基于现代医案挖掘中医药治疗慢性阻塞性肺疾病的证治规律

目的 基于文献医案借助中医传承辅助平台（V2.5）挖掘中医药治疗慢性阻塞性肺疾病（COPD）的证治规律，为中医药治疗COPD提供新思路。方法 检索中国知网（CNKI）、万方数据库（WanFang DATA）、维普中文科技期刊数据（VIP）等关于中医治疗COPD的医案，将符合纳入文献的医案整理在单独的Word文档中，经数据规范化后逐一录入中医传承辅助平台（V2.5），借助此软件携带的算法对所纳入COPD医案的“症状、中医证型、中药及中药性味归经”进行频数统计及对纳入医案的“组方规律”进行关联分析并挖掘出治疗COPD潜在的核心药对及新方。结果 共纳入103篇文献，共收集医案126个医案，共131次诊疗。经统计COPD常见的症状有咳嗽、咳痰、胸闷、气喘等；常见的中医证型有痰热壅肺证、痰瘀阻肺、肺脾气虚等；常见的中医治法有清热化痰、培土生金、降逆平喘等；其中治疗COPD的高频中药有半夏、苦杏仁、麻黄、陈皮等；常用药对组合有细辛-半夏、半夏-五味子-甘草等；并挖掘出12首治疗COPD的新方药。结论 中医认为COPD是由外邪、痰、瘀等病理因素相互形成的以咳、痰、喘为主要症状的肺系疾病，其主要的证候有痰热壅肺证、痰瘀阻肺、肺脾气虚等，“扶正祛邪”是其治疗的基本原则，在临床应采用祛痰化瘀，补益肺脾或肺肾的中医治法治疗COPD。     

丹红注射液配合苯溴马隆片治疗痛风实例

通过丹红注射液配合苯溴马隆片治疗痛风实例,说明中西医结合治疗痛风,具有治疗效果良好、无反复且副作用少的优势。     

洛阳正骨医院门诊病人退药情况分析及管理方法探讨

目的调查分析本院门诊患者退药原因，以促进合理用药。方法对本院门诊药房2010年1—12月的患者退药情况进行分类分析。结果患者退药有发生药品不良反应、不合理用药、更改治疗途径等6个原因。结论加强合理用药指导，减少不良反应，提高服务质量。     

Difficult temperament and children’s peer relations: the moderating role of quality of parent–child relationships

ABSTRACT

The current study is an examination of contributions of difficult temperament and qualities of parent–child relationship to Turkish children’s peer relations, with a specific focus on the moderating role of parent–child relationships (closeness and conflict) on difficult temperament when predicting children’s peer relations. Participants were 94 children (56 boys) with the mean age of 7.05 years (SD?=?.88) enrolled in 24 classrooms from five elementary schools in a suburban school district in Turkey. Mothers reported on parent–child relationships and child temperament, and teachers reported on peer relations. Results from the hierarchical regression analyses showed that parent–child conflict was negatively associated with children’s peer relations. Parent–child conflict moderated the association between children’s difficult temperament and their peer relations. Children who experienced low levels of parent conflict and were not temperamentally difficult showed more positive peer relations as rated by their teachers. Limitations and future directions of the current study are discussed.     

Incidence,causes, and management of failed awake fibreoptic intubation—A retrospective study of 833 procedures

Awake fibreoptic intubation has been considered a gold standard in the management of the difficult airway. However, failure may cause critical situations. The aim of this study was to investigate the incidence and causes of failed awake fibreoptic intubation at a tertiary care hospital. The study was conducted at St. Olav University Hospital in Trondheim, Norway. Problems occurring during anaesthesia are routinely recorded in the electronic anaesthesia information system (Picis Clinical Solutions Inc.), including difficult intubations. We applied text search on all anaesthesia records between 2011 and 2021 and identified 833 awake fibreoptic intubations. The anaesthesia records were examined to identify failed awake fibreoptic intubations, the cause of failure and how the airway ultimately was secured. Among 233,938 patients who received anaesthesia, 90,397 received tracheal intubation and 833 received awake fibreoptic intubation. Twenty-nine of the procedures failed. In nine patients the failure caused loss of airway control with desaturation and hypoventilation. The major causes of failure were dislodged tube after induction of general anaesthesia (n = 8), patient distress (n = 5), tube not able to pass (n = 5), and airway bleeding (n = 3). The situations were primarily solved using direct laryngoscopy, with or without bougie, or with video laryngoscopy. Tracheostomy was performed in four patients. Awake fibreoptic intubation failed in 3.5% of patients, most often due to dislocation, problems passing the tracheal tube, or patient discomfort. The failure rate was higher than in previous studies.     

