医药电商平台持续使用意愿及影响因素研究

构建医药电商平台持续使用意愿理论模型,采用问卷调查分析用户对医药电商平台持续使用意愿及影响因素,结果表明感知有用性和用户主观规范正向影响用户对平台持续使用意愿,感知风险负向影响持续使用意愿。在此基础上提出平台运营建议,包括设计创新、口碑化宣传、建设生态链等。     

表观遗传修饰在神经退行性变性疾病中的作用研究进展

表观遗传修饰对神经发育、神经干细胞命运决定和神经系统的生理功能发挥具有重要的调节作用。异常的表观遗传修饰与阿尔茨海默病、帕金森病和亨廷顿病等神经退行性变性疾病的发生和发展有密切关系：异常升高的DNA甲基化修饰抑制了一些修复基因的表达,影响亨廷顿病进展;阿尔茨海默病患者大脑中H3K27ac和H3K9ac组蛋白修饰增加,影响神经变性;RNA甲基化修饰在阿尔茨海默病和帕金森病两种疾病动物模型中呈现差异化的改变。因此,表观遗传修饰可能作为神经系统疾病的潜在治疗靶点。本文综述了表观遗传修饰参与神经退行性变性疾病及其分子机制的最新研究进展。     

抑郁症患者脑结构网络效率属性及与疾病严重程度的相关分析

目的 探讨抑郁症患者与健康对照者脑结构的网络效率及节点效率属性的异同,分析抑郁症患者大脑全局信息处理模式和脑区间信息整合效率的改变,及其与疾病严重程度的关系.方法 对27例抑郁症患者(抑郁症组)和36名健康对照者(对照组)进行弥散张量成像扫描,利用解剖学自动标记模板将整个大脑划分为90个区域,同时对全脑进行确定性纤维追踪,构建脑结构二值化网络.并对所得抑郁症组与对照组脑结构网络的效率属性值进行双样本t检验.结果 (1)2组脑网络分别与相匹配的随机网络比较:网络全局效率均与随机网络相似;网络局部效率均大于随机网络.(2)抑郁症组网络全局效率(0.86±0.01)较对照组(0.87±0.01)下降(t=-2.31;P =0.02).(3)抑郁症组节点全局效率属性值较对照组(右侧额上回眶部:0.41±0.04与0.44±0.02;左侧颞中回颞极:0.31 ±0.02与0.33±0.03)下降(t=-3.52、-3.84;P=0.0008、0.0003;通过多重校正).(4)抑郁症组右侧额上回眶部全局效率属性值与HAMD17总分呈负相关(r=-0.46,P=0.02).结论 抑郁症患者与健康人大脑都具有高效经济的“小世界”式的信息处理模式.抑郁症患者脑区间信息整合的能力已受损,且与疾病严重程度呈负相关.     

OCTA观察早期ARMD患者黄斑区血流密度及形态结构的变化

目的：应用光相干断层扫描血管成像(OCTA)观察早期年龄相关性黄斑变性(ARMD)患者黄斑区血流密度和形态学结构的改变。

方法：本研究为病例回顾性研究,纳入2018-02于我院眼科被初次明确诊断为单眼湿性年龄相关性黄斑变性(wARMD)且另一眼为早期ARMD患者的35例35眼,并纳入与试验组年龄相匹配的健康眼35例。所有患者早期ARMD眼于初诊时及2a后均行OCTA检查,观察黄斑区3mm×3mm范围内浅层、深层视网膜及脉络膜毛细血管层血流密度,黄斑中心凹面积、周长及非圆指数,及黄斑区全层、内层、外层视网膜和光感受器与Bruch膜之间(ISOS-BRM)厚度变化。

