基于GMPGIS全球变暖情景下人参未来生态适宜产区变化

目的:通过开展未来时期人参全球潜在生态适宜产区分析,为其合理规划生产布局提供科学依据。方法:采用"药用植物全球产地生态适宜性区划信息系统"(Global Geographic Information System for Medicinal Plant,GMPGIS),以人参本草文献记载的道地产区、野生分布区以及当前主产区人参生态因子数值为依据,对其在全球范围内的潜在生态分布区进行分析。结果:亚洲东部、北美洲中部及东部、欧洲中南部及大洋洲东部地区是当前人参全球范围内的主要适生区域。随着全球气候变暖,在温室气体排放相对较少的A1b模型和排放较多的A2a模型下,2050年人参潜在生态适宜产区面积约为9 500×10~3km~2,比当前产区适宜面积增加了7.05%~7.12%,增长区域主要分布在亚洲东北部和欧洲北部地区;2100年人参适宜产区面积约为10 800×10~3km~2,比当前产区适宜面积增加了22.89%~27.41%,增长区域主要分布在欧洲北部及亚洲中部及东部地区。结论:气温升高有助于人参适宜产区增加,本研究结果可为人参生产布局规划、引种栽培、规模化种植提供科学依据。     

中药类产品国际市场分析

近年来,包括中药在内的植物药和传统药日益受到世界各国的重视和青睐。2015年,全球植物药市场销售额为931.5亿美元。但据中华人民共和国工业和信息化部最新统计数据显示,2014年我国中成药及饮片的销售额约1200亿美元。为进一步明确全球中草药市场现状及中药产品的国际市场份额,本研究从 PubMed 数据库、政府网站、研究报告及搜索引擎中收集相关数据,分析世界主要国家和地区的传统药物市场现状。结果显示,中药类产品包括中成药、中药饮片、中药提取物、中药保健品的国内外市场销售额约为1350亿美元,而我国中药类产品(不包括保健品)约占国际中草药或传统药物市场的80%。     

国际视野下全球卫生教育及启示

全球卫生教育是一个以跨国因素直接或间接引起的健康问题为重点的教育领域。目前,全球卫生教育迅速发展,国外高校纷纷设立全球卫生教育机构,开展通识教育、学位项目教育和非学位项目教育等形式多样的全球卫生教育,并且采取了提供经济资助、学分认定等扶持性措施。借鉴国际经验,我国在医学教育改革中应该支持并推动全球卫生教育的发展,加强高校全球卫生教育机构建设,鼓励开展形式多样的全球卫生教育活动,并提高全球卫生教育的国际化程度。     

养血清脑颗粒对蒙古沙鼠全脑缺血再灌注后Glu和Caspase-3表达的影响

目的探讨养血清脑颗粒对全脑缺血再灌注后的蒙古沙鼠的神经保护作用。方法采用蒙古沙鼠两血管（2-VO）结扎30rain再灌注损伤模型,将模型随机分为假手术组、模型组、治疗组。用Nieel染色法观察蒙古沙鼠海马细胞的变化,用免疫组织化学方法观察假手术组、模型组、治疗组Glu、caspase-3阳性细胞表达变化。并将3组结果进行比较。结果蒙古沙鼠全脑缺血再灌注治疗组海马CAl存活细胞数明显增加,Glu、caspase-3阳性细胞表达量较模型组明显降低,凋亡细胞相应减少。结论养血清脑颗粒能选择性抑制Glu、caspase-3的表达,减少神经细胞的死亡,发挥神经保护作用。     

无症状中国年轻人颈椎矢状位曲度正常值及其与全脊柱平衡的关系

目的：探讨无症状中国年轻人颈椎矢状位曲度的正常值及其与全脊柱平衡的关系。方法：2011年11月—2014年12月招募并选择年龄18～30岁的志愿者行全脊柱侧位X线检查,在X线片上测量指标包括C₀-C₂角、从C₂-C₃到C₆-C₇的间盘角、从C₃到C₇的椎体角、T₁倾斜角、胸椎后凸角(thoracic kyphosis, TK)、腰椎前凸角(lumbar lordosis, LL)、骨盆入射角(pelvic incidence, PI)、骶骨倾斜角(sacral slope, SS)、C₂-C₇矢状轴向垂线(C₂-C₇ sagittal vertical axis, C₂-C₇SVA)、头重心至C₇的矢状位轴向垂线(center of gra...     

Development and Validation of Global Leadership Initiative on Malnutrition for Prognostic Prediction in Patients Who Underwent Cardiac Surgery

The Global Leadership Initiative on Malnutrition (GLIM) has achieved a consensus for the diagnosis of malnutrition in recent years. This study aims to determine the prognostic effect of the GLIM after cardiac surgery. A total of 603 patients in the training cohort and 258 patients in the validation cohort were enrolled in this study. Perioperative characteristics and follow-up data were collected. A nomogram based on independent prognostic predictors was developed for survival prediction. In total, 114 (18.9%) and 48 (18.6%) patients were defined as being malnourished according to the GLIM criteria in the two cohorts, respectively. Multivariate regression analysis showed that GLIM-defined malnutrition was an independent risk factor of total complication (OR 1.661, 95% CI: 1.063–2.594) and overall survival (HR 2.339, 95% CI: 1.504–3.637). The c-index was 0.72 (95% CI: 0.66–0.79) and AUC were 0.800, 0.798, and 0.780 for 1-, 2-, and 3-year survival prediction, respectively. The calibration curves of the nomogram fit well. In conclusion, GLIM criteria can efficiently identify malnutrition and has a prognostic effect on clinical outcomes after cardiac surgery. GLIM-based nomogram has favorable performance in survival prediction.     

Global,regional, and national survey on the burden and quality of care of pancreatic cancer: a systematic analysis for the Global Burden of Disease study 1990–2017

BackgroundPancreatic cancer (PC) is among the most lethal cancers worldwide, and the quality of care provided to PC patients is a vital public health concern. We aimed to investigate the quality of care of PC globally and to report its current burden.MethodsThe Quality of Care Index (QCI) was achieved by performing a Principal Component Analysis utilizing the results of the GBD study 2017. The QCI was defined as a range between 0 and 100, in which higher QCIs show higher quality of care. Possible gender- and age-related inequalities in terms of QCI were explored based on WHO world regions and the sociodemographic index (SDI).ResultsIn 2017, Japan had the highest QCI among all countries (QCI = 99/100), followed by Australia (QCI = 83/100) and the United States (QCI = 76/100). In Japan and Australia, males and females had almost the same QCIs in 2017, while in the United States, females had lower QCIs than males. In contrast to these high-QCI nations, African countries had the lowest QCIs in 2017. Besides, QCI increased by SDI, and high-SDI regions had the highest QCIs. Regarding patients’ age, elderly cases had higher QCIs than younger patients globally and in high-SDI regions.ConclusionThis study provides clinicians and health authorities with a wider vision around the quality of care of PC worldwide and highlights the existing disparities. This could help them investigate possible effective strategies to improve the quality of care in regions with lower QCIs and higher gender- and age-related inequities.