随着医学科学的进步和发展,高等护理教育已成为医学教育中重要的一部分.研究发现,启发式教学在实际的临床教学中起着重要的作用.西南医科大学附属中医医院对实习生采用启发式教学法进行带教,引导实习生主动思考问题,激发实习生的学习热情,培养实习生的自学能力,提升实习生的创造思维能力,让实习生全面掌握专科知识,提升临床综合能力.文章探讨了启发式教学对神经内科护理教学活动的作用,以供参考.

目的 探讨高敏心肌肌钙蛋白T(hs-cTnT)在重症监护室(ICU)患儿预后评估中的价值.方法 回顾性收集我院ICU住院治疗的非创伤和外科干预患儿的临床资料,根据出院时的结局分为存活组和死亡组.通过Logistic回归分析影响患儿住院期间死亡的危险因素,使用受试者工作特征(ROC)曲线评价hs-cTnT对ICU住院患儿预后的预测价值.结果 死亡组hs-cTnT水平显著高于存活组(P＜0.05);死亡组儿童危重病例评分(PCIS)的危重和极危重比例显著高于存活组(P＜0.05).多因素Logistic回归分析显示hs-cTnT(OR=9.590)和PCIS(OR=3.114)是ICU患儿临床不良预后的独立危险因素.hs-cTnT预测预后的ROC曲线下面积(AUC:0.816)大于PCIS的ROC曲线下面积(AUC:0.769).结论 hs-cTnT能很好地预测ICU非创伤和手术干预患儿的临床预后.

目的:探讨开天门结合五音疗法在失眠患者中的运用.方法:选取的是2020年1月到2020年6月在西南医科大学附属中医医院就诊的100名失眠患者随机分成两组,对照组(n=50例)和观察组(n=50例).对照组给予了辩证中药汤剂和常规腹地治疗,观察组给予开天门加五音疗法,经过治疗后对患者效果进行评估,比较两组患者的睡眠质量和两组患者的不良情绪.结果:观察组患者护理后的睡眠效率、睡眠障碍和日间功能障碍评分均高于对照组(P＜0.05);观察组患者的焦虑、恐惧及抑郁情绪的评分明显低于对照组(P＜0.05).结论:说明

目的:研究美洲大蠊不同提取物及不同提取方法对肿瘤细胞的细胞毒性,为美洲大蠊的抗肿瘤细胞研究提供实验依据.方法:以人肝癌SMMC-7721细胞株,红白血病细胞株K562,人结肠癌细胞株HCT116 3种肿瘤细胞为研究对象,采用细胞计数试剂盒-8(CCK-8)法,比较不同的提取物(乙醇提取液、石油醚部位、乙酸乙酯部位、正丁醇部位)和不同的提取方法(渗漉法、超声法、回流法)对3种肿瘤细胞的体外抗肿瘤活性.结果:美洲大蠊乙醇提取液和乙酸乙酯部位对上述肿瘤细胞增殖均有不同程度的抑制作用,其中以乙醇提取液的活性最强;3种提取方法提取的美洲大蠊均表现出不同程度的体外抗肿瘤活性,其中以渗漉法提取的美洲大蠊对3种肿瘤细胞的抑制作用最强,所计算出的半数抑制浓度(IC50)均最小.结论:美洲大蠊乙醇提取液的体外抗肿瘤活性最强,乙酸乙酯部位次之,美洲大蠊宜选择渗漉法提取.

Objective To optimize the preparation technology for total glucosides from Paeonia lactiflora (TGP) liposome and study on its in vitro release. Methods Liposomes were prepared by reverse-phase evaporation technique. Taking the entrapment efficiency (EE) as indexes, the preparation of liposome was optimized using Box-Behnken design-response surface method (BBD-RSM), and the in vitro release was studied. Results The optimal formulation was cholesterol-lecithin (1∶2.7), TGP-lipid (1 29), ∶ and hydrated medium of 5.1 mL. The average EE were 73.0% and the 12 h in vitro accumulative release rate was 42.18%. Conclusion The optimized process is rational and feasible, and the TGP liposome has the higher EE and good stability with better sustained release in vitro.

目的：通过空气压力波治疗卒中后偏瘫患者的疗效观察。方法将72例中风后下肢偏瘫患者随机分为对照组和观察组，对照组予以常规治疗，观察组在常规治疗基础上给予空气压力波治疗，比较两组患者治疗前后的神经功能缺损评分、日常生活能力评分(ADL)，评定临床治疗效果。结果观察组患者在肢体功能恢复、生活自理能力提高方面均显著优于对照组，两组比较差异显著（P<0.05），具有统计学意义。结论空气压力波治疗结合常规的药物治疗和康复训练方法，可以有效改善中风后偏瘫患者神经缺损情况，预防及治疗下肢深静脉血栓，促进肢体功能的恢复，提高患者生活质量。

