Clinical analysis of colistin sulfate in the treatment of pneumonia caused by carbapenem-resistant Gram-negative bacteria

BACKGROUND Multidrug-resistant Gram-negative bacteria,exacerbated by excessive use of antimicrobials and immunosuppressants,are a major health threat.AIM To study the clinical efficacy and safety of colistin sulfate in the treatment of carbapenem-resistant Gram-negative bacilli-induced pneumonia,and to provide theoretical reference for clinical diagnosis and treatment.METHODS This retrospective analysis involved 54 patients with Gram-negative bacilli pneumonia admitted to intensive care unit of The General Hospital of the Northern Theater Command of the People's Liberation Army of China from August 2020 to June 2022.After bacteriological culture,the patients'airway secretions were collected to confirm the presence of Gram-negative bacilli.The patients were divided into the experimental and control groups according to the medication used.The research group consisted of 28 patients who received polymyxin sulfate combined with other drugs through intravenous,nebulization,or intravenous combined with nebulization,with a daily dosage of 1.5–3.0 million units.The control group consisted of 26 patients who received standard dosages of other antibiotics(including sulbactam sodium for injection,cefoperazone sodium sulbactam for injection,tigecycline,meropenem,or vaborbactam).RESULTS Of the 28 patients included in the research group,26 patients showed improvement,treatment was ineffective for two patients,and one patient died,with the treatment efficacy rate of 92.82%.Of the 26 patients in the control group,18 patients improved,treatment was ineffective for eight patients,and two patients died,with the treatment efficacy rate of 54.9%;significant difference was observed between the two groups(P<0.05).The levels of white blood cell(WBC),procalcitonin(PCT),and C-reactive protein(CRP)in both groups were significantly lower after treatment than before treatment(P<0.05),and the levels of WBC,PCT,and CRP in the research group were significantly lower than those in the control group(P<0.05).Compared with before treatment,there were no significant changes in aspartate aminotransferase,creatinine,and glomerular filtration rate in both groups,while total bilirubin and alanine aminotransferase decreased after treatment(P<0.05)with no difference between the groups.In patients with good clinical outcomes,the sequential organ failure assessment(SOFA)score was low when treated with inhaled polymyxin sulfate,and specific antibiotic treatment did not improve the outcome.Sepsis and septic shock as well as a low SOFA score were independent factors associated with good clinical outcomes.CONCLUSION Polymyxin sulfate has a significant effect on the treatment of patients with multiple drug-resistant Gram-negative bacilli pneumonia and other infections in the lungs and is safe and reliable.Moreover,the administration route of low-dose intravenous injection combined with nebulization shows better therapeutic effects and lower adverse reactions,providing new ideas for clinical administration.

mok E基因过表达对红曲霉Monacolin K产量、菌丝及孢子形态的影响

红曲霉中mok E基因是红曲霉次级代谢产物Monacolin K生物合成的一个相关基因,mok E基因表达量与Monacolin K产量呈正相关。以mok E基因为目的基因,构建红曲霉mok E基因过表达工程菌株,通过逆转录实时荧光定量聚合酶链式反应(reverse transcription-quantitative real-time polymerase chain reaction,RT-q PCR)确定mok E基因过表达转化子,对转化子Monacolin K产量进行测定,同时利用扫描电镜,对野生型红曲霉M1及转化子菌丝、孢子进行观察。结果表明:以潮霉素抗性基因为筛选标记,成功得到240个转化子,对其中9个转化子进行mok E基因表达量测定,有3株转化子mok E基因表达量增加,分别为T2、T8、T9转化子,确定其为mok E基因过表达转化子;T2、T8、T9转化子内酯型Monacolin K产量分别为2 159.7、4 177.6、3 365.7μg/g,与野生型红曲霉Monacolin K产量(1 447.8μg/g)相比,分别提高了49.2%、188.5%及132.5%。扫描电镜结果显示,mok E基因过表达,对红曲霉的菌丝体、孢子形态及生殖方式均有影响。

