吴鞠通法象用药临证举隅

中医理论是于现象之中阐明气化之妙,形质之上发明无形之奥,因此中药用药理论,其本质是法象用药,诸如质地之轻重、形状之殊异、纹理之疏密、气之清浊、味之厚薄、五运六气之禀赋、阴阳五行之制化等等,总括无余,然后心裁意度,对证切机,收效宏捷。文章试对吴鞠通运用法象中药临证运用的经验进行文献整理和分析,探讨《温病条辨》中法象中药的运用规律,旨在对温病临床治疗发挥指导意义。     

临床药师参加会诊的典型病例分析

目的:总结临床药师参加会诊的典型病例,以便为临床药师的工作提供参考。方法:结合以往临床药师参加的会诊工作,从个体化给药方案的制定、药品不良反应的判别、参与中毒急救、不良反应监测、围术期预防性使用抗菌药物的选择等几个方面进行总结。结果:通过参加会诊,临床药师能够为临床提供帮助,对药师的工作有一定的指导作用。结论:通过以上会诊工作的开展,临床药师的建议得到临床医生的采纳,药师自身素质明显提高。     

临床药师参与3例重症感染病例治疗的经验体会

目的:结合襄阳市第一人民医院临床药师参与感染性病例会诊的情况,探讨临床药师在重症感染性病例药物治疗过程中的经验与教训,促进抗菌药物的合理使用。方法:回顾性分析我院临床药师参与的3例重症感染性病例的药物治疗方案调整过程。结果:临床药师通过干预用药,配合医生为患者提供最佳的用药方案,使患者获得优质的医疗服务。结论:临床药师参与患者药物治疗会诊,将成为医院整体医疗技术工作中不可或缺的一环,临床药学依托患者与临床才能有更广阔的发展空间。     

临床药师学员的病例教学方法探讨

目的:探讨适合带教临床药师学员的病例教学模式。方法:根据临床药师学员工作的基本要求,采用以问题为导向的病例教学方法、模拟病例教学法以及DV演示教学法对临床药师学员进行带教。结果:通过对临床药师学员的病例教学经验进行总结,制定病例教学流程。通过病例教学,可以培养临床药师学员信息收集、整理的能力,训练学员交流沟通和参与临床药物治疗的能力,使其能够更快的掌握开展临床药学服务的方法。结论:病例教学法是提高临床药师学员带教质量和学员素质的有效方法。     

Association Between Human Cases and Poultry Outbreaks of Highly Pathogenic Avian Influenza in Vietnam From 2003 to 2007: A Nationwide Study

This study quantifies the spatio‐temporal association between outbreaks of highly pathogenic avian influenza H5N1 in domestic poultry (n = 3050) and human cases (n = 99) in Vietnam during 2003–2007, using rare events logisitic regression. After adjusting for the effect of known confounders, the odds of a human case being reported to authorities increased by a factor of 6.17 [95% confidence interval (CI) 3.33–11.38] and 2.48 (95% CI 1.20 – 5.13) if poultry outbreaks were reported in the same district 1 week and 4 weeks later respectively. When jointly considering poultry outbreaks in the same and neighbouring districts, occurrence of poultry outbreaks in the same week, 1‐week later, and 4 weeks later increased the odds of a human case by a factor of 2.75 (95% CI 1.43–5.30), 2.56 (95% CI 1.31–5.00) and 2.70 (95% CI 1.56–4.66) respectively. Our study found evidence of different levels of association between human cases and poultry outbreaks in the North and the South of the country. When considering the 9‐week interval extending from 4 weeks before to 4 weeks after the week of reporting a human case, in the South poultry outbreaks were recorded in 58% of cases in the same district and 83% of cases in either the same or neighbouring districts, whereas in the North the equivalent results were only 23% and 42%. The strength of the association between human and poultry cases declined over the study period. We conclude that owner reporting of clinical disease in poultry needs to be enhanced by targeted agent‐specific surveillance integrated with preventive and other measures, if human exposure is to be minimized.     

