品管圈活动在降低气动物流运送等待时间中的实践

目的：通过规范物流运送的管理办法,降低气动物流运送等待时间,充分发挥气动物流优点,提高医院整体工作效率。方法：开展以“降低气动物流运送等待时间”为主题的跨科室品管圈活动,采用现状调查方法对运送量相对较多的9个站点的物流运送等待时间进行了调查研究,通过分析研究制定相应的对策并在全院组织实施,比较开展品管圈活动前后物流运送平均等待时间。结果：物流运送等待时间从原来的平均7.44min下降到平均4.78min,明显提高了整体工作效率。结论：跨科室品管圈活动在降低气动物流运送等待时间中效果显著,有效地提高了工作效率,也充分提高了团队协作能力。     

终末期肾脏病患者首次透析血管通路使用情况及原因分析

【摘要】目的调查维持性血液透析（MHD）患者首次透析时血管通路使用情况,并分析未使用内瘘的原因。方法研究对象为2007年10月1日到2012年9月30日于首都医科大学附属复兴医院行MHD的所有患者,调查首次透析时血管通路使用情况,分为内瘘组和深静脉导管组。比较2组临床各项指标,分析未使用内瘘的原因。结果研究期内开始MHD治疗的患者共160例,内瘘组32例,深静脉导管组128例。深静脉导管组患者在年龄、首次透析时合并心力衰竭的患者比例、查尔森合并症指数（CCI）、行急诊透析比例、估计的肾小球滤过率（eGFR）、专科随诊以及血红蛋白（Hb）水平不同于内瘘组,差异有统计学意义。首次透析未使用内瘘的主要原因有,在肾脏专科随诊但未及时建立血管通路占30．5％,非专科随诊患者占30．O％;多年前知道有。肾脏受损但是一直未复查造成诊治延误占16．4％;在CKD3～4期基础上急性加重占15％。导致CKD3-4期急性加重的原因主要是心力衰竭。结论绝大部分终末期肾脏病患者首次透析血管通路为深静脉导管,未使用内瘘的原因有多种,这些因素大部分为可调节因素。     

大黄与姜黄不同配比降高血脂大鼠模型疗效研究

目的研究不同配比的大黄和姜黄组方,比较其降脂效果的差异,为临床合理应用大黄与姜黄的组方治疗高脂血症奠定基础。方法给大鼠灌服高脂乳剂,建立高血脂症模型,随机分4组,即对照组,大黄与姜黄比例为1:1组,1:2组,2:1组,造模的同时对实验组的大鼠给药,干预高血脂症的形成。4周后,测定血浆中总胆固醇(CHO),甘油三酯(TG),高密度脂蛋白(HDL-C),低密度脂蛋白(LDL-C)的浓度,将数据进行统计分析,观察各组差异。结果各实验组与对照组差异均有统计学意义,2:1组与1:1组及1:2组的HDL-C、LDL-C、CHO差异存在统计学意义,其他几组的各指标均未见统计学差异。结论大黄与姜黄比为2:1的组方配比降高血脂疗效优于其他实验组。     

2008～2013年张家口地区献血人群梅毒ELISA和TP-PA检测结果分析

目的：统计分析张家口地区献血人群梅毒筛查和确认结果。方法：采用酶联免疫吸附试验（ELISA）对献血人群梅毒进行筛查,采用梅毒螺旋体明胶颗粒凝集试验（TPPA）对ELISA检测阳性样本进行确认。结果：2008至2013年张家口地区献血人群梅毒筛查阳性率为0．47％,经 TPPA 确认阳性率为44.3％。结论：张家口地区献血人群阳性率成上升趋势,ELISA检测阳性样本经TPPA确认后部分为假阳性,采用科学的解释和归队方案既能保障合格献血者献血,同时屏蔽不合格献血者,保障输血安全。     

神经影像学在血管性认知障碍诊断中的应用

血管性认知障碍（vascular cognitive impairment,VCI）是脑血管病危险因素（如高血压、糖尿病、高脂血症）以及明显的脑血管病（如脑梗死、脑出血）或不明显的脑血管病（如脑白质疏松、慢性脑缺血）引起的从轻度认知损害到痴呆的认知谱系疾病。VCI 早期的临床体征和症状通常不足以支持最终诊断,也不能鉴别病因,而神经影像学可以显示缺血性和出血性损伤灰质和白质损害,在VCI 的诊断和治疗中十分重要,同时也可以探索血管性认知障碍的病理生理机制。该文综述了计算机断层扫描（computed tomography,CT）、高分辨率核磁共振成像（high resolution magnetic resonance imaging,HRMRI）、弥散张量成像（diffusion tensor imaging,DTI）、磁共振波谱（magnetic resonance imaging spectroscopy,MRS）、动态增强核磁（dynamic contrast-enhanced MRI,DCEMRI）、依赖血氧水平的功能磁共振（blood oxygen level dependent functional magnetic resonance imaging,BOLD-fMRI）等影像学方法在VCI 诊断中的运用。     