结果：与正常人相比,早期ARMD患者黄斑区3mm×3mm范围内浅层、深层视网膜及脉络膜毛细血管层血流密度降低(P<0.05),黄斑区全层及内层视网膜厚度降低(P<0.05),而ISOS-BRM厚度有增加的趋势(P=0.37),黄斑中心凹无血管区面积、周长及非圆指数无明显变化(P>0.05); 初次诊断2a后早期ARMD患者深层视网膜及脉络膜毛细血管层血流密度较前进一步降低(P<0.05),外层视网膜厚度较前增加(P=0.02),ISOS-BRM厚度较前进一步有增加的表现(P=0.18),黄斑中心凹无血管区面积、周长及非圆指数较前无明显变化(P>0.05)。此外初次诊断及2a后早期ARMD患者脉络膜毛细血管层血流密度与黄斑区视网膜浅层及深层血流密度均呈正相关(初次诊断组：r_浅层=0.407,r_深层=0.56,均P<0.05; 2a后组：r_浅层=0.57,r_深层=0.628,均P<0.05)。

结论：早期ARMD患者黄斑区浅层、深层视网膜及脉络膜毛细血管层血流密度和内层视网膜厚度较正常人均降低,这对ARMD的早期发现和及早干预具有临床参考意义。     

Lyophilization provides long-term stability for a lipid nanoparticle-formulated,nucleoside-modified mRNA vaccine

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“I think I could have designed it better,but I didn’t think that it was my place”: a critical review of home modification practices from the perspectives of health and of design

Abstract

Purpose: The research presented demonstrates the disharmony between end user goals and their consideration in service outcomes within ageing-in-place and asks “what can design offer health” within this domain.

Methods: Data was collected using semi-structured interviews with various stakeholders within the context of ageing in place. All data are thematically analysed through a theoretical lens of control theory.

Results: The results demonstrate a contrast between purported patient-centred care models, and a human-centred design model. This contrast in cultures causes a disconnect between the health practitioners and the end users, with a lack of clarity about the end user's intended engagement within the modification of their environment. Consequently, the goals of older adults are inadequately represented as typical home modification design processes often fail to support the reflection of goals in practice, in turn, restricting client engagement and control. Reviewing occupational therapy practices through the critical lens of control has highlighted opportunities for service improvements.

Conclusion: The consideration of co-design methodologies within home modification design is a way to reinforce client engagement and provide better pathways for older adults to remain in control and raise acceptability of modification through a better-informed decision-making process.

• Implications for Rehabilitation

• The following points detail the implications of this research upon the rehabilitation practice and theory:

• Compliance with recommendations is deeply connected to a person’s intrinsic sense of control within the clinical decision-making process.

• Co-design practices between practitioners and clients provide and novel pathway to achieve truly person-centred care and create better service experiences and clinical outcomes.

• The human-centred design methodology is highly applicable within clinical practice and provides an opportunity for clinicians to see and learn about their patients through a holistic lens centred around goals and motivations rather than physical impairments.

• The scoping of health literacy should be inclusive of all service artefacts and touchpoints that a client may encounter throughout the entire duration of experience, this includes design artefacts such as architectural drawings and other home modification designs.

     

载药量对后交联祖师麻凝胶贴膏剂流变学及体外经皮渗透特性的影响

目的通过载药量对后交联凝胶贴膏流变学及体外经皮渗透特性的影响,考察后交联凝胶贴膏基质的载药量。方法采用流变学技术测定不同载药量时胶料的各项流变学参数,并以祖师麻乙醇提取物为模型药物,以祖师麻甲素的累积透过率及皮肤滞留率为指标,对成品贴膏进行体外经皮渗透试验,确定基质载药量。结果当载药量在4.0%～12.4%时,含药胶料的结构强度、黏弹性、耐温耐剪切性及抗变形能力、稳定性均符合要求,其中以载药量为6.8%时最佳;祖师麻甲素的累积透过率随载药量逐渐增大,皮肤滞留率分别变化不明显。结论通过比较流变学及体外经皮渗透试验结果,确定基质处方的最佳载药量为6.8%。     

