中国临床医生转化医学实践之路

转化医学旨在构建基础医学与临床实践之间的桥梁。对转化医学的正确理解可有助于临床医生在该领域发挥自主能动性。临床医生应该积极走进实验室解决身边的实际问题,但一定要进得去、出得来。对转化医学的正确认识有助于提高医生对疾病诊、治、防的水平。     

你眼中的“循证医学”是循证医学吗?

循证医学(evidence-based medicine,EBM)是科学做出临床决策的方法学,要求医生以遵循证据为基础,同时结合临床状态和环境以及病人的意愿和行动做出合理医疗.目前出现了被滥用的情况.本文结合EBM概念的演变、与转化医学和精准医学的关系、以及关于EBM的争论展开讨论,期望能帮助临床医生合理认识EBM,正确应用EBM方法做出合理医疗决策.     

精准医学概念在肺癌靶向治疗中的应用

精准医学是临床转化医学的组成部分,是对医学的进一步理解,其服务于患者,有助于健康医疗,基于肺癌驱动基因指导下的肺癌靶向治疗是精准治疗的重要部分.文中就精准医学概念在肺癌靶向治疗中的应用作一综述,以肺癌靶向治疗研究进展为例,阐述对精准医学的理解,并展望肺癌靶向治疗在临床上的前景.     

从转化医学角度谈高血压非药物治疗的发展

转化医学是指将医学生物学基础研究成果转化为临床实际应用的理论、技术、方法和药物，既实现从“实验室到病床旁”的转化，又从临床应用中提出新的问题回到实验室。近年许多研究表明，各学科领域通过转化医学途径成功地将基础研究转化为临床应用。对原发性高血压（高血压）的治疗也体现出基础研究与临床治疗的转化应用。本文从转化医学角度对非药物治疗高血压，重点对去肾交感神经支配术治疗高血压的进展作一综述。     

脑脊液、类淋巴和淋巴管的发现及临床意义

脑脊液是脑的重要守护者,目前人们对其有了进一步认识,特别是近年来对类淋巴系统的认识和脑膜淋巴管的发现,为脑研究开拓了新方向,作为临床医生的我们应该加强与基础学科合作,开展转化医学和临床研究,为推动医学发展,造福广大患者而努力。本文主要结合国内外文献和个人体会对以上发现及其意义阐述如下。     

临床医师要重视医学人文修养

<正>临床医生赖以进行工作的基础是医学科学技术,但由于其工作对象是人,因而医学不是一种单纯的科学技术,而是医学科学与人文科学的高度结合体。近年来,由于大量高科技成果被引入临床,使临床医生对医学的人文特性逐渐有所忽视。产生了"高科技与     

循证医学证据与脑血管病临床决策

有人认为,循证医学已被公认为21世纪临床医学发展的必然趋势,21世纪的临床医生如果不具备循证医学知识是会落伍的。还有人认为,循证医学从根本上改变了脑血管疾病的临床思维模式,循证医学的应用标志着一个新的医学时代的到来。真是这样吗?其实,自从1992年JAMA发表循证医学工作组对“循证医学”的全面阐述的文章以来,各国专家,尤其是临床医生从各个角度批评、反对     

第三讲临床测量误差评价与诊断试验

临床上判断人的生理或生化等功能是否正常，主要依据医学测量结果。无论何种类型的临床测量结果，都不可避免存在误差。临床测量过程包括症状和体征、测量数据和医生判断．每一环节都存在误差并向后传递，其中最基本和最重要的环节是测量数据；如果测量数据不准确，医生无法做出正确的判断。实际测量结果中可能含有多个误差成分，主要包括生物变异、随机测量误差和系统误差。正确认识不同误差的性质及来源，有助于进行临床诊断和根据数据对临床试验做出客观评价。     

