Subjectivities of the Scientific Endeavor:Noting the Illusion of Objectivity in the History of Science and Medicine

The history of science and medicine has long been steeped in the notion that they are objective(untainted by the philosophical and ideological ebbs and flows of society)and utilitarian(doing what is best for the greater good).Because of this,scientific and medical epistemologies and praxis are often held to an esteem that is unquestioned,celebrated,and occasionally unchecked.A closer look at the history of science and medicine,however,readily reveal the extent to which the milieu of society has informed scientific and medical endeavors.As such,an understanding of how the subjectivities of scientific and medical endeavors situate within our contemporary disciplines and practices is significant to one’s ability to truly understand said disciplines.Likewise,such an evaluation will provide insight into our role in perpetuating the illusion of objectivity in these fields.With this in mind,this paper provides a philosophical and historical examination of the concept of objectivity(in contrast to subjectivity)in science and medicine.

Profile of Urinary Tract Infections in the Elderly in the Internal Medicine Department of the University Hospital Center of Point G, Bamako, Mali

Introduction: Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study concerning UTIs in the elderly has been conducted, hence the interest in this innovative work. Objectives: To determine the prevalence and clinical and paraclinical aspects of urinary tract infections in the elderly. Materials and Methods: This was a prospective descriptive and cross-sectional study from September 1, 2013 to August 31, 2014, i.e. duration of 12 months. All patients aged 65 years and over, hospitalized or ambulatory in the internal medicine department with a documented urinary tract infection were included. Results: We collected and examined 194 patients. The cytobacteriological study of urine (CBSU) was positive in 28 patients, i.e. a prevalence of 14.43%. The male sex represented 59.8% of the cases, the sex ratio was equal to 1.46. The age groups between 65 - 69 and 70 - 74 years were the most affected, respectively 28.57% and 39.28%. The main clinical signs were: asthenia, anorexia, dependence, fever, urinary burning, dysuria. Hospitalization was associated with urinary tract infection with P = 0.01. The group of enterobacteria were incriminated in 75% of cases. Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa represented 39.28%, 14.28% and 10.71% of cases. Urinary tract infections were represented by pyelonephritis, acute prostatitis, orchi-epididymitis and simple cystitis. Conclusion: Urinary tract infection is frequent in the elderly, its clinical presentation is polymorphic and enterobacteria are the most incriminated group of bacteria.

Clinical surgery-oriented subject librarian services in medical colleges and schools

Regarding subject librarian services for clinical studies, researchers outside China have been focusing on subject service performance,evidence-based medicine, and comprehensive consulting services. In contrast, Chinese researchers have concentrated on service systems and methods but have not established mature systems and methods for clinical surgery-oriented services. Therefore,subject librarians in medical schools should become involved in clinical research and expand their perspective on medical library research. In addition, they should collaborate with clinicians to improve the overall level of research in hospitals while increasing the impact of subject librarian services in medical colleges and schools.

A Brief Introduction of Yi Xue Shi (《医学史》 History of Medicine)

The book Yi Xue Shi(《医学史》History of Medicine)was written and edited by Cecilia Mettler and Fred Mettler couple,published in 1947.The book is about the literature research of systematic introduction to the history of medical development worldwide.The book provides a detailed description of the development of various medical disciplines and subjects through various documents and the authors and publication dates.Especially,Prof.Mettler has introduced the Chinese Yin and Yang(阴阳)and the five element theory(五行学说)and Shen Nung’s Materia Medica(神农本草)in this book.

Epidemio-Clinical, Therapeutic and Evolutive Aspects of Pulmonary Embolism in Young Subject in the Cardiology Department in Point “G” Hospital University Center Bamako

