注重学生主体性的刺法灸法学习实践

围绕以学生为主体,从扩大课堂内外学习广度的角度出发,结合学生自身的教学和学习实践,并以学生自身的口吻来强调在教与学的过程中以学生为主体的重要性,为刺法灸法的学习拓宽了新的思路。     

Acute Lymphoblastic Leukemia and Klinefelter's Syndrome

Collins' law states that the period of risk for tumor recurrence is the age of the child at diagnosis plus 9 months. The purpose of this study is to validate this rule through a retrospective review of common pediatric tumors seen at 1 institution. Inclusion criteria for this study included an age at diagnosis of < 16 years old, minimum follow-up time of the Collins risk period (CRP) if child did not relapse and treatment with curative intent. The records of 424 children seen and treated for neuroblastoma (n = 98), Wilms tumor (n = 86), rhabdomyosarcoma (n = 82), medulloblastoma (n = 59), Ewing sarcoma (n = 43), ependymoma (n = 25), supratentorial PNET (n = 22), and synovial sarcoma (n = 9) from 1960 to 2001 were reviewed. CRP was calculated using the age of child at initial diagnosis plus 9 months. The median follow-up time was 164 months (range, 11–484 months), while the median follow-up/CRP ratio was 4.89 (range, 1.0–48.0). A total of 183 of 424 (43.2%) patients relapsed, with 180 (98.4%) relapses occurring during the CRP. Relapses beyond the CRP were seen in 3 young children (ages 7 months, 24 months, and 2 weeks at initial diagnosis) with a diagnosis of Wilms tumor (n = 2) and supratentorial PNET (n = 1) at 1, 3, and 26 months post-CRP. Collins' law is a useful and simple way of predicting risk period for relapse in the tumor types studied.     

认真实施“一法一例” 抓好母婴保健工作

沈阳市人大、市政府高度重视《中华人民共和国母婴保健法》和《辽宁省母婴保健条例》的贯彻实施，认真抓好宣传工作，建立起一支高素质的执法队伍，加强监督执法的力度，清理整顿了母婴保健技术服务市场，使该市的妇幼卫生工作向法制化管理迈出了一大步     

基于粗糙集的类方配伍规律研究的决策规则模型

为了挖掘类方配伍与其证候指标之间的相关关系,将粗糙集理论应用于类方配伍规律的研究,建立了类方配伍规律研究的决策规则模型。根据此模型通过属性约简可以得到类方中影响药效的核心药物,通过挖掘有效的决策规则可以分析类方内各药物之间的相互作用,并且可以利用决策规则对药效进行预测。该模型的建立对优化类方配伍及临床实践具有一定的指导意义。     

人体心脏舒张最大吸力的模拟实验研究

目的:模拟研究人体心脏舒张早期潜存的心室最大负压.材料与方法:先在血液循环体外模拟装置上模拟正常生理情况下的左、右心室心动周期压力曲线,然后近似阻断房室瓣,分别测定左、右心室压力.结果:模拟实验得到的左、右心室心动周期压力曲线和正常生理情况下的左、右心室心动周期压力曲线非常接近.近似阻断房室瓣时,左、右心室舒张的负压平均值分别是-93.25 mmHg(-12.43 kPa)和-10.28 mmHg(-1.37 kPa).结论:(1)模拟得到的实验结果可以定性地说人体心脏舒张和静脉血液回流心生物动力学关系;(2)心脏舒张时心室压力的减低(负压)是形成静脉-心房-心室压力梯度的根本原因,心脏舒张所产生的舒张吸力是静脉血液回流心室的主要动力,即静脉血液回流心脏是心脏舒张吸力作用的结果;(3)心脏前负荷产生的机理应该是心脏舒张抽吸静脉血液回流心脏所需的吸力;(4)静脉血液在被抽吸回流心室腔的过程中对心室肌没有伸展作用,即Starling心定律没有心脏舒张动力学基础.     

"医检互认"的法理审视

卫生部《关于医疗机构间医学检验、医学影像检查互认有关问题的通知》引起了社会的广泛关注。它固然存在降低医疗费用等进步之处,但不可否认也可能引起法律风险和争议,文章就此着重分析了医师的注意义务、医疗责任的划分等内容,并提出若干推进途径。     

论"医源性疾病"的法律责任

在医学界实施举证责任倒置及新的《医疗事故处理条例》后，应进一步明晰医源性疾病的法律责任问题，因为医源性疾病的定义本身就包容着承担民事法律责任的要件，鉴于医源性疾病的广袤性和它与法律关系的紧密性，对该病的研究应从缩小医源性疾病的界定范畴入手，把医与法结合起来，在加强我国卫生法制建设的同时，促进医学的进步。     

Drugs and firearm deaths in New York City, 1990–1998

Firearm deaths remain among the leading causes of mortality in the United States. Changing law enforcement activities, incarceration, drug use, and socioeconomic conditions may have played roles in the declining rates of firearm deaths during the 1990s. Using records from the Office of the Chief Medical Examiner, we analyzed the role of drugs in firearm deaths in New York City between 1990 and 1998. Positive drug toxicology was present in over half of all firearm death victims during this time. Cocaine, cannabis, opiates, and alcohol accounted for almost all of these deaths with drug-positive toxicology. There were decreases in cocaine- and alcohol-positive toxicology for firearm deaths in New York City starting in the early 1990s; there was a more gradual decrease in heroin-positive toxicology for firearm deaths. Cannabis-positive toxicology for firearm deaths increased in the early part of the 1990s and then decreased starting in the mid-1990s. Although the disparities between minority and white firearm death rates narrowed during this time, minorities remained about three times more likely to be victims of fatal firearm violence than whites in 1998. The highest firearm death rates were among African American and Latino male decedents, with a larger proportion of Latinos testing cocaine or opiate positive, while a larger proportion of African Americans tested cannabis positive. These results suggest a complex role of drugs in firearm-related deaths.