IZL-2003免疫治疗系统穴位辐照对恶性肿瘤放化疗减毒作用的观察

目的:观察IZL-2003免疫治疗系统对恶性肿瘤放、化疗患者骨髓抑制的近期疗效和生存质量的影响。方法:将120例骨髓不同程度抑制的放、化疗患者随机分为治疗组(IZL-2003免疫治疗系统辐照)、对照组(仅常规给予维生素C、维生素B6)各60例,治疗10 d为1个疗程。结果:治疗组外周血白细胞数明显增多,与对照组比较,差异有显著性(P<0.05);治疗组与对照组KPS改善率分别为28.33%和10.00%,恶化率分别为31.67%和53.33%,两组比较,差异有显著性(P<0.05)。生存质量治疗组优于对照组(P<0.05)。结论:IZL-2003免疫治疗系统辐照能拮抗放、化疗所致白细胞减少,并在一定程度上改善患者KPS评分,提高生存质量。     

补肾益精方对去势大鼠椎体结构、成分与生物力学性能的影响

目的:评价补肾益精方提高去势大鼠椎体骨质量的有效性,探讨本方改善模型松质骨生物力学性能的作用机制.方法:40只12月龄Wistar雌性大鼠随机分为正常对照组、模型对照组、补肾益精方组与倍美力组,每组10只.给药组的给药时点是双侧卵巢切除术后90 d,给药组与非给药组的处死时点是卵巢切除术或假切除术后180 d.处死以后,分别测定各组大鼠第二腰椎宏观几何结构参数、生物化学成分参数、生物力学性能参数.结果:模型对照组的腰椎宏观几何结构参数与正常对照组比较,未见显著性差异(P>0.05);补肾益精方组、倍美力组与模型对照组比较,也均未见显著性差异(P>0.05).模型对照组的生物化学成分参数与正常对照组比较,其中骨矿盐密度显著减少(P<0.05),骨胶原密度减少不显著(P>0.05);补肾益精方组、倍美力组与模型对照组比较,补肾益精方组的骨矿盐密度与骨胶原密度分别上升3%(P<0.05)和8%(P>0.05),倍美力组分别上升9%(P<0.05)和12%(P>0.05).模型对照组的结构力学参数以及材料力学参数都显著低于正常对照组(P<0.05);尤其在弹性阶段的结构力学参数与材料力学参数方面,补肾益精方组比模型对照组显著升高(P<0.05),但是倍美力组升高不显著(P>0.05);在塑性阶段的结构力学参数与材料力学参数方面,补肾益精方组、倍美力组与模型对照组比较均明显升高(P<0.05),两者升高的幅度分别是30.3%与25.8%.结论:补肾益精方不仅提高去势大鼠椎体的骨质量,改善模型椎体弹性阶段的力学性能的作用也相对优于倍美力,具体机制有待进一步研究.     

大接经法治疗脑梗死临床研究

目的:观察大接经法治疗脑梗死瘫痪的临床疗效.方法:在药物结合康复治疗基础上,对30例脑梗死患者行大接经法治疗,运用 Brunnstrom六阶段评估法,与30例单纯药物、康复治疗患者作疗效对比观察.结果:治疗组瘫痪上肢功能达到Ⅵ阶段的由16.7%上升到70.0%,对照组由16.7%上升到43.4%;治疗组瘫痪下肢功能达到Ⅵ阶段的由20.0%上升到73.3%,对照组由23.3%上升到46.7%.组间比较,差异有显著性(P<0.05).结论:大接经法对脑梗死瘫痪肢体功能的改善具有显著作用.     

益气、活血、益气活血法对气虚血瘀证脑缺血再灌注模型鼠血液流变性的影响

目的 :观察益气、活血、益气活血法对气虚血瘀证局灶性脑缺血再灌注模型鼠血液流变性的影响。方法 :采用饥饿、劳累、高脂饮食等多因素复合制备气虚血瘀证模型 ,然后用线栓法阻断大脑中动脉复制局灶性脑缺血再灌注模型。实验动物随机分为假手术组、模型组、益气组、活血组、益气活血组。给药后 ,分别在脑缺血再灌注 1 ,3,7d检测血液流变学指标。结果 :与模型组比较 ,各治法组均有显著改善血液流变性的作用 (P <0 .0 5或P <0 .0 1 ) ,各治法组间比较 ,差异没有显著性 (P >0 .0 5 )。结论 :益气、活血、益气活血法改善脑缺血模型鼠的血液流变性可能是其抗脑缺血再灌注损伤的作用机制之一。     

仙灵骨葆配合推拿手法治疗神经根型颈椎病38例

目的:观察仙灵骨葆配合推拿手法对神经根型颈椎病的治疗效果.方法:随机将108例神经根型颈椎病患者分为3组.仙灵骨葆 手法组38例用仙灵骨葆加手法治疗,并与单纯仙灵骨葆治疗36例、单纯手法治疗34例作对照观察,治疗30 d后根据症状、体征进行疗效评定.结果:仙灵骨葆 手法组与仙灵骨葆组、手法组治疗后临床症状、体征积分比较,差异有显著性(P＜0.05),治疗前后积分差值也有明显改善(P＜0.01);仙灵骨葆 手法组与手法组、仙灵骨葆组疗效比较,差异有显著性(P＜0.05),仙灵骨葆 手法组的疗效优于对照组.结论:仙灵骨葆配合推拿手法治疗神经根型颈椎病具有较好的治疗作用.     

