基于数据挖掘技术研究治疗膝骨关节炎肾虚血瘀型方剂的组方配伍规律

目的:基于中医传承辅助平台分析期刊与专利文献中治疗膝骨关节炎肾虚血瘀型方剂的用药配伍规律。方法:筛选2013年1月至2019年1月中国知网、维普、万方、超星、读秀学术、超星汇雅图书、国研等数据库中治疗膝骨关节炎肾虚血瘀型的方剂,通过中医传承辅助平台构建方剂数据库,利用该软件集成的关联规则及熵聚类等数据挖掘算法,总结治疗膝骨关节炎肾虚血瘀型方剂中的用药频次、常用药对、潜在药对及发现新处方。结果:通过对85首治疗膝骨关节炎肾虚血瘀型方剂所含药物的频次统计分析,得到常用药物33味,其中牛膝、川芎、当归、杜仲、甘草、独活的使用频次较高;使用频次较高的药对有26个,其中川芎与牛膝、当归与牛膝位居前2位,杜仲与牛膝、当归与川芎并列第3位;通过熵层次聚类分析法发现关联系数较高的潜在药对44个及潜在新处方10个。结论:治疗膝骨关节炎肾虚血瘀型的方剂多以补益肝肾为主,兼以活血化瘀、通络止痛为辅,挖掘得到的新处方具有潜在的临床应用和新药开发价值。     

基于关联规则研究五味温通除痹胶囊对类风湿关节炎寒湿证患者的影响

目的:研究五味温通除痹胶囊对类风湿关节炎寒湿证患者免疫炎症指标的影响。方法:整理2018年12月至2019年6月安徽中医药大学第一附属医院类风湿关节炎寒湿证住院患者的病例资料。根据是否使用五味温通除痹胶囊将患者分为治疗组(五味温通除痹胶囊+中药)73例,对照组(单纯中药)317例。分析患者的免疫及炎症指标。结果:①2组患者在性别、年龄方面比较,差异无统计学意义(P>0.05)。②治疗后,2组超敏C-反应蛋白(hs-CRP)、类风湿因子(RF)等指标均降低(P<0.05);而治疗组在改善hs-CRP、抗环瓜氨酸肽抗体、免疫球蛋白M方面优于对照组(P<0.05)。③关联规则分析显示,hs-CRP、RF、补体C3等指标的改善均与五味温通除痹胶囊有较强关联,且联合丹参、桂枝等中药指标的改善明显优于单纯中成药。结论:五味温通除痹胶囊能有效改善类风湿关节炎寒湿证患者免疫炎症指标,且联合中药内服与指标的改善存在明显关联关系。     

Home Food Environment in Relation to Children’s Diet Quality and Weight Status

The objective of this cohort study was to explore relationships among the home food environment (HFE), child/parent characteristics, diet quality, and measured weight status among 699 child-parent pairs from King County, WA, and San Diego County, CA. HFE variables included parenting style/feeding practices, food rules, frequency of eating out, home food availability, and parents’ perceptions of food costs. Child dietary intake was measured by 3-day recall and diet quality indicators included fruits and vegetables, sweet/savory snacks, high-calorie beverages, and Dietary Approaches to Stop Hypertension (DASH) score. Individual linear regression models were run in which child BMI z score and child diet quality indicators were dependent variables and HFE variables and child/parent characteristics were independent variables of interest. Fruit and vegetable consumption was associated with parental encouragement/modeling (β=.68, P<0.001) and unhealthful food availability (−0.27, P<0.05); DASH score with food availability (healthful: 1.3, P<0.01; unhealthful: −2.25, P<0.001), food rules (0.45, P<0.01), and permissive feeding style (−1.04, P<0.05); high-calorie beverages with permissive feeding style (0.14, P<0.01) and unhealthful food availability (0.21, P<0.001); and sweet/savory snacks with healthful food availability (0.26, P<0.05; unexpectedly positive). Children's BMI z score was positively associated with parent's use of food restriction (0.21, P<0.001), permissive feeding style (0.16, P<0.05), and concern for healthy food costs (0.10, P<0.01), but negatively with verbal encouragement/modeling (−0.17, P<0.05), and pressure to eat (−0.34, P<0.001). Various HFE factors associated with parenting around eating and food availability are related to child diet quality and weight status. These factors should be considered when designing interventions for improving child health.     

基于中医传承辅助平台探讨张伦忠治疗中老年郁证经验及组方用药规律

目的基于中医传承辅助平台,分析和总结张伦忠教授治疗中老年郁证的组方规律和用药经验。方法收集张伦忠教授治疗中老年郁证的门诊首诊处方122首,运用中医传承辅助平台软件,分析其组方规律和用药经验。结果122首处方中得出12个核心组合和6个新处方。结论张伦忠教授治疗中老年郁证善于从阴阳角度辨焦虑与抑郁,重视肝、脾、肾三脏,治以疏肝解郁、顾护中焦、补肾填精,多以桑麻地黄汤为基础方临证加减,采用复方治疗,标本兼治。     

Does play promote self-regulation in children?

