中医经皮给药研究进展

中医经皮给药即中药外治,本文主要从中医经皮给药渊源、临床应用及中药透皮吸收促进剂三方面进行综述,提出中医经皮给药应遵循辨证的原则、加大开发中药透皮吸收促进剂、临床给药应结合中医经络穴位理论、借助现代仪器促进透皮吸收、利用现代新的制剂技术等新观点。     

山海螺本草考证与临床研究进展简

目的：考证山海螺文献记载,综述其临床研究进展。方法：通过查阅古今文献,考证历代本草学对山海螺的记述,汇总其功效报道。结果：山海螺别名有：羊乳（根）、四叶参、奶党、奶树、白河车等,古代本草著作中作为＂羊乳＂的一种,山海螺为肺经药,兼入肝、脾经,是治疗气虚伴有阴津亏乏、痰结肿疡的良药,有扶正之功,无恋邪之弊,补中可清,清中有宣,润而不腻。结论：中医临床应用山海螺有悠久历史,其功效不断被发掘和完善,特别是治疗肿瘤疾患方面具有广阔应用和开发前景。     

Hunting for robust gene signature from cancer profiling data: Sources of variability,different interpretations,and recent methodological developments

Gene microarray is a powerful platform to investigate the expression patterns of thousands of genes simultaneously. One central objective of such analysis is to select sets of genes (i.e., gene signatures) which correlate with clinical characteristics, such as disease subtype diagnosis, response to drug treatment and prognosis. However, previous studies have found that mRNA signatures are highly unstable and strongly depend on the selection of patient samples. Based on five large microRNA profiling datasets, we empirically found that microRNA signatures are also generally unstable. Therefore, concerns arise regarding the reproducibility and clinical applicability of these derived gene signatures. Here, we first provide a brief review on the sources of variability and different interpretations of multiple distinct gene signatures. We then focus on those recent methodological progresses aimed at developing more stable gene signatures.     

Developments in surgical revascularization to achieve improved morbidity and mortality

Coronary artery bypass graft surgery remains the main treatment modality for multivessel coronary artery disease and has consistently been demonstrated to have significantly lower rates of major adverse cardiac and cerebrovascular events in comparison to percutaneous coronary intervention. In this article we will explore the advances over time and the recent refinements in the techniques of surgical revascularization and how these contribute to the superior outcome profile associated with coronary artery bypass graft surgery. These include the current outcome status of coronary artery bypass grafting; the major landmark trials, registries and meta-analyses comparing coronary artery bypass grafting and percutaneous coronary intervention; the developments in coronary artery disease lesion classification; the techniques for the physiological assessment of coronary artery lesions; bypass grafting using arterial conduits; the role of off-pump coronary artery surgery; the outcomes of reoperative surgery; hybrid techniques for coronary revascularization; minimally invasive coronary artery surgery and finally robotic surgery.     

Practice developments supporting change implementation in Wellington,New Zealand (NZ) for ‘continuity of care when transitioning complex preterm infants from NICU to home’

The discussion paper will focus on continuity of care relating to previous NZ research, specifically to transitioning complex preterm infants from NICU to home based on parent experiences, and on the practice developments that have occurred, to ensure optimal health outcomes. Previous NZ research discovered parent desire a consistent service delivery for the entire transition journey from NICU and at home.An informative and comprehensive opportunity has occurred for reflective professional practice, evaluation, development and implementation which have transpired in positive change through innovative practice developments and support change implementation in Wellington, NZ. This has resulted in the articulation of a model of care that has both embraced and integrated parental desires for a continuity of care process for complex preterm infants. This has been achieved by having the same Discharge Facilitator/Key Case Manager present within the NICU and external to the NICU for Home-based infants for the entire transition journey.The paper will focus and emphasis additional practice development changes and furthermore, will present a real purpose, for other countries to learn of such practice developments that have exemplified a celebratory success for families of Wellington, NZ.     

