血液净化技术在危重患者治疗中的应用进展

近年来血液净化技术不断发展，新模式和新材料不断涌现。在多种病因导致的危重患者中，血液净化均可以发挥重要的治疗作用。特别是对于内环境严重紊乱的危重患者，血液净化已经成为重要的生命支持手段。因为连续性血液净化技术对血流动力学影响较小，在危重患者的治疗中更具有优势。免疫吸附等新技术的出现，对一些危重患者的原发病也有很好的治疗效果。但是目前还存在抗凝剂选择、容量控制等需要进一步研究的问题。     

The technological imperative in tuberculosis care and prevention in Vietnam

ABSTRACT

A monocausal bacteriological understanding of infectious disease orients tuberculosis control efforts towards antimicrobial interventions. A bias towards technological solutions can leave multistranded public health and social interventions largely neglected. In the context of globalising biomedical approaches to infectious disease control, this ethnography-inspired review article reflects upon the implementation of rapid diagnostic technology in low- and middle-income countries. Fieldwork observations in Vietnam provided a stimulus for a critical review of the global rollout of tuberculosis diagnostic technology. To address local needs in tuberculosis control, health managers in resource-poor settings are readily cooperating with international donors to deploy novel diagnostic technologies throughout national tuberculosis programme facilities. Increasing investment in new diagnostic technologies is predicated on the supposition that these interventions will ameliorate disease outcomes. However, suboptimal treatment control persists even when accurate diagnostic technologies are available, suggesting that promotion of singular technological solutions can distract from addressing systemic change, without which disease susceptibility, propagation of infection, detection gaps, diagnostic delays, and treatment shortfalls persist.     

正交试验优选益母阿胶膏的最佳工艺研究

目的优选益母阿胶膏生产的最佳提取工艺。方法以出膏率为指标,采用正交试验考察A加水量(倍)、B提取时间(h)、C提取次数(次)三个因素的影响,确定益母阿胶膏的最佳提取工艺。结果提取因素按影响大小依次是C提取次数>B提取时间>A加水量,最佳提取条件为:加12倍量水,提取1.5 h,提取2次。结论该制备工艺合理可行,可作为益母阿胶膏的最佳提取工艺。     

科技期刊嵌入的多重复合科技创新生态系统研究

【目的】 深入探究科技期刊和科技创新生态系统的关系,为科技期刊响应国家号召,高质量、可持续地服务科技创新提供参考。【方法】 基于生态隐喻和模型构建法,构造出科技期刊嵌入的多重复合科技创新生态系统模型,理顺期刊创新运作机制和复合系统构建路径。【结果】 科技期刊被嵌入科技创新生态系统后,形成身兼二任的次生生态,不仅是创新成果作者与多种科技创新主体的接口,而且上下联通不同层级创新生态圈,还衍生出动态自调节、协同共生、交互作用机制。【结论】 科技期刊强力嵌入并高效发挥主观能动性,为科技期刊服务国家科技创新提供全新理论和实践动力,并丰富科技创新生态系统层次、内涵。     

扁塑藤素调控Notch信号通路诱导人肺癌条件重编程细胞死亡的作用机制研究

目的：应用条件性重编程细胞（conditionally reprogrammed cells，CRCs）技术建立人肺癌细胞体外长期培养体系，研究扁塑藤素对人肺癌CRCs增殖和迁移能力的影响，并探讨相关作用机制。方法：免疫组化法检测Notch 1、HES1和Cyclin D3在肿瘤组织和癌旁组织中的表达水平；使用CRCs技术分离培养非小细胞肺癌原代细胞；使用2，4，8，16 μmol·L^-1的扁塑藤素处理人肺癌CRCs，MTS法检测细胞活力，Annexin V/PI流式细胞术检测细胞凋亡，Transwell法检测细胞迁移能力，Western Blot检测细胞中Notch信号通路相关蛋白Notch 1、HES1和Cyclin D3的表达水平。结果：在非小细胞肺癌患者肿瘤组织中Notch 1、HES1和Cyclin D3的表达水平高于癌旁组织；扁塑藤素能够诱导人肺癌CRCs死亡，并在一定范围内呈现时间和浓度依赖性（P<0.05）；随着扁塑藤素作用浓度的增高，人肺癌CRCs凋亡率明显增高（P<0.05），细胞迁移能力下降（P<0.05）；扁塑藤素能够下调人肺癌CRCs中Notch 1、HES1和Cyclin D3的蛋白表达水平。结论：扁塑藤素可能通过调控Notch信号通路相关蛋白的表达水平，抑制人肺癌CRCs的增殖和迁移，并诱导其凋亡，为肺癌的治疗提供新的实验数据和理论依据。     

Continuing education in the child health handbook: an educational software for primary care1

ObjectiveTo present, the process of development and evaluation of an educational software on the Child Health Handbook proposed for the continuing education of primary care nurses and physicians.MethodsQuantitative study of methodological development. For software development, the following steps were followed: definition of objectives; determination of the target audience; choice of pedagogical and theoretical reference for content; content selection and structuring; software development and evaluation by experts (five nurses and four physicians). All responded to an instrument that included four domains: pedagogical; content; functionality; system presentation and usability. The evaluation criteria were arranged on a Likert-type scale. The percentage of agreement and Content Validity Index were used for the quantitative analysis of the degree of agreement, considering a Content Validity Index cutoff point equal to 0.80.ResultsThe overall agreement index, calculated by the arithmetic mean of the Contents Validity Index of the evaluated domains, was 0.96, with scores ranging from 0.90 to 1.00. The average percentage of agreement of the experts per domain was 92.86%, with lower agreement in the content (80.95%), presentation, and usability (90.48%) domains. 100% of percentage of agreement was observed in the pedagogical and functionality domains among the evaluated specialists.ConclusionThe percentage of agreement, Content Validity Index and overall agreement index of the Child Health Handbook educational software in the context of primary care disclosed the software adequacy as an educational resource for continuing education of primary care nurses and physicians. Considering the assessed dimensions, it can also be used by other health professionals and undergraduate students.     

基于ICT技术的中医向其他自然科学学科知识迁移的研究

探讨中医现代化研究中中医学科向其他自然科学学科知识迁移的问题。通过对学科知识的成分进行分析,提出建立知识模型之间的迁移路径是知识迁移的有效方法。提出中医学科知识到数学和物理学科的迁移过程应该以现代的ICT技术为基础,由文句解析、文字形式化处理、数值图像建模、状态抽象化、导入物理元素、导入环境因素这六个阶段构成。还提出了中医知识迁移的过程中应该利用异步通讯的方法进行反馈。