研究性学习法在临床医学教学中的应用

研究性学习法认为，学生学习是积极的思考（思雏）活动。是学生进行的独立脑力劳动过程，其核心是思考，即观察、比较、分析、综合、抽象、概括、推理、判断等一系列活动。教师的任务就是指导学生，让学生学会思考。临床医学教学直观性、实践性强，在临床医学课堂教学中渗透研究性学习可培养学生的医学科研思维意识。     

大剂量盐酸氨溴索防治早产儿肺透明膜病68例的体会

目的观察盐酸氨溴索防治早产儿肺透明膜病(HMD)的疗效。方法将68例新生儿监护室住院早产儿随机分两组,治疗组36例在常规治疗基础上加用大剂量盐酸氨溴索静滴,对照组32例仅予常规治疗。比较两组早产儿HMD的发生率、治愈率、病死率以及需要机械通气的时间。结果治疗组HMD发生率13.89%、治愈率80.00%、病死率2.78%,使用机械通气的时间为(58.40±14.47)h;对照组HMD发生率34.38%、治愈率54.55%、病死率15.66%,使用机械通气的时间为(84.18±20.74)h。治疗组HMD发生率低于对照组,需要使用机械通气的时间短于对照组,差异有统计学意义(P<0.05)。结论大剂量盐酸氨溴索预防HMD的疗效显著,值得临床推广应用。     

HPLC-ELSD测定平贝母中贝母素甲的含量

平贝母是百合科植物平贝母Fritillaria ussurien-sisMaxim·的干燥鳞茎,具有清热润肺、化痰止咳的功能,其含有的贝母类生物碱是贝母止咳化痰作用的主要有效成分。贝母类生物碱传统的定量方法常采用比色法、两相滴定法、非水滴定法等3种方法均有一定的局限性;采用薄层色谱法、反相离子对高效液相色谱法、柱前衍生化法、气相色谱法对贝母素甲、贝母素乙进行定量,存在前处理步骤多,排除干扰困难等不足之处。ELSD是一种质量型检测器....     

清开灵治疗新生儿泪囊炎51例

目的 :观察清开灵对新生儿泪囊炎的疗效。方法 :观察组以清开灵注射取代生理盐水作泪道冲洗 ,对照组用生理盐水作泪道冲洗。结果 :观察组 60眼治愈 5 9眼 ,治愈率 98.33% ,对照组 60眼治愈 5 3眼 ,治愈率 88.33% ,P<0 .0 5。提示 :清开灵能提高新生儿泪囊炎的疗效     

急性脑梗死早期高血糖调治技术对近期预后的影响

目的观察急性脑梗死应激性高血糖早期调治技术对近期预后产生的影响。方法将急性脑梗死伴血糖增高患者106例，随机分成治疗组53例和对照组53例。两组治疗脑梗死基本方法相同，治疗组早期应用普通胰岛素凋治高血糖，分别于第7天、30天评定和比较两组神经功能缺损情况。结果治疗组第7天、30天时神经功能缺损评分与对照组比较有显著差异性。结论急性脑梗死伴血糖升高患者早期调治高血糖可使患者有较好的预后。     

阿维森纳《医典》中脉诊与中医脉诊关系的澄清

为了明确有关阿维森纳《医典》记载的48种脉中有35种与中医脉诊相同、或与《脉经》所载相同的说法是否准确,笔者对相关文献进行追查,对中医脉诊以及《医典》中的脉诊不同语言术语的含义、以及脉的具体内涵进行分析比较,发现《医典》脉诊的内容与中医脉诊没有直接的关系,而与古罗马医学家盖仑的脉诊有着密切关系。这一发现有助于明确中医脉诊与《医典》中脉诊之间的关系,并为中国和阿拉伯医学交流史提供了新的参考。     

