Enfoque estratégico para la acreditación de la especialidad de Higiene y Epidemiología en Villa Clara / Strategic approach for the accreditation of the Hygiene and Epidemiology specialty in Villa Clara

La epidemiología es una ciencia básica de la Salud Pública porque sus fundamentos científicos permiten la toma de decisiones en los problemas de salud. Para controlar la calidad de la formación de los profesionales y perfeccionarla, se aplica el sistema de acreditación de escenarios docentes, proceso de gran importancia que garantiza la calidad del pregrado y el posgrado. En la Universidad de Ciencias Médicas de Villa Clara se realizó dicho proceso en la especialidad de Higiene y Epidemiología, fue utilizada la autoevaluación estratégica del escenario laboral como actividad previa. El interés de los autores es exponer el método seguido para cumplir con los requerimientos establecidos. Con la aplicación de esta matriz estratégica para lograr el estado deseado en el proceso docente de la especialidad de Higiene y Epidemiología en la Universidad de Ciencias Médicas de Villa Clara se logró una evaluación de excelente.

Epidemiology is a basic science of Public Health because its scientific foundations make possible decision-making regarding health problems. To control the training quality for professionals and improve it, the accreditation system for teaching scenarios is applied, a very important process that guarantees the quality of undergraduate and postgraduate training. At the University of Medical Sciences of Villa Clara, in the specialty of Hygiene and Epidemiology, this process was carried out; the strategic self-assessment of the work scenario as a prior activity, was used. To expose the method followed to comply with the established requirements, is the aim of the authors. By using this strategic matrix to achieve the desired state in the teaching process of the specialty of Hygiene and Epidemiology at the University of Medical Sciences of Villa Clara, an excellent evaluation was achieved.

Iron deficiency and child psychomotor development in a rural region of Chota, Peru, 2022 / Deficiencia de hierro y desarrollo psicomotor infantil en una zona rural de Chota, Perú 2022 / Deficiência de ferro e desenvolvimento psicomotor infantil em uma área rural de Chota, Peru 2022

Introduction: Iron deficiency and psychomotor developmental delay are two public health problems that cause high childhood morbidity and mortality worldwide, which can be related to social, economic, cultural and health factors that affect the environment where children and their family live. Objective: To determine the relationship between iron deficiency anemia and psychomotor development in children aged 2 to 4 years treated at the Cuyumalca Clinic, Chota. Materials and methods: Relational, cross-sectional study conducted on 48 children, who underwent hemoglobin testing through a portable hemoglobinometer and were subjected to the Psychomotor Development Test. Results: 31.2% of the children displayed some type of anemia, with the most common being moderate anemia (17.7%). On average, 10.9% showed some type of psychomotor developmental delay, including coordination (6.3%), language (8.4%), motor skills (16.7%), and overall development (12.5%). 4.2% of the children who had minor to moderate anemia showed developmental delay risks in the three assessed areas as well as in their overall development. Conclusion: There is no statistically significant relationship between iron deficiency anemia and several domains of psychomotor development, including coordination, language, motor skills as well as overall development.

Introducción: La deficiencia de hierro y las alteraciones en el desarrollo psicomotor son dos problemas de salud pública que causan una alta morbimortalidad infantil alrededor del mundo. Los estudios apuntan a que esto se relaciona con los factores sociales, económicos, culturales y sanitarios en los que el niño y su familia vive. Objetivo: Determinar la relación entre anemia ferropénica y desarrollo psicomotor en niños de 2 a 4 años atendidos en el Puesto de Salud de Cuyumalca, Chota. Materiales y métodos: Estudio relacional, transversal, desarrollado con 48 niños a quienes se les realizó un dosaje de hemoglobina con hemoglobinómetro portátil y se les aplicó el Test de Desarrollo Psicomotor. Resultados: El 31,2% de niños presentaron algún tipo de anemia, siendo la anemia moderada la más frecuente (16,7%); en promedio 10,9% evidenciaron alguna alteración en el desarrollo psicomotor en coordinación (6,3%), lenguaje (8,4%), motricidad (16,7%) y desarrollo global (12,5%). El 4,2% de niños con riesgo para el desarrollo presentaron anemia leve o moderada en las tres áreas evaluadas, al igual que en el desarrollo global. Conclusión: No existe relación estadística significativa entre anemia ferropénica y desarrollo psicomotor para las áreas de coordinación, lenguaje y motricidad; además del desarrollo global.

