妈富隆结合固冲汤治疗育龄期非妊娠女性异常子宫出血的临床观察

[目的]观察中西医结合治疗育龄期非妊娠女性异常子宫出血的临床疗效。[方法]将58例异常子宫出血患者随机分为观察组(32例)和对照组(26例),观察组给予西药妈富隆及中药固冲汤治疗,对照组仅给予妈富隆治疗。[结果]观察组治疗总有效率为96.9%,明显高于对照组的总有效率73.1%(P0.05);随访观察,观察组复发率6.3%,明显低于对照组复发率30.8%(P0.05)。[结论]妈富隆结合固冲汤治疗育龄期非妊娠女性异常子宫出血疗效显著,止血效果良好,不良反应少。     

基于分布式技术的中西医信息资源整合平台设计

针对目前中医和西医信息资源集成整合的难题,本文在研究分布式相关技术的基础上,采用基于SOA架构的Web 服务技术,将相同疾病的中西医治疗方案相关联,提出了基于分布式技术的中西医信息资源整合模型,并进行了深入分析设计,解决了专业中医或西医医生较难利用中西医结合方案的难题,实现了中西医信息资源的集成性、重用性和扩展性,为现代医学发展提供了重要的参考价值。     

BRAF mutation testing with a rapid,fully integrated molecular diagnostics system

Fast and accurate diagnostic systems are needed for further implementation of precision therapy of BRAF-mutant and other cancers. The novel Idylla^TM BRAF Mutation Test has high sensitivity and shorter turnaround times compared to other methods. We used Idylla to detect BRAF V600 mutations in archived formalin-fixed paraffin-embedded (FFPE) tumor samples and compared these results with those obtained using the cobas 4800 BRAF V600 Mutation Test or MiSeq deep sequencing system and with those obtained by a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory employing polymerase chain reaction–based sequencing, mass spectrometric detection, or next-generation sequencing. In one set of 60 FFPE tumor samples (15 with BRAF mutations per Idylla), the Idylla and cobas results had an agreement of 97%. Idylla detected BRAF V600 mutations in two additional samples. The Idylla and MiSeq results had 100% concordance. In a separate set of 100 FFPE tumor samples (64 with BRAF mutation per Idylla), the Idylla and CLIA-certified laboratory results demonstrated an agreement of 96% even though the tests were not performed simultaneously and different FFPE blocks had to be used for 9 cases. The Idylla^TM BRAF Mutation Test produced results quickly (sample to results time was about 90 minutes with about 2 minutes of hands on time) and the closed nature of the cartridge eliminates the risk of PCR contamination. In conclusion, our observations demonstrate that the Idylla test is rapid and has high concordance with other routinely used but more complex BRAF mutation–detecting tests.     

An integrative approach for the identification of prognostic and predictive biomarkers in rectal cancer

Introduction

Colorectal cancer is the third most common cancer in the world, a small fraction of which is represented by locally advanced rectal cancer (LARC). If not medically contraindicated, preoperative chemoradiotherapy, represent the standard of care for LARC patients. Unfortunately, patients shows a wide range of response rates in which approximately 20% has a complete pathological response, whereas in 20 to 40% the response is poor or absent.

Results

The following specific gene signature, able to discriminate responders'' patients from non-responders, were founded: AKR1C3, CXCL11, CXCL10, IDO1, CXCL9, MMP12 and HLA-DRA. These genes are mainly involved in immune system pathways and interact with drugs traditionally used in the adjuvant treatment of rectal cancer.

Discussion

The present study suggests that new ideas for therapy could be found not only limited to studying genes differentially expressed between the two groups of patients but deepening the mechanisms, associated to response, in which they are involved.

Methods

Gene expression studies performed by: Agostini et al., Rimkus et al. and Kim et al. have been merged through a meta-analysis of the raw data. Gene expression data-sets have been processed using A-MADMAN. Common differentially expressed gene (DEG) were identified through SAM analysis. To further characterize the identified DEG we deeply investigated its biological role using an integrative computational biology approach.     

The hidden impact of home adaptations: Using a wearable camera to explore lived experiences and taken‐for‐granted behaviours

Most adults over 65 years old live in mainstream housing in the United Kingdom, yet these can often be unsuitable for an individual's needs. With increased understanding of the relationship between housing, and health and well‐being, the importance of modifying the home to suit individuals is recognised as being paramount. However, it is often difficult to monitor the ways in which home adaptations and equipment are used in the home. This study used innovative wearable technology to explore everyday, lived experiences of using home adaptations and equipment. Six older adults who had received a major home adaptation in the last 24 months took part in this study. Each participant used a wearable camera for one day and participated in a semi‐structured interview while watching the images back as a ‘slideshow’. Using this novel approach, three themes were generated from the data: acquiring adaptations and equipment, adapting routine and changing behaviour, and inconsistent and unintended uses. The findings of this study open up the complexity of the lived experience of using home adaptations and equipment. Experiences from access to long‐term outcomes are personal, and individuals modify and use the adaptations in various ways to suit their own needs. The wearable camera allowed additional insight into lived experience that would otherwise not have been captured without its use, as the photographs acted as a way of stimulating conversation and highlighting taken‐for‐granted behaviours not often consciously considered by the individuals.     

