微信公众平台对医学专业人员继续医学教育的影响

目的　探讨微信公众平台在医学专业人员获取知识中所发挥的作用,为继续医学教育提供新的途径。方法　借助“腾讯问卷”平台设计电子版调查问卷,通过Spine脊柱微信公众平台推送、微信群和朋友圈转发,对医学专业人员进行问卷调查。调查内容包括医学专业人员的一般情况、医学专业人员对Spine脊柱微信公众平台的评价和医学微信公众平台对其获取知识的影响。回收问卷并进行描述性分析。结果　共回收901份有效问卷,91.9%（828人）的医学专业人员选择休息时间为最合适的推送时间,选择最多的是18：00—21：00;对于推送频率多数选择“1周2次”;97.3%（877人）的医学专业人员对Spine脊柱微信公众平台的总体评价选择了“非常满意”或“比较满意”;医学专业人员对Spine脊柱微信公众平台推送文章质量评分为（8.5±1.4）分;79.1%（713人）的医学专业人员关注了5个以上医学微信公众平台,最看重推送内容的质量和可靠性;92.7%（835人）的医学专业人员认为医学微信公众平台对提升专业知识面“帮助非常大”或“帮助比较大”。在获取最新专业知识的渠道方面,68.4%（616人）的医学专业人员选择了“微信公众平台推送文章”,仅18.4%（166人）的医学专业人员选择了“传统纸质媒介（期刊杂志、报纸和书籍）”。结论　微信公众平台针对关注人群、固定时间和频率推送原创文章,有利于医学专业人员获取知识,为继续医学教育提供一种新的补充形式。     

医药大学学报微信公众平台现状及优化策略

探究医药大学学报微信公众号的开通情况和运营状况,将2018年版《中国科技期刊引证报告（核心版）：自然科学卷》中的医药大学学报56例和中医药大学学报13例纳入本研究,并将已开通微信公众号的学报导入清博大数据,通过分析各项指标发现各微信公众号存在功能建设不完善,推送内容形式单一,消息推送数量少,推送时间不合理等问题。笔者就此提出转变思维模式,优化功能建设,丰富内容形式,优化推送时间,实现多渠道推广等策略,为医药大学学报微信公众平台建设提供思路。     

广东省本科院校图书馆微信服务状况及建议

广东省32所本科院校图书馆中,有16所开通了微信公众帐号,11所有历史消息推送。通过分析11所本科院校图书馆微信服务的历史消息推送频率、内容和互动等情况,发现有50%的广东省本科院校图书馆对微信服务不够重视,缺乏深层次开发;微信公众帐号囿于形式,未能发挥真正作用;微信内容的表现形式较为单一,难以实现信息的个性化推送;图书馆与用户的微信公众平台互动不足。针对上述问题,提出了规范微信公众帐号、注重微信帐号推广、明确微信服务定位、加强微信信息主动推送、创新微信服务内容、丰富微信的表现形式、完善微信自助服务功能等建议。     

广东省本科院校图书馆微信服务状况分析

统计了广东省32所本科院校图书馆微信的开通情况,发现有16所开通了微信公众帐号,而有历史消息推送的只有11所。通过分析11所本科院校微信服务的历史消息推送频率、内容和互动等情况,发现有50%的广东省本科院校图书馆对微信服务不够重视,缺乏深层次开发;微信公众帐号囿于形式,未能发挥真正作用;微信内容的表现形式较为单一,难以实现信息的个性化推送;图书馆与用户的微信公众平台互动不足。针对存在问题,提出了规范微信公众帐号、注重微信帐号推广;明确微信服务定位,加强微信信息主动推送;创新微信服务内容,丰富微信的表现形式;完善微信自助服务功能。     

