不同类型社区卫生服务中心居民对中医服务认知情况比较

目的对不同类型社区卫生服务中心社区居民对中医服务认知情况比较,为国家有关部门制定相关中医药参与社区卫生服务的政策提供参考依据。方法2008年调查以中医治疗为主和以西医治疗为主的不同类别的社区卫生服务中心。结果中医特色社区卫生服务中心的居民在患病后更能接受中医药技术,并且大多吃过中药,接受中药治疗,更能正确看待中医药适宜技术的治疗花费。并且中医特色社区卫生服务中心的居民对本社区的“软件方面”更满意,如服务质量、服务态度等。结论中医是社区卫生服务的主要内容,是构建健康守门人的重要方面。进一步加强社区卫生服务机构中医药特色建设,发挥中医药服务在健康维护中的重要地位。     

朗迈UriSed尿沉渣分析仪检测尿液RBC、WBC与人工镜检的比对分析

目的探讨朗迈UriSed尿沉渣分析仪对尿液RBC、WBC检测的灵敏度和特异性,并评价该分析仪和人工镜检的相关性。方法选取1985例尿液标本,使用朗迈UriSed尿沉渣分析仪进行RBC、WBC的检测,以人工镜检为金标准,并进行受试者工作特征曲线（Receiver Operating Characteristic curve,简称ROC曲线）分析,评价其灵敏度、特异性,两种方法的相关性。结果朗迈UriSed分析仪检测的1985例尿液标本RBC、WBC参数ROC曲线下面积分别为0．959和0．963。最佳分界点分别为4．68个／111、8．91个／ul,对应的灵敏度分别为0．875和0．940,特异性分别为0．933和0．897;UriSed分析仪与人工镜检分级比较,对RBC、WBC符合率分别为81．92％和84．86％;Urised分析仪检测RBC、WBC与人工镜检的皮尔逊（pearson）相关系数分别为0．709和0．784。呈高相关性。结论朗迈UfiSed尿沉渣分析仪检测尿液RBC、WBC灵敏度、特异性较好,与人工镜检的相关性好。可较好地应用于临床。     

2008-2009年高密市居民死因及减寿年分析

目的 了解高密市居民死亡水平、死因特征及减寿情况,为制定切实可行的预防控制措施提供科学依据.方法 对高密市2008-2009年度死因统计报告中的常住人口死亡资料进行分析.结果 2008-2009年,合计死亡病例12 116例,年均死亡率为704.66/10万,标化死亡率为479.43/10万.年均死亡率男性(797.03/10万)高于女性(612.05/10万),差异有统计学意义(P＜0.01);全人群主要死因前5位的为循环系统疾病、恶性肿瘤、呼吸系统疾病、损伤和中毒、内分泌代谢性疾病,占全部死亡病例的92.98％;死亡的潜在减寿年数为83 083.5人年,平均减寿年数为6.86人年,减寿率为48.34％.结论 慢性非传染性疾病为高密市居民的第1位死亡原因,损伤和中毒为第1位减寿死亡原因,慢性非传染行疾病及损伤和中毒是高密市今后防治的重点.     

Source imaging of seizure onset predicts surgical outcome in pediatric epilepsy

ObjectiveTo assess whether ictal electric source imaging (ESI) on low-density scalp EEG can approximate the seizure onset zone (SOZ) location and predict surgical outcome in children with refractory epilepsy undergoing surgery.MethodsWe examined 35 children with refractory epilepsy. We dichotomized surgical outcome into seizure- and non-seizure-free. We identified ictal onsets recorded with scalp and intracranial EEG and localized them using equivalent current dipoles and standardized low-resolution magnetic tomography (sLORETA). We estimated the localization accuracy of scalp EEG as distance of scalp dipoles from intracranial dipoles. We also calculated the distances of scalp dipoles from resection, as well as their resection percentage and compared between seizure-free and non-seizure-free patients. We built receiver operating characteristic curves to test whether resection percentage predicted outcome.ResultsResection distance was lower in seizure-free patients for both dipoles (p = 0.006) and sLORETA (p = 0.04). Resection percentage predicted outcome with a sensitivity of 57.1% (95% CI, 34–78.2%), a specificity of 85.7% (95% CI, 57.2–98.2%) and an accuracy of 68.6% (95% CI, 50.7–83.5%) (p = 0.01).ConclusionIctal ESI performed on low-density scalp EEG can delineate the SOZ and predict outcome.SignificanceSuch an application may increase the number of children who are referred for epilepsy surgery and improve their outcome.     

