AVAPS通气模式联合TCM监测在慢性阻塞性肺疾病急性加重期患者脱机中的应用价值

目的探讨AVAPS通气模式联合经皮氧/二氧化碳检测仪(TCM)监测在慢性阻塞性肺疾病急性加重(AECOPD)患者有创-无创序贯通气中的应用价值。方法选取行有创通气的老年慢阻肺患者120例,根据无创呼吸机的不同通气模式,将患者脱机后随机分为S/T组及AVAPS组,每组患者60例。所有患者在“出窗”时记录呼吸频率(RR)、心率(HR)、血氧饱和度(SpO_(2))、吸氧浓度(FiO_(2))、序贯性器官功能衰竭评分(SOFA)、白细胞总数、降钙素原、血小板、白蛋白及肌酐等指标,并记录无创机械通气6h后呼吸频率(RR)、心率(HR)、血氧饱和度(SpO_(2))及吸氧浓度(FiO_(2))等指标。同时记录二氧化碳分压(PaCO_(2)),行经皮二氧化碳分压(PtcCO_(2))监测,比较PtcCO_(2)与PaCO_(2)的相关性及治疗前后各生理参数的差异。比较两组患者48h再插管率、距插管时间、ICU住院时间。分析撤机后行无创机械通气6h后PtcCO_(2)变异度对48h再插管的预测效能。结果两组患者“出窗”时各生理参数及PtcCO_(2)值,均无统计学差异(P>0.05)。与S/T组比较,无创通气6h后,AVAPS组的生理参数RR、HR、PtcCO_(2)变异度及ROX指数均有所改善,差异有统计学意义(P<0.05),且AVAPS组的48h再插管率优于S/T组,且距插管时间更长(P<0.05)。ROC曲线分析显示,通气6h后的PtcCO_(2)变异度对AVAPS组患者48h再插管具有一定的诊断效能,其敏感度为92.30%,特异度为82.60%,AUC为0.898。结论AVAPS通气模式联合PtcCO_(2)在重症慢阻肺有创-无创“序贯”治疗的运用,能有更好的生理参数,更低的再插管率,以及更为优势的“人机协调性”。

基于TCM模式的护理干预对胃癌手术患者负性情绪及生活质量的影响

分析胃癌手术患者在倡导TCM的理念下所实施的护理,对其心态和生活健康情况的影响。方法 将2021年3月至2022年3月本院接诊的胃癌手术患者共计92例全部作为研究对象,进行研究分析,利用红蓝球法分为对照组、观察组,每个小组46例患者。对照组实施传统护理,观察组在TCM的理念下进行护理。对比两组护理后的心态、睡眠和生活健康情况。结果 观察组总体心态好转情况均好于对照组,差异表现显著(P<0.05);观察组睡眠好转情况强于对照组,差异表现显著(P<0.05);观察组生活健康评分比对照组更好,差异显著(P<0.05)。结论 对于胃癌手术患者,可采取TCM的理念下的康复护理,能够显著改善患者的心理状态,提高其睡眠情况,同时生活更加健康。

中医药团体标准评价体系(SCORE-TCM)解读

本文全面解读了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine,SCORE-TCM)。SCORE-TCM是结合定性与定量评价,全面评估中医药团体标准在制定主体、文本编写、技术内容、推广应用和实施效益等几方面特征的综合评价工具。文中详述了SCORE-TCM的构建目的、定义和构建过程,解释了评价指标体系中的各项指标,并对每项指标的评价材料进行介绍。本文旨在帮助中医药团体标准的制定者、第三方评价机构和其他相关方更好地理解SCORE-TCM各评价条目的含义,更有效地运用于中医药团体标准的自评价或第三方评价,SCORE-TCM将为《中医药团体标准管理办法》的贯彻实施,以及中医药团体标准的高质量发展提供技术支持。

