药品执法的归责原则及过错推定

在处理药品违法行为时适用过错责任原则，而过错推定作为该原则的一个必要补充，可弥补执行中的不足，有利于执法工作的顺利进行，体现法律的公正性，并促进有关单位提高质量意识和质量管理水平。     

论军事医学系统的环境

军事医学系统的环境决定了军事医学的生存、发展和功能.论文研究目的是揭示军事医学系统的环境及其对军事医学的影响.作者研究提出了军事、国防、国家安全等任务需求,是军事医学发展牵引力,决定了军事医学发展的价值取向;军事、医学、相关科学和技术,是军事医学发展的推动力,决定了军事医学发展的科学可能性和技术可行性;军事医学的国际竞争与合作,是军事医学发展的助动力;军事医学的政策法规,是军事医学发展的规范和约束力.     

发展康复事业促进实现“健康中国2030”目标北大核心CSCD

目的回顾中国康复事业发展的历程,总结发展经验,研究康复事业发展的法律法规政策和规划以及服务发展。方法采用文献研究和政策研究方法,回顾中国康复事业,总结发展经验,并对相关法律、法规、政策和规划进行系统的内容分析。结果2021年是中国共产党建党百年。本文回顾中国康复事业的历史发展和宝贵经验,分析中国康复事业相关法律法规的产生背景、主要内容和社会意义,着重对《“健康中国2030”规划纲要》和《关于加快推进康复医疗工作发展的意见》相关康复政策进行研讨。结论中国康复事业是健康服务体系的重要组成部分,基于健康服务的视角,中国康复事业的发展,提升了康复相关领导力和治理能力,建立了康复事业发展的筹资机制,培养了大批康复专业技术人员,建立了覆盖三级医疗服务的康复医疗服务体系,并且将辅助技术纳入到现代康复服务体系中,建立了相应的卫生健康信息系统。康复事业在实现“健康中国2030”规划纲要相关目标中发挥着重要作用。     

Experimental Study on Mechanical Properties and Failure Laws of Granite with Artificial Flaws under Coupled Static and Dynamic Loads

Rock is the main construction material of rock engineering, such as the engineering of mines and tunnels; in addition, its mechanical properties and failure laws are of great significance to the stability evaluation of rock engineering, especially under the conditions of coupled static–static stresses. In this study, granite specimens were manufactured with artificial flaws. Coupled static and dynamic loads tests were carried out with a modified split Hopkinson pressure bar (SHPB) apparatus; and six typical levels of axial pre-stresses and three crack inclination angles were designed. Three-dimensional digital image correlation (3D-DIC) was also applied to record and analyze the fracturing process and damage evolution of the specimens. The test results show that there was no compaction stage in the stress–strain curve under combined dynamic and static loading. The dynamic strength of the specimens increased first and then decreased with the increase in the static pressure; moreover, the specimens reached the maximum dynamic strength when the static pressure was 10% UCS. The dynamic strength decreased first and then increased with the increase in the crack inclination angle; and the lowest strength appeared when the inclination angle was 45°. The change in axial compression had a significant influence on the failure mode, and the failure mode gradually transformed from shear–tensile failure to shear failure with the increase in the pre-stress. The tensile strain was usually generated at the end of the fractures or near the rock bridge. When the axial pressure was small, the tensile strain zone parallel to the loading direction was easily generated; and when the axial pressure was large, a shear strain zone developed, extending along the diagonal direction. The research results can provide a theoretical reference for the correct understanding of the failure mechanisms of granite and its engineering stability under actual conditions.     

