基于数据挖掘和网络药理学的血脂异常用药规律和作用机制研究＊

目的 从文献研究的角度出发，运用数据挖掘和网络药理学研究方法，探讨中医药在血脂异常治疗中的组成规律和作用机制研究，为该病的防治提供参考。方法 以1979-2019年“中国知网（CNKI）”、“万方数据”、“维普中文期刊”等数据库中检索到的中药复方治疗血脂异常文献为数据来源，采用中医传承辅助平台对其进行频次分析、关联规则分析和熵聚类方法分析，研究防治血脂异常方药组成规律，并在此基础上采用网络药理学方法，通过KEGG通路和基因本体富集分析，研究高频核心药物的生物信号通路，阐明其作用机制。结果 共计786篇文献符合检索条件，包含314味中药，发现48味高频中药，按照药物使用频次从高到低排序为：活血化瘀药、补虚药（健脾补肾为主）、利水渗湿药、消食化积药；药物性味以温、苦为主，归肝经和脾经最多；进一步关联分析得到高频药对（药组）17个；经过熵聚类分析发现潜在药物组合22个和新方组合11个。应用网络药理学研究方法，对核心药组“山楂、泽泻和决明子”的作用机制进行探索，发现其主要通过作用于包括雌激素受体1（ESR1）、大麻素受体1型（CNR1）、糖皮质激素受体基因（NR3C1）、环氧合酶2（PTGS2/COX2）等潜在靶点，干预三羧酸（TCA）循环、脂质代谢、脂肪酸降解等调节血脂相关的关键信号通路而发挥调节血脂作用。结论 中药治疗血脂异常以健脾补肾治其本，活血化瘀、消痰化积治其标的方法为主，核心药组的作用机制可能是通过干预脂质代谢和基础代谢相关通路发挥治疗作用。     

疫情催生的“云馆配”与其他采访模式的比较与思考

以浙江省首届“云馆配”图书展示会为例，介绍了“云馆配”采访模式的具体实践，对“云馆配”与现场采访、征订目录采访、读者荐购、读者决策采购等不同采访模式进行了比较，指出了各种模式的优势与不足，提出了“云馆配”采访模式的优化发展策略。认为“云馆配”立足用户需求，不仅使图书馆（用户）、馆配商、出版社三方得到了及时、有效的沟通，还成为读者决策采购的一种新的积极尝试。“云馆配”采访模式已在疫情期间得到了较好应用，未来可辅助日常图书采访。     

A trivalent vaccine candidate against hepatitis E virus,norovirus, and astrovirus

Hepatitis E virus (HEV), norovirus (NoV), and astrovirus (AstV) are enterically-transmitted viral pathogens causing epidemic or endemic hepatitis (HEV) and gastroenteritis (NoV and AstV) respectively in humans, leading to significant morbidity and mortality worldwide. While a recombinant subunit vaccine against HEVs is available in China, there is no commercial vaccine or antiviral against NoV or AstV. We report here our development of a trivalent vaccine against the three viral pathogens through our new polymer vaccine technology. All HEV, NoV, and AstV are non-enveloped RNA viruses covered by a protein capsid, featuring surface protruding (P) proteins that are responsible for virus–host interaction. These dimeric P proteins elicit neutralizing antibody and are good targets for subunit vaccine development. The trivalent subunit vaccine was developed by fusion of the dimeric P domains of the three viruses together that formed tetramers. This trivalent vaccine elicited significantly higher antibody responses in mice against all three P domains than those induced by a mixture of the three free P domains (mixed vaccine). Furthermore, the post-immune antisera of the trivalent vaccine showed significantly higher neutralizing titers against HEV infection in cell culture and higher blocking activity against NoV binding to HBGA ligands than those of the post-immune sera of the mixed vaccine. Thus, the trivalent vaccine is a promising vaccine candidate against HEV, NoV, and AstV.     