桂皮醛对脑缺血小鼠的脑保护作用及对Toll样受体6/核因子-κB信号通路的影响

目的探讨桂皮醛对局灶性脑缺血小鼠的脑保护作用及机制。方法雄性CD-1小鼠通过腹腔注射的方法给予桂皮醛干预,应用改良线栓法建立小鼠右侧永久性大脑中动脉闭塞模型,将成年健康雄性CD-1小鼠随机分为大脑中动脉闭塞(MCAO)组及桂皮醛(CA)低、中、高剂量干预组,即CA25组、CA50组和CA75组(在MCAO小鼠模型基础上腹腔给予25 mg/kg、50 mg/kg及75 mg/kg桂皮醛)。术后24 h通过测定小鼠神经功能缺损评分、脑梗死体积及脑组织含水量来评价桂皮醛的脑保护作用。通过Western blot法和实时荧光定量PCR法测定Toll样受体6(TLR6)、肿瘤坏死因子受体相关分子6(TRAF6)和核因子-κB(NF-κB)在脑组织中的表达。结果与MCAO组相比,CA50组神经功能评分显著改善(中位数2.0 vs.3.5),病变侧脑组织含水量降低[(83.72±0.73)%vs.(85.09±0.95)%],脑梗死体积缩小(0.45±0.06 vs.0.54±0.02),均P0.05。同样与MCAO组相比,CA50组TLR6、TRAF6及NF-κB基因表达明显下调(TLR6:3.26±0.03 vs.6.32±0.07;TRAF6:1.88±0.21 vs.3.33±0.48;NF-κB:1.47±0.33 vs 4.21±0.57,均P0.05)。TLR6、TRAF6及胞核NF-κB蛋白表达明显下降(TLR6:0.12±0.01 vs.0.19±0.03;TRAF6:0.45±0.09 vs.0.67±0.07;胞核NF-κB:0.32±0.06 vs.0.46±0.06,均P0.05)。结论桂皮醛可能通过抑制TLR6/TRAF6/NF-κB通路对局灶性脑缺血小鼠发挥脑保护作用。     

先天性马蹄内翻足动物模型胚胎后肢(芽)评分系统的建立

Objective Quantification of the severity of congenital clubfoot is essential for its re-search and treatment. Up to date, no scoring system is available for hind limb bud development. In this study,a scoring system was established based on a murine model Methods Sixty female Wistar rats weighing 220～250 g were randomized into the six control groups and six experimental groups. Vaginal sperm plug detection day was considered to be day 0 of gestation. Hind limb buds from fetuses of E13, 14, 15,16,17 and 18 days were removed and processed. Results Morphogenetic differentiation changes were detected in the experimental groups. According the new scoring system, clubfoot-like deformity was present in 80.9% of the experimental fetuses. We were able to quantify the extent morphogenetic diffcrentiation of the hind limb accordingly. Conclusions Congenital clubfoot deformities begin at early developmental stage and become exaggerated as the fetuses mature. The scoring system can quantify the extent of congenital clubfoot deformity and facilitate its management.     

先天性马蹄内翻足动物模型胚胎后肢(芽)评分系统的建立

Objective Quantification of the severity of congenital clubfoot is essential for its re-search and treatment. Up to date, no scoring system is available for hind limb bud development. In this study,a scoring system was established based on a murine model Methods Sixty female Wistar rats weighing 220～250 g were randomized into the six control groups and six experimental groups. Vaginal sperm plug detection day was considered to be day 0 of gestation. Hind limb buds from fetuses of E13, 14, 15,16,17 and 18 days were removed and processed. Results Morphogenetic differentiation changes were detected in the experimental groups. According the new scoring system, clubfoot-like deformity was present in 80.9% of the experimental fetuses. We were able to quantify the extent morphogenetic diffcrentiation of the hind limb accordingly. Conclusions Congenital clubfoot deformities begin at early developmental stage and become exaggerated as the fetuses mature. The scoring system can quantify the extent of congenital clubfoot deformity and facilitate its management.     

医院财务出纳人员应具备的基本素质

医院出纳工作是整个会计核算工作的基础和重要组成部分，出纳工作的质量和效率，直接关系到整个会计核算工作的质量和效率，甚至影响医院的整体工作。尤其是教学医院，财务名目繁多，医疗、教学、科研时有经费条块分割现象，这就给出纳人员的工作带来了巨大的压力。有一个具有高度责任心的、坚持原则的出纳人员，好比“一夫当关”，各种违纪违法的现象就可避免。[第一段]     

先天性马蹄内翻足动物模型胚胎后肢(芽)评分系统的建立

Objective Quantification of the severity of congenital clubfoot is essential for its re-search and treatment. Up to date, no scoring system is available for hind limb bud development. In this study,a scoring system was established based on a murine model Methods Sixty female Wistar rats weighing 220～250 g were randomized into the six control groups and six experimental groups. Vaginal sperm plug detection day was considered to be day 0 of gestation. Hind limb buds from fetuses of E13, 14, 15,16,17 and 18 days were removed and processed. Results Morphogenetic differentiation changes were detected in the experimental groups. According the new scoring system, clubfoot-like deformity was present in 80.9% of the experimental fetuses. We were able to quantify the extent morphogenetic diffcrentiation of the hind limb accordingly. Conclusions Congenital clubfoot deformities begin at early developmental stage and become exaggerated as the fetuses mature. The scoring system can quantify the extent of congenital clubfoot deformity and facilitate its management.