紫杉醇用于治疗胃癌的临床进展分析

目的对最近几年用紫杉醇抗癌的研究文献进行总结,并分析我院最近几年收治胃癌患者给予紫杉醇治疗的疗效。方法选取2011年1月一2013年10月在我院接受治疗的胃癌患者45例为研究对象,上述选取对象均为胃癌晚期,将其随机分成对照组和观察组,对照组采取FOLXFOX4方案进行治疗。观察组采取紫杉醇联合卡倍他滨进行治疗,观察两种治疗方式的疗效。结果经过两个周期的治疗后,观察组总缓解明显高于对照组,差异有统计学意义（尸〈0．05）;但两组间在不良反应发生隋况对比差异上无统计学意义（P〈0．05）。结论紫杉醇作为一种抗癌药物,其在治疗胃癌、乳腺癌等癌症效果明显,对于癌症晚期患者,给予紫杉醇联合卡倍他滨进行治疗,有助于减轻癌痛、提升患者生活质量,有较高的研究价值和推广价值。     

9例莫西沙星致血小板减少症的文献分析

摘 要 目的：探讨莫西沙星致血小板减少症的临床特点及可能机制,为临床用药提供参考。方法：检索国内外文献数据库中关于莫西沙星致血小板减少症的文献报道,检索时限均为建库至2019年2月,筛选确定的文献后提取文献的患者基本信息、用药情况、药品不良反应（ADR）发生经过和转归等信息进行分析。结果：共检索到9例患者,男5例,女4例,平均年龄（57.7±13.1）岁。6例ADR在用药后10 d内发生,8例患者使用莫西沙星后血小板计数最低值下降至30×109·L 1以下,5例患者血小板计数降至10×109·L 1以下。9例患者的血小板减少症均与莫西沙星相关,其中8例患者为严重的ADR,停药或对症治疗后好转。结论：尽管莫西沙星导致血小板减少症罕见,但多为严重的ADR,可能导致患者死亡,需引起临床重视。     

达比加群酯不良反应文献的分析

通过检索PubMed、中国知网数据库和维普数据库关于达比加群酯不良反应的文献并对其进行回顾性分析和总结。达比加群酯致ADR的个案报道共73例;其性别分布男性44例（60.3%）,女性29例（39.7%）;年龄分布以70岁以上较多（59例,80.8%）;多发生在用药后6个月内（60例,82.2%）;达比加群酯致ADR临床表现以消化系统损害（50.7%）、血液系统损害（15.1%）和心血管系统损害（11.0%）多见。临床使用达比加群酯过程中应重点考量患者肾功能、年龄、体重和性别等危险因素,并重点监测和防治其ADR,避免ADR的发生。     

Personal attitudes and misconceptions,not official recommendations guide occupational physicians’ vaccination decisions

Introduction

Healthcare personnel (HCP) are often under-vaccinated. The aim of this study was to evaluate occupational physicians’ potential role by assessing relations between their knowledge and attitudes regarding HCP vaccination and the extent to which official vaccination recommendations are communicated.

Methods

Cross-sectional survey, n = 135 occupational physicians.

Results

Occupational physicians who treat HCP recommend vaccinations more often to HCP when they have better knowledge of official vaccination recommendations and a more positive attitude towards vaccination compared to physicians with less such knowledge or a more negative attitude. The attitude towards vaccination most strongly affects whether occupational physicians recommend the measles, mumps, and rubella (MMR) vaccination: physicians with less positive attitudes recommend MMR to HCP in a more restricted way. A more positive attitude towards vaccination also relates to fewer misconceptions. Occupational physicians’ knowledge and attitude further influence the extent to which pregnant HCP receive vaccinations against influenza. Knowledge about official recommendations does not influence the recommendation of influenza vaccination for pregnant women.

Conclusions

Reasons for vaccination gaps in HCP might have their roots in occupational physicians’ incomplete knowledge of vaccination recommendations. Attitudes, which are related to misperceptions, also influence which vaccinations are recommended to HCP. Official recommendations, and not personal attitudes and misconceptions, should guide occupational vaccination behavior.     

我国高校教师职业倦怠的元分析

目的考察高校教师的职业倦怠状况是否随年代变化,为高校和教育主管部门干预职业倦怠提供理论参考。方法通过检索中国知识资源总库-CNKI系列数据库,采用元分析方法对我国教师职业倦怠情况进行研究。结果年代与高校教师职业倦怠的情绪衰竭因子、非人性化因子和低成就感因子呈显著正相关(r=0.11,0.151,0.136;P0.01),年代可以解释3个因子1.2%、2.2%和2.1%的变异;不同性别在职业倦怠的情绪衰竭、去个性化因子上有统计学意义,95%的置信区间分别为(-0.03,-0.02)、(0.06,0.11)和(-0.03,0.02);高校教师与中小学教师相比,情绪衰竭、去个性化和低个人成就感因子差异均有统计学意义,95%的置信区间分别为(-0.08,-0.02)、(-0.03,-0.01)和(-0.04,-0.01);(-0.07,-0.04)、(-0.04,-0.02)和(-0.06,-0.02)。结论高校教师的职业倦怠情况逐年增加;男性教师的去个性化情况较女性教师严重,女性教师的情绪衰竭较男性教师严重;高校教师的职业倦怠显著轻于中小学教师。     

The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis

Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure/pre-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25–6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses.     