HIV-positive Romanian Adolescents: Acquisition Routes,Risk Behaviors,and Psychological Correlates

This research evaluated risk behaviors in HIV-positive adolescents (N = 153) receiving routine HIV medical care from their providers at a large medical center in Bucharest, Romania. Although the participants were of an appropriate age (M = 15.94 years) to have acquired HIV as one of the large numbers of pediatric AIDS cases during Ceau?escu’s Communist regime, many (20%) reported acquiring HIV sexually, relatively recently. The sample as a whole exhibited significant deficits in HIV knowledge, attitude, subjective norm, perceived control, and intention; significant risk behavior also appeared in terms of reports of unprotected intercourse with both HIV-positive and -negative partners. These results imply a change in the epidemiological model for HIV transmission in Romania, with increased sexual transmission of HIV. Discussion centers on interpretations of these patterns and drawing implications for HIV risk reduction for young people in Romania.     

政府信息公开类纠纷案件司法审查的若干问题研究——以《政府信息公开条例》的理解与适用为视角

《中华人民共和国政府信息公开条例》(以下简称《条约》)通过法规的形式正式确立了我国的信息公开制度,首次将侵害行政相对人合法权益的政府信息公开行为列入行政诉讼的受案范围,明确了对公民知情权的司法保护?相应的,如何在现行的行政诉讼框架内妥善解决信息公开类行政纠纷成为了人民法院面临的紧要课题?该文拟在行政诉讼法有关规定的基础上,结合《条例》及《关于审理政府信息公开行政案件若干问题的规定》的有关规定,对信息公开类行政纠纷案件法院受案范围?诉讼当事人?司法裁判方式及行政赔偿等问题略陈管见?     

APACHE Ⅱ评分在临床应用的现状及进展

目前,急性生理学及慢性健康状况评分系统(APACHEⅡ)主要用于危重患者病情的评估,根据不同的评分将病情分类,采取不同治疗方案,并且预测其病死率及住院率。随着APACHEⅡ评分系统在临床的广泛应用,发现它与临床某些指标有一定的相关性及在临床使用中有一定的局限性。现就APACHEⅡ评分系统在临床中应用的现状及进展予以综述。     

478例流感样病例的证候特点分析

目的 分析流感样病例的证候分布特点.方法 对流感样病例进行中医证候的问卷调查,采用六经、卫气营血与三焦辨证三法合用进行证候分析.结果 流感样病例共478例,对465例进行了证候分析(其余13例进行症候特点描述),其病邪以风热为主,98.9%为温热病邪.①证候分布:88%有太阳证(伤寒证74.6%,太阳病证17.6%),...     

大同市住院病例分析

目的通过住院病例分析,了解山西省大同市疾病谱特征,为疾病预防控制、政府卫生决策提供依据。方法收集大同市2005-2006年度电子病例,Microsoft Access建立数据库并进行频数分析。结果大同市住院病例中,男女构成比接近（1：1．03）,0～5岁年龄组构成比较大（13．42％）;年龄越小,住院时间越短：年龄越大,住院时间越长。0～14岁年龄组,平均住院天数为5．8d,〉75岁年龄组,平均住院天数为13．9d;住院病因中,依据ICD一位码分类,前五位的疾病分别为呼吸系统疾病（15072,16．4％）、消化系统疾病（1359514．84％）、循环系统疾病（1095711．96％）、妊娠、分娩和产褥期疾病（82168．9695％）、损伤、中毒和外因的某些其他后果（78038．519％）;按ICD三位码分类,前五位疾病因分别为肺炎（4．60％）、胆石病（2．88％）、多发性和未特指部位的急性上呼吸道感染（2．63％）、慢性缺血性心脏病（2．56％）和脑梗死（2．26％）;结论O～14年龄组主要疾病为呼吸系统疾病（7682,46．4％）;45-64年龄组主要疾病为消化系统疾病（4539,21．54％）;〉65岁年龄组的首位疾病为循环系统疾病（5202,28．43％）。青壮年（15-44年龄组）分性别分析,男性排首位的为损伤、中毒和外因的某些其他后果（4026,33．53％）,女性是妊娠、分娩和产褥期疾病（8216,34．7％）。