Objective: The purpose of this work was to determine the epidemiological, clinical and evolutionary aspects of the pulmonary embolism of the young person in the cardiology department of the University Hospital Center (CHU) Point G in Bamako-Mali. Methodology: This was an analytical study from January 01, 2018 to December 31, 2018 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 1379 hospitalized patients, 19 patients were concerned by pulmonary embolism of the young person. The prevalence of pulmonary embolism of the young person was 1.37%. The most affected age group was 21 - 30 (47.4%) of patients. The predominance was female (89.47%) with a gender ratio of 0.11 in favour of women. The average age in the series was 29.79 years with extremes of 16 years and 40 years. Factors predisposing to pulmonary embolism were dominated by peri partum, cardiomyopathy and obesity with 47.3%, 31.57% and 21.1%, respectively. The dominant signs were chest pain and dyspnea in 94.7% and 89.5% of cases respectively. Pulmonary embolism was unlikely in 60.52% according to the Geneva and Wells score simplified. At the thoracic angioscanner, the embolism was bilateral in 52.6% of cases and distal in 36.8% of patients;in 10 patients who performed cardiac ultrasound, pulmonary arterial hypertension (70%), dilation of the right ventricle (20%) and left ventricular dilation (40%). Hyper leucocytosis (47.4%), anemia and low prothrombin rate (TP) (22.2%) were the most found biological abnormalities. More than 2/3 (68.5%) our patients had an intermediate mortality risk according to the PESI (Pulmonary Embolism Severity Index) score. The average hospital stay was 10 days. Hospital mortality was 10.5%. Conclusion: The pulmonary embolism of the young person is a frequent, serious and multifactorial pathology and the female sex is most affected especially during peri partum periods, hence the need for preventive measures. Clinical signs are not specific and based on the assessment of clinical probability. Pulmonary angioscanner remains the confirmation review in our context.

Visualization analysis of the international standard ISO/TC 249 for traditional Chinese medicine

Objective This study proposes to visually review the current situation and progress of standards sets by the International Organization for Standardization/Technical Committee on Traditional Chinese Medicine(ISO/TC 249). The review aims to explore the development strategies of the standards, which will exhibit the considerable impact on the economy, trade and exchanges, and cooperation in the area of traditional Chinese medicine(TCM).Methods ISO/TC 249 standards were searched on the ISO website, and their title, proposed time, current stage, scope, and classification were obtained for further summarization. Gephi was utilized to portray the co-occurrence network graph of the ISO/TC 249 standards subject.Results In ISO/TC 249, there were 116 standards, including 81 published standards and 35 developing standards by April 30, 2022. Two withdrawal standards were published after revision, which were not counted in the total standards. The number of published standards has been increasing since the first standard was published in 2014, whose title was “Sterile acupuncture needles for single use”. Among these standards, 17.24%(20/116) standards were in review, 56.03%(65/116) in publication, 3.45%(4/116) in approval, 5.17%(6/116) in enquiry,3.45%(4/116) in committee, and 14.66%(17/116) in preparation, respectively. With 116 standards, most of the research focused on the medicament, as its classification of the International Classification for Standards(ICS) showed the proportion reaching 49.54%. The network analysis data revealed that the top five most frequent words were “materials” “root” “requirements” “products” and “system”, after removing the noise data, such as prepositions,conjunctions, and pronouns. Additionally, the word “system” co-exists with the terms “computerized” “coding” “image” “tongue” and “analysis”;the word “requirement” co-exists with“manufacturing” “decoction” “process” and “materials”;whereas the word “devices” coexists with “pulse” “electric” “skin” and “measurement”.Conclusion With the increased diversification and complexity of problems, the development of standards is also oriented to multidisciplinary fields to cultivate the interdisciplinary talents, and especially the international standardization talents of compound TCM. Multi-angle analysis, formulation, and demonstration of standards, in line with industry needs in different disciplines, enhance the availability of standards and the ability to serve the industry.

基于“脑玄府-神机”理论的风药开玄在慢性主观性头晕中的应用进展

慢性主观性头晕(CSD)是临床常见的难治性疾病,其发病机制复杂,证候多变,病情反复,缠绵难愈。中医学认为,脑玄府开阖通利,气液流通,神机清明则体健;脑玄府闭郁,气液昧之,伤及脑体,损及脑用,神机散失则发为CSD,主张治疗上重在开玄通府,恢复神机。本文以脑玄府-神机理论为指导,主要探讨CSD的发病机制及治法治则。

Association of KRAS Gene and microRNA-124-3p in Sporadic Colorectal Tumours

Aim: To reveal the exonic and 3’UTR sequences of KRAS, TP53, APC, BRAF, PIK3CA genes in sporadic colorectal tumors and to investigate the clinical relevance of 3’UTR variations in miRNA profiles. Methods: In the study, the exonic and 3’UTR sequences of five genes in 12 sporadic colorectal tumors were extracted by next generation sequencing. In tumors with variation in the 3’UTR region, the changes caused by the variation in the miRNA binding profile were detected. The expression profile of these miRNAs in colorectal and other solid tumors compared to normal tissue was determined. Pathway analysis was performed to determine which signaling pathways miRNAs affect. Results: Case-10 in our study was wild type KRAS and received cetuximab treatment and developed drug resistance. In this case, it was concluded that the expression of KRAS increased and tumorigenesis progressed due to miRNAs that do not bind to this region due to variations in the 3’UTR region. Among these miRNAs, hsa-miR-124-3p was found to have decreased expression in colorectal tumors and to be associated with the ECM-receptor interaction pathway. Conclusion: Variations in the 3’UTR regions of genes critical in the process of carsinogenesis are associated with drug resistance and the process of tumorigenesis.

