医药信息应用型人才培养模式研究

为适应信息技术的高速发展和医药领域对医药信息人才的大量需求,对应用型人才培养模式进行认真分析的基础上,探讨了医药院校如何构建具有医药特色信息应用型人才培养模式,并形成具有特色的教学模式。     

AST／ALT比值对心肌梗塞诊断价值探讨

分析15例心肌梗塞AST／ALT比值在心肌梗塞发病后6h，与正常组无显著差异，8～24h显著高于正常对照组（P＜0．05～0．01），4d后无显著差异，表明心肌梗塞发病后8～24h内测定AST／ALT比值对心肌梗塞诊断有价值。     

5-氨基水杨酸缓释剂的药代动力学及其与肠道pH的关系

5-氨基水杨酸缓释剂在美国和欧洲自80年代初开始发掘与研究,于80年代末、90年代初进入临床,其药代动力学和肠道pH间的关系与其效果有至为重要的关联。本文重点叙述其吸收、分布、蛋白结合、清除、局部与全身性生物利用度,及其与肠道pH和效果的关系。     

甲泼尼龙在PKP术中预防骨水泥植入综合征的作用

目的研究在经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗老年性骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)中,预防性应用注射用甲泼尼龙琥珀酸钠来减少骨水泥植入综合征的发生。方法对2015年8月至2017年3月在本院行PKP治疗的40例新鲜老年性OVCF患者随机分成两组。A组在PKP术中骨水泥注入前用2ml生理盐水作对照,共20例;B组用预防性应用注射用甲泼尼龙琥珀酸钠40mg,共20例。术中观察骨水泥注入前、注入后1、3、5、7、10分钟的桡动脉有创动脉血压、心率及氧饱和度变化,并进行对比研究。结果 A组患者收缩压、舒张压、心率和氧饱和度变量在骨水泥植入前后有明显的变化,变化有统计学意义(P0.05),B组患者收缩压、舒张压、心率和氧饱和度变量在骨水泥植入前后变化较小,变化无统计学意义(P0.05)。结论在PKP术中,预防性的应用甲泼尼龙琥珀酸钠能有效的减少骨水泥植入综合征的发生,降低术中心血管风险,值得临床深入观察。     

鼻内窥镜下泪囊鼻腔造孔术的护理配合

通过对30例经鼻内窥镜下泪囊鼻腔造孔术患者的术前准备及术中配合，总结认为：术前做好病人心理护理，使患者积极配合手术。器械准备充分，术中熟悉手术步骤并能及时准确地准备、传递各种器械，确保仪器运转正常是保证手术顺利进行的关键。     

大学生口腔保健状况的调查分析

目的了解大学生口腔保健状况及存在的问题,为促进大学生的口腔保健提供依据。方法采用自行设计的大学生口腔保健状况调查表对南京市江宁区4所高校231名大学生进行调查。结果80.87%大学生每天刷牙2次及以上,30.43%每次刷牙满3min;68.83%曾经有过或经常出现牙龈出血;58.87%对自己的牙齿功能基本满意;9.52%、25.11%分别对牙齿功能和美观不满意。男女生刷牙次数、牙龈出血不及时就医原因、成人恒牙数回答正确率比较,差异有统计学意义(均P0.01);每天刷牙2次及以上、成人恒牙数回答正确者医学生显著多于非医学生(均P0.01)。结论大学生口腔保健状况欠佳,且存在性别和专业差异。应提高大学生的口腔保健意识,加强口腔保健健康教育,以切实改善大学生口腔健康状况。     

表面增强激光解析电离飞行时间质谱法筛选肺癌患者血清和肺泡灌洗液中标志蛋白的研究

Objective To detect the protein markers in serum and bronchoalveolar lavage fluid (BALF) of the patients with lung cancer by surface-enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) technology, and to explore if they can be used as markers for the diagnosis of lung cancer.Methods SELDI-TOF-MS technology and protein chips weak cation exchange (WCX-2 chip) were used to detect the protein mass spectrum in serum and BALF of 35 patients with lung cancer and 18 cases of benign pulmonary diseases.The different protein markers were analyzed by Biomarker Pattern Software and the initial diagnosis models were set up.The diagnosis models were verified further by blind screen to confirm the efficacy of diagnosis.Results Five protein peaks in the sera of the patients with lung cancer were significantly higher (P ＜ 0.05 ).The protein peak with a mass/charge ratio (M/Z)of 5639 was selected to establish the classification tree model.The sensitivity of diagnosis was 80% (28/35) and the specificity was 78% (14/18).The results verified by blind screen showed a sensitivity of 85% (17/20),a specificity of 90% (9/10), a crude accuracy (CA) of 87% ( 26/30 ) and Youden' s index (γ) of 0.7.Eight protein peaks in the BALF of the patients with lung cancer were significantly higher ( P ＜ 0.05).The different protein peaks with M/Z of 7976 and 11 809 respectively were selected to establish the classification tree model.The sensitivity of diagnosis was 86% (30/35) and the specificity was 72% (13/18).The results verified by blind screen showed a sensitivity of 90% (18/20), a specificity of 90% (9/10), a CA of 90% (27/30) and γof 0.8.There was a complementary role in combination of differential proteins in serum and BALF and the sensitivity, specificity and accuracy of diagnosis for lung cancer were 100% by parallel test.Conclusions The SELDI-TOF-MS technology can screen out the differential protein markers in serum and BALF of the patients with lung cancer, which show high sensitivity and specificity as tumor markers.The differential proteins in the BALF may be more promising for clinical application.     

轻度认知功能损害的睡眠障碍

目的:研究轻度认知功能障碍(MCI)患者睡眠障碍的发生情况并研究其发病机制。方法:使用匹兹堡睡眠质量指数量表(PSQI)对MCI患者(MCI组)和年龄相匹配的健康老年人(对照组)进行睡眠质量的检测,同时运用简易精神状态检查量表(MMSE)对受试者进行认知功能的检测,运用SPSS12.0统计学软件对两组间MMSE评分与PSQI评分进行相关性分析。结果:①MCI组和正常对照组之间MMSE得分和PSQI得分均没有明显差异性(P>0.05);②MMSE得分和PSQI得分具有显著负相关性(P<0.01)。结论:MCI患者睡眠障碍发生情况与正常对照组无明显差异,但认知功能减退与睡眠质量下降呈正相关,表明睡眠障碍可能是导致MCI的重要因素之一。     

骨梗死MRI影像学表现

目的 探讨骨梗死的MRI影像学表现及其特点.方法 回顾性分析经临床随访及病理证实的9例骨梗死的MRI影像特点.结果 病变主要累及股骨的下段及胫骨的上段,很少累及膝关节面.骨梗死MRI影像表现为病灶呈现斑片状不规则的异常信号,及"地图样"改变,病灶中央于T1WI序列上呈现近似于等或稍低信号,于T2WI序列上呈现近似于等或稍高信号,边缘于T1WI序列上呈现花边样的低信号,于T2WI序列上内层为高信号,外层为低信号的"双信号带",于STIR序列上病变呈中央低信号,周边高信号改变.最后MRI呈长T1短T2信号,为坏死组织被肉芽组织和纤维组织替代而发生纤维化和钙化或骨化.结论 MRI是诊断早、中期骨梗死最有效的影像检查方法,于MRI影像上有其特征表现,能提供更多的病区信息,可以较早地发现病变,作出相应的诊断,为临床提供更有价值的治疗信息.