Study on the tongue manifestations for the blood-stasis and toxin syndrome in the stable patients of coronary heart disease

Objective  

To explore the tongue manifestations for the blood-stasis and toxin syndrome in the stable patients of coronary heart disease (CHD) according to the acute cardiovascular events (ACEs) in one-year follow-up which based on the pathogenesis hypothesis of “blood-stasis and toxin causing catastrophe”.     

ENGLISH TRANSLATION OF CHINESE MEDICINE——Concerning the Use of Western Medical Terms to Represent Traditional Chinese Medical Concepts：Answer to Prof. XIE and His Colleagues

This paper strongly rejects the notion that the use of biomedical terms to represent traditional Chinese medical concepts is helpful to the internationalization of Chinese medicine. It further argues that this practice destroys the integrity and independence of Chinese medical concepts. Taking the term 风火眼 fěng huǒ yǎn as an example, it shows that the biomedical term ＂acute conjunctivitis＂ often suggested as the translation for this term is unsatisfactory, because （ 1 ） the clinical reference is not identical, （2） it introduces the concepts of ＂conjunctiva＂ and ＂inflammation＂, which are not Chinese medical concepts, and （3） destroys the Chinese medical concepts ＂wind＂ and ＂fire＂ expressed in the Chinese, which reflect the way the disease is traditionally diagnosed and treated. While for English readers not familiar with Chinese medicine, ＂acute conjunctivitis＂ may be immediately intelligible, for those seeking a deep understanding of the subject, the literal translation （loan translation） ＂wind-fire eye＂ is much more helpful. This paper supports these arguments with numerous other examples.     

The Evaluation of Psychopharmacological Enhancers Beyond a Normative “Natural”–“Artificial” Dichotomy

The extra-therapeutic use of psychotropic drugs to improve cognition and to enhance mood has been the subject of controversial discussion in bioethics, in medicine but also in public for many years. Concerns over a liberal dealing with pharmacological enhancers are raised not only from a biomedical–pharmacological perspective, but particularly from an ethical one. Within these ethical concerns, there is one objection about the normative differentiation between “natural” and “artificial” enhancers, which is theoretically indeed widely discredited in bioethics, which has, however, entrenched itself in such a persistent way in everyday moral consciousness that it keeps a crucial influence on the assessment of pharmacological enhancers made by the public and medical professionals. This paper tries to first show why a normative differentiation between “natural” and “artificial” enhancers is highly problematic. In a second step, the resulting implications for our current dealing with pharmacological enhancers shall be examined. In a specific comparison of synthetic pharmaceuticals (modafinil, SSRIs) with phytopharmaceuticals (ginkgo biloba, St. John’s wort) and other already established enhancers (alcohol, caffeine), argumentative inconsistencies are pointed out which, at least partly, result from a rationally untenable preference for the “natural” over the “artificial”. Therefore, it is conclusively argued the case for an unprejudiced assessment of pharmacological enhancers beyond a “natural”–“artificial” dichotomy, which equally takes into account biomedical and ethical aspects. The goal is to reach a coherent dealing with pharmacological enhancement in the long run.     

Syphilis,psychiatry and offending behaviour: clinical cases from nineteenth-century Ireland

Background  Syphilis presented substantial challenges to nineteenth-century medical and psychiatric services. Aims  To illustrate the clinical course and diagnostic challenges associated with neurosyphilis in nineteenth-century Ireland. Method  This paper uses original archival material from the Central Criminal Lunatic Asylum, Dublin to present clinical cases and inform a discussion of related issues. Results  Mr A, a 34-year-old banker convicted of “felonious entry”, demonstrated many psychiatric and neurological features of neurosyphilis (“general paralysis of the insane”); he soon became “feeble”, “paralytic” and “demented”, and died within 2 years. The case of Mr B, a 38-year-old game-keeper convicted of “attempting to upset trains”, illustrates diagnostic dilemmas associated with neurosyphilis, especially when complicated by evidence of tuberculosis (“scrofulous diathesis”). Conclusions  The clinical and diagnostic challenges presented by syphilis have changed over the past century, but these cases, combined with recent evidence of syphilis outbreaks, highlight ongoing needs for clinical and epidemiological vigilance.     

