Epilepsy Treated by Traditional Chinese Medicine Based on Syndrome Differentiation： A Review / 中国实验方剂学杂志

Epilepsy is a chronic brain disease characterized by seizures， and is one of the most common nervous system diseases in clinic practice with the recurrent， transient， and refractory characteristics. Clinically， western medicine therapy is mainly adopted in the treatment of epilepsy， but it is not conducive to long-term use for patients on account of severe side effects， which can result in abnormalities in the digestive system， central nervous system， hematopoietic system， urinary system， and liver function to varying degrees. Syndrome differentiation is usually used for the treatment of epilepsy by traditional Chinese medicine （TCM）， which can avoid the side effects of western medicine treatment on the basis of improving patients' syndromes. The literature on TCM in the treatment of epilepsy in China and abroad indicates that the syndrome differentiation in TCM is often based on phlegm， blood stasis， wind， and deficiency， and the treatment methods include acupuncture， acupoint catgut embedding， moxibustion， Chinese medicine monomer， drug pair， and compound decoction. The various treatments of TCM play an important role in the comprehensive treatment of epilepsy through multiple channels and links， such as reducing the degree and number of seizures. This paper comprehensively summarized the clinical experience of TCM in the treatment of epilepsy， systematically expounded various treatment methods and ideas of TCM in the treatment of epilepsy， and deeply discussed the mechanism of TCM in the treatment of epilepsy， aiming to provide a theoretical basis for the clinical formulation of a reasonable individualized treatment plan for epilepsy and diversified ideas for the more effective treatment of epilepsy by TCM.

Construction of clinical efficacy evaluation system based on optimal clinical experience / 中国中药杂志

Evidence-based medicine plays an important role in promoting the scientific nature of clinical decision-making. Howe-ver, there is a problem where evidence derived from clinical research may not necessarily be applicable to individual patients. Evidence-based medicine has been introduced into the field of traditional Chinese medicine(TCM) for over 20 years, and although certain achievements have been made, the overall level of clinical research evidence based on the principles of evidence-based medicine in TCM is not high. The acceptance of TCM diagnosis and treatment guidelines developed based on evidence-based medicine methods is generally low. As revealed by the analysis of the problems in the application of evidence-based medicine in the field of TCM, it is found that there is a structural contradiction between clinical randomized controlled trial(RCT) of TCM and the characteristics of TCM clinical practice. They cannot comprehensively, objectively, and truthfully reflect the clinical efficacy and safety of TCM. Conducting clinical RCTs of TCM in pursuit of "evidence" actually means giving up the advantages of TCM in clinical treatment based on syndrome differentiation, prescription changes along with syndromes, and treatment in accordance with three categories of disease cause, which leads to sacrificing some clinical effectiveness of TCM. Based on the concept of evidence-based medicine, this article proposed the construction of "clinical syndrome-based medicine" based on the optimal clinical experience, which was suitable for the characteristics of TCM clinical practice. The key to clinical syndrome-based medicine is the optimal clinical experience, and the core elements of the optimal clinical experience are regularity and reproducibility. Real-world research methods are recommended as a reference for obtaining the optimal clinical experience. Clinical syndrome-based medicine, combining the characteristics of TCM clinical practice and incorporating the concept of evidence-based medicine, is the product of integrating TCM into evidence-based medicine. It is dedicated to improving the clinical efficacy of TCM along with evidence-based medicine.

Application of "three-dimensional knowledge-objective" teaching combined with immersive clinical experience in nursing practice teaching in the operating room of department of ophthalmology and otorhinolaryngology / 中华医学教育探索杂志