@Note: A workbench for Biomedical Text Mining

Biomedical Text Mining (BioTM) is providing valuable approaches to the automated curation of scientific literature. However, most efforts have addressed the benchmarking of new algorithms rather than user operational needs. Bridging the gap between BioTM researchers and biologists’ needs is crucial to solve real-world problems and promote further research.We present @Note, a platform for BioTM that aims at the effective translation of the advances between three distinct classes of users: biologists, text miners and software developers. Its main functional contributions are the ability to process abstracts and full-texts; an information retrieval module enabling PubMed search and journal crawling; a pre-processing module with PDF-to-text conversion, tokenisation and stopword removal; a semantic annotation schema; a lexicon-based annotator; a user-friendly annotation view that allows to correct annotations and a Text Mining Module supporting dataset preparation and algorithm evaluation.@Note improves the interoperability, modularity and flexibility when integrating in-home and open-source third-party components. Its component-based architecture allows the rapid development of new applications, emphasizing the principles of transparency and simplicity of use. Although it is still on-going, it has already allowed the development of applications that are currently being used.     

头孢唑肟致溶血性贫血文献分析

摘 要 目的：探讨头孢唑肟致溶血性贫血的临床特点及相关因素，为临床安全用药提供参考。方法：检索中国知网、万方、维普、PubMed数据库截止2017年1月31日公开发表的头孢唑肟致溶血性贫血的文献，对获得文献中患者的一般情况 、临床表现、溶血发生时间、转归及发生机制等相关因素进行统计分析。结果：共检索到相关文献17篇，病例21例；其中男16例（76.19%），年龄分布以60岁以上年龄段最多（9例，42.86%）；溶血反应多发生在用药后的7 d内（18例，85.71%）；贫血纠正的平均时间为7.5 d，血红蛋白值与贫血恢复时间呈负相关。3例（14.29%）患者救治无效死亡。发生机制主要为免疫复合物和药物吸附。结论：临床医师和药师应了解头孢唑肟导致溶血性贫血的发生规律，正确选择用药人群，加强用药监护及用药教育，尽早识别严重不良反应并及时处理。     

Influenza seasonality goes south in the Yucatan Peninsula: The case for a different influenza vaccine calendar in this Mexican region

IntroductionWhile vaccination may be relatively straightforward for regions with a well-defined winter season, the situation is quite different for tropical regions. Influenza activity in tropical regions might be out of phase with the dynamics predicted for their hemispheric group thereby impacting the effectiveness of the immunization campaign.ObjectiveTo investigate how the climatic diversity of Mexico hinders its existing influenza immunization strategy and to suggest that the hemispheric vaccine recommendations be tailored to the regional level in order to optimize vaccine effectiveness.MethodsWe studied the seasonality of influenza throughout Mexico by modeling virological and mortality data. De-trended time series of each Mexican state were analyzed by Fourier decomposition to describe the amplitude and timing of annual influenza epidemic cycles and to compare with each the timing of the WHO's Northern and Southern Hemispheric vaccination schedule.FindingsThe timings of the primary (major) peaks of both virological and mortality data for most Mexican states are well aligned with the Northern Hemisphere winter (December–February) and vaccine schedule. However, influenza peaks in September in the three states of the Yucatan Peninsula. Influenza-related mortality also peaks in September in Quintana Roo and Yucatan whereas it peaks in May in Campeche. As the current timing of vaccination in Mexico is between October and November, more than half of the annual influenza cases have already occurred in the Yucatan Peninsula states by the time the Northern Hemispheric vaccine is delivered and administered.ConclusionThe current Northern Hemispheric influenza calendar adopted for Mexico is not optimal for the Yucatan Peninsula states thereby likely reducing the effectiveness of the immunization of the population. We recommend that Mexico tailor its immunization strategy to better reflect its climatologic and epidemiological diversity and adopt the WHO Southern Hemisphere influenza vaccine and schedule for the Yucatan Peninsula.     

川芎嗪致30例不良反应文献分析

目的:探讨川芎嗪致不良反应的一般规律及特点,为临床合理用药提供参考。方法:对国内医药期刊报道的30例川芎嗪不良反应病例进行分类统计分析。结果:川芎嗪致不良反应与性别无关,多发生于>50a年龄组,其出现时间可发生于用药后的各个时间段。不良反应累及机体多个器官系统,临床表现复杂多样,主要表现为变态反应,严重者可出现过敏性休克。结论:临床医师、药师应了解川芎嗪所致不良反应的规律和特点,加强其应用的监测,以减少不良反应的发生。