Introdução: A deficiência de ferro e as alterações no desenvolvimento psicomotor são dois problemas de saúde pública que causam elevada morbidade e mortalidade infantil em todo o mundo. Estudos sugerem que isso está relacionado aos fatores sociais, econômicos, culturais e de saúde em que vivem a criança e sua família. Objetivo: Determinar a relação entre anemia ferropriva e desenvolvimento psicomotor em crianças de 2 a 4 anos atendidas no Posto de Saúde Cuyumalca, Chota. Materiais e métodos: Estudo relacional, transversal, desenvolvido com 48 crianças que realizaram dosagem de hemoglobina com hemoglobinômetro portátil e foi aplicado o Teste de Desenvolvimento Psicomotor. Resultados: 31,2% das crianças apresentaram algum tipo de anemia, sendo a anemia moderada a mais frequente (16,7%); em média, 10,9% apresentaram alguma alteração no desenvolvimento psicomotor na coordenação (6,3%), linguagem (8,4%), motricidade (16,7%) e desenvolvimento global (12,5%). 4,2% das crianças em risco de desenvolvimento apresentaram anemia leve ou moderada nas três áreas avaliadas, bem como no desenvolvimento global. Conclusão: Não há relação estatística significativa entre anemia ferropriva e desenvolvimento psicomotor para as áreas de coordenação, linguagem e motricidade; bem como o desenvolvimento global.

La inmunidad más allá de las ciencias médicas y biológicas / Immunity beyond the medical and biological sciences

El contexto socio-cultural actual, con su vertiginoso indi¬vidualismo y cada vez más alejado de lo colectivo, nos exige ejercitar la bioética y reflexionar sobre la lógica inmunitaria y la teoría del sistema inmunitario. La división siempre fue igual: blanco/negro, el bien/el mal, anticuerpo/antígeno, normal/patológico, occidente/oriente, civilización/barbarie, gen/proteína, y la lista es inagotable. Desde la lógica inmunitaria estas asociaciones se sintetizan en el par dicotómico vertical lo propio/lo no propio, donde el cuerpo humano biologizado (o biomedicalizado) representaría lo propio, que debe protegerse de lo considerado no propio, como podría ser un microorganismo o un cáncer. ¿De qué hablamos cuando hablamos de inmunidad? Depende. En la sinopsis del libro de divulgación científica Qué es el sistema inmune, escrito por Gabriel Rabinovich y Jorge Geffner, se anuncia (2014): "Sin que nos demos cuenta, nuestro organismo es un territorio en el que día y noche se desarrollan batallas épicas. Se producen en la intimidad de nuestros tejidos, y con armas más versátiles y efectivas que ninguna de las diseñadas por la industria bélica. Las protagoniza el sistema inmune, que distingue lo propio de lo extraño, nos protege de microorganis¬mos patógenos y descarta errores en la cadena de producción de las células (1)". En otro sentido, en la solapa del libro Immunitas. Protec¬ción y negación de la vida de Roberto Espósito se lee (2009): "La inmunidad preserva la comunidad al tiempo que la debilita". La fisiología del sistema inmunológico obedece a una lógica contradictoria: "la vida busca afirmase en aquello que la niega" (2). Es decir, para sobrevivir, conservar, proliferar y potenciar lo propio, se necesita de lo extraño. ¿Quién se puede negar a proteger lo que es de uno (tu cuerpo, tu casa, tu renta, tu país)? "Lo no propio" representa la esencia de la categoría "enfermedad" y se establece como ejemplar predilecto del discurso inmunitario, habiendo evo¬lucionado en sentido común. El sentido común, la obviedad vacía, materializa las re¬presentaciones del vulgo y produce un ethos mediado por el discurso biomédico con el objetivo de cosificar y colocar a las personas bajo la órbita comercial, donde "lo no propio" y la "enfermedad" funcionan como dispositivo espectacular de valor agregado. En este sentido, Donna Haraway sostiene: "Dirijo mi atención principalmente hacia ese polimorfo y poderosos objeto de fe, conocimiento y práctica llamado sistema inmunitario. Mi tesis es que el Sistema Inmunitario es un elaborado ícono para sistemas clave de "diferenciación" simbólica y material en el capitalismo tardío. Preeminente¬mente un objeto del siglo veinte, el Sistema Inmunitario es un mapa dibujado para guiar el reconocimiento y el desconoci¬miento del sí mismo y del otro en la dialéctica de la política occidental (Haraway en Esposito, 2009)." Este rasgo esencial del Sistema Inmune (lo no propio) se encuadra en el hábito de designar a las instituciones y a los eventos culturales como conceptos médico-biológicos y calificarlos en términos de moralidad, siempre en pares dicotómicos verticales, donde lo "mejor/peor" o "superior/inferior" es el sustrato favorito para fabricar conceptos aso¬ciados a ellos, en este caso "lo propio/lo no propio" (3, 4). La naturaleza del mecanismo inmunitario es una teoría, devenida verdad, cuya atracción para el estudiantado y su facilidad para estudiarla y comprenderla proviene de la dicotomía axiológica "lo propio y lo no propio" y desde la metáfora bélica. El problema surge cuando ­televisión de por medio­ se produce el pasaje de verdades (conceptos) médicas a la comunidad, porque la sociedad y el espectáculo encuentran en el fascinante discurso médico su argumentación teórica (5). Ahora bien, imaginemos la siguiente definición: El Sistema Inmunitario se encarga de reconocer e incluir lo no propio, para interactuar con lo propio y fortalecerse. El contenido y el mecanismo fisiológico es el mismo; sólo cambió el discurso y, por ende, el significado. Lamentablemente, para que "la cosa funcione" el discurso inmunitario debe ser el de siempre: el de una batalla, y si es épica mejor.