TCM抗阻训练在肥胖型阻塞性睡眠呼吸暂停低通气综合征患者中的应用

目的:探讨过渡期护理(TCM)抗阻训练在肥胖型阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的应用效果。方法:选取2022年1月1日~2023年1月1日接受治疗的102例肥胖型OSAHS患者作为研究对象,根据随机数字表法将其分为对照组和研究组各51例。对照组行常规抗阻训练,研究组行TCM抗阻训练;对比两组入院次日、出院1个月时体质指标[包括体质量指数(BMI)、颈围、腹围]、嗜睡程度[采用中文版Epworth嗜睡量表(ESS)]及生活质量[采用睡眠呼吸暂停低通气综合征生命质量评估表(QOL-OSAHS)]。结果:共有102例患者参与研究,其中对照组有1例在中途失访剔除,最后101例患者完整参与研究。出院1个月时,两组BMI、颈围、腹围及均ESS评分均低于入院次日(P<0.05),且研究组低于对照组(P<0.05);出院1个月时,两组QOL-OSAHS评分高于入院次日(P<0.05),且研究组高于对照组(P<0.05)。结论:TCM抗阻训练可有效改善肥胖型OSAHS患者体质指标,提升睡眠质量和生活质量。

基于SCORE-TCM的中医药团体标准抽样评价方案设计

目前,各社会团体积极参与中医药标准的制定和发布,特别是“十四五”以来,中医药团体标准化工作更是迎来了提质增效的关键阶段。深入评估社会团体发布的中医药标准质量,是推进中医药团体标准工作的关键环节和重点任务。前期已研制并形成了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine, SCORETCM)。在上述背景下,本研究通过专家共识法,设计了一套基于SCORE-TCM的中医药团体标准抽样评价方案,应用场景为对于特定社会团体发布的标准,或各团体发布的特定技术类别的标准进行快速评估。该方案涵盖了标准抽样、材料收集、标准评价、结果解读的完整流程,为中医药团体标准的抽样评价工作提供了参考方案。

Chen Shigong,Founder of“TCM Orthodox School of External Medicine”

Chen Shigong,styled name Yuren,was also known by the literary name Ruoxu.Coming from Donghaichongchuan(present Nantong City,Jiangsu Province)he was a famous traditional Chinese medicine(TCM)specialist of external medicine of the Ming Dynasty(1368-1644).The Orthodox Lineage of External Medicine(Wai Ke Zheng Zong)written by him has been valued as the founder of the TCM Orthodox School of External Medicine.

Disparities across the CREOG Districts —Variations of Wellness and Inclusivity Efforts in Obstetrics & Gynecology Residency Websites between Two Consecutive Years

Background: Few studies have focused on the geographic and chronologic assessment of inclusivity and wellness in Obstetrics and Gynecology residency websites across the US. Objective: To identify variations in wellness and inclusivity website depictions across CREOG districts over the past two years. Methods: This is a cross-sectional analysis of the websites of ACGME-accredited OB/GYN residency programs across the United States between April 2022 and April 2023. The assessment was based on a compilation of 22 attributes devised and piloted by 49 medical students. A racially, geographically, and gender-diverse cohort of 11 students performed data collection. Results: A total of 560 websites were analyzed over two years. Wellness efforts remained unchanged in both years (website content, dedicated support personnel, and group activities). In 2023, a reduction in referencing of wellness (22%) and inclusivity (30%) occurred in leadership messaging. However, a 7% increase in the use of inclusive pronouns was noted. A reduction in gender diversity was identified (9% in faculty, 5% in residents), with programs favoring female-only teams. Similarly, a 7% reduction in the number of underrepresented in medicine faculty and residents was noted. A 15% reduction was noted in curricula referencing inclusivity in their mission statement and inclusivity focused research. Conclusions: This study suggests the variations across websites relative to inclusivity and wellness over the past two years. Updated websites may provide an accurate reflection of the offerings of programs and their investment in wellness and inclusivity across the nation.

From Research on TCM Images to Historiography of TCM Images——Comments on History of Chinese Image Culture:Medical Image Volume

1 Introduction.Chinese medicine has a long and rich history,dating back to the classics of the Qin and Han dynasties and extending to the integration of Chinese and Western medicine in the modern era.The vast amount of literature and scholarly works in this field makes it essential to thoroughly study the history of traditional Chinese medicine(TCM)in order to understand its development path throughout the ages and boost innovation based on tradition.This is why the sages emphasized the importance of“classifying the works into different schools and tracing back to their origins”(辨章学术,考镜源流).