PCOS患者和肽素、Ghrelin、DHEA-S水平及与胰岛素抵抗的相关性研究

目的探究和肽素、生长激素释放肽(Ghrelin)、硫酸脱氢表雄酮(DHEA-S)在多囊卵巢综合征(PCOS)中的水平及与胰岛素抵抗的相关性。方法选取2019年4月至2021年4月在秦皇岛市第一医院生殖医学科就诊治疗的PCOS患者130例作为研究对象(PCOS组),选择同期在该院接受体检的健康女性100例作为健康对照组。又根据体质量指数(BMI)不同将PCOS组分为肥胖型组(50例)和非肥胖型组(80例)。PCOS患者接受炔雌醇环丙孕酮和二甲双胍治疗。采用血糖仪测量所有参与研究人员的空腹血糖水平,化学发光法测量DHEA-S水平、酶联免疫吸附法检测和肽素和Ghrelin水平。比较PCOS组、健康对照组的基线资料及PCOS肥胖型组、非肥胖型组治疗前后与健康对照组的和肽素、Ghrelin、DHEA-S及胰岛素抵抗指数(HOMA-IR)水平,并分析PCOS患者和肽素、Ghrelin、DHEA-S水平与HOMA-IR的相关性。结果PCOS组、健康对照组的年龄、BMI分布、血脂水平、血压水平等比较均无显著性差异(P>0.05)。PCOS肥胖型组患者治疗前和肽素、DHEA-S及HOMA-IR水平显著高于健康对照组和PCOS非肥胖型组(P<0.05),而Ghrelin水平显著低于健康对照组和PCOS非肥胖型组(P<0.05)。PCOS组患者治疗后和肽素、DHEA-S与HOMA-IR水平显著低于治疗前,而Ghrelin水平显著高于治疗前(P<0.05),且PCOS非肥胖型组患者各指标改善情况显著优于PCOS肥胖型组(P<0.05)。Pearson相关性分析显示,PCOS患者治疗前和肽素、DHEA-S水平与HOMA-IR呈显著正相关(P<0.05),Ghrelin水平与HOMA-IR呈显著负相关(P<0.05)。结论PCOS患者和肽素、DHEA-S高表达,Ghrelin低表达,且与HOMA-IR显著相关,可能为临床PCOS的诊断和治疗提供参考。

Effect of endogenous insulin-like growth factor and stem cell factor on diabetic colonic dysmotility

AIM: To investigate whether the reduction of stem cell factor (SCF) is mediated by decreased endogenous insulin-like growth factor (IGF)-1 in diabetic rat colon smooth muscle. METHODS: Sixteen Sprague-Dawley rats were randomly divided into two groups: control group and streptozotocin-induced diabetic group. After 8 wk of streptozotocin administration, colonic motility function and contractility of circular muscle strips were measured. The expression of endogenous IGF-1 and SCF was tested in colonic tissues. Colonic smooth muscle cells were cultured from normal adult rats. IGF-1 siRNA transfection was used to investigate whether SCF expression was affected by endogenous IGF-1 expression in smooth muscle cells, and IGF-1 induced SCF expression effects were studied. The effect of high glucose on the expression of endogenous IGF-1 and SCF was also investigated. RESULTS: Diabetic rats showed prolonged colonic transit time (252 ± 16 min vs 168 ± 9 min, P < 0.01) and weakness of circular muscle contraction (0.81 ± 0.09 g vs 2.48 ± 0.23 g, P < 0.01) compared with the control group. Endogenous IGF-1 and SCF protein expression was significantly reduced in the diabetic colonic muscle tissues. IGF-1 and SCF mRNA expression also showed a paralleled reduction in diabetic rats. In the IGF-1 siRNA transfected smooth muscle cells, SCF mRNA and protein expression was significantly decreased. IGF-1 could induce SCF expression in a concentration and time-dependent manner, mainly through the extracellular-signal-regulated kinase 1/2 signal pathway. High glucose inhibited endogenous IGF-1 and SCF expression and the addition of IGF-1 to the medium reversed the SCF expression. CONCLUSION: Myopathy may resolve in colonic motility dysfunction in diabetic rats. Deficiency of endogenous IGF-1 in colonic smooth muscle cells leads to reduction of SCF expression.