Objective:To investigate the application of "three-dimensional knowledge-objective" teaching combined with immersive clinical experience in nursing practice teaching in the operating room of department of ophthalmology and otorhinolaryngology.Methods:A total of 86 nursing students who received practice teaching in the operating room of Department of Ophthalmology and Otorhinolaryngology in our hospital were selected as research subjects and were divided into control group and observation group using a simple random number table, with 43 students in each group. The students in the control group received traditional teaching, and those in the observation group received "three-dimensional knowledge-objective" teaching and immersive clinical experience. The two groups were assessed in terms of the effectiveness of classroom teaching, nursing quality score, and the score of the ability to handle nurse-patient dispute. SPSS 22.0 was used to perform the chi-square test and the t-test. Results:After training, both groups had significant increases in the scores of basic nursing, specialized nursing, equipment management, equipment coordination ability, patrol coordination ability, and document recording ability and the total score of all dimensions, and the observation group had significantly higher scores than the control group ( P<0.05). After training, both groups had significant increases in the scores of dispute identification ability, the ability of emergency response to dispute, nurse-patient communication skills, the awareness of nursing laws and regulations, and psychological stress adjustment ability and the total score of all dimensions, and the observation group had significantly higher scores than the control group ( P<0.05). Conclusion:In the nursing practice teaching in the operating room of the department of ophthalmology and otorhinolaryngology, "three-dimensional knowledge-objective" teaching combined with immersive clinical experience can improve the effectiveness of classroom teaching, enhance nursing quality, and strengthen the ability to handle nurse-patient dispute.

Práctica Basada en Evidencia en Adicciones: Conocimientos y Habilidades de Psicoterapeutas del Noroeste de México / Evidence-Based Practice in Addictions Area: Knowledge and Skills of Therapists from Northwestern Mexico

Resumen La Práctica Basada en Evidencia (PBE) es un proceso que inicia con el conocimiento de las evidencias disponibles y concluye con la selección de la mejor intervención para su implementación en escenarios clínicos lo cual impacta la efectividad de las intervenciones. Objetivo. Caracterizar el perfil de los terapeutas que laboran en 17 centros de tratamiento ambulatorio en adicciones del noroeste de México, además de sus conocimientos y habilidades en el uso de la PBE (fuentes de consulta, uso de manuales) y percepción de su autoeficacia. Método. Participaron 102 terapeutas, se contemplaron dos etapas: cuantitativa basada en la aplicación del CUTEA y cualitativa con aplicación de entrevista semi-estructurada, buscando contrastar las respuestas. Resultados. La mayoría de los participantes tuvo dificultad para describir el concepto de PBE, solo el 37.25% logró una adecuada definición sin embargo, reportaron altos niveles (95.91%) de autoeficacia para implementarla. En relación a las fuentes de consulta el 50% reportó utilizar cualquier buscador comercial en internet, mientras que el 46.08% referían usar los manuales de la institución. Al ingreso a su trabajo, no contaban con capacitación en adicciones ni en el área clínica. Discusión. Se aborda la necesidad del entrenamiento en la PBE y no solo en la implementación de tratamientos específicos.

Abstract Introduction. Evidence-Based Practice (EBP) is a process which starts with the knowledge of available evidence and concludes with the evaluation and selection of the best intervention for the implementation in clinical settings, this process impact the efficacy of the interventions. The variables which can impact on the EBP could be: personal and institutional variables and therapist skills and variables of the interventions. However, to make decisions in the clinical context, it has prevailed a position based on the risks and needs of the clients, which would justify using any treatment, regardless of its effectiveness, which makes the professional psychologist a passive subject who is dedicated only to implementing interventions that institutions request. Therefore, EBP demands that the psychologist be critical of the research and this allows the identification of the best evidence available and also must have the skills to adapt that evidence to their particular context. The objective is to characterize the profile of therapists working in 17 outpatient treatment centers in Mexico, as well as the skills related to the use of EBP (sources of consultation and use of manuals, transfer of knowledge to the population and other therapists) and perception of their self-efficacy. Method. This is a cross-sectional research in which 102 therapists participated. Two stages were considered: quantitative, based on the application of a questionnaire, and the second was qualitative, seeking to contrast the responses. Results. Most of the participants had difficulties in explaining EBP, but reported high levels of self-efficacy to implement it. At the beginning of their work, they had no training in addictions or in the clinical area. Discussion. The need for training in EBP from undergraduate studies is addressed so that future therapists will find it more natural to implement it in clinical settings, through the analysis of scientific articles and, if possible, its application.

