晕痣与白癜风的相关性及祛除晕痣中央痣对疗效的影响

 目的 探讨晕痣与白癜风的相关性及祛除晕痣中央痣对疗效的影响。方法 收集2010-07至2017-10就诊于武警特色医学中心白癜风门诊的晕痣患者的临床资料进行统计学分析。结果 144例晕痣患者平均发病年龄(20.69±12.73)岁,皮损单发118例(81.94%),多发26例(18.06%),好发于躯干部(48.62%)及面颈部(41.44%)。125例合并白癜风,其中非节段型占108例(86.40%),节段型占17例(13.60%),与单纯晕痣患者相比就诊时病程较长(P=0.014)。随访106例合并白癜风患者的临床转归情况,祛除晕痣中央痣的疗效明显好于非手术治疗组(P=0.001),而采取CO₂激光或者手术祛除晕痣中央痣两种方式之间差异无统计学意义(P=0.694)。17例单纯晕痣患者祛除晕痣中央痣组总体有效率为91.67%,明显好于非手术治疗组。结论 晕痣好发于青少年,皮损以单发多见,以躯干、面颈部好发。大部分晕痣合并白癜风,且以非节段型为主。祛除晕痣中央痣对于晕痣本身及伴发白癜风均可加快其消退。     

基于本体的临床医学知识库系统构建探讨

在阐述医学知识组织方法的基础上,指出以本体理念组织医学知识的重要性和必要性,具体探讨在本体理论的指导下构建临床医学知识库系统的思路。综合考虑网络环境下临床医生信息需求变化,构建以知识节点为对象的疾病库、药物库、检查库3大医学知识库,并在各库中通过知识节点建立起不同知识子库之间的关联。     

Transforming nursing education in a 140-character world: The efficacy of becoming social

A generational gap exists across educational settings today. The potential and actual mismatch of learning styles and curriculum delivery suggests that the current educational models are in need of change. The advent of social media has transformed students from passive recipients of information to co-creators and engaged members of a global and information rich community. Responding proactively with social media integration through a responsive curriculum delivery system would serve to enhance student engagement and improve collaborative learning opportunities. Future implications for social media use in research and education will allow for rapid and efficient research to practice dissemination.     

The effects of contextual relevance and ownership on a reaching and placing task

Aim:  This study investigated whether a more familiar environment and object ownership would result in enhanced motor performance.
Methods:  Thirty-two women from the community aged 30 to 60 years lifted and placed their mug and a second mug they did not own in their home kitchen and in a laboratory.
Results:  Although no differences were found on the factor of location, participants were more efficient (i.e. less movement time) when reaching for their own mug. Additionally, there were fewer movement units with their own mug in the lab than when at home.
Conclusions:  Implications are that perceived compatibility between context and ownership may influence the quality of movement. Further research is needed to investigate the role these factors have in the formation of meaning.     

种植体直径-长度比的三维有限元应力分析

目的:探讨直径与长度连续变化时选择种植体尺寸的方法。方法 :运用Pro/E和ANSYS软件建立不同长度(7¹6 mm)、不同直径(316 mm)、不同直径(3⁶ mm)的三维有限元模型,施加垂直荷载和侧向荷载,观察种植体位移峰值和骨组织VonMises应力峰值等评估指标。结果:垂直或侧向荷载作用下,随着直径和长度的增大,各评估指标均明显下降(60%6 mm)的三维有限元模型,施加垂直荷载和侧向荷载,观察种植体位移峰值和骨组织VonMises应力峰值等评估指标。结果:垂直或侧向荷载作用下,随着直径和长度的增大,各评估指标均明显下降(60%⁸0%),相关度分析显示,两种荷载下直径的影响均较大(约90%),长度的影响与荷载有关(垂直荷载:18%80%),相关度分析显示,两种荷载下直径的影响均较大(约90%),长度的影响与荷载有关(垂直荷载:18%⁶0%;侧向荷载:<7%)。直径-长度比兼顾种植体直径与长度,当确定皮质骨承载力及安全系数,便可由直径-长度关系曲线选择合适的种植体直径与长度。结论:种植体直径与长度均可明显影响种植体位移和骨组织应力峰值。本文介绍的直径长度比法可为临床医生选择、优化种植体提供一种新的思路。     

基于网络的大学英语教学机制与效果

教学既是知识要素的组织方式,也是方法和学习过程的传承载体.方法创新和学习过程在教学中的作用和效果一直是教学理论研究的重点.通过分析网络教学的创新和机制,借助系统学习模型重点探讨了网络教学的关联和学习激励,并结合教学效果阐述大学英语的教改意义.     

