“In the field of modern palliative care, Chinese experts have established consensus definitions for "palliative care" and "hospice care", providing a foundation for discipline development, clinical practice, and public communication.”
缓和医疗定义中国专家共识工作组*
2025, 40(2): 89-99. DOI: 10.24920/004496
Abstract:背景和目的中国的现代缓和医疗发展源千上个世纪80年代,目前正处千加速发展期。然而,缓和医疗术语和概念不统一阻碍了政策制定、临床实践以及研究等诸多方而。2023年,《常用临床医学名词〉>确立了“ 缓和医疗”(palliative care)和“ 安宁疗护” (hospice care)的专业名词。木研究旨在基于已确立学科名词,建立符合中国语境的缓和医疗与安宁疗护定义。方法我们检索搜集国内外缓和医疗定义相关的文献和政策文件,折解和分析定义相关概念要素。5位核心专家组成员基千国际安宁缓和医疗协会(International Association for Hospice and Palliative care, IAHPC)最新版缓和医疗定义及其概念要素,经2次线上会议讨论并拟定中国缓和医疗初始推荐定义。经提名和遴选,我们邀请61位国内缓和医疗领域专业人员组建共识专家组,发放两轮德尔菲问卷函询,对缓和医疗初始推荐定义的31项条目内容以及缓和医疗和安宁疗护定义文字表述的同意程度进行Likert评分。核心专家组根据德尔菲函询反馈结果修定推荐定义的条目内容和推荐定义的文字表述,以共识率超过80%为达到共识。经患者和公众参与(patient and public involvement, PPI)小组成员反馈,形成最终推荐定义。结果第一轮和第二轮德尔菲问卷调研函询的应答率分别为83.6%和100.0%。纳入推荐定义的条目和语句的共识率均超过90%。据此,我们推荐定义如下:缓和医疗是一种积极的全人照护实践,而向因危及生命的疾病而遭受痛苦的各年龄段患者及其家属和照护者,通过预防、评估和缓解其身体、心理、社会和灵性痛苦,提升患者及其家属和照护者的生命质晕;安宁疗护是缓和医疗的重要组成部分,是为处千生命末期的患者及其家属和照护者提供的全人照护实践,其目标是在不刻意加速或推迟死亡的前提下,通过缓解患者的身体、心理、社会和灵性痛苦,维护患者尊严并帮助其实现善终,同时提升患者家属和照护者的生命质最。结论本研究确立了中国语境下缓和医疗和安宁疗护的中文定义,明确了缓和医疗包含安宁疗护的逻辑关系。定义强调缓和医疗是全人照护的实践,为学科发展、临床实践和公众传播奠定了基础。
“In the field of attention assessment, researchers have developed the Multi-dimensional Attention Rating Scale (MARS), a self-report tool that evaluates six-dimension attention levels. The MARS, based on Classical Test Theory, demonstrated high reliability and validity, offering a new tool for assessing multi-dimensional attention impairments in various mental disorders.”
“Reporting on the latest medical research, a study at Peking Union Medical College Hospital has identified postoperative pneumonia as a key factor contributing to prolonged hospital stays in elderly patients after hip fracture surgery. The research, which analyzed data from 155 patients aged 90 or older, found no significant association between anesthesia types or airway management methods and extended postoperative length of stay or pneumonia occurrence. Instead, preoperative conditions, particularly chronic obstructive pulmonary disease and systemic inflammation, were significantly linked to postoperative pneumonia. This insight could guide future treatment strategies for the elderly undergoing hip fracture repair.”
“In the field of medical technology management, a bibliometric analysis reveals a steady increase in research output and a shift in focus from basic medical needs to emergency response and medical information security. The United States, Italy, and the United Kingdom are the main contributors, with the United States leading in both publication volume and academic impact. Cross-border cooperation is led by authors from the UK and the US, and top institutions are primarily in Canada and Spain. Future research should emphasize interdisciplinary and international collaboration.”