Formative research for the development of an Eye Health Strategic Planning and Evaluation Framework and a Checklist: A health systems approach

This formative research process aimed to develop an Eye Health Strategic Planning and Evaluation Framework and indicator Checklist. The research process utilized a multi‐phased multiple methods approach including literature review, initial expert review (n = 27), findings from a Cambodian Avoidable Blindness Initiative demonstration project (2009‐2012), observation and analysis of four rural sites of the Indian LV Prasad Eye Institute Pyramid Model (n = 21), and finally, a critique by Cambodian government eye health professionals/staff (n = 15), health center staff and community representatives (n = 77) and patients (n = 62). Results from three Cambodian population‐based surveys (KAP n = 599, patient follow‐up n = 354, and RAAB 4650) also informed the development of the Framework and the Checklist. The Framework domains include: situation analysis, determinants of accessibility, service delivery systems, operation systems, networks and linkages, outcomes, and impact. Domains were subdivided into 59 components. The Checklist consists of 253 indicator items. The Eye Health Strategic Planning and Evaluation Framework and the Checklist can assist policy makers, program planners, and evaluators to develop a comprehensive whole of systems approach to eye health care to improve coverage and utilization of services.     

Analysis of Clinical Evaluation of Response to Treatment of Parkinson’s Disease with Integrated Chinese and Western Medicine Therapy

Objective:To analyze the clinical evaluation of Parkinson's disease(PD) patients receiving integrated Chinese and Western medicine therapy.Methods:One hundred and twenty patients were enrolled and randomly allocated to a control group or treatment group.Patients in the two groups received placebo and Bushen Huoxue Granule(补肾活血颗粒,BHG),respectively.Both groups received baseline levodopa and benserazide(Madopar).The effects of treatment were assessed monthly during the 9-month treatment.Means of evaluation included Unified PD Rating Scale(UPDRS) scores(Ⅱ and Ⅲ),sleep scale score,10 m turn back test(getting up time,10 m×2 times,and turning time),timing motor test(TMT)-left and TMT-right,which were treated as the dependent variables;and age,sex,duration of PD,Hoehn and Yahr(H-Y) stage and Madopar dosage of admitted PD patients were as the independent variables.Multiple linear regression was used to analyze these factors.Results:H-Y stage significantly affected UPDRS Ⅱ score,UPDRS Ⅲ score,and getting up time(P0.01).Madopar dosage and H-Y stage significantly affected the 10 m×2 times(P0.05 or P0.01).Madopar dosage significantly affected the sleep scale score(P0.05).There were also significant correlations between age and TMT-left or TMT-right(P0.01),and duration of PD and TMT-right(P0.05).Conclusions:The six assessed means of clinical evaluation(including UPDRS Ⅱ and UPDRS Ⅲ scores,sleep scale score,getting up time,10 m×2 times,and turning time) are sensitive indexes in all PD patients.H-Y stage and Madopar dosage are the major factors influencing means of clinical assessment of PD treatment.     

军队医院体系综合管理信息平台的研发实践

目的：开发一个针对部队医院体系管理的信息共享平台,实时掌握各家医院的人员管理、质量效率、为兵服务、经济运行和科研教学等统计分析情况。方法使用后台数据采集系统定时采集各医院的日报信息,形成独立数据仓库,利用B/S（Browser/Server）架构的前台程序形成分析报表、图形等浏览界面。结果以信息化手段实现了对军队医院体系的动态管理,方便机关首长的信息查询统计和决策分析。结论为医疗卫生行业利用信息化手段来抓行政管理建设提供了很好的事例。     

中西医联合治疗糖尿病肾病

中医认为,糖尿病肾病(消渴肾病)以本虚为主,虚和瘀贯穿了疾病的始终.治疗上不能一味追求西药强化治疗,应当中西医结合攻补兼施,增强疗效,减轻不良反应.从中西医角度分析糖尿病肾病的发病机制及其治疗进展,发现糖尿病肾病的发病机制从中医及西医的角度解释是相通互补的,并且中医联合西医治疗糖尿病肾病有着相辅相成的作用.中医联合西医治疗糖尿病肾病可延缓糖尿病肾病的进展,并且可以减少低血糖的风险和西药带来的毒副作用.     

神经节苷脂联合丹参治疗成人缺氧缺血性脑病疗效观察

目的观察神经节苷脂联合丹参治疗成人缺氧缺血性脑病的疗效。方法 104例成人缺氧缺血性脑病患者随机分为两组。对照组给予常规治疗,治疗组在对照组基础上给予神经节苷脂联合丹参联合治疗,对两组治疗效果和转归情况进行比较。结果治疗组总有效率明显高于对照组(P0.05);治疗组的良好转归率明显高于对照组(P0.05)。结论神经节苷脂联合丹参治疗成人缺氧缺血性脑病,能够改善患者预后,促进患者神经功能的康复,有着重要的临床参考意义。