国医大师韦贵康手法治疗脊柱源性血糖异常的经验总结

韦贵康教授在脊柱及相关疾病的手法治疗方面具有独到的治疗理念及丰富的治疗经验,文章介绍了韦贵康教授对脊柱源性血糖异常的相关认识,从脊督一体观出发认为脊柱与督脉是一个整体,而血糖水平的异常与及督脉密切相关,进而与脊柱的异常(如脊柱失稳错位与局部软组织的病变等)息息相关,故而对于因脊柱异常所导致的血糖水平异常,则需从调整...     

基于知识图谱构建和定性访谈法探析张忠德教授辨治间质性肺病临床特征与方药规律＊

目的 构建个性化知识图谱技术和定性访谈法结合，进一步挖掘张忠德教授辨治间质性肺疾病临证特征与用药规律。方法 采用回顾性分析，系统收集张忠德教授广东省中医院门诊2010年8月至2020年8月治疗间质性肺疾病病历，按照诊断标准、纳入标准、排除标准，严格筛选后，通过广东省中医院大数据挖掘团队中医药大数据智能处理与知识服务系统进行数据挖掘分析，并通过多元化视觉定性访谈法，将定量与定性分析有效结合。结果 共筛选出347首方，共141味药物，常用药物频次 ≥ 84次的药物有10味，其中党参、麦芽、黄芪、紫菀、白术等为核心用药，通过症状与药物推理知识地图显示，党参、炒麦芽、黄芪、大枣、太子参、山萸肉、巴戟天等为主要治疗用药；临证遣方用药知识关联分析，得知咳嗽、耳鸣、心悸、水肿、头痛、胸闷、恶寒等为多见，针对咳嗽，首选紫苏子、橘红、桂枝等温肺降气通阳之品等；频繁聚集显示，常用药对炒麦芽-炒白术、黄芪-党参、黄精-菟丝子、前胡-紫菀、炙枇杷叶-浙贝母等；聚类分析结果得到4组关系密切的聚类新药物组合；以脾为中轴，肺肾共扶为主的“平调五脏论”，分期阶梯辨治间质性肺疾病。结论 张忠德教授认为间质性肺疾病，虚实夹杂为多见，应从肺、脾、肾着手，采用平调五脏论分期阶梯辨治，用药配伍精简，以和为贵，以平为期。     

诊断学教案书写体会

教案书写是教师上课的总体设计和思路的书面反映，是高质量课堂教学的保障。文章结合作者自己的诊断学教学实践，从教学目标、重点难点、教学方法、教学过程、课后记五个方面总结了教案书写的心得体会。     

医德医风教育与建设之我见

医德医风,事关民生,事关医疗卫生行业形象,事关党和政府与人民群众的血肉联系。我院主要从建立组织管理,完善制度建设,拓展监督渠道,强化服务考核四个方面,不断深化医德医风教育与建设。有效地提高了患者满意度和社会信誉度,树立了医院的良好形象。     

人工全髋置换术后的护理分析

目的：总结行人工全髋置换术的护理要点,为今后的护理工作提供可靠依据。方法将2013年1月-2014年12月该院收治的26例行人工全髋置换术患者纳入该研究,并对26例患者的手术护理体会进行回顾性总结。结果经专科护理后,患者的疼痛程度、关节恢复情况及生活质量显著高于护理前(P<0.05),差异有统计学意义。结论对行人工全髋置换术的患者进行全面的专科护理,并做好预防并发症的准备,能有效提高患者的治疗效果。     

The relationship between hospital or operator volume and outcomes of coronary patients undergoing percutaneous coronary interventions

Summary The relationship between volume and outcome in medicine has been intensively investigated in the last few decades. The large amount of accumulated data demonstrates that for many surgical or non-surgical procedures and medical conditions, patients being treated in high-volume hospitals or by high-volume physicians have lower mortality rates and better quality of life compared to those treated by low-volume hospitals or by low-volume physicians. Although the degree of the relationship between high volume and better outcome varies, it is persistent across a wide range of procedures and conditions.Percutaneous coronary interventions (PCIs) have an important impact on public health, given the frequency of coronary heart disease for which these procedures are performed. Studies carried out before and after the advent of stents on the relationship between volume and outcome for PCIs have almost consistently reported that performance of PCIs in high-volume institutions or by high-volume operators is associated with improved outcomes for patients, regardless of the specific indication for PCI.For those procedures for which a relationship between high volume and better outcome has been clearly demonstrated, patients as well as their referring physicians should be informed that patients can benefit both in terms of reduced mortality and improved quality of life if they are treated by high-volume health care providers. Consequently, for these procedures, a health care policy aiming at their concentration in high-volume institutions should be strongly considered.     

不同国家和地区学校卫生工作模式比较和借鉴

通过比较不同国家和地区学校卫生工作的建设和发展状况,运用归纳法和比较分析法总结各国学校卫生工作模式,分析各模式的特点和发展趋势。在此基础上,结合我国学校卫生工作的实际,借鉴国外理念和方法,提出相关建议。     

Unpleasant Subjective Emotional Experiencing of Pain

The field of pain medicine that once began as a supportive and compassionate care, adding value to the management of acute and chronic ailments, has now transformed into a vital and essential specialty with structured training programs and service units with professionals dedicating their careers to it. The expansion of understanding of the direct relationship of pain relief to the quality of life, uncovering of neuronal pathways, and technological advances in imaging as well as in interventional techniques have all contributed to this phenomenal growth. However, there is a growing concern whether the training programs and the specialized practitioners are gradually limiting their skilled inputs primarily within the sensory realm of the pain experience with sophisticated interventional techniques and relegating its subjective and emotional dimensions to perfunctory realms within the schema of service provision. While the specialty is still young, if we can understand the inherent aspect of these dimensions within the pain experience and acknowledge the gaps in service provision, it may be possible to champion development of truly comprehensive pain relief programs that responds effectively and ethically to a patient''s felt needs. This article attempts to position the subjectivity of pain experience in context and surface the need to design complete systems of pain relief services inclusive of this dimension. It presents authors’ review of literature on perspectives of ‘unpleasant subjective emotional experiencing of the pain” to elucidate possible clinical implications based on the evidences presented on neuro-biology and neuro-psychology of the pain experience; the aim being to inspire systems of care where this dimension is sufficiently evaluated and managed.     

杨少山运用千金苇茎汤临证思路与验案3则

国家级名老中医杨少山对千金苇茎汤的运用有自己独特的见解,不囿于古法,除用于治疗肺痛外,亦用于治疗其他肺系疾病或肠道疾病。