中医药类大学生思想状况调查分析与对策

目的调研当前中医药类大学生的思想状况,为有关部门加强和改进中医药类大学生思想教育工作提供相应的对策。方法对650名学生进行多方位的问卷调查分析。结果学生思想状况主流是积极向上的,但存在一些不容忽视的问题。结论培养学生良好的道德品质、搭建学生心理调适平台等是发展中医药事业的迫切需要。     

老年性胆道疾病患者急诊外科手术治疗的临床观察

目的 探讨老年性胆道疾病患者急诊外科手术治疗的术式与疗效.方法 回顾性分析本院收治的56例老年性胆道疾病患者的病例资料,所有患者均为急诊手术治疗,并随机分为两组,治疗组使用改良胆总管空肠Roux-en-y吻合术进行治疗,对照组使用胆管十二指肠吻合术进行治疗,并对两组疗效进行对比.结果 治疗组各项指标均高于对照组,差异有统计学意义（P〈0.05）.结论 改良胆总管空肠Roux-en-y吻合术治疗老年胆道疾病患者的远期疗效要高于胆管十二指肠吻合术,其可作为急诊手术的首选手术术式.     

时毓民论治小儿慢性咽炎经验

小儿慢性咽炎根据临床表现属于中医"喉痹"的范畴,以虚火喉痹多见,多因急性喉痹反复发作,以致脏腑失调,虚火上炎所致,时毓民教授认为结合儿童本身的体质特点,小儿慢性喉痹以虚实夹杂最常见,本质是小儿肺、脾、肾先天虚弱和后天失于调养出现气血阴阳的失衡;治疗无论从脏腑虚实论治,还是从阴阳气血论治,都应标本兼顾,扶正祛邪为主要治则...     

Lymphoscintigraphy—Techniques and applications in themanagement of breast carcinoma

Radiocolloid lymphoscintigraphy is a versatile, simple technique which has been utilized extensively in the assessment of lymphatic function and structure in anatomic regions accessible to neither clinical examination nor radiocontrast lymphography, as well as in circumstances where radiocontrast lymphography is not feasible. The most important requirement for an effective study are: (a) Determination of the appropriate injection site for reproducibly visualizing the majority of the lymphatics under study and, (b) use of an agent with the optimum properties of a preformed small, uniform, well-dispersed particle colloid. Multiple applications of lymphoscintigraphy in the patient with breast carcinoma have demonstrated its value in distinguishing abnormalities of the internal mammary lymphatics shown to have significant prognostic implications, in providing accurate localization of the parasternal lymphatics for radiation therapy and its potential for determining the status of axillary lymphatics in lieu of surgical intervention. The following review is based on an experience of over 6500 studies in 5550 patients with breast carcinoma.     

长骨液在下肢骨延长中的疗效观察

目的:观察“长骨液”对下肢骨延长术后的治疗效果。方法:56例患者分为长骨液组和对照组进行配对对照观察。于术后第3天开始口服长骨液。观察骨延长区新骨生长情况、肢体伤后肿胀及并发症发生的情况。结果:①对照组平均骨延长愈合指数为41.797±3.5862(d/cm),治疗组平均骨延长愈合指数为36.291±2.8969(d/cm)(P<0.01)。②治疗组的46例病例平均骨延长愈合指数为37.121±2.2176(d/cm),明显低于国内报道指数。结论:“长骨液”有明显促进骨延长区新骨再生与成熟及减少并发症的作用。     

《基础护理学》中浪纹线的应用问题探讨

本文指出了《基础护理学》中浪纹线应用存在的一些问题,对其中的语病分为成分赘余、表意不明和不合逻辑三类,并进行了深入分析,提出了具体的修改意见。对于浪纹线应用中存在的争议进行了深入的探讨,力求引起教科书编者和编辑的高度重视,从而提高医学教材编写水平和教科书质量。     

Effect of a Boarding Restriction Protocol on Emergency Department Crowding

PurposeAccess block due to the lack of hospital beds causes crowding of emergency departments (ED). We initiated the “boarding restriction protocol” that limits the time of stay in the ED for patients awaiting hospitalization to 24 hours from arrival. The purpose of this study was to determine the effect of the boarding restriction protocol on ED crowding.Materials and MethodsThe primary outcome was ED occupancy rate, which was calculated as the ratio of the number of occupying patients to the total number of ED beds. Time factors, such as length of stay (LOS), treatment time, and boarding time, were investigated.ResultsThe mean of the ED occupancy rate decreased from 1.532±0.432 prior to implementation of the protocol to 1.273±0.353 after (p<0.001). According to time series analysis, the absolute effect caused by the protocol was -0.189 (-0.277 to -0.110) (p=0.001). The proportion of patients with LOS exceeding 24 hours decreased from 7.6% to 4.0% (p<0.001). Among admitted patients, ED LOS decreased from 770.7 (421.4–1587.1) minutes to 630.2 (398.0–1156.8) minutes (p<0.001); treatment time increased from 319.6 (198.5–482.8) minutes to 344.7 (213.4–519.5) minutes (p<0.001); and boarding time decreased from 298.9 (109.5–1149.0) minutes to 204.1 (98.7–545.7) minutes (p<0.001). In pre-protocol period, boarding patients accumulated in the ED during the weekdays and resolved on Friday, but this pattern was alleviated in post-period.ConclusionThe boarding restriction protocol was effective in alleviating ED crowding by reducing the accumulation of boarding patients in the ED during the weekdays.     

不同液体复苏方法对重症胸部创伤合并休克患者ARDS发生率及预后的改善作用

目的：：探讨急诊手术对重症胸部创伤合并休克患者ARDS发生率及预后的改善作用。方法：随机选取我院2014年5月至2016年5月收治的112例重症胸部创伤合并休克患者,依据急诊手术方法将这些患者分为常规液体复苏组( n＝56)和限制液体复苏组( n＝56)两组,对两组患者的临床疗效、ARDS等并发症发生情况及死亡情况进行统计分析。结果：限制液体复苏组患者治疗的总有效率显著高于常规液体复苏组( P<0.05),ARDS、脓胸、肺部感染发生率及死亡率均显著低于常规液体复苏组( P<0.05)。结论：急诊手术中限制液体复苏法较常规液体复苏法更能有效降低重症胸部创伤合并休克患者ARDS发生率,改善其预后。     

中药“四气”概念的起源与嬗变

＂四气＂原本是气候术语,约西汉末被引进本草,借作为药物寒热理论的总称。北宋末寇宗奭认为＂气＂即香臭之气,倡言改＂四气＂为＂四性＂,但响应者稀。金元时＂四气＂概念发生嬗变,由药性寒热扩展为天气寒热,进而区分厚薄阴阳、升降浮沉,并与人体各脏腑产生对应关系。于是＂四气＂的作用从针对病因的寒热,扩大到针对不同的病位及脏腑发挥作用。明代医家曾尝试对嬗变后的＂四气＂理论进行条理与规范。用＂四气＂概括药性寒热理论是一个创举,无须更名。其含义在历代医疗实践中不断嬗变,以适应临床所需。