中国循证心血管医学论坛2009会议通知

当今医学模式正在发生深刻变革,循证医学已逐渐为临床医生认可,而心血管疾病的研究则是循证医学中最活跃的领域。但是随着循证证据层出不穷,疾病治疗指南不断更新,治疗理念不断变化,也使得忙碌的临床医生对纷繁的证据目不暇接、无所适从。为便于临床医生在这些浩如烟海的文献中,轻松地获得疾病诊疗预防的信息,提高循证医学在心血管领域中的实践应用,由中国循证心血管医学杂志社主办的“中国循证心血管医学论坛2009”,将于2009年8月20—23日在“避暑胜地”河北·承德召开。本次会议将邀请国内知名专家对心血管疾病最新循证研究结果、心血管疾病的最佳治疗方案、目前心血管领域循证医学研究现状、热点以及如何开展循证医学研究等方面进行深入研讨。     

搭建循证心血管医学传播平台,促进循证证据快速转化

正循证医学与转化医学是近二十年来在国内外快速发展和成熟起来的新兴医学模式,对于实现以"临床和患者为核心",并对临床医疗政策、决策、指南制定及规范医疗、基础及临床研究与临床应用的双向转化进程起到巨大的推动作用。国外尤其是美国、英国、加拿大等国家在     

以转化医学为向导的人体寄生虫学教学

人体寄生虫学在医学本科生教育层面的教学,要怎样顺应转化医学发展的潮流、把握转化医学提供的创新机遇,在深人学习、体会转化医学基本内函和创新启示的基础上,应运一系列有效措施,改进医学本科生人体寄生虫学教学现状,提升该课程的教学质量,仍是需认真思考和协同攻关的研究课题。本文探讨了人体寄生虫学所涉及转化医学的一些相关问题。     

Text Mining Supporting Search for Knowledge Discovery in Diabetes

Due to increasing specialization, silo effects and literature deluge, researchers are struggling to draw out general truths and to generate testable hypotheses. This is especially true when considering the needs of biomedicine. Medicine faces many challenges, not least the fragmentation into multiple subspecialist areas, and, at the same time, the need for cutting-edge research to be interdisciplinary. There are also issues of communication and understanding between those working at different ‘-omics levels’ and those working in a myriad of diverse areas including: basic research, translational medicine, clinical care, clinical trials, epidemiology, public health, clinical guideline development, evaluation of new drugs and treatments and personalized medicine. Most importantly, there is a lack of effective communication between these groups and members of the general public who seek to become better informed about their health. Different people have different views, perspectives and information needs relating to the same topic. Text mining methods can support information access for diverse groups such as researchers, clinicians, caregivers, patients and also members of the general public.     

转化医学背景下心内科研究生教学策略探讨

转化医学是连接基础医学和临床医学的重要纽带。在心血管病学研究生教学改革中运用转化医学理念,培养具有转化医学实践能力的研究生具有重要意义。心内科研究生教学还有很多不足,转化医学理念为教学改革指明了方向。     

Are Australasian academic physicians an endangered species?

It has been stated that academic medicine is in a worldwide crisis. Is this decline in hospital academic practice a predictable consequence of modern clinical practice with its emphasis on community and outpatient‐based services as well as a corporate health‐care ethos or does it relate to innate problems in the training process and career structure for academic clinicians? A better understanding of the barriers to involvement in academic practice, including the effect of gender, the role and effect of overseas training, expectation of further research degrees and issues pertaining to the Australian academic workplace will facilitate recruitment and retention of the next generation of academic clinicians. Physician‐scientists remain highly relevant as medical practice and education evolves in the 21st century. Hospital‐based academics carry out a critical role in the ongoing mentoring of trainees and junior colleagues, whose training is still largely hospital based in most specialty programmes. Academic clinicians are uniquely placed to translate the rapid advances in medical biology into the clinical sphere, by guiding and carrying out translational research as well as leading clinical studies. Academic physicians also play key leadership in relations with government and industry, in professional groups and medical colleges. Thus, there is a strong case to assess the problems facing recruitment and retention of physician‐scientists in academic practice and to develop workable solutions.     