Efetividade da experiência clínica em serviços de tratamento especializados em álcool e outras drogas nas atitudes dos estudantes de enfermagem frente ao álcool, alcoolismo e ao alcoolista: revisão sistemática / Effectiveness of clinical experience in specialized treatment services on alcohol and other drugs in nursing students' attitudes towards alcohol, alcoholism and alcoholics: a systematic review

Introdução: As atitudes dos estudantes de enfermagem frente ao álcool, alcoolismo e alcoolista tem sido descritas de maneira geral como negativas, isso é atribuído a pouca atenção dada à educação dos estudantes de enfermagem frente a temática de adições durante sua graduação. Essas atitudes negativas refletem negativamente no cuidado gerado pelo futuro profissional a indivíduos com problemas associados ao uso do álcool. Embora não haja consenso, estudos têm sugerido que a experiência clínica em serviços especializados no tratamento de uso e abuso de substâncias exercerem influência nas atitudes dos estudantes frente ao álcool, alcoolismo e alcoolista. Objetivo : Identificar, analisar e sintetizar as melhores evidências sobre a efetividade da experiência clínica em serviços de tratamento especializados em álcool e outras drogas nas atitudes dos estudantes de enfermagem frente ao álcool, alcoolismo e ao alcoolista. Método: Trata-se de uma revisão sistemática de efetividade, baseada no modelo proposto pelo Instituto Joanna Briggs (JBI). A primeira etapa foi realizada em duas bases de dados para coletar mais descritores para a estratégia de busca, a segunda foi realizada a seleção das publicações por meio do título e resumo e, a terceira, foi realizada análise das referências dos artigo que preencheram os criteros de inclusão. Tanto a busca, extração e síntese foi realizada por dois revisores independentes. A busca contemplou artigos publicados e nas línguas inglesa, portuguesa e espanhola, sem limitação de período. Utilizou-se a ferramenta SUMARI, para a extração e avaliação crítica dos artigos selecionados. Resultado: Foram identificadas 4655 publicações, oito artigos foram incluídos de acordo com critérios previamente estabelecidos. Estes são apresentados em um artigo. Artigo 1: Efetividade da experiência clínica em serviços especializados no tratamento de álcool e outras drogas nas atitudes dos estudantes de enfermagem frente ao álcool, alcoolismo e alcoolista: revisão sistemática e meta-análise A maioria dos estudos mostrou mudanças positivas nas atitudes dos estudantes em relação ao álcool, alcoolismo e alcoolismo, além de uma maior motivação dos estudantes para trabalhar com esse paciente após a experiência clínica. Conclusão: Conclui-se que a experiência clínica em serviços especializados no tratamento de dependentes de álcool e outras drogas possibilita atitudes mais positivas dos estudantes de enfermagem frente ao alcoolismo e ao alcoolista, contribuindo também para motivar os estudantes a trabalhar com essa clientela. Contudo, esse estudo necessita de uma análise quantitativa com mais estudos para reforçar o efeito presente no resultado e contornar as limitações apresentadas.

Introduction: Nursing students\' attitudes towards alcohol, alcoholism and alcoholics have been generally described as negative, this is attributed to the little attention given to the education of nursing students regarding the theme of addictions during their graduation. These negative attitudes reflect negatively on the care provided by the future professional to individuals with problems associated with alcohol use. Although there is no consensus, studies have suggested that clinical experience in specialized services in the treatment of substance use and abuse has an influence on students\' attitudes towards alcohol, alcoholism and alcoholics Objective: To identify, analyze and synthesize the best evidence on the effectiveness of clinical experience in specialized treatment services on alcohol and other drugs in nursing students\' attitudes towards alcohol, alcoholism and alcoholics. Method: This is a systematic review of effectiveness, based on the model proposed by the Joanna Briggs Institute (JBI). The first step was carried out in two databases to collect more descriptors for the search strategy, the second was the selection of publications by means of the title and summary and the third was carried out an analysis of the references of the articles that met the inclusion criteria. Both search, extraction and synthesis were performed by two independent reviewers. The search included published and unpublished articles in English, Portuguese and Spanish, with no period limitation. The SUMARI tool was used to extract and critically evaluate the selected articles Result: A total of 4655 publications were identified, and eight articles were included according to previously established criteria. These are presented in an article. Article 1: Effectiveness of clinical experience in specialized treatment services on alcohol and other drugs in nursing students\' attitudes towards alcohol, alcoholism and alcoholics: Systematic review and meta-analysis. Most studies showed positive changes in students\' attitudes towards alcohol, alcoholism and alcoholism, as well as a greater motivation of students to work with this patient after clinical experience. Conclusion : It is concluded that clinical experience has the potential to change nursing students\' attitudes towards the studied theme, besides helping to motivate students to work with it. However, this study needs a quantitative analysis with more studies to reinforce the effect present in the result and to overcome the limitations presented.

