醒脑开窍针刺法治疗恢复期中风临床及实验研究

采用醒脑开窍针刺法与传统针刺法治疗恢复期中风92例,按随机原则分成醒脑开窍针刺组50例,传统针法组42例。治疗结果表明,醒脑组与传统组基本治愈率分别为42％、16.67％,醒脑组显效及有效率亦明显优于传统组。实验结果表明,醒脑组在血液流变学、血脂、微循环和体外血栓形成等绝大多数指标上,均有明显改善,其程度和范围均明显优于传统针刺组。     

中药结合心理干预治疗不安障碍40例

[目的]探索不安障碍治疗的有效途径。[方法]采用中药结合心理干预治疗不安障碍患者40例。[结果]显效31例(77·5%)、有效7例(17·5%)无效2例(5·0%)。SDS、CMI有显著性差异。[结论]中药结合心理干预治疗不安障碍疗效显著。     

Use of self-efficacy and dyspnea perceptions to predict functional performance in people with COPD.

This correlational and comparative study explored whether self-reports of self-efficacy and dyspnea perceptions predict the perceived level of functional performance in adults who have chronic obstructive pulmonary disease (COPD). The convenience sample included 97 Caucasian men (52) and women (45). Participants had to have a forced expiratory volume in 1 second (FEV1) of less than 70% predicted, and a FEV1/forced vital capacity (FVC) of less than 70%. Participants were recruited from pulmonary function laboratories and from better breather support groups in a Midwestern state. Three standardized, self-report instruments, COPD Self-Efficacy Scale (CSES), the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ), and Functional Performance Inventory (FPI) were used to measure the participants' self-report of their perceptions of self-efficacy, dyspnea, and functional performance. Dyspnea predicted 38.1% of the variance in functional performance, with self-efficacy contributing an additional 6.5% to the variance in the total sample. Self-efficacy predicted 36.5% of the variance in functional performance in men, with dyspnea contributing an additional 7.2% to the variance. However, in women, only dyspnea was a significant predictor of functional performance, at 48.5% when both dyspnea and self-efficacy were entered as independent variables. To improve patients' perceptions of functional performance, nurses can use methods such as breathing techniques and upper- and lower-body exercises that increase optimal management of dyspnea. Nurses may increase the self-efficacy of managing dyspnea by helping patients master breathing techniques and exercise through coaching and providing vicarious experiences through patient support groups or pulmonary rehabilitation programs.     

经阴道超声介入治疗多囊卵巢综合征的临床分析

目的探讨在B超引导下经阴道卵泡穿刺术(transvaginal immature follicle aspiration,TV-IMFA)治疗耐药多囊卵巢综合征(polycystic ovarian syndrom,PCOS)合并不孕患者的疗效和可行性.方法选择78例难治性PCOS患者,随机分为两组:A组(n=40)为B超引导下经阴道卵巢穿刺组(TV-IMFA),B组(n=38)为腹腔镜下卵巢打孔组(LOD),术后监测排卵,若2个月无排卵,则使用促排卵药物,同时指导性生活,并随访1a,了解妊振情况.结果 A,B两组术后内分泌激素水平都得到改善,而两组排卵率、妊振率、自然流产率差异无显著性.结论 A,B两组治疗手段不同,但具有相同的临床疗效.     

Integrated plasma cortisol concentration in children with asthma receiving long-term inhaled corticosteroids.

We assessed the effect of long-term therapy with inhaled beclomethasone dipropionate (BDP) on the pituitary-adrenal axis, by measuring the integrated concentration (IC) of plasma cortisol in eight children with asthma (age, 6-16 years) who regularly used inhaled BDP in doses ranging from 8 to 26.5 micrograms/kg (200-450 micrograms/day) for 6 months to 4 years. The control group included six children (age, 6-16 years) who had the IC of plasma cortisol measured as part of an endocrinological evaluation and were found to be healthy. Cortisol concentration was measured in blood samples collected continuously over a 24-hr period. Mean IC of plasma cortisol in the study group was significantly lower than in the healthy controls (mean +/- SD, 4.9 +/- 3.3 vs 9.1 +/- 1.9 micrograms/mL; P less than 0.02). Cortisol response to 0.25 mg ACTH (iv) was abnormal in one of the eight BDP-treated patients. No correlation was found between IC of plasma cortisol and the BDP dose, severity of asthma, height percentile, or the Tanner stage. We conclude that long-term therapy, even with relatively conventional doses of inhaled BDP may cause reduction in the normal physiological secretion of cortisol. The clinical relevance of low IC of plasma cortisol is not clear, but it may reflect partial suppression of the pituitary-adrenal axis.     

糖尿病肾病临床研究述评

本文从中医病名、病因病机、诊断标准、临床分期、疗效评定、辨证论治、临床科研七个方面对糖尿病肾病的研究进行了述评。指出：糖尿病肾病的中医病名、诊断、分期及疗效评定标准亟待统一；立足于临床实际，参考现代医学有关认识，应用ＤＭＥ方法，开展糖尿病肾病临床和实验研究，深入探讨其病因病机和证治规律，在中医基本理论指导下，大胆创新，是提高临床疗效的关键；分期辨证论治较为符合疾病的发展规律，便于寻找防治糖尿病肾病的有效方法。     

脂肪栓塞综合征：附19例报告

脂肪栓塞综合征是创伤或骨折的严重并发症，死亡率高，通过对１９例临床观察分析及复习文献，提出对本征诊断有重要意义的４项标准：（１）“暴风雪”样肺片；（２）皮肤或粘膜有出血点；（３）低氧血症；（４）血小板减少，并认为应用高压氧治疗本征是一种有效的方法。     

高血压病合并脑梗死的动态血压特点

目的 :观察高血压病合并脑梗死患者的动态血压特点。方法 :对 70例高血压病合并脑梗死患者和 1 0 2例单纯高血压病患者进行 2 4h动态血压监测。结果 :84 %高血压病合并脑梗死患者血压昼夜节律消失 ,而单纯高血压病患者 5 8%消失 (P <0 .0 1 ) ;高血压病合并脑梗死组 85 %出现晨峰 ,而单纯高血压病组 5 5 %出现晨峰 (P <0 .0 1 )。结论 :血压的昼夜变化和晨峰与高血压病合并脑梗死密切相关。高血压病合并脑梗死患者晨峰明显增加 ,昼夜节律消失明显     

影响现代大学制度综合因素分析和改革探索

从影响现代大学制度的综合因素分析出发,提出建立现代大学制度的核心是要落实大学自治、学术自由和教授治校.此外建立现代大学制度还要树立正确的人才观、发展观、质量观、模式观,培育具有鲜明特色大学精神和大学文化.     

医用耗材采购决策中存在的问题与对策

本文分析了目前医疗机构医用耗材采购中存在的一些问题和造成危害的原因，提出了要解决这些问题，就要建立和完善集中决策机制等对策思路。