Serum Uric Acid is Associated with the Predicted Risk of Prevalent Cardiovascular Disease in a Community-dwelling Population without Diabetes

Objective To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.Methods We investigated the association between serum uric acid levels and the risk of prevalent cardiometabolic diseases, 10-year Framingham risk for coronary heart disease, and 10-year risk for atherosclerotic cardiovascular diseases （ASCVD） among 8,252 participants aged 〉 40 years without diabetes from Jiading district, Shanghai, China.Results Body mass index, waist circumference, blood glucose, glycated hemoglobin, blood pressure, and serum lipids increased progressively across the sex-specific quartiles of uric acid （all P trend 〈 0.05）. Compared with individuals in the lowest quartile, those in the higher quartiles had a significantly higher prevalence of obesity, hypertension, and dyslipidemia （all P trend 〈 0.05）. A fully adjusted logistic regression analysis revealed that individuals in the highest quartile had an increased risk of predicted cardiovascular disease compared with those in the lowest quartile of uric acid. The multivariate adjusted odds ratios （ORs） [95% confidence intervals （C/s）] for the highest quartiles for high Framingham risk were 3.00 （2.00-4.50） in men and 2.95 （1.08-8.43） in women. The multivariate adjusted ORs （95% C/s） for the highest quartile for high ASCVD risk were 1.93 [1.17-3.17） in men and 4.53 （2.57-7.98） in women.Conclusion Serum uric acid level is associated with an increased risk of prevalent obesity, hypertension, dystipidemia, 10-year Framingham risk for coronary heart disease, and lO-year risk for ASCVD among Chinese adults without diabetes.

Investigation of scale efect for the computation of turbulent flow around a circular cylinder

In order to investigate the scale effect of turbulent flow around a circular cylinder, two similarity numbers （criteria） based on turbulent kinetic and dissipation rates associ- ated with the fluctuation characteristics of turbulence wake are deduced by analyzing the Reynolds averaged NavierStokes equations （RANS）. The RNG k-s models and finite volume method are used to solve the governing equations and the second-order implicit time and upwind space discretization algorithms are used to discrete the governing equations. A numerical computation of flow parameters around a two-dimensional circular cylinder with Reynolds numbers ranging from 102 to l07 is accomplished and the result indicates that the fluctuation of turbulence flow along the center line in the wake of circular cylinder can never be changed with increasing Reynolds numbers when Re ≥ 3 × 10^6. This conclusion is useful for controlling the scale of numerical calculations and for applying model test data to engineering practice.

Unusual tunability of multiferroicity in GdMn_2O_5 by electric field poling far above multiferroic ordering point

The multiferroicity in the RMn_2O_5 family remains unclear, and less attention has been paid to its dependence on high-temperature(high-T) polarized configuration. Moreover, no consensus on the high-T space group symmetry has been reached so far. In view of this consideration, one may argue that the multiferroicity of RMn_2O_5 in the low-T range depends on the poling sequence starting far above the multiferroic ordering temperature. In this work, we investigate in detail the variation of magnetically induced electric polarization in GdMn_2O_5 and its dependence on electric field poling routine in the high-T range. It is revealed that the multiferroicity does exhibit qualitatively different behaviors if the high-T poling routine changes, indicating the close correlation with the possible high-T polarized state. These emergent phenomena may be qualitatively explained by the co-existence of two low-T polarization components, a scenario that was proposed earlier.One is the component associated with the Mn^(3+)–Mn^(4+)–Mn^(3+) exchange striction that seems to be tightly clamped by the high-T polarized state, and the other is the component associated with the Gd Mn^(3+)–Mn^(4+)–Mn^(3+) exchange striction that is free of the clamping. The present findings may offer a different scheme for the electric control of the multiferroicity in RMn_2O_5.