Influence of various implant platform configurations on peri-implant tissue dimensions: an experimental study in dog

Aim: To evaluate the influence (i) of various implant platform configurations and (ii) of implant surface characteristics on peri‐implant tissue dimensions in a dog model. Material and methods: Mandibular premolars and first molars were extracted bilaterally in six Labrador dogs. After 3 months of healing, two implants, one with a turned and a second with a moderately rough surface, were installed on each side of the mandible in the premolar region. On the right side of the mandible, implants with a tapered and enlarged platform were used, while standard cylindrical implants were installed in the left side of the mandible. Abutments with the diameter of the cylindrical implants were used resulting in a mismatch of 0.25 mm at the tapered implant sites. The flaps were sutured to allow a non‐submerged healing. After 4 months, the animals were sacrificed and ground sections were obtained for histometric assessment. Results: All implants were completely osseointegrated. A minimal buccal bone resorption was observed for both implant configurations and surface topographies. Considering the animals as the statistical unit, no significant differences were found at the buccal aspect in relation to bone levels and soft tissue dimensions. The surface topographies did not influence the outcomes either. Conclusions: The present study failed to show differences in peri‐implant tissue dimensions when a mismatch of 0.25 mm from a tapered platform to an abutment was applied. The surface topographies influence a neither marginal bone resorption or peri‐implant soft tissue dimension. To cite this article:
Baffone GM, Botticelli D, Pantani F, Cardoso LC, Schweikert MT, Lang NP. Influence of various implant platform configurations on peri‐implant tissue dimensions: an experimental study in dog.
Clin. Oral Impl. Res. 22 , 2011; 438–444.     

A 5-year prospective study on small diameter screw-shaped oral implants

Alveloar ridges of limited dimensions could preclude the placement of dental implants of the regular dimension. Smaller diameter implants - narrow platform (NP) implants were commercially available to address this issue. The aim of the study was to determine the 5-year clinical performance of 3.3 mm diameter NP implants. Twenty-three machined screw-shaped NP implants were placed in nine patients (six males; three females) between 18 and 70 years of age. Clinical and radiographic examinations were performed annually for 5 years. Recognized implant success criteria was used. The criteria were based on the mean marginal alveolar bone loss, the placement of prosthesis of satisfactory appearance, and the absence of implant mobility, peri-implant radiolucency, pain, discomfort or infection. One implant failed at abutment connection. The remaining 22 implants were restored and functioned successfully according to the criteria. The mean marginal alveolar bone loss during the first year was 0.41 +/- 0.17 mm. The mean marginal alveolar bone loss between the second and fifth year was 0.03 +/- 0.06 mm. The success rate of NP implants according to a well-established set of criteria was 96%.     

Effect of platform switching on peri-implant bone levels: a randomized clinical trial

Objective: The concept of platform switching has been introduced to implant dentistry based on observations of reduced peri‐implant bone loss. However, randomized clinical trials are still lacking. This study aimed to test the hypothesis that platform switching has a positive impact on crestal bone‐level changes. Material and methods: Two implants with diameters of 4 mm were inserted epicrestally into one side of the posterior mandibles of 25 subjects. After 3 months of submerged healing, the reentry surgery was performed. On the randomly placed test implant, an abutment 3.3 mm in diameter was mounted, resulting in a horizontal circular step of 0.35 mm (platform switching). The control implant was straight, with an abutment 4 mm in diameter. Single‐tooth crowns were cemented provisionally. All patients were monitored at short intervals over the course of 1 year. Standardized radiographs and microbiological samples from the implants' inner spaces were obtained at baseline (implant surgery), and after 3, 4, and 12 months. Results: After 1 year, the mean radiographic vertical bone loss at the test implants was 0.53±0.35 mm and at the control implants, it was 0.58±0.55 mm. The mean intraindividual difference was 0.05±0.56 mm, which is significantly <0.35 mm (P=0.0093, post hoc power 79.9%). The crestal bone‐level changes depended on time (P<0.001), but not on platform switching (P=0.4). The implants' internal spaces were contaminated by bacteria, with no significant differences in the total counts between the test and the control at any time point (P=0.98). Conclusions: The present randomized clinical trial could not confirm the hypothesis of a reduced peri‐implant bone loss at implants restored according to the concept of platform switching. To cite this article:
Enkling N, Jöhren P, Klimberg V, Bayer S, Mericske‐Stern R, Jepsen S. Effect of platform switching on peri‐implant bone levels: a randomized clinical trial.
Clin. Oral Impl. Res. 22 , 2011; 1185–1192.
doi: 10.1111/j.1600‐0501.2010.02090.x     

