课题研究引领下的高校精品课程建设

课题研究引领下的高校精品课程建设,发展教育教学优质资源网上共享机制,加强高等教育的开放性,提高教学水平和教学质量。     

中药新药研发的立题依据及评价思路

立题依据是中药新药研发的一项重要内容,本文分析了当前注册申请的中药新药不同的立题依据,介绍了源于古方、依据临床应用经验、依据中医药理论组方、依据现代药理研究结果等不同的立题依据在新药研发中的风险和优势,分析了申报资料应注意哪些问题,如何开展相关的研究工作,如何才能提高新药研发的成功率。并从审评角度分析了非临床药效学试验的必要性,药效学试验应重点关注的内容,以及其结果对支持中药新药进行临床试验在立题依据方面的作用。     

基于信息系统的医院ICU管理实践

重症加护病房（ICU）是对危重病人进行“集中／强化”治疗的场所,其规模和质量在一定程度上体现了呕症陕学学科的技术能力和建设水平。然而,目前国内外关于ICU的管理模式各具特色、不一而同。因此信启、技术对ICU的作用广泛而深刻。结合重症监护信息系统（CIS）存医院的应用,阐述了在建立全院级晕症峪护协作中心,创新ICU管理模式的框架下,利用信息、技术实现了ICU分散式设定、集约型管理、同质性服务、数字化运行的管理实践。一年多来的运行表明,该模式在管理上同步发展、住技术上统一规范、在学术上其享资源,成为医院虚拟学科建设的又一成功典范。     

研究生失眠的临床技术干预与效果分析

目的考察条件性情绪干预对失眠来访者治疗的有效性。方法采用单被试多基线实验设计对1名患有失眠的研究生来访者进行个案实验研究。结果来访者在基线观察期具有明显的失眠症状,SCL-90睡眠分量表为4分,经过对其正式干预后SCL-90睡眠分量表为1分,失眠症状基本消失。预后效果良好。结论条件性情绪干预是治疗失眠有希望的方法。     

Recruitment to a Randomized Web-Based Nutritional Intervention Trial: Characteristics of Participants Compared to Non-Participants

Background

Web-based behavioral programs efficiently disseminate health information to a broad population, and online tailoring may increase their effectiveness. While the number of Internet-based behavioral interventions has grown in the last several years, additional information is needed to understand the characteristics of subjects who enroll in these interventions, relative to those subjects who are invited to enroll.

Objective

The aim of the study was to compare the characteristics of participants who enrolled in an online dietary intervention trial (MENU) with those who were invited but chose not to participate, in order to better understand how these groups differ.

Methods

The MENU trial was conducted among five health plans participating in the HMO Cancer Research Network in collaboration with the University of Michigan Center for Health Communication Research. Approximately 6000 health plan members per site, between the ages of 21 and 65, and stratified by gender with oversampling of minority populations, were randomly selected for recruitment and were mailed an invitation letter containing website information and a US$2 bill with the promise of US$20 for completing follow-up surveys. Administrative and area-based data using geocoding along with baseline survey data were used to compare invitees (HMO members sent the introductory letter), responders (those who entered a study ID on the website), and enrollees (those who completed the enrollment process). Generalized estimating equation multivariate and logistic regression models were used to assess predictors of response and enrollment.

Results

Of 28,460 members invited to participate, 4270 (15.0%) accessed the website. Of the eligible responders, 2540 (8.9%) completed the consent form and baseline survey and were enrolled and randomized. The odds of responding were 10% lower for every decade of increased age (P < .001), while the likelihood of enrolling was 10% higher for every decade increase in age (P < .001). Women were more likely to respond and to enroll (P < .001). Those living in a census tract associated with higher education levels were more likely to respond and enroll, as well as those residing in tracts with higher income (P < .001). With a 22% (n = 566) enrollment rate for African Americans and 8% (n = 192) for Hispanics, the enrolled sample was more racially and ethnically diverse than the background sampling frame.

Conclusions

Relative to members invited to participate in the Internet-based intervention, those who enrolled were more likely to be older and live in census tracts associated with higher socioeconomic status. While oversampling of minority health plan members generated an enrolled sample that was more racially and ethnically diverse than the overall health plan population, additional research is needed to better understand methods that will expand the penetration of Internet interventions into more socioeconomically diverse populations.

Trial Registration

Clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00169312","term_id":"NCT00169312"}}NCT00169312; http://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT00169312","term_id":"NCT00169312"}}NCT00169312 (Archived by WebCite at http://www.webcitation.org/5jB50xSfU)     

A case of pure red cell aplasia and systemic lupus erythematosus caused by human parvovirus B19 infection

Human parvovirus B19 (B19) rarely induces pure red cell aplasia (PRCA) in healthy hosts. Meanwhile B19 infection is often clinically similar to systemic lupus erythematosus (SLE), and several cases have been reported wherein B19 actually stimulated SLE exacerbation in an immunocompetent subject. An 82-year-old healthy woman was diagnosed to have complicated with B19 infection and PRCA. Four weeks later, she had high fever, polyarthritis, and oral ulcers, additionally diagnosed with SLE, and subsequently, 15 mg of prednisone was started. This is the first case wherein B19 infection caused both PRCA and SLE in a healthy patient as far as our investigations are concerned.     