Bioética e integración de la inteligencia artificial en la medicina: reflexiones desde el cine sobre la condición humana y la responsabilidad hacia las generaciones futuras / Bioethics and Integration of AI in Medicine: reflections from Cinema about the Human Condition and Responsibility towards Future Generations

La discusión sobre la ética en torno a la inteligencia artificial y la medicina ha ganado cada vez más relevancia en el ámbito académico y público. Independientemente de los diversos enfoques, hay un hecho innegable: la práctica médica y todos los agentes involucrados, tanto profesionales como usuarios, se verán condicionados por la inteligencia artificial. En este análisis ético narrativo, basado en el cine, se aborda la condición humana y la responsabilidad hacia las generaciones futuras como elementos cruciales dentro de la discusión bioética y fundamentales para lograr una incorporación reflexiva y coherente de la inteligencia artificial en la medicina. Como conclusión, se propone que la autenticidad, la responsabilidad y el diálogo son pilares esenciales en el proceso de integración de esta tecnología

The discussion on the ethics surrounding artificial intelligence and medicine has gained increasing relevance in the academic and public sphere. Regardless of the various approaches, there is an undeniable fact: medical practice and all the agents involved, both professionals and users, will be conditioned by artificial intelligence. In this narrative ethical analysis, based on cinema, the human condition and responsibility towards future generations are addressed as crucial elements within the bioethical discussion and fundamental to achieve a thoughtful and coherent incorporation of artificial intelligence in medicine. In conclusion, it is proposed that authenticity, responsibility and dialogue are essential pillars in the process of integration of this technology

Current status of musculoskeletal ultrasound in Colombian rheumatology

Introduction: Ultrasound is very useful in the management of rheumatological pathology today. Despite this, in Colombia, progress towards its implementation is limited and entails great difficulties. This deficit is also related to the difficulties in training new human talent. In Colombia, there is no study that identifies the current status of ultrasound among rheumatologists in the country. Methods: This is a descriptive cross-sectional study where medical specialists in Rheumatology practising in Colombia were surveyed through an online form. They were asked about general aspects and for their opinion regarding ultrasound in rheumatology and, if they practiced it, they were asked about specific aspects of its application in clinical practice. Additionally, questions were asked of the rheumatologists who are part of the specialist training processes in the country. Closed multiple-choice or Likert scale assessment questions were presented as required. The main objective was to describe the current use and opinion of musculoskeletal ultrasound in Colombian rheumatologists, as well as the limitations for its implementation. Frequency measurements were performed of the categorical variables of nominal type and ordinal type. The intention was to survey all rheumatologists in the country, who according to Colombian Society of Rheumatology data for the end of 2019 totalled 186. Results: Taking into account the number of rheumatologists of the Colombian Association of Rheumatology (Asoreuma) for 2019 totalling 186, a participation of 139 specialists (74.7%) was obtained, of which 22 of the respondents performed ultrasound in their daily practice (15.8%) the majority in this group being trained in Colombian territory (80.6%). Of the 139 respondents, 64.7% have received some type of training in ultrasound, generally pre-congress courses (22.5%), EULAR courses (16.7%) and training included in their residency curriculum outside the rheumatology service (9.8%). The acceptance of ultrasound is high among rheumatologists practicing in Colombia, 75.5% consider it important or very important and 84.9% indicated that for a comprehensive rheumatology service it is important or very important to have ultrasound. From the responses, however, they consider that its use could change their behaviour frequently, and very frequently in less than half of the cases at 46.7%. Regarding the opinion on the use of ultrasound in specific pathologies, rheumatoid arthritis (77.7%) and crystal arthropathies (72.7%) were considered the highest and most important, as well as in the performance of procedures at 87%. For decision-making in the inflammatory pathology study, 60.4% would consider performing ultrasound compared to 28.8% who responded MRI. Regarding the limitations for implementation, the lack of training in the country (25.6%), followed by the lack of resources to procure equipment (17.9%) and ignorance and lack of interest on the part of the health entities (17.1%) were the most recognized. Conclusion: Musculoskeletal ultrasound is only practiced by a minority of rheumatologists practicing in Colombia, even though the majority consider it important. Its importance lies in its use to treat patients with rheumatoid arthritis, crystal arthropathies and psoriatic arthropathy, as well as for the performance of procedures. More than half of the rheumatologists have received some type of training in ultrasound, usually very few hours' education and without practical or informal training, this being the main problem for its implementation.