Edición de la Disertación sobre la manía aguda (1827) del médico Diego Alcorta / An edition of the Disertación sobre la manía aguda (1827) by physician Diego Alcorta

Resumen El surgimiento de la experiencia clínica en la medicina europea posee hoy numerosos estudios que han abordado su proceso de emergencia desde comienzos del siglo XIX. Con respecto a la indagación acerca de dicho proceso en el espacio del Río de la Plata, la historiografía ha brindado mayor atención al análisis del desarrollo institucional de la práctica médica, que a la elaboración que los médicos del escenario local llevaron a cabo sobre las obras más relevantes de la ciencia médica. Por lo tanto, la presente edición de la Disertación de la manía aguda (1827), del médico Diego Alcorta, busca arrojar nuevos indicios que permitan profundizar en el registro del desarrollo de la experiencia clínica, en el espacio rioplatense.

Abstract The rise of clinical experience in European medicine has by now been the subject of numerous studies dealing with the process of its emergence since the beginning of the nineteenth century. As regards research on this process in the River Plate area, the historiography has devoted more attention to analysis of the institutional development of medical practice than to local physicians' creation of the most important works of medical science. Therefore, this edition of the Disertación de la manía aguda (1827), by physician Diego Alcorta, seeks to shed new light on records of the development of clinical medicine in the River Plate área.

Experience on clinical treatment of caugh / 中国中西医结合急救杂志

Objective To observe the clinical effect of Qingjinhuatan decoction in the treatment of exogenous cough. Methods Qingjinhuatan decoction (for relieving cough) was used for external cough (caused by common cold), the ingredients of the decoction include tenuifolia 10 g, common hogfennel root 10 g, campanulaceae 10 g, sweet almonds 10 g, licorice10 g, cynanchum glaucescens 10 g, eriobotrya japonica 10 g, aster tataricus 15 g, citrus peels 10 g, tabasheer 20 g, fritillaria (shellfish) 1 g, reed roots 20 g, melons 20 g), the above ingredients were mixed and boiled in water to make decoction, 2 times a day, 200 mL each time. The clinical effect of the decoction was observed. Results After 3-5 days of treatment, the clinical symptoms of the patients were relieved and satisfactory results were achieved. Conclusion Qingjinhuatan decoction can significantly improve the clinical symptoms of patients with exogenous cough, and the effective rate is high.

Clinical experience of Filipino clinicians on the use of Bedaquiline for treating multidrug-resistant Tuberculosis

@#<p><strong>BACKGROUND:</strong> The Philippines is among countries globally with high multidrug-resistant tuberculosis (MDR-TB) burden. An operations research on Bedaquiline (BDQ), a new drug for MDR-TB, was launched by the Department of Health (DOH) in 2016.</p><p><strong>OBJECTIVES:</strong> This paper aimed to gather the opinions and first-hand experiences of clinicians in the Philippines regarding BDQ.</p><p><strong>METHODS:</strong> A facilitated roundtable discussion among nine clinicians included in the operations research on BDQ in the Philippines was conducted in June 2018. Topics covered included: (a) considerations in the use of BDQ, (b) outcomes of patients given BDQ, and (c) perceptions on effectiveness and safety of BDQ. Recordings and field notes from the discussion were subjected to framework analysis.</p><p><strong>RESULTS AND CONCLUSION:</strong> Participants gave BDQ an overall positive feedback due to the effectiveness, less toxicity, and ease of administration compared to other anti-TB drugs. Issues on BDQ included the novelty of the drug that caused doubts at first use and the limited application of the drug as dictated by the inclusion criteria within the context of the operations research, among others. The significant number of patients lost to follow up and ways to address this challenge were also discussed.</p>

Experience of Professor Fan Yongsheng in treating arthralgia with insect drugs / 中国中药杂志

National-level famous traditional Chinese medicine( TCM) doctor Professor Fan Yong-sheng has high-level accomplishments in the treatment of arthralgia. According to clinical diagnosis and dialectic,TCM with appropriate medicinal properties were flexibly applied,with a remarkable efficacy. Especially in the application of insect drugs,he has accumulated abundant clinical experience.According to the main syndromes of arthralgia and pathogenic site,patient' s constitution,Scorpio,Scolopendra,Pheretima,Vespae Nidus,Bombyx Batryticatus,Manis Squama,Bungarus Parvus,Zaocys,Agkistrodon,Cicadae Periostracum,Aspongopus,Eupolyphaga Steleophaga,Silkworm Sand were properly selected. Attention was also paid to the compatibility between insect drugs and antirheumatic drugs,blood-activating drugs and tonifying drugs. In the premise of safe and effective application in the treatment of arthralgia,insect drugs show such efficacies as antipyretic,activating collaterals and relieving pain.

