RxNorm的词表结构及应用领域

RxNorm是美国临床信息系统中药物数据交互的药物标准,通过对RxNorm的基本情况、词表结构、应用领域的细致分析,提出了国内药物编码标准建设的策略。     

The mental stress of the accompaniment in Alzheimer's disease

Introduction

Alzheimer's disease affects patients in time and space and all dimensions of emotional, cognitive and social life. It is, in return, an unprecedented threat for the family, a disaster for each member of the family. Because of the love story, because of the suffering, the disease remains the relationship between patient and caregiver. We try to approach their suffering according to the carer's reports. Our research, conducted with support from France Alzheimer, aims to understand the nuances of the experience of becoming the accompanying person, drawing on some key moments of this accompaniment.

Methodology

It is through an exploratory research that we met eight caregivers of patients with Alzheimer's disease. Among them, seven were the spouses (four of seven patients are men), and one was the daughter of a patient. In a clinical psychological environment, we asked each caregiver the same question: “How would you talk about living or having lived Alzheimer’disease?” Our response will only aim to support words of the participant whenever necessary, but will also propose in difficult and particularly challenging moments, the possibility of sharing to enable the participant to verbalize their emotions.

Results

The meeting with some caregivers evidenced the preservation of a particular relationship with the patient, relationship within which the caregiver perceives in return the unspeakable weight of a disease, which works silently. Alzheimer's disease induces psychological modifications and requires great investment by caregivers, which is grafted on an earlier relationship. We should not consider the modifications in a linear relationship patient–caregiver but in a circular relationship, which complicates the relation of the couple and makes it indecisive. The violence of the confrontation with this disease results from multiple factors: social representations, impact of the diagnosis, evolution of the disease, affectivity and permanent interactions, in spite of the non verbal communication of the patient, which associates a love story, behaviour disorders and the impact on the social circle. The family's responses are for example denial, overprotection, mothering and aggressiveness in caregiving in order to maintain the relationship. Becoming a caregiver is difficult because of the limit between professional and caregiver. Accompaniment is not a simple role of watching and caring. Because of the love, because of the strength of the communication which continues even in the absence of words, the investment remains massive and Alzheimer's disease opens a distance where the relationship, if it is perturbed, is none the less reactivated, and makes the accompaniment possible, however painful it may be.     

2型糖尿病患者24h尿微量白蛋白相关因素分析及临床意义

目的:筛查2型糖尿病患者(T2DM)24 h尿微量白蛋白(24 h UMA)相关因素,以期进一步指导2型糖尿病患者肾病预防和治疗。方法:测定住院的2型糖尿病患者的体重,血生化如肾功能、血脂等,尿生化如24 h尿微量白蛋白等,计算BMI,肾小球滤过率、肌酐清除率,晨尿微量白蛋白/肌酐。结果:24 h尿微量白蛋白与体重、BMI、血肌酐、血尿素氮、24 h尿总蛋白、24 h尿肌酐、晨尿微量白蛋白、微量白蛋白/肌酐、TC、LDL、收缩压均有相关性,与HbA1c、FMN无相关性。结论:24 h尿微量白蛋白反映糖尿病肾脏病变,控制肾病要作好体重、血脂、收缩压的控制,血糖控制不宜过严。     

正中关系位-正中[牙合]位垂直向不调患者戴用Roth诊断[牙合]垫前后头影测量比较

目的比较髁突位置垂直向异常患者传统的最大牙尖交错位（centricocclusion,CO）头颅侧位片与戴用骀垫后获得的正中关系位（centricrelation,CR）头颅侧位片头影测量结果差异,揭示患者真实的咬合关系,了解不同下颌位置的头影测量分析存在的差异可能为临床诊断带来的影响,为临床提供参考。方法选取髁突位置垂直向异常患者14例,拍摄传统CO位头颅侧位片和戴用殆垫后获得的CR位头颅侧位片,比较两组头影测量21项指标结果差异。结果CR位头影测量值ANB角、关节角、Y轴角、覆盖明显大于CO位头影测量值（P〈0．05）,而SNB角、面轴角明显小于CO位头影测量值（P〈0．05）。结论髁突位置垂直向异常患者CO位和CR位头影测量各项目差异说明,髁突从CO位退到CR位时下颌位置在矢状和垂直向发生改变,对这类患者的临床诊断和治疗设计可能会产生影响。     

