基于Apriori算法与网络药理学的藏医治疗肝胆疾病用药规律及机制分析＊

目的 挖掘藏医治疗肝胆疾病的用药规律，寻找核心药组，并预测核心药组的潜在靶点，以探讨核心药组治疗肝胆疾病的作用机制。方法 收集藏医药典籍中治疗肝胆疾病处方，采用SPSS软件进行Apriori算法关联规则分析得到藏医治疗肝胆疾病的核心药组。检索中药系统药理学分析平台（TCMSP）、Therapeutic Target Database （TTD）、Genecards、Metascape等数据库进行基因本体（GO）和KEGG富集分析。结果 共纳入607首方剂，数据挖掘得到藏医治疗肝胆疾病的核心药组为蒂达-洪连-波棱瓜子。收集到核心药组56个活性成分，作用于47个关键靶点，预测出1194条生物过程、49个细胞组成、54个分子功能以及226条信号通路。结论 藏医在治疗肝胆疾病中主要以“清赤巴热”为核心，所使用方剂中的药物多以苦味为主；核心药组治疗肝胆疾病可能是通过缓解体内氧化应激、降低炎症表达以及调节胆汁酸肝肠循环等作用机制。     

Effect of political imprisonment and trauma history on recent Tibetan refugees in India

We sought to examine the impact of political imprisonment on anxiety, depression, and somatic symptoms reported by newly arrived Tibetan refugees in Dharamsala, India. We used the Hopkins Symptom Checklist-25 to compare 76 previously imprisoned with 74 never imprisoned recent Tibetan refugees. Previously imprisoned refugees reported more traumatic events, especially torture and deprivation. Previously imprisoned refugees reported more anxiety than nonimprisoned refugees, but the groups were similarly high in terms of depression and number of somatic complaints. According to assessment with the Harvard Trauma Questionnaire, 20% of the tortured and imprisoned refugees met criteria for posttraumatic stress disorder.     

Maternal and child health in Yushu, Qinghai Province, China

Introduction

Surmang, Qinghai Province is a rural nomadic Tibetan region in western China recently devastated by the 2010 Yushu earthquake; little information is available on access and coverage of maternal and child health services.

Methods

A cross-sectional household survey was conducted in August 2004. 402 women of reproductive age (15-50) were interviewed regarding their pregnancy history, access to and utilization of health care, and infant and child health care practices.

Results

Women's access to education was low at 15% for any formal schooling; adult female literacy was <20%. One third of women received any antenatal care during their last pregnancy. Institutional delivery and skilled birth attendance were <1%, and there were no reported cesarean deliveries. Birth was commonly attended by a female relative, and 8% of women delivered alone. Use of unsterilized instrument to cut the umbilical cord was nearly universal (94%), while coverage for tetanus toxoid immunization was only 14%. Traditional Tibetan healers were frequently sought for problems during pregnancy (70%), the postpartum period (87%), and for childhood illnesses (74%). Western medicine (61%) was preferred over Tibetan medicine (9%) for preventive antenatal care. The average time to reach a health facility was 4.3 hours. Postpartum infectious morbidity appeared to be high, but only 3% of women with postpartum problems received western medical care. 64% of recently pregnant women reported that they were very worried about dying in childbirth. The community reported 3 maternal deaths and 103 live births in the 19 months prior to the survey.

Conclusions

While China is on track to achieve national Millennium Development Goal targets for maternal and child health, women and children in Surmang suffer from substantial health inequities in access to antenatal, skilled birth and postpartum care. Institutional delivery, skilled attendance and cesarean delivery are virtually inaccessible, and consequently maternal and infant morbidity and mortality are likely high. Urgent action is needed to improve access to maternal, neonatal and child health care in these marginalized populations. The reconstruction after the recent earthquake provides a unique opportunity to link this population with the health system.     

西藏自治区尼玛县一起导致3例死亡病例的水痘暴发疫情分析

目的 查明此次水痘疫情暴发的传染来源、传播途径和感染危险因素,为有效防控疫情提供科学依据.方法 本次暴发调查的病例定义为:2010年11月7日以来,尼玛县吉瓦乡四村当贡自然村的村民中,出现发热(腋下温度≥37.3℃或自述发热者)伴有皮疹者.应用调查问卷搜集病例信息,主要内容包括基本信息(年龄、性别、住址)、发病时间、临...