中学生考试焦虑问题的综述研究

目的中学生由于必须面对中考、高考等与自身前途命运密切相关的重大考试．考试焦虑问题也就显得尤为突出。本文旨在探讨中学生考试焦虑的成因及其干预策略。方法采用综述研究法。结果本文将相关理论研究更为系统化．将其更加密切地纳入心理学的理论体系之中．并将理论结合中学教育实践进行探索与研究。结论只要学生掌握了这些考试焦虑的调试方法，就能很好地调整自身考试状态，预防考试过度焦虑。     

A patient with an interstitial deletion of the short arm of chromosome 6

The clinical history and subsequent progress of a child with an interstitial deletion in the short arm of chromosome 6 is described. This abnormality coupled with a reduced Hageman factor (Factor XII) led to an earlier publication which suggested that this gene was localized to the breakpoint region involved. A review of similar phenotypes from the literature is presented.     

Pancreatic glucagonoma with and without syndrome

Summary In five patients single or multiple glucagonomas were characterized by immunocytochemistry. Two large single glucagonomas were associated with the glucagonoma syndrome, which completely dissappeared after removal of the tumours. The morphologic findings in these patients are compared with 48 others collected from literature.In the other three patients, the glucagonomas were not associated with a clinical syndrome and were detected by chance (one accompanying an insulinoma; the other in pancreases of patients suffering from multiple endocrine neoplasia I; MEN I). These tumours appeared by their histological, immunocytochemical and ultrastructural features better organized than the glucagonomas with syndrome.Glucagonomas not producing a syndrome can be classified into (a) solitary, often malignant endocrine pancreatic tumours, (b) glucagonomas associated with insulinomas and other tumours, (c) multiple glucagonomas in MEN I and (d) single microglucagonomas in elderly patients. It is emphasized that only immunohistology allows clear identification of these tumours as glucagonomas.     

Pathophysiology of mild endometriosis: review of literature

Endometriosis is a puzzling condition and the literature ischaracterized by a large number of uncontrolled reports on itsaetiology and pathophysiology. In particular the relationshipbetween mild endometriosis and subfecundity is uncertain. Thispaper critically reviews the published literature on the pathogenesis,prevalence, menstrual symptomatology and natural history ofendometriosis. Furthermore, factors implicated in causing subfecundityin relation to endometriosis and the impact of various treatmentsin enhancing fertility among women with mild endometriosis havebeen assessed.     

Intraparenchymal pulmonary lymph node: case report and literature review

Summary A case of a 44-year-old woman with a solitary pulmonary coin lesion is presented. Histologic study of this nodule revealed a normal intraparenchymal pulmonary lymph node. A review of the literature discusses the incidence and characteristics of this entity.

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Nud lymphatique intrapulmonaire: revue de la littérature. A propos d'un cas

Résumé L'observation d'un cas de lésion nodulaire du poumon est rapportée chez une femme de 44 ans. L'étude histologique du nodule a révélé un nud lymphatique intrapulmonaire normal. La revue de la littérature apprécie l'incidence et les caractéristiques de cette localisation.

     

护士主导的高血压管理范围综述

目的对国内外护士主导的高血压管理相关研究进行范围审查,为完善护士主导的高血压防治措施提供循证建议。方法系统检索中国生物医学文献数据库、中国知网、万方、维普、Web of Science、PubMed、CINAHL、Cochrane和Embase等数据库2010年1月1日至2020年9月20日相关研究,提取相关信息。结果共纳入22篇文献。主导护士类别包括社区护士、医院护士、专科护士,管理团队以护士主导的多学科团队为主,管理形式以面对面会议、电话随访、电子邮件等形式为主,管理内容涉及评估、设定健康目标、个性化指导、与多学科团队沟通、转介、评价与反馈等,评价指标以患者血压变化/血压控制达标率、治疗/服药依从性为主,仅1项以社区护士为主导的研究显示与常规护理相比血压未明显下降。结论护士主导的高血压管理措施对单纯性原发性高血压具有较好效果。建议基于区域医联体,建立医院—社区—家庭高血压管理模式;完善我国社区护士认证与培养体系;借鉴其他发展中国家护士处方权经验,结合我国国情,制定相关法律法规,适当给予护士一定范围内处方权;发展“互联网+”慢病管理模式。     