Introducción: En la actualidad, la ecografía es de gran utilidad en el manejo de la patología reumatológica. A pesar de esto, en Colombia, los avances para su implementación son escasos y han enfrentado grandes dificultades. Este déficit también se encuentra relacionado con las complicaciones para la formación del nuevo talento humano. En Colombia no se dispone de ningún estudio en el que se identifique el estado actual de la ecografía entre los reumatólogos del país. Métodos: Se trata de un estudio descriptivo de carácter transversal en el cual se encuestó, por medio de un formulario on-line, a médicos especialistas en reumatología que hacen su práctica en el territorio colombiano. Se les preguntó acerca de los aspectos generales y su opinión sobre la ecografía en la reumatología, si la practicaban, como también en torno a los aspectos específicos de su aplicación en la práctica clínica. De manera adicional, se formularon preguntas dirigidas a aquellos reumatólogos que hacen parte de los procesos de capacitación de especialistas en el país; se presentaron preguntas cerradas de opción múltiple o de valoración por escala de Likert según se requirió. El objetivo principal fue describir el uso y la opinión actual sobre la ecografía musculoesquelética en reumatólogos colombianos, así como las limitantes para su implementación. A las variables categóricas de tipo nominal y de tipo ordinal se les hicieron medidas de frecuencia. Se pretendía encuestar a la totalidad de los reumatólogos en el país, los cuales, según información de la Asociación Colombiana de Reumatología (Asoreuma) de finales del 2019, eran 186. Resultados: De acuerdo con el número de reumatólogos proporcionado por la Asoreuma, de 186 especialistas en el año 2019, se obtuvo una participación de 139 de estos (74,7%), de los cuales 22 realizaban ecografía en su práctica diaria (15,8%), siendo este grupo en su mayoría formado en Colombia (80,6%). De los 139 encuestados, el 64,7% había recibido algún tipo de estudios en ecografía, generalmente cursos precongreso (22,5%), cursos de la Liga Europea Contra el Reumatismo (EULAR) (16,7%) y formación incluida en el pensum de su residencia fuera del servicio de reumatología (9,8%). La aceptación de la ecografía es alta entre los reumatólogos que ejercen en Colombia, el 75,5% la consideraron importante o muy importante. Asimismo, el 84,9% indicó que para un servicio de reumatología integral es importante o muy importante contar con ecografía. Sin embargo, los encuestados consideraron que su uso podría llegar a cambiar su conducta de manera frecuente, y muy frecuentemente en menos de la mitad de los casos (46,7%). Con respecto a la opinión sobre el uso de la ecografía en patologías específicas, se consideró con importancia y mucha importancia en artritis reumatoide (77,7%) y artropatías por cristales (72,7%), que fueron las más altas, así como para la realizaron de procedimientos (87%). Para la toma de decisiones en estudio de patología inflamatoria, el 60,4% consideraría realizar ecografía, comparado con 28,8% que se inclina por la resonancia. En relación con las limitaciones para la implementación, la falta de entrenamiento en el país (25,6%), seguida de la carencia de recursos para la consecución del equipo (17,9%) y el desconocimiento y la falta de interés por parte de los entes de salud (17,1%) fueron las más reconocidas. Conclusiones: La ecografía musculoesquelética solamente es practicada por una minoría de los reumatólogos que ejercen en Colombia, a pesar de que la mayoría la considera importante. Su relevancia radica en su uso para tratar a los pacientes con artritis reumatoide, artropatías por cristales y por artropatía psoriásica, así como para la realización de procedimientos. Más de la mitad de los reumatólogos ha recibido algún tipo de formación en ecografía, la mayoría de las veces educación de muy pocas horas o sin entrenamiento práctico, o no formal, lo cual constituye el principal problema para su implementación.