王流芳, 黄玉妮, 王思惟, 秦小平, 胡致远, 王炳龙, 胡志民
2025, 40(2): 120-131. DOI: 10.24920/004456
Abstract:目的采用文献计量方法分析医疗科技管理(medical technology management,MTM)研究领域相关文献,探讨此领域潜在关键词、研究集群、合作情况及研究趋势,为研究者、政策制定者和医院管理者提供有价值的信息。方法在Web of Science核心数据库中,通过检索文献标题、摘要及关键词,结合系统推荐术语,筛选MTM相关文献。最终纳入发表于1974年至2022年的181篇文献。采用VOSviewer软件分析研究产出,总被引次数、平均被引次数和H指数等质量指标,文献耦合、共同作者以及关键词共现。结果MTM领域的文献数量总体上呈逐年稳步增长。研究重点已从满足基本医疗需求转向优先关注应急响应和医疗信息安全。美国、意大利和英国是主要的研究贡献国家,其中美国在发文量(60篇)和学术影响力(H指数 = 21)均居首位。来自英国和美国的作者在跨国合作方面处于领先地位。按跨机构作者之间的总链接强度排名,前五名的机构主要来自加拿大和西班牙。结论在过去30年(1993~2022年)中,MTM领域发文数量呈稳定增多。研究重点的转移促使人们更加重视保护患者隐私和确保医疗数据的安全。未来的研究应着重加强跨学科和专业间的协作,以及推动国际合作和知识的开放共享。
“In a groundbreaking study, researchers have uncovered the causal link between cytoplasmic unactivated mineralocorticoid receptor levels and the risk of tubulointerstitial nephritis, as well as its impact on lipid metabolism in diabetic kidney disease patients. This discovery could pave the way for the development of MR-antagonists to mitigate renal damage and lipid metabolism-related complications.”
何敏, 杨晓萍
2025, 40(2): 132-143. DOI: 10.24920/004447
Abstract:目的探究胞质盐皮质激素受体(mineralocorticoid receptor,MR)水平与肾小管间质性肾炎(tubulointerstitial nephritis,TIN)发展之间的因果关系,并评估MR对糖尿病肾病患者血脂异常,特别是继发性高脂血症的影响。方法我们利用全基因组关联研究(genome-wide association study,GWAS)汇总数据,采用双样本孟德尔随机化分析方法,以MR水平相关的遗传变异为工具变量,探讨MR对TIN及血脂等结局变量的因果效应。血脂指标包括低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、甘油三酯和高密度脂蛋白胆固醇。采用两步孟德尔随机化分析评估TIN在MR和血脂代谢之间的中介效应。孟德尔随机化分析主要采用逆方差加权法,以敏感性分析、孟德尔随机化-Egger分析和加权中位数法作为补充。结果胞质非活化MR水平与TIN风险降低呈显著因果关联(OR = 0.8598,95% CI [0.7775~0.9508],P <0.001)。尽管我们未发现MR水平与继发性高脂血症呈显著因果关系,但胞质非活化MR水平可能与LDL-C水平降低存在潜在关联(OR = 0.9901,95% CI [0.9821~0.9983],P = 0.018)。此外,TIN与继发性高脂血症(OR = 1.0016,95% CI [1.0002~1.0029],P = 0.020)以及LDL-C水平升高(OR = 1.0111,95% CI [1.0024~1.0199],P = 0.012)均存在因果关联,TIN与LDL-C的关联在欧洲男性人群中更为明显(OR = 1.0230,95% CI [1.0103~1.0358],P < 0.001)。反向孟德尔随机化分析显示:TIN与甘油三酯(OR = 0.7027,95% CI [0.6189~0.7978],P < 0.001)、高密度脂蛋白胆固醇(OR = 1.1247,95% CI [1.0019~1.2626],P = 0.046)以及LDL-C(OR = 0.8423,95% CI [0.7220~0.9827],P = 0.029)均存在显著因果关系。TIN在MR与LDL-C水平之间的因果链中起中介作用,中介效应占比达16.7%。结论MR在TIN及脂质代谢紊乱的进展中发挥重要作用。这一结果提示以非奈利酮为代表的MR拮抗剂可望缓解肾脏损伤和预防脂质代谢相关并发症。
“Reporting on the latest research in the medical device procurement and sales sector, the article introduces its research progress in the field of anti-commercial bribery. Expert xx established the preventive regulatory framework, which provides solutions to effectively reduce commercial bribery risks and prevent illegal and non-compliant conduct.”
“In the field of medical research public platform construction, West China Hospital has made significant progress. The hospital has established a hierarchical management system and precise service model, which provides solutions to enhance resource efficiency and support major scientific research tasks.”
“Reporting on a recent medical case, an 85-year-old man who underwent prostate cancer surgery in 2011 and used a penile clamp for severe stress incontinence developed a urethral diverticulum. The case highlights the potential complications of using penile clamps as an alternative to artificial urinary sphincters, emphasizing the need for caution and periodic removal to prevent serious issues.”