Professor 's experience in triple-stage regimen for herpes zoster with herbal thread moxibustion of medicine / 中国针灸

The clinical experience of professor is introduced in treatment of herpes zoster and post-neuralgia with herbal thread moxibustion of medicine combined with acupuncture. Professor divides the pathological process of herpes zoster into pre-herpes stage, herpes stage and post-herpes stage. At pre-herpes stage, in pathogenesis of medicine, the deficiency of antipathogenic , invasion of pathogens, retarded and blood circulation in dragon and fire pathways are involved. Clearing heat, detoxification, promoting circulation in the pathways and dispersing and blood are considered in treatment. The herbal thread moxibustion is provided at " point" and " point" and seize "the head and tail of snake", and 3 needles are used at each of ends of skin leison. At herpes stage, toxin stagnation in dragon and fire pathways, stagnation on skin and muscle, and blood disturbance and dysfunction of three kinds of are considered in pathogenesis. The treatment focuses on removing pathogens and toxin, assisted with regulating and blood circulation, removing herpeses and promoting wound healing. The herbal thread moxibustion is used at " point", " point" and the two ends of skin lesion. The local row-like puncture is provided at skin lesion according to the intercostals nerve distribution. At post-herpes stage, the retention of pathogens and stagnation of blood in dragon and fire pathways are considered in pathogenesis. The treatment focuses on activating blood circulation, removing stasis and eliminating the pathogen residuals. " point", " point" and the two ends of skin lesion are selected in herbal thread moxibustion, or sweeping and dragging techniques of acupuncture are adopted. The timely application of herbal thread moxibustion controls the development of herpes zoster and prevents from post-neuralgia.

MIN Zhongsheng's Clinical Experience in Delayed Post-adolescent Acne / 浙江中医药大学学报

[Objective] To explore the clinical experience of Professor MIN Zhongsheng treatment in delayed post -adolescent acne. [Methods] Through studying with Professor MIN, collecting clinical medical cases, representing academic views of others, discussing clinical experience of Professor MIN, treatment in delayed post -adolescent acne from the pathogenesis, explanation of the prescription was presented, and a classic case was cited as an evidence. [Results] Ancient doctors considered that wind, cold, heat and wet were the external cause, while the weakness of vital Qi and blood heat were the internal cause. It led to stasis, when body was infected with wind-cold damp pathogen. Professor MIN considers that the etiology of this disease contains two aspects, one is endocrine disorder, the other is metal facts. He also thinks that deficiency of energy is the root cause and blood stagnation is the clinical manifestation. He also regards tonifying Yin of liver and kidney,cleating away heat and toxin, removing blood stasis as treatment. In the classic case, Professor MIN used Rubus idaeus L, Eclipta prostrata as monarch drugs to tonify Yin of liver and kidney; used Hedyotis diffusa, Taraxacum mongolicum, Citrus reticulata Blanco, Salvia miltiorrhiza as minister drugs to clear away heat and toxin, and remove blood stasis. The patient of delayed post-adolescent acne became much better after the treatment.[Conclusion]The therapeutic method put emphases on tonifying Yin of liver and kidney, then clearing away heat and toxin. Removing blood stasis is the key of the treatment.

