摘要：背景:越来越多的证据表明精神因素对健康有一定影响。测评精神状况的方法要适合所研究的人群。SpREUK问卷的设计便是为了更好地研究世俗社会中的慢性病患者如何看待精神因素对其健康的影响及其如何对待疾病。目的:本文描述可能适用于生活在世俗社会中的病人的SpREUK问卷这一评价工具的产生背景及其心理测量功能,并总结在德国病人中的验证结果。设计和受试者:采用横断面研究,对496位平均年龄(53.5±14.4)岁的慢性病患者(84%为慢性疼痛,6%为癌症,10%为其他疾病)进行问卷调查,问卷由受试者自行完成。结局指标:我们旨在设计一种SpREUK问卷的缩减版(SpREUK-SF10),并检测其因子结构及概念效度,同时使用该问卷测评患者的精神实践参与度(SpREUK-P)、生活满意度(BMLSS)及对疾病的理解(IIQ)。结果:这一问卷具有良好的心理测量功能,区分了3个心理因素,分别是:(1)信仰;(2)寻求精神/宗教支持;(3)对疾病的积极理解。其中,对疾病的积极理解与信仰和寻求支持有一定关联,揭示了其在精神层面的内涵。结论:SpREUK-SF10问卷对于不单一信仰或反对某一宗教的世俗社会中人们的精神因素有较好的测评作用。适合其他文化背景的问卷还有待进一步研究开发。

摘要：电化学一氧化氮传感器能够实时监测颅内一氧化氮浓度,对于了解大脑中一氧化氮的功能至关重要.然而,在大脑中使用的传统刚性传感电极面临着灵敏度低和植入后神经炎症引起一氧化氮浓度异常的问题.在这里,我们报道了一种结合物理和化学吸附能力、具有高灵敏度和准确性的电化学一氧化氮传感器.其对一氧化氮的物理和化学吸附能力分别来自于电极的高比表面积和丰富的羧基官能团.此外,柔软的电极可以与脑组织的力学性能相匹配,实现了一个高度适应的电极/组织界面.由此设计的颅内一氧化氮传感器表现出迄今为止所报道文献中最高的灵敏度,为3245 pA nmol^(-1)L,检测限为0.1 nmol L^(-1).电极在植入后未观察到显著的炎症反应以及过量的一氧化氮表达,提高了检测的准确性.该传感器成功捕捉了大脑中的一氧化氮波动,并实现了对多个脑区的同时检测,促进了对大脑中一氧化氮生理病理作用的研究.

摘要：Insulin is widely used in treating diabetes, but still needs to be administered by needle injection. This study investigated a new needle-free approach for insulin delivery. A portable powder needleless injection（PNI） device with an automatic mechanical unit was designed. Its efficiency in delivering insulin was evaluated in alloxan-induced diabetic rabbits. The skin irritation caused by the device was investigated and the results were analyzed in relation to aerodynamic parameters. Inorganic salt-carried insulin powders had hypoglycemic effects, while raw insulin powders were not effective when delivered by PNI, indicating that salt carriers play an important role in the delivery of insulin via PNI. The relative delivery efficiency of phosphate-carried insulin powder using the PNI device was 72.25%. A safety assessment test showed that three key factors（gas pressure, cylinder volume, and nozzle distance） were related to the amount of skin irritation caused by the PNI device. Optimized injection conditions caused minimal skin lesions and are safe to use in practice. The results suggest that PNI has promising prospects as a novel technology for delivering insulin and other biological drugs.

摘要：近年来,在中医针灸随机对照临床试验(randomized controlled trial,RCT)中恰当地应用统计学方法日益受到重视。基于假设检验的统计推断是临床试验与循证医学的基础,根据临床试验设计的基本统计原则,本文探讨了中西方文献中针灸RCT设计与分析方法学的差异。国内针刺临床试验多采用3级或4级定性法进行临床统计分析,而国外的临床试验则多采用组间症状积分的定量比较。本文以针刺治疗疼痛的临床试验为例,讨论了两种分析方法的利弊。我们认为两种方法可以兼用,但应以定量分析方法为主,分级定性法为辅,以取各自方法的所长。本文的目的是希望通过提出问题来抛砖引玉,以期引起更多的学术讨论,从而提高中医针灸临床研究的科学性和严谨性。