中国重症医学发展之路--专科重症与综合重症及多学科的借鉴、融合、共同提高

综合重症与专科重症有着各自独立的发展路线,在急危重症的救治中发挥着重要作用。综合重症的优势在于对各种重症横向、广泛的研究,强调在整体治疗理念的指导下,平衡各个功能不全脏器之间的关系。专科重症的优势在于对某个专科或者专病进行纵向、深入的研究,强调在专科理论的指导下,专业化地解决某个重症的主要矛盾。当前,重症医学面临的最大挑战是如何避免惯性思维。综合重症需要向专科重症学习,不断加深对各专业领域的探索,以便在处理专科重症时更加得心应手。专科重症也需要向综合重症学习,不断强化整体救治观念,以便优化利用各种救治资源,提高专科重症的救治效果。综合重症和专科重症的互相借鉴、融合和共同提高,将最终使双方获益,使专科重症医学的治疗宽度更广,综合重症医学的治疗深度更深。各自独立的专科重症、专病重症之间也需要互相联合,共同为重症医学学科体系填补新的内涵。

蒙药加减通拉嘎-5对维甲酸所致大鼠骨质疏松的治疗作用

目的:观察蒙药加减通拉嘎-5对维甲酸所致大鼠骨质疏松的治疗作用.方法:雌性Wistar大鼠32只,随机分为空白组,模型组,骨肽片组,加减通拉嘎-5组,采用维甲酸诱导大鼠骨质疏松的模型,观察经蒙药加减通拉嘎-5治疗前后大鼠血清中钙(Ca)、磷(P)、血清碱性磷酸酶(ALP)及脏器指数、骨组织形态计量学的变化.结果:与模型组比较,经蒙药加减通拉嘎-5治疗后,维甲酸所致骨质疏松大鼠骨组织形态计量学参数变化均有显著性差异,血清中碱性磷酸酶显著降低,钙、磷含量升高,结论:蒙药加减通拉嘎-5对维甲酸诱导的大鼠骨质疏松有一定的治疗作用.

从现代到后现代--全科医学兴起的后现代哲学审视

本文拟论证一个观点,现代医学模式从专科向全科的转变与哲学从现代向后现代转变二者之间存在着内在的关联。在分析、还原为特点的现代哲学影响下产生的是专科医学,在后现代哲学影响下产生的是全科医学。后现代哲学思维成为影响医学思维的主流,其发展的结果是全科医学的"全科思维",这种思维逻辑的特征是注重生活世界,强调主体间性,强调"效果历史",重视差异性、反对科学"元叙事"等。本文从后现代维度对全科医学的目的和方法、医学效果、医学的主体和医患关系以及医学文化等6个方面进行理论建构。

1994-2009年我国检验医学论文的文献计量学研究

以中国知网CNKI数据库为数据源,通过关键词途径检索,获得1994-2009年我国公开发表的检验医学论文1211篇。利用SPSS13.0统计软件对论文进行分析,内容包括文献的增长规律及主题内容分布。分析表明,我国检验医学论文的分布呈现指数曲线型增长趋势,其函数表达式为Y=32.657 e0.268x;我国检验医学研究主要集中在《微生物学及检验》课程的教学方法与管理研究等5个主要方面。

Constituents of the anti-asthma herbal formula ASHMI^(TM) synergistically inhibit IL-4 and IL-5 secretion by murine Th2 memory cells,and eotaxin by human lung fibroblasts in vitro

