深圳市医疗市场结构与集中度分析

目的了解深圳市医院市场集中度情况，分析深圳市医疗市场结构，为下一步发展方向提供理论依据。方法对深圳97家医院的规模、市场份额等分析，计算深圳医疗市场的HHI指数，绘制洛伦兹曲线并计算相应基尼系数。结果深圳医疗市场HHI值均小于1000。分别以职工数和病床数表示医院规模，计算出门急诊量、出院病人数和手术量的基尼系数均小于0．40。结论深圳市医疗市场集中度较低，属垄断竞争市场。不同规模医院市场份额分配相对合理。深圳市应充分利用市场发育较好这一优势，发挥市场的作用，通过市场竞争，提高整体医疗市场效率。     

Decreased centrality of cortical volume covariance networks in autism spectrum disorders

Autism spectrum disorders (ASD) are a group of neurodevelopmental conditions characterized by atypical structural and functional brain connectivity. Complex network analysis has been mainly used to describe altered network-level organization for functional systems and white matter tracts in ASD. However, atypical functional and structural connectivity are likely to be also linked to abnormal development of the correlated structure of cortical gray matter. Such covariations of gray matter are particularly well suited to the investigation of the complex cortical pathology of ASD, which is not confined to isolated brain regions but instead acts at the systems level. In this study, we examined network centrality properties of gray matter networks in adults with ASD (n = 84) and neurotypical controls (n = 84) using graph theoretical analysis. We derived a structural covariance network for each group using interregional correlation matrices of cortical volumes extracted from a surface-based parcellation scheme containing 68 cortical regions. Differences between groups in closeness network centrality measures were evaluated using permutation testing. We identified several brain regions in the medial frontal, parietal and temporo-occipital cortices with reductions in closeness centrality in ASD compared to controls. We also found an association between an increased number of autistic traits and reduced centrality of visual nodes in neurotypicals. Our study shows that ASD are accompanied by atypical organization of structural covariance networks by means of a decreased centrality of regions relevant for social and sensorimotor processing. These findings provide further evidence for the altered network-level connectivity model of ASD.     

广州市2008-2017年注射吸毒人群HIV-1分子网络特征分析

目的 分析2008-2017年广州市注射吸毒人群HIV-1分子网络的分布特征,为该人群艾滋病防控提供参考依据。方法 选取2008-2017年广州市新确证的注射吸毒HIV-1感染者血清样本,进行pol区基因扩增及测序后,利用Cluster Picker 1.2.3软件识别系统进化树中的分子簇,使用HyPhy 2.2.4中TN93模型计算成簇序列间的基因距离,通过可视化软件Cytoscape 3.8.2构建分子网络,采用χ²检验或确切概率法进行成簇分析和中心性分析。结果 成功扩增获得pol区基因片段586条（73.9%,586/793）,共产生80个分子簇,成簇率为46.6%（273/586）。成簇样本与未成簇样本比较,汉族（48.4%,260/537）、广东籍（52.7%,146/277）和CRF55_01B（93.3%,14/15）的成簇比例更高。分子网络度值范围为1~7,度值≥ 3的节点占12.8%（24/187）,其与网络中另外81个节点相关联（43.3%,81/187）。中心性分析结果显示,HIV-1感染者职业为家务/待业者在高程度中心性（19.0%,19/100）、高中介中心性（22.0%,22/100）和高亲近中心性（32.0%,32/100）的比例更高。结论 广州市注射吸毒人群HIV-1分子成簇风险较高,应将具有本地及广西籍、家务/待业特征的注射吸毒人群作为重点干预目标,并实施精准干预,降低该人群HIV-1感染率。     

中央型肝癌的手术切除

目的探讨中央型肝癌手术切除的方法和疗效。方法回顾分析1988—2005年在我所行手术切除的257例中央型肝癌的临床资料及随访结果。按手术切除的方式将患者分为半肝切除（包括扩大半肝，n=19）和肝中叶切除（包括部分及扩大肝中叶，n=238）两组，比较手术情况及预后的差异。结果257例中央型肝癌患者术后1、3、5年生存率及无瘤生存率分别为73．4％、55．6％、41．2％和83．8％、73．8％、63．4％。Cox多因素分析提示，肿瘤大小、包膜及微血管侵犯是影响患者预后的相关因素。两种手术方式对手术时间、术后并发症、围手术期死亡、生存率及无瘤生存率的影响差异无统计学意义（P〉0．05）。结论手术切除是治疗中央型肝癌的有效手段，而对于合并有肝硬化的中央型肝癌，肝中叶切除术（包括部分及扩大肝中叶）则是首选的治疗方法。     

