中医药高等院校临床教学50年的回顾与思考

回顾了我国中医药高等院校临床教学50年的发展历程。分析、总结了50年来在临床教学方面我们的成功之处与问题所在。针对管理体制、办学方向与培养目标、七年制教育、课程设置与教学安排、中医临床专业课教材、学生的专科特色与临床特色共6个方面目前存在的问题提出了改革建议。     

速可眠、三唑仑、唑吡坦、佐匹克隆催眠效果的神经电生理特征

目的；比较速可眠（SEC）、三唑仑（TZI）、唑吡坦（ZP）、佐匹克隆（ZPL）催眠效果的多道睡眠图（PSG）特征。方法：对8名（18－20岁）健康男性青年志愿者进行PSG描记，观察口服SEC、TZL、ZP、ZPL后觉醒时间（AT）、睡眠潜时（SL）、实际睡眠时间（AST）、睡眠效率（SE）、睡眠分期（S1、S2、S3＋4，REMS）的变化。结果：4种催眠药的AT未见明显增加，AST未见明显减少，催眠效率均大于85％。SEC组SL短于其它3组，SEC对增强S3＋4，REM睡眠期的作用显著。结论：4种催眠药均通过缩短SL，减少AT，相对增加AST而提高催眠效率，差异不显著，但SEC对睡眠结构的影响较TZL、ZP、ZPL明显。     

Informing patients about drug side effects

Two hundred forty-nine newly diagnosed hypertensive patients prescribed thiazide medication were recruited for study. Two-thirds were given a leaflet or patient package insert (PPI) that described the drug and its possible side effects, and one-third were not. At a revisit about 1 month later, patients were asked whether they had experienced any of 17 different “health problems.” For each problem that they experienced, they were asked whether they thought the problem was related to the medicine they were taking. Ten of the health problems were taken verbatim from the PPI's list of possible drug side effects. Patients who received the PPI reported experiencing about the same number of side effects as the non-PPI subjects. However, those who recieved the PPI were more likely to attribute experienced reactions to the drug. This was true both for reactions specifically listed in the PPI and for similar reactions not listed. Results support the notion of an “attribution-labeling” process rather than a “suggestion” effect.     

Heart Rate Changes in Pain and Hypnosis

Heart rate was measured in four experiments using the cold pressor test, with the following results: (1) the heart rate rise between relaxation and stress levels was significant when the water was sufficiently cold (significant in 0°C and 5°C water, not 10°C); (2) the amount of heart rate rise in the normal waking state in 0°C water is unrelated to the hypnotizability of the subject; (3) there is a significant difference in heart rate following a hypnotic induction with suggestions of analgesia, although the reduction in heart rate rise is unrelated to the amount of reduction in felt pain; (4) heart rate rise during hallucinated pain in highly hypnotizable subjects is not significantly different from the rise recorded during normal waking or hypnotically analgesic conditions. These moderately confusing results take on some semblance of order if it is assumed (1) that the control of voluntary processes through hypnotic analgesia (agitation, grimacing) accounts for some reduction in heart response even though uncorrelated with reduced pain, (2) that the homeostatic and sensory-information aspects of the cold water pain are probably little reduced, even though subjectively the pain may be absent altogether, and (3) the motivational-emotional aspects of pain are more labile than the sensory-discriminative aspects, in accordance with the Melzack-Wall Gate Theory.     

Evaluation of behavioral and pharmacological effects of Hedyosmum brasiliense and isolated sesquiterpene lactones in rodents

Ethnopharmacological relevance

Hedyosmum brasiliense Miq. (Chloranthaceae) is an essential Brazilian species largely found in the Atlantic Forest. It is popularly known as “cidrão” and in folk medicine, this aromatic species is widely used as a calmative/tranquilizer and to treat sleep disorders.

Aim of the study

To examine the neurochemical properties of ethanol extract (EEHb), fractions and compounds of fresh leaves of Hedyosmum brasiliense and the antidepressant effect of the isolated sesquiterpene lactones podoandin and 13-hydroxy-8,9-dehydroshizukanolide.