Realidade Aumentada e Realidade Virtual como inovação no curso médico / Augmented Reality and Virtual Reality as innovation in the medical course / Realidad Aumentada y Realidad Virtual como innovación en el curso médico

Apesar do ensino da medicina ser um dos mais tradicionais, o conceito de educação médica tem se desenvolvido nos últimos séculos em paralelo à evolução da medicina. Uma reflexão sobre este processo é extremamente benéfica e esclarecedora, justamente nesta fase caracterizada pelo aumento de escolas médicas e de um profundo questionamento do paradigma curricular vigente na maior parte destas instituições

La formación y especialización médica en medicina transfusional / Medical training and specialization in transfusion medicine

Introducción: Para una práctica transfusional segura se requiere una formación en medicina transfusional. Objetivo: Determinar la manera en que se integran los contenidos y las habilidades de medicina transfusional en la formación y la especialización médica en Cuba. Métodos: Se hizo un estudio educacional, analítico, de corte transversal en la Universidad de Ciencias Médicas de Camagüey, desde marzo de 2020 hasta julio de 2021. Se realizó un análisis documental para precisar cómo se integraban los contenidos y las habilidades de medicina transfusional al currículo para la formación de médicos, a los programas de estudio del internado vertical en 26 especialidades médicas, y a 29 planes de estudio y programas de especialización en Cuba. Resultados: El currículo para la formación de médicos en Cuba no incluye medicina transfusional. La asignatura que más contribuye a la formación en esta área del saber es Sangre y Sistema inmune. Los contenidos y las habilidades de medicina transfusional solo se incluyen expresamente en nueve programas de estudio del internado vertical y en 12 planes de estudio y programas de especialización. Conclusiones: Existe una insuficiente integración de los contenidos y las habilidades de medicina transfusional en el currículo de la carrera de medicina en Cuba, situación que se manifiesta también en los programas de estudios de los internados verticales y en la mayoría de los programas de las especialidades médicas.

Introduction: Safe transfusion practice requires training in transfusion medicine. Objective: To determine the way in which transfusion medicine contents and skills are integrated into medical training and specialization in Cuba. Methods: An educational, analytical and cross-sectional study was carried out at Universidad de Ciencias Médicas de Camagüey, from March 2020 to July 2021. A documentary analysis was conducted to determine how transfusion medicine contents and skills were integrated into the curriculum for the training of physicians, into the study programs of the vertical internship in 26 medical specialties, as well as into 29 study plans and specialization programs in Cuba. Results: The curriculum for the training of physicians in Cuba does not include transfusion medicine. The subject that most contributes to training in this area of knowledge is Blood and Immune System. Transfusion medicine contents and skills are only expressly included in nine vertical internship study programs and in twelve study plans and specialization programs. Conclusions: There is insufficient integration of transfusion medicine contents and skills in the Cuban medical major curriculum, a situation that is also manifested in the study programs of vertical internships and in most of the medical specialties programs.

The challenges faced after a major trauma at an expedition ship at a remote area. Report of one Case / Desafíos enfrentados después de un trauma mayor en un barco de expedición en un área remota. Informe de un caso

The challenges of practicing medicine in small ships on remote sites involve limited resources, lack of specialized support, and longer interactions with a patient in an isolated environment. This report describes the successful management of a patient who suffered a major injury after fell from the stairs in an expedition ship in the Southern Ocean in the Antarctic route. The patient was managed by the onboard physician for four days until the medical evacuation was possible.

Los desafíos de practicar la medicina en barcos pequeños en sitios remotos implican recursos limitados, falta de apoyo especializado e interacciones más prolongadas con el paciente en un entorno aislado. Este manuscrito describe el manejo exitoso de un paciente quien sufrió un trauma mayor producto de una caída en un barco de expedición en el Océano Austral en la ruta Antártica. El paciente fue manejado por el médico de a bordo durante cuatro días hasta que fue posible realizar la evacuación médica.

The research status and development trends of brain-computer interfaces in medicine / 生物医学工程学杂志

Brain-computer interfaces (BCIs) have become one of the cutting-edge technologies in the world, and have been mainly applicated in medicine. In this article, we sorted out the development history and important scenarios of BCIs in medical application, analyzed the research progress, technology development, clinical transformation and product market through qualitative and quantitative analysis, and looked forward to the future trends. The results showed that the research hotspots included the processing and interpretation of electroencephalogram (EEG) signals, the development and application of machine learning algorithms, and the detection and treatment of neurological diseases. The technological key points included hardware development such as new electrodes, software development such as algorithms for EEG signal processing, and various medical applications such as rehabilitation and training in stroke patients. Currently, several invasive and non-invasive BCIs are in research. The R&D level of BCIs in China and the United State is leading the world, and have approved a number of non-invasive BCIs. In the future, BCIs will be applied to a wider range of medical fields. Related products will develop shift from a single mode to a combined mode. EEG signal acquisition devices will be miniaturized and wireless. The information flow and interaction between brain and machine will give birth to brain-machine fusion intelligence. Last but not least, the safety and ethical issues of BCIs will be taken seriously, and the relevant regulations and standards will be further improved.

