人才学分支学科研究（一）

实施人才强国战略，我们必须自始至终认真研究和解决人才和人才问题，加强对人才学的交叉性边缘性深度性研究，丰富和发展人才学学科体系是构建学习型社会的需要。本文重点对人才学的新兴交叉分支学科进行了探讨，以供研究者管理者参考。     

Modeling and visualizing two‐way contingency tables using compositional data analysis: A case‐study on individual self‐prediction of migraine days

Two‐way contingency tables arise in many fields, such as in medical studies, where the relation between two discrete random variables or responses is to be assessed. We propose to analyze and visualize a sample of 2 × 2 tables in the context of single‐subject repeated measurements design by means of compositional data (CoDa) methods. First, we propose to visualize the tables in a quaternary diagram. Second, we show how to represent these tables by means of logratios indicating the relationship between the two variables as well as their strength and direction of dependency. Finally, we describe a technique to model those tables with a simplicial regression model. Data from a real‐world study of self‐prediction of migraine attack onset is used to illustrate this methodology. For each individual, the 2 × 2 table of their migraine expectation vs next day migraine occurrence is computed, generating a sample of tables. Then we visualize and interpret the prediction ability of individuals both in the simplex and in terms of logratios of components. Finally, we model the self‐prediction ability with respect to demographic variables, days tracked and disease characteristics. Our application demonstrates that CoDa can be a useful tool for visualizing, modeling, and interpreting the components of 2 × 2 tables.     

Reducing uncertainty when using knee‐specific finite element models by assessing the effect of input parameters

Little is known about knee‐specific factors that influence contact mechanics. Finite Element (FE) models offer a powerful tool to study contact mechanics, but there often exists ambiguity in the exact values of the inputs (e.g., tissue properties), which can result in a range of output values. Our objective was to quantify the reduction in the range of output values (defined herein as “uncertainty”) from FE models of the human knee joint when known pre‐defined values are used for clinically measurable inputs. To achieve this goal, we applied a statistically augmented FE approach to three human cadaveric knees for which full geometric and kinematic data were available. Two sets of conditions were simulated: All model inputs, clinically measurable or not, were varied to represent a “normal” patient population (Condition 1); subsets of clinically measurable variable inputs were fixed at specific values (called “patient derived inputs,” or PDIs) while the other variables were varied over “normal” values (Condition 2). We found that by fixing body mass index and the anterior–posterior position of the meniscal‐bony insertion points, model output uncertainty was reduced by one‐ to three‐fifths. The magnitude of uncertainty reduction was strongly influenced by the individual knee. It was observed that knees with great anterior–posterior translation during gait had greater reductions in uncertainty when PDIs were used. This study represents the first step in developing FE models of the human knee joint based on inputs that can be derived from patients in a clinical setting. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2233–2242, 2017.

     

医师胜任特征探讨

采用主题分析和内容分析建立医师胜任特征,采用专家咨询对各胜任特征进行重要性评价。结果显示：人际关系能力是医师胜任力的重要特征;专业基本素质是医师胜任力的核心特征;职业发展能力、个人发展能力和心理特质是胜任力中的基本特征。     

Evaluation of oxidative stress and antioxidant status: Correlation with the severity of sepsis

Sepsis is a condition caused by infection followed by unregulated inflammatory response which may lead to the organ dysfunction. During such condition, over‐production of oxidants is one of the factors which contribute cellular toxicity and ultimately organ failure and mortality. Antioxidants having free radicals scavenging activity exert protective role in various diseases. This study has been designed to evaluate the levels of oxidative and antioxidative activity in sepsis patients and their correlation with the severity of the sepsis. A total of 100 sepsis patients and 50 healthy controls subjects were enrolled in this study from the period October 2016 to June 2017. The investigation included measurements of oxidative enzyme, myeloperoxidase (MPO ), antioxidant enzymes including superoxide dismutase activity (SOD ) and catalase activity (CAT ) and cytokines (TNF ‐α, IL ‐8 and IFN ‐γ). Furthermore, the level of these activities was correlated with severity of sepsis. Augmented levels of oxidants were found in sepsis as demonstrated by DMPO nitrone adduct formation and plasma MPO level activity (1.37 ± 0.51 in sepsis vs 0.405 ± 0.16 in control subjects). Cytokines were also found to be increased in sepsis patients. However, plasma SOD and CAT activities were significantly attenuated (P  < .001) in the sepsis patients compared with controls subjects. Moreover, inverse relation between antioxidant enzymes (SOD and CAT ) and organ failure assessment (SOFA ), physiological score (APACHE II ), organ toxicity specific markers have been observed as demonstrated by Pearson's correlation coefficient. This study suggests that imbalance between oxidant and antioxidant plays key role in the severity of sepsis.     