This theoretical paper discusses the role of pretend play and games with rules in fostering children's self-regulation. It proposes several pathways through which play facilitates self-regulation processes. First, in play, children learn to inhibit their impulsive behaviour and follow rules which transform their behaviour from impulsive and spontaneous to mediated and voluntary. Second, play liberates children from situational constraints as children begin to act upon the meanings of objects as opposed to their immediate motivational valence. Third, children develop internal representations which guide their behaviour. Finally, play promotes verbal self-regulation as children are engaged in an ongoing dialogue with their partners in order to resolve differences in perspectives, to reach an agreement about roles, and to invent play rules. The paper further reviews empirical studies which explore the effect of play on inhibition, working memory, and private speech. The current status of play and implications for practice are discussed.     

基于现代医案挖掘中医药治疗慢性阻塞性肺疾病的证治规律

目的 基于文献医案借助中医传承辅助平台（V2.5）挖掘中医药治疗慢性阻塞性肺疾病（COPD）的证治规律，为中医药治疗COPD提供新思路。方法 检索中国知网（CNKI）、万方数据库（WanFang DATA）、维普中文科技期刊数据（VIP）等关于中医治疗COPD的医案，将符合纳入文献的医案整理在单独的Word文档中，经数据规范化后逐一录入中医传承辅助平台（V2.5），借助此软件携带的算法对所纳入COPD医案的“症状、中医证型、中药及中药性味归经”进行频数统计及对纳入医案的“组方规律”进行关联分析并挖掘出治疗COPD潜在的核心药对及新方。结果 共纳入103篇文献，共收集医案126个医案，共131次诊疗。经统计COPD常见的症状有咳嗽、咳痰、胸闷、气喘等；常见的中医证型有痰热壅肺证、痰瘀阻肺、肺脾气虚等；常见的中医治法有清热化痰、培土生金、降逆平喘等；其中治疗COPD的高频中药有半夏、苦杏仁、麻黄、陈皮等；常用药对组合有细辛-半夏、半夏-五味子-甘草等；并挖掘出12首治疗COPD的新方药。结论 中医认为COPD是由外邪、痰、瘀等病理因素相互形成的以咳、痰、喘为主要症状的肺系疾病，其主要的证候有痰热壅肺证、痰瘀阻肺、肺脾气虚等，“扶正祛邪”是其治疗的基本原则，在临床应采用祛痰化瘀，补益肺脾或肺肾的中医治法治疗COPD。     

Cautious observation or blanket scanning? An investigation into paediatric attendances to an emergency department after head injury

In September 2007, the National Institute for Health and Clinical Excellence (NICE) in the UK issued a newly updated guideline (CG56) on the early care of adults and children with head injuries.⁸ The guideline gives some new recommendations, in particular with regards to imaging of children with head injury.We undertook a study to investigate the management of children presenting with head injury to our emergency department and to assess their outcomes and the CT scanning rate. We then retrospectively applied the new NICE guidelines, using information documented in the case notes, to establish whether adherence to the guidelines would significantly affect CT scanning rates.237 paediatric head injury cases were seen over the 2-month period that was studied. The actual CT scanning rate observed was 2.1%, rising to 18.1% after strictly applying NICE criteria. This increased scanning rate raises some important issues with regards to patient safety and service provision.     

Memory related dysregulation of hippocampal function in major depressive disorder

Hippocampal abnormalities have frequently been associated with major depressive disorder (MDD), however evidence of a functional hippocampal deficit has remained illusive. Here, functional magnetic resonance imaging (fMRI) is employed in conjunction with an associative memory paradigm to investigate functional irregularities of the hippocampus during the encoding process. The use of a focussed analytical approach and a behavioural task targeted to hippocampal function confirmed the hypothesis that the normal modulation of hippocampal activation by encoding strength is dysregulated in MDD. Further analysis demonstrated that this impairment of function was specific to the hippocampus. A double dissociation between groups in the hippocampus and intraparietal sulcus indicates that compensatory mechanisms may exist. These results show that MDD is associated with a dysregulation of hippocampal function that cannot be explained in terms of overall brain state or motivational stance and provides an important link between memory impairments and hippocampal changes in MDD.     

基于关联规则的名老中医冠心病用药规律研究

目的：分析、挖掘名医治疗冠心病心绞痛的用药规律,探索名医经验整理的方法。方法：收集7位名医治疗冠心病心绞痛典型医案115例,建立名医冠心病诊疗数据库,运用关联规则分析名医医治疗冠心病的方剂配伍规律。结果：在所使用的175种中药中,活血药、化痰药及补虚药之间的配伍是最常用的药物组合,瓜蒌薤白类方、活血通脉剂及生脉散等是名医治疗冠心病的基本方药,三者之间的配合应用构成了名医用药的一般规律。结论：以关联规则所得的名医治疗冠心病药对、药组反应了名医治疗冠心病标本同治的治疗思想,为以后的研究提供了方法学参考。     

数据挖掘在大型医疗设备故障诊断中的应用研究

本文阐述了数据挖掘的概念及实际应用的意义,尝试着将数据挖掘方法应用于我院部分大型医疗设备的故障监测与诊断中,取得了良好的收效。