生对影像学诊断方法的选择,还有助于学生对影像诊断学与中医相结合部分的理解。