State of the art contemporary treatment of patients with ST elevationmyocardial infarction： pre- and in-hospital organization,devices anddrugs

Objective To review the presentation, diagnosis and recent developments in the pharmacological and invasive treatmentof ST elevation myocardial infarction （STEMI） with a special focus on health-care organization in order to increaseaccessibility of primary percutaneous coronary intervention （PCI）.     

Exploration of Stratified Evidence Scoring Method of Acupuncture Clinical Practice Guidelines

Due to its own internal laws of development,Chinese medicine(CM)seems more inclined to empirical medicine in a relatively long historical period.It is considered to be lacking objective and unified clinical practice guidelines(CPGs),and the difficulties in diagnosis and therapeutic effect evaluation comes with it,have restricted its further inheritance,development and international communication.Over the years,our research group has been committed to improving the standardization theory and methodology of CM,also perfecting relative techniques for further application,which are all based on the stratified evidence scoring method.We have already applied this method to 45 issued guidelines,including 5 national guidelines,3 industrial guidelines,and 37 formulation/revision social organization guidelines.The stratified evidence scoring method has been recognized and used widely.It helps scholars and applicators to study,formulate,publish and popularize the acupuncture therapy clinical practice guidelines better,thus further promotes the development of acupuncture therapy.     

John Murtagh全科病案研究(五)——7岁男孩24小时内疲乏嗜睡发热呕吐皮疹

1病例简介患儿,男,7岁,突发高热,精神萎靡,嗜睡。发病12h后厌食,呕吐3次后就诊。患儿自诉头痛,在胸部和背部发现细小皮疹。体检结果提示,患儿明显地表现为麻木状态,面色潮红,病态显著。躯干上发现一些细小的斑点状皮疹。四肢末端温度较低,而且毛细血管回流低于正常。生命体征为     

感冒的病因与诊治

由上海强生制药有限公司与<中国社区医师>杂志社联合开展的"强生泰诺杯--社区爱心天使大奖赛"已启动,请根据相关文章将第3期、7期、11期、15期的参赛答题卡连续4次正确填写并按要求回寄给我们,您可获国家一类学分4分并有资格参加"强生泰诺怀-社区爱心天使大奖赛".     

震后皮肤病预防与治疗

传染性软疣 由传染性软疣病毒引起,一般可通过直接接触传染,也可自体接种,儿童常见.皮损为有圆形或半圆形丘疹,呈肉色或粉红色,有蜡样光泽,中心呈脐凹状,含有干酪样物,数目较多,多发于前胸后背,可挤压出.治疗可用小镊子夹住疣体,将之挤出或挑出干酪样物,外涂2%碘酒.     

Bloodletting Puncture at Hand Twelve Jing-Well Points Relieves Brain Edema after Severe Traumatic Brain Injury in Rats via Inhibiting MAPK Signaling Pathway

Objective:To investigate whether blood-brain barrier(BBB)served a key role in the edema-relief effect of bloodletting puncture at hand twelve Jing-well points(HTWP)in traumatic brain injury(TBI)and the potential molecular signaling pathways.Methods:Adult male Sprague-Dawley rats were assigned to the shamoperated(sham),TBI,and bloodletting puncture(bloodletting)groups(n=24 per group)using a randomized number table.The TBI model rats were induced by cortical contusion and then bloodletting puncture were performed at HTWP twice a day for 2 days.The neurological function and cerebral edema were evaluated by modified neurological severity score(mNSS),cerebral water content,magnetic resonance imaging and hematoxylin and eosin staining.Cerebral blood flow was measured by laser speckles.The protein levels of aquaporin 4(AQP4),matrix metalloproteinases 9(MMP9)and mitogen-activated protein kinase pathway(MAPK)signaling were detected by immunofluorescence staining and Western blot.Results:Compared with TBI group,bloodletting puncture improved neurological function at 24 and 48 h,alleviated cerebral edema at 48 h,and reduced the permeability of BBB induced by TBI(all P<0.05).The AQP4 and MMP9 which would disrupt the integrity of BBB were downregulated by bloodletting puncture(P<0.05 or P<0.01).In addition,the extracellular signal-regulated kinase(ERK)and p38 signaling pathways were inhibited by bloodletting puncture(P<0.05).Conclusions:Bloodletting puncture at HTWP might play a significant role in protecting BBB through regulating the expressions of MMP9 and AQP4 as well as corresponding regulatory upstream ERK and p38 signaling pathways.Therefore,bloodletting puncture at HTWP may be a promising therapeutic strategy for TBI-induced cerebral edema.     

《安徽医学》版权声明

本刊已建立数字化期刊,本刊及本刊合作机构通过光盘、网络、手机等载体传播本刊论文,论文著作权使用费及相关稿酬,本刊均用作为作者文章发表、出版、推广交流（含信息网络）以及赠送样刊之用途,即不再另行向作者支付。     

