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find Keyword "定义" 19 results
  • Definition and Literature of Evidence-Based Pharmacy: A Systematic Review

    Objective To provide evidence for the definition, current development and prospect of Evidence-based pharmacy through systematically assessing the extant literatures. Methods We searched CBM, VIP, CNKI, PubMed, EMbase, and Google for supplement. We extracted definitions of evidence-based pharmacy, types of studies, published year, topics of studies, and the author information from the included studies. We compared the definitions on different domains, and assessed the current development of evidence-based pharmacy literature. Results a) The definition of evidence-based pharmacy: We found 4 definitions, and there were great differences among them on the people who practiced evidence-based pharmacy as well as the methods and areas of the practice. b) The evidence-based pharmacy literature: 12 English and 202 Chinese articles were included in the review. The number of Chinese evidence-based pharmacy articles was increasing annually, especially in recent 3 years; Most of their authors were from hospitals, especially from pharmacy department; Their study orientations mostly involved clinical pharmacy and hospital pharmacy; The topics mainly refered to the practice and development of clinical pharmacy, rational drug use, and development of hospital pharmacy. Conclusion a) There is yet no consensus on the definition of evidence-based pharmacy. b) Few researchers worldwide know or show interest in evidence-based pharmacy, while, so far, more and more researchers are getting to know evidence-based pharmacy in China. c) Further efforts should be made to develop the theoretical system of evidence-based pharmacy and the pattern of its practice.

    Release date:2016-08-25 02:48 Export PDF Favorites Scan
  • Application of International League Against Epilepsy’ s New Consensus Definition of Drug-resistant Epilepsy in Developing Regions

    目的 评估国际抗癫痫联盟(ILAE)耐药癫痫定义专家共识在发展中国家、发展中地区应用的可行性及应用中存在的问题。 方法 2010年12月9日-2011年2月18日,连续登记癫痫专科门诊患者409例。共纳入183例患者,根据ILAE耐药癫痫新定义对每位纳入患者癫痫分类进行评估。 结果 耐药癫痫患者18例(8.7%),临床治愈患者29例(14.1%),不能判断为159例(77.2%)。入组患者共涉及癫痫药物治疗方案321项。根据ILAE定义步骤一分类为不确定的治疗方案共有199项(62.00%),其中数量最多的为服药剂量<50% WHO限定日剂量有157例(78.89%)。 结论 由于治疗剂量未能够达到国际统一标准,大量患者分类不明确,使得该共识应用面临巨大挑战,但目前为止该共识对于发展中地区耐药癫痫治疗有很强的指导促进意义,对未来耐药癫痫的早期识别有非常大的应用潜力。

    Release date:2021-06-23 07:35 Export PDF Favorites Scan
  • Research Progression of Perineural Invasion of Tumor

    Objective To further comprehend the definition, molecular mechanism, and clinical significance of perineural invasion (PNI) so as to explore new therapy for the tumors. Methods The literatures about the definition, molecular mechanism, and clinical study of PNI were reviewed and analyzed. Results At present, widely accepted definition of PNI was that at least 33% of the circumference of the nerve should be surrounded by tumor cells or tumor cells within any of three layers of the nerve sheath. The newest theory on molecular mechanism of PNI was that PNI was more like infiltration, invasion, not just diffusion. “Path of low-resistance” and “Reciprocal signaling interactions” were the main theories. More recently, the studies had demonstrated that “Reciprocal signaling interactions” could more clearly explain the mechanism of PNI. Stromal elements, including fibroblasts, seemed to play a key role in the complex signaling interactions driving PNI. Neurotrophins and axonal guidance molecules had been implicated in promoting the progress of PNI. PNI was a prognosis index in the cancers of the head and neck, stomach, pancreas, colon and rectum, and prostate, which was positive indicated that the patients would have a poor prognosis and a low 5-year survival rate. Conclusions The mechanism of PNI is very complex, and its clear mechanism is still undefined. Keeping on researching the mechanism of PNI could provide theoretical foundation to disclose the mechanism and the therapy of PNI.

