西汉时期,骏马贸易是汉王朝经营西域战略中十分重要的部分,不仅是出于统治者对良马的渴望,更直接关乎着国家的军事实力,而敦煌正处于西汉至西域交通的枢纽地带,因此与骏马贸易有着密切关系.汉武帝时期,军队的士卒为了迎合武帝对天马的喜好,曾先后编造出余吾水出天马与渥洼水出天马的传说.随着张骞的通使,西域各国的良马得以进贡入中原,并由此引发了西汉与大宛国的战争,由李广利率兵先后两次征伐大宛得胜后,西域间的骏马贸易方得以正常进行,这些西域良马通过敦煌进入中原,改良了西汉的马种,迅速提高了西汉的兵力.

敦煌郡的设置时间,《汉书·地理志》敦煌郡条记载是汉武帝后元年间(前89-88),《汉书·武帝纪》记载是元鼎六年(前111),二者自相矛盾;根据敦煌文献记载,元鼎六年在赵破奴的主持下修筑敦煌城,同时还修筑了敦煌郡的防御体系——塞城和土河,并修筑了敦煌郡水利灌溉体系,特别是马圈口堤堰,通过这些记载可以了解敦煌郡初置时期的管辖范围.

在医学研究领域,先行性与可行性研究是为降低正式试验的不确定性、提高正式试验的总体质量及成功率而实施的先行性探索性试验;先行性与可行性研究是为了回答"未来的正式试验能否实行、是否应该实行(如果应该实行,如何实行)"这样的问题.Ⅲ期临床试验耗时耗力、需大量的资源投入,所以在实施正式试验前往往需要开展先行性探索性的小规模试验、以确保正式试验的可行性与顺利开展.目前先行性与可行性研究越来越受到关注,然而在国内此类研究才刚引起重视.本文就先行性与可行性研究的相关概念、对正式试验的价值、实例分析与研究现状作简单介绍.

本文首先向读者介绍了出土于加兹温(Qazvin),克尔曼沙赫(Kermanshah)、赞詹(Zanjan)三地的印章,并将它们与其他地区出土的类似印章进行了对比分析.在对比过程中,印章上的独特迹号向世人提出了一些有趣的猜想,比如这些印章在伊朗铁器时代Ⅲ期(ca.800-600B.C)的历史进程中所扮演的角色,以及在流通过程中它们发行与贸易相关的历史地理问题.除去描述亚述艺术风格的特点外,印章中来自卢利斯坦(Luristan)本地艺术风格元素与埃兰文化艺术元素的结合,向我们证明这些印章是伊朗文明的本土产物.尽管如此,这些伊朗本土印章还是受到了新亚述艺术风格的影响,而这影响的根源则来自伊朗地区与美索不达米亚地区之间长期的贸易往来和政治军事活动.

Objective To analyze the epidemiological characteristics, clinical manifestations, diagnosis and treatment effect of brucella in=nfection, and to provide practical foundation and valuable experience for clinical treatment and prevention of brucellosis.Methods One hundred and nineteen patients with brucella infection hospitalized at the First Hospital of Lanzhou University from January 1st 2011 to July 30th 2011 were enrolled.Clinical data including gender, age, contact history with bovine and clinical manifestations such as fever, sweating and joint and muscle pain were extracted.Diagnosis and treatment effect of these patients were all recorded.The epidemiological characteristics and clinical manifestations were analyzed.Results The majority of patients were middle-aged male, and the number of male cases were 2.5 times of female cases.The brucella infections were observed all seasons in Lanzhou, while most cases were observed between May and July.A total of 78 cases had clear animal contact history.Among them, 53 cases (44.54%) had contact history with bovine.Main clinical manifestations included fever (n=84, 70.59%), muscle and joint pain (n=93, 78.15%), sweating (n=52, 43.70%), fatigue (n=29, 24.37%), and the most common clinical symptoms was joint and muscle pain.Blood routine test showed neutropenia (n=25, 21.01%), increase in blood sedimentation (n=34, 28.57%) and blood coagulation dysfunction (n=30, 25.21%).Liver function examination showed increase in ALT (n=37, 31.09%) and AST (n=43, 36.13%).Other examination showed that splenomegaly (n=28, 23.52%) was the most common finding, and liver diffuse lesions (n=22, 18.49%) ranked second.The most common drugs were doxycycline (n=79, 66.39%), rifampin (n=60, 50.42%) and cephalosporins (n=50, 42.02%).Among them, 45 cases (37.82%) were treated with combination therapy of rifampin and doxycycline, and 31 cases were treated with combination therapy of doxycycline and rifapentine or cephalosporins.Totally 112 cases (94.12%) recovered.Conclusions The majority of patients with brucellosis are male.The clinical manifestations of brucellosis are varied.Clinicians should pay attention to identify and prevent misdiagnosis.The timely and effective treatment should be provided according to patients' conditions.The relevant departments should also strengthen supervision and education of brucellosis.