疑难ICD-9疾病编码1例

正确掌握ICD-9编码，是病案管理人员的基本技能。对于个别疑难患者的编码，首先从掌握疾病名称的内涵着手，根据发病机理，反复进行推敲，直至得到正确编码，为临床从事医教研活动提供正确的医疗资料。     

中国县及县以上医疗机构2005年死亡病例漏报及报告质量评价

目的了解中国县及县以上医疗机构网络直报死亡病例的漏报情况,评价网络直报死亡病例的报告质量。方法使用分层随机抽样的方法在全国范围内抽取130家医疗机构开展调查,分别使用现场调查数据和网络直报数据评价医疗机构死亡病例漏报及其报告质量。结果2005年全国的县区报告率为78．25％,单位报告率为37．93％,与2004年相比略有下降;全国平均报告合格率为79．62％,比2004年有所提高;县及县以上医疗机构死亡病例有明显编码错误的比例为24．68％。现场调查共收集门诊、急诊、住院部死亡病例5226例,全国县及县以上医疗机构死亡病例总的漏报率为33．07％,不同级别医疗机构死亡病例漏报率的差异无统计学意义。结论全国县及县以上医疗机构死亡病例网络报告系统自运转以来,提高了数据报告的及时性,但也存在不足,如死亡病例存在缺漏报、及时性和编码准确性还有待提高,多系统并存工作重复的医院不在少数,应逐步建立全国统一的生命登记系统。     

Acupuncture Treatment for Optic Nerve Contusion

Optic nerve contusion is a commonly-seen eye injury, which is mostly caused by traffic accident, collision, and falling. Early diagnosis and timely emergency treatment can make such patients restore vision to a certain extent. Otherwise, there may appear optic atrophy or loss of vision. At present, in the treatment of this disease, cortical hormone, dehydrating agent, vasodilator, vitamin, energy mixture and neurotrophic agent, or surgical operation can all give certain therapeutic effect. In the recent 5 years, the Department of Ophthalmology of the Hospital Affiliated to Hubei College of Traditional Chinese Medicine has adopted acupuncture for treatment of optic nerve contusion, and obtained quite good therapeutic results. Some typical cases are reported in the following.     

A multilevel time-series model for the incidence of AIDS cases in Spain

OBJECTIVE: The main aim of this research is to study the quantitative evolution of the incidence of AIDS in the 19 Spanish Communities. The hypothesis is that incidence follows a multilevel autoregressive model, where each Community shows random variability around a general process. METHOD: On the basis of official data on the number of existing AIDS cases, an autorregressive multilevel time-series model was developed. RESULTS AND CONCLUSIONS: Analysis shows that the hypothesis is supported, indicating that overall AIDS incidence in Spain has already reached a maximum and has a tendency to remain stable or to decline in future. Long term expected values have become stable in most Communities; a slight increase is expected only in Extremadura. However, this Community has a relatively sparse population, and its contribution on the overall Spanish incidence is small.Long term expected values are estimated to be around 152.99 new cases per million inhabitants per year. This value is slightly smaller than the maximum incidence, observed in 1994 (179.4 cases).     

胃平滑肌肿瘤12例临床分析

本文报告我科从1972年7月－1994年底共收治经手术和病理证实胃平滑肌肿瘤12例，其中平滑肌瘤6例，平滑肌肉瘤6例，临床没有特异性表现，腹痛，出血和腹块是最常见的三大症状。术前诊断困难，误诊率为83．3％，X线和胃地诊断有重要意义，积极的手术切除治疗肉瘤五年生存率为50％。