芳香化酶抑制剂治疗期间乳腺癌患者症状群对生活质量的影响

目的 探讨乳腺癌患者在接受芳香化酶抑制剂（aromatase inhibitor,AI）治疗期间所出现的症状群及生活质量,并分析症状群与生活质量的相关性。方法 采取横断面调查,选取2020年4月—2021年1月就诊于北京市某肿瘤专科医院乳腺中心门诊患者260例。采用一般情况调查表、安德森症状量表、简明健康调查量表进行调查。 结果 回收有效问卷254份。通过主成分分析,提炼出3组症状群：病感症状群、治疗相关-心理症状群、消化系统症状群。患者简明健康调查量表生理健康、心理健康得分分别为（38.51±12.03）分、（43.06±14.29）分。多元线性回归分析显示,病感症状群越重、治疗相关-心理症状群越重、体重指数越高、文化程度越低,患者的生理健康越差;随着口服AI时间的延长,生理健康会有所改善。治疗相关-心理症状群越重,则患者的心理健康越差。 结论 乳腺癌患者在接受AI治疗期间存在多组症状群,症状群与生活质量呈负相关。医护人员应关注接受AI治疗患者,有必要制订针对性的干预措施,以缓解症状群并改善患者的生活质量。     

急性髓系白血病患者诱导缓解治疗期症状群的纵向研究

目的 探讨急性髓系白血病（acute myeloid leukemia,AML）患者诱导缓解治疗（induction therapy,IT）期症状群的变化情况。方法 2018年1月—2020年6月,便利选取山东省某三级甲等医院血液内科首次确诊为AML并接受IT的130例患者,运用中文版记忆症状评估量表在IT开始前1 d（T1）、IT结束当天（T2）、IT结束后第7天（T3）对其进行评估,运用因子分析确立症状群的组成。 结果 T1存在4个症状群,为心理症状群、营养症状群、神经症状群和疼痛-出汗症状群。T2存在3个症状群,为胃肠道症状群、疲乏症状群和治疗相关症状群。T3存在4个症状群,为心理症状群、胃肠道症状群、疲乏症状群和形象改变症状群。其中心理症状群在T1和T3存在,疲乏症状群和胃肠道症状群在T2和T3持续存在。结论 AML患者在IT期经历的症状群呈动态变化。IT前的心理症状群、IT中的胃肠道症状群、IT结束后的疲乏症状群可作为优先干预的症状群。     

新冠肺炎疫情背景下心理健康研究现状及展望

目的：通过对新冠肺炎疫情背景下心理健康相关研究成果进行定量分析,总结该领域的研究热点,为未来的心理健康研究和服务提供依据。方法：以2019年12月1日到2022年5月9日期间被Web of Science核心合集收录的、新冠肺炎疫情背景下心理健康研究的7 332篇文献为样本展开文献计量分析,并利用VOSviewer软件对样本文献进行关键词聚类分析,挖掘该领域的核心研究力量和研究热点。结果：新冠肺炎疫情背景下心理健康研究主要分布在欧美国家,中国学者在该领域的科研产出有较高影响力,发文量居于前3位的国家为美国、中国、英国;新冠肺炎疫情背景下心理健康研究聚焦在心理健康的干预措施、感染风险对心理健康造成的影响、对不同人群心理健康的影响、医护人员的创伤后应激反应、常用的心理健康状况量表等。结论：后疫情时代的心理健康研究应加深国际交流与合作,扩大覆盖面,并进行追踪研究,以形成一个完整的研究链条;未来的心理健康服务应发挥社区的作用,探索建立以社区初级服务为基础、与专家咨询相结合的协作护理策略。     

炎症性肠病患者症状群评估量表的编制及信效度检验

目的 编制科学、规范的炎症性肠病患者症状群评估量表,并进行信效度检验。 方法 以症状经历模型为指导,通过文献回顾、德尔菲专家函询形成量表初稿;对条目进行描述性定义后进行小样本预调查,根据患者反馈完善量表。便利选取2019年6月—9月在江苏省4所三级甲等综合医院消化科门诊就诊或住院的150例炎症性肠病患者进行问卷调查。运用SPSS 20.0对数据进行项目分析,测定量表的信效度。 结果 最终形成的炎症性肠病患者症状群评估量表包括18个条目,量表的内容效度指数为0.850,各条目的内容效度指数为0.941~1.000。探索性因子分析提取出5个公因子,累计方差贡献率为77.390%。各因子与总量表间呈正相关,相关系数为0.580~0.857,总量表与炎症性肠病生活质量问卷的相关系数为0.925。总量表的Cronbach’s α系数为0.900,重测信度为0.856。 结论 炎症性肠病患者症状群评估量表具有良好的信效度,可引导医护人员精准、针对性地评估患者,为患者制订个性化的症状管理措施提供依据。     

