基于互联网医院药房建设的北京中医医院线上处方饮片使用特点分析

目的：以北京中医医院互联网处方中药饮片的使用情况为例，分析互联网中医医疗的特色特点， 为互联网医院药房建设合理性发展提供参考。方法：通过回顾分析的方法，利用医院HIS系统抽取2020 年3-6月的互联网中药饮片处方，采用Excel 2010对患者情况、药味、剂数、饮片使用频率等数据进行整理统计。结果：北京中医医院开展互联网医疗以来共诊疗患者621例、1378人次，线上饮片处方共计1022 张、16872剂。其中，患者年龄涵盖各年龄段，但以31~60岁为主，达到了412人，占66.3%；本研究涉及医院科室17个，以肿瘤、皮科、肝病科位居前位，占63.4%；患者所在地区分布以华北地区为主，占60%。 结论：开展线上中医互联网诊疗服务是日常线下门诊医疗的重要补充，在保证中医辨证论治特点的同时，可有效缓解看病难等问题，使优质医疗服务的范围得到了有效拓展。针对互联网药房服务目前面临的监管与技术困局，本文提出线上药房建设“八要素”，为互联网药学服务的发展提供参考方向。     

山西营养与慢性病家庭队列人群体质指数与死亡率的关系

目的 分析山西营养与慢性病家庭队列人群BMI与总死亡率的关系。方法 以"2002年中国居民营养与健康状况调查"山西省调查人群为基线建立队列，于2015年12月至2016年3月对研究对象进行随访调查，对逝者进行死因回顾调查。2002年基线信息完整的≥ 18岁研究对象7 007人，随访到5 360人，随访率为76.5%。将研究对象按BMI分为8组，计算死亡率，以死亡率最低组作为参照，采用Cox比例风险回归模型估计全人群、分性别、年龄（≥ 60岁、<60岁）的各组死亡风险比（HR）及95% CI，模型调整基线年龄、性别、吸烟、饮酒、文化程度等因素，并进行敏感性分析。结果 共随访67 129人年，平均随访12.5年，死亡615人，队列总死亡率为916/10万人年。BMI为26.0~27.9 kg/m²组死亡率最低，以该组为参照组，多因素调整后，BMI<18.5、18.5~19.9、22.0~23.9和≥ 30.0 kg/m²组的死亡风险明显升高，调整HR值（95% CI）分别为1.90（1.26~2.86）、1.68（1.15~2.45）、1.49（1.08~2.06）和1.72（1.07~2.76）。对于≥ 60岁老年人，BMI<18.5 kg/m²组的死亡风险明显升高，调整HR值（95% CI）为1.94（1.20~3.15）。结论 BMI ≤ 19.9、22.0~23.9及≥ 30.0 kg/m²均会增加全因死亡风险。除关注肥胖外，低体重营养不良造成的老年人高死亡风险应特别引起重视。     

Enhanced immune response to foot-and-mouth disease vaccine by oral administration of ginseng stem-leaf saponins

Vaccination is an important approach to the control of foot-and-mouth disease (FMD). This study evaluated the effect of oral administration of ginseng stem–leaf saponins (GSLS) on the immune response to FMD vaccine and the gut mucosal immunity in mice. In experiment 1, mice were orally administered GSLS or not treated as a control. The animals were then immunized twice with FMD vaccine. Blood was sampled weekly within five weeks after the boost immunization for measurement of serum IgG and the isotypes. In experiment 2, mice were orally administrated GSLS or not treated as a control. After that, splenocytes were prepared from sacrificed mice for lymphocyte proliferation assay and intestinal tissues were sampled for immunohistochemistry and histological examination. The results showed that oral administration of GSLS significantly enhanced serum IgG and the isotype responses to FMD vaccine as well as the number of intestinal intraepithelial lymphocytes (IELs) and immunoglobulin A (IgA)+?cells. Therefore, GSLS may be a potent oral adjuvant and deserve further study to improve vaccination in susceptible animals.     

基于海量视频存储技术的超声动态影像工作站系统

针对当前超声影像面临的问题及制约因素，详细介绍了基于海量存储技术的超声影像工作站系统构成及特点，并全面分析了该新型工作站系统的主要功能和应用效果。     

The Nitrone Spin Trap 5,5-Dimethyl-1-pyrroline N-oxide Affects Stress Response and Fate of Lipopolysaccharide-Primed RAW 264.7 Macrophage Cells

The nitrone spin trap 5,5-dimethyl-1-pyrroline N-oxide (DMPO) is commonly used to study free radicals. Due to its free radical trapping properties, DMPO is thought to reduce free radial-mediated oxidative damage and other related cellular responses. The purpose of this study was to assess the effect of DMPO on lipopolysaccharide (LPS)-induced inflammation, endoplasmic reticulum (ER) stress, and apoptosis in RAW 264.7 cells. The results showed that DMPO at 50 mM inhibited inducible nitric oxide synthase expression when added shortly after LPS treatment (≤3 h). Interestingly, DMPO increased anti-inflammatory heme oxygenase-1 (HO-1) expression and reversed LPS-induced decrease in HO-1 expression. LPS could increase cellular ER stress as indicated by C/EBP homologous protein (CHOP) induction; DMPO reduced LPS effect on CHOP expression. Unexpectedly, DMPO had a synergistic effect with LPS on increased caspase-3 activity. Overall, DMPO harbors multiple modulating effects but may induce apoptosis in LPS-stressed cells when given at 50 mM, an effective dose for its anti-inflammatory activity in vitro. Our data provide clues for further understanding of the nitrone spin trap with therapeutic potential.     

Psychological dysregulation during adolescence mediates the association of parent-child attachment in childhood and substance use disorder in adulthood

Objective: This prospective study tested the hypothesis that psychological dysregulation in mid-adolescence (age 16) mediates the association between parent-child attachment in late childhood (age 10–12) and development of substance use disorder (SUD) in adulthood (age 22). Method: The Youth Attachment to Parents Scale (YAPS) was developed in 10–12-year-old boys and girls (N?=?694) at baseline residing in western Pennsylvania. Psychological dysregulation was measured by the neurobehavior disinhibition trait. Substance use was assessed at ages 10–12, 12–14, 16 and 19. SUD was diagnosed at age 22 using the Structured Clinical Interview for DSM Disorders. The mediation of parent-child attachment and SUD by neurobehavior disinhibition was tested separately for mothers and fathers while controlling for baseline substance use. Results: Psychological dysregulation mediates the association between attachment to mothers and SUD, and partially mediates the association between attachment to fathers and SUD. Significant mediation effects remains after controlling for baseline substance use. Conclusion: Optimal prevention of SUD should include ameliorating both psychological dysregulation predisposing to SUD and quality of the parent-child relationship.     

心血管内科医护人员焦虑状况调查分析

目的探讨心血管内科医护人员的焦虑状况。方法采用焦虑自评量表(self-rating anxiety scale,SAS)对98名心血管内科医护人员进行问卷调查,并与国内常模比较。了解心血管内科医护人员焦虑状况。结果非焦虑者35名,占35.7%,焦虑者63名,占64.3%;心血管内科医护人员焦虑水平明显高于国内常模(P<0.05);心血管内科护士焦虑水平明显高于医生(P<0.05)。结论心血管医务人员心理健康状况与医疗职业特点密切相关,医护人员焦虑水平明显高于国内常模,护士焦虑水平明显高于医生,应切实提高其心理应对能力。