The Adoption of Mobile Health Management Services: An Empirical Study

As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people. In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption of personal health management services is one way to maintain current levels of personal health and to efficiently manage the distribution of healthcare resources. This study introduces Mobile Health Management Services (MHMS) and employs the Technology Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile health management technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed that “perceived usefulness” and “attitude” significantly affected the behavioral intention of adopting MHMS. Both “perceived ease of use” and “perceived usefulness,” significantly affected “attitude,” and “perceived ease of use” significantly affected “perceived usefulness” as well. The results also show that the determinants of intention toward MHMS differed with age; young adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably promote the management of personal health among this population. Successful promotion of personal health management will contribute to increases in both the level of general health and the efficient management of healthcare resources.     

Characterizing Cancer Information Systems

The objective is to determine the extent to which information systems (IS) for cancer are unique and necessary. Via an analysis of Medical Subject Headings used to index relevant literature and other bibliometric techniques, cancer IS are compared and contrasted with IS of other specialties. Cancer IS are relatively little discussed and primarily connect radiation equipment with the radiation oncology staff. By contrast, clinical laboratory and radiology IS are frequently discussed and connect specialized equipment to the hospital. A “Specialty Need” model accounts for these patterns and says that the “need for a specialty IS” is proportional to the “uniqueness of the specialty tools” plus the “degree to which the information from those tools is needed throughout the particular health care entity.”     

Is simple nephrectomy truly simple? Comparison with the radical alternative

Background  

The Oxford English dictionary defines the term “simple” as “easily done” and “uncomplicated”. We tested the validity of this terminology in relation to open nephrectomy surgery.     

A Proposed Instrument for the Assessment of Job Satisfaction in Greek Mental NHS Hospitals

Since its introduction in 1983, the Greek NHS is under an almost constant reform, aiming improvement on the efficiency and the quality of provided services. The national program of psychiatric reform “Psychargos” introduced new models of therapeutic approach to the care of the mentally ill, that required expansion of the existing roles and development of new roles of the healthcare staff. Consequently, the efficient management of the healthcare workforce in Greek mental facilities was identified as a primary determinant of the successful implementation of the program. Primary objective of this study was the development of a research framework for the assessment of job satisfaction in Greek Mental Health Hospitals. Among the objectives was the evaluation of the capacity of the underlying motivators and hygiene factors and the identification of potential correlations of the global job satisfaction and the motivation and retention factors with the demographic, social and occupational characteristics of the employees. A custom questionnaire was developed, based on Herzberg two-factor theory, after a systematic review of the relevant literature. The instrument was constructed by two parts and 37 items. Ten items addressed the sociodemographic characteristics of the subjects, while the remaining 27 items were distributed in 11 subscales which addressed the global satisfaction index and the “retention” and the “motivation” variables. The instrument was validated by means of the Cronbach alpha for each subscale and by confirmatory factor analysis. The study was conducted at the Public Mental Hospital of Chania (PMHC). From the 300 employees of the PMHC, 133 subjects successfully responded to the questionnaire (response rate, 44.3%). In accordance to former surveys, subjects presented average scores in the global satisfaction index (GSI). The professional category of the employee was identified as the primary determinant of the GSI. Nurses presented statistically significant lower scores in comparison to the rest of the employees. Strong Pearson correlations were detected between GSI and “working conditions”, “interpersonal relations”, “organization”, “salary” and “supervision” factors. The retention factors presented stronger impact on GSI in comparison to the motivation ones. The results of the study indicate that the proposed instrument presents satisfactory validity and reliability for the assessment of job satisfaction in Greek mental NHS hospitals.     

Use of RSS Feeds for the Implementation of Clinical Reminder

A computer-based reminder system can help physicians get right information and make right decisions in daily clinical work in time. This study presents a RSS-based Clinical Reminding System (RCRS) designed for reminding clinicians to deal with their varied unfinished clinical works. The RCRS was implemented in a hospital to automatically generate messages for every clinician on the basis of clinical information gathered from the hospital information system (HIS) and send them by RSS feed. In order to allow all physicians to participate in the project, the RCRS was integrated with the Computerized Physician Order Entry (COPE) system to provide messages whenever a clinician logs in the HIS; the connection on screen lets the clinician easily make some response. The system can help clinicians focus on patient care without keeping track of the schedule of clinical chores stored in various systems. Two physicians, also directors from Clinical Informatics Research & Development Center (CIRD) who were appointed as project leaders of the RCRS project who went through the entire development process were chosen as interviewees to obtain a preliminary evaluation of the system. The results show the “Information Content” of this system was suggested to be modified, and “Information Accuracy”, “Formats”, “Ease of use” and “Timeliness” of the system were appropriate to meet the system design purposes.     