Objective:To explore the optimal concentration and time of LPS inducing the apoptosis of HUVEC cells.Methods:Human umbilical vein endothelial cells(HUVEC)were cultivated in vitro,Lipopolysaccharides were divided into100、10、1、10-1、 10-2、10-3、10-4、10-5 μg·ml-1 respectively,time of stimulate were 0.5,1,2,6,12,24 h,cell viability were observed by CCK-8;cell morphology were measured by fluorescence microscopy after dyeing with Hochest33342/PI.Results:Compared with control group,cell viability was significantly decreased in over 10-2 g·ml-1 LPS and 24 h(P<0.05).100μg·ml-1 LPS for 1 h,10μg·ml-1 and 1g·ml-1 6 h can induce HUVEC cell viability decreased,but 12 h and 24 h cell viability decreased more signifi- cantly(P<0.05),10-1 g·ml-1 LPS 12hcan induce HUVEC cell viability decreased(P<0.05);nuclear enrichment and apoptotic body,and even death can be obviously by Hochest33342/PI.Conclusion:HUVEC cell viability decrease after administrate with LPS in a time and dose way,comprehensive consider time and dose,1g·ml-1 LPS stimulate 12 h or 24 h and 10-1 g·ml-1 LPS stimu- late 24 h can cause the ideal model of HUVEC apoptosis.

目的:对脑梗死偏瘫患者实施早期康复训练效果观察,探讨中医康复技术介入对脑梗死偏瘫患者生活质量的影响。方法:选择106例脑梗死偏瘫患者,随机分观察组53例、对照组53例。2组药物治疗基本相同,对照组患者给予常规护理及患者自我随意的锻炼,对观察组患者进行系统的肢体康复训练配合中医康复技术介入。结果:经早期中医康复介入的患者肢体肌力恢复的进展明显优于对照组,差异具有统计学意义(P<0.05)。结论:对脑梗死偏瘫患者进行早期康复训练可减轻患者偏瘫肢体的致残程度,对提高患者日常生活能力和提高患者生存质量起到非常重要的作用。

Objective: To observe the clinical effect of traditional Chinese medicine fumigation with acupressure on apoplexy spastic paralysis. Methods: 60 cases of apoplectic hemiplegia spasticity were randomly divided into treatment group(30 cases) and control group(30 cases),both groups received conventional nursing for encephalopathy. The treatment group received herbal fumigation and acupoint massage. The limb spasticity, motor function and self-care ability were compared. Results: The recovery of limbs motor function and self-care ability were significantly better in the treatment group than in the control group with statistical significance(P<0.05).Conclusion:Acupoint massage therapy combined with traditional Chinese medicine fumigation can effectively alleviate the high muscle tension, improve limb spasticity and raise the life quality of patients.

<正>本院从2005年1月至2011年1月应用生化颗粒联合米非司酮、米索前列醇等药物治疗流产后阴道出血的150例患者取得了显著疗效,现报道如下。临床资料入选的300例患者均符合宫内早孕,年龄16～40岁。将患者随机分为两组:治疗组150例,年龄

5-(4-Carheboxypnyl)-10,15,20-tris(3-Hydroxyphenyl)chlorin,a photosensitizer,was synthesized starting from methyl 4-formylbenzoate,3-hydroxybenzaldehyde and pyrrol via Alder reaction,esterolysis,reduction and selective oxidation.The target compound was obtained in overall yield of 4.92%.The structure was characterized by IR,UV-Vis,MS and 1H NMR spectra.

AIM To investigate effect of resvertrol on apoptosis and mitochondial transmembrance potential(MTP) of PC12 cells induced by Aβ25-35.METHODS 160,80,40,20 μg/L resveratrol were adminstrated after PC12 cells induced by 20μmol/L Aβ25-35,cell viability was observed by CCK-8,apoptosis was tested by the flow cytometry,cell morphology and MTP were observed by fluorescence microscopy.RESULTS Compared with model group,resvertrol could increased the cell viability and MTP,and decreased the apoptosis in dose dependend mode.CONCLUSION Resvertrol could be against the apoptosis of PC12 cell induced by Aβ25-35.

Objective:To establish quality criteria of ShiWei PingCuo capsule. Method:Indentified the radix rhizome,anemarrhena rhizome,dandelion,violae herba and angelica root with the thin layer chromatography(TLC); testing the concentration of emodin in the capsule with high performance liquid chromatography(HPLC). Result:The radix rhizome,anemarrhena rhizome,dandelion,violae herba and angelica root are examined from the ShiWei PingCuo capusule. The emodin is in linea with the absorption area when the amount between 0.01792 and 0.224 μg .the average recovery rate of emodin is 100.14% and RSD=0.71%. Conclusion:The quality criteria established is stable and reliable. It could control the quality effectively.

