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Prevalence of depression in coronary heart disease in China：a systematic review and meta-analysis

中国生理学会第23届全国会员代表大会暨生理学学术大会

作者： Gavin McKenzie Paul K Witting Johannes-Peter Stasch Michael Hahn Dechaboon Changsirivathanathamrong Helen J Ball shane r thomas Vimal Kapoor David S Celermajer Andrew L Mellor John F Keaney,Jr Nicholas H Hunt roland Stocker School of Medical Sciences University of New South WalesNSW 2052Australia School of Medical Sciences(Pathology)and Bosch Institute Faculty of MedicineUniversity of SydneyNSW 2006Australia Cardiovascular research Bayer HealthCare WuppertalGermany Medicinal Chemistry Bayer HealthCareWuppertalGermany Centre for Vascular research School of Medical Sciences(Pathology)and Bosch InstituteFaculty of MedicineUniversity of SydneyNSW 2006Australia Centre for Vascular research University of New South WalesNSW 2052Australia School of Medicine and Pharmacology University of Western AustraliaPerth WA 6009Australia royal Prince Alfred Hospital University of SydneyNSW 2006Australia Immunotherapy Center Medical College of GeorgiaAugusta GA 30912U.S.A

＜正＞Control of blood vessel tone is central to vascular *** we show that metabolism of tryptophan to kynurenine by indoleamine 2,3-dioxygenase（Ido） expressed in endothelial cells contributes to arterial vessel relaxation and the control of blood *** of mice with malarial parasites（Plasmodium berghei） or induction of endotoxemia in mice led to endothelial expression of Ido,decreased plasma tryptophan concentration, increased kynurenine concentration and *** inhibition of Ido increased blood pressure in systemically inflamed mice but not in mice deficient in Ido or interferon-γ,which is required for Ido *** tryptophan and kynurenine dilated preconstricted porcine coronary arteries;the dilating effect of tryptophan required the presence of active Ido and an intact endothelium,whereas the effect of kynurenine was endothelium *** arterial relaxation induced by kynurenine was mediated by activation of the adenylate and soluble guanylate cyclase *** administration decreased blood pressure in a dose-dependent manner in spontaneously hypertensive *** results identify tryptophan metabolism by Ido as a new pathway contributing to the regulation of vascular tone.

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Chinese Medical Journal 2014年第16期127卷 2991-2998页

作者： ren Yanping Yang Hui Colette Browning shane thomas Liu Meiyan Department of Geriatric-Cardiology First Hospital of Xi'an JiaotongUniversity Xi'an Shannxi 710061 China School of Primary Health Care Faculty of Medicine Nursing andHealth Sciences Victoria 3165 Monash University Australia Department of Cardiology Beijing Anzhen Hospital Affiliated toCapital Medical University Beijing 100029 China

Background Coronary heart diseases （CHD） have been identified as one of topmost diseases affecting the Chinese ***,depression in CHD has not been reported and there are limited high quality empirical studies in China focused on the prevalence of the *** study aimed to estimate the pooled prevalence of depression with CHD in *** Systematic review and meta-analysis of published epidemiologic studies on the depression in CHD patients in China were *** research findings dated before 30 September 2013 were obtained from Ovid Medline,EMBASE and two Chinese electronic publication libraries WANFANG and *** used ＂cardiovascular disease＂,＂depression＂ and ＂China＂ as the search themes in Ovid Medline and EMBASE and ＂cardiovascular disease＂ and ＂depression＂ in WANFANG and ***-effects meta-analysis was used to estimate the prevalence of depression in CHD *** Twenty-seven studies were included in the ***-three studies had 5 236 participants who were hospitalized and four studies had 1 353 participants from *** overall prevalence of depression in CHD from hospital was 51% （95% CI：0.43,0.58; Ⅰ-squared=97%,P=-0.000）.The prevalence of depression in CHD from community ranged between 34.6% to 45.8%,and the severe depression was found ranging between 3.1% to 11.2%.Conclusions On comparing data with other countries,the prevalence of depression in CHD among admitted patients in China was found to be *** physicians and healthcare providers should pay more attention to the ＂physical-mental＂ health of the CHD patients.

