三部六段教学法在癌病教学中的应用

[目的]探讨三部六段教学法在癌病教学中的应用效果。[方法]研究对象为广西中医药大学中医学专业本科2013级、2014级、2015级学生各240人,各级按随机数字表法分成三部六段教学组和传统教学组各120人。本研究3个年级共纳入720人,将各级三部六段教学组学生定为实验组共360人,各级传统教学组学生定为对照组共360人,由共同的老师教授第九版《中医内科学》教材癌病内容。以教学问卷调查、期末考试成绩、课后作业成绩评价两组教学效果。[结果]三部六段教学法组的期末考试及课后作业成绩均高于传统教学法组,差异有统计学意义(P<0.05);对教学效果和教学法的评价也优于传统教学法组。[结论]三部六段教学法在培养学习主观能动性、创造性思维能力、临床思维能力和综合素质上优于传统教学方法。

浅谈手术室的风险管理及预防手术室风险的措施

近年来,风险管理逐渐被纳入到医疗卫生管理中。其中,手术室风险管理是护理安全管理的基础和前提,是保障病人护理安全的必要条件。实施手术室风险管理,在提高医院的护理质量,防止意外事件的产生,化解医疗风险等方面具有重要的意义。本文通过对手术室存在的风险因素进行分析,并采取一系列的预防措施,以探讨手术室风险管理对手术室护理管理的意义。

固本解毒汤联合西药治疗晚期非小细胞肺癌随机平行对照研究

[目的]观察固本解毒汤联合化疗治疗晚期非小细胞肺癌疗效。[方法]使用随机平行对照方法,将84例门诊及住院患者按病志号抽签法简单随机分为两组。对照组42例常规化疗;地塞米松,3mg/次,5次/d,化疗前1天晚上7点及化疗当日6点口服;异丙嗪,25m L/次,化疗前30min肌注;西咪替丁,0.6m L/次,0.6m L/d,肌注;化疗期间予止吐补液。治疗组42例固本解毒汤(太子参30g,生白术10g,猪苓12g,茯苓10g,生地12g,熟地15g,当归10g,白芍5g,枸杞20g,砂仁、木香各5g,仙鹤草20g,莪术10g,甘草3g,半枝莲10g),1剂/d,水煎300m L,早晚口服;西药治疗同对照组。连续治疗21d为1疗程。观测临床症状、肿瘤体积、生活质量评分、KPS评分、不良反应。连续治疗4疗程(84d),判定疗效。[结果]治疗组完全缓解14例,部分缓解25例,稳定1例,恶化2例,总有效率95.24%。对照组完全缓解8例,部分缓解17例,稳定8例,恶化9例,总有效率78.57%。治疗组疗效优于对照组(P<0.05)。两组生活质量评分均有改善(P<0.01),治疗组改善优于对照组(P<0.05,P<0.01)。KPS评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]固本解毒汤联合化疗治疗晚期非小细胞肺癌疗效满意,无严重不良反应,值得推广。

Mechanism of Pingyang Jiangya Formula in treating hypertension based on network pharmacology and in vivo study

Objective This study aimed to analyze the mechanism of action of the Pingyang Jiangya Formula(平阳降压方,PYJYF)in treating hypertension,based on network pharmacology,and to verify the subsequent predictions through animal experiments.Methods The active components and related target genes of PYJYF were screened using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine(BATMAN-TCM),Encyclopedia of Traditional Chinese Medicine(ETCM),and Drug Bank databases and available literature.The hypertension target genes were screened based on Therapeutic Target Database(TTD),GeneCards,Online Mendelian Inheritance in Man(OMIM),UniProt,and relevant literature.The component-disease-target network intersection target genes were inputted into the STRING database,and the key target genes were selected according to the degree algorithm.Gene Ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses were performed to explore the multitarget mechanism of action and molecular regulatory network of PYJYF in the treatment of hypertension.To verify this prediction,we used PYJYF to intervene in spontaneously hypertensive rats(SHRs)and Wistar–Kyoto rats(WKY)as normal control,and the noninvasive tail artery manometry method was used to measure systolic blood pressure(SBP)in the rat tail before PYJYF intervention.After drug intervention,the SBP of each group rats were measured and compared every week.Enzyme-linked immunosorbent assay(ELISA)was used to test plasma renin,angiotensin II(Ang II),and aldosterone(Ald)levels,and hematoxylin-eosin(HE)staining was used to observe pathological damage to the renal vessels in each group of rats.Western blot and reverse transcription real-time quantitative PCR(RT-PCR)were used to detect the protein and mRNA expression levels of PI3 K,AKT1,BAX,and Bcl-2,respectively.Results A total of 4123 hypertension targets were obtained from related databases.From the TCMSP and chemical databases,78 active components of PYJYF and the corresponding 401 drug targets were retrieved.Data analysis revealed that 208 drug targets directly interacted with the hypertension targets in PYJYF.The 10 targets most closely related to hypertension target proteins in PYJYF were directly retrieved from relevant databases.GO analysis revealed that 10 direct target proteins were involved in all aspects of the antihypertensive effects of PYJYF,as well as molecular biological processes,such as the regulation of blood pressure,renin-angiotensin-aldosterone system(RAAS),angiotensin-mediated ligand reactions,and biological stimulation of cardiomyocyte apoptosis.KEGG pathway enrichment analysis revealed that PYJYF directly affected 20 signaling pathways associated with hypertension.In animal experiments,PYJYF reduced the protein and m RNA levels of PI3 K,Akt,and Bax and upregulated the expression of the protein and m RNA levels of Bcl-2,reduced plasma renin,Ang II,and Ald levels,improved the hyperactivity of RAAS,and significantly reduced SBP in SHRs.Conclusion PYJYF is effective for hypertension therapy that acts through multiple compounds and targets.The possible underlying molecular mechanism includes regulating the PI3 K/Akt signaling pathway to suppress RAAS,increasing the ratio of Bcl-2/Bax proteins,and inhibiting apoptosis,thereby mediating the repair of renal and renal vascular damage caused by hypertension.These findings warrant further research for use in clinical settings.

