何廉臣《感症宝筏》手校稿本述考

《感症宝筏》原名《伤寒指掌》,为清代医家吴贞所著,何廉臣重订,体现了清代中后期寒温思想的融合。该稿本为何廉臣出版该书时手校之底本,由其子抄录,内有多处校对、抄录笔迹及校改痕迹。从该稿本的抄写和体例、稿本与通行本之对比、该稿本中的修改符号等几个方面进行论述,探讨其学术与文物价值。     

哺乳期乳腺脓肿患者经超声引导下细针穿刺冲洗术后回乳的影响因素分析

目的探讨采用超声引导下细针穿刺冲洗术治疗乳腺脓肿的效果，分析影响治疗后患者回乳的相关因素。 方法回顾性分析2016年1～12月北京市海淀区妇幼保健院乳腺病防治中心应用超声引导下细针穿刺冲洗术治疗的799例哺乳期乳腺脓肿患者的临床资料。从患者穿刺次数、产后时间、是否使用抗生素和脓肿位置等方面，采用χ²检验进行单因素分析，采用非条件Logistic回归模型分析各因素与回乳的关系。 结果799例患者中有753例通过超声引导下细针穿刺冲洗术治愈，治愈率为94.2%(753/799)。治疗后回乳的患者有75例，回乳率为9.4%(75/799)。单因素分析显示，回乳与产后时间，抗生素的使用，穿刺次数和脓肿位置有关(χ²＝7.159、7.794、39.394、21.243，P＝0.007、0.005和P<0.001)。Logistic回归分析显示，穿刺次数(OR＝6.442，95% CI：1.851～22.420，P＝0.003，)和中央区脓肿(OR＝2.643，95% CI：1.480～4.721，P＝0.001)是导致回乳的危险因素，而产后时间长是回乳的保护因素(OR＝0.540，95% CI：0.315～0.927，P＝0.025)。 结论超声引导下细针穿刺冲洗术治疗哺乳期乳腺脓肿的治愈率高，回乳率低，具有良好的临床应用价值。产后42 d内发病、穿刺次数多和中央区脓肿更容易导致患者回乳。     

Finding ways together: Researching with Aboriginal women in a mental health setting

IntroductionThis paper describes the collaborative development of a method and process for transcultural qualitative enquiry, undertaken as the second phase of a mixed methods PhD research project.AimTo develop an ethical, sensitive and culturally secure research method and process with which to explore the experiences of Aboriginal women in an acute mental health inpatient unit, a potentially vulnerable research population. To invite Aboriginal women to share their stories and their experiences as current inpatients, or as carers, visitors and health service providers.MethodA local Aboriginal Reference Group (ARG) was constituted and collaborated with the first author in developing working strategies and tools. Members of the ARG guided all aspects of the research process, acted as primary agents for information-giving, informed consent and interview processes, and were co-authors of relevant publications.ResultsThe method described here fostered trust and cultural respect, and embedded informed consent as an ongoing process. Eleven Aboriginal women inpatients undertook a single semi-structured interview prior to discharge from the inpatient unit. Five ARG members also gave interviews, adding insights from their ‘insider-outsider’ perspectives. A rich dataset of personal experience was made available for analysis.ConclusionsThe process devised for this study integrated principles of cultural respect and collaboration with an ongoing process of informed consent. By integrating these principles into research initiatives and evidence-based practice, and by ensuring familiarity with local Aboriginal and Torres Strait Island cultures, non-Aboriginal mental health nurses can enhance transcultural mental health service delivery in an acute setting.     

探讨创新管理理念下医院管理的方法与实践

目的分析创新管理理念下医院管理的方法与实践工作。方法对创新管理理念组和常规管理组进行回顾性分析,比较两组的医疗服务效果。结果创新管理理念组在医疗质量、医技水平、服务水平、就医环境、医风医德的总体评分以及医护人员满意度上均优于常规管理组。结论切合医院实际创新的内部管理理念,能够提升医院的服务质量,提高医院的竞争力。     

中医针灸标准化关键问题研究

针对中医标准化理论方法不足、共性技术缺乏、评价体系缺失等关键性问题,开展了中医标准化理论与方法学的研究,在理论方面,提出了中医标准化发展战略,明确了国际中医针灸标准发展现状,构建了以标准研制为主体的针灸标准体系,提出中医标准化基本理论,厘清了标准化研究中几个重要的关系问题;在方法技术方面,提出了"三证合一"的指南制定方法并得到应用,提出了中医证据分级标准及证据集合方案,构建了标准适用性评价方法,总结了标准化人才培养方法;在中医药院校开设《中医药标准化导论》课程,提高了标准研制质量,推动了中医标准化发展,对中医标准研制起到了引领和示范作用。     

Extraction of artefactual MRS patterns from a large database using non-negative matrix factorization

Despite the success of automated pattern recognition methods in problems of human brain tumor diagnostic classification, limited attention has been paid to the issue of automated data quality assessment in the field of MRS for neuro-oncology. Beyond some early attempts to address this issue, the current standard in practice is MRS quality control through human (expert-based) assessment. One aspect of automatic quality control is the problem of detecting artefacts in MRS data. Artefacts, whose variety has already been reviewed in some detail and some of which may even escape human quality control, have a negative influence in pattern recognition methods attempting to assist tumor characterization. The automatic detection of MRS artefacts should be beneficial for radiology as it guarantees more reliable tumor characterizations, as well as the development of more robust pattern recognition-based tumor classifiers and more trustable MRS data processing and analysis pipelines. Feature extraction methods have previously been used to help distinguishing between good and bad quality spectra to apply subsequent supervised pattern recognition techniques. In this study, we apply feature extraction differently and use a variant of a method for blind source separation, namely Convex Non-Negative Matrix Factorization, to unveil MRS signal sources in a completely unsupervised way. We hypothesize that, while most sources will correspond to the different tumor patterns, some of them will reflect signal artefacts. The experimental work reported in this paper, analyzing a combined short and long echo time ¹H-MRS database of more than 2000 spectra acquired at 1.5T and corresponding to different tumor types and other anomalous masses, provides a first proof of concept that points to the possible validity of this approach.     

Predictors of discordance in self-report versus device-measured physical activity measurement

Purpose

Accurate measurement of free-living physical activity is challenging in population-based research, whether using device-based or reported methods. Our purpose was to identify demographic predictors of discordance between physical activity assessment methods and to determine how these predictors modify the discordance between device-based and reported physical activity measurement methods.

巨大腹膜后肿瘤的外科手术策略

目的 探讨巨大腹膜后肿瘤的临床特征及其外科手术治疗的要点和难点.方法 对2006年5月至2013年5月在哈尔滨医科大学附属第一医院手术切除的59例巨大腹膜后肿瘤（肿瘤直径＆gt;10 cm）的临床资料进行回顾性分析.结果 59例巨大腹膜后肿瘤均经病理确诊,其中良性肿瘤22例,恶性肿瘤37例.48例获得随访,随访时间为5个月至7年,良性肿瘤18例,完整切除15例,其中原位复发5例;恶性肿瘤30例,完整切除26例,其中原位复发12例.二次手术3例.死亡6例,3例为完整切除原位复发,3例为姑息切除.结论 巨大腹膜后肿瘤手术难度大,风险高,术前认真评估及准备,术中稳健操作,准确判断,力求做到R0切除方能使患者长期受益.