从科学证据到临床实践

从1992年加拿大McMaster大学循证医学工作组第一次提出“循证医学”这一名词和概念至今只有短短十五年时间，循证医学已经在世界各地蓬勃发展，其原理内容的阐述以及方法学的探索一直在日新月异的完善和发展，它对医疗实践和卫生决策产生了积极重大的影响，得到了卫生工作者的普遍认同。     

2013年《医学研究杂志》征订征稿启事

《医学研究杂志》(原名《医学研究通讯》)于1972年创刊,是由卫生部主管、中国医学科学院主办的国家级医学学术刊物。中国科技论文统计源期刊,中国科技核心期刊。世界卫生组织西太区医学索引(WPRIM)收录期刊。月刊。CN11-5453/R,ISSN1673-548X。     

2013年《医学研究杂志》征订征稿启事

《医学研究杂志》(原名《医学研究通讯》)于1972年创刊,是由卫生部主管、中国医学科学院主办的国家级医学学术刊物。中国科技论文统计源期刊,中国科技核心期刊。世界卫生组织西太区医学索引(WPRIM)收录期刊。月刊。CN11-5453/R,ISSN1673-548X。     

未来中国糖尿病教育发展之路

我国开展糖尿病教育比较晚,在各方面的共同推动下,目前已经取得了非常大的进步,但是与国际上很多地区相比,我国的糖尿病教育还存在不小的差距。如我们没有真正的专业队伍,没有专职的糖尿病教员等。而据国际糖尿病联盟主席Mbanya教授坦言,目前全世界有3亿的糖尿病患者,而我国就占了0．92亿患病人群和1．5亿的高危人群,如果不控制的话,20年后全世界将会有10亿人患糖尿病。因此糖尿病教育在未来的工作中依然任重而道远。     

“中国循证心血管医学论坛2010”会议通知

为了进一步提高循证医学证据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2010”，将于2010年8月在山东烟台召开。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。大会论文将择优在《中国循证心血管医学杂志》上正式发表。与会者将授予国家继续教育Ⅰ类学分。     

“中国循证心血管医学论坛2009”征文通知

为了进一步提高循证医学证据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。大会论文将择优在《中国循证心血管医学杂志》上正式发表。与会者将授予国家继续教育Ⅰ类学分。     

中国重症医学30年发展之路

重症医学(critical care medicine)是研究任何损伤或疾病导致机体向死亡发展过程的特点和规律性,并根据这些特点和规律性对重症患者进行治疗的学科。中国重症医学的理念起步于20世纪70年代初期。随着第一个重症监护病房(ICU)的建立及之后ICU逐渐在医疗工作中起到的不可比拟作用,重症医学已经成为中国医疗卫生系统中不可缺少的重要组成部分。今天,作为临床二级学科、具有丰富学术内涵的重症医学,正在系统化、规范化的道路上持续发展。     

糖尿病教育：中国VS世界

上海：医院社区一体化管理 致力于社区糖尿病教育管理的贾伟平教授强调将医院社区一体化。目前整个医疗体系主要采用三级分级制度,三级医院应当承担专业指导的任务,解决重症危重患者的问题,而社区可以实施对患者的具体管理,起到干预监督作用,从而达到优势互补的目的。     

中国临床实践指南制定的现状与建议

1990年,美国医学研究所（Institute of Medicine,IOM）提出了临床实践指南的定义：即针对特定的临床情况,系统制定出帮助临床医生和患者做出恰当处理的指导性意见（推荐意见）.2011年IOM对临床指南给出了一个新定义：即通过系统综述生成的证据以及对各种备选干预方式进行利弊评价之后提出的最优指导意见.此定义强调了制定循证指南的重要性,即强调在复习和评价现有临床证据的基础上制定指南,在没有证据的情况下通过严格共识达成一致性推荐意见.     

中国亟待建立灾害医学救援体系

目前,紧急医学救援基地建设已被纳入中国卫生事业发展"十二五规划"初稿,在"十二五"期间中国将建设国家级、省级、地市级三级紧急医学救援网络,以应对未来的挑战,保障公众的生命健康安全。目前卫生部已将卫生应急人员培训纳入《医药卫生中长期人才发展规划     

Telemedicine--the way ahead for medicine in the developing world

An e-mail link with the facility to send high-resolution digital images is a cheap and uncomplicated telemedicine method. The Swinfen Charitable Trust helped establish such a link in Patan Hospital Kathmandu, Nepal in March 2000. Over 12 months using this link 42 telemedicine referrals were sent to specialists throughout the world. Referrals were: 36% respiratory medicine; 21% neurology, 21% dermatology; 14% cardiology; 5% nephrology; and 3% radiology--28 had digital pictures attached, of which 96% were of high enough quality on which specialists were able to comment. Thirty-nine replies were received. The average time for a specialist reply was 2 days, and 45% were answered within 24 hours. All replies were judged by independent assessors to be helpful or very helpful for diagnosis, management and education. The assessors decided that in 50% of cases the advice if acted upon would have shortened hospital stay. This pilot study has shown that a low-cost telemedicine link is technically feasible and can be of significant benefit for diagnosis, management and education in a developing world setting.     