Network Meta-analysis of Qi-benefiting and blood-activating Chinese patent medicines against ischemic stroke / 中国中药杂志

This study aimed to compare the efficacy of Qi-benefiting and blood-activating Chinese patent medicines in the treatment of ischemic stroke with network Meta-analysis. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library were searched from database inception to October 2022 for randomized controlled trial(RCT) on 11 Qi-benefiting and blood-activating Chinese patent medicines in the treatment of ischemic stroke. The risk of bias plot was made by RevMan 5.3, and network Meta-analysis and efficacy ranking were performed by Stata 17. Ninety-two RCTs were included, involving 10 608 patients. According to the network Meta-analysis, in terms of the clinical total effective rate, surface under the cumulative ranking curve(SUCRA) as followed: Qilong Capsules+conventional western medicine>Zhishe Tongluo Capsules+conventional western medicine>Longshengzhi Capsules+conventional western medicine>Naoxintong Capsules+conventional western medicine>Tongsaimai Tablets+conventional western medicine>Naoan Capsules+conventional western medicine>Naoluotong Capsules+conventional western medicine>Xiaoshuan Changrong Capsules+conventional western medicine>Dengzhan Shengmai Capsules+conventional western medicine=Tongxinluo Capsules+conventional western medicine>Naomaitai Capsules+conventional western medicine. In terms of the improvement in National Institute of Health stroke scale(NIHSS) score, SUCRA as followed: Longshengzhi Capsules+conventional western medicine>Naomaitai Capsules+conventional western medicine>Naoxintong Capsules+conventional western medicine>Dengzhan Shengmai Capsules+conventional western medicine>Xiaoshuan Changrong Capsules+conventional western medicine>Naoluotong Capsules+conventional western medi-cine>Tongxinluo Capsules+conventional western medicine>Naoan Capsules+conventional western medicine>Qilong Capsules+conventional western medicine. In terms of safety, the overall adverse reactions/events of Qi-benefiting and blood-activating Chinese patent medicines + conventional western medicine were less than those of the control group. Since Qilong Capsules+conventional western medicine and Zhishe Tongluo Capsules+conventional western medicine were preferred to improve the clinical total effective rate. In the aspect of improving NIHSS score, Longshengzhi Capsules+conventional western medicine and Naomaitai Capsules+conventional western medicine were first options. Due to the lack of direct comparisons between drugs, the overall quality of RCT was not high, so more studies are needed to verify the strength of the evidence.

Application and development of systems biology in computer-aided drug design / 中国中药杂志

With the advances in medicine, people have deeply understood the complex pathogenesis of diseases. Revealing the mechanism of action and therapeutic effect of drugs from an overall perspective has become the top priority of drug design. However, the traditional drug design methods cannot meet the current needs. In recent years, with the rapid development of systems biology, a variety of new technologies including metabolomics, genomics, and proteomics have been used in drug research and development. As a bridge between traditional pharmaceutical theory and modern science, computer-aided drug design(CADD) can shorten the drug development cycle and improve the success rate of drug design. The application of systems biology and CADD provides a methodological basis and direction for revealing the mechanism and action of drugs from an overall perspective. This paper introduces the research and application of systems biology in CADD from different perspectives and proposes the development direction, providing reference for promoting the application.

Visual analysis of research on traditional Chinese medicine treatment of Alzheimer's disease in recent ten years / 中国中药杂志

This study employed bibliometrics tools to review the studies of traditional Chinese medicine(TCM) treatment of Alzheimer's disease(AD) in recent ten years, aiming to explore the research status, hotspots, and future trends in this field at home and abroad. The relevant literature published from January 1, 2012 to August 15, 2022 was retrieved from Web of Science and CNKI. CiteSpace 6.1R2 and VOSviewer 1.6.15 were used for the visual analysis of authors, countries, institutions, keywords, journals, etc. A total of 2 254 Chinese articles and 545 English articles were included. The annual number of articles published showed a rising trend with fluctuations. The country with the largest number of relevant articles published and the largest centrality was China. SUN Guo-jie and WANG Qi were the authors publishing the most Chinese articles and English articles, respectively. Hubei University of Chinese Medicine and Beijing University of Chinese Medicine published the most articles in Chinese and English, respectively. Journal of Ethnopharmacology and Neuroscience Letters published the articles with the highest cited frequency and the highest centrality. According to the keywords, the research on TCM treatment of AD mainly focused on the mechanism of action and treatment methods. Metabolomics, intestinal flora, oxidative stress, tau hyperphosphorylation, β-amyloid(Aβ), inflammatory cytokines, and autophagy were the focuses of the research on mechanism of action. Acupuncture, clinical effect, kidney deficiency and phlegm stasis, and dredging governor vessel to revitalize mind were the hotspots of clinical research. This research field is still in the stage of exploration and development. Exchanges and cooperation among institutions should be encouraged to carry out more high-quality basic research on TCM treatment of AD, obtain high-level evidence, and clarify the pathogenesis and prescription mechanism.