The Ultraviolet Detection of Corona Discharge in Power Transmission Lines

Corona discharge is a common phenomenon in power transmission lines external insulation, and it may cause serious defect if without effective detection. The ultraviolet (UV) imagery technology has been widely used to detect the corona discharge in industry in recent years, but some influence factors’ functions are not definite. In this paper, the fracture aluminum strands which is common in power transmission lines were used as the electrode model while a SuperB ultraviolet imager were utilized to detect, the photon count rate was detected with different detect distance, electric field, aluminum strands length and UV gain were applied. Then the multivariate regression analysis (MRA) was taken to calculate the function between the photon count and the factors.

Climate change impacts the distribution of Quercus section Cyclobalanopsis(Fagaceae),a keystone lineage in East Asian evergreen broadleaved forests

East Asian evergreen broadleaved forests(EBFLs) harbor high species richness,but these ecosystems are severely impacted by global climate change and deforestation.Conserving and managing EBLFs requires understanding dominant tree distribution dynamics.In this study,we used 29 species in Quercus section Cyclobalanopsis-a keystone lineage in East Asian EBLFs-as proxies to predict EBLF distribution dynamics using species distribution models(SDMs).We examined climatic niche overlap,similarity,and equivalency among seven biogeographical regions’ species using’ecospat’.We also estimated the effectiveness of protected areas in the predicted range to elucidate priority conservation regions.Our results showed that the climatic niches of most geographical groups differ.The western species under the Indian summer monsoon regime were mainly impacted by temperature factors,whereas precipitation impacted the eastern species under the East Asian summer monsoon regime.Our simulation predicted a northward range expansion of section Cyclobalanopsis between 2081 and 2100,except for the ranges of the three Himalayan species analyzed,which might shrink significantly.The greatest shift of highly suitable areas was predicted for the species in the South Pacific,with a centroid shift of over 300 km.Remarkably,only 7.56% of suitable habitat is currently inside protected areas,and the percentage is predicted to continue declining in the future.To better conserve Asian EBLFs,establishing nature reserves in their northern distribution ranges,and transplanting the populations with predicted decreasing numbers and degraded habitats to their future highly suitable areas,should be high-priority objectives.

敲低lincRNA-COX2抑制单核细胞增生李斯特菌感染相关的巨噬细胞的凋亡和M1型极化

目的探讨长链基因间非编码RNA环加氧酶2(lincRNA-COX2)在单核细胞增生李斯特菌(Lm)感染所致RAW264.7细胞凋亡和细胞极化中的作用.方法体外培养RAW264.7细胞,分为未感染对照组、Lm感染组、小干扰RNA阴性对照(si-NC)组、si-NC联合Lm组、lincRNA-COX2小干扰RNA(si-lincRNA-COX2)组、si-lincRNA-COX2联合Lm组.Lm感染复数(MOI)=10感染RAW264.7细胞,细菌感染6 h后收集细胞,倒置荧光显微镜和实时定量PCR检测siRNA转染抑制效率,Western blot法检测细胞中裂解型胱天蛋白酶3(c-caspase-3)、caspase-3、B细胞淋巴瘤因子2(Bcl2)、Bcl2相关X蛋白(BAX)、精氨酸酶1(Arg1)和诱导型一氧化氮合酶(iNOS)蛋白水平.结果Lm感染RAW264.7细胞后,c-caspase-3/caspase-3、BAX/Bcl2比值、iNOS蛋白水平较对照组显著上调,而Arg1水平较对照组下调.敲低lincRNA-COX2可抑制Lm感染引起的RAW264.7细胞中BAX/Bcl2、c-caspase-3/caspase-3及iNOS蛋白的升高,上调Lm感染后RAW264.7细胞中的Arg1蛋白.结论敲低lincRNA-COX2抑制Lm感染引起的RAW264.7细胞凋亡并抑制其向M1型极化.

