Through over a decade of painstakingeffort, the Fujian AgricultureUniversity has witnessed abreakthrough in its research and applicationof bacterioflora technology, and has obtaineda series of results at the internati...Through over a decade of painstakingeffort, the Fujian AgricultureUniversity has witnessed abreakthrough in its research and applicationof bacterioflora technology, and has obtaineda series of results at the international advancedlevel. Since 1983, under the leadership of LiZhanxi, a senior agronomist, the universityhas successively and successfully developed16 technical items, including "edible funguscultivation using bacterioflora to replace woodand grain" and "bacterioflora fermentationmethod for the cultivation of mushroom andauricularia auriculajudae". The bacteriofloratechnology has basically solved the"contradiction between fungus and forestry",that is, the contradiction between edible fungusproduction and the ecological balance inforestry. This technology has captured展开更多
中成药临床应用实践指南在国家药物目录遴选、医疗机构处方集制定、中成药临床合理用药等方面提供重要的参考依据,是中医药指南的重要组成部分。中成药作为中国药品供应保障体系的重要组成部分,在许多疾病门类中均发挥着重要的治疗、预...中成药临床应用实践指南在国家药物目录遴选、医疗机构处方集制定、中成药临床合理用药等方面提供重要的参考依据,是中医药指南的重要组成部分。中成药作为中国药品供应保障体系的重要组成部分,在许多疾病门类中均发挥着重要的治疗、预防及保健作用,但也存在乱用甚至滥用现象。为了规范中成药的合理应用,浙江中医药大学研究团队基于国际实践指南报告标准(RIGHT)清单框架,研制了中成药临床应用实践指南的报告规范(RIGHT for CPM)。RIGHT for CPM清单汇集了已发布的中成药指南、现有的中医药报告清单、RIGHT清单及其扩展版中的关键信息,形成初始报告清单条目池,邀请不同学科的17位专家进行2轮德尔菲问卷调研后形成,最后由来自国内外中医药研究、报告指南领域的18位权威专家审查并批准发布。RIGHT for CPM清单较RIGHT清单新增16个亚条目和修订了RIGHT清单的2个亚条目,更加突出中成药指南的报告特点,考虑到了中成药遴选及入选标准、政策准入、适应证候和症状、联合用药说明、特殊人群用药、使用注意事项、西医医师用药建议等方面,可进一步提升中成药指南报告质量和透明度,促进中成药指南的规范化报告和中成药的临床合理应用。该文就RIGHT for CPM清单的研制过程、重点突出中成药指南特色的条目内容进行解读,以期促进RIGHT for CPM清单的推广应用。展开更多
In this study, we investigated the changes in the right-to-left shunt (RLS) of the patent foramen ovale (PFO) at different phases of the Valsalva maneuver and analyzed the possible mechanisms. The study population con...In this study, we investigated the changes in the right-to-left shunt (RLS) of the patent foramen ovale (PFO) at different phases of the Valsalva maneuver and analyzed the possible mechanisms. The study population consisted of 57 patients with symptoms highly suggestive of a PFO. These patients had been diagnosed with apsychia, migraine with aura, cerebral infarction, transient ischemic attack (TIA), and cerebral ischemia with unknown cause. Routine echocardiography was performed in all patients to rule out a cardiac malformation. Contrast-transcranial Doppler (c-TCD) and contrast-enhanced transthoracic echocardiography (c-TTE) were used to visualize and quantify the RLS. The standard apical four chamber view was used to observe the changes of E peak, A peak, and velocity-time integral (VTI) ratio of tricuspid blood flow during the strain phase and release phase of the Valsalva maneuver. Paired t-test was used to compare E peak, A peak, and VTI ratio of tricuspid blood flow during the different phases. The right-to-left shunt across the PFO (PFO-RLS) was graded in the two phases and compared by Kruskal-Wallis test. Compared with the strain phase of the Valsalva maneuver, the parameters of E, A, and VTI in diastolic period in patients with PFO-RLS at the release phase were significantly increased [54.30 ± 13.65 cm/s vs 100.35 ± 21.11 cm/s, 42.21 ± 12.32 cm/s vs 57.30 ± 18.88 