Challenges for precision public health communication in the era of genomic medicine

Although still in the early stages of development, the advent of fast, high-output, and cost-effective next-generation DNA sequencing technology is moving precision medicine into public health. Before this shift toward next-generation sequencing in public health settings, individual patients met geneticists after showing symptoms and through limited family screening. In the new era of precision public health, everyone is a possible participant in genetic sequencing, simply by being born (newborn screening), by donating blood (biobanking), or through population screening. These initiatives are increasingly offered to individuals throughout their life and more individuals are encountering opportunities to use DNA sequencing. This article raises awareness of these growing areas and calls for different models of public engagement and communication about genomics, including screening asymptomatic populations, obtaining consent for unspecified and unforeseen future uses of genomic data, and managing variants of uncertain significance. Given that such communication challenges loom large, established norms of practice in genomic medicine and research should be reconsidered.     

基于中医临床证候探讨新型冠状病毒肺炎在岭南地区的疫性特点

目的:通过分析广东省第二人民医院收治的新型冠状病毒肺炎(以下简称新冠肺炎)患者的临床资料,从中医临床证候探讨该病在岭南地区的疫性特点,更好地指导临床辨证治疗。方法:收集广东省第二人民医院收治的36例新冠肺炎患者的临床资料,其中输入病例20例,本地病例16例,分析全部病例、输入病例和本地病例的临床资料和证候特点。结果:新冠肺炎患者年龄分布较广,平均年龄45岁,以男性居多,55.56%的患者为外地输入病例,44.44%的患者为本地感染病例。全部病例证型以湿邪郁肺型和邪热壅肺型为主,分别占44.44%和38.89%;91.67%的患者呈现“湿”的病理特点,72.22%的患者呈现“热”的病理特点。其中输入病例证型以湿邪郁肺型为主,占65.00%,100%的患者呈现“湿”的病理特点,55.00%呈现“热”的病理特点;本地病例证型以邪热壅肺为主,占56.25%,93.75%的患者呈现“热”的病理特点,81.25%呈现“湿”的病理特点。结论:本次疫病在岭南地区的疫性属于以湿邪和热邪为主导的“湿热疫”,病机特点为湿热并重;输入性病例多表现为以湿邪为患的“湿疫”,有化热的趋势和倾向,病机特点为湿重于热;本地病例多表现为以热邪为主的“温热疫”,病机特点为热重于湿。此次新冠肺炎不同地区存在不同疫性的可能,辨证和治疗要遵守三因制宜的原则。     

新型冠状病毒肺炎中医病因与辨治的思考

新型冠状病毒肺炎是感受新型冠状病毒所致,属于中医学“疫病”的范畴,其病因为吴又可提出的“异气”,与六淫不同,具有生物学属性;侵袭人体主要造成气阴损伤,气化失常,湿饮停聚;治疗当以“逐邪为第一要义”,恢复机体平衡状态。     

中外康复治疗学专业教育现状分析与启示

随着我国经济社会的发展和人口老龄化的趋势,康复技术人才的需求快速增长。与发达国家先进的康复教育水平相比,我国亟需借鉴成熟的康复治疗专业学科建设经验。通过介绍国内外康复治疗专业的学位模式、课程设置和执业资格,对比分析目前我国高校康复人才培养过程中存在的主要问题,为完善康复治疗学专业建设提供可行的建议。     

维吾尔医“库西提”法炮制技术规范化研究及巴豆脂肪油含量测定

目的:评价维吾尔医“各立衣克买提”泥法炮制技术和在这种炮制方法前提下改进的新“库西提”法炮制技术对巴豆中脂肪油的含量测定的影响。方法:利用两种炮制方法炮制生巴豆,按《中国药典》2015年版一部巴豆项下的脂肪油含量测定方法进行测定。结果:采用这两种方法炮制的巴豆根据炮制时间不同脂肪油含量依次递减。结论:采用新“库西提”法炮制技术炮制的巴豆的脂肪油含量明显降低。     

社区获得性肺炎的中西医治疗研究进展

社区获得性肺炎(Community Acquired Pneumonia,CAP)是比较常见的院外肺部炎性疾病之一,随着细菌、支原体、衣原体等多种病原体的耐药率的上升,以及病患梯度的范围增加,CAP的发病率呈逐年上升的趋势,死亡率日益增高,导致医疗资源消耗巨大。目前临床上CAP的患者主要依靠经验性治疗。正确选择抗生素、减少病原体的耐药率,优化肺部炎症疾病的医疗方案,提高CAP临床治愈率已经成为临床医生当前面临的一项重大挑战。中药制剂具有广谱抗菌、调节免疫、不易耐药、简便价廉等特点,是解决上述难题的一个很好途径。     

优化新生脉散方治疗心力衰竭的网络药理学机制分析

[目的] 运用网络药理学方法分析优化新生脉散方治疗慢性心力衰竭（CHF）的作用机制。[方法] 基于中药系统药理数据库和分析平台（TCMSP）、BATMAN-TCM及UniProt数据库查询优化新生脉散方药物的主要活性成分与相应靶点，利用GeneCards数据库检索CHF相关靶点，通过OmicShare网站分析并结合Cytoscape-v3.6.0软件构建优化新生脉散方中药-化合物-靶点-疾病网络图，使用DAVID数据库对潜在靶点进行基因功能（GO）及京都基因和基因组百科全书（KEGG）通路富集分析。[结果] 根据类药性（DL）、口服吸收利用度（OB）、参数评分（Scorecutoff）筛选出与CHF相关的潜在化合物85种及靶点89个，其中，化合物有quercetin、luteolin、kaempferol等，靶点包括SCN5A、ADRB2、NOS2等。功能富集分析涉及生物过程、分子功能、细胞组分的GO条目共497个，主要参与调控细胞凋亡、增殖及缺氧、炎症反应等方面，KEGG通路富集得到139条，主要与缺氧诱导因子-1（HIF-1）、磷脂酰肌醇3激酶/蛋白激酶B（PI3K-Akt）、肿瘤坏死因子（TNF）信号通路等有关。[结论] 优化新生脉散方治疗CHF具有多成分、多靶点、多途径的作用，为进一步研究优化新生脉散方治疗CHF的潜在复杂机制提供参考方向。     

Dr PK Sen TAI gold medal oration

The current write-up is for Dr P.K.Sen TAI Gold Medal Oration Award for 2020 conferred to Dr Rupak Singla and delivered on 19 th December 2020. The title chosen for the oration was “Introduction and scale up of new anti-TB drugs in India: role of NITRD.? However, in the oration the role this institute has played for overall scale up of Drug-resistant TB services in India under National Tuberculosis Elimination Programme (NTEP) at different times from the beginning of national TB programme has also been presented. National Institute of TB and Respiratory Diseases has travelled with our country from beginning of DR-TB care. It demonstrated for the first time use of a Standardized Treatment Regimen with second line drugs for MDR-TB in field conditions. NITRD assisted NTEP for the concept of DST guided treatment. This institute guided NTEP for the management of MDR-TB failure patients with Pre-XDR and XDR-TB. Also, NITRD assisted India for the introduction of newer DR-TB drugs and scale up of newer drugs across the country. The strength of NITRD include clinical expertise, laboratory support and training division. NITRD commitment is strong and will continue to support NTEP for all endeavors in future also.