Agriculture in the developing world: Connecting innovations in plant research to downstream applications

Enhancing agricultural productivity in those areas of the world bypassed by the Green Revolution will require new approaches that provide incentives and funding mechanisms that promote the translation of new innovations in plant science into concrete benefits for poor farmers. Through better dialogue, plant breeders and laboratory scientists from both the public and private-sectors need to find solutions for the key constraints to crop production, many of which center around abiotic and biotic stresses. The revolution in plant genomics has opened up new perspectives and opportunities for plant breeders who can now apply molecular markers to assess and enhance diversity in their germplasm collections, to introgress valuable traits from new sources, and to identify genes that control key traits. Functional genomics is also providing another powerful route to the identification of such genes. The ability to introgress beneficial genes under the control of specific promoters through transgenic approaches is yet one more stepping stone in the path to targeted approaches to crop improvement, and the new sciences have identified a vast array of genes that have exciting potential for crop improvement. For a few crops with viable markets, such as maize and cotton, some of the traits developed by the private sector are already showing benefits for farmers of the developing world, but the public sector will need to develop new skills and overcome a number of hurdles to carry out similar efforts for other crops and traits useful to very poor farmers.     

针药结合治疗非酒精性脂肪肝的临床研究

目的：探讨针药结合治疗非酒精性脂肪肝的疗效和作用机制。方法：随机选择40例非酒精性脂肪肝患者作为针药结合治疗组，同时设立对照组30例，给予口服胆维他25mg/次，3次／d，维生素C10mg／次，3次／d。疗程均为2个月，观察患者症状、体重指数、腰臀比和肝功能、血脂指标的变化。结果：治疗组总有效率90．0％，对照组总有效率76．7％，两组相比差异有显著性意义（P〈0．05）。治疗后两组症状、体重指数、腰臀比和肝功能、血脂指标比较有显著性差异（P〈0．05）。结论：针药结合治疗非酒精性脂肪肝具有较好的疗效，有一定的临床应用价值。     

Traditional medicine to DNA vaccines: the advance of medical research in West Africa

Summary West Africa has a rich medical history. Herbal medicine has been practiced for hundreds of years and the establishment of an effective herbal pharmacopoeia was probably the first medical research carried out in West Africa. Arabic medicine was practiced in the countries of the Sahel in the 15th and 16th centuries. The coming of the Europeans focused research on infectious diseases such as malaria, yellow fever and sleeping sickness, to which Europeans were very susceptible and which caused devastating epidemics among the populations of their new colonies. The end of the colonial era saw the establishment of a few large, well-equipped teaching hospitals but these proved too expensive for the newly independent states of West Africa to run effectively, and the second generation of West African medical schools was based on more modest government hospitals. This led to a change in the focus of research away from the more unusual conditions seen in a specialist referral hospital to an interest in conditions, such as the common infectious diseases, seen more frequently in district hospitals. The advent of the primary health care movement in the 1970s was followed by an increased emphasis on community studies. Molecular biology is likely to have an enormous impact on medicine in general in the coming years. One of the main challenges facing medical researchers in West Africa is how these new technologies can be used most effectively to improve health in countries with limited resources.     

Probiotics for the developing world

Every minute of every day more and more children die of diarrheal diseases and women, and girls become infected by HIV. An estimated 7,000 women become infected each day. While many valiant efforts are being made to address these issues, until now they have proved to be markedly ineffective. The notion that lactic acid bacteria, formulated into food or dietary supplements, could have a role to play in slowing the morbidity and mortality associated with HIV/AIDS and gastroenteritis, is built upon sound clinical findings and scientific investigations, yet no international efforts have been placed in this approach, to date. We hereby summarize the reasons why such efforts should be made, provide an example of one model being set up in sub-Saharan Africa, and challenge the international community to consider the potential benefits of probiotics, especially for communities not reached by governmental and nongovernmental agencies.