cm/s, 10.34 ± 3.27 cm/s vs 19.58 ± 4.56 cm/s, respectively], and the difference was statistically significant. The positive consequence of PFO-RLS, as diagnosed by c-TTE with the Valsalva maneuver at the release phase of the Valsalva maneuver, was significantly higher than that at the strain phase of the Valsalva maneuver. At the beginning of release phase of the Valsalva maneuver, decreased intrathoracic pressure led to increased venous backflow into the right atrium. Thus, high-velocity blood flow rapidly pushed the PFO open, which resulted in a significant increase in the PFO-RLS. Therefore, the increase of the PFO-RLS during the Valsalva maneuver is caused by the impact of high-velocity blood flow the PFO.展开更多
Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure fo...Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure for this indication. We present a case of acute right to left intra-cardiac shunt across PFO where the shunting is not persistent. Hence making a decision on PFO closure based on the aforementioned promising trial may not have been the right decision for the patient. This case highlights that the decision on PFO closure for such indication needs to be individualized. We also review the sparse literature on PFO closure for this indication and discuss how the decision making for such indication needs to be individualized.展开更多
目的基于国际公认评价指南的方法学质量工具AGREEⅡ(the appraisal of guidelines for research and evaluationⅡ)及国际实践指南报告标准(reporting items for practice guidelines in healthcare,RIGHT)清单评价中成药临床实践指南...目的基于国际公认评价指南的方法学质量工具AGREEⅡ(the appraisal of guidelines for research and evaluationⅡ)及国际实践指南报告标准(reporting items for practice guidelines in healthcare,RIGHT)清单评价中成药临床实践指南的方法学和报告质量,分析报告内容中的不足之处,以期为中成药临床应用及后续指南的制定提供参考。方法检索中国知网、重庆维普中文科技期刊数据库、万方医学网和中国生物医学数据库,补充检索医脉通、中华中医药学会和中华医学会网站并追溯纳入文献的参考文献,收集中成药临床实践指南。采用AGREEⅡ和RIGHT清单评价指南质量,使用组内相关系数进行一致性检验,采用描述性分析和卡方检验分析各领域报告率和各条目平均得分。结果最终纳入140部中成药临床实践指南,其中51部为以病为纲类,89部为以药为纲类,均为中国发布。以病为纲类在AGREEⅡ6个领域平均得分率最高为表达的清晰性73.32%,最低为应用性26.80%;以药为纲类在AGREEⅡ6个领域平均得分率最高为范围和目的55.62%,最低为制定严谨性31.32%。以病为纲类在RIGHT清单7个领域平均报告率最高为背景68.26%,最低为评审和质量保证13.73%;以药为纲类在RIGHT清单7个领域平均报告率最高为背景61.31%,最低为其他方面4.49%。统计分析结果显示,以病为纲类中成药临床实践指南在AGREEⅡ的3个领域(制定严谨性、表达的清晰性、编辑的独立性)和RIGHT清单的4个领域(基本信息、证据、资助与利益冲突声明和管理、其他方面)的平均报告率均高于以药为纲类中成药临床实践指南(P<0.05)。结论本研究纳入的140部中成药临床实践指南总体方法学和报告质量均有待提高,纳入文献的推荐等级多为B级和C级,难以直接应用于临床诊疗决策过程中,建议未来指南制定团队应严格参照AGREEⅡ和RIGHT清单制定相关指南以指导中成药的临床应用。展开更多
The Netac Technology Co., Ltd brought suit against Beijing Huaqi Information Digital Technology Co., Ltd for infringing Netac＇s patent. This case was the preclude to the intellectual property rights （IPR） war of th...The Netac Technology Co., Ltd brought suit against Beijing Huaqi Information Digital Technology Co., Ltd for infringing Netac＇s patent. This case was the preclude to the intellectual property rights （IPR） war of the internal enterprises. The process of this case was followed with great interest because it would influence the development of the hundreds of Mobile Storage enterprises in China. This paper is based on the brief review of the details of the case, the authors analyze the main legal issues covered by this case from the two aspects of the substantive and the procedural law, and reach the conclusions that the IPR strategy has gradually become the key to the IT enterprises in their intense market competition and that the concerned laws and regulations in China should be rectified and improved accordingly.展开更多