    Release date:2016-09-08 10:34 Export PDF Favorites Scan
  • 癫痫持续状态研究进展

    从国内外研究现状出发, 对癫痫持续状态(Status epilepticus, SE)的定义、流行病学和病因、发病机制、分类、诊断评估、治疗及预后等进行了全面阐述。有关SE定义的历史变迁, 从理论性定义到实用性定义均给出了明确界定, 其中实用性定义为适应人们对SE病理生理机制的进一步理解和满足临床容易操作需要不断更新。国际抗癫痫联盟(ILAE)已对强直-阵挛SE、复杂部分发作SE和失神SE实用性定义给出了明确规定。并对SE的流行病学及病因进行了探讨, 多种神经系统及全身性病理生理改变可导致SE, 发作自我维持与自我终止的平衡破坏是SE发生的必要条件, 发作导致神经系统兴奋性和抑制性系统失衡, 后者反过来又促进发作持续。有关SE分类一直备受关注, 几经变迁, 最新方案重新按惊厥性和非惊厥性分为两大类。诊断需依靠脑电图监测, 尤其非惊厥类型, 典型癫痫发作且持续时间足够长, 可无需脑电图监测证据。神经影像及实验室检查有助于发现病因。SE为神经科急症, 尽早控制发作, 并应与详细的病史采集同时进行, 院前积极给药明显增加SE控制率, 咪达唑仑和苯二氮卓类为首选药物。对难治性SE及早应用麻醉药物, 可减少并发症及死亡率, 提高控制率

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  • 癫痫实用性临床定义

    2005年的癫痫概念性定义:一种具有持久性产生癫痫样发作倾向的大脑疾患。实际上,这个定义通常用于间隔24 h以上的两次非诱发性痫性发作。国际抗癫痫联盟(ILAE)接受了一个特别工作组的建议,在没有满足两次非诱发性发作标准的特殊情况下,改变了实用性定义。特别工作组建议,在符合下列任何一项条件时,癫痫可以考虑为一种脑部疾病:①至少两次间隔>24 h的非诱发性(或反射性)痫性发作;②一次非诱发性(或反射性)痫性发作,在未来10年内,再次发作的可能性与两次非诱发性发作后的再发可能性相当(至少60%);③癫痫综合征的诊断,具有年龄相关的癫痫综合征的个人,目前已经超过该患病年龄,或保持无发作至少10年,并停用抗癫痫药物至少5年,这类癫痫被认为是可以解除的。"解除"与传统上"缓解"或"治愈"的观点不同。不同的实用性定义的形成服务于各种不同的目的。这次修订癫痫定义所使用的术语与常用的术语一致。

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  • 癫痫定义分类新观念及个体化治疗新进展

    作为一种高发病率的谱系疾病,癫痫受到国内外研究者的持续关注。随着认识的深入,研究者们对癫痫的定义及分类提出了新的观点。癫痫的个体化治疗也面临着新挑战和机遇。基因检测的进展、用药时机的研究、高危及特殊人群用药的新证据、神经调控术的发展都有助于医生做出针对性更强的医疗决策。

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  • 癫痫持续状态的定义与分类——ILAE工作组关于癫痫持续状态分类的报告

    国际抗癫痫联盟(ILAE)分类与术语委员会和流行病学委员会组织了一个工作组来修订癫痫持续状态(Status epilepticus, SE)的概念、定义和分类。提出SE的新定义如下:癫痫持续状态是一种由于癫痫发作终止机制的失败或者导致异常的、延长的(在时间点t1之后)癫痫发作机制的启动而导致的情况。这是一种产生长期后果(在时间点t2之后), 包括神经元死亡、神经元损伤及神经元网络改变的情况, 具体取决于癫痫发作的类型和持续时间。该定义是概念性的, 包括两个操作维度:第一是癫痫发作的时长以及时间点(t1), 超过该时间点的发作应当被认为是"持续的发作活动"; 第二时间点(t2)正在进行的发作活动的时间, 在该时间点之后存在造成长期后果的风险。在抽搐性(强直-阵挛)SE的病例中, 2个时间点(t1为5 min, t2为30 min)是基于动物试验和临床研究的。此证据不完整, 并且有待进一步证实, 所以这些时间点应被认为是目前可用的最佳时间点。其它形式的SE数据尚不可用, 但对它们的了解正在增加, 可以基于科学证据为特定形式的SE定义时间点并整合到定义当中而不改变基本的概念。一个新的SE诊断性分类系统被提出, 将为每个患者的临床诊断、研究、治疗方法提供框架。共有4个轴:①症状学; ②病因学; ③脑电图(EEG)相关; ④年龄。轴1(症状学)列出了SE的不同形式, 分为具有显著运动系统症状、无显著运动系统症状和目前尚不确定的情况(如急性意识障碍伴癫痫样EEG图形)。轴2(病因学)分为已知病因和未知病因。轴3(EEG相关)采用了最新的专家共识推荐, 应用以下EEG指标:图形的名称、形态、部位、时间相关特点、调节和干预的影响。轴4将年龄组分为新生儿、婴幼儿、儿童、青少年、成年和老年。

