基于全寿命周期医院建设项目风险分析与控制

医院建设项目是一个复杂的系统工程,其全寿命周期各阶段会面临各种风险。动态地识别风险、定量地评估风险、科学地应对风险、有效地降低风险是医院建设项目顺利实现的关键。对医院基建项目全寿命周期风险管理进行了系统研究,将熵权系数法应用于医院基建项目风险评估,提出了医院建设项目全寿命周期内风险应对措施。     

广西卫生资源配置公平性分析

目的：对2005—2011年广西卫生资源配置状况及公平性进行分析。方法：采用描述性分析及基尼系数法分析广西不同时期卫生资源配置状况及公平性。结果：2005—2011年广西卫生资源数量呈总体上升的趋势;按人口及按地理面积配置的社区卫生服务中心和卫生事业费的基尼系数总体在0.4以上,其余基尼系数总体小于0.4。结论：当前广西卫生资源已有相当规模。社区卫生服务中心和卫生事业费的公平性较差,其余类别卫生资源公平性合理或较佳。     

Estimation of eicosapentaenoic acid and docosahexaenoic acid intakes in pregnant Japanese women without nausea by using a self-administered diet history questionnaire

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intakes during pregnancy affect fetal development and maternal mental health; therefore, an accurate assessment of EPA and DHA intakes is required. We hypothesized that a self-administered diet history questionnaire (DHQ) that was developed for non-pregnant adults could be used for estimating EPA and DHA intakes in pregnant Japanese women; thus, we evaluated the validity and reproducibility of the DHQ during pregnancy. We recruited 262 healthy participants with singleton pregnancies during their second trimester at a university hospital in Tokyo between June 2010 and July 2011. Plasma concentrations of EPA and DHA were measured as reference values. Fifty-eight women completed the DHQ twice, within a 4- to 5-week period to assess the reproducibility of the results. Among the participants without pregnancy-associated nausea (n = 180), significantly positive correlations were observed between energy-adjusted intakes and plasma concentrations of EPA (r_s = 0.388), DHA (r_s = 0.264), and EPA + DHA (r_s = 0.328). More than 60% of the participants without nausea fell into the same or adjacent quintiles according to energy-adjusted intakes and plasma concentrations of EPA, DHA, and EPA + DHA. Meanwhile, among the participants with nausea, a low correlation for EPA and no correlation for DHA and EPA + DHA were found. Intraclass correlation coefficients for the 2-time DHQ measurements were 0.691 (EPA) and 0.663 (DHA). The results indicate that the DHQ has an acceptable level of validity and reproducibility for assessing EPA, DHA, and EPA + DHA intakes in pregnant Japanese women without nausea.     

Phosphatidylserine and caffeine attenuate postexercise mood disturbance and perception of fatigue in humans

Phosphatidylserine (PS) may attenuate the adverse effects of physical fatigue. Therefore, we investigated the effects of a multi-ingredient supplement containing 400 mg/d PS and 100 mg/d caffeine (supplement [SUP]) for 2 weeks on measures of cognitive function (CF), reaction time (RT), and mood (MD) following an acute exercise stress. It is hypothesized that PS will maintain preexercise CF and RT scores, while attenuating postexercise fatigue. Participants completed 2 acute bouts of resistance exercise (T1 and T2) separated by 2-week ingestion of SUP or control (CON). Outcome measures were assessed pre- and postexercise. When collapsed across groups, a significant decrease in RT performance was seen in the 60-second reaction drill from pre- to postexercise at T1. All other RT tests were similar from pre- to postexercise at T1. Reaction time was not significantly changed by PS. When collapsed across groups, a significant increase in performance of the serial subtraction test was seen. A significant increase (8.9% and 7.1%) in the number of correct answers and a significant decrease (8.0% and 7.5%) in time to answer were seen from pre- to postworkout at T1 and T2, respectively. A significant increase in total MD score from pre- to postworkout was observed for CON but not for PS at T2. Phosphatidylserine significantly attenuated pre- to postexercise perception of fatigue compared to CON. Ingestion of SUP for 14 days appears to attenuate postexercise MD scores and perception of fatigue, but does not affect CF or RT, in recreationally trained individuals.     