多糖抗2型糖尿病作用机制研究进展及分析

多糖是由10个以上单糖分子通过糖苷键连接形成的大分子化合物。多糖来源广泛、安全低毒,且具有抗肿瘤、抗病毒、免疫调节、降血糖、降血脂等多种生物活性,受到研究学者的广泛关注。2型糖尿病(type 2 diabetes mellitus,T2DM)是一种以高血糖、胰岛素抵抗、低度炎症为特征的慢性代谢紊乱疾病。近年来,多糖对T2DM的治疗成为研究热点,多糖不仅能弥补阿卡波糖、双胍类和磺脲类等降糖药物长期治疗引起的低血糖、体质量增加、肠胃损伤等副作用,还能通过调节机体糖代谢、氧化应激、炎症反应、肠道菌群等发挥高效降糖作用。该文对多糖治疗T2DM的研究进展进行综述,并对化学修饰多糖的降糖活性等热点方向进行总结,为活性多糖降糖药物的开发及作用机制研究提供理论指导。     

甲氧基聚乙二醇体外修饰移植物细胞对单倍体相合小鼠造血干细胞移植后GVHD的影响

本研究探讨甲氧基聚乙二醇(mPEG)化学修饰移植物细胞对小鼠单倍体相合干细胞移植后移植物抗宿主病(GVHD)的影响.取经mPEG修饰及未修饰的成年CB6小鼠脾细胞悬液注入BALB/c新生幼鼠的腹腔(5×106脾细胞/只),以脾增大指标判断新生BALB/c小鼠注射单倍体相合供鼠脾细胞后的GVHD反应;取经mPEG修饰及未修饰的成年BALB/c小鼠骨髓及脾细胞混合悬液(BMS)尾静脉注入接受致死量γ射线照射后的成年BALB/c小鼠(2×105个BMS/只),注射后第8天取受鼠脾脏,计数脾结节数.结果表明修饰组脾指数1(SI1)较未修饰组减低,修饰组脾指数2(SI2)值＜1.3,未修饰组SI2值＞1.3,提示接受mPEG修饰的单倍体相合脾细胞输注后,修饰组GVHD程度较未修饰组轻;未修饰组与修饰组相比较,脾结节形成的数量差异无显著性意义(p＞0.05),说明mPEG修饰不影响造血干祖细胞的活性.结论mPEG修饰移植物可减轻小鼠单倍体相合干细胞移植后的GVHD,而不影响干祖细胞活性.     

Visualization of the amygdalo–hippocampal border and its structural variability by 7T and 3T magnetic resonance imaging

The amygdala and the hippocampus are two adjacent structures in the medial temporal lobe that have been broadly investigated in functional and structural neuroimaging due to their central importance in sensory perception, emotion, and memory. Exact demarcation of the amygdalo‐hippocampal border (AHB) is, however, difficult in conventional structural imaging. Recent evidence suggests that, due to this difficulty, functional activation sites with high probability of being located in the hippocampus may erroneously be assigned to the amygdala, and vice versa. In the present study, we investigated the potential of ultra‐high‐field magnetic resonance imaging (MRI) in single sessions for detecting the AHB in humans. We show for the first time the detailed structure of the AHB as it can be visualized in T1‐weighted 7T in vivo images at 0.5‐mm³ isotropic resolution. Compared to data acquired at 3T, 7T images revealed considerably more structural detail in the AHB region. Thus, we observed a striking inter‐hemispheric and interindividual variability of the exact anatomical configuration of the AHB that points to the necessity of individual imaging of the AHB as a prerequisite for accurate anatomical assignment in this region. The findings of the present study demonstrate the usefulness of ultra‐high‐field structural MRI to resolve anatomical ambiguities of the human AHB. Highly accurate morphometric and functional investigations in this region at 7T may allow addressing such hitherto unexplored issues as whether the structural configuration of the AHB is related to functional differences in amygdalo‐hippocampal interaction. Hum Brain Mapp 35:4316–4329, 2014. © 2014 Wiley Periodicals, Inc .