持续被动运动活动器促进下肢手术后功能恢复临床效果观察

目的:探讨持续被动运动活动器(CPM)在下肢手术后功能锻炼的效果。方法:将50例下肢骨折术后患者随机分为对照组和实验组,各25例。对照组术后行常规护理,实验组术后早期实施康复训练,术后2个月比较两组患者的康复效果。结果:实验组有效率明显高于对照组,差异有统计学意义(P<0.05)。结论:应用CPM有效防止了下肢手术后膝关节僵直和肌肉挛缩,可促进患者早日康复。     

Data mining for signals in spontaneous reporting databases: proceed with caution

PURPOSE: To provide commentary and points of caution to consider before incorporating data mining as a routine component of any Pharmacovigilance program, and to stimulate further research aimed at better defining the predictive value of these new tools as well as their incremental value as an adjunct to traditional methods of post-marketing surveillance. METHODS/RESULTS: Commentary includes review of current data mining methodologies employed and their limitations, caveats to consider in the use of spontaneous reporting databases and caution against over-confidence in the results of data mining. CONCLUSIONS: Future research should focus on more clearly delineating the limitations of the various quantitative approaches as well as the incremental value that they bring to traditional methods of pharmacovigilance.     

Continuous infusion of low-dose doxorubicin, epirubicin and mitoxantrone in cancer chemotherapy: A review

With the recent development of reliable portable pumps and safe venous access systems, continuous infusion of chemotherapeutic agents on an out-patient basis has become feasible. Advantages of continuous infusion are the long-term exposure of tumour cells to the drug and the fact that most toxic effects are reduced for doxorubicin, epirubicin and mitoxantrone due to elimination of the high peak plasma levels. Preliminary data for doxorubicin suggest that its antitumour activity is maintained. Pharmacokinetic studies with epirubicin and mitoxantrone showed a linear relationship between drug dose infused and the steady-state plasma level for these drugs. The area under the curve for leukocytes drug level was higher during continuous infusion than after an equitoxic bolus injection of epirubicin and mitoxantrone. Well-randomized clinical trials will be necessary to investigate the role of continuous infusion of antracyclines and mitoxantrone in cancer chemotherapy in the future.     

Working with communities, governments and academic institutions to make pregnancy safer

The major medical causes of maternal death and the effective interventions to prevent maternal death due to these causes are known. Yet, every year, an estimated 529,000 women die during and following pregnancy and childbirth. Most of these deaths occur in developing countries where other non-medical determinants of maternal health influence the accessibility to these interventions. Improvements in maternal health can be achieved through a health systems approach. Care should be provided as a continuum throughout the life cycle and across health facilities through the health system. Communities, professional organizations and academic institutions should work actively with the government to: provide a package of service, based on population health needs, that is close to home; ensure availability of essential medicines and commodities; address financial barriers to receiving care; strengthen the health workforce; and gather and use information to improve maternal health.     

Research on severe maternal morbidities and near-misses in Brazil: what we have learned

The occurrence of complications during pregnancy depends less on the degree of human development than differences in the way complications in pregnancy are detected and managed. It is the quick diagnosis and correct management that really contribute to the enormous differences in maternal mortality ratios between countries and regions. Understanding of the determinants of maternal mortality may be improved by studying cases of severe maternal morbidity. In this paper, various approaches to the concept of severe maternal morbidity and near-misses are discussed, and the relationship between these and maternal deaths. Although no consensus has been reached on a strict definition of near-miss or severe maternal morbidity, we show that the definitions used may be tailored to support diverse objectives, including monitoring progress, epidemiological surveillance and auditing of health care. We conclude that the versatility of the concept, the greater frequency of cases available for study and the possibility of interviewing the survivors of severe complications all support the value of studying severe maternal morbidity to help guide local efforts to reduce maternal mortality. Although this may almost be a reality in developed countries, it continues to represent an important and difficult challenge to overcome in places where its benefits would be most evident.     

不同麻醉方案对 TKA 术后深静脉血栓发生的影响

目的：对照研究连续硬膜外麻醉（CEA）和全身麻醉下人工全膝关节置换术（TKA）后深静脉血栓（DVT）的发生率,并探析其各自的临床意义。方法：分析2013年4月～2015年5月在我院接受治疗的68例患者的临床资料。将入选者随机分成 CEA 组和全麻组两组,各34例。比较两组患者的一般资料、术前术后的相关指标以及术前凝血、血小板相关指标以及 DVT 的发生率。结果：两组患者的一般资料无统计学差异。两组患者术中、术后的相关指标间差异均不明显。两组患者术前凝血与血小板比较无统计学差异。DVT 的总发生率为19.1％（13/68）,其中单纯远端血栓有12例,近端血栓有1例,无肺栓塞及髂静脉血栓患者。CEA 组的 DVT 发生率明显低于全麻组。结论：CEA 可以显著降低 TKA 后 DVT 的发生率,疗效显著。     

脉冲激光和连续激光对肿瘤治疗光动力疗效的影响

光动力疗法（PDT）是治疗肿瘤的主要方法之一。以光与生物组织的相互作用原理及生物效应理论为依据,对不同运转方式的激光在肿瘤治疗过程中所产生的光动力效应、热效应以及生物刺激作用等方面进行分析,并对激光作用时间不同和总能量的差异对疗效的影响进行了分析。从发展的角度讲,为使PDT达到最佳疗效,同时有益于新光源的开发和利用,PDT采用脉冲激光无疑是一种最佳的选择。     

Identifying food components: INFOODS tagnames and other component identification systems

Food components need to be identified correctly and unambiguously. This is essential in the documentation and interchange of compositional data and it avoids confusion and misinterpretation for the users of these data. For this purpose, INFOODS published the first set of component identifiers, also called tagnames, in 1989. Since then, reported food components have vastly increased in number due to advances in analytical methods and increased interest in bioactive non-nutrient components. Users of food composition data are increasingly interested in more detailed data on fatty acids (e.g. positional and geometric isomers), individual vitamers and the speciation of nutrient elements. Several hundred tagnames have been added to the INFOODS database in the past 15 years. In order to keep up with the plethora of food components being analyzed and compiled in food composition databases, as well demands from new sectors and user, INFOODS held a technical consultation in 2003 to review and update principles and practices. Recommendations included separating units and base quantities from the definition of a tagname, maintaining the principle of different tagnames for highly empirical methods, and maintaining the keyword approach through which the components can be further defined. The comparison between INFOODS tagnames and other component identification systems such as EUROFOODS shows that the majority of component identifiers are the same. Further discussions and trials are needed to continue the evolution of the harmonized system of component identification through the lenses of both nutrition science and information technology.