OBJECTIVE： Anti-asthma herbal medicine intervention （ASHMITM）, a combination of three tradi- tional Chinese medicinal herbs developed in our laboratory, has demonstrated efficacy in both mouse models of allergic asthma, and a double-blind placebo-controlled clinical trial in patients with asthma. This study was designed to determine if the anti-inflammatory effects of individual herbal constituents of ASHMITM exhibited synergy. METHODS： Effects of ASHMI and its components aqueous extracts of Lingzhi （Ganoderma lucidum）, Kushen （Sophora flavescens） and Gancao （Glycyrrhiza uralensis）, on Th2 cytokine secretion by murine memory Th2 cells （D10.G4.1） and eotaxin-1 secretion by human lung fibroblast （HLF-1） cells were determined by measuring levels in culture supernatants by enzyme- linked immunosorbent assay. Potential synergistic effects were determined by computing interaction indices from concentration-effect curve parameters. RESULTS： Individual Lingzhi, Kushen and Gancao extracts and ASHMI （the combination of individual extracts） inhibited production of interleukin （IL）-4 and IL-5 by murine memory Th2 cells and eotaxin-1 production by HLF-1 cells. The mean 25%-inhibitory-concentration （IC2s） values （mg/mL） forASHMI, Lingzhi, Kushen and Gancao for IL-4 production were 30.9, 79.4, 123, and 64.6, respectively; for IL-5 production were 30.2, 263, 123.2 and 100, respectively; for eotaxin-1 were 13.2, 16.2, 30.2, and 25.1, respectively. The IC50values （mg/mL） for ASHMI, Lingzhi, Kushen and Gancao for IL-4 production were 158.5, 239.9, 446.7, and 281.8, respectively; for eotaxin-1 were 38.1, 33.1, 100, and 158.5, respectively. The interaction indices of ASHMI constituents at IC25 were 0.35 for IL-4, 0.21 for IL-5 and 0.59 for eotaxin-l. The interaction indices at IC^0 values were 0.50 for IL-4 and 0.62 for eotaxin-1 inhibition. Inhibition of IL-5 did not reach IC^0 values. All interaction indices were below 1 which indicated synergy. CONCLUSION： By comparing the interaction index values, we find that constituents in ASHMITM synergistically inhibited eotaxin-1 production as well as Th2 cytokine production.

Role of the histone methyltransferases Ezh2 and Suv4-20h1/Suv4-20h2 in neurogenesis

Mechanisms regulating neurogenesis involve broad and complex processes that represent intriguing therapeutic targets in the field of regenerative medicine.One influential factor guiding neural stem cell proliferation and cellular differentiation during neurogenesis are epigenetic mechanisms.We present an overview of epigenetic mechanisms including chromatin structure and histone modifications;and discuss novel roles of two histone modifiers,Ezh2 and Suv4-20h1/Suv4-20h2(collectively referred to as Suv4-20h),in neurodevelopment and neurogenesis.This review will focus on broadly reviewing epigenetic regulatory components,the roles of epigenetic components during neurogenesis,and potential applications in regenerative medicine.

Interleukin-6-174G/C polymorphism is associated with a decreased risk of type 2 diabetes in patients with chronic hepatitis C virus

BACKGROUND Chronic hepatitis C(CHC)is associated with type 2 diabetes mellitus.Although the pathogenesis remains to be elucidated,a growing evidence has suggested a role of pro-inflammatory immune response.Increased serum concentrations of Interleukin 6(IL-6)have been associated with insulin resistance,type 2 diabetes mellitus as well as advanced forms of liver disease in chronic hepatitis C infection.AIM To investigate the frequency of IL-6-174G/C(rs1800795)single nucleotide polymorphism(SNP)in CHC patients and in healthy subjects of the same ethnicity.Associations between type 2 diabetes mellitus(dependent variable)and demographic,clinical,nutritional,virological and,IL-6 genotyping data were also investigated in CHC patients.METHODS Two hundred and forty-five patients with CHC and 179 healthy control subjects(blood donors)were prospectively included.Type 2 diabetes mellitus was diagnosed according to the criteria of the American Diabetes Association.Clinical,biochemical,histological and radiological methods were used for the diagnosis of the liver disease.IL-6 polymorphism was evaluated by Taqman SNP genotyping assay.The data were analysed by logistic regression models.RESULTS Type 2 diabetes mellitus,blood hypertension and liver cirrhosis were observed in 20.8%(51/245),40.0%(98/245)and 38.4%(94/245)of the patients,respectively.The frequency of the studied IL-6 SNP did not differ between the CHC patients and controls(P=0.81)and all alleles were in Hardy-Weinberg equilibrium(P=0.38).In the multivariate analysis,type 2 diabetes mellitus was inversely associated with GC and CC genotypes of IL-6-174(OR=0.42;95%CI=0.22-0.78;P=0.006)and positively associated with blood hypertension(OR=5.56;95%CI=2.79-11.09;P<0.001).CONCLUSION This study was the first to show that GC and CC genotypes of IL-6-174 SNP are associated with a decreased risk of type 2 diabetes mellitus in patients chronically infected with hepatitis C virus.The identification of potential inflammatory mediators involved in the crosstalk between hepatitis C virus and the axis pancreas-liver remains important issues that deserve further investigations.

