基于数据挖掘的刺络放血疗法治疗 外感发热的选穴规律研究

〔摘 要〕 目的：探究基于数据挖掘的刺络放血疗法治疗外感发热的选穴规律。 方法：2019 年 7 月至 2019 年 12 月采 用 Excel 2019 建立刺络放血数据仓库模型,随后下载、筛选已建数据库中刺络放血疗法治疗外感发热的文献资料,以及所 需信息的录入,借助建立的刺络放血数据库平台,对其进行数据挖掘。 结果：纳入刺络放血疗法治疗外感发热的文献共计 63 篇,其中刺络放血针具三棱针使用频次最高,刺络放血刺法使用频次最高的为点刺;刺络放血治疗未配合拔罐的研究 占比 80 %;采用刺络放血配合疗法的有 46 项,占比 73 %,其中以拔罐使用频次最高。 结论：刺络放血疗法治疗外感发热 以三棱针点刺治疗为主,且部分研究常配合其他疗法以明显提升治疗效果,但配合拔罐治疗临床应用较少。     

To What Extent Do Local Nursing Home Prescribing Patterns Relate to Psychotropic Prescribing in Assisted Living?

ObjectiveIn nursing homes (NHs), psychoactive medication use has received notable attention, but less is known about prescribing in assisted living (AL). This study examined how antipsychotic and antianxiety medication prescribing in AL compares with NHs.DesignObservational, cross-sectional AL data linked to publicly reported NH measures.Setting and ParticipantsRandom sample of 250 AL communities and the full sample of 3371 NHs in 7 states.MethodsWe calculated the percentage of residents receiving antipsychotics and antianxiety medications. For each AL community, we calculated the distance to NHs in the state. Linear models estimated the relationship between AL prescribing and that of the closest and farthest 5 NHs, adjusting for AL characteristics and state fixed effects.ResultsThe prescribing rate of potentially inappropriate antipsychotics (i.e., excluding for persons with recorded schizophrenia and Tourette syndrome) and of antianxiety medications (excluding for those on hospice) in AL was 15% and 21%, respectively. Unadjusted mean antipsychotic prescribing rates were nominally higher in AL than NHs (14.8% vs 14.6%; P = .056), whereas mean antianxiety prescribing was nominally lower in AL (21.2% vs 22.6%; P = .032). In adjusted analyses, AL rates of antipsychotic use were not associated with NH rates. However, being affiliated with an NH was associated with a lower rate of antipsychotic use [b = −0.03; 95% confidence interval (CI) −0.50 to −0.001; P = .043], whereas antianxiety rates were associated with neighboring NHs’ prescribing rates (b = 0.43; 95% CI 0.16–0.70; P = .002).Conclusions and ImplicationsThis study suggests reducing antipsychotic medication use in NHs may influence AL practices in a way not accounted for by local NH patterns. And, because antianxiety medications have not been the focus of national campaigns, they may be more subject to local prescribing behaviors. It seems advantageous to consider prescribing in AL when efforts are implemented to change NH prescribing, as there seems to be related influence whether by affiliation or region.     

Defining the Core Skills and Activities of the Attending Physician in Post-Acute and Long-Term Care

The American Board of Post-Acute and Long-Term Care Medicine (ABPLM) contracted with a psychometric firm to perform a 3-phase Job Analysis following best practices. Literature was reviewed, a task force of subject matter experts was convened, a survey was developed and sent via Survey Monkey to attending physicians practicing in post-acute and long-term care settings (PALTC). The task force refined a comprehensive list of the tasks, knowledge, and medical knowledge needed in the role of attending physician in PALTC. These items were written as statements and edited until consensus was reached on their accuracy, conciseness, and lack of overlap. Task statements described distinct, identifiable, and specific practice-related activities relevant across multiple care settings. Knowledge statements described previously acquired information considered necessary to effectively perform such tasks. The survey consisted of 260 items, including 21 demographic questions, 115 task statements, 73 knowledge statements, and 72 medical knowledge statements. The survey was disseminated via e-mail invitations to Society for Post-Acute and Long-Term Care (AMDA) members and through an online link available through ABPLM’s website. A total of 389 respondents participated. Survey data were analyzed with statistical analysis software SPSS. For each task and knowledge statement, an Overall Task Rating and Knowledge Rating were developed by combining the importance rating weighted at 65% and (for task) the frequency rating or (for knowledge) the cognitive level weighted at 35%. One task statement and 1 medical knowledge statement had a mean importance rating lower than 2.5 and were dropped from further review, resulting in a final count of 114 task, 73 knowledge, and 71 medical knowledge statements (258 total). The results of this Job Analysis highlight the unique and specific nature of medical care provided by attending physicians across a range of PALTC settings. These findings lay a foundation for Focused Practice Designation or Subspecialty in PALTC and changes in practice and policy.     

基于CiteSpace的我国出院准备度研究可视化分析

目的分析我国出院准备度的研究现况、热点及前沿,为出院准备相关工作及研究方向提供依据。方法以中国知网（CNKI）为检索源,以“出院准备度”“出院准备”“出院计划”为检索词,检索1982年1月1日—2020年12月31日相关文献,应用CiteSpace V5.6.R5软件进行可视化分析。结果共纳入相关文献820篇。年发文量呈逐年上升趋势。发文机构和作者分布均较为分散,且相互合作不紧密。研究热点有出院计划、影响因素、护理和出院准备服务等,研究前沿为延续护理和脑卒中。结论出院准备度日益受到关注,研究机构、作者间需加强合作,不断拓展研究内容的广度和深度。     

