复印病案的情况调查与分析

目的调查病人复印病案的现状和目的,以进一步规范病案管理,提高病案质量。方法对本院3年来申请复印病案资料进行回顾性统计分析。结果复印病案办理大病统筹的数量占第一位,其次为报销凭证、司法鉴定和保险理赔等。结论落实《医疗机构病历管理规定》,加强病历复印管理工作,从而体现病案的社会价值,尊重患者的知情权,确保病案信息的完整性、准确性,维护医患双方的合法权益,使病案信最大限度的为社会服务。     

HIV-1准种的变化与疾病进展关系的研究

目的　研究HIV 1准种的变化对疾病进展的影响。方法　PCR方法扩增HIV 1V3～V5区片段 ,采用HMA(异源双链泳动分析 )的方法分析 4 8例HIV/AIDS准种的变化 ,并结合HIV/AIDSCD4 T淋巴细胞计数及病毒载量的结果分析HIV 1准种的变化对疾病进程的影响。结果　在不同的疾病状态下 ,体内病毒变异是不相同的 ,在体内CD4 T淋巴细胞计数较高 ,血浆病毒载量低的个体内 ,病毒毒株有很强的变异特征 ,体内具有很高的准种复杂度 ;而在CD4 细胞数很低 ,病毒载量较高的个体 ,病毒基因变异较少 ,病毒准种较为单一。结论　HIV 1准种的变化与疾病进展相关。     

Simple,rapid, and accurate determination of deletion mutations by automated dna sequencing of heteroduplex fragments of the adenomatous polyposis coli (APC) gene generated by PCR amplification

Germline mutations in patients with familial adenomatous polyposis were analyzed by polymerase chain reaction (PCR) amplification of the adenomatous polyposis coli gene. PCR products from heterozygous patients for deletions of this gene formed four distinct bands on polyacrylamide gel electrophoresis. The four fragments were subsequently purified and both strands of each fragment were directly sequenced, using an automated DNA sequencer and the same primers as those for PCR amplification. It was found that the two slower migrating fragments were “bulge” heteroduplexes, while the other two were homoduplexes made up of two wild-type strands and two deletion-mutant strands, respectively. The sites of deletions in the adenomatous polyposis coli gene could be exactly determined in four of the five patients. In an attempt to identify deletion-carriers of familial adenomatous polyposis at the presymptomatic stage, a family study was also carried out, and two children were found to have the same mutations as those of their affected parents. The direct sequencing of heteroduplex fragments generated during PCR amplification is a potentially useful method for detecting mutations of not only the adenomatous polyposis coli gene but also many other genes of genetic diseases. © 1993 Wiley-Liss, Inc.     

一测多评法同时测定胃力康颗粒中7种成分的含量

[目的]建立可用于胃力康颗粒中7种成分含量测定的一测多评法。[方法]采用超高效液相色谱(UPLC),以芍药苷为内参物,确定芦丁、柚皮苷、迷迭香酸、丹酚酸B、大黄素-8-O-β-D-葡萄糖苷、甘草酸的相对校正因子,通过相对校正因子计算各成分的含量;同时比较10批胃力康颗粒一测多评法的计算值与外标法测定结果的差异。[结果]建立了胃力康颗粒中7种成分一测多评的含量测定方法,10批胃力康颗粒中7种成分采用一测多评法测定与外标法测定结果无明显差异。[结论]本实验建立的一测多评法可用于胃力康颗粒中7种成分的含量测定,方法快速、准确,可用于胃力康颗粒的质量控制。     

肿瘤患者住院成本效果分析及药品利润剥离政策敏感度分析

通过对肿瘤住院患者进行住院成本效果分析,针对医院实施药品利润剥离后,提高不同比例的医疗服务费用进行敏感性分析,研究不同假设下成本效果比的优化程度、医院的资金缺口及假设效率等,并提出当前降低患者成本效果比最优方案与解决途径。     

通过多元回归分析确定甲状腺癌的诊断程序

为制定甲状腺癌术前、术中诊断的严格程序, 减少其误诊误治。选择２７ 项观察指标, 采用Ｓｔａｔａ统计学软件, 对所有指标进行Ｌｏｇｉｓｔｉｃ逐步多元回归分析。单因素分析显示,１９ 项指标在甲状腺良恶疾病的表现中, 有显著性差异 （Ｐ＜ ０． ０５）; 多因素分析表明, ６ 项指标在判断甲状腺良恶性肿瘤作用中, 有显著意义（分析水平： α＝ ０．１）。最后据分析结果建立甲状腺癌的诊断程序。结果表明： ①术中明确诊断是非常重要的阶段。若发现肿块质地硬、与周围组织粘连、肿瘤数目多于一个, 以及肿块是混合性或实质性, 应考虑恶性可能; ②术前仔细体检及综合分析有关辅助检查结果, 将有助于明确诊断。尤其当肿块质地较硬且位于右侧甲状腺时, 须格外注意     

张仲景治疗便秘理法方药探析

张仲景称便秘为"大便难"、"大便坚"、"脾约"、"不更衣"、"阴结"、"阳结"等,多与外感、津亏肠燥、阳虚寒凝、阴血亏虚等有关。临证治疗也有侧重。仲景治疗便秘,泻有轻重缓急,三承气汤主之;素体赢弱有别,抵当汤、麻仁丸及大黄附子汤区别应对;局部灌肠通导,蜜煎导、土瓜根及大猪胆汁通之。诸法中尤重大黄配伍灵活运用,以达精准把握病机,求本为上。     

重型渗出性多形红斑110例临床分析

重型渗出性多形红斑是一种发病急的严重病症，皮肤粘膜广泛损害，同时有内脏改变，我院近１０年内收治１１０例，药物过敏所致者８４例（７６．３６％），体温在３９℃以上８５例（７７．２７％），皮损以水疱大为主６５例（５９．１０％），口腔和外阴粘膜同时损害９３年（８４．５５％），内脏有改变１０４例（９４．５５％）。     

中国人Ⅰ型神经纤维瘤病基因突变分析

目的对中国人Ⅰ型神经纤维瘤病（NF1）基因20、28、29、39号外显子进行基因突变分析及评价聚合酶链反应-单链构象多态／异源双链（PCR-SSCP／HA）技术在NFl基因诊断中的价值。方法应用PCR—SSCP／HA技术，结合DNA测序，筛查56例患者NF1基因20、28、29、39号外显子的突变或多态性。结果在20号外显子发现一个家系父子3人的SSCP／HA出现泳动异常，DNA测序证实为20号外显子上T—G的杂合突变即Leul 141Arg错义突变；发现1例患者28号外显子的SSCP／HA检测有泳动异常，测序证实为28号外显子5’端上游的第28位核苷酸G—T杂合；29、39号外显子未检测到泳动异常的条带。结论联合应用SSCP／HA的方法可提高基因突变检测敏感度及检出率，NF1基因20、28、29、39号外显子不是突变热点或突变率相对较高的区域。     

Conversion in gene b1 of Ascobolus: Polarity of 6:2 and inverted polarity of aberrant 4:4 segregations

Summary Thirteen mutations located in gene b1 of Ascobolus immersus were studied for their non-mendelian segregation patterns. All these motations yield post-meiotic segregations. The non-mendelian segregation frequencies are the highest for the left end mutations. From left to right, the frequency of aberrant 4:4 asci increases. The hybrid DNA formation and distribution pattern as deduced from this result is consistent with that previously found in gene b2, providing further support to the Aviemore model. The frequency of 6:2 asci decreases from left to right. This constitutes an entirely new observation, the meaning of which is discussed.