基于CiteSpace的结直肠癌患者生命质量研究

目的：通过中英文文献了解结直肠癌患者生命质量研究现状及发展趋势。方法：运用CiteSpace对中国知网（CNKI）、万方数据知识服务平台、中国生物医学文献数据库、Web of Science核心数据集、PubMed、Cochrane Library中收录的关于结直肠癌患者生命质量研究的中英文文献进行可视化分析。结果：检索得到中文文献1 285篇，英文文献871篇，中英文文献发文量均呈上升趋势，相关研究关注的重点主要是结直肠癌患者造口、抑郁、免疫、肠道功能、化疗及化疗药物，但机构之间、学者之间合作程度及研究类型等方面存在一定差异。结论：中文文献相关研究起步晚、发展快，但在研究质量与研究深度等方面与英文文献相比还有一定差距；国内学者之间、机构之间应加强合作，关心患者肠道功能、心理状况，提高患者体力活动水平，开展更多高质量研究。     

Over‐the‐scope clip system: A review of 1517 cases over 9 years

Rescue therapy for gastrointestinal (GI) refractory bleeding, perforation, and fistula has traditionally required surgical interventions owing to the limited performance of conventional endoscopic instruments and techniques. An innovative clipping system, the over‐the‐scope clip (OTSC), may play an important role in rescue therapy. This innovative device is proposed as the final option in endoscopic treatment. The device presents several advantages including having a powerful sewing force for closure of GI defects using a simple mechanism and also having an innovative feature, whereby a large defect and fistula can be sealed using accessory forceps. Consequently, it is able to provide outstanding clinical effects for rescue therapy. This review clarifies the current status and limitations of OTSC according to different indications of GI refractory disease, including refractory bleeding, perforation, fistula, and anastomotic dehiscence. An extensive literature search identified studies reported 10 or more cases in which the OTSC system was applied. A total of 1517 cases described in 30 articles between 2010 and 2018 were retrieved. The clinical success rates and complications were calculated overall and for each indication. The average clinical success rate was 78% (n = 1517) overall, 85% for bleeding (n = 559), 85% (n = 351) for perforation, 52% (n = 388) for fistula, 66% (n = 97) for anastomotic dehiscence, and 95% (n = 122) for other conditions, respectively. The overall and severe OTSC‐associated complications were 1.7% (n = 23) and 0.59% (n = 9), respectively. This review concludes that the OTSC system may serve as a safe and productive device for GI refractory diseases, albeit with limited success for fistula.     

De l’attachement au crime : une revue systématique des relations entre styles d’attachement et nature du passage à l’acte criminel

ObjectiveBased on the premises that attachment theory is an innovative paradigm for studying crime in its various facets, this article aims to present and clarify the current state of knowledge about the relationship between attachment and criminal behavior.MethodsA systematic literature review identifying all meta-analyses and reviews published over the past twenty years – from 1998 to 2018 inclusive – was therefore conducted in order to question the clinical and even explanatory value of the various attachment styles with respect to a certain type of offending. The bibliographic databases Science Direct, PsycInfo, PsycArticles, EMBASE and PubMed were examined using the following keywords and boolean operators: (attachment style) AND (criminal behavior) AND (offenders).ResultsThe data indicate that an insecure attachment style is significantly associated with all types of crime (violent behaviors, sexual violence, domestic violence, rule-breaking and antisocial behaviors), regardless of gender or age. The results also provides a network of correspondences and entanglements between particular attachment patterns and specific criminal acts; perpetrators of sexual violence are indeed characterized by a more anxious attachment style than perpetrators of violent offences, who themselves are more insecure in their relationships than perpetrators of non-sexual violence.ConclusionsThe present review emphasizes the decisive role – and the discriminatory value – of attachment dynamics in the protean nature of criminal behaviors.     

The availability of pharmacists with Additional Prescribing Authorization in relation to the distribution of vulnerable populations - A cross-sectional study

BackgroundFor vulnerable patients- such as immigrants or those with low income- to benefit from pharmacists’ advanced services, such as independent prescribing, pharmacists must be accessible to these populations.ObjectivesThis research examines the geographical relationship between Alberta pharmacists with Additional Prescribing Authorization (APA) and a neighbourhood's proportion of vulnerable populations.MethodsPublicly available data were extracted from the Alberta College of Pharmacy website for active registered pharmacists' primary location of practice and APA status. Pharmacists with APA were grouped depending on the postal codes of their main self-reported place of practice. These postal codes were converted to geospatial locations and then linked to aggregated dissemination area's (ADA's) income and immigrant quintiles. The mean number of APA pharmacists per ADA was compared using analysis of variance (ANOVA) between income and immigrant quintiles. The number of APA pharmacists per ADA in the highest and lowest income and immigrant quintiles was compared using negative binomial regression model.ResultsThe records of 3,742 pharmacists with 1,054 unique postal codes of practice sites were included in the study and were linked to unique ADAs (N = 527). Almost one half of all ADAs in Alberta (47.6%, n = 251) had no APA pharmacist. Income quintiles of ADAs were associated with the mean number of APA pharmacists (p < 0.001), with high income areas estimated to have 0.44 more APA pharmacists (p = 0.01). Similarly, areas with the highest quintile of recent immigrants were estimated to have 0.66 more APA pharmacists than other ADAs (p < 0.01).ConclusionsA sizable proportion of the Alberta population still does not have access to a pharmacist with APA, and those with APA seem to concentrate in areas with higher income and higher proportions of the population who are immigrants. Future research should examine the utilization of expanded scope of practice in relation to the distribution of vulnerable populations.     

