提高中医临床疗效的科学学检讨(连载三)

中医学的生命力在于临床疗效 ,社会对于中医学的需要也在于临床疗效。提高中医临床疗效的科学学研究 ,要以中医基础理论为依据 ,以理、法、方、药一脉相承的辨证论治为前提。造成中医临床疗效下降的问题在于“三个脱节” ,即中医学与自身文化基础脱节 ,中医临床与辨证论治脱节 ,中药与中医临床脱节。中医学正处于行将消亡的边缘 ,也处在新的突破的前夜。实事求是地进行科学、历史的反思 ,中医学完全有可能走出百年困惑 ,得到振兴和发展。     

北京市城区四～六年级小学生体力活动现状

目的 了解小学生体力活动模式，为采取有效的措施促进他们积极参加体力活动、制定相关政策和健康目标提供依据。方法 随机选取北京市城区4所小学四～六年小学生453名，采用问卷调查和Caltrac体力活动测量仪收集其上周参加体力活动的情况。结果 男女生经常参加的业余活动依次为上下楼梯、劳动、步行、跑步等，男女生平均每天参加业余体力活动的时间分别为1．30、1．1lh，每天业余体力活动消耗的能量分别为27．89、23．65kJ/kg，每天总体力活动消耗的能量分别为42．17、35．53kJ／kg，每天静坐时间分别为2．00、1．79h，男女生各评价指标之间差异均无显性。结论 男女生经常参加的活动类型大致相同，活动水平接近。     

《内经》俞、输、腧探源

《素问》用“俞”，《灵枢》用“输”与“腧”表示腧穴，三字用法基本相同。“俞”源于用船运送，“输”源于用车运送，均引申为转运气血的穴位。“腧”是“俞”的今字，其字形代表的意义最符合中医学中腧穴的含义。应以“腧”作为规范的词语，表示腧穴的各种意义。     

中医医院现代化建设的思考

从中医现代化建设方面提出了几个注意的问题:强化改革开放意识,转变旧的封闭观念;重视医、教、研协同发展;加快传统科室的改造;加速陈旧设备的更新;基础设施建设应具有超前意识;开展对外交流,引进与输出相结合。     

Ultrasound for diagnosis of apophyseal injuries

Avulsion injuries of the apophysis is a problem in young athletes. A correct diagnosis is necessary for establishing the appropriate treatment and the rehabilitation program. However, it is often difficult to distinguish between a simple muscle strain and an avulsion fracture. The X-ray examination is helpful only when an ossification center of the apophysis exists. Ultrasonography is considered the suitable diagnostic tool for these cases. From June 1988 to June 1993, 243 young athletes were seen with an anamnestic and clinically suspected apophyseal injury of the lower extremity. In all cases X-ray examination and ultrasound examination were performed. In 80 cases the diagnosis was confirmed by X-ray examination and in 97 by ultrasonography. Four criteria were defined for the sonographic examination: (a) a hypoechogenic zone, (b) increased distance to the apophysis, (c) dislocation of the apophysis, and (d) mobility of the apophysis on dynamic examination. These criteria are correlated to (a) edema, (b) lysis, (c) avulsion, and (d) unstable avulsion of the apophysis. Ultrasonography is a proven technique for the detection of apophyseal injuries. In comparison to X-ray examination, it has the advantages of no radiation exposure, early detection even without ossification center, and dynamic examination.     