A Conversation with Professor Ted Kaptchuk,a Key Architect of Modern TCM in the West

The interview was conducted on November 20th,2022 by Ioannis Solos and Charles Buck.Ted Kaptchuk(泰开阳)is a Professor of Medicine and a Professor of Global Health&Social Medicine at Harvard Medical School.In 1975,he graduated from the Macao Institute of Chinese Medicine,Macao,China.After returning to the West,Ted taught Chinese medicine throughout the States,Europe,Latin America,and Australia.Ted’s book,The Web that Has No Weaver:Understanding Chinese Medicine is a groundbreaking explanation of East Asian medicine that continues to shape the discourse of the Chinese medicine profession in the West and has been translated into 13 languages.In 1990,Ted was recruited in Harvard Medical School to help research Chinese medicine.After encountering high placebo responses in multiple acupuncture clinical trials,Ted decided to switch his career to primarily studying placebo.He has published over 300 peer-reviewed articles.He has been awarded the Lifetime Achievement Award from the Society of Acupuncture Research(2015),the Lifetime Achievement Award from the Society for Interdisciplinary Placebo Studies(2021),and the William Silen Lifetime Achievement Award in Mentoring from Harvard Medical School(2022).

Analysis of standardization development of TCM in Sichuan

Sichuan province is home to rich traditional Chinese medicine(TCM)resources.Recent years have seen unremitting efforts of TCM standardization in the province.By analyzing the measures and existing problems,this paper provides recommendations to boost TCM development through standardization.

My Relationship with TCM

A Spanish businessman becomes a dedicated advocate of traditional Chinese medicine after witnessing its effects in treating his terminally ill young son.MY relationship with traditional Chinese medicine(TCM)-and with China-began in 1988,when I traveled to Beijing with my two-year-old son Joan.He was suffering from an extremely rare disease called leukoencephalopathy,in which the brain is affected,and we wanted to explore treatment possibilities.

Classification research of TCM pulse conditions based on multi-label voice analysis

Objective:To explore the feasibility of remotely obtaining complex information on traditional Chinese medicine(TCM)pulse conditions through voice signals.Methods: We used multi-label pulse conditions as the entry point and modeled and analyzed TCM pulse diagnosis by combining voice analysis and machine learning.Audio features were extracted from voice recordings in the TCM pulse condition dataset.The obtained features were combined with information from tongue and facial diagnoses.A multi-label pulse condition voice classification DNN model was built using 10-fold cross-validation,and the modeling methods were validated using publicly available datasets.Results: The analysis showed that the proposed method achieved an accuracy of 92.59%on the public dataset.The accuracies of the three single-label pulse manifestation models in the test set were 94.27%,96.35%,and 95.39%.The absolute accuracy of the multi-label model was 92.74%.Conclusion: Voice data analysis may serve as a remote adjunct to the TCM diagnostic method for pulse condition assessment.

Research Status of TCM Rehabilitation in Chronic Obstructive Pulmonary Disease (COPD)

This paper mainly analyzes the application status of TCM rehabilitation in chronic obstructive pulmonary disease(COPD),hoping to provide support and help for clinical staff through this study,and promote the further development of COPD rehabilitation program.

Application of Guizhi Fuling Pill in Gynecology

This paper reviews the research progress of Guizhi Fuling Pill in the clinical application of gynecology,such as the treatment of uterine leiomyoma,ovarian cyst,infertility and dysmenorrhea,in order to provide further research ideas for clinical researchers.

Exploring the Future Of TCM Cooperation--2024 China-ASEAN Traditional Chinese Medicine Industry Exchange and Promotion Conference in Taiyuan

“Traditional Chinese medicine(TCM)is very popular in Cambodia because it can treat a variety of diseases,”said Nhek Soparama,ministercounselor of the Embassy of Cambodia in China,at the 2024 China-ASEAN Traditional Chinese Medicine Industry Exchange and Promotion Conference in Taiyuan,Shanxi Province,on July 26.“Over the past two years,more than 20,000 Cambodians have received TCM treatment.”