网格定位器在腰椎椎体成形术中的应用

目的比较网格优化椎体成形术(percutaneous vertebroplasty,PVP)与传统PVP治疗骨质疏松性椎体压缩骨折的疗效。方法回顾性分析2016年5月至2019年5月北部战区总医院脊柱外科收治196例腰椎单节段行PVP治疗患者的临床资料,根据手术方法不同分为网格优化组(102例)和传统PVP组(94例)。网格优化组:男38例、女64例,年龄(67.3±8.5)岁,病程(2.3±1.2)d,L1椎体59例、L2椎体31例、L3椎体8例、L4椎体3例、L5椎体1例。传统PVP组:男26例、女68例,年龄(71.5±5.6)岁,病程(2.1±1.1)d,L1椎体52例、L2椎体33例、L3椎体7例、L4椎体2例。术前按两组不同方法选择最佳穿刺点及穿刺角度,完成穿刺后置入导丝及工作通道,推入骨水泥,术毕。主要观察指标为手术时间、术中X线透视次数、骨水泥注入量、骨水泥渗漏情况,以及疼痛视觉模拟评分(visual analogue scale,VAS)、伤椎前缘和伤椎中缘高度。结果两组患者术前一般资料的差异均无统计学意义(P>0.05),证明两组患者的基线资料具有可比性。所有患者均顺利完成手术,术中、术后均未出现脊髓神经损伤、切口感染、肺栓塞、死亡等严重并发症。网格优化组患者手术时间(34.8±6.5)min、透视次数(29.5±5.5)次、骨水泥注入量(5.3±2.1)ml、骨水泥渗透率3.9%(4/98)均优于传统PVP组,差异均有统计学意义(P<0.05)。网格优化组术后第3天、3个月及末次随访时VAS评分分别为(1.1±0.6)分、(1.0±0.3)分和(0.9±0.2)分,均优于传统PVP组(P<0.05)。两组患者术后第3天伤椎前缘及中缘高度的差异均无统计学意义(P>0.05),但网格优化组术后3个月伤椎前缘和中缘高度分别为(1.8±0.4)mm、(1.8±0.3)mm,末次随访时分别为(1.7±0.3)mm、(1.7±0.3)mm,均优于传统PVP组,差异均有统计学意义(P<0.05)。结论相比传统PVP手术,术前应用网格定位器进行网格优化PVP手术治疗骨质疏松性椎体压缩骨折更安全、有效。     

A retrospective study of neck rejuvenation using a noninsulated microneedle radiofrequency in Chinese subjects

Lasers in Medical Science - Large-scale long-term retrospective study of noninsulated microneedle radiofrequency treatment on neck rejuvenation is lacking. We conducted a 3-year retrospective...     

Application of network pharmacology and molecular docking to elucidate the potential mechanism of Astragalus–Scorpion against prostate cancer

The present study aimed to investigate the molecular mechanism of the Astragalus–Scorpion drug pair in the treatment of prostate cancer (PCa). We employed network pharmacology and molecular docking technology to retrieving the active ingredients and corresponding targets of Astragalus–Scorpion by using TCMSP, BATMAN-TCM, TCMID and Swiss Target Prediction Databases. The targets related to PCa were retrieved through GeneCards. Cytoscape software was used to construct the ‘active ingredient–target disease’ network, and GO and KEGG enrichment analyses were performed on the common targets. Autodock software was used for molecular docking verification. In total, 26 active ingredients, 340 potential targets related to active ingredients and 122 common targets were screened from Astragalus–Scorpion drug pair. The core targets of the protein–protein interaction (PPI) network were JUN, AKT1, IL6, MAPK1 and RELA, whereas the core active ingredients were quercetin, kaempferol, formononetin, 7-o-methylisomucronulatol and calycosin. Nearly 762 GO entries and 154 pathways were obtained by using the pathway enrichment analysis. Molecular docking results revealed that quercetin and kaempferol bind to AKT1 and formononetin binds to RELA, all of which were found to be stable bounds.     

Research trends of prostatitis over past 20 years: A bibliometric analysis

In the past two decades, thousands of documents in the field of prostatitis have been published. This bibliometric analysis aimed to assess the characteristics, hotspots and frontiers trend of global scientific output on prostatitis. With the trend of moderate growth, altogether 2,423 papers were reviewed. The leading role of the United States in global prostatitis research was obvious, while China had developed rapidly in recent years. Queen's University and JOURNAL OF UROLOGY were the most prolific affiliation and journal respectively. Nickel, J. C made the greatest contribution to the field of prostatitis. Five hotspots have been confirmed: (a) male infertility associated with prostatitis and the molecular mechanisms; (b) diagnosis and treatment of prostatitis; (c) inflammation, pain and bladder irritation symptoms; (d) relationship between chronic prostatitis/chronic pelvic pain syndrome, benign prostatic hyperplasia and prostate cancer; (e) epidemiology, complications of prostatitis and improvement of acupuncture. This bibliometric analysis reveals that the international cooperation was becoming more and more close. Hotspot analysis shows that the molecular mechanism of prostatitis will be a hotspot in the future, mainly focussing on inflammatory immunity and oxidative stress.     

中药复方发明专利创造性审查的影响因素分析

目的 寻找中药复方发明专利创造性审查的关键影响因素并分析原因,为完善相关审查标准提供参考。方法 筛选驳回依据为创造性的中药复方发明专利复审决定,建立数据库,通过分类和单因素逻辑（Logistic）回归等方法分析影响因素。结果 中药复方专利创造性的审查标准受年度变化的影响明显。按要求补充实验数据、区别技术特征数量、复方的发明类型、审查员所引用的对比文件及公知常识情况均能提高专利复审的撤驳率。结论 我国尚未建立合理、统一、清晰的中药复方发明专利创造性审查标准,仍有待从多个方面进一步完善。