Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-12-28 Cooperative journals: 《中国全科医学》
Abstract： Background In the context of the national efforts to promote the development of home care services for the elderly，chronic diseases and disabled patients，the adoption of professional assessment tools that can effectively assess the health of patients in the home environment and meet the needs of care services is an important guarantee to accurately match the needs of patients for home medical care. Objective To sinicize the Community Health Intensity Rating Scale（CHIRS）and evaluate its reliability and validity in the elderly patients with chronic diseases in the community. Methods After obtaining authorization from the original author，the translation，back translation and cultural adaptation process of the Brislin model were followed to form the Chinese version of CHIRS. From March to June 2021，a convenience sampling method was used to select elderly patients managed by a community health service center（station）in Chengdu as the research subjects. Expert consultation was used to evaluate the content validity of the scale; the internal consistency coefficient was used to test the reliability of the scale and to verify its practicality. Results A total of 244 patients were investigated and completed the household questionnaire，with a valid recovery rate of 100%. The expert consultation results showed that the S-CVI/ave of the Chinese version of CHIRS was 0.98，and the I-CVI ranged from 0.71 to 1.00; the overall Cronbach'α coefficient was 0.884，and the Cronbach'α coefficients for the four dimensions ranged from 0.593 to 0.787，the predictive validity results showed that the Spearman correlation coefficients of CHIRS result with self-rated health status and demand for home care services were -0.611（P<0.001）and 0.584（P<0.001）. Conclusion After sinicization and localization modification，the Chinese version of CHIRS has better reliability and reference value，which can be used to evaluate the health status and demand for home care services of elderly patients with chronic diseases in the community.
Subjects: Digital Publishing >> New Media submitted time 2023-10-08 Cooperative journals: 《中国传媒科技》
Abstract：在互联网时代的大背景下,助学类少儿报刊也纷纷投入到线上新媒体平台的建设中。但传统出版行业在平台的建设和运营过程中,存在很多不足。本文是笔者几年运营《时代学习报》微信公众平台矩阵、《时代学习报》微网站及相关线上平台的工作总结。笔者结合自己的工作实践,梳理了助学类少儿报刊线上平台的探索历程,正视助学类少儿报刊线上平台的运营困境,并提出相应对策,在一定程度上为助学类少儿报刊线上平台的发展提供了参考。
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-30 Cooperative journals: 《中国全科医学》
Abstract：
Background Under the background of increasing aging, diversified medical needs of the elderly and the shortage of medical resources, the demand for home-based medical services is increasing. So the state strongly encourages the development of home-based medical services. As a pilot area of home care service for the aged in Sichuan Province, primary health service institutions are the main providers of services at present. so it is necessary to explore their organizational characteristics and service development status. Objective To investigate the organizational characteristics and the present situation of home-based medical service of primary health service institutions in Sichuan Province, so as to provide a reference basis for further promoting the standardization and development of home-based medical service. Methods From August to October 2021, the relevant persons in charge of 7 municipal districts, including 62 primary medical health institutions in Sichuan Province were selected by convenience sampling method. A self-designed questionnaire was used to collect data, then the general information, human resources, the development of home health care and the problems faced by the institution were investigated and analyzed. Results Among the 62 primary health care institutions, the number of full-time medical staff varied greatly, ranging