Sporolactobacillus GD201215-the Reason forSwelling of Fruit Jelly

A gram-positive facultatively anaerobic bacterium, named Sporolactobacillus GD201215, was isolated from swollen fruit jelly. Colonies were circular, bulgy, opaque, moist and white, with a 1-2 mm diameter. Its sequence showed 97.46% and96.91% homology with Sporolactobacillus vineae SL153 T and S. putidus QC81-06 T, respectively. Sporolactobacillus GD201215 uses glucose, fructose and sucrose to produce acid, and metabolizes sodium citrate to generate CO_2 which is responsible for swelling of fruit jelly. It grew anaerobically in GYP broth at 37 ℃, p H 3.5-7.0, with 0-2%(w/v) Na Cl, and could be killed by heating at 71 ℃ for above 5 min.

Development of a Detection Method for Assaying Calf Intestine Alkaline Phosphatase Activity

[ Objective] This study was to develop a detection method for assaying calf intestine alkaline phasphatase activity in scientific research. [ Method ] By simulating the conditions and buffers for assaying calf intestine alkaline phosphatase used in the scientific research, the parameters influencing substmte concentration, reaction duration, eoloration time and buffer pH were optimized. [ Result] The activity of alkaline phosphatase detected varied hugely among different buffers, and potassium ferricyanide solution added with boracic acid achieved the stable coloration. The optimal water bath time was determined as 10 rain, and the substrate concentration was optimized as 0.04 moL/L. The increasing temperature did not have a large influence on low temperature enzymatic activity while did on high coneentration enzymatic activity. When the buffer pH was 7.0 - 8.0, the detection stability of alkaline phosphatase could be maintained well The ion intensity of buff- er had little effects on alkaline phasphatase activity. [ Conclusion] A detection method for assaying calf intestine alkaline phosphatase activity in scientific research was successfully developed in this study.

Progress in clinical trial of histone deacetylase(HDAC) inhibitors for non-small cell lung cancers

Histone deacetylase(HDAC) inhibitors, which represent a structurally diverse group of molecules, have emerged as a novel therapeutic class of molecules with significant anticancer potential. Vorinostat and romidepsin, known as the first generation of HDAC inhibitors, were approved in the United States for the treatment of T-cell lymphomas. Preliminary activity of HDAC inhibitors has also been observed in non-small cell lung cancer(NSCLC) in combination with the existing treatment regimens, of which is the focus of the current review.

Effects of Qishen Yiqi dripping pills-containing serum on KATP channel opening and PI3K/AKT signaling pathway in hypoxic/reoxygenated H9C2 cardiocytes

Objective:To investigate the effects of Qishen Yiqi dropping pills serum on KATP channel opening and PI3K/AKT signaling pathway of hypoxic/reoxygenated H9C2 cardiocytes.Methods:H9C2 cardiocytes cultured in vitro were randomly divided into five groups,A:H9C2 cell group B:H9C2 cells+H2O2 model group C:H9C2 cells+H2O2 model+Qishen Yiqi group D:H9C2 cells+H2O2 model+Qishen Yiqi+wort group E:H9C2 cells+H2O2 model+Qishenyiqi+5-HD group,the drug intervention is according to the corresponding conditions.CCK-8 method was used to detect the cell activity of each group;Western blot was used to detect the expression of AKT and P-Akt proteins in myocardial cells in each group.The current was recorded by the standard patch clamp whole cell recording method,and the current was collected and analyzed by Pclamp6.0 software.Results:CCK-8 test results showed that compared with group A,the activity of myocardial cells in group B was significantly decreased,and the difference was statistically significant(P<0.01);compared with group B,the difference in group C was statistically significant(P<0.01);compared with C,cardiomyocyte activity in D and E group were significantly decreased,and the difference was statistically significant(P<0.05);WB results showed that compared with A,p-Akt protein expression in B,C,D and E groups were significantly decreased,and the difference was statistically significant(P<0.01);compared with group B,p-Akt protein expression in C,D and E group were significantly increased,and the difference was statistically significant(P<0.01),but there was no significant difference in AKT expression among groups(P>0.05);The results of whole cell patch clamp experiment showed that the outward current of B was significantly increased compared with that of A,and the difference between groups was statistically significant(P<0.01);compared with group B,cardiomyocytes in group C further increased the outward current,and the difference between groups was statistically significant(P<0.01);compared with C,the current of D and E group were significantly decreased,with statistical significance between groups(P<0.01).Conclusion:QishenYiqi dropping pills can protect cardiomyocytes by activating p-Akt protein expression and KATP channel opening in H9C2 cardiomyocytes.