Qualitative systematic review is a kind of research method in which qualitative questions are included into qualitative researches for objectively reviewing and analyzing conclusions after system retrieval. Data synthesis is an important procedure in qualitative systematic review, and the included researches are summed up and meanwhile the results of systematic review is directly determined. There are three major synthesis methods used by most reviewers including thematic synthesis, Meta-ethnography and CIS (critical interpretive synthesis). Thematic synthesis is characterized by forming descriptive and analytical themes. Meta-ethnography is used when included literature or extracted themes have obvious similar or contradictory relationship, and conclusion can be obtained through linear argument. CIS is a data synthesis method with broader applicability developed based on Meta-ethnography. These three synthesis methods for qualitative research data are introduced in details here, and the methodological guideline will be provided to researchers.

目的:系统评价黄芩汤治疗溃疡性结肠炎(UC)的有效性与安全性.方法:计算机检索PubMed,The CochraneLibrary,Embase,Web of Knowledge,CBM,Wanfang Data,VIP和CNKI数据库,查找关于以黄芩汤为干预措施治疗UC的随机对照试验,检索时限均从建库至2015年1月24日.由两名研究者按照纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan 5.2软件进行Meta分析.结果:共纳入5个研究,共计309例患者.Meta分析结果显示,与柳氮磺胺吡啶相比,黄芩汤可以明显提高溃疡性结肠炎治疗的治愈率[RR=1.54,95％ CI(1.19,2.01),P=0.001],并且能明显降低不良反应发生率;但不能明显提高治疗的总有效率[RR=1.06,95％ CI(0.97,1.17),P=0.21],也不能明显降低临床症状腹泻、脓血便、里急后重、腹痛的积分.结论:黄芩汤治疗溃疡性结肠炎疗效在治愈率与降低不良反应方面优于柳氮磺胺吡啶,上述结论尚需开展更多研究予以验证.

目的 评价中华医学会系列期刊中定性研究的现况和质量.方法 计算机检索中国生物医学文献数据库内中华系列杂志发表的定性研究,并利用严格评价项目(CASP)评价量表评价其质量.结果 共检索到1 212篇研究,通过筛选最终纳入309篇定性研究.自2001年起,定性研究数量逐年递增;研究主题方面:护理87篇(28.16％)、内科61篇(19.74％)、医学教育45篇(14.56％)、肿瘤31篇(10.03％)等;研究对象方面:以患者为研究对象118篇(38.19％)、以护理工作者为研究对象72篇(23.30％)、以家属为研究对象30篇(9.71％)、以学生为研究对象38篇(12.30％);研究方法较为单一,89％为深度访谈.通过质量评价发现:225篇(72.8％)的研究设计存在缺陷;240篇(77.7％)无研究者反思;35篇(11.3％)的研究对象招募策略不恰当;45篇(14.5％)不符合伦理学标准;48篇(15.5％)资料分析过程有缺陷.综上,纳入研究的质量在研究设计和研究者反思上最薄弱,在抽样、资料收集、资料分析和伦理学方面需加强.结论 中华医学会系列期刊定性研究发表数量逐年递增,研究主题多样,但存在研究对象局限,研究方法单一等问题.定性研究的质量仍待加强,以便日后对基于定性研究的决策提供最佳证据.