基于生物活性与效应基准的中药质量 评价技术发展现状与展望

中药质量的评控问题是制约中药现代化发展的瓶颈,因此有必要在现有检测方法的基础上结合生物评价,继而更为全面地保证中药质量。生物评价是完善中药质量标准、保证临床功效和安全性评价的重要方法,已成为中药质量标准化发展趋势之一。在此处主要论述了近年来基于生物活性与效应基准的中药质量评价技术和已取得的部分研究进展,同时对目前中药质量生物评价研究与应用中存在的主要问题进行探讨,进一步对其未来应用做出展望,从而更好的对中药质量进行控制。     

中医药文化在美国发展现状及展望

文章立足于中医药文化在美国发展的现状,以及中医药文化国际传播的政治大局与大势,通过查阅和梳理相关文献资料,探讨中医药文化在美国传播的价值意义,分析中医药文化在美国传播的发展前景及战略,以期揭示促进中医药文化在美国传播的各种动力,加速中医药对外传播的进程,增强和提升中国文化软实力和国际影响力。     

肝细胞癌免疫治疗的现状和展望

肝细胞癌因其发病率和病死率较高,已成为关乎全民健康的严重问题。肝细胞癌的治疗方法众多,近年来免疫治疗的兴起为肝细胞癌的治疗提供了新武器,其实用价值亦得到越来越多的肯定和关注。肝细胞癌的免疫治疗经历了最初的细胞毒性药物、小分子抑制剂到现在的免疫检查点抑制剂,促进肿瘤治疗的模式发生重大改变。同时,应重视免疫相关不良事件的管理和治疗,通过建立多学科诊断与治疗团队促进和提高肝细胞癌的综合治疗水平,从根本上提高疗效,造福患者。     

体育情境中的风险决策行为:前景理论的初步系统验证

以90名在校大学生作为被试,使用自编体育情境风险决策问卷,并通过E-prime系统呈现,初步系统验证了前景理论对于解释、预测体育情境中的风险决策行为的适用性,并检验了认知风格、成就动机、风险偏好等因素对体育情境决策制定的影响。结果表明:(1)在体育情境下人们同样存在着与理性决策系统的偏差,与前景理论的理论模型基本一致;(2)上述因素对体育情境中的风险决策行为具有部分影响。场依存型对于三种启发法的依赖明显高于场独立型;在收益和损失情境下的风险追求者表现出较高的追求成功的动机水平,且与风险回避者在该动机上存在显著差异;局外人和局内人的参与角度对于被试的行为抉择没有显著影响。对上述结果的理论与实践意义,以及今后研究的可能方向进行了讨论。     

我国轻度认知障碍研究热点分析及展望

背景　随着人口老龄化进程的加快，包括痴呆在内的老年人健康问题日益突出。轻度认知障碍作为阿尔茨海默病的临床前阶段，早已成为研究者关注的热点。但是目前尚缺乏对我国轻度认知障碍研究热点的整理与分析。目的　分析2008-2018年我国轻度认知障碍研究的热点，了解该领域的现状和发展趋势。方法　2019年6月，以“轻度认知障碍”为关键词，采用主题检索的方式，在中国期刊网全文数据库（CNKI）中进行检索，检索时间为2008-2018年，文献来源类别限定为SCI来源文献、EI来源期刊、核心期刊、中文社会科学引文索引（CSSCI）以及中国科学引文数据库（CSCD）。采用中医药数据关联分析平台（XMiner软件）、SPSS 22.0统计学软件、Excel软件对关键词进行词频分析和共词聚类分析。结果　最终纳入符合标准的文献413篇，获得高频关键词41个（g=41）。通过共词聚类分析总结出2008-2018年我国轻度认知障碍的7个研究热点，分别为轻度认知障碍的病因学研究、神经心理评估及筛查研究、诊断及分类研究、干预研究、流行病学研究、精神行为症状研究、生物标志物及中医证候研究。结论　2008-2018年我国轻度认知障碍的研究热点分别为轻度认知障碍的病因学研究、神经心理评估及筛查研究、诊断及分类研究、干预研究、流行病学研究、精神行为症状研究、生物标志物及中医证候研究，该分析结果有助于广大卫生服务人员了解该领域的现状和发展趋势，且对其今后的研究方向有一定的指导作用。     