Adrenal cortical and medullar hyperplasia—A retrospective analysis of 6 cases

Summary The features of the symptoms, laboratory tests and pathological characteristics of adrenal cortical and medullary hyperplasia were studied. In 6 cases of hypercatecholaminenia, plasma norepinephrine (NE), epinephrine (E), catecholamine (CA) and 24-h urinary vanillylmandelic acid (VMA), 17-hydroxycorticosteroid (OHCS) and 17-ketosteroid (KS) were determined. Adrenal glands were examined by CT scan and¹³¹I-MIBG imaging. Pathological examination was performed after operation. The results showed that in 6 cases of hypercatecholaminenia (3 men and 3 women) aged from 34–50 years, the clinical features were just like “pheochromocytoma”, for example, episodic headache, perspiration, palpitation, pallor, apprehension, nausea, tremor, anxiety and so on. Plasma levels of CA, NE and E were elevated in all 6 cases. 24-h urinary samples obtained at the onset revealed elevated VMA in 1 case. 24-h urinary cortisol was obviously elevated in all 6 cases. 24-h urinary 17-OHCS, 17-KS was normal. B-type ultrasound, CT, MRI and¹³¹I-MIBG revealed 9 lateral adrenal gland diffuse or nodular enlargement in 6 cases. Pathologic examination showed adrenal cortical and medullary hyperplasia. Clinically, adrenal cortical and medullary hyperplasia resembled “pheochromocytoma”. The most significant feature of this disease was both elevated plasma CA and 24-h urinary cortisol obviously. Pathologic examination showed adrenal cortex nodular hyperplasia and medullar diffuse or limit hyperplasia. Whether it is an independent disease or symptoms of the other disease has not final conclusion up till now     

“谷歌”、“百度”与图书馆的关系

分析了谷歌、百度等网站的"图书馆计划"给图书馆事业带来的冲击和影响,认为谷歌网站的"图书馆计划"在可预见的未来与图书馆应是互利关系.因此图书馆必须练好内功,在与谷歌等网站的竞争中谋求共存与发展.     

An experimental study of using “tendon bridge” or “tendon tunnel” as a conduit for nerve regeneration

In our experiments, a “tendon bridge” or a “tendon tunnel” was used as a conduit to repair the defect of a peripheral nerve in rabbits. A gap of about 1 cm was made on the deep peroneal nerve in each animal. In group 1, the tendon of anterior tibial muscle was isolated near the severed nerve, and a segment of half cross section of tendon was removed in ladder-shaped reversed fashion. The proximal and distal nerve stump were sutured respectively to the tendon by 11/0 atraumatic sutures under surgical microscope. In group 2, the nerve stumps were sutured to the tendon of anterior tibial muscle without cutting the tendon, but the tendon was dissected free and turned to form a tunnel wrapping the gap in between the nerve stumps. The results showed that a gap of 1 cm of the deep peroneal nerve might be repaired by both methods, but the results of using “tendon tunnel” in group 2 were much better than those of using “tendon bridge” in group 1.     

Heart Monitoring Garments Using Textile Electrodes for Healthcare Applications

We measured the electrical activity signals of the heart through vital signs monitoring garments that have textile electrodes in conductive yarns while the subject is in stable and dynamic motion conditions. To measure the electrical activity signals of the heart during daily activities, four types of monitoring garment were proposed. Two experiments were carried out as follows: the first experiment sought to discover which garment led to the least displacement of the textile electrode from its originally intended location on the wearer’s body. In the second, we measured and compared the electrical activity signals of the heart between the wearer’s stable and dynamic motion states. The results indicated that the most appropriate type of garment sensing-wise was the “cross-type”, and it seems to stabilize the electrode’s position more effectively. The value of SNR of ECG signals for the “cross-type” garment is the highest. Compared to the “chest-belt-type” garment, which has already been marketed commercially, the “cross-type” garment was more efficient and suitable for heart activity monitoring.     