学习"五脏皆有不寐"证治经验的体会

在学习中医理论利临床实践中,对不寐与五脏病变的相关性进行分析。通过3145例失眠症患者的临床调查研究与辨证总结,浅谈“五脏皆有不寐”的证治体会。     

Movement dynamics and occupational embeddedness in a grasping and placing task

The investigators examined the movement dynamics of 39 female participants aged 22–52 years during a grasping and placing task with objects having varying levels of occupational embeddedness. The occupationally embedded (OE) condition involved labelled soup cans, the limited occupationally embedded (LOE) condition used unlabelled soup cans, and the non-occupationally embedded (NOE) condition used modelling clay having the same mass and relative size as the cans. The task involved grasping and placing the objects from a designated countertop location to a designated location on a cupboard shelf, with each condition involving three trials. It was hypothesized that the OE condition would yield the most efficient movement compared with the LOE condition, followed by the NOE condition. Data were collected using an electric goniometer placed on the participant's right elbow. Significance was found between the LOE and NOE conditions with angular displacement (p<0.05) and in the OE and NOE conditions with movement units (p<0.05). A limitation of the study was that there was little time between trials. This may have influenced participant performance on subsequent trials. In addition, the investigators were not blind to the hypotheses and could have inadvertently influenced the participant during data collection. Clinical implications include the importance of structuring the occupational forms to be as relevant to the occupation as possible. Future research is needed to examine the influence of contextual relevancy on occupational performance. Additionally, this line of research needs to be extended to special populations. Copyright © 1999 Whurr Publishers Ltd.     

Mode of action framework analysis for receptor-mediated toxicity: The peroxisome proliferator-activated receptor alpha (PPARα) as a case study

Several therapeutic agents and industrial chemicals induce liver tumors in rodents through the activation of the peroxisome proliferator-activated receptor alpha (PPARα). The cellular and molecular events by which PPARα activators induce rodent hepatocarcinogenesis has been extensively studied and elucidated. This review summarizes the weight of evidence relevant to the hypothesized mode of action (MOA) for PPARα activator-induced rodent hepatocarcinogenesis and identifies gaps in our knowledge of this MOA. Chemical-specific and mechanistic data support concordance of temporal and dose–response relationships for the key events associated with many PPARα activators including a phthalate ester plasticizer di(2-ethylhexyl) phthalate (DEHP) and the drug gemfibrozil. While biologically plausible in humans, the hypothesized key events in the rodent MOA, for PPARα activators, are unlikely to induce liver tumors in humans because of toxicodynamic and biological differences in responses. This conclusion is based on minimal or no effects observed on growth pathways, hepatocellular proliferation and liver tumors in humans and/or species (including hamsters, guinea pigs and cynomolgous monkeys) that are more appropriate human surrogates than mice and rats at overlapping dose levels. Overall, the panel concluded that significant quantitative differences in PPARα activator-induced effects related to liver cancer formation exist between rodents and humans. On the basis of these quantitative differences, most of the workgroup felt that the rodent MOA is “not relevant to humans” with the remaining members concluding that the MOA is “unlikely to be relevant to humans”. The two groups differed in their level of confidence based on perceived limitations of the quantitative and mechanistic knowledge of the species differences, which for some panel members strongly supports but cannot preclude the absence of effects under unlikely exposure scenarios.     

基于结构变动度和灰色关联法评价药品改革对门诊患者次均费用影响及政策探讨

目的了解天津市北辰医院取消药品加成政策及"4+7"集中采购对患者门诊次均费用的影响。方法运用结构变动度分析和灰色关联分析,2014—2019年下半年天津市北辰医院患者门诊各项费用结构变动和关联程度。结果 2014—2019年,2019年门诊次均费用增幅0.57%,较2018年增幅明显下降。中成药费、化验检查费、化学药费、体检费构成比变化对患者门诊费用变动度的贡献率较高,累计贡献率达79.85%,除中药饮片费用外其他药品费用均成负性变动。门诊次均费用中,治疗费、化验检查费、中药饮片药费的关联度较大,中成药费、护理费、抗菌药费的关联度小。结论政策实施发挥药师价值,现政策初现成效,患者药品费用下降,治疗费及化验检查费占比有增加趋势,患者次均费用增幅得到控制,切实降低患者就医负担。