循证医学在急诊住院医师培训中的应用

循证医学（Evidense—based medicine,EBM）是一门新兴临床学科,著名流行病学专家David Sackett教授将循证医学定义为：慎重、准确和明智地应用能获得的最好研究依据来确定患者的治疗措施。其实质就是医生诊治患者的一个过程,是精益求精地认识疾病的本质,从而去寻求最佳证据,并联系的实际情况,取得最佳治疗效果。循征医学的3个基本要素是临床医生的个人专业技能、最好的科学证据、患者的价值和愿望。     

医务人员循证医学相关知识与技能的现状分析

实践循证医学（Evidence-based Medicine,EBM）有助于医务人员制定最佳临床决策。为了解医务人员EBM的相关知识与技能,对江苏省区域内三级和二级医院的医务人员进行问卷调查,结果表明需尽快开展系统、有效的EBM继续教育。     

循证医学应用于急诊临床教学的价值

被誉为“21世纪临床医学新思维”的循证医学（Evideneedbased medicine,EBM）日益引起广大包括急诊医师在内的临床医学工作者的关注。EBM的出现为现代医学教育提供了新的教学模式．在急诊医学临床实习教学中应用EBM．对促进循证医学的发展。培养高素质的急诊医学人才,提高医疗质量将产生重大的影响。     

抑郁症治疗的循证医学研究进展

循证医学是近年来国际上临床医学领域迅速发展起来的新学科,已成为当前国际医学研究中的热点之一,是指对病人的诊 断、治疗、预防、康复和其他决策应建立在当前最佳临床研究证据,是遵循证据的临床医学,强调收集最佳证据。其理念的科学性 和有效性迅速渗透到医学领域的众多学科,循证精神卫生也相继提出并发展。抑郁症是由各种原因引起的以抑郁为主要症状的 一组心境障碍或情感性障碍,近几年能够有效运用循证医学方法为治疗抑郁症寻找最佳临床证据,制定循证诊疗指南成为了临 床医生的迫切要求。本文就抑郁症治疗方面的循证医学研究进展做一综述。     

循证医学在慢性充血性心力衰竭药物治疗中的应用

循证医学(evidence-based medicine,EBM)是近年来国际临床医学领域迅速发展起来的新学科,强调"为每位病人作出医疗决定时,应明确而仔细地使用现有的最好证据"。本文利用循证医学的方法,参照若干著名的大规模多中心的随机对照试验(ran- domized controlled trial,RCT)来评估目前几类临床常用药物在治疗慢性充血性心力衰竭中的作用,试图找出针对不同NYHA等级患者的最佳治疗建议。     

我国本科护理专业开设循证医学课程的现状

循证医学是二十一世纪医学实践的新模式,是指导临床医生和医学生进行科学医疗实践的一种工具,又是实现临床医生终生自我教育的一种好的方法。循证医学的理念和方法对护理专业的影响,必将促进护理向科学化护理迈进,而循证医学教育是促进护理人员掌握循证医学知识和技能的关键,本文重点论述了我国本科护理专业开设循证医学课程的现状以及存在的主要问题。     

硫酸镁在产科麻醉中的研究进展

镁离子是人体内最丰富的阳离子之一,在机体许多的细胞功能中都发挥重要作用,参与体内多种重要的生物合成过程。硫酸镁是一种传统药物,在预防和治疗母亲与胎儿相关的各种疾病如妊娠高血压综合征、先兆子痫、子痫发作及先兆早产中的作用越来越受到重视,能够降低产妇及胎儿的发病率和死亡率。随着研究的不断深入,人们发现其在麻醉领域中的作用愈加突出,能够与全身麻醉药、局部麻醉药、麻醉镇痛药等产生协同作用,可作为术中安全的麻醉辅助用药。本文阐述了硫酸镁对于产科麻醉医生的重要性,硫酸镁在产科麻醉中的应用,并查找其在妊娠高血压疾病、早产儿的神经保护、麻醉辅助镇痛、预防应激反应以及稳定血流动力学等方面应用的最新证据。     

麻醉闭环自动控制系统的研究进展

正随着医学科学的不断发展,麻醉技术也在不断改进,在追求确保患者安全的同时,也重视医疗质量和成本的控制。传统的静脉、吸入麻醉药物的给药方式没有反馈控制,麻醉医生根据手术刺激程度和病人的生理状态等监测指标来进行药物调整。由于临床环境的复杂性和患者个体的差异性,即使是临床技能高和经验丰富的麻醉医生也难免发生给药过多而导致心血管或神经损伤等事件,或是药物不足而发生术中知晓。因此研究人员把临床麻醉和自动控制技术、设备     

循证护理在抗蝮蛇毒血清所致血清病的应用

循证护理是循证医学在护理学领域的应用,是一种科学有效的提高护理实践的方法,即以有价值的、可信的科学研究结果为证据,提出问题,寻找实证,运用实证,对病人实施最佳的护理。血清病指注射动物免疫血清后所并发的一种过敏性疾病,是一种典型的Ⅲ型变态反应。     

不同层流净化级别室内微量麻醉气体对医护人员的影响

目的:研究净化级别不同室内麻醉药物残留浓度对医护人员健康的影响,为制定麻醉操作规范提供参考依据。方法:通过Tedlar采样袋采集麻醉医生及麻醉恢复室人员呼出气20 mL,双盲法送30 min内相关人员应用气相色谱法进行分析。结果:不同层流净化级别室内医务人员呼出微量麻醉气体的浓度不同。十万级恢复室内医护人员呼出气体的浓度高于百级和万级手术间。结论:麻醉废气污染对手术室工作人员的心理行为及操作能力产生影响,医护人员应增强自我防护意识,定期监测手术室环境污染的程度,制定预防和减少麻醉废气污染的有效措施。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.