Materials, methods and results

The effects of EEHb were demonstrated by the open field, elevated-plus-maze, forced swimming, pentobarbital-induced sleeping time, PTZ-induced seizure, and inhibitory avoidance tests. EEHb did not show a protective effect against PTZ-induced convulsions. In the plus-maze test, EEHb (100 mg/kg, i.p.) exhibited an anxiolytic effect through the effective enhancement of the frequency and time spent in the open arms of the maze. Conversely, the time spent and the number of entrances to the closed arms were decreased. All these effects were also completely reversed by pre-treatment with flumazenil (2.5 mg/kg, i.p./a benzodiazepine receptor agonist), similar to the results observed with diazepam used as a positive standard. In this test, the anxiolytic effect of EEHb was also totally blocked by pre-treatment with reserpine (2.0 mg/kg, i.p.), a drug known to induce depletion of biogenic amines. In the forced swimming test, the treatment of EEHb (100 mg/kg, i.p. or 100 mg/kg, p.o.) given in acute and chronic form (10, 50 and 100 mg/kg), produced a decrease in immobility time, similar to that of imipramine (10 mg/kg, i.p.), the positive control. The dichloromethane and hexane fractions (100 mg/kg, p.o.) also produced a decrease in immobility time. In addition, the two isolated compounds tested in a single dose (10 mg/kg, i.p.), the antidepressant effect was observed only with the compound podoandin, which also caused a decrease in immobility time. EEHb (10–100 mg/kg) a dose-dependent manner also caused a decrease in barbiturate sleeping time in mice, and in high doses (100 mg/kg), did not interfere in memory consolidation.

Conclusions

The results suggest that EEHb presents psychopharmacological activities, including anxiolytic, antidepressant, and hypnotic effects.     

Rosewood oil induces sedation and inhibits compound action potential in rodents

Aim of the study

Aniba rosaeodora is an aromatic plant which has been used in Brazil folk medicine due to its sedative effect. Therefore, the purpose of the present study was to evaluate the sedative effect of linalool-rich rosewood oil in mice. In addition we sought to investigate the linalool-rich oil effects on the isolated nerve using the single sucrose-gap technique.

Materials and methods

Sedative effect was determined by measuring the potentiation of the pentobarbital-induced sleeping time. The compound action potential amplitude was evaluated as a way to detect changes in excitability of the isolated nerve.

Results

The results showed that administration of rosewood oil at the doses of 200 and 300 mg/kg significantly decreased latency and increased the duration of sleeping time. On the other hand, the dose of 100 mg/kg potentiated significantly the pentobarbital action decreasing pentobarbital latency time and increasing pentobarbital sleeping time. In addition, the effect of linalool-rich rosewood oil on the isolated nerve of the rat was also investigated through the single sucrose-gap technique. The amplitude of the action potential decreased almost 100% when it was incubated for 30 min at 100 μg/ml.

Conclusions

From this study, it is suggested a sedative effect of linalool-rich rosewood oil that could, at least in part, be explained by the reduction in action potential amplitude that provokes a decrease in neuronal excitability.     

对目前中医名词术语翻译中的一些建议

针对目前中医名词术语翻译中存在的问题,探讨“ V + ing + N ”和 “N + V + ed + N”结构特点,分析其应用在中医名词术语翻译中的优点,以及该结构在中医名词术语翻译中的具体应用, 以解决目前中医名词术语翻译中存在的问题。     

天津市生活垃圾分类试点选取及实施建议

结合国内垃圾分类试点分类经验,从合理选取垃圾分类试点的角度着眼,探讨天津市垃圾分类试点选取模式,并提出了实施、复制推广的建议。     

基层医疗机构医院感染和消毒灭菌现状调查及分析

目的了解基层医疗机构医院感染和消毒灭菌现状，探讨加强规范管理对策，提出改进措施。方法采用统一的问卷调查方式，对132家基层医疗机构的医院感染和消毒灭菌组织制度及管理、消毒设备设置及使用、一次性医疗用品的使用和处理进行调查，进行消毒质量监测，结果用spss13．0统计软件进行统计分析。结果基层医疗机构医院感染组织制度不健全，消毒设施和消毒液的缺乏以及使用不符合要求，消毒质量监测合格率低（66．9％），一次性医疗用品和医疗垃圾的处理不规范。结论强化培训，加大投入，提高认识、加强以小型医疗机构、诊所和村卫生室为重点的卫生监督力度和处罚，同时应加强空气消毒工作的落实。     

社区卫生服务改革的可持续发展与政策建议

通过对上海市长宁区社区卫生服务综合配套改革运行过程及社区卫生服务发展效率、质量的研究,提出了对社区卫生服务可持续发展的政策建议,即进一步巩固和完善医疗保险预付制、进一步加强社区卫生服务能力建设以及推进以社区卫生服务为基础的城市新型医疗服务体系构建。