“筋骨平衡,气血为重”理论在肝肾亏虚型神经根型颈椎病中的应用探讨

平乐正骨平衡理论包含气血共调、动静互补、形神统一平衡等理论,其中气血平衡理论是平乐正骨理论体系的核心,气血是人体生命活动之总纲,也是伤科病机之总纲。气血平衡理论是颈椎平衡的内在表现,人体气血亏虚,肝肾不足,筋脉不得濡养,而出现“筋出槽,骨错缝”的病理状态,这是颈椎病发病的根源所在。因此,临床中治疗肝肾亏虚型神经根型颈椎病,应当调气血在先,治筋骨于后;于“先治筋,再调骨”理念前运用“未病先防,既病防变”思想先调气血而治疗肝肾亏虚型神经根型颈椎病。     

中医处方及书写规范化的商讨

目的：探讨中医处方辨证用药的特色,使其更加合理完善、科学使用。方法：通过对国中医药医政发（2010）057号《中药处方格式及书写规范》一文及国家其它有关处方文件的学习。结果：发现《中药处方格式及书写规范》中有些地方不符合实际情况或解说不明了。结论：《中药处方格式及书写规范》一文及式样符合中医药辨证特色,但中药饮片处方样式注2和中成药处方正文对丸剂单位要求需要修改,才能更加符合实际应用。     

西藏那曲地区藏族中小学生恒牙牙合期颅面硬组织的结构特征：

BACKGROUND: Craniofacial hard tissue structures vary in age, gender, regional and racial differences. Some researchers have conducted X-ray cephalometric measures of malocclusion deformity in some domestic cities, and obtained normal cephalometric measures of craniofacial hard tissue structure. However, little data have been available concerning cephalometric measures of craniofacial hard tissue structure of Tibetan youth in Tibet region. OBJECTIVE: To observe structural features of craniofacial hard tissue of permanent tooth occlusal period in the adolescent of Lhasa. DESIGN, TIME AND SETTING: Stratified cluster sampling survey was performed at Naqu, Tibet from June to August 2008. PARTICIPANTS: A total of 200 adolescents at permanent tooth occlusal period, 100 males and 100 females aged 11-14 years were selected from middle and primary schools of Lhasa in 2003. The inclusion criteria included: teeth in order, neutral occlusal adjustment, normal maxilla and mandible appearance and relationship, normal teeth number and overbite and overjet, concordant face, and no history of orthodontic management. METHODS: According to the requirements and standards for the irradiation, 200 subjects underwent X-ray cephalometric measures, and the results were compared with normal values of the same age. MAIN OUTCOME MEASURES: SNA angle, SNB angle, ANB angle, 1-SA angle, 1-NA angle, 1-NA, ī-MP angle, Y axial angle, NP-FH angle, NA-PA angle, 1-ī angle, MP-SN angle, Po-NB, ī-NB angle, ī-NB, and MP-FH angle. RESULTS: No significant differences were found between Lhasa adolescents and normal values in terms of SNA angle, SNB angle, ANB angle, 1-SN angle, 1-NA angle, 1-NA, ī-MP angle, Y axial angle, NP-FH, NA-PA, 1-ī, and MP-SN. Po-NB was slightly greater than normal value and ī-NB angle, ī-NB and MP-FH were significantly less than normal values. CONCLUSION: Lhasa adolescents have significantly different craniofacial hard tissue structure from normal values: forward protrusion of mental region, flat mandible angle, straight mandible anterior teeth, upward and forward rotated mandible, and straight face type.     

二级及以下医疗机构开展药品不良反应监测工作的探讨

目的:为二级及以下医疗机构做好药品不良反应(ADR)监测工作提供借鉴。方法:分析二级及以下医疗机构ADR监测工作存在的主要问题,以我院为二级医疗机构模型,探讨二级及以下医疗机构如何加强ADR监测工作。结果与结论:二级及以下医疗机构ADR监测工作存在总体技术水平落后、缺乏先进信息网络、医院领导重视不够、医护人员意识不强、药学部门不能充分发挥作用等一些问题,对此应当引起重视,可通过扩大宣传、提高认识、完善组织结构和相关工作制度、发挥临床药师和护理人员的作用、建立奖惩机制等措施促进此项工作开展。     

医科和理工科联合培养医学研究生的优势

本文对医科和理工科联合培养医学研究生的优势进行了探讨,认为这种培养方式可以达到医工结合、资源共享,可以培养医学研究生的良好思维方式和科研能力,可以增强医学研究生的创新意识.同时,对高校创新教育模式及其存在问题进行了探讨.     