Treatment of insomnia in suboptimal health status with Zhuang medicine herbal-thread moxibustion:A randomized clinical trial

Objective:The objective of this study is to explore the clinical effect and safety of Zhuang medicine herbal-thread moxibustion therapy for the treatment of suboptimal health status-related insomnia through a randomized clinical trial.Methods:A total number of 60 patients with insomnia of suboptimal health status(SHS) were enrolled from the Clinic of Zhuang Medicine,Renai Branch of the First Affiliated Hospital of Guangxi University of Chinese Medicine and the Clinic of Zhuang Medicine,the First Affiliated Hospital of Guangxi University of Chinese Medicine,as well as Guangxi University of Chinese Medicine.According to the random number table method,they were randomized into a Zhuang medicine herbal-thread moxibustion therapy group(30 patients) and a western medication group(30 partients).The outcome assessors were blinded for patients allocation.In the herbal-thread moxibustion group,Zhuang medicine herbal-thread moxibustion therapy was provided once daily.In the western medication group,alprazolam tablets were prescribed for oral administration once daily.One course consisted of 10 treatments.After three consecutive courses of treatment,the score of the Pittsburgh sleep quality index(PSQI) was compared between groups,and both clinical effect and safety were assessed.Results:Sixty eligible patients were enrolled,and thirty were assigned to each group and included in the data analysis.After treatment,the score of each PSQI indicator(sleep latency,sleep duration,sleep efficiency,sleep disturbance,and daytime dysfunction) and total PSQI score were compared with those before treatment in both groups(all changes were statistically significant when P <0.05).Scores in the herbal-thread moxibustion group were superior to those in the western medication group(all values were statistically significant at P <0.05).The total effective rate was 93.3% in the herbal-thread moxibustion group and 80.0% in the western medication group(P <0.05).During treatment,no adverse reactions were reported in the herbal-thread moxibustion group.In the western medication group,three patients reported dizziness and headache,and one patient reported dry mouth,the incidence of adverse reactions was 13.3%.Conclusion:The Zhuang medicine herbal-thread moxibustion therapy is a safe and effective management strategy for the clinical symptoms of suboptimal health status-related insomnia.

讨论腰椎间盘突出按摩护理体会

目的:探讨如何有效并全面的方法使腰椎间盘突出患者找到有效的方法进行治疗,通过对穴位按摩与扣击对腰椎间盘突出症的护理,使其恢复生理功能及社会职能。方法:本文主要通过家庭按摩疗法、自我按摩疗法及其他具体方式和方法进行介绍。腰椎间盘突出症的患者由于病程较长,心理负担沉重,极其容易产生抑郁情绪,对患者应当给予开导,帮助其建立治疗的信心,除了介绍一些按摩方法之外,对患者的心理辅导也是必不可少的。穴位按摩、卧硬板床休息是治疗腰椎间盘突出症的有效方法。结果:对110例患者进行穴位按摩与扣击治疗腰椎间盘突出症的护理与分析,对患者2—5个疗程治疗,结果治愈优良率达88.3%。结论:腰椎间盘突出通过穴位按摩与护理疗效较好,且无副作用,解除患者忧虑心理,促进病情的康复。