劳务女工孕期血铅水平与血压相关性研究

目的 探讨劳务女工孕期血铅水平与其血压的关系,为改善围生期工作,促进孕妇健康提供参考.方法 对2008年3月至2009年11月在深圳市宝安区妇幼保健院产前门诊建卡的劳务女工孕妇进行问卷调查、血压及血微量元素浓度测定.随机选取其中897例资料完整并在深圳居住满2年者作为研究对象,采用简相关和回归方法评价血铅与血压的关系.结果 孕妇血铅均值为(45±23)μg/L;家族史、体质量指数(BMI)、血铅浓度对血压升高有预测作用;在血铅56 μg/L分界点时,两组舒张压比较差异有统计学意义(P＜0.05);高铅组(血铅浓度≥100 μg/L)收缩压、舒张压均显著高于低铅组(P＜0.05).结论 低铅暴露是致孕妇血压升高的危险因素之一,铅对血压的影响以舒张压更为敏感. Abstract： Objective To observe the degree of blood lead in pregant women and the influence of different levels of blood lead on blood pressure under environmental lead exposure, in order to previde basic evidences for taking the further measures. Methods A quesionnaire survey was administed, blood pressure and the serum of microelements were tested for the pregnant women who took the prenatal examinationin the Maternal and Child Care Service Centre of Baoan between March 2008 and November 2009, gathered 897 pregnant women whose materials were complete and stayed in Shenzhen more than one year as the study objects. Compare the differences between groups distributed by quartileand carried out the pair matching study. Correlation, stepwise regression analysis and T test were usedto statistic. Results The average of blood lead was (45±23)μg/L;The Bivriate correlations showed the association between blood lead and blood pressure was positive. Stepwise regression analysis indicated family history, BMI,blood lead were predictors of increasing blood pressure. After excluding the confounding factors, on the 56 μg/L the diastolic pressure(DBP) with statistical significance (P＜0.05);Blood pressure of case group was higher than that of control group with significant difference (P＜0.05). Blood calcium of case group was lower than that of control group without statistical significance (P＞0.05). Conclusions The results indicate the degree of blood lead of pregnant women in Shenzhen is low. Environmental lead exposure is one of the dangerous factors of increasing blood pressure .DBP is more sensitive to lead.     

激素应用的误区——镇痛

先讲一个真实的病例。半年前早春时节,田嫂因在山间水田里劳动时感受风寒,诱发旧病关节痛,听邻居说激素药强的松有消炎、止痛作用,治疗关节痛有特     

直肠癌脐孔牛角样转移1例

1病历摘要患者,男,36岁。1994年2月排便时下腹部坠痛不适,大便时干时稀,带黏液,脐孔红肿,两家医院按肠炎、脐炎治疗无效。1994年5月患者自感脐部皮下肿硬,不久脐孔长出玉米粒大角状物,迅速膨胀性生长,触摸角状物无疼痛。此时,腹痛、腰痛、排便困难等全身症状亦明显加重。1997年     

POCT的经济学简介

POCT是检验医学的一个新的分支,其经济学更是陌生,这里我们介绍一些国外POCT的经济学方面的知识,供大家学习、讨论。     

出院的老年人服药存在问题及对策

目前,我国人口已日趋老龄化,老年人的健康保健问题亦引起了社会的广泛关注.以我院的老年病房的病人为例,他们年龄大多在70～80岁之间,高血压、冠心病、脑血栓、糖尿病患者居多,很多病人都兼有两种或两种以上的疾病,因此用药种类的剂量及用法需要严格按医嘱给药,病人在住院期间用药(口服药)不成问题.     

儿童可否练瑜伽

虽然,瑜伽有悠久历史,但正式从国外传入中国却只有40年左右的时间。瑜伽是一种健康时尚的纤体塑身运动,形式比较多,目前在全国各地流行的有高温瑜伽、力量瑜伽、芭蕾瑜伽、印度瑜伽、恋爱瑜伽、     

认识老年痴呆症

老年痴呆症,又称阿尔茨海默病,其患病率呈逐年上升的趋势。据中国阿尔茨海默病协会公布,我国该病患者已超过500万,占世界总病例的1/4以上。一项对北京、上海、西安、成都、重庆、沈阳六城市部分区县的调查显示,被调查的43000名老人中,老年性痴呆患病率为2.9%,65岁以上患病率为5.22%,且每年新增病例30万人以上,已成为威胁老年人健康继心脑血管病、肿瘤之后的第三位疾病。     

国殇与国威

2008年5月12日,国际护士节。母亲节的后一天。这一天,天津多云,东南风4～5级。14时28分,四川汶川发生了8.0级的特大地震,连2000公里外的天津、北京都有明显的震感。一时,汶川、北川、平武、茂县一个个我们本     

参茸白凤丸质量控制方法的研究

参茸白凤丸是<中国药典>2005年版一部收载的传统成方制剂,有大蜜丸和水蜜丸两种剂型,是由人参、鹿茸、党参、当归、熟地黄、黄芪、白芍、延胡索、葫芦巴、续断、白术、香附、砂仁、益母草、黄芩、桑寄生、甘草18味中药组成.     

话说抗血栓病

血栓病是中老年人最常见、最可怕的疾病,如心肌梗死和脑梗死。其主要原因是心脑动脉在动脉粥样硬化的基础上又继发了血栓形成,致使血流完全中断,局部组织死亡(坏死)。死亡的细胞难以再生,只能靠增生的组织来修复。     

中华医学会第九次全国血液学学术会议纪要

中华医学会第九次全国血液学学术会议于2006年10月20～22日在江苏省南京市召开.会议由中华医学会、中华医学会血液学分会主办,江苏省医学会承办,江苏省血液研究所、南京医科大学第一附属医院、东南大学附属中大医院协办.     

如何学好药理学

药理学是研究药物与机体相互作用、作用机制及规律的科学,是连接基础医学与临床医学、医学与药学的一门重要课程.许多学生在初次学习药理学时,认为药理学不好学,内容复杂、抽象,药物种类较多,抓不住重点,难以记忆,不知道怎样学习药理学,现就这些问题谈谈学习药理学的方法.