本文介绍了罗仁教授治疗儿童肾病综合征蛋白尿的学术思想及理法方药.肾病综合征蛋白尿属中医学的"水肿""尿浊""虚劳""腰痛"范畴,发病主要与肺、脾、肾三脏功能失调有关.蛋白尿是肾病综合征的必要诊断条件,不仅可直接导致低蛋白血症,引发水肿,还会促进肾功能的恶化.罗仁教授认为尿蛋白源于血浆,是水谷精微,为至阴之精,应固藏于肾,并且有赖于肺之宣发、脾之升清、肝之疏泄的共同作用,创立了肾病1号方从肺、脾、肝、肾四方面减少尿蛋白,使患者更早进入缓解期,延缓疾病进展,调节免疫,防止复发,尤其对激素抵抗、激素依赖患者具有更重要的意义,并随证或随症加减,对于病情复杂的复合病或复合证患者可用单双日疗法调整阴阳,单日用肾病1号方减少蛋白尿,双日用小生六汤调和脏腑,还从心理、运动、饮食三方面指导患者积极面对疾病.

“五脏元真通畅,人即安和”的证治思想,体现了仲景的发病观,深刻理解“五脏元真”的内涵,临床遣方用药时重视通畅五脏元真,是探求、拓宽疾病的治疗思路与方法的新路径,对临床实践具有重要的指导意义.

“以学生为中心”及“以病人为中心”的教学导向是目前国内外医学教育教学模式改革的新趋势.中医内科学临床见习是以培养学生的中医临床思维与技能为主要目的课程,本项目遵循临床见习的教学规律,整合中医内科学国家精品资源共享课网络教学平台、临床见习CTPF教学模式及网络即时通讯信息平台等多种教学模式,构建中医内科学临床见习路径,从课前资源整合、课中组织实施、课后持续教育及效果反馈等四部份持续调动学生主观能动性,提高了教学效果.

本文通过问卷调查法、访谈法以及数理统计法对江苏省高校园区内体育社团校际交流的整体状况进行了调查,分析出对体育社团校际交流影响较大的几个因素,为改善江苏省高校园区内体育社团校际交流现状提供依据.研究表明,体育社团校际交流呈现了明显的两极分化态势;交流形式与内容并不单一和局限;Logistic回归分析得出是否有交流平台、是否有外部资金支持、社团场地状况、骨干成员对外交流意愿、有无指导老师、社团活动频度6个因素对江苏省高校园区内体育社团校际交流有影响,其中OR值最高的为"是否有交流平台",本文还针对调查结果给出了相关建议.

The Department of TCM in Nanfang Hospital developed the intern-centered clinical teaching mode of Traditional Chinese Medicine and kept practicing in clinical teaching.The result indicated that the intern-centered clinical teaching mode can improve students’ enthusiasm with clinical practice and develop their ability to analyze and solve problems,which will help to promote the innovation and collaboration.

Objective:To analyze the correlation between random micro-albuminuria and creatinine ratio and preeclampsia retrospectively,explore the application value of random micro-albuminuria and creatinine ratio for nursing and monitoring of preeclampsia.Methods:A total of 69 patients with preeclampsia who were treated in departments of gynecology and obstetrics,departments of critical care medicine in the hospital and Southern hospital affiliated to Southern medical university from October 2011 to February 2012 were selected,then they were divided into mild preeclampsia group and severe preeclampsia group according to random micro-albuminuria and creatinine ratio,the perinatal outcomes of pregnant women in the two groups were compared.Results:There was no statistically significant difference in age and BMI between the two groups.Systolic blood pressure,diastolic blood pressure,gestational weeks at delivery,and 24-hour urine protein level in severe preeclampsia group were statistically significantly higher than those in mild preeclampsia group(P<0.05).The birth weight of neonates in severe preeclampsia group was statistically significantly lower than that in mild preeclampsia group(P<0.05).The incidence of adverse pregnancy outcome in mild preeclampsia group was statistically significantly lower than that in severe preeclampsia group.Conclusion:Random micro-albuminuria and creatinine ratio can reflect the severity of preeclampsia in pregnant women rapidly and simply,which has high application value for nursing and monitoring of preeclampsia.

本文对青年教师如何提升中医内科学教学能力进行了分析思考及总结.青年教师需要扎实提高临床基本功、教学基本功,努力学习多种教学技巧;在中医内科学教学过程中,掌握课程的重点,并合理讲解;紧跟教学发展方向,合理运用各种多媒体教学手段,从而最终提升自身的中医内科学教学能力.