关键词： prevalence depression coronary heart disease China meta-analysis

心理健康服务的去机构化：国际经验和对中国的启示--第二届中澳(2012．6·郑州)全科医学学术交流论坛暨全国全科医学师资(骨干)培训班内容摘登

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中国全科医学 2012年第25期15卷 2856-2857页

作者： shane thomas Monash大学医学护理与卫生科学部

2012年6月15—18日,"第二届中澳(郑州)全科医学学术交流论坛暨全国全科医学师资(骨干)培训班"在郑州市隆重召开。卫生部医改办副主任、疾病预防控制局副局长王斌,卫生部妇幼保健与社区卫生司社区卫生处处长刘利群,河南省卫生厅副厅长张... 详细信息

2012年6月15—18日,"第二届中澳(郑州)全科医学学术交流论坛暨全国全科医学师资(骨干)培训班"在郑州市隆重召开。卫生部医改办副主任、疾病预防控制局副局长王斌,卫生部妇幼保健与社区卫生司社区卫生处处长刘利群,河南省卫生厅副厅长张智民,郑州市人民政府副市长刘东,郑州市卫生局党委书记、局长顾建钦,中国全科医学杂志社社长韩建军,澳大利亚Monash大学Grant russell教授、Lyn Clearihan副教授、杨辉博士,澳大利亚Melbourne大学Grant Blashki副教授及我国各省市的全科医学培训专家、学者及管理者参加了本次会议。大会的主论坛从我国全科医学发展、澳大利亚全科医学经验等方面进行了讨论;分论坛针对我国全科医学人才培养、全科医疗中的心理健康管理、家庭医生服务等内容进行了深入的探讨和交流。在后一天半的全科医学师资(骨干)培训中,以角色扮演和案例分析的Workshop教学模式,针对全科医疗中常见的心理疾患问题进行了专题培训。其意义在于给两国卫生政策的制定者、卫生服务的管理者及全科医学师资提供了一个信息交流共享的平台,有助于开拓视野、拓宽思路。我刊本期继续对论坛及培训中的精彩内容进行摘登,敬请关注。

关键词：心理健康服务的去机构化经验启示社区卫生服务

转诊文件——全科医学服务质量的一个关键指标

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中国全科医学 2009年第5期12卷 359-362+365页

作者：杨辉 shane thomas 澳大利亚Monash大学医学、护理和卫生科学学部

目的通过国际间比较,探讨开发和使用中国社区与医院医疗服务转诊文件的标准,从而改善转诊的效益和效率,提高服务质量和保证病人安全。方法文献学习和政策分析。结果转诊文件是西方医学的一个传统,经历了从书信到表格的转变过程。澳大利... 详细信息

目的通过国际间比较,探讨开发和使用中国社区与医院医疗服务转诊文件的标准,从而改善转诊的效益和效率,提高服务质量和保证病人安全。方法文献学习和政策分析。结果转诊文件是西方医学的一个传统,经历了从书信到表格的转变过程。澳大利亚皇家全科医生学会规范了转诊文件的质量标准,并推行使用统一的全科医学转诊表。转诊文件应该包括全科医生、专科医生、病人的详细联系方式;转诊原因、临床症状和表征、潜在危险、过敏史、用药情况、社会和家族史、既往病史、病程及初步检查结果;医疗保障形式;病人知情同意。规范的转诊文件有助于改善病人信息在医疗服务系统中的流动,便于对病人采取更恰当的筛拣、确定优先和治疗服务,提高电子方式转诊的效率,提高全科医生使用计算机软件的效果和效率。中国尚未规范社区与医院之间的转诊文件,传统的"三联单"的功能实际上是记账,而非交换病人的医学信息。结论需要通过研究来优化转诊文件提供的医学信息,以提高转诊的效率和效益,改善针对病人服务的连续性和质量。