基于UPLC-PDA生物碱指标性成分含量合特征图谱的不同产区黄连（味连）整体质量表征研究＊

目的 通过对不同产地黄连（味连）药材质量进行分析，得到黄连药材质量差异表征。方法 采用UPLC-PDA色谱法，建立黄连生物碱指标性成分含量合特征图谱分析方法，采用PLS-DA模型分析，找到不同产区黄连药材质量差异表征。结果 不同产区黄连药材特征图谱色谱峰数量和成分类型一致，以生物碱类成分和非生物碱类成分相对含量同时考量可将黄连药材分为3类：第1级黄连药材主要来源于四川、重庆产区，生物碱和非生物碱类成分含量均较高，9（酚类）号色谱峰成分相对含量为主要相关成分；第2级黄连药材主要来源于四川、重庆产区，生物碱和酚类成分含量较高，1（未知）、13（黄连碱）、2（酚类）、5（其他）、12（生物碱）号色谱峰成分相对含量为主要相关成分；第3级黄连药材主要来源于湖北、重庆、四川产区，生物碱和非生物碱含量较低，11（生物碱）、6（酚类）、8（未知）号色谱峰成分相对含量为主要相关成分。结论 不同产区黄连药材质量差异表征为：四川产黄连药材主要表现为生物碱类成分、其他类成分含量较高，与其他产区黄连差异较大；重庆产黄连主要表现为酚类成分含量较高；湖北产区黄连与重庆产区黄连相似。     

川黄连多指标成分定量及特征图谱建立研究＊

目的 测定川黄连（味连、雅连、凤尾连）中7个生物碱（小檗碱、黄连碱、巴马汀、药根碱、表小檗碱、非洲防己碱、格陵兰黄连碱）的含量并建立3种川黄连的特征图谱，构建川黄连科学的质量控制方法，以提升川黄连药材、饮片及其中成药制剂的质量控制水平，保障临床用药安全有效。方法 建立了同时测定7个黄连生物碱成分的HPLC含量测定方法，经方法学验证该方法准确性、重现性、精密度、稳定性、线性均符合要求。测定6批味连、6批雅连、3批凤尾连的7个生物碱的含量以及总生物碱的含量；建立了黄连药材HPLC特征图谱测定方法，经方法学验证，该方法精密度、重现性、稳定性均符合要求。结果 味连的总生物碱含量最高，7个生物碱在味连、雅连、凤尾连中含量各不相同，差异较大；通过对15批黄连的特征图谱相似度的分析，找出共有特征峰15个，与黄连生物碱对照品比对后，指认了8个峰，均为黄连生物碱成分。结论 川黄连多指标成分定量结合特征图谱，可以有效控制川黄连药材的质量，为2020年版《中华人民共和国药典》黄连药材质量标准的完善与提高提供参考。     

Effect of nitroprusside on wave reflections in patients with heart failure

The relationship between wave reflections and ventricular-vascular coupling has been the subject of considerable speculation. Since we have previously shown that low-dose nitroprusside infusion improved ventricular-vascular coupling (as evidenced by increases in cardiac output and in aortic and pulmonary arterial total external power) in patients with severe left ventricular failure and secondary pulmonary hypertension, we chose to examine the changes in their aortic and pulmonary arterial wave reflections in this study. Wave reflection indexes examined included [1] calculated backward and forward pressure waves and the ratio of their magnitudes (reflection factor), [2] the reflection coefficient spectrum obtained by taking the ratios of the corresponding Fourier harmonics of the backward and forward waves, [3] two terminal reflection coefficients calculated as Γ _t =(R-Z _c )/R+Z _c ) where Z is characteristic impedance and R is either total resistance or vascular resistance, and [4] the difference between the maximum and minimum impedance moduli for frequencies of 4 to 15 Hz. In the systemic vasculature, nitroprusside produced large reductions in the elevated vascular resistances and decreased aortic reflections as indexed by the reflection factor and by both terminal reflection coefficients. In contrast, however, no significant changes were found in the pulmonary artery wave reflection indexes despite large reductions in the pulmonary resistances. Supported in part by Grant #P-50-HL17655 from the National Institutes of Health Ischemic Heart Disease Specialized Center on Research. Dr. Brin is a recipient of a Public Health Service Clinical Investigator Award (HL-01028) from the National Heart, Lung, and Blood Institute. Dr. Yin was a recipient of a Frank T. McClure Fellowship from the Johns Hopkins University Applied Physics Laboratory.     