from 10 to 316, with a median of 40(26,66). The percentage of the number of medical staff to the number of full-time employees was 84.9%±11.3% on average. Among all professional titles, the median proportion of doctors with junior titles or below was 45.5%(32.3%,56.5%), and that of nurses was 71.9%(50.7%,84.9%). The ratio of doctors to nurses ranged from 0.43 to 2.63, with an average of 1.44±0.5. The organizational characteristics of institutions in different locations and service areas were compared, and there were statistical significance in whether they participated in the evaluation of grade hospitals, had part-time medical staff, had inpatient beds, the proportion of medical staff, the ratio of doctors to nurses, the proportion of professional titles of doctors and nurses (P＜0.05). There were 51 institutions (82.3%) had launched home-based medical care service, and the development of chronic disease management was an influential factor in providing home-based medical service (P < 0.05). The service duration of 26 institutions (50.9%) was less than 3 years, 31 institutions (60.8%) were serving elderly patients ≥60 years old most, 35 institutions (68.7%) were serving patients ≤1-2 days/week, and the service form was family doctor contract service mainly (98.0%). The top three factors hindering the development of home-based medical services are insufficient human resources, no corresponding standards and norms, and inadequate supporting policies. Conclusion The organizational characteristics of primary health service institutions are distinct in different regions and service areas. The home-based medical service is widely available in Sichuan Province, but it needs to be improved in terms of service form, service time and workload. It is suggested that all institutions should pay attention to the problems facing the current development according to their own conditions, improve the standards and norms related to home-based medical services, pay attention to chronic disease management and the construction of talent team, and further promote the rapid development of home-based care.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-07-22 Cooperative journals: 《中国全科医学》
Abstract： background With the aggravation of population aging, the disabled or semi disabled elderly suffering from a variety of chronic diseases have an urgent need for home-based medical care services, but there are greater medical risks and personal safety problems in the door-to-door services of grass-roots medical personnel. Strengthening the safety management of door-to-door service is conducive to improving the willingness of grass-roots medical personnel to provide home-based medical care services. Objective To investigate the safety support of home care services in primary medical institutions and the willingness of medical staff to provide on-site services, and to analyze the influencing factors, so as to provide reference for further promoting the sustainable development of home care services. Methods A survey was conducted in 49 primary health service institutions in Sichuan Province from August to October 2021, using a self-designed questionnaire, including the general information of medical personnel, service experience, safety support of home-based medical care services, and the willingness of medical personnel to provide services on-site. Binary logistic regression was used to analyze the influencing factors of medical staff's willingness to visit. Results A total of 1131 questionnaires were distributed, and 1131 valid questionnaires were recovered. The effective recovery rate was 100%. The willingness rate of grassroots medical staff to provide home-based medical care services was 75.4% (853/1131), and 46.9% of medical staff said that they had not conducted a safety risk assessment of home-based medical care services. The results of