The complement lectin pathway after cardiac arrest

The lectin pathway (LP ) of the complement system may initiate inflammatory reactions when body tissue is altered. We aimed to investigate the levels of the LP proteins in out‐of‐hospital cardiac arrest patients, and to compare these with healthy individuals. Furthermore, we aimed to clarify whether the duration of targeted temperature management influenced LP protein levels, and we further examined whether LP proteins were associated with 30‐day mortality. We included 82 patients resuscitated from out‐of‐hospital cardiac arrest. The patients were randomly assigned to 24 or 48 hours of targeted temperature management at 33 ± 1°C. Blood samples were obtained 22, 46 and 70 hours after target temperature was reached. Levels of the LP proteins (mannan‐binding lectin [MBL ], M‐ficolin, H‐ficolin, collectin liver 1 [CL ‐L1], MBL ‐associated serine protease 1 [MASP ‐1], MASP ‐2, MASP ‐3 and MBL ‐associated protein of 44 kDa [MA p44]) were measured using time‐resolved immunofluorometric assays. Data from 82 gender matched healthy individuals were used for comparison. Levels of CL ‐L1, MASP ‐1, MASP ‐2 and MA p44 were significantly higher, whereas M‐ficolin levels were significantly lower in cardiac arrest patients compared with healthy individuals. MASP ‐2, MASP ‐3 and M‐ficolin levels changed significantly when comparing 24 and 48 hours of targeted temperature management. The LP protein levels were not different between 30‐day survivors and non‐survivors after cardiac arrest. The differences in LP protein levels between patients and healthy individuals may indicate that cardiac arrest patients have an activated LP . Overall, the LP protein levels were not influenced by the duration of targeted temperature management, and the levels were not associated with 30‐day mortality.     

冬凌草化学成分的研究

笔者对国内部分医药高等院校在国贸专业的招生及方向设置等情况进行调查分析，建议加强对国贸专业分化的研究与大胆尝试，适度增加医药院校国贸专业的新方向。同时，医药院校在开设国贸专业的时候，需要突出国贸专业的医药特色。     

Backward disequilibrium in elderly subjects

Backward disequilibrium is observed frequently in daily clinical practice. However, there are no epidemiological data concerning this postural disorder. Defined by a posterior position of the centre of mass with respect to the base of support, backward disequilibrium is abnormal postural behavior, usually characterized by a posterior trunk tilt in standing and sitting positions, which predisposes subjects to backward falls. Many afflictions whether they are somatic (degenerative, ischemic and traumatic brain lesions), psychosomatic (psychomotor disadaptation syndrome, confinement to bed, nonuse situations) or psychological (depression) can cause backward disequilibrium. A vicious circle of falls, and loss of autonomy can arise and this is the main consequence of backward disequilibrium. Thus, in this paper, we review backward disequilibrium in elderly subjects with regard to the causes, consequences, assessment, and management.     

右江民族医学院民族医药学科建设的现状与思考

通过对右江民族医学院民族医药学科发展的历史回顾,针对民族医药学科建设存在的突出问题,提出民族医药学科建设的总体构想:凝炼学科方向,突出学科特色;强化学科队伍建设,构建学科人才方阵;加强学科基本条件建设,搭建学科发展平台。