王铁良老师临床治疗肾脏病常用处方经验总结

王铁良教授是黑龙江省中医药科学院主任医师,黑龙江中医药大学博士生导师,全国第二、三、四、五批名老中医药专家学术经验继承工作指导老师,是我国著名中医肾病专家。从事中医临床四十余载,本着＂勤求古训,博采众方,融中西医各家之长＂的原则,尤其治疗肾系疾病疗效显著,现将其治疗肾脏疾病行之有效的常用处方做一简要归纳及总结。     

逍遥散近十年的临床应用概述

逍遥散为调和肝脾的常用代表方剂,具有疏肝解郁、健脾和营、养血调经之功。笔者总结近十年逍遥散临床应用概况,在妇科领域有痛经、月经不调、经前期紧张综合征、乳腺病、不孕症、更年期综合征等,消化系统疾病如肠易激综合症、功能性消化不良等,内分泌系统疾病如高催乳素血症、糖尿病、甲亢性心脏病等,神经系统疾病如神经衰弱、失眠等,皮肤科的黄褐斑、痤疮等都有应用。只要辨证准确,谨守病机,都取得了理想的治疗效果,充分体现了中医异病同治的治则精髓。     

多发性颅内血肿49例手术治疗体会

目的总结多发性颅内血肿手术治疗的体会。方法对49例经手术治疗的颅内多发性血肿患者的临床资料进行回顾性分析。结果同时行双侧血肿清除30例,二次手术19例;术后恢复良好30例,轻残9例,重残5例,死亡5例。结论对于有手术指征的多发性颅内血肿患者,早期手术治疗有利于降低手术后患者致残率及病死率,改善患者预后。     

Simple group fMRI modeling and inference

While many advanced mixed-effects models have been proposed and are used in fMRI, the simplest, ordinary least squares (OLS), is still the one that is most widely used. A survey of 90 papers found that 92% of group fMRI analyses used OLS. Despite the widespread use, this simple approach has never been thoroughly justified and evaluated; for example, the typical reference for the method is a conference abstract, (Holmes, A., Friston, K., 1998. Generalisability, random effects & population inference. NeuroImage 7 (4 (2/3)), S754, proceedings of Fourth International Conference on Functional Mapping of the Human Brain, June 7–12, 1998, Montreal, Canada.), which has been referenced over 400 times. In this work we fully derive the simplified method in a general setting and carefully identify the homogeneity assumptions it is based on. We examine the specificity (Type I error rate) of the OLS method under heterogeneity in the one-sample case and find that the OLS method is valid, with only slight conservativeness. Surprisingly, a Satterthwaite approximation for effective degrees of freedom only makes the method more conservative, instead of more accurate. While other authors have highlighted the inferior power of the OLS method relative to optimal mixed-effects methods under heterogeneity, we revisit these results and find the power differences very modest. While statistical methods that make the best use of the data are always to be preferred, software or other practical concerns may require the use of the simple OLS group modeling. In such cases, we find that group mean inferences will be valid under the null hypothesis and will have nearly optimal sensitivity under the alternative.     

尿石成分分析概述

尿石症是泌尿外科最常见的病种。目前我们关注更多的是尿石症的外科治疗方法的发展,而忽视了尿石症的发病因素及尿石成分研究对预防尿石的发生及发展有着非常重要的作用,尿石成分分析可为临床外科治疗尿石症提供帮助。现综述尿石成分的物理、化学分析的方法及最新进展。     

冠心病中医证型客观化的研究进展

冠心病的中医证型客观化一直是学者关注的研究课题,现就近年来该方面的研究文献作回顾分析,以为今后的临床和科研提供一些新方法和新思路。     

上海图书馆馆藏抄本医书《增补〈病机提要〉》考析

[目的]通过对上海图书馆藏孤抄本医书《增补〈病机提要〉》的研究,以辨明其作者,并对该书的内容及价值进行介绍。[方法]从地方志中的相关记载入手,以辨明该书编著者;并利用地方志中的有关资料,系统梳理编著者的生平及著作情况;运用文献学方法,对《增补〈病机提要〉》的内容进行考察。[结果]通过研究地方志,发现该书由明代医家陈时荣原著,后经名医秦景明增订而成;并对秦氏的生平、籍贯、交游、学术传承及著作情况等作了梳理;研究是书内容后发现,该书体例精当,便于查检,论治精详,征引广泛,具有临床应用手册的性质,又经秦氏增补,具有较高的理论和临床价值,值得深入研究。[结论]以《增补〈病机提要〉》为例,稿抄本医书中蕴藏着丰富的宝藏,是中医古籍文献的重要组成部分,具有很高的学术和临床价值,希望更多有志之士投身于此,使其学渐为兴盛。     

Ensemble perception of emotions in autistic and typical children and adolescents

Ensemble perception, the ability to assess automatically the summary of large amounts of information presented in visual scenes, is available early in typical development. This ability might be compromised in autistic children, who are thought to present limitations in maintaining summary statistics representations for the recent history of sensory input. Here we examined ensemble perception of facial emotional expressions in 35 autistic children, 30 age- and ability-matched typical children and 25 typical adults. Participants received three tasks: a) an ‘ensemble’ emotion discrimination task; b) a baseline (single-face) emotion discrimination task; and c) a facial expression identification task. Children performed worse than adults on all three tasks. Unexpectedly, autistic and typical children were, on average, indistinguishable in their precision and accuracy on all three tasks. Computational modelling suggested that, on average, autistic and typical children used ensemble-encoding strategies to a similar extent; but ensemble perception was related to non-verbal reasoning abilities in autistic but not in typical children. Eye-movement data also showed no group differences in the way children attended to the stimuli. Our combined findings suggest that the abilities of autistic and typical children for ensemble perception of emotions are comparable on average.     

Surgical treatment for non-parasitic liver cysts improves quality of life

Background&purposeLiver cysts occur frequently. Most are harmless, however some carry a significant patient burden. Optimizing treatment strategy is complicated as needs differ between patients. The current study assesses the effect of surgery on quality of life (QoL) of patients with non-parasitic liver cysts.MethodsA retrospective cohort study of all patients who underwent surgery for non-parasitic liver cysts in three major Dutch medical centers from 1993 to 2017. Patient characteristics and surgery related variables were collected from the electronic patient file. QoL was measured before and after surgery using the EORTC QLQ-C30. Summary scores (SumSc) were calculated and compared to reference values of the general population. Multivariate analysis using logistic regression was performed for identifying outcome related factors. Increase of ≥ 10% in SumSc was defined as clinically relevant.Main findingsEighty-eight of 132 eligible patients (67%) completed two QoL assessments. Respondents demonstrated significant improvement in the global health status, on all 5 functional scales (all p ≤ 0.005), on all 9 symptom scales after surgery (all p < 0.05), and on SumSc (p < 0.001) to levels similar or better than the general population. Patients with complications demonstrated a significant QoL gain (p < 0.05), and reported a similar postoperative status compared to patients without complications (p = 0.74). QoL gain for patients who underwent open and laparoscopic cyst fenestration were similar (p = 0.08). Multivariate analysis of SumSc found mechanical complaints as significant factor for ≥ 10% SumSc increase (OR 0.11, 95% CI (0.02–0.55).ConclusionsSurgery is a safe and effective strategy to significantly improve QoL in patients with symptomatic liver cysts.