A comparison of pneumoconiosis interpretation between Chinese and American readers and classifications

Summary As a preliminary step in joint Sino-American pneumoconiosis research efforts, a formal chest X-ray pneumoconiosis reading trial was conducted among Chinese and American radiologists. Tweleve Chinese readers from different institutions located in south central China used the 1986 Chinese Roentgenodiagnostic Criteria of Pneumoconioses. Three American radiologists, centified as NIOSH “B” readers, used the International Labour Office Classification of Pneumoconioses, The chest X-ray study set consisted of 150 posterior-anterior films. One-half were Chinese X-rays of silicaexposed workers, and the other half were American films of variously exposed workers but primarily coal miners. All readings were done independently. The results showed that the inter-reader variability among the Chinese was similar to that of the American readers, both being in an acceptable range. In addition, there was general agreement between the Chinese and American interpretations. For small opacity profusion, the Chinese readers tended to read slightly more diseases than their American counterparts, although there was exact agreement as to the major category in two-thirds of the films. Agreement for film quality, and pleural disease was less, but was not different from reported variation among American “B” readers. Overall, the results suggest that despite the use of two different classification systems, a valid correspondence exists between the Chinese and American Interpretations, which is suitable for use in epidemiologic research.     

Comments on Nigel Wiseman??sA Practical Dictionary of Chinese Medicine (I) ??On the ??word-for-word?? literal approach to translation

Comments were made on the “word-for-word” literal translation method used by Mr. Nigel Wiseman inA Practical Dictionary of Chinese Medicine. He believes that only literal translation can reflect Chinese medical concepts accurately. The so-called “word-for-word” translation is actually “English-word-for-Chinese-character” translation. First, the authors of the dictionary made a list of Single Characters with English Equivalents, and then they gave each character of the medical term an English equivalent according to the list. Finally, they made some minor modifications to make the rendering grammatically smoother. Many English terms thus produced are confusing. The defect of the word-for-word literal translation stems from the erroneous idea that a single character constitutes the basic element of meaning corresponding to the notion of “word” in English, and the meaning of a disyllabic or polysyllabic Chinese word is the simple addition of the constituent characters. Another big mistake is the negligence of the polysemy of Chinese characters. One or two English equivalents can by no means cover all the various meanings of a single character which is a polysemous monosyllabic word. Various examples were cited from this dictionary to illustrate the mistakes. The paper was written on the basis of an e-mailing discussion with FANG Ting-yu (Beijing University of Chinese Medicine), LIU Gan-zhong (China-Japan Friendship Hospital), LU Wei-bo (China Academy of Traditional Chinese Medicine), WANG Kui (World Association of Traditional Chinese Medical Societies), WANG Tai (Medical College, Qinghai University) and ZHANG Qing-rong (Liaoning Traditional Chinese Medical College)     

The Inheritance, Power and Predicaments of the “Brain-Reading” Metaphor

Purpose  

With the increasing sophistication of neuroimaging technologies in medicine, new language is being sought to make sense of the findings. The aim of this paper is to explore whether the “brain-reading” metaphor used to convey current medical or neurobiological findings imports unintended significations that do not necessarily reflect the genuine findings made by physicians and neuroscientists.     

Employing post-DEA Cross-evaluation and Cluster Analysis in a Sample of Greek NHS Hospitals

To increase Data Envelopment Analysis (DEA) discrimination of efficient Decision Making Units (DMUs), by complementing “self-evaluated” efficiencies with “peer-evaluated” cross-efficiencies and, based on these results, to classify the DMUs using cluster analysis. Healthcare, which is deprived of such studies, was chosen as the study area. The sample consisted of 27 small- to medium-sized (70–500 beds) NHS general hospitals distributed throughout Greece, in areas where they are the sole NHS representatives. DEA was performed on 2005 data collected from the Ministry of Health and the General Secretariat of the National Statistical Service. Three inputs -hospital beds, physicians and other health professionals- and three outputs -case-mix adjusted hospitalized cases, surgeries and outpatient visits- were included in input-oriented, constant-returns-to-scale (CRS) and variable-returns-to-scale (VRS) models. In a second stage (post-DEA), aggressive and benevolent cross-efficiency formulations and clustering were employed, to validate (or not) the initial DEA scores. The “maverick index” was used to sort the peer-appraised hospitals. All analyses were performed using custom-made software. Ten benchmark hospitals were identified by DEA, but using the aggressive and benevolent formulations showed that two and four of them respectively were at the lower end of the maverick index list. On the other hand, only one 100% efficient (self-appraised) hospital was at the higher end of the list, using either formulation. Cluster analysis produced a hierarchical “tree” structure which dichotomized the hospitals in accordance to the cross-evaluation results, and provided insight on the two-dimensional path to improving efficiency. This is, to our awareness, the first study in the healthcare domain to employ both of these post-DEA techniques (cross efficiency and clustering) at the hospital (i.e. micro) level. The potential benefit for decision-makers is the capability to examine high and low “all-round” performers and maverick hospitals more closely, and identify and address problems typically overlooked by first-stage DEA.