Prolonged Delays for Research Training in Medical School are Associated with Poorer Subsequent Clinical Knowledge

Background Complementary degree programs and research training are important alternative tracks in medical school that typically interrupt the traditional MD curriculum. Objective Examine effects of such a break on clinical knowledge after reentry into the MD curriculum. Design Retrospective cohort study. Participants Three hundred and two graduates of Mayo Medical School. Main Measurements Compared years of delay between the second and third years of medical school with third year clerkship grades, National Board of Medical Examiner’s (NBME) Subject Examinations, and United States Medical License Exam (USMLE) Step 2. Main Results 258, 13, and 31 students spent 0, 1, or ≥3 years pursing research between the second and third year. Baseline measures of knowledge before matriculation and before the third year were similar between groups. Whereas a 1-year delay had no significant effect, a ≥3-year delay was associated with fewer clerkship honors and lower NBME Medicine, Pediatrics, and Psychiatry percentiles compared to no delay (all p < .05). Students with a ≥3-year delay had a 77% reduction in the odds of honors in Medicine. For each year of delay beyond 3, students’ third-year NBME Medicine, Neurology, Obstetrics and Gynecology, and Psychiatry scores decreased as did USMLE Step 2 scores (r = −.38 to −.50, p < .05). Conclusions Delays of ≥3 years between the second and third years of medical school are associated with lower grades and scores on clinical knowledge tests. Further research is needed to determine the optimal timing of research training and develop effective interventions to facilitate reentry into the medical school curriculum.     

主体教育思想在大学生健康教育中的应用探讨

大学生健康教育的主体是大学生,大学生健康教育的关键是将科学的健康知识传授给大学生,并被运用于日常生活。随着主体教育理论的发展和完善,它受到越来越高的重视,被广泛应用于各门学科。针对大学生健康教育的特殊情况,文章提出在健康教育实践中可以通过“学生的自学”、“学生的自我”、“学生的自醒”三个原则实现主体教育理论在大学生健康教育中的应用,从而更好地促进大学生健康教育的发展。     

Single- and multiple-dose pharmacokinetics of genistein capsules in healthy chinese subjects: A phase I, randomized, open-label study

Background: Genistein capsules are currently being developed to treat osteoporosis in China. Genistein is extracted from the fruit of Sophora japonica Leguminosae.Objective: The objective of this study was to assess the pharmacokinetics of genistein capsules after single and multiple oral doses in healthy Chinese subjects.Methods: This was a Phase I, randomized, open-label, single- and multiple- dose study in healthy Chinese adults (aged 19-40 years). In the single-dose study, subjects were randomly assigned in a 1:1:1 ratio to receive genistein 50, 100, or 300 mg (in 50-mg capsules). To assess the effect of food on the pharmacokinetics, subjects in the 50-mg group were equally randomized again into fasting and postprandial (genistein was administered after a high-fat breakfast) groups according to a 2-way cross-over design. A separate equal-sized group of subjects were administered genistein 50 mg on day 1 (single dose), received no treatment on days 2 and 3, and were administered genistein 50 mg QD for 6 days (days 4-9) to obtain a multiple-dose pharmacokinetic profile. Because genistein is converted so rapidly and completely to glucuronidated genistein after administration, plasma concentrations of glucuronidated genistein were determined using a validated high-performance liquid chromatography/ tandem mass spectrometry method. Drug tolerability was assessed by monitoring adverse events (AEs) and laboratory parameters.Results: The study enrolled 40 healthy subjects (24 men, 16 women; 10 each in the 50-, 100-, and 300-mg single-dose groups and 10 in the multiple-dose group). Three subjects voluntarily withdrew (2 in the 100-mg group and 1 in the 300-mg group) before study drug administration. Thirty-seven subjects (24 men, 13 women) completed the study and were included in the analysis. The mean (SD) values of the single-dose genistein 50-, 100-, and 300-mg groups were as follows: T_max, 6.0 (2.4), 7.4 (2.4), and 5.6 (1.2) hours, respectively; t_l/2, 13.0 (4.0), 12.6 (5.8), and 9.4 (1.1) hours; AUC_0−t, 3344 (1635), 8389 (5164), and 9361 (2428) ng/mL · h⁻¹; and C_max , 218.7 (68.6), 435.7 (202.1), and 553.4 (152.8) ng/mL. The plasma glucuronidated genistein concentrations were directly proportional to the administered dose over the range of 50 to 100 mg and increased nonproportionately with the 300-mg dose. No statistically significant differences in pharmacokinetic parameters were found in the fasting group compared with the postprandial group. In the multiple-dose group, the mean (SD) steady-state pharmacokinetic parameters on day 9 were similar to those following a single dose of genistein on day 1 (T_max, 6.0 [1.0] vs 5.9 [1.5] hours, respectively; t_l/2, 9.5 [1.5] vs 9.1 [1.5] hours; AUC_0−t, 2830 [1541] vs 2078 [1308] ng/mL · h⁻¹; C_max, 203.1 [130.9] vs 168.4 [105.7] ng/mL). All AEs were assessed as mild or moderate and resolved without treatment, with the exception of elevated alanine aminotransferase and aspartate aminotransferase activities in one subject that resolved with treatment.Conclusions: The pharmacokinetics of glucuronidated genistein appeared to fit the linear-dose range of genistein 50 to 100 mg, but not the 300-mg dose in these healthy Chinese volunteers. Food consumption did not significantly affect the pharmacokinetic properties. No significant differences were observed in the pharmacokinetic parameters after multiple doses of genistein compared with a single dose, suggesting that the drug did not accumulate after multiple doses.     

肿瘤;规范化诊治;学科参考咨询

以“肿瘤规范化诊治”课题为例,探讨了应用Web2．0环境中的信息共享技术开展学科参考咨询的方法和途径。