TCMLLM-PR:evaluation of large language models for prescription recommendation in traditional Chinese medicine

Objective To develop and evaluate a fine-tuned large language model(LLM)for traditional Chinese medicine(TCM)prescription recommendation named TCMLLM-PR.Methods First,we constructed an instruction-tuning dataset containing 68654 samples(ap-proximately 10 million tokens)by integrating data from eight sources,including four TCM textbooks,Pharmacopoeia of the People’s Republic of China 2020(CHP),Chinese Medicine Clinical Cases(CMCC),and hospital clinical records covering lung disease,liver disease,stroke,diabetes,and splenic-stomach disease.Then,we trained TCMLLM-PR using Chat-GLM-6B with P-Tuning v2 technology.The evaluation consisted of three aspects:(i)compari-son with traditional prescription recommendation models(PTM,TCMPR,and PresRecST);(ii)comparison with TCM-specific LLMs(ShenNong,Huatuo,and HuatuoGPT)and general-domain ChatGPT;(iii)assessment of model migration capability across different disease datasets.We employed precision,recall,and F1 score as evaluation metrics.Results The experiments showed that TCMLLM-PR significantly outperformed baseline models on TCM textbooks and CHP datasets,with F1@10 improvements of 31.80%and 59.48%,respectively.In cross-dataset validation,the model performed best when migrating from TCM textbooks to liver disease dataset,achieving an F1@10 of 0.1551.Analysis of real-world cases demonstrated that TCMLLM-PR's prescription recommendations most closely matched actual doctors’prescriptions.Conclusion This study integrated LLMs into TCM prescription recommendations,leverag-ing a tailored instruction-tuning dataset and developing TCMLLM-PR.This study will pub-licly release the best model parameters of TCMLLM-PR to promote the development of the decision-making process in TCM practices(https://github.com/2020MEAI/TCMLLM).

一种变输入电压的TCM滞环电流逆变器控制方法

针对TCM逆变器在过零点附近因开关频率过高导致并网电流THD和开关损耗增加的问题,提出一种变输入电压的准恒频控制方法。通过控制后级输入电压限制TCM电流源型逆变器的最大开关频率,降低了并网电流的谐波失真率。通过Simulink搭建仿真模型,对并网电流进行FFT分析,结果显示该方法相比传统的TCM调制方法使得并网电流的THD下降了0.02%,验证了所提方案的可行性。

具有全重联功能的TCMS系统方案论述

城市轨道交通线路客流量的特征具有不同运营阶段或全天内不同时段以及不同区段差异较大等特点,传统的固定编组运营模式无法很好地解决运力、客流、能耗匹配的问题。根据城市轨道交通在不同区段、时段下的客流特征,在保证较高列车服务水平的条件下,通过绞线式列车总线(Wire Train Bus,WTB)架构以及列车之间全重联,使得头车可以控制后面与其重联的列车,达到所有列车控制指令完全一致性,最终达到灵活改变列车编组长度来实现运力与客流需求动态匹配,合理优化各时段列车满载率,有效解决动力浪费或服务水平低下的问题。

Application of transcutaneous electrical acupoint stimulation in perioperative gynecology

Transcutaneous electrical acupoint stimulation(TEAS)is also known as low-frequency pulsed electrophysiological technology.TEAS is an enhanced recovery after surgery,which covers the preoperative,intraoperative,and postoperative phases of the perioperative period,and the core concept is to promote the rapid recovery of patients.TEAS helps to repair local smooth muscle as well as nerves caused by surgery,increase blood circulation in the damaged area,restore innervation and vascular function,restore the balance of local venous and lymphatic circulation,reduce local pain as well as local tissue edema,reduce the occurrence of complications,reduce surgical discomfort,enhance therapeutic effects,and promote rapid recovery from surgery.

Evaluation of The Effectiveness of Abdominal and Vaginal B-Ultrasound in The Diagnosis of Acute Abdomen in Obstetrics and Gynecology

Objective: To explore the clinical effect of the combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen in obstetrics and gynecology. Methods: Eighty patients admitted to our hospital from March 2023 to March 2024 were selected, all of whom were acute abdomen patients admitted to the Department of Obstetrics and Gynecology. In this study, the patients were divided into two groups. One group of 40 patients was given a simple abdominal B-ultrasound diagnosis (control group). The other group of 40 patients was given both abdominal and vaginal B-ultrasound examinations (experimental group). The diagnostic accuracy between the two groups was compared. Results: Patients in the experimental group had higher consistency rates with pathological diagnosis results in ectopic pregnancy rupture, embryonic arrest, acute pelvic inflammation, corpus luteum rupture, and intrauterine adhesions as compared to the control group. At the same time, the inspection accuracy rate of the experimental group (92.50%) was higher than that of the control group (70.00%) (P < 0.05). Conclusion: The combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen was of great significance in improving the accuracy of clinical diagnosis and guiding doctors to provide effective treatment.