剖宫产术中妊娠相关性血小板减少症问题探讨

目的探讨PAT患者在剖宫产术中的可行性方法。方法正常孕妇组、血小板>80×10~9/L组、血小板50～80×10~9/L组采用不同麻醉方法及处理方式,观察术中、术后疼痛感、平均手术时间、术中出血量、术后肛门排气时间、新生儿Apgar评分的异同点。结果血小板正常组及血小板减少组在不同麻醉方法下均顺利完成手术,且术中疼痛感,平均手术时间,出血量,术后肛门排气时间,新生儿Apgar评分均无明显差异。结论在急诊剖宫产术中对PAT患者根据血小板数不同采用不同麻醉方法及处理方式,简便易行,麻醉风险减少,疼痛度小,出血量无明显增加,新生儿Apgar评分与正常组无明显差异。     

生理学教学的探讨

我国中医药领域正处于高速发展时期,需要大量有知识、有能力的高素质创新人才是中医教学的主要任务之一.生理学是基础课程,学好生理学是医学生学习医学专业课程的必备条件.由于本课程理论性较强,内容繁杂,概念抽象,难理解和记忆,因而通过改革教学模式,提高教学质量成为当前生理学教学过程中亟需解决的问题和目标.     

急诊科护士培训模式的探讨

目的:通过理论及操作技能培训,提高护士的整体素质、分诊能力、沟通能力,建立一支综合素质高,应急能力强、急救技术过硬的护理队伍。方法:从2008年起本科对在职30名护士进行了系统、全面、规范化的培训工作,制定详细周全的培训计划和考核制度。结果:护士业务技能显著提高,综合素质增强。结论:急诊护士不仅要具备较强的专业技能,还必须具备敏捷的分析判断能力与应急能力,同时应具备因其他特殊原因造成的紧急情况时的应变能力。     

The "con" of concept analysis A discussion paper which explores and critiques the ontological focus, reliability and antecedents of concept analysis frameworks

This paper draws on the work of Paley and Duncan et al in order to extend and engender debate regarding the use of Concept Analysis frameworks. Despite the apparent plethora of Concept Analysis frameworks used in nursing studies we found that over half of those used were derived from the work of one author. This paper explores the suitability and use of these frameworks and is set at a time when the numbers of published concept analysis papers are increasing.For the purpose of this study thirteen commonly used frameworks, identified from the nursing journals 1993 to 2005, were explored to reveal their origins, ontological and philosophical stance, and any common elements. The frameworks were critiqued and links made between their antecedents. It was noted if the articles contained discussion of any possible tensions between the ontological perspective of the framework used, the process of analysis, praxis and possible nursing theory developments.It was found that the thirteen identified frameworks are mainly based on hermeneutic propositions regarding understandings and are interpretive procedures founded on self-reflective modes of discovery. Six frameworks rely on or include the use of casuistry. Seven of the frameworks identified are predicated on, or adapt the work of Wilson, a school master writing for his pupils. Wilson's framework has a simplistic eleven step, binary and reductionist structure. Other frameworks identified include Morse et al's framework which this article suggests employs a contestable theory of concept maturity.Based on the findings revealed through our exploration of the use of concept analysis frameworks in the nursing literature, concerns were raised regarding the unjustified adaptation and alterations and the uncritical use of the frameworks. There is little evidence that these frameworks provide the necessary depth, rigor or replicability to enable the development in nursing theory which they underpin.     

儿科综合医院人员编制方案探讨

我国现行的《综合医院组织编制原则试行草案》是1978年制订的。30多年来,随着医疗事业的发展、国家休假制度的调整、医学人才培训体制的改变等原因,明显地反映出它已不能适应目前医院正常工作的需求,也严重影响了医院的医疗、护理及科研水平,建议国家有关部门尽快对医院编制原则进行重新调研和修订。本文对儿科综合医院人员编制进行了探讨并提出了相关建议。