Objective:By observing an effect of synchronically treating phlegm and blood stasis on preventing and treating the acute myocardial ischemia in rats,provide laboratory evidence for the theory of synchronically treating phlegm and blood stasis to prevent and treat the thoracic obstruction. Methods:To inject 0.7u/kg pituitrin by sublingual intravenous to establish the model of acute myocardial ischemia in rats,then,the researchers instantly record the variations in T wave of each rat,and observe the level of malondialdehyed(MDA),lactate dehydrogenase(LDH) and superoxide dismutase(SOD) in the serum of rats. Results:To compare two methods with dissipating phlegm and promoting blood stasis,the method with synchronically treating phlegm and blood stasis could apparently reinforce SOD activity,reduce the level of MDA and LDH in the serum of the acute myocardial ischemia in rats,improve the condition with acute myocardial ischemia in rats. Conclusion:The method of synchronically treating phlegm and blood stasis can improve acute myocardial ischemia,and inhibit the lipid peroxdation,the effect on controlling the thoracic obstruction with the method of synchronically treating phlegm and blood stasis has apparent advantages over the single method of dissipating phlegm or promoting blood stasis,it's an important way of preventing and curing coronary heart disease(thoracic obstruction).

Objective:To approach the therapeutic effect and possible mechanism of synchronically treating phlegm and blood stasis in curing the thoracic obstruction by animal model,so as to provide laboratory evidence for the theory of synchronically treating phlegm and blood stasis which could prevent and treat the thoracic obstruction in clinic.Method:The methods of dissipating phlegm,activating blood circulation to dissipate blood stasis and synchronically treating phlegm and blood stasis were compared by detecting the content of serum total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)in hyperlipemia rats.And the effect on hemorheology in acute blood stasis rats was studied at the same time.Result:Comparing with method of activating blood circulation to dissipate blood stasis,the methods of dissipating phlegm and synchronically treating phlegm and blood stasis could markedly decrease TC,TG and LDL-C in experimental hyperlipidemia rats and increase HDL-C.The method of synchronically treating phlegm and blood stasis could also markedly decrease the level of blood viscosity(high,medium and low shear rate),plasma viscosity and hematocrit in acute blood stasis rats,and the effect had an advantage than the other two methods.Conclusion:The method of synchronically treating phlegm and blood stasis can markedly improve the abnormal lipid metabolism,protect blood vessel endothelium(BVE),improve the obstacle of blood flow degeneration,and eliminate risk factors of proceeding and aggravating artherosclerosis(AS),so as to achieve the purpose of preventing and curing thoracic obstruction(coronary heart disease).

地骨皮为茄科植物枸杞(Lycium chinense Mill.或宁夏枸杞 Lyrcium barbarum L.)的干燥根皮[1].传统本草认为其性寒,味甘,归肺、肝、肾经,有凉血除蒸、清肺降火之功效,主要用于阴虚潮热,骨蒸盗汗,肺热咳嗽,咯血,衄血及内热消渴等方面.

李东垣在《东垣试效方》等著作中对疮疡的病因病机、治法方药作了较为全面的论述,并将脾胃学说应用于外科疮疡的诊治,丰富和发展了中医外科学术理论,进一步开拓了疮疡治疗的视野。

Objiective:To observe the effect of madecassoside on lipopolysaccharides(LPS)-induced febrile response in SD rats.Methods: Fifty-six male SD rats were randomly divided into normal group , model group, vehicle group, paracetamol group and madecassoside 10mg/kg,20mg/kg,40mg/kg. Fever model of rat was induced by ip LPS (100 μg/kg). The changes of deep body temperature (T) was tested every 30 min after ip LPS, and lasted for 6 h. Madecassoside (10,20 and 40 mg/kg) was ig once every day and last 3 days before ip LPS. The rats of normal and model groups were ig normal saline, vehicle group were ig 0.5% carboxymethyl cellulose instead of madecassoside. Paracetamol group rats were ip paracetamol (50 mg/kg) only once ,30 min later ip LPS. the activity of MPO in liver was detected by myeloperoxidase (MPO) kit; the content of PGE2 in brain and IL-6 in plasma was detected by ELISA. Results: The fever was appearance three febrile phase, the maxlmum amplitude of temperature achieved 2.01℃. Compared with model group, madecassoside (10,20 and 40mg/kg) have the effection of hypothermia obviously, and madecassoside 40 mg/kg inhibite the febrile is similar to the paracetamol group . compared with model group, madecassoside (10,20 and 40mg.kg-1) reduce the activity of MPO in liver and the content of PGE2 in brain,IL-6 in plasma obviously. Conclusion:Madecassoside have the effection of hypothermia ,and this effects maybe is related to inhibite the express of MPO ,PGE2 and IL-6.

对名贵中药石斛的商品主流金钗石斛进行泡砂石垒床栽培试验,采用常规田间管理方法,可以在2~3年收获产量可观的药材。此法具有成本较低的优势,也便于石斛栽培后的田间管理,是一种植得推广的栽培方法。

梅核气为临床耳鼻喉科的一种常见病,笔者用经方半夏厚朴汤原方药治疗126例,取得较为满意的疗效,现总结如下.