中医药科技查新员的“中医特色”素养

介绍了目前中医药科技查新的概况与特色,论述了中医药科技查新员“中医特色”素养对保障中医药科技查新工作的重要性,探讨了查新员素养对中医药科技查新质量的影响以及相关培养途径,为其他院校及科研院所科技查新工作和查新员素质培养提供参考。     

六君子汤相态拆分及表征研究

目的 对六君子汤进行了真溶液相态、纳米相态和沉淀相态拆分,对样品透析-离心次数、稀释倍数以及样品放置时间进行了考察,并对其中纳米相态进行了表征研究。方法 为研究六君子汤中分散体系的组成,本试验利用丁达尔现象初步判断六君子汤中是否存在纳米相态,采用透析与超速离心相结合的方法,并采用TEM、粒径分析等方法。结果 六君子汤中存在纳米相态,在透析-离心4次,样品稀释5倍,室温放置0 h下,观察的TEM图像最清晰。此外,对最优方案的六君子汤中的纳米相态进行了粒径以及电位测定,试验结果表明,六君子汤纳米相态的粒径主要集中在100 nm,此外,还存在少量粒径大于100 nm的粒子,电位为-2.22~-1.97mV。结论 结果表明六君子汤中存在纳米相态,从六君子汤配伍增效角度来看,难溶性成分（人参中的人参皂苷、茯苓中的茯苓酸、陈皮中的黄酮）的溶出度增大,此外发现还存在少量粒径大于100 nm的粒子,说明体系不稳定,这可能是由于体系中出现不同程度的团聚造成的。     

Comparison between RVG UI sensor and Kodak InSight film for detection of incipient proximal caries

Object The purpose of this study was to compare the efficacy of the four combination modes of Trophy RadioVisioGraphy UI sensor (Trex-Trophy Radiology Inc., Marne-la-Valee, France) and Kodak InSight film (Eastman Kodak Co., Rochester, NY) for detecting proximal dental caries. Materials and Methods Thirty extracted human upper premolars were selected. Of 60 surfaces, 25 had carious lesions in the form of small cavities, and the rest showed no evidence of caries as verified by a micro computed tomogram (micro CT; XCT Research SA+, Stratec Medizintechnik GmbH, Pforzheim, Germany). All teeth were radiographed with the paralleling technique (60kV, 40 cm focus-to-sensor distance). Four combination modes (high-resolution caries mode—HRC; high-sensitivity caries mode—HSC; high-resolution periodontal mode—HRP; and high-resolution endo mode—HRE) were used. Exposure was set at 0.12 sec for HRC, 0.08 sec for HSC, 0.16 sec for HRP, 0.12 sec for HRE, and 0.16 sec for the Kodak InSight film. The resulting images were evaluated by three oral radiologists. The same three observers evaluated the digital images, and were allowed to use the contrast and brightness controls in doing so. Possible differences in ROC curve areas among image modalities were assessed by the Friedman test. Results The mean ROC curve areas were 0.66±0.11 for HRC, 0.78±0.02 for HSC, 0.76±0.04 for HRE, 0.77±0.04 for HRP, and 0.71±0.09 for the Kodak InSight film. There were no statistically significant differences between HRC, HSC, HRE, HRP and the Kodak InSight film in terms of proximal caries detection. Conclusion The four modes of RVG UI system are each a viable alternative to intraoral film for the detection of incipient dental caries.