肝阴虚证证候特点及辨证用药规律的文献研究

目的:为进一步深入研究和探讨肝阴虚证候的本质,本文分析和整理肝阴虚证的病因病机、证候表征、证候属性疾病及遣方选药的规律。方法:运用检索文献并进行频数统计的方法,检索查阅1960年9月1日至2019年1月10日中国知网中医临床研究文献。结果:肝阴虚证的病因病机为肝失疏泄,气机郁滞,化火伤阴,阴液亏虚,失于濡养;证候辨证要点主要为脉弦细数,舌红少津,头晕目眩,五心烦热,口咽干燥,两目干涩;证候临床属性疾病有肝炎、肝硬化、肝纤维化、肝癌;临床上治疗肝阴虚证使用处方主要为一贯煎、补肝汤、四物汤、芍药甘草汤,临床高频使用中药为生地黄、白芍、枸杞、当归、麦冬。结论:本文对于肝阴虚证的证候特点以及辨证用药规律做出系统的总结与归纳,将有关肝阴虚证的论述联系起来,形成统一的整体,为揭示肝阴虚证的本质与临床上形成较为成熟的肝阴虚证治疗方案提供参考。     

中医药治疗系统性红斑狼疮证型及用药规律演变研究

目的:基于文献整理探讨中医药治疗系统性红斑狼疮(Systemic lupus erythematosus,SLE)的证候分类及用药规律演变。方法:检索中国知网(CNKI)、维普中文科技期刊数据库、中国学术期刊数据库中中医药治疗SLE的相关文献,时间限定为从数据库建立至2018年7月。对证型及药物进行分类并统计分析。结果:纳入文献725篇,总结归纳高频证型11个,出现频次最高的五个证型分别为热毒炽盛证、脾肾两(阳)虚证、阴虚内热(火旺)证、肝肾两(阴)虚证、气阴两虚证,累计频率62.11%。1965-2018年间,阴虚内热(火旺)证呈明显增长趋势;热毒炽盛证、脾肾两(阳)虚证及气阴两虚证在1965-2010年间呈增长趋势,在2011-2018年间呈下降趋势;肝郁气滞(脾虚)证在1965-2018年间呈下降趋势;其余证型均呈动态波动。涉及组方1522个,药物309味,使用15910次,总使用频率最高的5味药分别为生地黄、牡丹皮、茯苓、黄芪、甘草,总累计频率16.42%。使用频率最高药类为清热药和补虚药;生地黄、牡丹皮等清热药的使用频率趋势与热毒炽盛证保持一致,不同年份高频用药大致相似,用药频率存在较小差异。结论:SLE在内以阴阳亏虚为主,在外与热毒侵袭相关,属于本虚标实,其发展与生态环境、社会环境、药物使用等紧密相关,治当以清热凉血、活血祛瘀、益气养阴,并结合个人体质及环境变化辨证治疗。     

Variation in the prescription drugs covered by health systems across high-income countries: A review of and recommendations for the academic literature

BackgroundBecause not all medicines are equally safe, effective, and affordable, health systems often use formularies to define explicitly which medicines will be included and excluded from coverage.ObjectiveWe sought to synthesize methods and findings from published studies of formulary variation across health systems in high-income countries.MethodsWe conducted a systematic review of peer-reviewed research papers published from 2000 to 2017, inclusively. Because of the heterogeneous nature of the literature, we used an inductive approach to summarize methods and findings.ResultsNine studies met our study inclusion criteria. Included studies used a variety of methods for selecting medicines for analysis, for measuring coverage levels, and for measuring concordance between formularies. Studies assessing variations in coverage of all licensed medicines and found lower rates of cross-national coverage variation than studies of coverage for selected specialty drugs and indications. The one study that focused on coverage of high-volume medicines found the most complete and consistent levels of formulary listings across countries.ConclusionAlthough published studies contain interesting findings that likely have prompted discussions about their policy implications, the literature can be improved with greater transparency concerning the overarching objective of work in this area and more rigor concerning the selection, analysis, and reporting of data.