心脑血管疾病用药不良反应与药品品种关系的聚类分析

目的寻找心脑血管疾病用药的不良反应与药品品种间聚类关系,促进临床安全合理用药。方法运用数据挖掘技术中的两阶段聚类算法对药品的严重不良反应与药品品种间的关系进行聚类分析。结果由聚类结果可知,在使用心脑血管疾病用药时,出现的严重和新的严重不良反应为肝功能异常、肾功能异常、呼吸困难、横纹肌溶解,导致这些严重不良反应的药物有受体类药物、钙离子拮抗剂、降低胆固醇类药物。结论在选择心脑血管疾病用药时,受体类药物、钙离子拮抗剂、降低胆固醇类药物应慎用、少用,尽量避免严重的不良反应发生。     

基于数据挖掘技术名老中医经验传承的研究

名老中医的经验是我们宝贵的财富,但是现在却面临着流失的风险,介绍了数据挖掘的概念以及将数据挖掘的方法引入到名老中医经验传承中。为经验的传承提供了新的思路。     

Chronic exposure by ingestion of environmentally relevant doses of 226Ra leads to transient growth perturbations in fathead minnow (Pimephales promelas,Rafinesque, 1820)

Abstract

Purpose: To assess the impact of environmentally relevant levels of ingested ²²⁶Ra on a common freshwater fish species.

Methods: Fathead minnow (Pimephales promelas, Rafinesque) were obtained at the first feeding stage and established on a commercial fish food diet containing ²²⁶Ra in the activity range 10 mBq/g^?1, –10,000 mBq/g^?1. They remained on this diet for 24 months and were sampled invasively at 1,6,18 and 24 months to assess growth, biochemical indices and accumulated dose and non-invasively also at 12 and 15 months to assess growth.

Results: Fish fed 10 and 100 mBq/g^?1 diet showed a small transitory deregulation of growth at 6 and 12 months. Fish fed higher activities showed less significant or insignificant effects. There was a trend at 18 months which was stronger at 24 months for the population distribution to change in all of the ²²⁶Ra fed groups so that smaller fish were smaller and bigger fish were bigger than the controls. There were also significant differences in the ratios of protein:DNA at 24 months which were seen as a trend but were not significant at earlier time points.

Conclusions: Fish fed a radium diet for 2 years show a small and transitory growth dysregulation at 6 and 12 months. The effects predominate at the lower activities suggesting hormetic or homeostatic adjustments. There was no effect on growth of exposure to the high activities ²²⁶Ra. This suggests that radium does not have a serious impact on the ecology of the system and the level of radium that would be transferred to humans is very low. The results may be important in the assessment of long-term environmental impacts of ²²⁶Ra exposure.     

Risk factors for persistent frequent use of the primary health care services among frequent attenders: A Bayesian approach

Abstract

Objectives . The aim of this study was to examine risk factors that predict persistent healthcare frequent attendance among a frequent attender (FA) population. Design. Prospective cohort study without intervention. Setting. Primary healthcare centre in Tampere, Finland. Subjects. A total of 85 primary healthcare working-age patients participated in the study. All participants were FAs in the first study year. Main outcome measures. We identified two groups of patients: temporary FAs and persistent FAs. A patient was considered as a persistent FA if he or she visited the health centre at least eight times a year for at least three out of four follow-up years. Some 59 different variables were examined as potential risk factors for persistent FA. P-course, a web-based Na ï ve Bayesian classification tool, was used for the modelling of the data. Results. In our model, the most influential predictive risk factors for persistent frequent attendance in an FA population were female gender, body mass index above 30, former frequent attendance, fear of death, alcohol abstinence, low patient satisfaction, and irritable bowel syndrome. New observations were high body mass index, alcohol abstinence, irritable bowel syndrome, low patient satisfaction, and fear of death. Conclusions. In FA analyses, distinction between temporary and persistent frequent attendance should be made. Our Bayesian model could be used for identifying persistent FAs in uncertain situations. The model can quite easily be further developed as a practical decision support tool for general practitioners. However, before its use in practice, the external validity of the model will need to be defined.     

袁少英治疗精索静脉曲张致不育症用药规律分析

目的:挖掘并探讨袁少英治疗精索静脉曲张致不育症的用药规律。方法:收集由袁少英诊断为精索静脉曲张致不育症并疗效较好的132例患者病历处方,运用中医传承辅助平台(V2.5)对病历处方药物进行频次、四气五味归经统计,并基于关联规则及复杂系统熵聚类进行用药规律分析及挖掘探讨。结果:聚类获得4对中药核心组合、2个中药新处方。在药物四气方面,以温平为主,根据辨证施治兼顾寒凉药;五味方面甘味为主,占48%;归经方面则以肝肾经为主。使用频次前5位的药物为枸杞子、黄芪、菟丝子、丹参、黄精,频次最高的对药是菟丝子-枸杞子、药物组合是菟丝子-枸杞子-覆盆子。结论:袁少英治疗精索静脉曲张致不育症着重调理肝肾经,药物以补益药与活血化瘀药为主,采用活血逐瘀通络、补肾滋阴调精为主线的治法及以"活血-逐瘀-补肾"为主轴的用药思路。     