Clinical study on the correlation between plasma lipopolysaccharide and the structural characteristics of coronary intravascular ultrasound plaques

Objective:To study the correlation between plasma lipopolysaccharide and coronary atherosclerotic heart disease risk factors and plaque stability.Methods:136 patients with unstable angina pectoris who underwent coronary angiography and intravascular ultrasound were selected from the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine.According to the results of IVUS,they were divided into stable plaques(stable plaques,SP)group of 72 patients With 64 cases in the Unstable plaques(UP)group,venous blood was drawn from the two groups of patients for blood lipid and lipopolysaccharide index detection,and the general baseline data of the two groups were recorded;the structural characteristics of the intravascular ultrasound plaques in the two groups were analyzed.To study the influencing factors of unstable plaques,the correlation between lipopolysaccharide and plaque structural characteristics,and the diagnostic efficacy of unstable plaques.Results:The expression levels of cholesterol,low-density lipoprotein,and LPS in the UP group were higher than those in the SP group(P<0.05),and the high-density lipoprotein expression levels were lower than those in the SP group(P=0.035);and the intravascular ultrasound structure of the plaque was UP The lipid pool area,the ratio of lipid pool to plaque area,the plaque eccentricity index,and the maximum plaque thickness of the group were higher than those of the SP group(P<0.05),and the minimum plaque thickness was smaller than that of the SP group and the difference was statistically significant(P<0.05);LPS was positively correlated with cholesterol,low-density lipoprotein,lipid pool area,ratio of lipid pool to plaque area,plaque eccentricity index,and maximum plaque thickness by Pearson correlation test(P<0.05),Is negatively correlated with high-density lipoprotein(P=0.021);LPS is a risk factor for coronary plaque stability,and HDL is a protective factor for coronary plaque stability by binary logistic regression test.The difference is statistically significant Scientific significance(P=0.049,P=0.002);LPS diagnosis of coronary atherosclerotic plaque stability ROC area under the curve(AUC)is 0.889,95%CI is(0.805,0.974),the best diagnosis point is 57.485 mg/L,the sensitivity is 80.60%,and the specificity is 73.70%.Conclusion:Plasma lipopolysaccharide is a risk factor of unstable plaque,which has certain diagnostic value for coronary artery plaque,and can be used as a quantitative diagnostic index of plaque vulnerability.

Online Parallel-Batch Machines Scheduling with a Single Server

We consider parallel-batch machines scheduling problem with a single server to minimize the maximum completion time.Jobs arrive over time.Every batch has to be loaded by the sever before being processed on machines.The loading(setup)operation of a batch occurs only when some machine is idle,and the server can perform only one setup operation every time.For some special case,we provide a best possible online algorithm with competitive ratio■.For general case,we give another online algorithm with competitive ratio 3.