binary logistic regression analysis showed that the type of grass-roots health service institutions where medical staff worked, the title of employment, whether to implement safety risk assessment, whether to equip with safety assurance facilities, and whether to participate in special training on home medical care were the influencing factors of grass-roots medical staff's willingness to provide home medical care services (p<0.05). Conclusion Grassroots medical staff are willing to provide home-based medical care services, but they are affected by many factors; At this stage, the safety support for home-based medical care services is insufficient. We should establish and improve the policies and regulations of home-based medical care, reduce the medical risk of medical personnel's on-site service, ensure their personal safety, and strengthen the training of relevant knowledge of home-based medical care service, which will help to improve the willingness of grass-roots medical personnel to provide on-site medical services.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2019-11-15 Cooperative journals: 《协和医学杂志》
Abstract：目的：对于2型糖尿病合并特发性膜性肾病(IMN)患者，比较不同治疗的疗效及预后。方法：本回顾性研究连续纳入89例2型糖尿病合并IMN患者，按初始治疗分为钙调磷酸酶抑制剂(CNIs)、环磷酰胺(CTX)及其它治疗三组，以总体缓解(TR)及完全缓解(CR)、估算肾小球滤过率(eGFR)下降≥30%或进入终末期肾病(ESRD)作为结局，采用生存分析比较不同治疗方案在上述结局事件方面的差异。结果：对于2型糖尿病合并IMN者，CNIs组和CTX组在CR(P=0.68)或TR(P=0.20)方面无统计学差异，但前者出现肾功能损害风险较高(P=0.010)，上述趋势在多因素COX回归中仍存在。结论：在2型糖尿病合并IMN中，CNIs治疗的蛋白尿缓解与CTX相似，但发生肾功能下降的风险更高。
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2019-11-15 Cooperative journals: 《协和医学杂志》
Abstract：目的 随着“住院医师核心胜任力框架共识”的提出，对围绕其开展的教学体系产生了更高的要求。本文旨在探索建立更加符合医学人才培养特点的过程性评价体系。方法 通过文献综述法回顾并借鉴国内外先进经验、依托360°评价方法的理论基础，构建基于核心胜任力的360°评价体系。结果 描述分析并讨论该体系在临床医学博士后培养项目中的初步实践过程。结论 基于核心胜任力的360°评价体系注重过程评估与反馈，能有效且有针对性的帮助住院医师进行能力提高，为进一步探索与完善医学人才评价体系打下基础。
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2019-02-25 Cooperative journals: 《协和医学杂志》
Abstract：虚拟切片（Virtual slide）又称数字病理（digital pathology），利用线性扫描技术对整个玻璃切片全方位快速扫描，将传统的载玻片转化为全景切片图像（whole slide images, WSI）。WSI 扫描系统则由光学显微镜、切片扫描、图像采集等硬件设备和图像获取软件共同组成。WSI 通过数字切片扫描装置采集高分辨数字图像，并由软件将图像自动进行无缝拼接处理制作而成。WSI 通过放大操作可还原原始的高分辨率图像，与普通的静态图像通过浏览软件缩放只改变尺寸而无法提高分辨率的操作有着本质的不同（图 1）。WSI 图像软件还可以让使用者旋转、编辑、标记、测量分析图像。近年来，交互技术的应用，使得虚拟切片的易用性进一步提升。以 virtual slide、digital pathology、whole slide image作为检索词在 Pubmed 检索发现，其相关研究数量呈现逐年增长趋势
Subjects: Biology >> Ecology submitted time 2018-06-09 Cooperative journals: 《生态学报》
Abstract：以黄土丘陵沟壑区坊塌流域不同植被类型为研究对象，在野外调查的基础上，利用离心机法测定不同植被类型0-10、10-20 cm土层不同吸力下的土壤含水率，并利用Van Gennuchten模型对土壤水分特征曲线进行拟合，对比分析了不同植被类型不同土层土壤水分特征曲线、土壤水分有效性和持水性。结果表明：随着植被恢复的进行，不同植被类型土壤水分特征曲线出现了明显的差异，但是其斜率基本不变且不同植被类型0-10、10-20 cm土层土壤水分特征曲线都呈近似的"S"型；不同植被类型0-10、10-20 cm土层土壤有效水范围分别为22.65%-26.80%、23.97%-28.13%，除白羊草群落和刺槐林外呈现出多年生蒿禾类群落低于灌木群落而高于一年生草本群落的变化趋势；不同植被类型土壤持水能力在0-10 cm土层没有显著性差异，在10-20 cm呈现出多年生蒿禾类群落低于灌木群落而高于一年生草本群落，其中白羊草群落最大，刺槐林最低。刺槐林有效水分和土壤持水能力都较低，建议适当采取间伐并促进其近自然化恢复来实现土壤水分的可持续利用，尽量避免在阳坡缺水地区种植刺槐。对于研究地区土壤水分的可持续利用、植被恢复和科学合理的进行植被配置具有重要意义。
Subjects: Biology >> Zoology submitted time 2017-10-10 Cooperative journals: 《动物营养学报》
Abstract：为研究饲料中胆固醇含量对淡水养殖条件下凡纳滨对虾（Litopenaeus vannamei）生长性能性能、抗弧菌和抗亚硝态氮胁迫能力的影响，在10%鱼粉的基础上设计胆固醇添加量分别为0（C0组）、1（C1组）、2（C2组）、3（C3组）和4 g/kg（C4组）的等氮等能饲料（实测饲料中胆固醇含量依次为0.78、1.57、2.45、3.43和4.18 g/kg），分别投喂初始体重为（0.160±0.002） g的凡纳滨对虾50 d。每种试验饲喂投喂4个网箱，每个网箱养殖凡纳滨对虾50尾。养殖试验结束后检测对虾的生长性能、肌肉常规组成以及急性哈维氏弧菌（Vibrio harveyi）感染及亚硝酸氮胁迫下的死亡情况。结果表明：凡纳滨对虾的特定生长率和存活率不受饲料胆固醇含量的显著影响（P>0.05），但C0组对虾的饲料系数显著高于C2、C3和C4组（P＜0.05）。随饲料胆固醇含量的增加，对虾肌肉中粗蛋白质含量逐渐升高，C3、C4组显著高于C0组(P＜0.05)；肌肉中粗脂肪含量先升高后降低，C2组显著高于其他组（P＜0.05）。肝胰腺和肌肉中胆固醇含量随饲料胆固醇含量的增加而显著升高（P＜0.05），血清中胆固醇含量先升高后降低，且C2组显著高于C0组（P＜0.05）。急性感染哈维氏弧菌后，随饲料胆固醇含量的增加，各组对虾累积死亡率均先降低后升高，C2组在感染24、36、48、72和96 h后的累积死亡率均最低。在8.5～9.0 mg/L亚硝态氮急性胁迫下，96 h后对虾累积死亡率与饲料中胆固醇含量呈负相关，且C0和C1组显著高于C2、C3和C4组（P＜0.05）。综上所述，淡水养殖条件下，1.57 g/kg的饲料胆固醇含量即可满足对虾生长的需求，但2.45 g/kg的饲料胆固醇含量可使对虾获得最佳的抗弧菌能力和理想的抗亚硝态氮胁迫能力。
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