预选卫生士官教育《中医理疗学》课程的建设

军医大学探索并打造一种新教育模式——预选卫生士官岗位任职教育,其中《中医理疗学》作为一门主干课程,有别于常规军医本科教育,需要从部队实际需求出发进行课程建设,其教学改革势在必行。本文针对预选卫生士官学员的特点及教学要求,总结近两年来的预选卫生士官教育情况,对《中医理疗学》课程建设情况进行初步总结与探讨。

天津市重点人群家庭医生服务利用度与满意度现况调查分析

目的调查分析天津市重点人群家庭医生服务利用度与满意度情况,从而为提升天津市家庭医生团队服务能力,促进家庭医生签约服务的开展提供参考。方法采用随机抽样方法,选取天津市16个行政区的社区居民作为研究对象,从机构的家庭医生团队签约底册中随机抽取被试样本,采用电话收集数据的方式完成对签约居民的问卷调查,根据问卷调查结果对居民服务利用情况、家庭医生服务效果等进行分析。结果居民对家庭医生签约服务的利用度、依从性和配合度较高,对家庭医生服务较认可。影响居民家庭医生服务利用度的主要因素为年龄、性别、文化程度、区域、供需不匹配以及签约服务内容等方面,签约居民对目前家庭医生签约服务总体满意度较高。结论需进一步提高家庭医生服务能力、水平及服务质量,细分居民群体,以更好地满足居民个性化需求,增加居民对签约的知晓度,优化基层医疗资源配置,提升居民满意度。

颅脑手术后应用高压氧99例

重型颅脑损伤,高血压脑出血,脑瘤原发病都比较重,术后死亡率高,后遗症重。降低其病死率,促进早日清醒,减少后遗症是当前神经外科有待攻克的难点。

The rationale behind the four major anti-COVID-19 principles of Chinese herbal medicine based on systems medicine

As the novel coronavirus disease 2019(COVID-19)and its variants continue to rage into the second year of a global pandemic,many success stories of applying Chinese herbal medicine(CHM)to treat COVID-19 patients continue to emerge from China and other part of the world.Herewith,from a systems medicine perspective,the authors analyze those experiences and categorize them into four major treatment principles:(1)focusing on eliminating toxins in the early stage of the disease,(2)tonifying deficiency of the body throughout the entire disease course,(3)treating the affected lung and intestine simultaneously based on visceral interactions,(4)cooling blood and removing blood stasis at the later stage,as well as interpret the rationale of these principles.This is helpful not only in reducing the complexity of promoting the CHM applications to enhance anti-COVID-19 efficacy,but also in ramping out the process of integrating traditional Chinese medicine with modern medical practices.

Effects of Huo Nao Fang in 60 Cases of Ischemic Apoplexy

To observe the therapeutic effects of the prescription of Huo Nao Fang (活脑方) on ischemic apoplexy,120 patients were divided into a treatment group and a control group, with 60 in each group, the formertreated with Huo Nao Fang while the latter with western medicine. The nervous function and bloodrheology were tested before and after treatment for both groups, and the effects of Huo Nao Fang wereevaluated. The results showed that the total effective rate was 91.7% in the treatment group and 61.6% inthe control group, with a significant difference (P＜0.01) between the two groups. The treatment group wassuperior to the control group in improving blood rheology, reducing blood lipid and restoring the nervousfunction (P＜0.05).

Correlation Analysis between TCM Syndromes and Physicochemical Parameters

Traditionally, differentiation of syndromes of Traditional Chinese Medicine (TCM) mainly depends on the information obtained from four diagnosis methods. Now many physicochemical parameters are available in clinic. There exists great correlation between TCM syndromes and physicochemical parameters. The objective of the paper is to analyze the correlation between TCM syndromes and physicochemical parameters quantitatively. Correlation analysis has been widely studied and many analysis methods have been developed. Mutual information based on entropy can measure arbitrary dependence between variables. It has been applied to many kinds of fields, especially to pattern recognition. But most works are restricted to discrete variables and little work has been done to study the relation between discrete and continuous variables. A novel algorithm is proposed to calculate the mutual information between discrete and continuous variables. It is used to analyze the correlation between TCM syndromes and physicochemical parameters.