基于Roy适应理论的健康宣教配合智慧平台在T1DM带泵治疗患儿中的应用

目的　探讨基于Roy适应理论的健康宣教配合智慧平台在1型糖尿病（T1DM）带泵治疗患儿中的应用效果。方法　纳入2020年5月至2022年5月经郑州儿童医院收治的84例T1DM带泵治疗患儿及主要监护人作前瞻性研究,按随机数字表法设为对照组（患儿42例,主要监护人42例）及观察组（患儿42例,主要监护人42例）。对照组予以常规健康宣教,观察组则于对照组基础上,基于Roy适应理论的健康宣教配合智慧平台实施干预,比较两组主要监护人健康教育知识掌握程度、照护水平及患儿血糖控制效果、治疗依从性。统计学方法采用χ²检验、t检验。结果　两组主要监护人干预前健康教育知识掌握度、照护者负担水平（ZBI）、家庭关怀度（APGAR）比较,差异均无统计学意义;两组干预后健康教育知识掌握度、APGAR均有提高,ZBI有所降低,观察组健康教育知识掌握度［（68.15±7.36）分比（54.62±10.18）分］、APGAR［（8.03±1.35）分比（6.72±1.13）分］均高于对照组,ZBI［（26.87±5.21）分比（30.24±5.48）分］低于对照组（t=6.98、4.822、2.888,均P<0.05）;两组患儿干预前HbA1c、FBG比较,差异无统计学意义。两组干预后糖化血红蛋白（HbA1c）、空腹血糖（FBG）均有降低,观察组HbA1c［（6.51±0.58）%］、FBG［（6.76±0.65）mmol/L］低于对照组［（7.44±0.86）%、（7.83±0.91）mmol/L］,差异均有统计学意义（t=5.810、6.201,均P<0.05）,且观察组干预后HbA1c、FBG合格率高于对照组（χ²=7.244、5.833,均P<0.05）;经Redit分析,两组患儿治疗依从性比较,差异有统计学意义（χ²=2.090,P<0.05）,且观察组MMAS-8评分高于对照组,差异有统计学意义（t=11.770,P<0.05）。结论　基于Roy适应理论的健康宣教配合智慧平台应用于T1DM带泵治疗患儿,可提升主要监护人健康教育知识掌握程度,提高照护水平,且患儿血糖控制效果良好,治疗依从性上升。     

影像学云平台在医学影像学实习教学中的应用与价值

目的　探讨将影像学云平台应用于医学影像学实习教学对学生诊断思维能力和学习体验的影响。方法　将重庆医科大学2016级医学影像系88位学生分为两组,每组44人。试验组以影像学云平台开展实习教学,对照组以传统实习方式教学。4周后对比两组在诊断思维能力和学习体验间的差异。采用SPSS 22.0软件进行t检验。结果　诊断思维能力的测试总成绩试验组高于对照组[（80.63±6.10） vs. （70.36±8.09）],差异有统计学意义（P<0.05）。其中征象描述、鉴别诊断及要点、新进展与建议3项得分差异有统计学意义（P<0.05）。对学习体验问卷调查的5个方面,试验组的评分均高于对照组,差异均有统计学意义（P<0.05）。结论　在影像学实习中应用影像学云平台对提高学生的诊断思维能力、提升学习体验具有重要的价值,值得实践与推广。     

地方高校大型仪器共享平台建设的探索与实践

建设大型仪器共享平台是我国实施创新驱动战略的重要内容,是新时代我国高等教育学校的重要使命。地方高校作为我国高等教育事业主体更应积极响应国家号召,探索和实践特色大型仪器共享平台建设之路。笔者分析了地方高校大型仪器共享平台建设现状及存在问题,并以温州医科大学为例,总结了大型仪器共享平台建设过程中实验室安全“一体化”管理、“共享平台3+”搭建和平台技术队伍建设三方面的创新举措,以期对地方高校大型仪器共享平台建设有所裨益。     

市场导向下的药企间仿制药一致性评价横向合作的现状分析及对策

中国仿制药占上市化学药品的绝大部分,由于仿制药的质量参差不齐,直接影响到人民群众用药的安全性和有效性。现阶段,我国提出要全面提高仿制药质量,将仿制药分期分批与被仿制药进行质量一致性评价,对于整个医药行业是一次重要的战略机遇。在市场导向下,以企业作为主体通过横向合作的方式,引导企业参与生物等效性(BE)研究平台的建设,通过企业联合建立仿制药一致性评价的参比制剂及研究信息共享机制;同时通过政府引导资源配置,适度倾斜照顾中西部地区企业,解决中西部地区药企面临的实际问题,实现医药行业的区域均衡发展,使之成为促进医药行业的供给侧结构改革的重要抓手。