千捶膏配合生肌玉红膏治疗感染性伤面的临床观察

我院多年来应用千捶膏和生肌玉红膏治疗感染性伤面。千捶膏用于去腐,生肌玉红膏用于生新。据我们观察二药有较强的抗感染作用,尤其有抗绿脓感染作用。应用千捶膏可以较快地达到脱腐作用,应用生肌玉红膏可以促进肉芽增生,达到伤面早期愈合,值得推广。     

中医药治疗子宫内膜息肉的临床研究进展

子宫内膜息肉是妇科常见疾病,现代中医认为本病主要病理因素是瘀滞,临床常见气滞血瘀、痰湿瘀阻、湿热瘀滞、气虚血瘀、阳虚血瘀诸证,运用中医药辨证治疗、中医外治法,可有效改善临床症状,降低息肉复发率,提高妊娠率。本文将近十年中医药治疗子宫内膜息肉的临床研究作以综述。     

Relationship between numbers of beta adrenergic receptors in lymphocytes and disease severity in asthma

In order to assess the status of beta adrenergic receptors in bronchial asthma, binding studies using (−) [³H] dihydroalprenolol (DHA) were performed on lymphocytes of 10 control subjects and 11 stable asthmatic patients. Specific DHA binding was generally lower at all DHA concentrations in asthmatics. At 12 nM DHA concentration, specific DHA binding was 391 ± 40 fM/mg protein in controls and 263 ± 35 fM/mg protein for asthmatic subjects (p < 0.05). A highly statistically significant positive correlation between specific DHA binding (at 12 nM DHA) and FEV₁/FVC% was observed (r = 0.93, p < 0.01), with those asthmatic subjects with the more severe airway obstruction and disease severity showing lower DHA binding. The results of the study suggest that a lymphocyte beta adrenergic receptor defect may be present among some patients with asthma. The magnitude of the receptor abnormality appears to be related to disease severity and degree of airway obstruction as measured by FEV₁/FVC%. Documentation of drug consumption was made, and restriction of beta adrenergic agonists was attempted; theophylline and corticosteroids were the predominant drugs used in the study. Even with these precautions, it is possible that the differences in DHA binding observed among subjects are the results of greater drug (e.g., theophylline and corticosteroids) consumption by the clinically more severe patients. On the other hand, the lymphocyte receptor alteration noted may reflect a more general beta adrenergic receptor abnormality in bronchial asthma.     

An action of disodium cromoglycate: inhibition of cyclic 3',5'-AMP phosphodiesterase.

Disodium cromoglycate (DSCG) prevents allergic asthma by inhibiting the release of chemical mediators of immediate-type allergic reactions. The mechanism of this action is unclear and prompted us to examine the effect of DSCG on cyclic adenosine 3',5'-monophosphate (cAMP), the implicated regulator of IgE-mediated reactions. We used the peripheral blood lymphocyte as a model to mirror the biochemical events occurring in the allergic shock organs. Isolated peripheral blood lymphocytes from perennial allergic asthmatic children receiving only DSCG had significantly (p less than 0.005) lower phosphodiesterase (PDE) activity (mean 1.05 +/- 0.17 SE per 10(6) cells) than normal individuals (2.93 +/- 0.14) and allergic children receiving methylxanthines (4.08 +/- 0.28) or no medications (3.58 +/- 0.2). DSCG (10 mug/ml) significantly lowered PDE activity in normal lymphocytes (p less than 0.005) in a beef heart extract (p less than 0.001), and 100 mug/ml lowered PDE activity in fetal rabbit lung homogenates (p less than 0.001). DSCG (10 mug/ml) significantly elevated (p less than 0.01) cAMP concentration in normal human lymphocytes (118 +/- 38 vs 30 +/- 10 picomoles cAMP/10(6) lymphocytes). Thus, DSCG appears to inhibit chemical mediator release by increasing intracellular cAMP through the inhibition of cAMP PDE.     

一种改良的抗氧化活性测定方法

活性氧自由基在生物体内参与生理，病理过程并起重大作用，在筛选和评价抗氧化药物时，越来越需要一种快速，简便，价廉而又可靠的抗氧化活性测定方法，本文发展了一种具备了上述优点新方法，ＳＯＤ（超氧化物歧化酶）及其模拟物的工作已有很多，很多文献报道了其活性一；Ｃｕ（Ⅱ）。本文着重研究了另一个金属辅基，Ｚｎ＾２＋并且发现了Ｚｎ＾２＋独特的，但为人们忽视了的；抗氧化活性加强作用。