Professor ZHANG Yonghong's Clinical Experience in Treatment of Cerebral Tumor / 浙江中医药大学学报

[Objective] To explore and analyze Professor ZHANG Yonghong's clinical experience in treating cerebral tumor.[Methods]Through the clinical study with the teacher to collect and collate the relevant information and medical records, from the etiology and pathogenesis of cerebral tumor, governance and other aspects of the specific analysis and discussion on Professor ZHANG Yonghong's treatment of this disease, academic point of view and clinical experience,it summed up the law of condemnation, and to the case of evidence,through regular follow-up, observing the treatment effect. [Results]Professor ZHANG Yonghong views that the pathogenesis of cerebral tumor can be summarized as Qi deficiency, phlegm and blood stasis, internal movement of the liver, and confusion of the body. Its pathologic factors are related to wind, fire, phlegm, blood stasis and poison. In the treatment of cerebral tumors, it is advocated to improve Qi, nourish Yin, promote positive Qi, and break loose to remove cancer toxins. On the basis of the selection of invigorating the spleen and protecting the stomach, the rational use of invigorating the Qi and nourishing the Yin and combining with the drugs of eliminating evils and removing toxin, in order to achieve the goal of strengthening the anti -cancer. The two cases both achieved good results by strengthening the body resistance, eliminating evils and removing toxin.[Conclusion]Professor ZHANG Yonghong stressed that strengthening of the body resistance is a primary treatment when the treatment for cerebral tumor. We should pay attention to replenishing Qi and nourishing Yin, eliminating evils and removing toxin are adjuvant therapy. The spleen and stomach should be protected throughout the treatment, and patient's mood are also important. It is of great significance to instruct TCM to treat cerebral tumor.

The Clinical Experience of Integrated Traditional Chinese and Western Medicine in Treating Elderly Acute Myeloid Leukemia of SHEN Yiping / 浙江中医药大学学报

[Objective] To summarize Dr. SHEN Yiping's clinical experience of integrated traditional Chinese and western medicine in treating elderly acute myeloid leukemia (AML). [Methods]By examining with cases of illness and warding round,collecting the medical records of elderly AML patients treated by Dr. SHEN, learning the latest diagnosis and treatment guidelines, reading a large number of related papers and a large number of classical books, from the aspects of etiology and pathogenesis, therapeutic principles and methods, the clinical experience of the treatment of elderly AML were analyzed and summarized, and one medical record was provided.[Results]Dr. SHEN believes that the pathogenesis is deficiency syndrome accompanied with excess syndrome. Mostly due to congenital deficiency and poor basic functions, deficiency of spleen and kidney, heat poison intrusion, burning Jin as sputum, forcing blood going in wrong line, phlegm and blood stasis, evil accumulating in bone marrow and then suffered. Dr. SHEN uses heat-clearing, detoxifying and anti-cancer drugs to suppress and eliminate leukemia cells on the basis of chemotherapy and supplements beneficial drugs to achieve the goal of chemotherapy without harming the positive effect, he uses "Kangbai Yannian Tang" combined with decitabine and chemotherapy as a basic solution and changes flexibly by according to the clinical manifestations, changes of syndrome types of the patients, the clinical effect is remarkable, and the case had good results. [Conclusion]Dr. SHEN is good at integrated traditional Chinese and western, combining of syndrome differentiation and disease differentiation, using the combination of heat-clearing method and complement in the treatment of elderly AML, the experience and wonderful methods are worth learning and spreading.

Microsurgical treatment of large parasellar meningiomas by pterional craniotomy: A clinical experience with 34 cases / 第二军医大学学报

Objective To introduce the microsurgery treatment method for large parasellar meningiomas by pterional craniotomy and its curative effect. Methods The clinical data of 34 patients with large parasellar meningiomas, who underwent microsurgery via pterional or extensive pterional craniotomy in Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine Jul. 2006 to Aug. 2016, were retrospectively analyzed. The patients included 13 men and 21 women with ages ranging from 21 to 72 (average, 49±13) years old. The course of disease ranged from 1 to 55 (average, 13±10) months. Maximum diameter of tumors ranged from 3.3 to 5.2 (average, [4.3±0.6]) cm. Results No surgical death occurred in this study. Postoperatively, the cranial imaging examination showed that 24 of 34 cases were totally removed, 5 cases were subtotally removed, and 5 cases were partially removed. The postoperative follow-up time was 24-48 (average, 36±13) months. Twenty-eight cases had good prognoses with Karnofsky score being 80 to 100, and six cases had fair prognoses with Karnofsky score being 60 to 79. Five cases had postoperative oculomotor paralysis, which was improved with nutritional nerve treatment. Conclusion The microsurgical treatment via pterional or extensive pterional craniotomy can improve the total resection rate of the large parasellar meningiomas. Palliative operations combined with postoperative radiotherapy may be employed for the tumors that can only be subtotally and partially removed.