痛风相关国家发明专利中药组方的用药规律及机制探讨

[目的] 探讨痛风相关国家专利中药组方的用药规律,并分析核心药物的作用机制。[方法] 通过中国专利公布公告网站检索治疗痛风的中药组方,提取数据并构建数据库。通过频数统计、Apriori算法、因子分析及系统聚类方法进行用药特点分析。在中药系统药理学分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP)中获取核心药物组合的中药靶点,在人类基因数据库(Human Gene database,GeneCards)、人类在线孟德尔遗传(Online Mendelian Inheritance in Man,OMIM)数据库中获得痛风疾病靶点,取两者靶点交集,将其导入Cytoscape 3.9.1软件,应用ClueGo插件对药物组合进行京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)富集分析。将交集靶点导入STRING数据库,构建蛋白互作(protein-protein interaction,PPI)网络,选取部分关键靶点,使之与对应的中药活性化合物进行分子对接。[结果] 纳入治疗痛风的专利中药组方共508项,涉及中药401味,用药频数共6 082次,药物类别以利水渗湿药为主,其次为补虚药、清热药及活血化瘀药等。关联规则分析得到二项关联规则3条,三项关联规则5条。因子分析共提取出8个公因子。系统聚类分析得到3组药物组合,药物组合富集的共同生物学通路56条。分子对接结果显示,槲皮素与肿瘤坏死因子(tumor necrosis factor,TNF)的结合效果最好,黄芩素与白介素-6(interleukin-6,IL-6)结合效果次之,槲皮素与三磷酸腺苷结合盒转运蛋白2(adenosine triphosphate binding cassette super family G member 2,ABCG2)的结合效果较好。[结论] 治疗痛风的国家专利组方多以“湿浊瘀阻”为核心病机,从湿、瘀、虚三方面治疗痛风,药物组合常以四妙散、茯苓泽泻汤和四物汤为基础加减,其主要通过TNF、缺氧诱导因子-1(hypoxia inducible factor-1,HIF-1)、Toll样受体(Toll-like receptors,TLRs)、IL-17等信号通路减轻炎症反应,促进尿酸排泄来发挥治疗作用。     

循法守度,援物比类

中医临床诊疗的基本路径应该是循法守度,援物比类,灵活变通.即在中医理论的指导下,发挥思维优势,立象尽意,依象而思虑,据象以辨证,灵活变通,“依思惟道理而生智慧”,如此方能以诊无过,以治不失.     

金银花颗粒在旋风分离器中的流场数值模拟分析

目的 针对金银花颗粒在旋风分离器中的运动行为过程进行研究,考察不同设计参数和操作工艺条件下,颗粒在设备内部的运动过程变化规律。方法 基于仿真模拟技术,考察受不同设备长径比、入口进气雷诺数、颗粒质量流量3个因素影响的金银花颗粒在分离器内的运动规律,并以金银花颗粒得粉率为验证指标参数,对模型可靠性进行了分析。结果 通过仿真模拟得到了各个不同工艺条件下的金银花颗粒运动轨迹分布,计算出了对应设备的颗粒得粉率。提出金银花颗粒分离的最佳工艺建议为设备长径比5∶1,入口进气雷诺数3.23×10⁴,颗粒质量流量80.1 mg/s,得到的金银花颗粒得粉率为96.30%。结论 为旋风分离器内金银花颗粒的有关研究提供指导,同时改善旋风分离器在控制和设计上的不足。     

2型糖尿病合并代谢综合征中医证候演变规律研究

目的总结和探讨2型糖尿病合并代谢综合征（MS）患者的证候分布特点和演变规律。方法选择符合标准的2型糖尿病合并MS患者295例,采用中华中医药学会糖尿病（消渴病）专业委员会制定的辨证标准进行辨证,对不同病程患者的临床症状、体征和证候分布进行统计分析和比较。结果以形体肥胖、唇舌瘀暗、头身困重、脉滑数等症状及体征为多见。以湿热、血瘀证候最为多见。病程小于5年者,主要表现为湿热、血瘀、胃肠结热证候;5-10年病程的患者则表现为邪实与正虚同时并见;病程超过10年者,主要表现为正虚。结论2型糖尿病合并MS早期以邪实为主,随着病程的延长,呈现出虚实错杂之证。邪实主要包括气郁、血瘀、湿浊、热结等,而以湿浊血瘀最为常见。     

Legal and ethical issues in telemedicine and robotics.

Modern medical concerns with telemedicine and robotics practiced across national or other jurisdictional boundaries engage the historical, complex area of law called conflict of laws. An initial concern is whether a practitioner licensed only in jurisdiction A who treats a patient in jurisdiction B violates B's laws. Further concerns are whether a practitioner in A who violates a contract or treats a patient in B negligently incurs liability in B, A, or both, and, if treatment lawful in A is unlawful in B, whether the practitioner commits a crime. Judicial procedures are set by courts in which proceedings are initiated, but courts may decline jurisdiction due to inconvenience to parties. If courts accept jurisdiction, they may apply their own substantive legal rules, but may find that the rules of a conflicting jurisdiction should apply. Cross-border care should not change usual medical ethics, for instance on confidentiality, but may mitigate or aggravate migration of specialists.