关键词：转诊文件全科医学质量

Challenges in the provision of community aged care in China

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Family Medicine and Community Health 2013年第2期1卷 32-42页

作者： HUI YANG COLETTE BrOWNING shane thomas School of Primary Health Care Faculty of MedicineNursing and Health SciencesMonash UniversityVictoria 3168Australia

Objective:Population ageing in China is a significant challenge for the Chinese government,the society and Chinese *** dramatic process of population ageing together with social and economic diversity in China has created issues in the availability,equality and sustainability of social and financial support for older *** aims of this review are to identify the social and economic challenges to the traditional caregiving system in China,and to examine possible solutions to improve the care of older people in China using the framework of ageing in ***:Electronic literature searches were conducted in May and June 2013 using PubMed,CNKI,and *** data and reports were retrieved from the United Nations,the World Health Organisation,the World Bank and National Bureau of Statistics of *** policy documents were found through government websites and formal ***:Family-centred care for older people in China is recognised as a cultural tradition in the Chinese ***,driven by large-scale social,political and economic changes,this model of caring for older people has dynamically changed over the last 50 *** the family has been the most important source of social support for older people followed by neighbour support and support from *** family obligations of caring are still centred in a cultural and practical context;however,support from family and children has weakened ***-based aged services are absent in most areas,while older people and their families have to pay out-of-pocket expenses for non-residential *** is a severe shortage of aged care or nursing home resources in China and those that exist are of low quality and *** staff who work in these facilities rarely have any formal training in aged *** addition,a market approach to the funding of residential aged care has the potential to create a moral hazard due to the poor

关键词： Population ageing Healthy ageing Ageing in place Aged care Community-based care China

Bone density, microarchitecture and stiffness in Caucasian and Caribbean Hispanic postmenopausal American women

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Bone research 2014年第3期2卷 194-202页

作者： Bin Zhou Ji Wang Emily M Stein Zhendong Zhang Kyle K Nishiyama Chiyuan A Zhang thomas L Nickolas Elizabeth shane X Edward Guo Bone Bioengineering Laboratory Department of Biomedical Engineering Columbia University Division of Endocrinology Department of Medicine Columbia University Department of Orthopedic Surgery First Affiliated Hospital School of Medicine Shihezi University

Hispanic Americans of Caribbean origin are a fast-growing subset of the US population, but there are no studies on bone density, microstructure and biomechanical integrity in this minority group. In this study, we aimed to compare Caucasian and Caribbean Hispanic postmenopausal American women with respect to these characteristics. Thirty-three Caribbean Hispanics were age-matched to thirty-three Caucasian postmenopausal women. At the lumbar spine, the Hispanic women had significantly lower areal bone mineral density （aBMD）. At the radius by high-resolution peripheral quantitative computed tomography （Hr-pQCT）, there were minimal differences between Hispanic and Caucasian women. At the tibia, Hispanic women had lower trabecular volumetric bone density and trabecular number, and higher trabecular separation. Individual trabecula segmentation （ITS） analyses indicated that at the tibia, Hispanic women not only had significantly lower bone volume fraction, but also had significantly lower rod bone volume fraction, plate trabecular number, rod trabecular number and lower plate-plate, plate-rod and rod-rod junction densities compared to Caucasian women. The differences in bone quantity and quality contributed to lower whole bone stiffness at the radius, and both whole bone and trabecular bone stiffness at the tibia in Hispanic women. In conclusion, Hispanic women had poorer bone mechanical and microarchitectural properties than Caucasian women, especially at the load-bearing distal tibia.

