河间学派之玄府探微

玄府首见于《黄帝内经》,经后世补充完善,至金元时期河间学派代表人物刘完素将其提炼为"升降出入"指导临床实践,河间学派门人后学亦秉承该理论,并各有侧重,如刘完素倡导出以宣通、张从正遵循下以通降、李东垣重视升以提清、朱震亨强调入以滋阴,共同发展和完善了玄府理论;现代学者围绕玄府的特性,提出与之相应的现代医学微观结构假说,促进了玄府理论在形质研究上的发展。本文通过论述河间流派对玄府及其升降出入理论的认识,加以严谨的探讨和总结,以期对玄府理论提供借鉴。     

国境卫生检疫行业标准体系修订初探

目的本文旨在从理论上探讨国境卫生检疫行业标准框架修订的必要性和重要性。方法回顾卫生检疫行业标准的发展和分类,提出对现有行业标准框架的修订意见。结果新的体系框架它对于规范和促进卫生检疫业务、在系统内开展基础培训、培养一专多能型人才起到了应有的作用。结论近十年来卫生检疫面临的形势不断变化,原有的标准体系已经难以适应当前工作需要,亟需进行修订规范。     

T-SPOT与结核菌素实验对结核病患者的临床诊断价值分析

目的分析T-SPOT与结核菌素实验对结核病患者的临床价值。方法选取2015年12月～2017年12月疑似结核病患者202例,经过实验组织学检验100例患者确诊为结核病患者,进行外周血T-SPOT检测和结核菌素实验,比较两组患者诊断结果。结果以最终实验组织学检验为金标准,T-SPOT阳性检出率明显优于结核菌素检出率,差异具有统计学意义(P0.05),T-SPOT监测灵敏度、特异度、准确度均优于结核菌素实验,差异具有统计学意义(P0.05),T-SPOT检测Kappa值为0.985,说明一致性良好,结核菌素实验检测Kappa值为0.512,说明两者一致性中等。结论利用T-SPOT诊断结核病患者,敏感度高且特异性明显,对结核和肺外结核都有很好的应用价值,值得推广应用。     

产后产道血肿16例临床分析

产后阴道显性流血常为助产者所重视,而产道的隐性出血即产道血肿易被忽略,影响产妇康复,甚至威胁产妇生命.1临床资料①一般资料:本院8年来经阴道分娩3200例,发生产后血肿16例,发生率为0.5%.其中初产妇14例,经产妇2例.②血肿情况:a.血肿大小,血肿范围最大直径＜4 cm者8例,4 cm～6 cm者6例,＞6 cm者2例.b.血肿发生时间,在第三产程时被发现者3例,产后2 h被发现者8例,产后2～24 h被发现者3例,产后＞24 h被发现者2例.     

新药甲磺酸帕珠沙星的手性拆分

目的：建立新药甲磺酸帕珠沙星手性拆分的方法。方法：运用AD手性柱法和流动相添加剂法，考察了不同条件下对分离的影响。结果：运用这两种方法，甲磺酸帕珠沙星都可以达到基线分离，相同条件下，柱温越低，拆分因子越大。结论：在分离甲磺酸帕珠沙星时，流动相添加剂法要优于手性柱法。     

低蛋白饮食对环孢素A肾病大鼠肾间质纤维化的作用

Objective To investigate whether low-protein diet has protective effect on the progression of renal interstitial fibrosis in rats with cyclosporine A (CsA)-induced nephropathy. Methods Eighteen male Sprague-Dawley rats were randomly divided into three groups (6 rats in each group). The rats in control group (C group) received common diet; in model group (M group) low-salt diet; in intervention group (Ⅰ group) low-salt and low-protein diet. After diet adaptation period of one week, the rats in C group received subcutaneous injection of olive oil 1 mg/kg daily for 5 weeks, while M group and Ⅰ group subcutaneous injection of CsA (diluted into 25 g/L with olive oil) 1 ml/kg for 5 weeks. All the rats were sacrificed at the end of the 5th week. The food-intake and body weight were measured daily. The creatinine clearance (Ccr) was examined before rats were sacrificed. The semi-quantitative pathological analysis on kidney sections was performed. The mRNA and protein expression of transforming growth factor-β1 (TGF-βI) and type Ⅰ collagen (Col Ⅰ) in kidney tissue was determined with real time PCR and immunohistochemical staining, respectively. Results The food-intake and body weight of rats in M and I groups were significantly lower than those in C group (P<0.05). Compared with C group, the Ccr levels in M and Ⅰ groups were significantly reduced [(0.65±0.15) ml/min, (0.40+0.13) ml/min vs (1.55±0.29) ml/min, P<0.05], the relative fibrosis areas of kidney interstitium in M and I groups were significantly increased (3.60%±0.46%, 3.26%±0.75% vs 0.44%±0.24%, P<0.05), the mRNA and protein expression of TGF-β1 in M and I group was significantly up-regulated (by 2.6 and 3.1 times in mRNA and by 1.5 and 1.6 times in protein, respectively, P<0.05), and the mRNA and protein expression of Col Ⅰ in M and I groups was also significantly up-regulated (by 3.0 and 3.5 times in mRNA and by 2.3 and 2.1 times in protein, respectively, P<0.05). There were no significant differences between M and I groups in every parameters above-mentioned except the rat body weight and Ccr. Both the body weight and Ccr in Ⅰ group were significantly lower than those in M group (P<0.05). Compared with C group, the urine osmotic pressure in M group and in I group were deceased (for M group, P>0.05; for I group, P<0.05). Compared with C group, the serum cholesterol levels in M and I groups were significantly increased (P<0.05), and the serum phosphorus level in I group was significantly decreased (P<0.05). The levels of serum albumin and serum calcium of all three groups had no statistical differences (P>0.05). Conclusion Low-protein diet has no renoprutective effects on the rat model of cyclosporin A nephropathy, on the contrary, may induce body weight loss.     

脑血管病引起眩晕的临床观察

临床上能引起眩晕的疾病很多,其中因脑血管病变引起的眩晕占大多数.为明确眩晕原因,及时给予病人正确治疗,减轻病人痛苦,笔者将我院自1994-1999年间共收治因脑血管病变引起的眩晕患者100例进行分析总结,报告如下.     

氩激光治疗中心性浆液性脉络膜视网膜病变

中心性浆液性脉络膜视网膜病变（CSR）是临床常见疾病。现将我院2002—12～2005—10行氩激光光凝治疗的23例CSR总结报告如下。