基于平衡计分卡和模糊理论的军队医院绩效评价模型研究

运用方法学和统计学论证了绩效评价体系研究,建立了模糊综合评价模型的绩效评价体系,构建了由23个指标构成的评价模型。同时,阐述了模糊综合评价理论的基本内容,运用层次分析法,确定了每个评价指标的权重,建立了军队医院工作绩效的模糊综合评价模型并通过实例应用分析,开展了军队医院绩效评价,验证了模型应用的合理性与可行性。     

An extract of neem leaves reduces anxiety without causing motor side effects in an experimental model

Anxiety modulation often requires pharmaceutical intervention, and though effective in the short-term, benzodiazepines may cause impaired motor function. As a potential alternative, anxiety-modulating effects of a neem leaf (Azadirachta indica, A Juss) extract were investigated using ethological analysis of rat behaviour on an elevated X maze and compared with diazepam treatment. Sexually immature female Sprague-Dawley rats received 0.07 or 7 mg/kg neem leaf steroidal extract, a sham injection, a 1% DMSO/saline vehicle, 2 mg/kg diazepam or no treatment one hour prior to a recorded five-minute exploration of the elevated X maze. Neem matched diazepam in anxiety reduction as both treatments caused a decrease in per cent protected stretched-attend postures (PPSAP). Neem treatment had no effect on closed arm entries or total rears, distinguishing it pharmacologically from diazepam which resulted in a predictable decrease in those locomotor measures. Whereas both neem and diazepam reduced anxiety in complex ethological behavioural indices, only neem produced anxiolysis without motor deficiency.     

一种胃癌模糊辨证模型的构建

目的：探讨一种构建胃癌模糊辨证模型的方法。方法：对收集的769例胃癌病例进行分析,确立论域U、证型集合V和症状-证型模糊关系,建立证型模糊集合,采用模糊集合贴近度的运算和最大隶属原则,构建胃癌的模糊辨证模型。结果：该模型对6种证型的符合率分别为肝胃不和型65.00%、胃热伤阴型72.22%、脾胃虚寒型70.00%、瘀毒内阻型57.14%、痰湿凝结型53.33%和气血双亏型72.22%,总体符合率为65.71%。结论：该辨证模型为辨证的客观化研究提供了一个思路,有一定的临床价值。     

运动疗法对代谢性疾病治疗作用机制的研究进展

 运动疗法是糖尿病、高脂血症、骨质疏松等代谢性疾病最基本的治疗方法之一。目前的研究表明,运动治疗糖尿病的机制主要是改善机体胰岛素依赖性靶组织对胰岛素抵抗;运动治疗高脂血症的机制主要是运动引起脂蛋白脂肪酶活性升高,导致三酰甘油分解代谢加强;运动治疗骨质疏松症,则主要是通过其机械应力效应和性激素效应等多种途径。     

人类熟悉性特征识别障碍神经机制的研究进展

本文综述了人类熟悉性特征识别障碍涉及复杂的神经机制,包括: 1面孔失认症在涉及到面孔识别过程中出现的解剖结构和认知功能的障碍。2声音失认症患者声音识别障碍涉及到的神经机制。3熟悉的面孔和熟悉的声音被同时处理时两者之间存在的相互关系。4在识别熟悉人中左侧或右侧大脑损伤的两种不同模型及其影响。5颞叶前部损伤在识别熟悉人障碍中起到关键作用。     

激光三维扫描系统重建下颌骨

目的 利用激光三维扫描技术重建下颌骨三维结构,探索建立有限元几何模型的新方法。方法 利用激光三维扫描系统,多次、分区域地扫描人体下颌骨标本并形成下颌骨表面轮廓点云文件,然后对扫描点云文件进行拼接,重建下颌骨表面轮廓。结果 建立了一个人体下颌骨骨性表面的三维模型。此模型造型逼真,并可以适当的文件格式应用于有限元结构力学仿真分析。结论 在生物力学仿真实验中,激光三维扫描系统可以用于建立有限元几何模型,可解决常规CAD(computer aided design)方法难以建立非规则人体结构模型这一难题。     

鼻咽癌放射治疗后复发因素Cox模型评价

目的 探讨鼻咽癌放射治疗后复发有关因素，为提高鼻咽癌的疗效，减少复发提供参考，方法 收集鼻咽癌复发病例６０例，对造成复发的可能因素进行Ｃｏｘ模型单因素分析，结果 年龄ＴＮ分期放射剂量及照射野与复发有关，Ｔ分期，鼻咽剂量，照射野是复主要因素，结论 对分期晚的患者应保证照射范围和放射剂量达到根治要求。     

Deep propensity network using a sparse autoencoder for estimation of treatment effects

