RESUMEN
Through analyzing the current situation of clinical comprehensive evaluation researches of domestic medical products from 2013 to 2023， it is found that there is a phenomenon of “four more， four less”. Specifically， there is a greater emphasis on conducting research on drug clinical comprehensive evaluation， but fewer comprehensive evaluation opinions provided； more research data come from publicly available information， but fewer derived from real world； more options for similar reference drugs， but less pre-defined research on reference drugs； the research process involves more steps， yet there are fewer studies strictly implementing quality control. Based on this， suggestions are proposed in three aspects： improving the quality of clinical comprehensive evaluation of medical products， enhancing the transformation and dissemination of results， and improving the standardization of clinical comprehensive evaluation of medical products. Regarding the current state of clinical comprehensive evaluation research on Chinese patent medicine， reflections are presented on elevating original research evidence and highlighting the characteristics and advantages of Chinese patent medicine， so as to promote better transformation and application of the results of clinical comprehensive evaluation of medical products.
RESUMEN
In developing countries, urban agglomerations have become one of the most important carriers of urbanization. In China, one of the largest national urban agglomerations is the UAMRYR (urban agglomeration in the middle reaches of the Yangtze River), which has the fastest urban development in Central China and is home to critical ecological spaces. On this basis, this study analyzed the urban expansion and loss of ecological lands in UAMRYR by establishing a spatial database, grid system, rose maps, and scenario simulation. The highlights of results are as follows: the urban expansion of UAMRYR includes four stages of development: steady growth, accelerated development, peak, and deceleration. Polarized development has occurred in the region, with the Wuhan, Changsha-Zhuzhou-Xiangtan, and Nanchang metropolitan areas having high levels of urban expansion while the other cities have varying levels of urban growth. The loss of ecological land was found to have a highly similar curve and spatial distribution with the urban growth. In terms of ecological land types, the loss of agricultural land accounted for more than half of ecological lands lost overall. Losses in forests, grasslands, wetlands, and water areas varied for different areas, depending on particular conditions and specific environmental characteristics of the city. The three metropolitan areas experienced the highest increases in urban built-up areas; they also had the highest loss of ecological land, which can have critical consequences given their proximity to the Yangtze River, Poyang Lake, Dongting Lake, and other important environmental sensitive areas. The simulation results show that the UAMRYR is projected to maintain a rapid expansion rate from 2020 to 2030. If the urban expansion, particularly in the metropolitan areas, is not managed well and controlled, serious ecological damage could be inflicted on the Yangtze River Basin.
Asunto(s)
Ríos , Urbanización , Agricultura , China , Ciudades , BosquesRESUMEN
Intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) is a special type of tumor occurring in the biliary system, with no specific clinical manifestations and imaging findings, and thus it is difficult to diagnose before surgery. It is often considered when a large amount of mucus is found in the bile duct during surgery and then it is forced to change the surgical plan. Clinicians lack an understanding of this disease due to its low incidence rate. This article reviews the recent research advances in the etiology and classification, clinical features, differential diagnosis, treatment, and prognosis of IPMN-B, so as to improve the clinical diagnosis and treatment of IPMN-B among clinicians.