对中国渐进式改革的思考

实行渐进式改革,是中国改革方式区别于原苏联、东欧改革的重要特征之一。中国的渐进式改革采取了非均衡的战略,将体制内改革和体制外改革、政治改革和经济改革以及强制性和诱致性改革结合起来,先试验后推广,不断试错,体现了鲜明的中国特色。这种改革方式是中国特殊的国情和历史文化传统以及民族心理的体现,有其产生的历史必然性。中国的渐进式改革在取得重大成功的同时还存在着一些问题,需要我们在今后的改革中不断去解决。     

中西医结合治疗重型颅脑损伤疗效观察

目的:观察高压氧加针灸推拿疗法对重型颅脑损伤的恢复作用.方法:将患者分为常规药物治疗组(Ⅰ组)、常规药物+针灸推拿治疗(Ⅱ组)及常规药物+针灸推拿+高压氧治疗(Ⅲ组).Ⅰ组、Ⅱ组和Ⅲ组病例数分别为58,65,76例.入院时与出院时分别对各组患者进行格拉斯哥昏迷评分(Glasgow coma scales, GCS)及功能综合评定量表(functional comprehensive assessment,FCA)评分.结果:与入院时比较,出院时3组GCS和FCA评分均显著增加(P<0.05).出院时Ⅱ组和Ⅲ组GCS和FCA评分显著高于Ⅰ组(P<0.05),Ⅲ组GCS评分显著高于Ⅱ组(P<0.05).结论:高压氧配合针灸推拿治疗能显著提高颅脑损伤患者的治疗效果.     

Deaths in Unlicensed Alcohol Rehabilitation Facilities,

Non‐English‐speaking people do not always seek medical care through established institutions. This paper reports a series of deaths in unlicensed alcohol rehabilitation facilities serving Spanish‐speaking men. These facilities are informal groups of alcohol abusing men who live together. New members receive various treatments, including administration of ethanol or isopropanol, restraint, and seclusion. We reviewed 42 deaths in unlicensed alcohol rehabilitation facilities in Los Angeles County during the years 2003–2014. Data gathered included age, length of time spent in the facility, blood alcohol and drugs at autopsy, and cause and manner of death. Causes of death included acute alcohol poisoning, alcohol withdrawal, and a variety of other causes. Three cases were considered homicides from restraint asphyxia. The Department of Medical Examiner‐Coroner has worked with the police, district attorney, and State Department of Health Services to try to prevent additional deaths in unlicensed alcohol rehabilitation facilities. Nevertheless, prevention has been difficult.     

Evidence-based practice in group work with incarcerated youth

As a result of the Youth Criminal Justice Act's increased focus on restorative justice, treatment, rehabilitation, and reintegration of youth, many more juvenile offenders require mental health services while resident in youth detention facilities [Youth Criminal Justice Act (2002, c.1). Ottawa: Department of Justice Canada. Retrieved September 19, 2008 from http://laws.justice.gc.ca/en/Y-1.5]. Several common characteristics such as violence, aggression, and other antisocial behaviors, associated with criminal behavior, have been identified among male and female offenders. Dialectical behavior therapy, originally developed by Linehan [Linehan, M. M., 1993a. Cognitive–behavioural treatment of borderline personality disorder. New York: Guildford Press] for chronically parasuicidal women diagnosed with borderline personality disorder, has been successfully modified for use with other populations, including violent and impulse-oriented male and female adolescents residing in correctional facilities. The intent of this article is to encourage the wider use of dialectical behavior therapy (DBT) with young offenders. It includes an extensive review of the evidence-base to date and describes some of the creative modifications that have been made to standard DBT program format to meet the particular needs of various groups in both Canada and the United States. In keeping with the movement toward more evidence-based practice, the authors argue that DBT is a promising approach in group work with incarcerated adolescents and should be more widely used.     

如实感知中的心灵解放：增能策略的东方视角

随着上世纪,80年代增能服务的兴起,增能这一概念几乎成了社会工作者在社会层面开展服务的代名词。但是,什么才是增能？怎样才能增能？这些基本问题却一直争论不休。文章希望通过对上世纪90年代兴起的正念治疗进行梳理,描述另一种崭新的增能策略的理论逻辑和实施方法。这种正念治疗的增能策略根植于东方的佛学,是东西方思想交融的结晶,它一反以往西方社会工作所倡导的自决和掌控的增能策略,以接纳和不批判的态度为核心,关注当下的整全实践,目的是实现生活的如实感知和心灵的解放。这种有着东方哲学基础的崭新的增能服务策略能够给正在寻求本土化道路的中国社会工作者带来许多有益的启示。