新中国70年卫生投入回顾与展望

本文基于新中国成立以来卫生投入等相关数据，回顾了70年来卫生投入的基本情况。结合文献分析，从卫生投入的规模与结构、世界排位、卫生投入政策的发展变化等方面，系统总结了卫生投入取得的成绩，着重分析了2009年新医改以来政府主导的多元投入机制的突出特点。分析发现，我国在卫生投入结构、政府卫生投入稳定性与可持续性、个人卫生支出占比等方面还存在一定问题。同时，对新时代下面临的新形势新挑战进行了研判。预测显示，为满足人民群众日益增长的需求，推动卫生系统高质量发展，未来一定时期我国卫生投入仍将继续保持增长趋势，到2030年我国卫生投入规模将达到15.3万亿元，占GDP的比重达到9.2%。为此，建议建立以结果为导向的健康投入机制，从"以治疗为中心"向"以人民健康为中心"转变。     

Socioecological and message framing factors influencing maternal influenza immunization among minority women

Objective

A suboptimal level of seasonal influenza vaccination among pregnant minority women is an intractable public health problem, requiring effective message resonance with this population. We evaluated the effects of randomized exposure to messages which emphasize positive outcomes of vaccination (“gain-frame”), or messages which emphasize negative outcomes of forgoing vaccination (“loss-frame”). We also assessed multilevel social and community factors that influence maternal immunization among racially and ethnically diverse populations.

Study design

Minority pregnant women in metropolitan Atlanta were enrolled in the longitudinal study and randomized to receive intervention or control messages. A postpartum questionnaire administered 30 days postpartum evaluated immunization outcomes following baseline message exposure among the study population. We evaluated key outcomes using bivariate and multivariate analyses.

Results

Neither gain- [OR = 0.5176, (95% CI: 0.203,1.322)] nor loss-framed [OR = 0.5000, 95% CI: (0.192,1.304)] messages were significantly associated with increased likelihood of immunization during pregnancy. Significant correlates of seasonal influenza immunization during pregnancy included healthcare provider recommendation [OR = 3.934, 95% CI: (1.331,11.627)], use of hospital-based practices as primary source of prenatal care [OR = 2.584, 95% CI: (1.091,6.122)], and perceived interpersonal support for influenza immunization [OR = 3.405, 95% CI: (1.412,8.212)].

Conclusion

Dissemination of vaccine education messages via healthcare providers, and cultivating support from social networks, will improve seasonal influenza immunization among pregnant minority women.     

抗抑郁药阿戈美拉汀合成综述

抑郁症的发病率逐年增高,抗抑郁药物的开发和利用也越来越受到国外跨国企业的关注。阿戈美拉汀是2009年刚在欧盟上市的第一个褪黑激素类抗抑郁药,能有效治疗抑郁症,改善睡眠参数和保持性功能。本文介绍了抗抑郁药的种类,总结了阿戈美拉汀合成路线并简要介绍了其应用前景。     

Nosocomial infections and hospital deaths. A case-control study

In an earlier study, nosocomial infections were reported to occur in one third of patients who died in the hospital. Lower respiratory tract infections appeared to be causally related to death, whereas urinary tract infections were not. A case-control study was therefore conducted to begin to explore epidemiologically these causal suppositions. By definition, all 100 patients in the case group died in the hospital and all 100 patients in the control group survived hospitalization. A patient in the control group was matched to a patient in the case group for age, sex, service, primary discharge diagnosis, and severity of primary diagnosis. Secondary discharge diagnoses were comparable in both groups. Nosocomial infections were present in 33 percent of patients in the case group and 13 percent of patients in the control group (p less than 0.001). Lower respiratory tract nosocomial infections occurred in 18 percent of patients in the case group and 4 percent of patients in the control group (p less than 0.005). Urinary tract nosocomial infections occurred in 6 percent of patients in the case group and 8 percent of patients in the control group (p = NS). Presence of a terminal prognosis on admission was found more often in case group patients than in control group patients (76 percent versus 11 percent, p less than 0.001). Nosocomial infections appeared to favor a fatal outcome only in those whose condition was not terminal on admission (p less than 0.05). In those whose condition was terminal on admission, the incidence of infection was equal in those who survived and in those who died. In conclusion, in these two groups well matched by many criteria, differences in prognosis on admission probably accounted for the major differences in survival. Nosocomial infections may affect outcome in those whose condition is not terminal on admission.