Chemical reaction mechanism of decoction of traditional Chinese medicines: a review / 中国中药杂志

Complicated chemical reactions occur in the decoction of traditional Chinese medicines(TCMs) which features complex components, influencing the safety, efficacy, and quality controllability of TCMs. Therefore, it is particularly important to clarify the chemical reaction mechanism of TCMs in the decoction. This study summarized eight typical chemical reactions in the decoction of TCMs, such as substitution reaction, redox reaction, isomerization/stereoselective reaction, complexation, and supramolecular reaction. With the "toxicity attenuation and efficiency enhancement" of aconitines and other examples, this study reviewed the reactions in decoction of TCMs, which was expected to clarify the variation mechanisms of key chemical components in this process and to help guide medicine preparation and safe and rational use of medicine in clinical settings. The current main research methods for chemical reaction mechanisms of decoction of TCMs were also summed up and compared. The novel real-time analysis device of decoction system for TCMs was found to be efficient and simple without the pre-treatment of samples. This device provides a promising solution, which has great potential in quantity evaluation and control of TCMs. Moreover, it is expected to become a foundational and exemplary research tool, which can advance the research in this field.

Effect of electroacupuncture at Tinghui (GB 2) and Benshen (GB 13) on abnormal auditory response in children with autism spectrum disorder / 中国针灸

OBJECTIVE@#To compare the effect of electroacupuncture at Tinghui (GB 2) and Benshen (GB 13) combined with routine rehabilitation training and simple routine rehabilitation training on abnormal auditory response in children with autism spectrum disorder (ASD).@*METHODS@#A total of 70 children with ASD were randomly divided into an observation group and a control group, 35 cases in each group. The control group was given routine rehabilitation training. On the basis of the treatment in the control group, the observation group was given electroacupuncture at Tinghui (GB 2) and Benshen (GB 13), disperse-dense wave, frequency in 2 Hz/10 Hz, 20 min each time, and 1 day off after 6 days of treatment. Both groups were treated for 12 weeks. The incidence of abnormal auditory response, the scores of childhood autism rating scale (CARS) and autism behavior checklist (ABC) were compared between the two groups before and after treatment.@*RESULTS@#After treatment, the total incidences of abnormal auditory response in the two groups and the incidences of dull and hypersensitive auditory response in the observation group were lower than those before treatment (P<0.05). The total incidence of abnormal auditory response and the incidence of hypersensitive auditory response in the observation group were lower than those in the control group (P<0.05). After treatment, CARS and ABC scores of both groups were lower than those before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05).@*CONCLUSION@#Electroacupuncture at Tinghui (GB 2) and Benshen (GB 13) combined with routine rehabilitation training can reduce the incidence of abnormal auditory response and improve the core symptoms in children with ASD, and the clinical effect is better than the simple routine rehabilitation training.

Clinical observation on syndrome-differentiation acupuncture combined with rehabilitation training for autism spectrum disorder / 中国针灸

OBJECTIVE@#To compare the clinical efficacy and safety between syndrome-differentiation acupuncture combined with rehabilitation training and simple rehabilitation training for children with autism spectrum disorder (ASD).@*METHODS@#A total of 60 children with ASD were randomly divided into an observation group and a control group, 30 cases in each group. In the control group, routine rehabilitation training was applied; in the observation group, syndrome-differentiation acupuncture (the main points were Baihui [GV 20], Dingshenzhen, Niesanzhen, etc., the supplementary acupoints were selected according to syndrome-differentiation) combined with rehabilitation training were applied, all the treatments were given once a day, 5-day continuous treatment with 2-day interval, 12 weeks were required. Before treatment and after 6, 12 weeks of treatment, the autism treatment evaluation checklist (ATEC), childhood autism rating scale (CARS) and autism behavior checklist (ABC) scores were observed, the therapeutic effect and safety were evaluated in the two groups.@*RESULTS@#After 6 and 12 weeks of treatment, except for the sensory perception score after 6 weeks of treatment in the control group, the item scores and total scores of ATEC, CARS scores and ABC scores were decreased compared with those before treatment in the two groups (P<0.05). After 6 weeks of treatment, the social score and total score of ATEC, CARS score in the observation group were lower than those in the control group (P<0.05); after 12 weeks of treatment, the item scores and total score of ATEC, CARS score and ABC score in the observation group were lower than those in the control group (P<0.05). The total effective rate in the observation group was 80.0% (24/30), which was higher than 56.7% (17/30) in the control group (P<0.05). There was no serious adverse reactions in the two groups, and there was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05).@*CONCLUSION@#Syndrome-differentiation acupuncture combined with rehabilitation training could improve the core symptoms in children with ASD, especially sensory perception and social ability, and with good safety, which is superior to simple rehabilitation training.

