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周华  李良松 《河南中医》2016,(3):540-542
《少林寺伤科秘方》之"少林寺经验损伤方"中载有方剂共41首,其中9首为专治相应部位之跌打损伤,5首为外用方剂。其所载方药基本符合跌打损伤"气血不流行"的病机特点。"祛瘀不伤正"是贯穿于伤科整个治疗过程,对于体弱之人时刻要顾护正气。纵观书中方剂,所有药物的用量均不大,应该考虑到了祛邪不伤正的原则。所以此书中的方药剂型虽多,但不循常规。《少林寺伤科秘方》用药以活血行气化瘀为主,兼以补养正气。通过对药物使用频率的分析,当归、桃仁、红花、乳香、没药、炙甲片、香附、枳壳、苏木使用的频率相对较高,尤其是当归,当之无愧的成为治疗伤科疾病的要药。  相似文献   
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Background

Whether the choice of antibiotic prophylaxis, the type of incision, or the use of wound protectors decreases surgical site infections (SSIs) in patients undergoing pancreatoduodenectomy (PD) remains unknown.

Methods

Patients undergoing open, elective PD between January 1, 2016 and June 30, 2017 were identified from the American College of Surgeons’ National Surgical Quality Improvement Program registry. Multivariable logistic regression models were constructed to determine the association of antibiotic prophylaxis type, incision type, and wound protector use on the incidence of any, superficial, and organ/space SSIs, and to profile hospitals.

Results

Overall, 5969 patients were included from 140 hospitals. The overall rate of SSI was 20.3% (n = 1213). Superficial SSIs occurred in 432 (7.2%) patients and organ/space SSIs in 841 (14.1%). Wound protector use was associated with 23% lower odds of experiencing any SSIs (OR 0.77, 95% CI 0.60–0.98), reflective of the decreased odds associated with superficial SSIs (OR 0.65, 95% CI 0.44–0.97), but not organ/space SSIs (OR 0.89, 95% CI 0.68–1.17). Highest-performing hospitals frequently utilized broad-spectrum antibiotics, midline incisions, and wound protectors.

Conclusion

Wound protectors reduced superficial, but not organ/space, infections in patients undergoing pancreatoduodenectomy. Routine use of wound protectors in patients undergoing proximal pancreatectomy is recommended.  相似文献   
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Splanchnic exchange rates of glucose, acetoacetate, beta-hydroxybutyrate, lactate, pyruvate, glycerol, alanine, glutamine, glutamate, free fatty acids, and triglycerides were measured in eight patients during moderate to severe diabetic ketoacidosis. Their arterial glucose concentration was 20.68 (9.80-52.79) mumole/liter and tic glucose release was 0.77 (0.09-2.44) mmole/min. Gluconeogenesis accounted for about one-half of net splanchnic glucose release, assuming quantitative conversion of net splanchnic extracted lactate, pyruvate, glycerol, alanine, and alpha-ketoglutarate equivalents to glucose. Net splanchnic free fatty acid extraction was 0.24 (0.09-0.52) mmole/min. There was a positive correlation between free fatty acid uptake and ketone-body release. Net splanchnic acetoacetate release was 0.50 (0.05-0.92) mmole/min and beta-hydroxybutyrate release was 0.35 (-0.16 to 0.84) mmole/min. Total ketone-body release was 0.84 (0.37-1.61) mmole/min. The wide ranges of net splanchnic glucose and ketone-body production rates show the heterogeneous characteristics of the diabetic patient in ketoacidosis. It is concluded that the hyperglycemia and hyperketonemia of diabetic ketoacidosis is due to the lack of reciprocity among rates of hepatic glycogenlysis, gluconeogenesis, and ketogenesis resulting in inappropriate net splanchnic release of glucose and ketone bodies.  相似文献   
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In contrast to clinical practice, behavior analysis has figured but little in behavior therapy outcome research. Misconception-based fears have not been separated from those based on direct emotional (autonomic) conditioning, and in the latter category little attempt has been made to distinguish and separate cases with different antecedents of anxiety that might require different treatments. As a result, practically all outcome research comparisons have involved subject groupings of uncertain and non-uniform constitution, from which few valid deductions can be made.  相似文献   
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The extended Wolpe-Lang Fear Survey Schedule (1969) was administered to 115 female and 141 male university students. Standardized data were obtained. The clinical and research implications of the data are discussed.  相似文献   
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