基于微信公众平台的眼视光校企共享资源建设与评价

目的：利用微信公众平台为校企双方提供眼视光共享资源并进行效果评价。方法：校企共建共享以专业学习交流为主的微信公众平台,利用问卷调查分析和比较不同用户的阅读频率和满意度。结果：平台累计推送信息276条,总阅读量6831人次。学校师生、企业员工及其他人员对推送信息阅读频率的总体差异有统计学意义。所有用户对6个满意度评价条目的评分从高到低依次是推送信息的频率、内容的新颖性、推送信息的长度、内容的实用性、内容的丰富性和内容的编辑形式。除“内容的实用性”和“内容的丰富性”2个条目的学校师生评分显著高于企业员工和其他从业人员外,三组用户间其他4个条目的评分均无显著性差异。结论：校企共建微信公众平台还需不断改善推送信息的内容和形式,加强平台运营团队建设,增加激励机制。     

军队医学科技期刊微信公众平台应用中存在的问题与对策

随着数字化的发展,读者的阅读习惯和阅读需求都在发生改变,科技期刊加快实施移动在线办公、移动查稿、信息推送、移动订阅等移动公众服务的步伐迫在眉睫[1-2]. 2012年腾讯公司推出微信公众平台服务,运营者无需进行重新开发,便能利用平台提供的服务,如即时信息推送、界面个性化管理、移动支付、web 2.0等[3-4]. 海军医学杂志微信公众号(微信号:hjyxzz )创建于2014年1月,本刊作为军队医学科技期刊,由于内容的专业性、受众的特殊性,使得期刊在微信公众平台的应用中存在一定的局限性,笔者现就军队医学科技期刊微信公众平台使用的优点、应用中存在的问题与对策分析如下.     

基于微信公众平台的健康信息推送服务

摘要：通过对国内外网络健康信息推送服务现状进行调查,针对网络上的健康信息服务存在不全面不专业,广告泛滥以及无法根据用户需求提供个性化信息的问题提出基于微信公众平台的健康信息推送策略。在现有微信公众平台的功能上,进行二次开发建立健康信息数据库和提供多元化健康信息参考咨询,实现智能化和个性化的信息推送服务。     

三甲医院微信公众平台使用分析

收集武汉地区主要三甲医院微信公众平台使用数据,同时与医院微信排行榜前10公立医院微信使用情况从基本运营情况、菜单功能设置、微信信息推送、公众平台影响力几方面进行对比,分析武汉地区主要三甲医院微信公众平台优点和不足,为武汉及有关地区完善医院微信公众平台的建设及推广使用提供参考。     

上海市社区卫生服务中心应用微信公众平台的现状调查

目的 了解当前上海市各卫生服务中心应用微信公众平台对外开展信息发布与健康宣教的状况,为加强服务中心的宣传力度提供建议和对策。 方法 通过微信App公众号及搜狗搜索引擎的搜索功能调查了上海市245家社区卫生服务中心的微信公众平台的开设、使用情况以及受众的参与度,采用SPSS 18.0统计学软件对调查结果进行分析,P<0.05为差异有统计学意义。此外,通过研究其中一家运营较为成功的社区卫生服务中心微信公众平台分析其运营的主要特质,以折线图展示平台平均月推送量与阅读量之间的关系。 结果 全市只有57家社区卫生服务中心(23.3%)拥有自己的微信公众平台,其中中心城区公众平台的开设比例为32.8%(39/119),郊区(县)的开设比例为23.3%(18/126),且在推送量和关注度方面均不理想,但中心城区的结果显著好于郊区(县)(P<0.01)。目前公众平台的运营存在的问题包括交互和其他拓展功能开发不足、更新推送不够及时、用户关注度较低及推送形式内容不尽合理等。此外,高频的更新和长期的运营时间是运营好公众平台的前提。 结论 目前社区卫生服务中心等基层医疗机构在利用社交网络平台开展信息发布和健康宣教方面尚处于起步状态,故应提高对此的重视,主动学习和借鉴优秀平台的运营经验,同时积极寻求第三方服务商的协助。      

西南地区医学院校图书馆微信公众平台服务调查与分析

对我国西南地区10所医学院校图书馆微信公众平台从帐号类型、认证情况、信息首推时间、最近文章点击量、月推送频率、服务功能等方面进行调查,分析存在的问题并提出相关建议,包括加强微信公众平台宣传与推广、重视信息推送频率及质量、加强服务功能开发与规范等。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.