中医药防治传染病的研究现状与展望

本文分析了传染病发病机制、诊断及治疗等方面的中医学研究现状,对中医药防治传染病研究的主要任务和转化医学在中医药防治传染病研究中的应用前景进行了展望,并提出应建立中医药防治传染病的临床研究方法学体系。     

Stem Cells and Their Derivatives: A Renaissance in Cardiovascular Translational Research

Moving from the bench to the bedside is an expensive and arduous journey with a high risk of failure. One roadblock on the path of translational medicine is the paucity of predictive in vitro models available during preclinical drug development. The ability of human embryonic stem (ES) and induced pluripotent stem (iPS) cells to generate virtually any tissue of the body, in vitro, makes these cells an obvious choice for use in drug discovery and translational medicine. Technological advancements in the production of stem cells and their differentiation into relevant cell types, such as cardiomyocytes, has permitted the utility of these cells in the translational medicine setting. In particular, the derivation and differentiation of patient-specific iPS cells will facilitate an understanding of basic disease etiology, enable better drug efficacy and safety screens, and ultimately lead to personalized patient therapies. This review will focus on recent advancements in the derivation and differentiation of human ES and iPS cells into cardiomyocytes and their uses in safety testing and modeling human disease.     

Are doctors the structural weakness in the e‐health building?

Progressive evaluations by the Organization for Economic Co‐operation and Development (OECD) demonstrate that health care is now or becoming unaffordable. This means nations must change the way they manage health care. The costly nature of health care in most nations, as a percentage of Gross Domestic Product (GDP) seems independent of the national funding models. Increasing evidence is demonstrating that the lack of involvement by clinicians (doctors, nurses, pharmacists, ancillary care and patients) in e‐health projects is a major factor for the costly failures of many of these projects. The essential change in focus required to improve healthcare delivery using e‐health technologies has to be on clinical care. To achieve this change clinicians must be involved at all stages of e‐health implementations. From a clinicians perspective medicine is not a business. Our business is clinical medicine and e‐health must be focussed on clinical decision making. This paper views the roles of physicians in e‐health structural reforms.     

The basic scientist in a clinical department

The basic scientist in a clinical department is a relatively recent phenomenon in the long course of the development of academic medicine. It came about as a response to the enormous growth in medical and scientific knowledge in comparatively recent times, coupled with the relative inability of medically educated clinicians to use the conceptual tools and investigational methods that were being made available by modern chemistry and statistics. The juxtaposition of basic scientists and clinicians in a common environment produces tensions, but also rich dividends for both parties. Whatever ways medicine develops in the future, it seems unthinkable that it will be able to advance very far unless basic scientists and clinicians continue to work in collaboration, side by side.     

转化医学理念在《细菌学检验》教学中的应用

转化医学是近年来新兴的医学研究模式,其核心理念是将基础研究和临床进行统一和结合。《细菌学检验》是检验专业重要的专业课。本教研室在转化医学理念的指导下,对理论和实验教学进行教学改革,重点培养检验系学生的临床实践操作能力。本文介绍了该课程目前理论教学、实验教学和教师方面存在的问题,并在转化医学理念的指导下进行教学改革的具体方法,提高了教学质量,培养出兼具动手和分析能力,毕业即能胜任临床细菌学检验工作的人才。     

Outcomes of a consultation service to emergency medicine clinicians for postexposure management of occupational bloodborne pathogen exposures

Potential bloodborne pathogen exposures, many of which occur after hours and are evaluated by emergency medicine physicians, are an important occupational hazard. Emergency medicine physicians might not be as conversant with the latest US Public Health Service guidelines as occupational medicine physicians. This research presents an efficient model in which a single expert occupational medicine physician provides guidance to many emergency medicine clinicians. Outcomes evaluation indicates that the service was widely utilized and highly rated.