以重点监控药品管理促进合理用药水平提升

通过开展以“合理用药”为核心的重点监控药品管理,促进合理用药水平提升。采取事后处方点评及处方前置审核,建立和完善重点监控药品管理方案,对不合理用药进行拦截、宣教、绩效处罚、限量采购、约谈等,实现了重点监控药品规范化管理。实践后,不合理医嘱减少,处方点评合格率提升,辅助用药种类减少。认为建立重点监控药品管理的相关制度及流程,对提升合理用药水平有一定促进作用。     

提质增量,卓越发展:《国家科学评论》办刊实践与进展

【目的】 介绍《国家科学评论》(National Science Review,NSR)的办刊实践,以期促进我国英文科技期刊办刊经验的交流。【方法】 以NSR为研究对象,结合办刊特色及发展实践,探讨建设高水平期刊的策略与举措。【结果】 NSR在重要研究成果组约和发表、访谈和论坛举办、学术质量控制、学术影响提升等方面开展了大量卓有成效的工作,有效地提高了期刊的品牌声誉,较好地服务了学术传播与交流。【结论】 NSR初步实现了全方位、多角度反映中外自然科学研究重要成就的定位和目标,学术指标和影响力得到快速提升,其办刊实践可为我国科技期刊的高质量发展提供参考与借鉴。     

The History and Future of the “ISPOR Value Flower”: Addressing Limitations of Conventional Cost-Effectiveness Analysis

ObjectivesSince its publication as part of the 2018 ISPOR Special Task Force (STF) on US Value Assessments, the “ISPOR value flower,” with its petals highlighting elements that may be overlooked or underappreciated in conventional drug value assessments, has been discussed and debated. We review the history of the value flower, describe recent developments, and consider implications for future value assessments.MethodsWe discuss various antecedents to the value flower, as well as conceptual and empirical articles published in the past 4 years.ResultsSince the publication of the ISPOR STF report, researchers have provided more rigorous theoretical and mathematical foundations for certain novel value elements (eg, severity of illness, value of insurance, value of hope) through “generalized risk-adjusted cost-effectiveness analysis,” which incorporates risk aversion in people’s preferences and uncertainty in treatment outcomes. Empirical estimates are also emerging to support key elements, such as insurance value, real option value, value of hope, and value of knowing. Although health technology assessment bodies have applied or are considering certain elements (eg, severity modifiers to cost-effectiveness thresholds), other elements have yet to gain traction.ConclusionsFive years after the STF began its work, the development of novel value measures continues to evolve. Although it is encouraging to see supporting empirical studies emerging, more are needed. Additional efforts are also needed to illustrate how the estimates can be used in the deliberative processes that are integral to health technology assessments.     

基于古今文献对经典名方中细辛毒性的有效避减探析

目的：通过研究细辛的相关文献,对影响细辛毒性的关键信息进行梳理,为经典名方中细辛的合理应用提供依据。方法：通过文献计量学的方式,搜集细辛的古今相关文献,分析细辛毒性与药物基原、用药部位、炮制方式、药物剂型、方药配伍、服药方法及患者体质因素之间的关系。结果：在经典名方的研发过程中,细辛在当归四逆汤、厚朴麻黄汤中的用量分别为9、6 g,煎煮时间应>120 min;细辛在辛夷散、三痹汤、大秦艽汤、清上蠲痛汤种的单次用量分别为0.8、1.2、0.9、1.1 g;当归四逆汤、厚朴麻黄汤、清上蠲痛汤等应选用辽细辛的根茎,辛夷散可选择汉城细辛的根茎。在药物的炮制上,当归四逆汤、厚朴麻黄汤、三痹汤、大秦艽汤四方中的细辛可选用酒制;辛夷散、清上蠲痛汤中的细辛可选用炒制;另外,细辛的毒性与药物的配伍和患者的体质等因素均有着密切的关系。结论：该研究通过梳理有关细辛毒性的文献资料,得出了影响细辛毒性的关键信息,探析了细辛毒性的有效避减方式,为包含细辛的经典名方的合理开发和安全应用提供了更为充分的依据。