《中药学》教学中涉及的药材种类繁多,教学过程中学生易于感到枯燥无味,学习热情不高。与传统教学相比,应用计算机互动教室进行教学,有利于师生之间的及时互动交流和反馈,有利于激发学生参与热情,培养学生的中医药科学素养。同时,利用先进的技术手段帮助学生建立教学成果档案袋,能有效促进教学效果的提升。

Objective To explore the prevalence of sub-health status of workers to provide a scientific basis for prevention and treatment.Methods On the spot,a total of 1 825 workers from the private enterprise of Shenzhen were investigated with our self-designed sub-health questionnaire using the method of cluster sampling,and the diagnostic criteria of sub-health status was established by literature review,discussion among experts.The data was analyzed by the software of Epidata 3.02.Results We received 1 773 of criteria questionnaire,of which 1 104 workers were in sub-health status,with a prevalence rate of 62.3%.Logistic analysis indicated that 5 factors were related to the sub-health status of workers,each of which were the satisfaction of working capability,work overtime,energetic,dietary bias and the satisfaction of current situation(P 0.05).Conclusion The workers of private enterprise were susceptible to sub-health status,and it was imperative to concern and solve their health problems.

Objective To study the clinical manifestations and the sub-health status of the workers. Methods 2 580 workers of overseas-funded enterprises in Dongguan were studied. Cross-sectional study method and cluster sampling were used. Survey was conducted using our own designed sub-health TCM Syndrome questionnaire,and the diagnostic criteria on the sub-health status were decided based on the literature review and discussion among experts. Results were analyzed by frequency analysis and factor analysis. Results The total sub-health incidence rate was 72.7%. Clinical manifestations included the various symptoms of the body,psychology and society. The frequent clinical manifestations were weary,headache,dizzy,common cold,afraid of heat,aching pain of waist and back,depression,sigh,insomnia and dreamful sleep. There were ten clinical subtypes. These included fatigue type ,insomnia type,pain type,urine and stool abberant type,dry eye and pharynx type,irregular menses and leucorrhea type,sex type,constitutional type,social pattern and psychological pattern. Conclusion Clinical manifestations of the sub-health status are complex and have many clinical subtypes.

针对中医临床专业实习生采用了"三步四要法"的临床查房训练模式:第一步问病查体,第二步汇报病历,第三步查房分析。查房分析从临床特点、诊断分析、辨证分析、治疗方案四个方面入手,结合临床具体病例进行阐释,是临床查房训练模式的关键。

AIM:The high-grade medical undergraduates endure large mental stress because they face the transition process from class study to clinical practice and many life choices. To describe the distribution and prevalence rate of mental subhealth among them and explore the correlated factors, the study analyzed the mental subhealth of 677 high-grade students from one medical high school of Guangzhou. METHODS: In December 2006, 700 grade 4 and 5 undergraduate students from some Guangdong medical university were surveyed by the self-made subhealth questionnaire. The mental health diagnosis was accorded with partial content of Chinese Medical Clinical Guide for Subhealth. The data were analyzed with Frequencies and Chi-square test. Correlation factors were analyzed statistically using logistic regression method. RESULTS: ①A total of 700 questionnaires were sent, 692 were recovered with the recovery rate of 98.86%, including 687 valid questionnaires, with a qualified rate of 99.28%. Among the 687 questionnaires, there were 320 from grade 4 students and 367 from grade 5. According to the medical examination reports, 10 students (1.46%) of disease state were removed. Finally, 677 questionnaires were involved in the result analysis. ②The total prevalence rate of mental subhealth in grade 4 and 5 medical undergraduate students was 32.5%. The prevalence rate in grade 4 was higher than grade 5 (χ2 = 4.549, P < 0.05), in female higher than that in male (χ2 = 4.050, P < 0.05). ③The manifestations of mental subhealth mainly involved in the hurry to finish the work, worry, repetitive examination, testiness, tension, dullness, negative, unable to sit down freely, impaired concentration, and dissatisfying to himself. ④The correlated factors included poor interpersonal relationship, poor school action, excessive concern about their own weight changes, study pressure, lack of family happiness, dissatisfying to study environment, and inadequate money. CONCLUSION: The prevalence rate of mental subhealth among high-grade medical undergraduate students is very high and the correlated factors are extremely complicated. It is necessary to carry out psychological health education for the students and effective intervention, prevention and treatment in many ways.

