目的:观察基于子午流注取穴的一指禅推法对腰椎间盘突出症(LDH)的临床疗效,为LDH寻找新的治疗手段.方法:选取2018年1月至2019年8月收治的LDH患者88例,所有病例随机分为子午流注组和常规推拿组(各44例).通过两组治疗前后比较疼痛视觉模拟(VAS)评分、日本骨科协会(JOA)评分及Barthel指数评分,评估基于子午流注取穴的一指禅推法对LDH的疗效.结果:基于子午流注取穴的一指禅推法在治疗LDH上能减轻疼痛,提高患者的腰椎功能.两组患者治疗1个疗程和2个疗程后VAS评分及JOA评分差异均有统计学意义(P＜0.05),治疗后子午流注组和常规推拿组患者总有效率分别为93.18％和81.82％,两组在总体疗效上差异有统计学意义(P＜0.05).结论:基于子午流注取穴的一指禅推法能够显著提高患者临床疗效,减轻疼痛,改善患者的腰椎功能,并降低腰痛对患者日常生活的影响,基于子午流注取穴的一指禅推法对LDH疗效更好.

Objective To explore the problems existing in the postgraduate education of preventive medicine and the corresponding solutions.Methods Qualitative method was adopted;professional teachers and administrators of preventive medicine of colleges and universities in Wuhan,relevant persons in charge and managers from the employers,and graduates of 2011 ～2013 of preventive medicine were selected as the research subjects.Semi-structured in-depth interviews were used among the research subjects.Then based on the interview outline,QSR Nvivo 10.0 software was used to code the interview material.These tree nodes were modified and merged again and again before they finally became the mature ones.Results The main problems existing in the postgraduate education of preventive medicine were as follows:unreasonable teaching methods and contents;lack of sense of identity among students,formalized practice;inappropriate assessment of students;the neglect of teaching because of the excessive importance attached to scientific research.Conclusions Teaching methods and contents should be improved.Colleges should guide students to form clear self-localization.Besides,in order to successfully manage the practice of preventive medicine,more importance should be attached to it by universities and teaching bases.What's more,the indicators and models of assessment of students should also be improved.Lastly,enough emphasis should be placed on undergraduate teaching which can also be improved by scientific research.

Objective To investigate the drug expenses burden, including traditional Chinese medicine and western medicine expenses, on hypertensive inpatients and if gender and age affect the drug expenses. Methods Data were derived from the medical record system according with the following requirements: from January 1, 2014 to October 30, 2015, 60 years old or older, diagnosed as hypertension. Drug expenses and some other information such as gender and age of each elderly hypertensive inpatient were collected simultaneously. Parameter test and Non-parameter test were utilized to analyze the drug expenses difference between male and female hypertensive inpatients, and in different age groups. Results Eighty-two percents of the drug expenses of elderly hypertensive inpatients came from Western medicine and the remaining drug expenses were from traditional Chinese medicine. Male hypertensive inpatients spent more money on traditional Chinese medicine and Western medicine than female hypertensive inpatients (P<0.001). Hypertensive inpatients in different age groups spent different amounts of money on drug expenses, including both traditional Chinese medicine and Western medicine expenses (P<0.001). In generally, getting older resulted in more drug (traditional Chinese medicine and Western medicine) expenses consumed by elderly hypertensive inpatients. Conclusion Being a male and getting older contribute to more drug expenses, including traditional Chinese medicine and Western medicine expenses spent by hypertensive inpatients.

目的 探讨IgA、C3和IgA/C3比值在原发性IgA肾病的诊断及牛津分类中的价值.方法 收集具有IgA、C3值的原发性IgA肾病患者667例和非原发性IgA肾病患者699例,采用散射免疫比浊法检测血清IgA、C3,病理学分级参照牛津分级标准(系膜细胞增生M0/M1,毛细血管内增生E0/E1,节段性肾小球硬化S0/S1,肾小管萎缩/间质纤维化T0/T1).结果 (1)原发性IgA肾病患者与非原发性IgA肾病患者血清IgA水平分别为[(2.78±1.11)g/L与(2.22±1.20)g/L,P＜0.01];血清C3水平分别为[(1.01 ±0.23) g/L与(1.09 ±0.57) g/L,P＜0.01];IgA/C3比值分别为[(2.92±1.75)与(2.23±1.43),P＜0.01].(2)IgA、C3、IgA/C3比值在不同病理学分级组间比较差异无统计学意义(P＞0.05).结论 血清IgA、C3及IgA/C3比值可作为鉴别原发性IgA肾病与非原发性IgA肾病的参考指标,但与原发性IgA肾病牛津分类无相关关系.

Objective To explore training model and theoretical framework of new prevention medical compound talents in order to meet the need on disease control work and career development of public health.Methods Choose high grade students of preventive medicine, graduates in the last three years, teachers and management, stewards and management of employers in Wuhan.And use the selfdesigned questionnaires amended via the panel discussion to conduct a survey regarding base conditions, abilities which prevention medical compound talents should possess, important degrees of preventive medicine, rationalities of courses offered, feasibility of some reform measures.SAS 9.2 software is used to analyze data, including frequency description, R×C contingency table chi square test and Wilcoxon rank sum test with α =0.05.Results Compound talents of preventive medicine are high-quality personnel who have related knowledge and practical application ability of preclinical medicine, clinical medicine and prevention medicine, together with required comprehensive quality in this field.The main problems in current training model of preventive medicine students include: ① lack of professional ideological stability of preventive medical students;② inconsistency of cognition on preventive medicine and its development;③ irrationality of current curriculum setting and teaching arrangement;and ④ teaching method that need to be improved.Colleges should union the power of students, teachers and employers, and coordinate their acknowledgements and suggestions to solve the above issues so as to meet the training model of compound talents of prevention medicine.Conclusions Training model of compound talents of prevention medicine is feasible, and universities need to improve the whole process of personnel training from multi-aspects.

目的 探讨女工中不良建筑综合征(SBS)及其各类症状的发病率和主要影响因素.方法 2012年5-10月随机抽取深圳市752名女工为研究对象,采用问卷调查方法探讨集中空调通风系统暴露和睡眠质量对SBS及其各类症状的影响.结果 女工SBS发生率为19.7％(148/752).在校正其他混杂因素的条件下,暴露于集中空调的女工发生SBS的危险性是自然通风者的3.45倍,发生一般症状、眼睛症状、呼吸道及口腔症状、皮肤症状的危险性分别是自然通风者的3.20、5.32、6.40和6.17倍;睡眠质量差的女工发生SBS的危险性是睡眠质量好者的6.78倍,发生一般症状、眼睛症状、呼吸道及口腔症状的危险性分别是睡眠质量好的女工的7.53、22.85和9.38倍.结论 暴露于集中空调、睡眠质量差等因素会增加女工发生SBS的风险,应减少其在集中空调环境中的暴露,并提高其睡眠质量.