Green tea supplementation increases glutathione and plasma antioxidant capacity in adults with the metabolic syndrome

Green tea, a popular polyphenol-containing beverage, has been shown to alleviate clinical features of the metabolic syndrome. However, its effects in endogenous antioxidant biomarkers are not clearly understood. Thus, we tested the hypothesis that green tea supplementation will upregulate antioxidant parameters (enzymatic and nonenzymatic) in adults with the metabolic syndrome. Thirty-five obese participants with the metabolic syndrome were randomly assigned to receive one of the following for 8 weeks: green tea (4 cups per day), control (4 cups water per day), or green tea extract (2 capsules and 4 cups water per day). Blood samples and dietary information were collected at baseline (0 week) and 8 weeks of the study. Circulating carotenoids (α-carotene, β-carotene, lycopene) and tocopherols (α-tocopherol, γ-tocopherol) and trace elements were measured using high-performance liquid chromatography and inductively coupled plasma mass spectroscopy, respectively. Serum antioxidant enzymes (glutathione peroxidase, glutathione, catalase) and plasma antioxidant capacity were measured spectrophotometrically. Green tea beverage and green tea extract significantly increased plasma antioxidant capacity (1.5 to 2.3 μmol/L and 1.2 to 2.5 μmol/L, respectively; P < .05) and whole blood glutathione (1783 to 2395 μg/g hemoglobin and 1905 to 2751 μg/g hemoglobin, respectively; P < .05) vs controls at 8 weeks. No effects were noted in serum levels of carotenoids and tocopherols and glutathione peroxidase and catalase activities. Green tea extract significantly reduced plasma iron vs baseline (128 to 92μg/dL, P < .02), whereas copper, zinc, and selenium were not affected. These results support the hypothesis that green tea may provide antioxidant protection in the metabolic syndrome.     

A quantification model of Traditional Chinese Medicine syndromes in children with idiopathic precocious puberty and early puberty

OBJECTIVE： To establish a quantification model of Traditional Chinese Medicine（TCM） syndromes by sampling patients undergoing idiopathic precocious puberty（IPP） and early puberty.METHODS： A questionnaire for classifying and quantifying TCM syndromes was designed and administered. All the results were analyzed; the relationship between 3 types of syndrome and 47symptoms were summated. Meanwhile, the frequency distribution of each symptom or sign was aggregated. Fuzzy mathematics was used to develop a quantification model ofTCM syndromes.RESULTS： We found that precocious puberty had 3types of syndrome, including hyperactivity of fire due to Yin deficiency（Syndrome I）, depressed liver Qi transforming into fire（Syndrome II）, and end retention of damp heat（Syndrome III）. In the IPP group, Syndrome I was the most common principal syndrome（100%）. Forty-six patients（43.81%） werediagnosed with Syndrome I accompanied by Syndrome II and 11（10.48%） were diagnosed with Syndrome I accompanied by Syndrome III. In the early puberty group, Syndrome I was also the main syndrome（98.39%）. The degrees of most symptoms were mild to moderate. Reddened tongue was the most common tongue manifestation（62.86% prevalence） in the IPP group. The most common pulse manifestations were slippery pulse, thread pulse, and taut pulse. The Asymptotic Normalization Coefficient（ANC） method was used to quantify the TCM syndromes in 167 cases. Diagnostic accuracy rate reached 91%, comparable to expert diagnosis.CONCLUSION： We find that there are 3 types of syndrome in the IPP group and in the early puberty group. Syndrome I（hyperactivity of fire due to Yin deficiency） is the main syndrome in the two groups. ANC may be an appropriate for quantification model ofTCM syndromes.     