Effect of TCM Combined with Chemotherapy on Immune Function and Quality of Life of Patients with Non-small Cell Lung Cancer inStage Ⅲ-Ⅳ

Objective: To observe and compare the effect of traditional Chinese medicine (TCM) combined with chemotherapy (CT) on immune function and quality of life (QOL)of patients with non-small cell lung cancer (NSCLC) in stage Ⅲ-Ⅳ. Methods: One hundred cases with stage Ⅲ-Ⅳ NSCLC were randomly divided into two groups. The treated group (n=50) received CT combined with TCM, and the control group received CT alone. The percentage of T lymphocyte subset in peripheral blood and the change of natural killer (NK) cell count were observed after treatment. The QOL and tolerance of CT were also compared between the two groups after treatment. Results: In the treated group, CD3 cell count, CD4 cell count, CD4/ CDg ratio and NK cell activity were higher than those in control group, while CD8 cell count in the treated group was lower than that in the control group (P<0.05), and QOL and tolerance of CT in the treated group were also better (P<0.05). Conclusion: TCM combined with CT could raise the patients' ability in tolerating CT in stage Ⅲ-ⅣNSCLC.

基于BERTopic与CiteSpace的中国中医药领域研究热点与主题演化分析

目的/意义 梳理近10年中国中医药领域文献,阐述该领域热点主题与发展趋势。方法/过程 检索2013-2022年万方数据平台中医药领域研究文献,以摘要为研究对象,利用BERTopic模型抽取主题,并采用CiteSpace进行可视化分析。结果/结论 纳入中文文献12 683篇,发现5个主题:临床试验与疗效、病机与药理研究、中医药领域发展、慢病治疗、药物分析与文献研究。对其中热度持续增长的中医药领域发展主题深入分析,提出人工智能与中医药领域的深度融合是未来趋势。

新医科背景下基于主观能动性培养的教学改革与实践——以安徽中医药大学《中医骨伤科学》为例

新医科建设是国家对医学教育的新要求,也是提高高等教育质量的重要措施。新医科对中医专业、针灸推拿学等国家级一流专业《中医骨伤科学》教学提出更高的要求,要求牢固树立守正创新的教学理念,抓紧构建交叉学科的“新结构”,积极探索新医科建设的“新模式”。因此,本研究通过综合策略更新教学法,革新评估体系,培养创新中医人才,助力中医药复兴。

叙事医学患教会的临床实践及价值探讨

介绍郑州市第六人民医院中西医结合肿瘤科叙事医学背景下患者教育会的临床实践探索及反思。通过临床“模板化”实践关注、倾听和反思,结合传统患者教育会形式,全面地去了解及掌握患者或家属的想法、观点、身体机能、就医期待等,糅合患者的主诉与病史,达到医患双方对疾病认知的趋同,发掘出临床工作需重点关注的高频问题,医者在多视角下更好地理解患者或家属,医患双方作为平等的主体共同完成医疗诊治工作,最终达到临床共情及医患共同决策。

基于“肺主皮毛”理论在历代古方中挖掘最具美白祛斑潜力中药“二白一辛”

目的基于《黄帝内经》“肺主皮毛”理论,分析美白祛斑用药规律,为中医理论临床实践和中医医美用药提供参考。方法检索《中华医典》收录的美白祛斑相关用药,对中医药美白祛斑用药的频数、性味归经、组方配伍进行统计及关联规则分析;采用网络药理学研究方法,对高频药物的美白祛斑作用和机制进行剖析,分析潜在有效成分,通过细胞毒性实验和黑色素含量检测验证美白祛斑功效。结果共筛选出171篇外用方文献,包含261味中药,归肺经、辛味的药物占比最多,使用频数最高的中药是“二白一辛”(白芷、白附子、细辛);网络药理学分析得到“二白一辛”美白祛斑核心靶点为TP53、EGFR、ALB等,主要参与氧气的感知和反应,皮肤免疫调节,皮肤细胞的生长、分化、应激、炎症反应等生物过程。基于分子对接结果,通过生物学分析证明“二白一辛”有效成分大黄酚、没食子酸和咖啡酸对黑色素瘤细胞的增殖和黑色素产生具有抑制作用。结论古方美白祛斑用药多为辛味、归肺经,体现了“肺主皮毛”理论;高频药物“二白一辛”可能是通过调控皮肤氧化还原、免疫和炎症等发挥作用,其有效成分对黑色素形成有抑制效果。该研究丰富了基于“肺主皮毛”理论的中医美白祛斑方的科学内涵,实现多学科交叉融合,为中医药现代化提供支持。