AIM To test the potential association between atrial septal aneurysm(ASA) and migraine in patent foramen ovale(PFO) closure patients through an observational, singlecenter, case-controlled study.METHODS We studied a t...AIM To test the potential association between atrial septal aneurysm(ASA) and migraine in patent foramen ovale(PFO) closure patients through an observational, singlecenter, case-controlled study.METHODS We studied a total of 450 migraineurs who had rightto-left shunts and underwent PFO closure in a retrospective single-center non-randomized registry from February 2012 to October 2016 on the condition that they were aged 18-45 years old. Migraine was diagnosed according to the International Classification of Headache Disorders, 3^(rd) edition and evaluated using the Headache Impact Test-6(HIT-6). All patients underwent preoperative transesophageal echocardiography, contrast transthoracic echocardiography, and computed tomography or magnetic resonance imaging examinations, with subsequent fluoroscopy-guided PFO closure. Based on whether they have ASA or not, the patients were divided into two groups: A(PFO with ASA, n = 80) and B(PFO without ASA, n = 370). Baseline characteristics and procedural and follow-up data were reviewed. RESULTS Compared to group B, group A had an increased frequency of ischemic lesions(11.3% vs 6.2%, P = 0.038) and migraine with aura(32.5% vs 21.1%, P = 0.040). The PFO size was significantly larger in group A(P = 0.007). There was no significant difference in HIT-6 scores between the two groups before and at the oneyear follow-up after the PFO closure [61(9) vs 63(9), P = 0.227; 36(13) vs 36(10), P = 0.706].CONCLUSION Despite its small sample size, our study suggests that the prevalence of ASA in PFO with migraine patients is associated with ischemic stroke, larger PFO size, and migraine with aura.展开更多
探讨不同激发方式在右心声学造影(agitated saline contrast echocardiography,ASCE)诊断卵圆孔未闭(patent foramen ovale,PFO)合并右向左分流(right to left shunt,RLS)中的作用。纳入2023年1月—2024年6月于川北医学院附属医院心内...探讨不同激发方式在右心声学造影(agitated saline contrast echocardiography,ASCE)诊断卵圆孔未闭(patent foramen ovale,PFO)合并右向左分流(right to left shunt,RLS)中的作用。纳入2023年1月—2024年6月于川北医学院附属医院心内科就诊的328例疑似PFO患者,采用咳嗽、改良蹲立动作、束臂试验及联合激发,以经食管超声(TEE)为金标准,比较不同方式的诊断效能。结果显示,束臂试验对中-大量RLS的检出率(45.8%)高于咳嗽(28.9%)和改良蹲立动作(35.4%);二阶法中咳嗽+束臂试验的检出率最高(52.1%),三阶法的检出率(54.3%)未显著提升但稳定性更佳;束臂试验及三阶法的AUC分别为0.842和0.891,显著优于单一激发。研究发现,束臂试验及联合激发可提高PFO-RLS检出率,推荐将其作为个体化联合方案以优化诊断效能。展开更多
文摘Through over a decade of painstakingeffort, the Fujian AgricultureUniversity has witnessed abreakthrough in its research and applicationof bacterioflora technology, and has obtaineda series of results at the international advancedlevel. Since 1983, under the leadership of LiZhanxi, a senior agronomist, the universityhas successively and successfully developed16 technical items, including "edible funguscultivation using bacterioflora to replace woodand grain" and "bacterioflora fermentationmethod for the cultivation of mushroom andauricularia auriculajudae". The bacteriofloratechnology has basically solved the"contradiction between fungus and forestry",that is, the contradiction between edible fungusproduction and the ecological balance inforestry. This technology has captured