无明显诱因的急性小脑共济失调1例报告

患儿男，1岁，11个月，因站立不稳、步态异常4d于2004年6月29日入院。患儿无明显诱因下出现步态不稳、蹒跚，12h内迅速发展至不能独走，进而不能独站，扶站时身体摇摆，双手握物时震颤，少言，48h出现双眼水平震颤。患儿无发热、无呕吐、无抽搐。食欲、睡眠好，大小便无异常。既往体健，病前3个月否认感染、服药史。家族史无特殊。外院头颅CT片模糊，怀疑基底节有病变。入院查体：T37℃，HR105次／min，RR30次／min，精神稍差，神志清楚。双眼球自发性水平粗震颤，眼底正常；颈软，心、肺、腹无异常。四肢肌力Ⅴ级，肌张力稍减低，双膝反射稍活跃，病理反射未引出。     

两型鼠疫菌耐链霉素菌株的检测

我国开始使用链霉素治疗鼠疫至今已50余年，以链霉素为首选的传统疗法极大降低了鼠疫病人的死亡率，但其药物的毒副作用日渐引起人们的关注，同时国外已有耐链霉素菌株和多重性耐药株出现，给链霉素在治疗鼠疫方面提出了质疑。为此，我们就选取了50年代以后分离株鼠疫菌进行了链霉素耐药性的监测。目的在于了解我省是否存在天然抗链霉素的菌株，以便为治疗鼠疫病人提供科学依据。现将结果报告如下：     

非血缘关系造血干细胞移植61例分析

Objective To study the therapeutic effectiveness, associated complications and related factors of unrelated allogeneic hematopoietic stem cell transplantation (URD-HSCT). Methods Sixty-one patients with malignant hematological diseases received URD-HSCT. All cases were subjected to myeloablative or nonmyeloablative conditioning regimen according to primary diseases. Among 61 patients, 21 were donor-recipient 6/6 HLA-matched, 5 were 5/6 HLA antigen-matched, 24 were 1 HLA gene subtype-mismatched, 11 were 2 HLA gene subtype-mismatched. Eighteen patients were ABO-compatible with donors, while 43 ABO-incompatible with donors. The median of infused donor nucleated cells was 4.5×108/kg, and the median of CD34+ cells were 4.3×106/kg. The graft-versus-host disease (GVHD) prevention regimens were based on short-term MTX, cyclosporin A and mycophenolate mofetil (MMF) regimen. Forty-nine cases also received CD25 Mab on the day of transplantation, and the day 4 after transplantation. Nine cases were also administrated with antilymphocyte globulin (ALG) or antithymocyte globulin (ATG). Two cases received ALG and CD25 Mab. Results Among 61 patients, 59 cases were successfully engrafted, which was identified by blood type, chromosome test and DNA polymorphism. Twenty-three cases developed grade Ⅱ～Ⅳ acute GVHD. Twenty-five patients experienced chronic GVHD. Infection of bacterial and/or fungal within 100 days after URD-HSCT was documented in 48 cases. Thirty-six cases had cytomegalovirus infection. Major infection site was lower respiratory tract. Eighteen cases died after URD-HSCT, and the 2-year disease-free survival rate was (68.0±6.4)%. Among these 18 deaths, 12 cases died because of transplantation related complications with the transplantation related mortality (TRM) being 19.7 %, and the remaining 6 cases died of relapse with the relapse rate being 9. 8 %, respectively. Conclusions URD-HSCT is an effective therapeutic strategy for malignant hematopoietic diseases when related donor is not available Acute GVHD and infection are risk factors of therapeutic effect and prognosis after URD-HSCT. Early prediction and prevention of acute GVHD and infection are essential problems to overcome.     

乳酸菌素与思密达治疗小儿消化性溃疡的临床观察

目的探讨应用乳酸菌素和思密达治疗消化性溃疡的临床效果。方法随机将30例患者分为治疗组和对照组,治疗组15例患者口服乳酸菌素＋思密达,对照组15例患者口服西米替丁＋阿莫西林＋硫糖铝片。两组均用药30d。结果呕吐症状缓解率两组均为100%;腹疼症状缓解率治疗组为100%,对照组为87%;溃疡愈合率治疗组为100%,对照组为97%。结论乳酸菌素在抑制幽门螺杆菌感染,保持消化道微生态的平衡和调节机体免疫方面效果明显,和思密达联用可治疗消化性溃疡。