Machine learning in medicine: what clinicians should know

With the advent of artificial intelligence (AI), machines are increasingly being used to complete complicated tasks, yielding remarkable results. Machine learning (ML) is the most relevant subset of AI in medicine, which will soon become an integral part of our everyday practice. Therefore, physicians should acquaint themselves with ML and AI, and their role as an enabler rather than a competitor. Herein, we introduce basic concepts and terms used in AI and ML, and aim to demystify commonly used AI/ML algorithms such as learning methods including neural networks/deep learning, decision tree and application domain in computer vision and natural language processing through specific examples. We discuss how machines are already being used to augment the physician's decision-making process, and postulate the potential impact of ML on medical practice and medical research based on its current capabilities and known limitations. Moreover, we discuss the feasibility of full machine autonomy in medicine.

Atuação da psicologia em unidade neonatal no contexto da pandemia da covid-19 / The work of psychology in a neonatal unit in the covid-19 pandemic / Actuación de la psicología en una unidad neonatal en el contexto de la pandemia de la covid-19

A pandemia de covid-19 provocou intensas mudanças no contexto do cuidado neonatal, exigindo dos profissionais de saúde a reformulação de práticas e o desenvolvimento de novas estratégias para a manutenção da atenção integral e humanizada ao recém-nascido. O objetivo deste artigo é relatar a atuação da Psicologia nas Unidades Neonatais de um hospital público de Fortaleza (CE), Brasil, durante o período de distanciamento físico da pandemia de covid-19. Trata-se de estudo descritivo, do tipo relato de experiência, que ocorreu no período de março a agosto de 2020. No contexto pandêmico, o serviço de Psicologia desenvolveu novas condutas assistenciais para atender às demandas emergentes do momento, como: atendimento remoto; registro e envio on-line de imagens do recém-nascido a seus familiares; visitas virtuais; e reprodução de mensagens de áudio da família para o neonato. Apesar dos desafios encontrados, as ações contribuíram para a manutenção do cuidado centrado no recém-nascido e sua família, o que demonstra a potencialidade do fazer psicológico.(AU)

The COVID-19 pandemic brought intense changes to neonatal care and required health professionals to reformulate practices and develop new strategies to ensure comprehensive and humanized care for newborn. This study aims to report the experience of the Psychology Service in the Neonatal Units of a public hospital in Fortaleza, in the state of Ceará, Brazil, during the social distancing period of the COVID-19 pandemic. This descriptive experience report study was conducted from March to August 2020. During the pandemic, the Psychology Service developed new care practices to meet the emerging demands of that moment, such as remote care, recordings and online submission of newborns' pictures and video images for their family, virtual tours, and reproduction of family audio messages for the newborns. Despite the challenges, the actions contributed to the maintenance of a care that is centered on the newborns and their families, which shows the potential of psychological practices.(AU)

La pandemia de la COVID-19 ha traído cambios intensos en el contexto de la atención neonatal, que requieren de los profesionales de la salud una reformulación de sus prácticas y el desarrollo de nuevas estrategias para asegurar una atención integral y humanizada al recién nacido. El objetivo de este artículo es reportar la experiencia del Servicio de Psicología en las Unidades Neonatales de un hospital público de Fortaleza, en Ceará, Brasil, durante el periodo de distanciamiento físico en la pandemia de la COVID-19. Se trata de un estudio descriptivo, un reporte de experiencia, que se llevó a cabo de marzo a agosto de 2020. En el contexto pandémico, el servicio de Psicología desarrolló nuevas conductas asistenciales para atender a las demandas emergentes del momento, tales como: atención remota; grabación y envío em línea de imágenes del recién nacido; visitas virtuales; y reproducción de mensajes de audio de la familia para el recién nacido. A pesar de los desafíos encontrados, las acciones contribuyeron al mantenimiento de la atención centrada en el recién nacido y su familia, lo que demuestra el potencial de la práctica psicológica.(AU)