Botany,phytochemistry, pharmacology,and potential application of Polygonum cuspidatum Sieb.et Zucc.: A review

Ethnopharmacological relevance

Polygonum cuspidatum Sieb. et Zucc. (Polygonum cuspidatum), also known as Reynoutria japonica Houtt and Huzhang in China, is a traditional and popular Chinese medicinal herb. Polygonum cuspidatum with a wide spectrum of pharmacological effects has been used for treatment of inflammation, favus, jaundice, scald, and hyperlipemia, etc.

Aim of the review

The present paper reviews the traditional applications as well as advances in botany, phytochemistry, pharmacodynamics, pharmacokinetics and toxicology of this plant. Finally, the tendency and perspective for future investigation of this plant are discussed, too.

Materials and methods

A systematic review of literature about Polygonum cuspidatum is carried out using resources including classic books about Chinese herbal medicine, and scientific databases including Pubmed, SciFinder, Scopus, the Web of Science and others.

Results

Polygonum cuspidatum is widely distributed in the world and has been used as a traditional medicine for a long history in China. Over 67 compounds including quinones, stilbenes, flavonoids, counmarins and ligans have been isolated and identified from this plant. The root of this plant is used as the effective agent in pre-clinical and clinical practice for regulating lipids, anti-endotoxic shock, anti-infection and anti-inflammation, anti-cancer and other diseases in China and Japan.

Conclusion

As an important traditional Chinese medicine, Polygonum cuspidatum has been used for treatment of hyperlipemia, inflammation, infection and cancer, etc. Because there is no enough systemic data about the chemical constituents and their pharmacological effects or toxicities, it is important to investigate the pharmacological effects and molecular mechanisms of this plant based on modern realization of diseases’ pathophysiology. Drug target-guided and bioactivity-guided isolation and purification of the chemical constituents from this plant and subsequent evaluation of their pharmacologic effects will promote the development of new drug and make sure which chemical constituent or multiple ingredients contributes its pharmacological effects. Additionally, chemicals and their pharmacological effects of the other parts such as the aerial part of this plant should be exploited in order to avoid resource waste and find new chemical constituents.     

The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis

In oral cancer surgery, the decision to perform a tracheotomy is often determined by the surgeon. In this study, we investigated the competency of clinical scoring systems in identifying patients who require tracheotomy and examined the degree of agreement between the surgeon''s decision and the indications of various scoring systems. We identified 110 patients who were surgically treated for oral cancer. Of these, 67 patients (44 men and 23 women) who underwent resection and reconstruction were retrospectively analyzed. To derive the score, we evaluated the endpoint of the airway management score using clinical records and images. We divided the patients into two groups based on the Cameron and Gupta scores (tracheotomy and no-tracheotomy groups) and evaluated the degree of agreement with the surgeon''s decision by calculating the κ coefficient. The κ coefficients of the Gupta and Cameron scores were 0.61 (95% confidence interval [CI]: 0.40–0.82) and 0.60 (95% CI: 0.38–0.82), respectively. The clinical evaluation of the κ coefficient indicated that the Cameron and Gupta scores agreed fairly with the surgeon''s decision. In this study, the Cameron and Gupta scores fairly agreed with the decision of experienced surgeons and were confirmed as acceptable guides for making clinical judgments.     

淫羊藿黄酮类组分表观溶解度和油水分配系数的测定

目的:测定淫羊藿黄酮类组分的表观溶解度和油水分配系数,为该组分整体水溶性和脂溶性的表征提供参考。方法:以淫羊藿黄酮类组分为模型药物,采用HPLC测定朝藿定A,B,C及淫羊藿苷在不同缓冲液中的平衡溶解度和表观油水分配系数(Papp),流动相乙腈-水(25∶75),检测波长270 nm。结果:朝藿定A,B,C和淫羊藿苷在不同pH缓冲液中的整体平衡溶解度顺序为朝藿定B>朝藿定A>朝藿定C>淫羊藿苷,Papp总体变化趋势均为先变大后变小再变大,油水分配系数-1.437~3.147。结论:淫羊藿黄酮类组分的水溶性及脂溶性较好,在不同pH缓冲液中变化趋势相近,朝藿定B属于微解,朝藿定A,C和淫羊藿苷属于极微溶解。