关键词： bone DXA Bone density microarchitecture and stiffness in Caucasian and Caribbean Hispanic postmenopausal American women

患者旅程与转诊行为:澳大利亚的模式及对中国的启发

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中国全科医学 2009年第1期12卷 3-10页

作者：杨辉 shane thomas Colette Browning 澳大利亚Monash大学医学、护理和卫生科学部

目的通过对澳大利亚和中国患者利用医疗服务的路线及其内外影响因素分析,讨论通过转诊行为来调节医疗服务利用行为的合理性。方法采用文献评价和政策文件分析,建立患者旅程的通用模型,并分析其在不同国家的变异。结果患者在医疗服务系... 详细信息

目的通过对澳大利亚和中国患者利用医疗服务的路线及其内外影响因素分析,讨论通过转诊行为来调节医疗服务利用行为的合理性。方法采用文献评价和政策文件分析,建立患者旅程的通用模型,并分析其在不同国家的变异。结果患者在医疗服务系统内的旅行路线,决定于社区医生、医院专家、患者的行为,而这些行为受制于他们各自的利益和价值取向,并与宏观上鼓励和(或)限制转诊行为的制度因素有关。结论缺乏对被调整者行为分析的政策理想,是难以在现实中实施的。而且仅仅调整社区医生的转诊行为,不足以改变医疗服务利用的方式和方向。应该通过对转诊行为主体,即社区医生、专科医生和患者的行为分析,探讨促成和阻碍有效医疗服务利用的内外因素,从而设计引导所有利益相关者的行为改变的政策。

关键词：转诊患者旅程社区医生医院医生患者行为

中国部分医院患者体验和满意监测工具应用比较分析

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北京大学学报（医学版） 2011年第3期43卷 397-402页

作者：王江蓉黄森 shane thomas 杨辉张拓红北京大学公共卫生学院北京100191 School of Primary Health Care Monash University

目的:患者体验和满意调查已被认为是收集患者对医疗服务的评价信息和促进医疗服务质量改善的重要方法,2005年至2009年,北京和广西共50余家医院使用本土化的澳大利亚维多利亚州患者满意度监测工具(victorian patient satisfaction monito... 详细信息

目的:患者体验和满意调查已被认为是收集患者对医疗服务的评价信息和促进医疗服务质量改善的重要方法,2005年至2009年,北京和广西共50余家医院使用本土化的澳大利亚维多利亚州患者满意度监测工具(victorian patient satisfaction monitoring,VPSM)进行了满意度测量,比较分析当前本土化VPSM在我国医院应用情况,为其进一步应用提供参考建议。方法:采用文献研究方法,收集2005年至2009年以来公开或未公开发表的VPSM医院调查方案和监测报告,比较各次调查的操作过程和调查结果,分析优势与不足。结果:各次调查方法大致相同,但问卷结构、提醒感谢信发放、数据采集分析机构等略有差异;调查结果的稳定性和医院间可比性较好,但结果报告形式不够统一,总体上调查逐渐规范。长期监测能够发现医院服务质量的变化,对医院服务质量改进有参考意义。结论:各次调查验证了本土化VPSM工具的优势特点,但仍存在问题,有待进一步本土化和扩大调查范围。

关键词：患者满意度卫生保健质量评价研究中国

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全科医学教育教科书的质量——开卷有益

中国全科医学 2009年第15期12卷 1364-1366页

作者：杨辉 shane thomas Colette Browning 澳大利亚Monash大学医学、护理和卫生科学部

目的通过对教科书和教育理念发展的研究,针对中国的全科医学教科书的质量和发展方向提出建议。方法文献研究和政策分析。结果教科书是给特定学科的学生开发的媒介、工具和资源。国外的全科医学教科书发展比较早,优秀的教科书能够反映全... 详细信息

目的通过对教科书和教育理念发展的研究,针对中国的全科医学教科书的质量和发展方向提出建议。方法文献研究和政策分析。结果教科书是给特定学科的学生开发的媒介、工具和资源。国外的全科医学教科书发展比较早,优秀的教科书能够反映全科医学的理念和操作技能,是全科医生重要的学习资源。结论中国的全科医学教科书的发展与学科本身的发展步伐相一致,需要进一步完善教科书,综合考虑教科书的质量,为全科医学培训提供重要的学习资源。

关键词：全科医学教科书质量