When the standards aren't standard: Evidence-based medicine in the Russian context

This paper examines the uses of evidence-based medicine (EBM) in post-Soviet Russia through the use of semi-structured interviews. It asks what it means to talk about practicing evidence-based medicine in a setting where the context of practice presents considerable barriers to the implementation of EBM principles. Drawing on interviews with Russian physicians, medical students and users of the healthcare system, the paper argues that in post-Soviet Russia EBM serves as a strategic discourse for segments of the medical profession. With the collapse of the U.S.S.R. the healthcare system has been going through a period of crisis, and Russian physicians are finding that they have to redefine their professional identity with respect to the domestic and the international context and have to seek new sources for legitimating their professional position. The western origins of EBM endow this rhetoric with considerable power in the Russian context and render it a very useful tool in the project of redefinition.     

浅议中医理论的科学美

科学美是美学形态分类中的一种 ,它从本质上反映事物运动的内在联系 ,属于美的深层形式。中医理论中存在简明、对称、新奇等科学美     

中药肾区渗透并常规治疗高血压性肾损害40例疗效观察

目的：观察中药肾区皮肤外敷渗透加西药常规治疗高血压肾损害结果。方法：将部分中药粉碎微细化处理，将另部分中药液化处理．粉液混合装袋醋浸后外敷在肾区皮肤上，用药物导入仪肾区靶点式导人人体。并用一般西医常规治疗。结果：平均治疗3周血肌酐下降23％，BUN下降26％，24h蛋白尿下降23％，尿量增加16％，收缩压下降9％，舒张压下降7％。结论：中药的肾区皮肤外敷渗透加西医常规治疗效果明显高于一般常规治疗。     

Treatment of calcaneal fractures: the available evidence

Abstract Calcaneal fracture is the most common of the tarsal fractures and represents 1%–2% of all fractures. The fractures may be divided into extra-articular (not affecting the joint) and intra-articular (involving the talo-calcaneal and calcaneal cuboid joints) types. The management of heel fractures includes nonoperative and operative treatments, but no clear consensus has been reached. The choice of operative treatment is still controversial with many factors influencing the final clinical outcome. Many studies have assessed the outcome of treatment of calcaneal fractures, but there is a general disagreement on their management. The objective of this study was to collect and evaluate the scientific evidence reported in the literature supporting the different treatments for calcaneal fractures.     

关于中成药口腔崩解片开发应用的思考

通过对口腔崩解片的特点及主要制备工艺的分析,结合当前中成药工业的现状及具体实际,认为口腔崩解片可以应用于中成药制剂的开发。     

End-of-life Models and Emergency Department Care

Many people die in emergency departments (EDs) across the United States from sudden illnesses or injuries, an exacerbation of a chronic disease, or a terminal illness. Frequently, patients and families come to the ED seeking lifesaving or life-prolonging treatment. In addition, the ED is a place of transition-patients usually are transferred to an inpatient unit, transferred to another hospital, or discharged home. Rarely are patients supposed to remain in the ED. Currently, there is an increasing amount of literature related to end-of-life care. However, these end-of-life care models are based on chronic disease trajectories and have difficulty accommodating sudden-death trajectories common in the ED. There is very little information about end-of-life care in the ED. This article explores ED culture and characteristics, and examines the applicability of current end-of-life care models.     

长托宁用于全麻术前用药的效果观察

目的:观察长托宁作为全麻病人麻醉前用药对心血管系统和呼吸道分泌物的影响.方法:随机选择20例需全麻手术病人,在麻醉诱导前静注长托宁0.015 mg/kg,观察注药前、后5、10、20分钟各时点的血压、心率、脉搏氧饱和度及口干程度以及术中术毕口腔和呼吸道分泌物情况.结果:病人使用长托宁后5、10、20分钟的血压、心率与使用前相比有下降趋势,但无统计学意义(P＞0.05),脉搏氧饱和度未见明显改变,用药10分钟病人有轻度口干,术毕拔除气管导管时口腔及呼吸道分泌物较少.结论:长托宁用于全麻病人麻醉前给药效果满意.     

黔东少数民族儿童行为问题与父母教养方式研究

目的探讨西部少数民族儿童行为问题及其与父母养育方式的关系,为少数民族地区开展心理健康教育提供理论依据。方法采用Achenbach儿童行为量表(CBCL)和儿童抚养行为问卷(CRPR)对415名苗族、土家族和侗族儿童进行调查。结果行为问题检出率为29.63%,其中男童为29.94%,女童为29.25%。男童检出率较高的因子为强迫、抑郁、交往不良、分裂样,女童检出率较高的因子为抑郁、分裂样强迫、多动。男童行为问题的绝大多数因子与父母的拒绝、惩罚定向呈显著的正相关,女童行为问题的多数因子与父母的拒绝呈显著正相关。结论黔东地区少数民族儿童行为问题显著高于全国水平,父母教养方式影响儿童的行为问题。     

~(125)Ⅰ眼镜蛇毒及抗眼镜蛇毒血清在小白鼠体内分布的比较观察

用氯胺-T法125I标记眼镜蛇毒示踪液及抗眼镜蛇毒血清。小白鼠分二组，用125I-眼镜蛇毒、125I-抗眼镜蛇毒血清分别给小白鼠尾静脉注射，于注射后的不同时间测定血、颈部肌肉、肝、肺、肾、心等脏器放射性分布。结果发现：125I-眼镜蛇毒在肌肉及肝、肺等器官中于注射后2小时过高峰，在肾脏中浓度高，在脑未见放射性分布，抗眼镜蛇毒血清与眼镜蛇毒分布相似但在肌肉及肺脏有更高的分布。证明抗眼镜蛇毒血清能跟踪分布眼镜蛇毒。     

A Chinese adolescent girl with Fechtner-like syndrome

We describe a 15-y-old girl with Fechtner-like syndrome, who is the first Chinese reported to have this rare syndrome. She presented with left homonymous hemianopia and neuroimaging revealed haemorrhage in both parietal and occipital lobes. Peripheral blood smear showed macrothrombocytopenia and intracytoplasmic inclusion bodies inside leucocytes. Thrombocytopenia and proteinuria responded to intravenous immunoglobulin and pulsed methylprednisolone. This case illustrates that life-threatening haemorrhage can occur in patients with Fechtner syndrome. Although there was no effective treatment reported in the literature, high dose steroid and immunoglobulin seemed to be useful in our patient. Our patient also had nephritic-nephrotic syndrome with renal insufficiency, which is unusual in adolescent female patients.