膝骨关节炎患者血清IL-1β、TGF-β变化及相关性研究

目的:观察膝骨关节炎(knee osteoarthritis,KOA)患者血清白细胞介素-1β(interleukin-l beta,IL-1β)、转化生长因子-β(transforming growth factor-β,TGF-β)变化及进行相关性研究。方法:采用酶联免疫吸附法(ELISA)检测60例KOA患者(KOA组)血清IL-1β、TGF-β、基质金属蛋白酶-3(matrix metalloproteinase-3,MMP-3)、基质金属蛋白酶组织抑制物-1(tissue Inhibitor ofmmatrix metalloprotease-1,TIMP-1),流式细胞术检测外周血CD4+CD25+CD127low/-调节性T细胞(regulatoryT cells,Treg)比例,另检测30例正常人(正常对照组)血清IL-1β、TGF-β作为对照;依据膝骨关节炎严重程度指数(LequesneMG)评分标准将60例KOA患者分为轻中重三组,并以60岁为界限把60例KOA患者分为两组,分析IL-1β、TGF-β在KOA患者血清中变化特点及与LequesneMG、症状量化积分、国际普适生活质量量表(SF-36)各维度积分、焦虑自评量表(SAS)积分、抑郁自评量表(SDS)积分、MMP-3、TIMP-1、CD4+CD25+CD127low/-Treg及其他实验室指标相关性。结果:①与正常对照组比较,KOA组血清IL-1β显著升高,TGF-β显著降低(P<0.05)。②轻中重三组间比较显示重度组血清IL-1β、TGF-β显著高于轻度组及中度组,中度组血清IL-1β、TGF-β显著高于轻度组(P<0.05)。③与<60岁组比较,≥60岁组血清IL-1β显著升高(P<0.05),TGF-β无统计学意义。④相关性分析示KOA患者血清IL-1β、TGF-β与LequesneMG、SAS积分、血沉、超敏C-反应蛋白、MMP-3、TIMP-1呈正相关(P<0.05),与SF-36各个维度积分、CD4+CD25+CD127low/-Treg呈负相关(P<0.05);IL-1β与SDS积分呈正相关(P<0.05),TGF-β与SDS积分无相关性。结论:TGF-β降低和IL-1β升高在KOA患者血清中表现明显,与Le-quesneMG、生活质量、血沉、超敏C-反应蛋白、MMP-3、TIMP-1、CD4+CD25+CD127low/-Treg的相关性,提示KOA发病过程存在炎性细胞因子表达紊乱。     

乡村两级卫生人才的道德关系比较研究——基于对B市五区县的调查分析

乡村卫生人才包括乡镇卫生院的医务人员和村卫生室的村医,他们作为农村基层医疗卫生事业的一线工作人员,其道德关系直接影响到医疗卫生服务的内容与效果、服务模式与医患关系.随着医疗卫生改革不断的深入农村基层,乡村两级卫生人才之间及其在村落社会所处的道德关系也在不断地发生着变化,具体表现在三个方面：一是乡村两级卫生人才之间体制内外的差异;二是乡村两级卫生人才与患者之间的医患关系和服务水平的差异;三是乡村两级卫生人才与村落社会之间,后者对前者医疗品行的养成与监督的差异.     

脉压与冠心病的关系探析

目的分析脉压(PP)与冠心病的关系,为临床制定预防措施提供依据。方法选取52例冠心病患者和65例非冠心病患者的临床资料进行分析,比较两组脉压的差异。结果冠心病组与非冠心病组脉压、收缩压、舒张压均存在差异(P<0.05)。结论血压与冠心病有密切关系,脉压增加,发生冠心病的概率也增加,临床需通过综合干预措施控制血压以做好冠心病的预防。     

Télépsychologie et visioconsultation

Telepsychology is an emerging field in present psychotherapeutic practices. There are different methods available to carry out psychotherapy at a distance. These methods more or less involve the participant's bodies. Videoconference is a technology that permits to users to see each other. This has an influence on interactions established at a distance. Video-interview is a method based on the adaptation online of the classical clinical face-to-face interview framework.

La demande de chirurgie esthétique : questions ouvertes et nouvelles perspectives pour la recherche

Objectives

This study aims to offer an overview of the most important results of current research on the request for cosmetic surgery, to provide some indications for practitioners working in the field, and to open new avenues for research.