百草枯中毒的研究进展

随着百草枯(PQ)的广泛应用,PQ中毒事件数量逐年增加,已成为我国第二位的农药中毒事件。PQ对人有剧毒,中毒后致多脏器严重损害,病死率极高,其中毒机制尚不完全明确,氧自由基产生学说为大多数学者认可。PQ中毒暂无特效解毒药,临床上主要采取综合治疗的办法,如洗胃、导泻、吸附体内毒素、应用激素及免疫抑制剂、清除氧自由基、保护各脏器功能等,同时结合有效的血液净化手段,本文旨在对相关进展做一简要综述。     

应用ROC曲线分析颗粒凝集法检测儿童肺炎支原体抗体在近期感染中的效价水平

目的探讨分析颗粒凝集法(PA)检测儿童肺炎支原体抗体在近期感染中的最优诊断界值。方法对260例以干咳和发热为主要症状的疑似肺炎支原体感染患儿,经荧光定量聚合酶链反应(PCR)法确诊肺炎支原体感染160例及非肺炎支原体感染100例,采用颗粒凝集法(PA)检测疑似患儿血清中的肺炎支原体抗体水平,利用受试者工作特征曲线(ROC曲线)判断抗体效价的最优截断值。结果抗体效价水平>1∶160为最佳的阳性截断值,即在判断近期感染时的最优临床诊断界值。此时的灵敏度为67.5%,特异性为95%,阳性预测值95.6%,阴性预测值64.6%,ROC曲线面积为0.868。结论 PA法检测肺炎支原体抗体对儿童肺炎支原体感染具有一定的诊断价值,其抗体水平能反映患儿的近期感染或既往感染。     

An analysis of discourses shaping mental health practitioners

A mental health practitioner (MHP) role was introduced to health services in southern England in 2003. The paper will discuss the initial phase within a longitudinal research study. A discursive approach will be adopted in order to understand how healthcare discourses constrain and provide possibilities for the emergence of a new worker role in mental health. The manner in which MHPs understand and talk about their work is socially constructed in interaction and constantly being modified by competing discourses. This paper will analyse three overarching health discourses, namely, the biomedical, person-centred and psychological discourses that have shaped MHP trainees. Discourses intersect to inform the role, where practices of nursing, psychology, medicine and occupational therapy are combined. Thus, the inclusion of physical, psychological and person-centred components of care serve as a multifaceted approach to care. This form of interprofessionalism leads MHPs one step closer in the advance towards an interdisciplinary discourse of holistic care.     

Extramammary Paget’s Disease: Diagnosis,Pathogenesis, and Treatment with Focus on Recent Developments

Extramammary Paget’s disease (EMPD) is a rare neoplasm that usually develops in apocrine gland-bearing areas, such as the vulva, scrotum, and penis. EMPD may present with a focal, multifocal, or an ectopic lesion. Clinically, EMPD lesions often exhibit infiltrative erythema, which is sometimes similar to other skin disorders such as eczema. While primary EMPD arises as intraepithelial neoplasm of the epidermis, EMPD-like lesions may occur from epidermotropic spread of malignant cells or direct extension from an underlying internal neoplasm, known as secondary EMPD. Because treatment strategies differ for primary EMPD and secondary EMPD, accurate diagnosis based on detailed histopathological evaluation is required. In the early stages, EMPD usually shows indolent growth, and most cases are diagnosed as carcinoma in situ. However, invasive lesions may result in metastases, and deep invasion is associated with high incidence of metastases. Conventional chemotherapies have been used for EMPD treatment in patients with distant metastases, but the efficacy is not satisfactory, and the prognosis for such patients remains poor. Recent studies have provided various insights into the molecular pathogenesis of the development and advancement of EMPD, which may lead to novel treatment approaches for metastatic EMPD. This review addresses the diagnosis, pathogenesis, and treatment of EMPD with focus on recent progress in understanding this disease.     

磁共振波谱分析技术在颅脑疾病中的应用进展

近年来,随着磁共振波谱(magnetic resonance spectroscopy,MRS)技术的发展,磁共振成像已由大体形态学向功能、代谢及分子诊断水平迈进,对了解各种疾病(特别是颅脑疾病)的生化、病理生理变化、临床诊断、判断疾病预后和治疗效果均有非常重要的意义。