Integrated clinical experience with concurrent problem-based learning is associated with improved clinical reasoning among physical therapy students in the United States / 보건의료교육평가

Clinical reasoning (CR) is a key learning domain for physical therapy educators and a core skill for entry-level practitioners. Integrated clinical experience (ICE) and problem-based learning (PBL) have each been reported to improve interpersonal and social domains, while promoting knowledge acquisition and CR. Unfortunately, studies monitoring CR during ICE with concurrent PBL in physical therapy education are sparse. We hypothesized that ICE with concurrent PBL would be associated with improved self-reported CR in third-year student physical therapists (PTs) in the United States. The Self-Assessment of Clinical Reflection and Reasoning (SACRR) survey was administered to 42 student PTs at the beginning and end of their third and final year of didactic training. Between the pretest and posttest analyses, the participants completed faculty-led ICE and PBL coursework for 16 weeks. The overall SACRR score and 26 individual item scores were examined. The Wilcoxon rank-sum test and paired t-test were used, with statistical significance accepted at P < 0.05. Significant improvements were observed in the overall SACRR score (P < 0.001), including 6 of the 26 survey items centered around decision-making based on experience and evidence, as well as self-reflection and reasoning. ICE with PBL was associated with improved self-assessed CR and reflection in third-year student PTs in the United States. Monitoring the impact of curricular design on CR may improve educators' ability to enhance cognitive and psychomotor skills, which underscores the importance of increasing the explicit use of theoretical frameworks and teaching techniques for coping with uncertainty as a way of enhancing entry-level training.

Clinical experience and academic thoughts of Professor LIU Feng-bin on case series of gastroesophageal reflux disease based on data mining / 中国中药杂志

To analyze and summarize Professor LIU Feng-bin's clinical experience and academic thoughts on gastroesophageal reflux disease (GERD), the study group adopted the retrospective study for case series and expert interview, extracted the retrospective data, including the herbs, diseases, syndrome type, medical expense and quantity of herbs of GERD patients attended the First Affiliated Hospital of Guangzhou University of Chinese Medicine. Statistical description and binary Logistic regression were used for the identification and modification of syndrome type and initial core herbs. After expert interviews were performed for the syndrome type and herbs, the final scheme were formed. A total of 112 GERD patients ages（48.97±13.13）y; male: 35 (31.3%), female: 77(68.7%) were enrolled. The numbers of patients with liver and stomach incoordination syndrome, heat stagnation of liver and stomach syndrome, syndrome of dual deficiency of Qi and Yin, syndrome of spleen deficiency and dampness-heat, spleen-stomach disharmony syndrome were 40, 26, 19, 17 and 10, respectively. The patients used totally 80 herbs, and 26 of them had significant differences among different syndrome groups. According to the logistic regression analysis on the 23 herbs used by 112 patients, the herbs scheme was modified for the second time. After the expert interviews and modification, the final consensus was reached. The main causes for GERD were dietary irregularities, moodiness, and weak constitution. The basic mechanism of GERD was spleen deficiency with Qi adverseness. The spleen-stomach disharmony syndrome was deleted by expert interviews. The 10 core herbs for GERD treatment were Taizishen(Pseudostellariae Radix), Fuling(Poria), Baizhu(Atractylodismacrocephalae Rhizoma), Gancao(Glycyrrhizae Radix Et Rhizoma), Zhebeimu(Fritillariae Thunbergii Bulbus), Haipiaoxiao(Sepiae Endoconcha), Zhiqiao(Aurantii Fructus), Chenxiang(Alosewood), Pugongying(Taraxaci Herba), Zhizitan(Cape Jasmine Fruit). The modification and psychological and diet interventions were also identified. This study summarized Professor LIU Feng-bin's clinical experience and academic thoughts of chronic atrophic gastritis based on data mining of case series and expert interviews. The quality of methodologies and report were both well. The results provide a foundation and ideas for further study on the complex intervention for GERD, and can be directly applied in clinical practice.