摘要：Malaria still threatens global health seriously *** the current discoveries of antimalarials are almost totally focused on single mode-of-action inhibitors,multi-targeting inhibitors are highly desired to overcome the increasingly serious drug ***,we performed a structure-based drug design on mitochondrial respiratory chain of Plasmodium falciparum and identified an extremely potent molecule,RYL-581,which binds to multiple protein binding sites of *** simultaneously(allosteric site of type Ⅱ NADH dehydrogenase,Q_(o) and Q_(i) sites of cytochrome bc_(1)).Antimalarials with such multiple targeting mechanism of action have never been reported ***-581 kills various drug-resistant strains in vitro and shows good solubility as well as in vivo *** structurebased strategy for designing RYL-581 from starting compound may be helpful for other medicinal chemistry projects in the future,especially for drug discovery on membrane-associated targets.

摘要：Atrial fibrillation is an “invisible killer” of human health. It often induces high-risk diseases, such as myocardial infarction, stroke, and heart failure. Fortunately, atrial fibrillation can be diagnosed and treated early. Low-level vagus nerve stimulation(LL-VNS) is a promising therapeutic method for atrial fibrillation. However, some fundamental challenges still need to be overcome in terms of flexibility,miniaturization, and long-term service of bioelectric stimulation devices. Here, we designed a closedloop self-powered LL-VNS system that can monitor the patient’s pulse wave status in real time and conduct stimulation impulses automatically during the development of atrial fibrillation. The implant is a hybrid nanogenerator(H-NG), which is flexible, light weight, and simple, even without electronic circuits,components, and batteries. The maximum output of the H-NG was 14.8 V and 17.8 μA(peak to peak). In the in vivo effect verification study, the atrial fibrillation duration significantly decreased by 90% after LLVNS therapy, and myocardial fibrosis and atrial connexin levels were effectively improved. Notably, the anti-inflammatory effect triggered by mediating the NF-κB and AP-1 pathways in our therapeutic system is observed. Overall, this implantable bioelectronic device is expected to be used for self-powerability,intelligentization, portability for management, and therapy of chronic diseases.

摘要：本针刺随机对照试验(Randomised controlled trials, RCT)专家共识是基于目前针刺试验面临的最普遍、最关键问题,由临床医生、研究人员、从事针灸和外科的临床试验专家、统计专家、临床流行病学和方法学专家以及患者组成的国际临床研究小组联合制订。该共识将有助于临床试验资助者、注册者以及期刊编辑等评估针刺RCT方案及研究结果的相关性、重要性和质量。

摘要：目的 与“不用针灸”对比,确定“使用针 灸”的治疗方法对慢性头痛患者的头痛、健康状 况及无病时间的影响。 设计 随机对照试验。 试验场所 英格兰和威尔士的开业医生诊所。 受试对象 401位慢性头痛患者,主要是偏 头痛患者。 干预 患者被随机分配进入针灸治疗组(在 3个月内接受12次针灸治疗)和对照组(接受常 规治疗)。 主要结果测定指标 治疗前、治疗后3个月 及12个月对头痛积分,SF-36健康状况及用药量 进行评估。每3个月对治疗方法作1次评估。头 痛积分即判定疗效的主要终点指标。 结果 针灸组治疗后12个月的头痛积分(针 灸组161例患者,平均头痛积分为16．2,标准差 13．7,比治疗前减少34％)比对照组低(对照组140 例患者,平均头痛积分为22．3,标准差17．0,比 治疗前减少16％)。两种方法调整后的差异为4．6 (95％可信区间为2．2-7．0;P=0．0002)。对于包 含缺失数据的灵敏度分析,该结果也是肯定的。 针灸组的患者每年少头痛22(8-38)天。尽管达到 统计学差异的项目仅有生理功能、精力和健康改 变等,SF-36的资料也有利于针灸组。与对照组相 比,针灸组的患者减少了15％的服药量(P=0．02), 减少了25％的就诊量(P=0．10),同时减少15％的 病休时间(P=0．2)。 结论 针灸在初级保健中用于治疗慢性头痛, 特别是偏头痛,可以产生与临床相关的持久益 处。应当考虑扩大英国国家医疗保险体系中针灸 治疗的范围。