基于中药有效成分族的方剂物质基础研究

本文以血管紧张素转化酶（Angiotensin Converting Enzyme，ACE）抑制剂、3-羟基-3-甲基戊二酰辅酶A还原酶（3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase，HMG—CoAR）抑制剂和血管紧张素Ⅱ（AngiotensinⅡ，AngⅡ）、血小板活化因子（Platelet Activating Factor，PAF）受体拮抗剂三维药效团为辨识模型，以三维数据库柔性搜索技术为辨识算法，发现了18首活血化瘀方剂及其所合20味中药可能具有的ACE、AngⅡ、PAF和HMG—CoAR受体活性的物质基础。结果表明，中药有效成分族的研究将为从分子层次上揭示方剂物质基础提供方法学支撑。     

Functional significance of arrangement of neurones in cell assemblies

Summary An account is given of the columnar arrangement in the cerebral cortex that has been discovered for neurones having a similar receptivity. This has been observed in the somaesthetic cortex for neurones with similar modality sensitivities and in the visual cortex for neurones with similar directional sensitivities. The anatomical basis is discussed. In the motor cortex also there is an arrangement in clusters of pyramidal cells that are responsible for particular movements.The functional significance of this organization in clusters in the cerebral cortex is discussed in relationship to the problem of securing a reliable performance despite the irregular background discharge of the individual neurones. It is proposed that reliability is secured by the in-parallel arrangement of neurones with similar receptivities in the clusters. The neurones of a cluster tend to converge onto common target neurones, which, as it were, read out the summed performance of the cluster from moment to moment. Recent work on the cerebellum also discloses that there is an arrangement of Purkyn cells in clusters with somewhat similar receptive fields and that their axons tend to converge onto neurones of the cerebellar nuclei (fastigial nucleus), which likewise are arranged in functional clusters.The general concept emerges that the arrangement of neurones in clusters both in the cerebrum and in the cerebellum, achieves functional significance not only in giving opportunity for amplification and integration of incoming signals and for their sharpening by surround inhibition, but it is also important in the output performance. Signals are lifted out of noise by the spatial summation deriving from the many similarly performing neurones that project by their axons to the same cluster of target neurones; and this orderly projection can go on sequentially through all the complexities of on-going actions initiated by some input.Prof. R. Jung to his 60th birthday.     

Estimation of a common odds ratio in paired-cluster randomization designs

We develop two estimators of a common odds ratio psi for designs in which the investigator randomly assigns each of two clusters to interventions within strata. The estimators rely on an empirical adjustment for clustering to provide improved estimators of psi relative to the standard Woolf and Mantel-Haenszel estimators, respectively. The results of a simulation study show that the suggested adjustment improves the accuracy of both of these well-known estimators under conditions likely to arise in practice. We find the clustered Woolf estimator as particularly effective in terms of mean squared error reduction. We also discuss interval estimation.     

Synchronization clusters of interictal activity in the lateral temporal cortex of epileptic patients: intraoperative electrocorticographic analysis

OBJECTIVE: Drug-resistant temporal lobe epilepsy (TLE) can be treated by tailored surgery guided by electrocorticography (ECoG). Although its value is still controversial, ECoG activity can provide continuous information on intracortical interactions that may be useful to understand the pathophysiology of TLE. The goal of this study is to characterize local interactions in multichannel ECoG recordings of the lateral cortex of TLE patients using three synchronization measures and to link this information with surgical outcome. METHODS: Intraoperative ECoG recordings from 29 TLE patients were obtained using grids of 20 electrodes (4 x 5) covering regions T1, T2, and T3 of the lateral temporal lobe. Linear correlation, mutual information, and phase synchronization were calculated to quantify lateral intracortical interactions. Surrogate data files were generated to test results statistically. RESULTS: By distributing locally the interactions between the electrodes, we characterized the spatial patterns of ECoG activity. We found clusters of synchronized activity at specific areas of the lateral temporal cortex in most patients. Methodologically, linear correlation and phase synchronization performed better than mutual information for cluster discrimination. ROC analysis suggested that surgical removal of sharply defined synchronization clusters correlated with seizure control. CONCLUSIONS: Our results show that synchronous intraoperative ECoG activity emerges from specific cortical areas that are highly differentiated from the rest of the temporal cortex. This suggests that synchronization analysis could be used to functionally map into the temporal cortex of TLE patients. Moreover, our results suggest that these sites might be involved in the circuits that participate in clinical seizures.