    Release date:2016-10-02 06:51 Export PDF Favorites Scan
  • Advances about Application of Patient Registry

    Through summarizing the definition, concept, and development of patient registry, and also retrieving ClinicalTrials.gov, we introduce its application areas, application range, disease, research number. Based on the application situation, we present the challenges faced now and future development of direction.

    Release date:2016-12-21 03:39 Export PDF Favorites Scan
  • Researches of doctor-patient conflicts in China: a systematic review

    ObjectiveTo systematically review the current status of doctor-patient conflicts in China.MethodsWe searched CNKI and CSSCI databases to collect literatures about the doctor-patient conflicts from inception to April 23rd, 2017. The literatures were categorized by the published time, the high-frequency vocabulary, the citation frequency, the researching discipline, the researching facility, the quality of literature, the theme of literature and so on. The current research status of the doctor-patient conflicts was analyzed.ResultsA total of 226 literatures were included, in which 72 defined and classified the doctor-patient conflicts, 122 analyzed the causing reasons of doctor-patient conflicts, and 160 analyzed the governance paths of doctor-patient conflicts. The research disciplinary vision was limited to the policies, regulations and the medical education and so on, and the researches in psychology or economics disciplinary vision were insufficient. The medical and comprehensive universities were the main research units of the studies of the doctor-patient conflicts. The frequency and quality of the researches about doctor-patient conflicts were low.ConclusionThe classified studies of doctor-patient conflicts are insufficient, so the scientific and manageable classified criterions are needed in the further studies. Systematic studies in influential factors of doctor-patient conflicts are insufficient, so the occurring mechanisms of conflicts are needed to be done by systematical researches on patient-centered way. The studies of governance paths of doctor-patient conflicts are insufficient, so the strategies of classified and systematical management which according to the different conflicting forms and entire process of the conflict occurrence should be put forward.

    Release date:2017-09-15 11:24 Export PDF Favorites Scan
  • Definition, classification, and staging for adenocarcinoma of esophagogastric junction: updates in controversies

    ObjectivesTo summarize the latest advances about definition, classification, and TNM stage of adenocarcinoma of esophagogastric junction (AEG).MethodThe available guidelines, consensuses, international conference proceedings, and clinical studies were reviewed and summarized.ResultsThe AEG trended to be an independent entity of malignant tumor at the special location. The previous misunderstanding of AEG definitions from the WHO needed to be corrected and unified in China. The Siewert classification was still a practical clinical approach to guiding treatment strategy, while the new draft of JGCA classification needed to be evaluated and verified in the clinical practice. By contrast, the 8th edition AJCC/UICC classification was relatively controversial in the guiding treatment strategies, mainly due to the staging system, surgical approach, and extent of lymphadenectomy of Siewert Ⅱ type AEG. Based on the available research results, the TNM staging system of the 8th edition of gastric cancer tended to be more reasonable for the Siewert Ⅱ and Ⅲ types AEG.ConclusionWith increasing incidence of AEG, more experimental and clinical studies on AEG are ongoing, and it is expected to have more optimized classification and exclusive staging system for AEG in future.

    Release date:2019-09-26 10:54 Export PDF Favorites Scan
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