文摘中成药临床应用实践指南在国家药物目录遴选、医疗机构处方集制定、中成药临床合理用药等方面提供重要的参考依据,是中医药指南的重要组成部分。中成药作为中国药品供应保障体系的重要组成部分,在许多疾病门类中均发挥着重要的治疗、预防及保健作用,但也存在乱用甚至滥用现象。为了规范中成药的合理应用,浙江中医药大学研究团队基于国际实践指南报告标准(RIGHT)清单框架,研制了中成药临床应用实践指南的报告规范(RIGHT for CPM)。RIGHT for CPM清单汇集了已发布的中成药指南、现有的中医药报告清单、RIGHT清单及其扩展版中的关键信息,形成初始报告清单条目池,邀请不同学科的17位专家进行2轮德尔菲问卷调研后形成,最后由来自国内外中医药研究、报告指南领域的18位权威专家审查并批准发布。RIGHT for CPM清单较RIGHT清单新增16个亚条目和修订了RIGHT清单的2个亚条目,更加突出中成药指南的报告特点,考虑到了中成药遴选及入选标准、政策准入、适应证候和症状、联合用药说明、特殊人群用药、使用注意事项、西医医师用药建议等方面,可进一步提升中成药指南报告质量和透明度,促进中成药指南的规范化报告和中成药的临床合理应用。该文就RIGHT for CPM清单的研制过程、重点突出中成药指南特色的条目内容进行解读,以期促进RIGHT for CPM清单的推广应用。
文摘In this study, we investigated the changes in the right-to-left shunt (RLS) of the patent foramen ovale (PFO) at different phases of the Valsalva maneuver and analyzed the possible mechanisms. The study population consisted of 57 patients with symptoms highly suggestive of a PFO. These patients had been diagnosed with apsychia, migraine with aura, cerebral infarction, transient ischemic attack (TIA), and cerebral ischemia with unknown cause. Routine echocardiography was performed in all patients to rule out a cardiac malformation. Contrast-transcranial Doppler (c-TCD) and contrast-enhanced transthoracic echocardiography (c-TTE) were used to visualize and quantify the RLS. The standard apical four chamber view was used to observe the changes of E peak, A peak, and velocity-time integral (VTI) ratio of tricuspid blood flow during the strain phase and release phase of the Valsalva maneuver. Paired t-test was used to compare E peak, A peak, and VTI ratio of tricuspid blood flow during the different phases. The right-to-left shunt across the PFO (PFO-RLS) was graded in the two phases and compared by Kruskal-Wallis test. Compared with the strain phase of the Valsalva maneuver, the parameters of E, A, and VTI in diastolic period in patients with PFO-RLS at the release phase were significantly increased [54.30 ± 13.65 cm/s vs 100.35 ± 21.11 cm/s, 42.21 ± 12.32 cm/s vs 57.30 ± 18.88 cm/s, 10.34 ± 3.27 cm/s vs 19.58 ± 4.56 cm/s, respectively], and the difference was statistically significant. The positive consequence of PFO-RLS, as diagnosed by c-TTE with the Valsalva maneuver at the release phase of the Valsalva maneuver, was significantly higher than that at the strain phase of the Valsalva maneuver. At the beginning of release phase of the Valsalva maneuver, decreased intrathoracic pressure led to increased venous backflow into the right atrium. Thus, high-velocity blood flow rapidly pushed the PFO open, which resulted in a significant increase in the PFO-RLS. Therefore, the increase of the PFO-RLS during the Valsalva maneuver is caused by the impact of high-velocity blood flow the PFO.
文摘Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure for this indication. We present a case of acute right to left intra-cardiac shunt across PFO where the shunting is not persistent. Hence making a decision on PFO closure based on the aforementioned promising trial may not have been the right decision for the patient. This case highlights that the decision on PFO closure for such indication needs to be individualized. We also review the sparse literature on PFO closure for this indication and discuss how the decision making for such indication needs to be individualized.