Notch 1 and NF-κB Expression and Clinical Correlation in Chinese Patients with Lymphoblastic Lymphoma

T-cell acute lymphoblastic leukemia/lymphoma (T-ALL/T-LBL) is commonly associated with Notch 1 mutations. There is limited data on the relationship between Notch l and NF-κB expression and clinical features in LBL. We evaluated the expression of Notch l and NF-κB in LBL using immunohistochemistry and analyzed their relationship with clinical characteristics, treatment results, and survival. From October 2000 to August 2008, 34 untreated patients with LBL were enrolled in the study. Median age was 11.8 years (range, 1 - 25 years). Twenty-five patients were diagnosed with T-LBL and 9 patients with B-LBL. Most patients received chemotherapy consisting of modified ALL-BFM- 90. Notch l showed high expression in 68% of T-LBL and low expression in 100% of B-LBL (p = 0.015). High expression of Notch l positively correlated with presence of a mediastinal mass but not with 5-year event free survival (EFS) in T-LBL. NF-κB showed high expression in 65% of all patients with LBL, with no difference between T- and B-LBL. NF-κB expression was higher in T-LBL patients with bulky disease and B symptom;it did not correlate with 5-year EFS in T-LBL. Expression of Notch 1 and NF-κB strongly correlated (p = 0.014) in T-LBL. Notch 1 is highly ex- pressed in T-LBL. NF-κB is highly expressed in all patients with LBL with no difference between T-LBL and B-LBL. Notch 1 expression was significantly associated with NF-κB expression in T-LBL. Notch l and NF-κB may play an important role in the development of T-LBL;further investigation is warranted.

Meet Jiaolong Ma Dancing in London Online

Since uploading his first short-form dance video on TikTok in May 2020,Jiaolong Ma,a Chinese dancer,has gained 4.67 million fans and more than 56 millio n likes on TikTok,in eluding one clip n ear Tower Bridge in Lon don that has been viewed more than 200 million times on various online platforms.It was incredible for him who used to conduct performance at theaters and provide instruction in schools.Jiaolong Ma is an excellent teacher at Beijing Dance Academy,specializing in Chinese classical dance.With a lot of questions,we had a conversation with this Chinese dancer who is still teaching at Goldsmiths College in London.

中国县域医共体研究热点与前沿分析

背景推进县域医共体建设是推动构建分级诊疗秩序的重要举措,国内学术界在县域医共体领域开展了丰富的理论和实证研究,但对现有研究成果的归纳与总结不足。运用文献计量学方法系统梳理该领域相关文献的研究进展,可以为全面推进县域医共体高质量发展提供借鉴与参考。目的基于中国县域医共体领域的文献数据进行可视化分析,探讨该领域的研究热点和前沿趋势。方法于2024-02-25,系统检索中国知网收录的县域医共体相关文献,检索时限为2016-2023年。采用CiteSpace软件对文献的发表年份、作者和机构,以及关键词共现、聚类、时间线分布、突现等情况开展文献计量学可视化分析。结果共纳入文献481篇,该领域的发文量受政策因素驱动呈递增趋势,2016-2019年发文65篇(13.51%),2020-2021年发文167篇(34.72%),2022-2023年发文249篇(51.77%)。发文量排在前3位的作者分别为陈迎春、王芳、郑英,发文量均为8篇。关键词的中心度和聚类规模排在前2位的是“医共体”和“分级诊疗”。时间线分布提示,“分级诊疗”是该领域出现最早且延续性最好的研究热点,此外,“医防融合”“绩效考核”“对策”“患者”等聚类也为研究热点。关键词突现分析显示,“医保基金”“慢性病”“管理模式”“发展策略”“乡村医生”是该领域近年来的研究热点和未来方向。结论关注分级诊疗制度建设,聚焦慢性病和公共卫生医防融合服务,探索绩效考核路径是县域医共体的研究热点。未来该领域在深化政策内涵研究,以县域医共体建设推动构建分级诊疗秩序、推进医防融合创新、强化绩效考核与优化内部管理领域表现出较强的研究趋势。

省域国土空间生态修复规划体系构建的逻辑与实践——基于“规划—设计—治理”的视角

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