FU Weimin's Experience in Treating Schizophrenia Through Accurate Differentiation / 浙江中医药大学学报

[Objective ]Summarizing the old Chinese medicine Professor FU Weimin's experience in diagnosis and treatment of schizophrenia. [ Methods ] Learning from Professor FU as well as collating his medical case of schizophrenia. [Results] Professor FU thinks that sputum fire blinded heart is the pathogenesis of schizophrenia, with the Qi stagnation and blood stasis as the main risk factors. Therefore, during the treatment, clear heat and resolve phlegm should be a fundamental, and with relieving the depressed liver, promoting blood circulation to remove stasis and purgation. He emphasizes the precise dialectical when talking about the disease stage. In aspect of the drug matching, Professor FU uses formulae to clear heat and resolve phlegm, regulate the Qi, treat the interior excess syndrome with purgation and open the orifices to solve the external and internal diseases. He prefers to protect the stomach and has already made a good therapeutic effect in clinical application. [Conclusion] Professor FU's experience in treating schizophrenia provides TCM ideas and methods for clinical practice, which is worthy of popularizing.

A Brief Study of the Clinical Experience on the Eight Extra Meridians of JIN's Acupuncture / 浙江中医药大学学报

[Objective] To explore the academic thought and clinical experience of JIN's acupuncture and moxibustion.[Methods] This paper summarizes the clinical academic characteristics of JIN's acupuncture in the aspects of mechanism, treatment, manipulation and acupoints.[Results] DrJIN deeply studied the theory of the eight extra meridians, and finally formed the unique JIN's acupuncture treatment based on the method.He supposed that the eight extra meridians were closely related to the liver and kidney, and came up with principles of treatment, such as distinguish deficiency from exces, emphasize on dredging and reinforcing meridians.He was also particular about choosing fine points of magical effect according to the condition. [Conclusion] JIN's acupuncture is unique in the treatment of different methods, and it inherits and develops the beauty of acupuncture in Zhejiang.

Exploration on Clinical Moxibustion Therapy of Chengjiang School Descendant QI Yongji / 浙江中医药大学学报

[Objective]To explore features of moxibustion therapy based on data mining through recorded cases during 1987-1991 by QI Yongji. [Methods] With modern computer technology, applying Epidata 3.1 to screen, record, collect and analyse cases of moxibustion therapy, exporting DTA-format, using Stata software to analyse and explore clinical applying features. [Results] A total of 1514 cases were recorded, including 468 cases of moxa-cone moxibustion, 493 cases of moxa-stick moxibustion. Moxa-cone moxibustion involves 45 points, the top five are A-shi point, ST36, GB34, EX-LE4, LI11; Moxa-stick moxibustion involves 66 points, the top five are A-shi point, EX-LE4, BL43, SI13, BL67. QI Yongji used moxibustion to treat 24 kinds of diseases, including medical, gynecological, orthopedic diseases. [Conclusion] To sum up treatment of diseases based on data mining 4 of which he was good at, consisting of omalgia, elbow strain, Bi syndrome and lumbago Through the integration of his descendants and family in-depth interviews, to generalize three major experiences of the moxibustion therapy: attaching importance to palpation, moxibustion based on syndrome differentiation, flexible use of moxibustion.

Professor LI Qiyi's Clinical Experience in Diagnosing and Treating Insomnia from Phlegm and Blood Stasis / 浙江中医药大学学报

[Objective] To summarize Professor LI Qiyi's clinical experience in diagnosing and treating insomnia from phlegm and blood stasis, who is the national traditional Chinese medicine experts academic experience inheritance work guidance teacher.[Method] To study and research Professor LI Qiyi's papers and books, to follow his guidance, to collect and arrange typical cases record, to summarize Professor LI Qiyi's methods and empirical medication in diagnosing and treating insomnia from phlegm and blood stasis.In order to analyse her experience, a clinical case was reported.[Result]Professor LI Qiyi treats the insomnia from phlegm and stasis, based on promoting blood circulation for removing blood stasis and reducing phlegm.Some people mixed with liver stagnation, are treated with clearing and calming heart, soothing liver and relieving depression.Some of others mixed with phlegm heat disturbance heart, are treated with clearing away heat and resolving phlegm, calming heart and tranquilizing mind.Because of being combined with symptoms and syndromes of TCM syndrome differentiation and treatment, satisfied results are predicted, the case shows the experience of TCM treating insomnia.[Conclusion]Professor LI Qiyi's experience in treating insomnia from phlegm and blood stasis is well worth learning for its significant clinical curative effect.