文摘目的基于国际公认评价指南的方法学质量工具AGREEⅡ(the appraisal of guidelines for research and evaluationⅡ)及国际实践指南报告标准(reporting items for practice guidelines in healthcare,RIGHT)清单评价中成药临床实践指南的方法学和报告质量,分析报告内容中的不足之处,以期为中成药临床应用及后续指南的制定提供参考。方法检索中国知网、重庆维普中文科技期刊数据库、万方医学网和中国生物医学数据库,补充检索医脉通、中华中医药学会和中华医学会网站并追溯纳入文献的参考文献,收集中成药临床实践指南。采用AGREEⅡ和RIGHT清单评价指南质量,使用组内相关系数进行一致性检验,采用描述性分析和卡方检验分析各领域报告率和各条目平均得分。结果最终纳入140部中成药临床实践指南,其中51部为以病为纲类,89部为以药为纲类,均为中国发布。以病为纲类在AGREEⅡ6个领域平均得分率最高为表达的清晰性73.32%,最低为应用性26.80%;以药为纲类在AGREEⅡ6个领域平均得分率最高为范围和目的55.62%,最低为制定严谨性31.32%。以病为纲类在RIGHT清单7个领域平均报告率最高为背景68.26%,最低为评审和质量保证13.73%;以药为纲类在RIGHT清单7个领域平均报告率最高为背景61.31%,最低为其他方面4.49%。统计分析结果显示,以病为纲类中成药临床实践指南在AGREEⅡ的3个领域(制定严谨性、表达的清晰性、编辑的独立性)和RIGHT清单的4个领域(基本信息、证据、资助与利益冲突声明和管理、其他方面)的平均报告率均高于以药为纲类中成药临床实践指南(P<0.05)。结论本研究纳入的140部中成药临床实践指南总体方法学和报告质量均有待提高,纳入文献的推荐等级多为B级和C级,难以直接应用于临床诊疗决策过程中,建议未来指南制定团队应严格参照AGREEⅡ和RIGHT清单制定相关指南以指导中成药的临床应用。
文摘The Netac Technology Co., Ltd brought suit against Beijing Huaqi Information Digital Technology Co., Ltd for infringing Netac＇s patent. This case was the preclude to the intellectual property rights （IPR） war of the internal enterprises. The process of this case was followed with great interest because it would influence the development of the hundreds of Mobile Storage enterprises in China. This paper is based on the brief review of the details of the case, the authors analyze the main legal issues covered by this case from the two aspects of the substantive and the procedural law, and reach the conclusions that the IPR strategy has gradually become the key to the IT enterprises in their intense market competition and that the concerned laws and regulations in China should be rectified and improved accordingly.
文摘AIM To test the potential association between atrial septal aneurysm(ASA) and migraine in patent foramen ovale(PFO) closure patients through an observational, singlecenter, case-controlled study.METHODS We studied a total of 450 migraineurs who had rightto-left shunts and underwent PFO closure in a retrospective single-center non-randomized registry from February 2012 to October 2016 on the condition that they were aged 18-45 years old. Migraine was diagnosed according to the International Classification of Headache Disorders, 3^(rd) edition and evaluated using the Headache Impact Test-6(HIT-6). All patients underwent preoperative transesophageal echocardiography, contrast transthoracic echocardiography, and computed tomography or magnetic resonance imaging examinations, with subsequent fluoroscopy-guided PFO closure. Based on whether they have ASA or not, the patients were divided into two groups: A(PFO with ASA, n = 80) and B(PFO without ASA, n = 370). Baseline characteristics and procedural and follow-up data were reviewed. RESULTS Compared to group B, group A had an increased frequency of ischemic lesions(11.3% vs 6.2%, P = 0.038) and migraine with aura(32.5% vs 21.1%, P = 0.040). The PFO size was significantly larger in group A(P = 0.007). There was no significant difference in HIT-6 scores between the two groups before and at the oneyear follow-up after the PFO closure [61(9) vs 63(9), P = 0.227; 36(13) vs 36(10), P = 0.706].CONCLUSION Despite its small sample size, our study suggests that the prevalence of ASA in PFO with migraine patients is associated with ischemic stroke, larger PFO size, and migraine with aura.
文摘探讨不同激发方式在右心声学造影(agitated saline contrast echocardiography,ASCE)诊断卵圆孔未闭(patent foramen ovale,PFO)合并右向左分流(right to left shunt,RLS)中的作用。纳入2023年1月—2024年6月于川北医学院附属医院心内科就诊的328例疑似PFO患者,采用咳嗽、改良蹲立动作、束臂试验及联合激发,以经食管超声(TEE)为金标准,比较不同方式的诊断效能。结果显示,束臂试验对中-大量RLS的检出率(45.8%)高于咳嗽(28.9%)和改良蹲立动作(35.4%);二阶法中咳嗽+束臂试验的检出率最高(52.1%),三阶法的检出率(54.3%)未显著提升但稳定性更佳;束臂试验及三阶法的AUC分别为0.842和0.891,显著优于单一激发。研究发现,束臂试验及联合激发可提高PFO-RLS检出率,推荐将其作为个体化联合方案以优化诊断效能。