ObjectiveDrawing causal estimates from observational data is problematic, because datasets often contain underlying bias (eg, discrimination in treatment assignment). To examine causal effects, it is important to evaluate what-if scenarios—the so-called “counterfactuals.” We propose a novel deep learning architecture for propensity score matching and counterfactual prediction—the deep propensity network using a sparse autoencoder (DPN-SA)—to tackle the problems of high dimensionality, nonlinear/nonparallel treatment assignment, and residual confounding when estimating treatment effects.Materials and MethodsWe used 2 randomized prospective datasets, a semisynthetic one with nonlinear/nonparallel treatment selection bias and simulated counterfactual outcomes from the Infant Health and Development Program and a real-world dataset from the LaLonde’s employment training program. We compared different configurations of the DPN-SA against logistic regression and LASSO as well as deep counterfactual networks with propensity dropout (DCN-PD). Models’ performances were assessed in terms of average treatment effects, mean squared error in precision on effect’s heterogeneity, and average treatment effect on the treated, over multiple training/test runs.ResultsThe DPN-SA outperformed logistic regression and LASSO by 36%–63%, and DCN-PD by 6%–10% across all datasets. All deep learning architectures yielded average treatment effects close to the true ones with low variance. Results were also robust to noise-injection and addition of correlated variables. Code is publicly available at https://github.com/Shantanu48114860/DPN-SAz.Discussion and ConclusionDeep sparse autoencoders are particularly suited for treatment effect estimation studies using electronic health records because they can handle high-dimensional covariate sets, large sample sizes, and complex heterogeneity in treatment assignments.     

激光三维扫描系统重建下颌骨

目的 利用激光三维扫描技术重建下颌骨三维结构，探索建立有限元几何模型的新方法。方法 利用激光三维扫描系统．多次、分区域地扫描人体下颌骨标本并形成下颌骨表面轮廓点云文件，然后对扫描点云文件进行拼接，重建下颌骨表面轮廓。结果 建立了一个人体下颌骨骨性表面的三维模型。此模型造型逼真，并可以适当的文件格式应用于有限元结构力学仿真分析。结论 在生物力学仿真实验中，激光三维扫描系统可以用于建立有限元几何模型，可解决常规CAD(computer aided design)方法难以建立非规则人体结构模型这一难题。     

从公共选择理论视角探析医疗保障机制优化问题

现行医疗保障机制存在许多冲突面,暴露出很多问题?文章运用公共选择理论,分析医疗保障机制中存在的政府与市场双重失灵现象,诠定政府与市场在医疗保障机制中的定位与协作关系,以期优化医疗保障机制?     

基于免疫机制的校园网安全模型设计

以生物免疫理论为基础,设计了校园网络安全防护体系模型,并对系统的测试方案和实施方案做了预测,提出了下一步研究方向。     

An empirical examination of the stage theory of grief

Context  The stage theory of grief remains a widely accepted model of bereavement adjustment still taught in medical schools, espoused by physicians, and applied in diverse contexts. Nevertheless, the stage theory of grief has previously not been tested empirically. Objective  To examine the relative magnitudes and patterns of change over time postloss of 5 grief indicators for consistency with the stage theory of grief. Design, Setting, and Participants  Longitudinal cohort study (Yale Bereavement Study) of 233 bereaved individuals living in Connecticut, with data collected between January 2000 and January 2003. Main Outcome Measures  Five rater-administered items assessing disbelief, yearning, anger, depression, and acceptance of the death from 1 to 24 months postloss. Results  Counter to stage theory, disbelief was not the initial, dominant grief indicator. Acceptance was the most frequently endorsed item and yearning was the dominant negative grief indicator from 1 to 24 months postloss. In models that take into account the rise and fall of psychological responses, once rescaled, disbelief decreased from an initial high at 1 month postloss, yearning peaked at 4 months postloss, anger peaked at 5 months postloss, and depression peaked at 6 months postloss. Acceptance increased throughout the study observation period. The 5 grief indicators achieved their respective maximum values in the sequence (disbelief, yearning, anger, depression, and acceptance) predicted by the stage theory of grief. Conclusions  Identification of the normal stages of grief following a death from natural causes enhances understanding of how the average person cognitively and emotionally processes the loss of a family member. Given that the negative grief indicators all peak within approximately 6 months postloss, those who score high on these indicators beyond 6 months postloss might benefit from further evaluation.      

模糊综合模型在评判医学生心理素质中的应用

目的　探讨模糊数学理论在医学生心理综合素质评定中的应用。方法　随机选取2017年10至12月在南京医科大学附属淮安第一医院见习和实习的80名医学本科生进行调查;采用自拟的医学生心理素质问卷,包括一级条目3个（学习压力、生活压力、人际压力）,二级条目19个。问卷回收率95%,运用模糊综合评判法进行数据的处理和分析。结果　通过将二级因素综合评判所得的数据与预先设定的评判集对应,根据最大隶属度原则;得出医学生前途压力需要调整者占25.00%,家人身体健康状况压力需要调整者占41.70%,容貌压力需要调整者占26.79%。通过一级因素综合评判所得的4个数据（0.249 7、0.268 9、0.270 2、0.211 2）,得出医学生心理综合素质为“良好”;定量分析显示,27.02%的医学生心理综合素质良好,心理综合素质需要调整者占24.97%,一般者占26.89%,优秀者占21.12%。模糊综合评判表明,需要调整医学生的学习压力和生活压力,而人际压力对医学生的心理素质影响较小。结论　模糊综合评判采用定量的方法,将定性指标统一量化处理,评析科学、合理,根据评判中建立的指标体系可以轻易识别每项指标所匹配的数值,为针对性提高医学生心理综合素质提供判别和决策的依据。该评价法具有较强实用性,为客观进行医学生心理综合素质评价提供了新的方法和思路。