Network Analysis of the Symptoms of Depressive Disorders Over the Course of Therapy: Changes in Centrality Measures

Objective Network analysis can be used in terms of a novel psychopathological approach for depressive syndrome. We aimed to estimate the successive network structures of depressive symptoms in patients with depressive disorder using data from the Clinical Research Center for Depression study. Methods We enrolled 1,152 South Korean adult patients with depressive disorders who were beginning treatment for first-onset or recurrent depressive episodes. We examined the network structure of the severities of the items on the Hamilton Depression Rating Scale (HAMD) at baseline and at weeks 2, 12, 25, and 52. The node strength centrality of all the HAMD items at baseline and at week 2, 12, 25, and 52 in terms of network analysis. Results In the severity networks, the anxiety (psychic) item was the most centrally situated in the initial period (baseline and week 2), while loss of weight was the most centrally situated item in the later period (weeks 25 and 52). In addition, the number of strong edges (i.e., edges representing strong correlations) increased in the late period compared to the initial period. Conclusion Our findings support a period-specific and symptom-focused therapeutic approach that can provide complementary information to the unidimensional total HAMD score.     

基于中心性分析的知识型员工对医药企业知识共享的影响

以案例分析的方式,采用网络中心性指标对员工知识共享意愿进行量化,构建知识量评价指标体系,采用yaahp6.0软件计算指标权重并分析两个因素之间的相关性,得出不同角色员工对企业内部知识共享的影响力。     

Functional centrality of amygdala,striatum and hypothalamus in a “small‐world” network underlying joy: An fMRI study with music

Current knowledge about small‐world networks underlying emotions is sparse, and confined to functional magnetic resonance imaging (fMRI) studies using resting‐state paradigms. This fMRI study applied Eigenvector Centrality Mapping (ECM) and functional connectivity analysis to reveal neural small‐world networks underlying joy and fear. Joy and fear were evoked using music, presented in 4‐min blocks. Results show that the superficial amygdala (SF), laterobasal amygdala (LB), striatum, and hypothalamus function as computational hubs during joy. Out of these computational hubs, the amygdala nuclei showed the highest centrality values. The SF showed functional connectivity during joy with the mediodorsal thalamus (MD) and nucleus accumbens (Nac), suggesting that SF, MD, and Nac modulate approach behavior in response to positive social signals such as joyful music. The striatum was functionally connected during joy with the LB, as well as with premotor cortex, areas 1 and 7a, hippocampus, insula and cingulate cortex, showing that sensorimotor, attentional, and emotional processes converge in the striatum during music perception. The hypothalamus showed functional connectivity during joy with hippocampus and MD, suggesting that hypothalamic endocrine activity is modulated by hippocampal and thalamic activity during sustained periods of music‐evoked emotion. Our study indicates high centrality of the amygdala nuclei groups within a functional network underlying joy, suggesting that these nuclei play a central role for the modulation of emotion‐specific activity within this network. Hum Brain Mapp 35:3485–3498, 2014. © 2013 Wiley Periodicals, Inc .     

中西医结合治疗中心性浆液性视网膜炎

通过55例中心性浆液性视网膜脉络膜病变的中西医结合和单纯西药治疗,发现中西医结合治疗比单纯用西药治疗效果好。结果表明有效率达90％(P<0.01)。两者治疗前后视力之化有差异,且中西医结合组复发率低,无副作用。     

基于社会网络分析的公众健康网群影响力研究

运用社会网络分析法,从健康类网站AlexaTop200和2015年复旦大学医院评价综合榜及医学领域学协会网站中筛选182个有效网站,根据主办单位性质划分为企业、个人、专业机构、社会团体和政府5个子群。基于网站间的链接关系构建整体网和子群的网络关系图,对比分析整体网群和子群的网络结构、中心度和网络的关联性,发现不同类型网站在规模和结构上的异同及各网群影响力差异,为完善大众健康类网群的建设、改善健康信息服务现状提供借鉴。     

Understanding human navigation using network analysis

We have considered a simple word game called the word-morph. After making our participants play a stipulated number of word-morph games, we have analyzed the experimental data. We have given a detailed analysis of the learning involved in solving this word game. We propose that people are inclined to learn landmarks when they are asked to navigate from a source to a destination. We note that these landmarks are nodes that have high closeness-centrality ranking.