论道教“祝由符咒”的实用价值及其对中医“意疗”的影响

道教“祝由符咒”起源于巫术,后世用以为人治病时,又体现出一定的实用价值。中医学受其启发,以祝由之术治疗情志疾病,其疗效受到历代医家推崇,由此丰富和发展了中医学的治疗方法。     

文化自信视域下中医药现代价值与发展定位探析

新冠肺炎疫情暴发以来,中医药广泛介入且疗效显著,引发学术界、媒体、民众对中医药现代价值和发展状况的思考与讨论。结合文化自信的战略视角,可从以下三个维度分析其价值与定位:从文化传承角度看,弘扬中医药文化是打开中华文明宝库的重要门户,中医药文化的承续与推广,是中华文明复兴的开路先锋;从文化创新角度讲,推动中医药与现代科技、文化的对接、融合,强化其作为连接传统文化与现实生活的纽带作用,有助于建立以健康实践为旨归的中国文化新体系;从文化传播布局言,宣传中医药文化是为世界卫生发展贡献中国智慧、提供中国方案,以中医药文化作为传播中华文化的先行军必将大有可为。     

中药组合物发明的创造性问题研究

针对中药组合物发明的创造性判断问题以及中药组合物发明的创造性与中药药理之间的关系问题展开研究。如果中药组合物发明是中医药领域的技术人员在现有的中药处方的基础上,仅仅根据已知的中药药理进行合乎逻辑的分析、推理或者有限的试验就可以得到,且没有产生预料不到的技术效果,则该中药组合物发明不具备创造性;如果中药组合物的原料组成或者技术效果是不容易想到的,则该中药组合物发明具备创造性。在中药组合物发明的创造性与中药药理的关系问题上,具备创造性的发明必然符合中药药理,但符合中药药理的发明不一定具备创造性,而人们对中药药理的认识也是不断拓展和深化的。     

中药“保健增乳乐”对围产期奶牛血液生化指标的影响

试验选用30头干奶牛随机分成试验Ⅰ组、Ⅱ组及对照组(Ⅲ),观察中药“保健增乳乐”对围产期奶牛血液生化指标的影响。在此基础上,异地选择10头干奶牛随机分成试验组(Ⅰ)和对照组(Ⅱ)进行了重复试验。结果显示:中药“保健增乳乐”能显著地降低产后奶牛血清谷草转氨酶(SGOT)、血清γ—谷氨酰转肽酶(Sγ—GT)、血清碱性磷酸酶(SALP)的活性(P<0.05),血清酮体含量(KB)、血清甘油三酯(TG)含量显著减少(P<0.01)。血糖(G)含量升高(P<0.05)。血清钙、无机磷的含量维持正常水平。结果显示中药“保健增乳乐”能有效地改善围产期奶牛的肝脏功能,维持奶牛的正常代谢,预防奶牛围产期的营养代谢性疾病。     

Development of predictive signatures for treatment selection in precision medicine with survival outcomes

For survival endpoints in subgroup selection, a score conversion model is often used to convert the set of biomarkers for each patient into a univariate score and using the median of the univariate scores to divide the patients into biomarker‐positive and biomarker‐negative subgroups. However, this may lead to bias in patient subgroup identification regarding the 2 issues: (1) treatment is equally effective for all patients and/or there is no subgroup difference; (2) the median value of the univariate scores as a cutoff may be inappropriate if the sizes of the 2 subgroups are differ substantially. We utilize a univariate composite score method to convert the set of patient's candidate biomarkers to a univariate response score. We propose applying the likelihood ratio test (LRT) to assess homogeneity of the sampled patients to address the first issue. In the context of identification of the subgroup of responders in adaptive design to demonstrate improvement of treatment efficacy (adaptive power), we suggest that subgroup selection is carried out if the LRT is significant. For the second issue, we utilize a likelihood‐based change‐point algorithm to find an optimal cutoff. Our simulation study shows that type I error generally is controlled, while the overall adaptive power to detect treatment effects sacrifices approximately 4.5% for the simulation designs considered by performing the LRT; furthermore, the change‐point algorithm outperforms the median cutoff considerably when the subgroup sizes differ substantially.     

