中药干预对急性心肌梗死远期预后影响的回顾性研究

目的回顾性分析早期使用中药对首次急性心肌梗死(AMI)患者远期预后的影响。方法以1996年1月~2002年4月因AMI在北京中医药大学附属东直门医院、东方医院心内科住院并渡过急性期(28d)且资料完整的所有患者(共162例)为研究对象;随访患者发生联合终点事件(死亡和重大心脑血管事件)的情况;单因素分析采用Kaplan-Meier法描绘生存曲线,用log-rank法进行比较检验,多因素分析采用Cox回归分析。结果单因素分析显示使用中药汤剂患者无事件生存率高于未使用者(P<0.01);多因素分析显示年龄、前壁梗死、心功能减低、心律失常和糖尿病史与联合终点事件的风险呈正相关,而使用血管紧张素转化酶抑制剂(ACEI)和中药汤剂呈负相关,其中中药汤剂的相对危险度RR为0.093(95%CI=0.029~0.294,P<0.001)。结论年龄、心力衰竭、前壁梗死、梗死后心律失常、糖尿病史是AMI远期预后的危险因素,而早期应用中药汤剂和ACEI制剂是AMI远期预后的保护因素,初步从回顾性研究的角度为中医药治疗AMI提供了基于循证医学的证据。     

摩梭人传统医药知识研究

目的:以世代居住于泸沽湖地区(包括云南省的永宁乡和四川省泸沽湖镇)的摩梭人为研究对象,对其传统医药知识进行调查研究。方法:本研究应用医学人类学基本原理和方法,对传统医药知识及其相关影响因素进行调查。结果:感冒、胃肠炎、风湿病、高血压和妇科疾病为当地常见病;摩梭人就医行为在医疗文化中展现其多重性、多元性;摩梭人的传统医药知识掌握在年长妇女手里;宗教在摩梭人的生老病死中扮演着重要的角色;在朴素的对疾病和病因的认识上,摩梭人的传统医药还处于巫医结合的原始阶段;摩梭人传统医药文化受多民族医药文化的影响。结论:泸沽湖地区摩梭人传统医药知识具有丰富的内涵,对传统医药知识的发掘整理具有重要的学术和现实意义。     

Toward a prostate cancer precision medicine

The promise of precision cancer medicine is that we will be able to pair clinical and genomic data to provide better and more efficient treatment for cancer care. Although the focus is on the optimal pairing of existing Food and Drug Administration–approved drugs with the patient׳s tumor, precision medicine should also help determine a patient׳s risk for disease progression. Precision medicine will hopefully also lead to improved molecular biomarkers. The specific needs for predictive biomarkers vary significantly based on cancer type. The chief aim for prostate cancer biomarker development is to help distinguish indolent from aggressive disease.     

Do Job Demands of Chinese Manufacturing Employees Predict Positive or Negative Outcomes? A Test of Competing Hypotheses

Karasek's job demands–control (JDC) model posits that job control can buffer against the harmful effects of demands experienced by employees. A large volume of JDC research has obtained support for the main effects of demands and control, but not the interactive effects. Recent research on the challenge–hindrance stressors framework, however, found that work stressors may not always be deleterious, suggesting alternative hypotheses about the effects of demands and control. The present study therefore examined competing hypotheses concerning the effects of job demands on occupational health outcomes. Using a sample of 316 employees in a Chinese manufacturing company, we found that, consistent with the challenge–hindrance framework, production demands were challenge stressors associated with favourable outcomes (i.e. job satisfaction and psychological well‐being). In addition, results showed that the interactive role of job control depended on the nature of outcome variables. Future recommendations and implications of findings are discussed. Copyright © 2014 John Wiley & Sons, Ltd.     

The Chinese approach to complementary and alternative medicine treatment for interstitial cystitis/bladder pain syndrome

Management of interstitial cystitis/bladder pain syndrome (IC/BPS) remains a challenge due to poor understanding on its etiology. Complementary and alternative medicine (CAM), as an optional treatment, has been widely used, because no definitive conventional therapy is available. The different domain of CAM provides miscellaneous treatments for IC/BPS, which mainly include dietary modification, nutraceuticals, bladder training, biofeedback, yoga, massage, physical therapy, Qigong, traditional Chinese medicine and acupuncture. Clinical evidence has shown that each therapy can certainly benefit a portion of IC/BPS patients. However, the target patient group of each therapy has not been well studied and randomized, controlled trials are needed to further confirm the efficacy and reliability of CAM on managing IC/BPS. Despite these limitations, CAM therapeutic characteristics including non-invasive and effectiveness for specific patients allow clinicians and patients to realize multimodal and individualized therapy for IC/BPS.     

Mentoring Underrepresented Minority in Medicine (URMM) Students Across Racial,Ethnic and Institutional Differences

Cross cultural mentoring for underrepresented minority in medicine (URMM) students has increased significance. It is especially important for non-URMM faculty and others from different backgrounds, ethnicities and cultures to know how to provide mentorship for URMM student success. This article provides approaches to mentorship for URMM students. Recommendations include mentoring around scholarly projects, identifying mentorship role, acknowledging personal attributes for mentoring, addressing racism, stereotypes and bias, collaborating with Historically Black Colleges and Universities and being attentive to the unique needs of URMM students.