对《中药药剂学》有关问题的质疑

对中国中医药出版社2006年第一版,新世纪全国中医药高职高专规划教材（供中药学专业用）《中药药剂学》有关定义、论述及观点、技术等提出质疑,与同行切磋,使学术正本清源,教科书科学严谨。     

“罢极”音义考释

"罢极之本"语出《素问.六节藏象论》。因"罢极"一词,王冰未注,历代注家莫衷一是,争论较多。本文从训诂学角度、《素问》原文分析和肝的藏象功能特点等三个方面,详细考释,最终得出"‘罢’通‘疲’,‘极’,困也。‘罢极’即疲困、疲劳的意思,属同义词复用"的结论。并首次引用《汉书》中有关"罢极"的书证资料,丰富了中医训诂文献。     

Decreased galanin serum levels are associated with alcohol-craving during withdrawal

Background

The hypothalamic galanin expression has been associated with increased intake of carbohydrates and fats in preclinical studies. The appetite stimulating effect of galanin is thought to underlie the positive association between alcohol consumption and hypothalamic galanin expression observed in preclinical studies.

Methods

In this pilot study we investigated alterations in galanin serum levels (33 male patients) in alcohol-dependent patients during alcohol withdrawal (days 1, 7 and 14) in comparison to healthy controls (19 male controls). In order to assess the putative association between appetite regulation, galanin serum levels and alcohol consumption we additionally investigated the serum levels of insulin, glucose and triglycerides.

Results

The galanin serum levels on day 1 of alcohol withdrawal were significantly reduced in the alcohol-dependent patients (T = − 3.302, p = 0.002) and increased significantly from day 1 to day 14 of alcohol withdrawal (F = 6.437, p = 0.002). We found a significant negative association between the galanin serum levels and alcohol craving measured by the Obsessive Compulsive Drinking Scale (OCDS) (r=−0.449, p=0.009) and the obsessive subscale of the OCDS (r = − 0.521, p = 0.002) on day 1 of alcohol withdrawal. There was no association between the galanin serum levels and the parameters of energy homeostasis (triglycerides, cholesterol, insulin, and glucose) investigated.

Conclusions

Acute alcohol withdrawal was associated with decreased galanin serum levels in this pilot study. There was no association between the galanin serum levels and the parameters of energy homeostasis. Further research of galanin serum levels in active drinkers will be necessary to clarify the putative association between galanin serum levels, appetite regulation and alcohol consumption.     

Reliability and Validity of a German Version of the Questions About Behavioral Function (QABF) Scale for Self-Injurious Behavior in Individuals With Intellectual Disabilities

The psychometric properties of a German version of the Questions About Behavioral Function Scale (QABF) (Matson & Vollmer, 1995 Matson, J. L. and Vollmer, T. R., eds. 1995. User's guide: Questions About Behavioral Function (QABF), Baton Rouge, LA: Scientific Publishers.  [Google Scholar]) were examined in a sample of 522 individuals with intellectual disabilities residing in large facilities participated. The factor structure was first examined by exploratory factor analysis, yielding a five-factor-solution that was identical to the one described by the authors of the QABF and was statistically and clinically meaningful. Furthermore the factor structure was validated by confirmatory factor analysis. Fit indices indicated satisfactory model fit. Internal consistency was found to be good with Cronbach's alphas ranging from .84 to .62.

Interrater reliability was fair with intraclass correlations ranging from .66 to.58.     

云南省县域医院消化内镜诊疗现状调查及建议

目的　综合分析云南省县域医院消化内镜中心（室）的基本情况、诊疗现状等信息,为提高与规范云南省消化内镜诊疗水平提供依据。方法　采用网络调查方式开展,对2019年1月—2020年1月期间云南省县域医院消化内镜中心（室）的医疗质量相关数据信息,包括内镜中心（室）设置、人员配置、诊疗技术及诊疗量、质量控制指标等进行统计分析。结果　共有143家县域医院参加调查统计,消化内镜中心（室）平均仅1.74个操作间,内镜主机平均1.42台,胃肠镜数量平均4条,143家县域医院内镜中心（室）的超声内镜主机共10台,小肠镜主机仅2台,经内镜逆行胰胆管造影术仅4家县域医院在开展。省内县域医院专职消化内镜医师共392名,能够完成四级手术的医师仅占医师总人数的18.62%（73/392）,其中掌握内镜黏膜下剥离术的医师比例仅6.12%（24/392）。省内县域医院消化道癌早期诊断率仅19.48%（1 133/5 817）,其中食管癌早期诊断率21.04%（276/1 312）、胃癌早期诊断率19.53%（397/2 033）、结直肠癌早期诊断率18.61%（460/2 472）。结直肠腺瘤检出率12.83%（12 207/95 148）,盲肠插管成功率70.49%（67 067/95 148）,内镜黏膜下剥离术完整切除率为12.54%（221/1 763）。结论　云南省县域医院消化内镜中心（室）配置、诊疗技术水平、质量控制指标整体水平较低下,仍需要在完善消化内镜质量控制体系的基础上,提升县域医疗机构消化内镜服务能力、诊疗技术水平。     

Constructing language: evidence from a French-English bilingual child

This paper presents evidence from a French-English bilingual child between the ages of two years three months and three years five months, growing up bilingually from birth, with a French mother and English father in an English speaking environment. In focussing upon questions in the child's two languages, and charting in some detail the emergence of particular structures, it is argued that the data support a growing body of evidence that young children learn language in a piecemeal, item-by-item fashion. Furthermore, analysis of the questions in the parents' two languages suggests that the input also has an important role to play. The implications of these findings are considered with regard to the training of professionals working in early years settings.     

西北军队医院开展整体护理的难点及对策

按照医院分级管理标准对西北军队１０所医院２８个责任制护理病区进行检查，发现存在以下问题：床、护比例不合理；病房无中、高级技术职称的护理人员进行专科业务指导；医院领导对责任制护理认识不足；缺乏信息交流。以上问题均影响了新的护理制度的开展，并提出了针对性的对策。     

“新校正”非“林校”说

“新校正”是《内经素问》中北宋校书者所作注文的冠语。明清以来学者无不以为它出于林亿等人之手，故有简称“林校”之说。本文作者首次提出，“新校正”是孙兆对林亿等《补注黄帝内经素问》作再一次重新校正时使用的称谓，是用来与林亿等的校注相区别的标志；并从校注的条文总数、校注写作的年代与孙兆作“新校正”的可能性等方面，作了必要的论证。