数据挖掘法探讨周珉教授治疗原发性肝癌用药规律及经验总结

[目的]数据挖掘法分析周珉教授治疗原发性肝癌的中医用药规律，探讨相关病机并进行经验总结。[方法]收集2016年2月—2018年5月周珉教授门诊期间治疗原发性肝癌的方剂，运用“中医传承辅助系统（V2.50）”进行数据挖掘，并结合周珉教授临床经验，进行原发性肝癌病机探讨及用药规律分析。[结果]共收集治疗原发性肝癌方剂176首，涉及中药235种，列出方剂中的高频药物及组合规律。[结论]总结原发性肝癌以“湿热痰毒、气阴两伤”为基础病机，“清热化湿、健脾养阴”治则贯穿原发性肝癌治疗始末，同时，根据疾病不同发展阶段及治疗措施，权衡“扶正”与“祛邪”的主次分配，斟酌应用“攻毒散结”“行气化瘀”等治法，以达到改善患者生活质量、延缓疾病进展的目的。     

教育数据挖掘对教育要素的影响研究

大数据时代,通过教育数据挖掘技术能够对教育教学过程中产生的海量数据进行有效地分析,且运用数据分析的结果,发现教育过程中的问题,提供指导性的建议,促成行之有效的解决策略。文章从教育者、受教育者、教育管理者、教育资源四个要素探究教育数据挖掘对教育产生的影响,剖析教育数据挖掘技术精进对教育各要素带来的影响,阐释个中不足,旨在顺应智慧时代发展,使教育数据挖掘技术更好地促进教育发展。     

基于数据挖掘吴生元教授辨治痛风用药规律研究*

目的通过检索吴生元教授门诊记录的痛风医案,分析吴教授治疗痛风用药规律,以期为吴生元教授治疗痛风的临床经验传承与创新,为临床治疗痛风提供借鉴。方法 应用中医传承辅助平台系统（V2.5）对方剂及医案原始资料进行统计分析及归纳,总结其用药规律。结果 通过对 105首方剂分析,涉及中药 79味,使用频次≥10次的药物共 34味,经典组合模式42条,高频药物关联程度大致6组,常用药对51条,并演化得到3首治疗痛风的新处方,药组多以祛风除湿通络药物为主。结论 吴生元教授治疗痛风多以清热养阴、散寒除湿、温通经络、健脾渗湿等立法,处方常寒热共用、通补结合,注重顾护脾胃、扶正与祛邪并举,形成了独具特色的诊治经验,值得大家借鉴。     

以“四则四法”论治肺间质纤维化

[目的]通过数据挖掘方法,探讨分析宋康教授治疗间质性肺病的中医组方特色和用药规律,总结其临证经验。[方法]收集2014年1月至2018年12月于浙江中医药大学第一附属医院宋康教授门诊治疗的间质性肺病患者病案,提取所有患者处方药物,建立处方数据库;采用关联规则分析、系统聚类分析及中医复杂网络分析等数据挖掘方法进行分析总结,归纳宋康教授辨治间质性肺病的学术经验及用药规律。[结果]本研究共纳入处方1 114首,涉及药物203味。使用频次居前3位的单味药物为浙贝、桔梗、苏子,总结出核心药对3个、药组3组,并得出治疗间质性肺病的核心处方,由前胡、苏子、浙贝、桔梗、半枝莲、半边莲、虎杖、蛇舌草、鱼腥草、紫草、茜草、甘草组成。方中前胡、苏子、浙贝宣肺降气、化痰平喘,桔梗、半枝莲、半边莲、虎杖、蛇舌草、鱼腥草清热解毒散结,紫草、茜草走血分,有解毒祛瘀之功效,甘草调和诸药。[结论]宋康教授在治疗间质性肺病时以"痰""毒""瘀"为切入点,以清热解毒、化痰散瘀、化痰止咳平喘为主,重视固本祛邪、调畅气机,并擅用药对,精于配伍。     

朱仁康治疗湿疹用药规律分析

目的:分析朱仁康治疗湿疹的用药规律,明晰其经验与学术思想。方法:以朱仁康教授门诊病历为数据源,运用中国中医科学院中药信息研究所研发的“古今医案云平台V1.4”软件,采用频数分析、关联规则分析方法进行数据挖掘,确定处方中核心药物组合、用药模式及药物间的关联规则等。结果:本研究共收集湿疹患者168例、190诊次、临床表现190个、舌质65个、舌苔75个、脉象60个、方剂130个、中药130味,挖掘出湿疹常见临床症状、常用中药以及药物四气、五味、归经的频数分布;四诊信息、中药的聚类现象;中药与中药、症状与中药的关联规则;核心药物组合的复杂网络。结论:常用药有30味;用药以寒凉为主,兼以温药;苦泻淡渗为主,兼用辛甘;调理心、脾为主,兼治肺、肝、肾、膀胱;常用组合有8组及随症加减常用药。