尤昭玲教授运用中医药对宫腔粘连致不孕症的诊疗特色

宫腔粘连(IUA)又称Asherman综合征,是宫腔内膜受损导致宫腔部分或全部粘连的现象,90％以上系刮宫损伤子宫内膜所致[1],其他原因致IUA的有子宫内膜结核、子宫肌瘤挖除术、诊断性刮宫术等.其主要表现为月经量减少甚至闭经,周期性下腹痛,流产和继发性不孕.宫腔粘连严重影响妇女生活质量,对有生育要求的患者影响更大.近年来,其发病率呈上升趋势.经阴道超声检查无创、便捷、费用低,其对中、重度宫腔粘连的检出率较高,分别为71.7％(33/46)和82.1％(23/28)[2],是宫腔粘连的重要辅助检查.     

昆明医科大学护理专业学生职业安全态度与职业暴露的关系调查

目的：了解昆明医科大学在校护理专业学生职业安全态度、职业暴露、专业意愿的现状,探讨其职业安全态度与职业暴露的相关关系,为改善护理人员的职业安全操作、减少职业暴露,提出切实有效的干预措施．方法对昆明医科大学在校护理专业854名学生进行问卷调查,调查内容包括人口学特征、职业暴露情况、以及职业安全态度．采用简单线性相关分析职业安全态度与职业暴露的相关关系．结果调查对象中女性所占比例居多,占94.30%,男性仅占5.7%;平均年龄（22.52±2.90）岁．简单线性相关分析可得：“消极态度”与职业暴露呈正相关,“管理者的支持”、“乐观态度”与职业暴露呈负相关,其P值均小于0.05．结论职业安全态度与职业暴露有关,护理人员应该规范操作,提高自我的专业素质和业务能力;学校要加强对护理学生的职业防护教育,做好就业前的培训工作;医院管理层要定时组织护理人员学习职业暴露的防护知识,对护士在工作中所取得的成绩给予充分的肯定,并适当地给予一定的奖励．     

双波长薄层扫描法测定风油精中华蟾毒精的含量

应用双波长薄层扫描法测定了风油精中蟾酥的含量。特别对蟾酥中含量较高的华蟾毒精进行了定量测定。薄层色谱条件：固定相为硅胶ＧＦ２５４,展开剂为苯－丙酮（７：３）;λｓ＝２８０ｎｍ;λＲ＝３３５ｎｍ;回收率为１００．６％;ＲＳＤ为３．９％（ｎ＝５）。本法准确简便,也可供其它含蟾酥制剂进行定量分析。     

“神转不回，回则不转”理论治疗痫证临证探微

[目的] 探求“ 神转不回,回则不转”理论的内涵及其临床治疗痫证的运用。[方法] 通过查阅《黄帝内经》及后世医药典籍等,分析“神转不回,回则不转”理论,依此阐释痫证病机及立法选方,分析典型案例以论述其理论。[结果] 痫证是由神气逆乱、三焦不通而诱发,五脏不平、内生积滞致痫证不愈,神回不转,神机失用,痫证避无可避,方以柴胡加龙骨牡蛎汤为基础,整理三焦枢转五脏神气,荡平五脏积滞并解其标。所举验案为气机阻滞、痰火扰神之证,治以清肝泻火、豁痰醒神之法,方用柴胡加龙骨牡蛎汤合涤痰汤加减,辄收佳效。[结论“] 神转不回,回则不转”说明人之神机、气血阴阳不能逆乱,应当在各脏间一以贯之流转,每脏间如环无端运转;痫证的治疗应以“通”字为法,方以柴胡加龙骨牡蛎汤加减,旨在通调使道,平治五脏,标本兼顾,恢复神机,并以言语宽慰,则可痫定神安。     

A comparison of the Enk Fiberoptic Atomizer Set™ with boluses of topical anaesthesia for awake fibreoptic intubation

We compared the Enk Fiberoptic Atomizer Set^? with boluses of topical anaesthesia administered via the working channel during awake fibreoptic tracheal intubation in 96 patients undergoing elective surgery. Patients who received topical anaesthesia via the atomiser, compared with boluses via the fibreoptic scope, reported a better median (IQR [range]) level of comfort: 1 (1–3 [1–10]) vs. 4 (2–6 [1–10]), p < 0.0001; experienced a reduced total number of coughs: 6 (3–10 [0–34]) vs. 11 (6–13 [0–25]), p = 0.0055; and fewer distinct coughing episodes: 7% vs. 27% respectively, p = 0.0133. The atomiser technique was quicker: 5 (3–6 [2–12]) min vs. 6 (5–7 [2–15]) min, p = 0.0009; and required less topical lidocaine: 100 mg (100–100 [80–160]) vs. 200 mg (200–200 [200–200]), p < 0.0001. Four weeks after nasal intubation, the incidence of nasal pain was less in the atomiser group compared with the control group (8% vs. 50%, p = 0.0015). We conclude that the atomiser was superior to bolus application for awake fibreoptic tracheal intubation.     

Targeted-HASTE imaging with automated device tracking for MR-guided needle interventions in closed-bore MR systems.

Percutaneous MR-guided interventions with needles require fast pulse sequences to image the needle trajectory with minimal susceptibility artifacts. Spin-echo pulse sequences are well suited for reducing artifact size; however, even with single-shot turbo spin-echo techniques, such as rapid acquisition with relaxation enhancement (RARE) or half-Fourier acquisition single-shot turbo spin-echo (HASTE), fast imaging remains challenging. In this work we present a HASTE pulse sequence that is combined with inner-volume excitation to reduce the scan time and limit the imaging field of view (FOV) to a small strip close to the needle trajectory (targeted-HASTE). To compensate for signal saturation from fast repeated acquisitions, a magnetization restore pulse (driven equilibrium Fourier transform (DEFT)) is used. The sequence is combined with dedicated active marker coils to measure the position and orientation of the needle so that the targeted-HASTE image slice is automatically repositioned. In an animal experiment the coils were attached to an MR-compatible robotic assistance system for MR-guided interventions. Needle insertion and infusion via the needle could be visualized with a temporal resolution of 1 s, and the needle tip could be localized even in the presence of a stainless steel mandrel.     

轻浅慢针法及其临床运用举隅

根据疾病特点和临床诊疗经验创立轻浅慢针法。介绍该针法的操作方法、功效和适用证，并例举该针法治疗智力低下、小儿抽动症和结节性红斑验案三则。     

朱晓男分期辨治湿热毒盛糖尿病足

朱晓男教授认为糖尿病足多因消渴日久,气阴受损,脉道不利,血行瘀滞,瘀久化热,热盛肉腐或在某些外因诱发下局部感染毒邪所致;病位在血脉,病性为本虚标实;气阴两虚为本,湿热蕴阻、脉络瘀阻为标,湿热、瘀血即是气阴两虚的病理产物,又是消渴导致脱疽的病理因素。湿热毒盛糖尿病足发病迅速,易于变化,若失治、误治易出现损筋坏骨等严重病理变化;又因足部皮薄近骨且间隙较多,常引起深部组织及骨关节间化脓性感染而出现损筋坏骨等严重病理变化;虽属"疽"的范畴,又兼具"疔"的特点,临症要有"走马看疔"的态度,严密观察,病不容缓,及时应对,不可贻误;分为急性期、缓解期、恢复期,中西医结合综合内外兼治,标本合治,适时祛腐切开引流,清脉康洗剂浴足,内服糖足方,外用一效膏、油调膏等,各有侧重,注重局部,兼顾整体。