The case of vegetovascular dystonia: inventing the most common Soviet disease

ABSTRACT

The paper considers the case of vegetovascular dystonia, one of the most typical and common “Soviet” diseases. This syndrome emerged in Soviet medicine after World War II, and very quickly become a popular diagnosis among physicians. The author describes how the construct of vegetovascular dystonia was formed and developed, what changes it underwent, and what affected those changes. The concept and history of vegetovascular dystonia can provide an understanding of Soviet medicine and health science in general.     

"百苗图"源流考略--以《黔苗图说》为范本

“百苗图”是历史背景较为复杂的一种反映贵州古代少数民族的地方文献,其版本众多。据考,它们是源自清人陈浩著的《八十二种苗图并说》。关于其母本的产生历史,学术界纷争不一。《黔苗图说》是贵州省博物馆收藏的一部较为典型的百苗图册页。本文以它为例,试对“百苗图”的源流做一些考证。并认为其母本并非某一时代实地调查的第一手资料,而主要是利用许多地方文献的相关材料编纂成册。     

On evaluating how well a biomarker can predict treatment response with survival data

One of the objectives of personalized medicine is to take treatment decisions based on a biomarker measurement. Therefore, it is often interesting to evaluate how well a biomarker can predict the response to a treatment. To do so, a popular methodology consists of using a regression model and testing for an interaction between treatment assignment and biomarker. However, the existence of an interaction is not sufficient for a biomarker to be predictive. It is only necessary. Hence, the use of the marker‐by‐treatment predictiveness curve has been recommended. In addition to evaluate how well a single continuous biomarker predicts treatment response, it can further help to define an optimal threshold. This curve displays the risk of a binary outcome as a function of the quantiles of the biomarker, for each treatment group. Methods that assume a binary outcome or rely on a proportional hazard model for a time‐to‐event outcome have been proposed to estimate this curve. In this work, we propose some extensions for censored data. They rely on a time‐dependent logistic model, and we propose to estimate this model via inverse probability of censoring weighting. We present simulations results and three applications to prostate cancer, liver cirrhosis, and lung cancer data. They suggest that a large number of events need to be observed to define a threshold with sufficient accuracy for clinical usefulness. They also illustrate that when the treatment effect varies with the time horizon which defines the outcome, then the optimal threshold also depends on this time horizon.     

A visualization method measuring the performance of biomarkers for guiding treatment decisions

Biomarkers that predict efficacy and safety for a given drug therapy become increasingly important for treatment strategy and drug evaluation in personalized medicine. Methodology for appropriately identifying and validating such biomarkers is critically needed, although it is very challenging to develop, especially in trials of terminal diseases with survival endpoints. The marker‐by‐treatment predictiveness curve serves this need by visualizing the treatment effect on survival as a function of biomarker for each treatment. In this article, we propose the weighted predictiveness curve (WPC). Based on the nature of the data, it generates predictiveness curves by utilizing either parametric or nonparametric approaches. Especially for nonparametric predictiveness curves, by incorporating local assessment techniques, it requires minimum model assumptions and provides great flexibility to visualize the marker‐by‐treatment relationship. WPC can be used to compare biomarkers and identify the one with the highest potential impact. Equally important, by simultaneously viewing several treatment‐specific predictiveness curves across the biomarker range, WPC can also guide the biomarker‐based treatment regimens. Simulations representing various scenarios are employed to evaluate the performance of WPC. Application on a well‐known liver cirrhosis trial sheds new light on the data and leads to discovery of novel patterns of treatment biomarker interactions. Copyright © 2015 John Wiley & Sons, Ltd.     

医教结合：实践、争议与问题

目前我国特殊教育学校学生残障程度趋重,残障类型、教康需求日趋多样化。我国在不断的探索中形成符合自身特点的教育和康复的整合模式———医教结合,并在医教结合的实践中取得一定成果。但目前国内不仅对医教结合内涵、过程等方面未达成一致观点,学者们在其他一些问题上也存在争议。医教结合推进过程中,适用对象、学校教师、理论本身、政策制定方面存在的问题,仍需各方共同努力去解决,研究完善医教结合的理论与政策,促进特殊教育医教结合的发展。