An Evidence-Based Review of Total Body Irradiation

The purpose of this literature review is to investigate clinical treatment methods of total body irradiation within the context of a clinical department adopting a paediatric cohort with no existing technique. An extensive review of the literature was conducted using PubMed, Science Direct, Google Scholar, and Clinicians Knowledge Network. Articles were limited to nonhelical tomotherapy, nonparticle therapies, and those using hyperfractionated regimes. Total marrow irradiation was excluded because of national treatment and trial limitations. Of the numerous patient positioning methods present within the literature, the most comfortable and reproducible positioning methods for total body irradiation include both supine and the supine and/or prone combination. These positions increased stability and patient comfort during treatment, while also facilitating computed tomography data acquisition at the simulation stage. Ideally, dose calculations should be performed using a three-dimensional treatment planning system and quality assurance procedures that include in vivo dosimetry measurements. The available literature also suggests inhomogeneity correction factors and intensity modulation are superior to conventional open field techniques and should be implemented within developing protocols. Dynamic machine dose modulation is suggested to reduce department impact, removing the need for tissue compensators and accessory shielding devices, while providing significant improvements to treatment time and dose accuracy. Further long-term survival and intensity modulation studies are warranted, including direct comparisons of both dose modulation and treatment efficiency.     

Observations on the efficacy of combined acupuncture and medicine in Treating 50 cases of pseudobulbar paralysis

目的：观察针药结合治疗假性延髓麻痹的疗效。方法：采用完全随机抽样法分为针刺组50例，对照组48例。针刺组在西医治疗的同时，应用针刺进行综合治疗；对照组单纯接受西医药物治疗。结果：针刺组有效率为92．0％，对照组为62．5％。两组疗效差异具有非常显著性意义（P〈0．01）。结论：针药结合治疗假性延髓麻痹效果明显优于单纯西药治疗。     

Pharmacological therapy of vascular malformations of the gastrointestinal tract.

Vascular malformation (AVM) in the gastrointestinal tract is an uncommon, but not rare, cause of bleeding and iron deficiency anemia, especially in an aging population. While endoscopic coagulative therapy is the method of choice for controlling bleeding, a substantial number of cases require additional therapy. Adjunctive or even primary phamacotherapy may be indicated in recurrent bleeding. However, there is little evidence-based proof of efficacy for any agent. The bulk of support is derived from anecdotal reports or case series. The present review compares the outcome of AVM after no intervention, coagulative therapy or focus on pharmacological agents. Most of the literature encompasses two common AVMs, angiodysplasia and hereditary hemorrhagic telangiectasia. Similarly, the bulk of information evaluates two therapies, hormones (estrogen and progesterone) and the somatostatin analogue octreotide. Of these, the former is the only therapy evaluated in randomized trials, and the results are conflicting without clear guidelines. The latter therapy has been reported only as case reports and case series without prospective trials. In addition, other anecdotally used medications are discussed.     

患肢注射高浓度尿激酶治疗下肢深静脉血栓形成45例报告

探讨下肢深静脉血栓的溶栓治疗与疗效。方法 :经患肢注射尿激酶每日 75万单位溶栓治疗 4 5例下肢深静脉血栓形成。结果 :病程在 2周内溶栓治愈 72 % (18/2 5 ) ,有效率 10 0 % (2 5 /2 5 ) ,病程超过 2周溶栓治愈率 30 % (6 /2 0 ) ,有效率 85 % (17/2 0 ) ,治疗过程无出血倾向。结论 :溶栓时间越早效果越好 ,经患肢注射尿激酶的增加局部的药物浓度而且药物用量可增大     

略述中医刺血术发展史

刺血术是中医学中一种古老而独特的针刺治疗方法，文章对刺血术的发展进行了概述，并对其历史分期进行了总结。刺血术发展的四个历史阶段是：第一阶段为起源及萌芽阶段(春秋以前)，以砭石的出现及其应用标志；第二阶段为理论奠基及经验积累阶段(战国至唐)，以《黄帝内经》的问世为其理论体系形成标志；第三阶段为理论创新及特色形成阶段(宋金元)，以金元四大家刘完素、张从正、李杲、朱震亨的刺血成就为其代表；第四阶段为不断完善及日趋成熟阶段(明清)，以诸医家对瘟毒疫疠的刺血经验为其特征。     

Pharmacy customers’ views and experiences of using pharmacies which provide needle exchange services in Aberdeen and Glasgow, Scotland

Community pharmacists contribution to the management of drug problems is considerable. As the use of illicit drugs has increased, pharmacists have come under increasing pressure to offer services to problem drug users. However, there is concern among some pharmacists that offering such services may deter other customers. There is particular concern among some pharmacists about needle exchange services. Only 9.5% of Scottish pharmacies offer needle exchange services compared to 69% which are dispensing methadone (57% of which supervise methadone consumption). Qualitative interviews were used in a purposive sample of 10 pharmacies in Scotland. Eight customers were interviewed in each pharmacy to ascertain pharmacy customers’ views on these services. The majority of customers were supportive of these services. Customers were often unaware that the pharmacy they were interviewed in was offering services for people with drug problems. Pharmacy customers were more knowledgeable about, and more supportive, of needle exchange services than they were of methadone. This was because they believed needle exchange services helped to reduce the amount of discarded needles in public places. Pharmacy customers also recognised that needle exchange helped reduce the spread of disease. These findings should be used to encourage more pharmacists to offer needle exchange services.     

胸腰椎病变CT监视下穿刺活检路径分析

目的探讨胸腰椎病变CT监视下穿刺活检中穿刺路径的选择方法。方法141例胸腰椎病变临床诊断不清患者，其中胸椎70例，腰椎71例。根据病变位于脊椎的不同部位选择合适的穿刺路径，于CT监视下穿刺取材。穿刺路径：经椎旁路径63例，经椎弓根路径45例，经肋椎关节路径11例，其他路径22例。结果141例中共有128例诊断正确，穿刺结果诊断正确率为90．8％。无并发症发生。结论胸腰椎病变穿刺路径的选择要根据病变的位置不同具体分析。总的原则是安全、取材量多、对患者损伤小。