目的:了解广东省某高校职工亚健康状态的中医证候分布特征,为其防治提供指导.方法:采用现场调查的方法,对参加体检的职工发放中医证候调查表,共调查891名职工.结果:有510名职工出现亚健康状态,亚健康发生率为57.2%,其涉及到34个中医证型,其中10个主要证候的累积百分数达到69.8%,依次为脾气虚、肝郁脾虚、肾阴虚、肝肾阴虚、肝郁气滞、肾阳虚、脾肾阳虚、肾精不足、肾气虚、心脾两虚型.结论:亚健康状态中医证候以虚证为主,与肾、脾、肝、心、肺五脏均密切相关.

OBJECTIVE:To evaluate the reliability and validity of the questionnaire we designed for subhealth status survey based on the symptoms described in traditional Chinese medicine.METHOD:By on-the-spot investigation, the recovery rate of the questionnaires was 96.3% and the response rate of the items was 97.2%.RESULTS:Internal consistency reliability coefficient of the questionnaire was high (0.9274-0.9676), and each item was closely associated with its related factors (with Spearman coefficient mostly above 0.6 except for that for bodily symptoms in female). Factor loading was approximately consistent with the structure and content of the questionnaire.CONCLUSION:This subhealth status questionnaire can be reliable and effective.

目的了解目前教师、医务人员的亚健康现状及其影响因素。方法以某医学高校的891名职工为研究对象,采用自行设计的亚健康中医证候调查量表开展调查,采用文献回顾、专家讨论的方法确立亚健康的诊断标准,对调查结果进行频数分析、2检验及单因素Logistic回归分析。结果总体亚健康发生率为57.2%,以20~30岁教工的发生率最高,该年龄组亚健康状态占总数的64.7%;女教工亚健康发生率明显高于男教工(2=9.817,P<0.01);对亚健康的发生有重要影响的因素包括工作压力、不良生活习惯、社会环境状况等。结论教师和医务人员的健康情况不容乐观,相关单位应积极采取各种针对性的预防干预措施,提高这些亚健康高发人群的整体健康水平和生活质量。

目的了解广州市某医院职工亚健康状态常见的临床表现。方法采用现场调查的方法,对参加体检的职工发放亚健康调查表,将合格问卷录入Epidata 3.02,然后进行统计学分析。结果共有613名职工问卷合格,其中355名出现亚健康状态,亚健康发生率为57.9%,其临床表现涉及到躯体、心理及社会等多种症状,以疲倦乏力、手脚发凉、腰背酸痛、咽干、健忘、脱发、失眠、急躁易怒等症状为主。应用多因素Logistic回归分析显示:压抑、交往困难、苦闷、腰背酸痛、急躁易怒、焦虑、记忆力差、腿膝酸软、疲倦乏力、手脚发凉等为亚健康状态的常见临床表现。结论医务人员亚健康状态的临床表现多样,其健康状况不容乐观。

OBJECTIVE To explore the clinical manifestation of subhealth status in teachers and medical staff. METHODS An on-the-spot investigation was conducted in 891 personnel of a medical college using a self-designed subhealth questionnaire. The diagnostic criteria for subhealth status were formulated on the basis of literature review and expert counseling. The results were analyzed by frequency analysis and multiple-factor logistic analyses. RESULTS The total subhealth incidence was 57.2 %, and the clinical manifestations included many symptoms of the body, psychology and society. Multiple-factor logistic analysis revealed the most common clinical manifestations of subhealth status including ademonia, weariness, insomnia, waist and back pain, frequent sighs, eye dryness, inattention, irritability, foot and hand coldness, vulnerability to common cold etc. CONCLUSION The clinical manifestations of sub-health status complex.

高血压心脏损害的相关因素可归纳为分子机制和动力学影响;高血压属于中医阴阳失调、气血违和的表现,高血压的病理特征为"血郁于上"、"血郁生风",而高血压性心脏损害属"久郁致瘀",这也是中医"久病入络"的体现之一.从"高血压证"整体辨治、平衡阴阳调和气血、防以行血治以化瘀、中西药结合等方面探讨如何保护由高血压导致损害的心脏.

近年来,肾病与脂代谢紊乱的关系愈来愈引人注目,在慢性进行性肾损伤时常伴随脂代谢异常,而高脂血症又可促发肾损害,除了介导肾小球损伤外,在小管间质损伤中也起作用.

高脂血症是临床常见病和多发病.近年来认识到高脂血症不仅是某些肾脏病的常见临床表现,还参与肾病的发生和发展,据研究,致动脉粥样硬化的脂蛋白可能在肾小球细胞增殖和有丝分裂中起着重要的内源性调节作用[1].