EFFECT OF ELECTROACUPUNCTURE OF SCALP-POINTS ON ABNORMAL DISCHARGES OF NEURONS AROUND THE CEREBRAL HEMORRHAGE FOCUS IN THE RAT

Objective: To study the mechanism of electroacupuncture (EA) of scalp-points for regulating abnormal discharges of neurons in different regions around the cerebral hemorrhage focus by using neuro-electrophysiological methods. Methods: 80 Wistar rats (anesthetized with 20% urethane 1 g/kg, i.p.) were randomly divided into normal, saline, model and EA groups, with 20 cases in each group. Cerebral hemorrhage model was established by intracerebral injection of the rat’s own arterial blood sample (40 uL). In rats of saline group, the same volume of saline was given for intracerebral injection. Extracellular electrical activity of neurons of the caudate nucleus and parafascicular nucleus and Tail flicking latency (TFL) were used as the indexes. “Baihui”(百会 GV 20) and “Taiyang”(太阳 EX-HN 5) were punctured from GV 20 towards EX-HN 5 with filiform needles and stimulated electrically with stimulating parameters of strength of 1 V, frequency of 15 Hz and duration of 15 min. Results: Compared with normal group, TFL values of model group and EA group increased significantly (P<0.01); and compared with model group, those of EA group decreased significantly (P<0.01), suggesting that the pain threshold increased significantly in cerebral hemorrhage rats while after acupuncture stimulation, it lowered strikingly. Compared with normal and saline groups, the latency values of the pain excitement and inhibitory responses of the cellular discharges of the caudate and parafascicular nuclei in model and EA groups increased significantly (P<0.05～0.01), while after EA, it recovered apparently (P<0.01), showing an apparent regulative effect of EA on the abnormal changes of discharges of neurons around the cerebral hemorrhage focus. Conclusion: Scalp-acupuncture possesses an apparent regulatory effect on the abnormal electrical activity of neurons around the cerebral hemorrhage focus which may favor the early recovery of functional activity of neurons near the focus tissues.

Biomechanopharmacology in Evaluation of Herbs of Activating Blood Circulation to Remove Blood Stasis

Herbs of activating blood circulation to remove blood stasis (ABCRBS) are a category of over 10% in the modern Chinese Pharmacopoeia. A new borderline discipline, biomechanopharmacology, is shaping by the efforts of applying biomechanics in pharmacological studies of ABCRBS herbs. Biomechanics is involved in modeling of blood stasis syndrome (BSS) with mechanical force induced injury and model evaluation by shear stress monitoring for blood coagulation. Investigations showed that tetramethylpyrazine (TMP) contained in Ligusticum chuanxiong Hort and diallyl trisulfide (DT) extracted from garlic demonstrated inhibiting characteristics on vWF mediated platelet activation and thrombus formation occurring under high shear rates. The effect of TMP on shear-induced platelet aggregation might be due to inhibition of calcium channel activity since it showed significant inhibition on intracellular level of calcium demonstrated by laser confocal microscope. The combined effects of TMP and shear stress on rat cerebral microvascular endothelial cell (rCMEC) were investigated by various doses of TMP incorporated with different levels of shear stress generated by a rotational cone-plate rheometer. The results indicated that apoptosis of rCMECs could be restrained by a combination of medial level of shear stress with a suitable dose of TMP. To study the influences of shear stress, pressure and TMP on angiogenesis of vascular endothelial cell, cultured rCMEC was pretreated in a flow chamber with independent adjustment for levels of shear stress and pressure, and then 3D cultured on Matrigel. The results indicate that combined effects of shear stress, pressure and TMP may influence angiogenesis significantly. We believe that research on interactions among blood shear stress, secretion of endothelial cell, and pharmacodynamics will be an interesting area of biomechanopharmacology. Herbs of ABCRBS and their extracts for protecting endothelial cells to maintain their normal functions are expected.

Retrospective study on Professor Zhongying Zhou's experience in Traditional Chinese Medicine treatment on diabetic nephropathy

OBJECTIVE:To study and analyze the etiology and pathogenesis,diagnosis and prescription for cases of diabetic nephropathy(DN) treated by Professor Zhongying Zhou(Prof.Zhou) with the help of dada mining technique,so as to inherit his clinical experience and academic thoughts.METHODS:After pretreatment of the medical record information,statistical software SPSS 13.0 was used to analyze and process the standardized data using the descriptive analysis,cluster analysis and association rules.RESULTS:Ninety-four entries derived from Traditional Chinese Medicine(TCM) four-diagnostic information were selected.Through data mining,the highest frequency was yellow-thin-greasy tongue coating,followed by dark tongue,and then by thready-slippery pulse.The main self-conscious symptoms were limb numbness,dry mouth,frequent micturition,etc.With respect to pathogenesis,the etiology related to kidney reached 73.46%.The frequency of pathological factors for deficiency,blood stasis,heat,dampness,phlegm and dryness were 137.65%,80.25%,78.40%,48.77%,21.60%,and 14.20% respectively.A total of 236 kinds of herbs were used 2913 person times,averaging 17.98 herbs per prescription.CONCLUSION:The pathological location of DN is in the kidney.The pathogenesis of the disease is deficiency in origin and excess in superficiality,the former of which include deficiency of the liver and kidney,and deficiency of both Qi and Yin.The main pathological factors are blood stasis,heat,dampness,phlegm,and dryness;and they act upon each other to form the complex pathogenesis in terms of blood stasis-heat,dampness-heat,phlegm-heat,and dryness-heat.All the above factors are always crucial in the aggravation of DN throughout the whole course of its pathological evolution.