中医医院护理工作量及人力资源配置的研究

目的调查上海市部分中医医院病房护理工作量,制定中医医院普通病房的护理人力资源配置标准。方法对上海2所三级甲等和3所二级甲等医院的肛肠科、肾内科、心内科和骨科等进行工作量的测定,了解中医医院护理人员总体配置、学历、职称结构等方面的现状。结果上海市三级医院的理论床护比为1：0.45,二级医院理论的床护比为1：0.43。结论中医医院护理人力资源配置不足,应适当增加护士人数,优化人才配置结构,提高中医医院护理质量。     

急性黄疸型肝炎患者合并急性溶血的多因素回归分析

急性黄疸型肝炎合并急性溶血在临床上较多见，其原因还未完全明确，我们利用电子计算机对近2年我和收治的伴有可疑溶血的急性黄疸型肝炎207例以及其中G—6PD缺陷者49例病人的临床资料进行多因素逐步回归分析，发现性别、红细胞数、G－6PD、血钙等4个项目对溶血有显著性意义，另对49例G－6PD缺陷者的临床资料进行多因素逐步回归分析，发现白细胞数、红细胞数、凝血时间、血钙、血肌吁、游离胆固醇、尿酸7个项目有显著性意义，在临床上应引起重视。     

干扰素治疗急性轮状病毒肠炎临床疗效观察

目的观察干扰素(IFN)治疗轮状病毒肠炎的.临床疗效.方法将163例轮状病毒肠炎患儿随机分成2组,对照组74例,予思密达保护胃肠黏膜、促菌生调节肠道微生态、纠正水电解质及酸碱平衡紊乱等治疗,治疗组89例,在上述治疗基础上,予肌注重组人干扰素α1b 8万u/kg,1次/d×5d.结果干扰素组退热时间、腹泻持续天数、呕吐症状消失时间和静脉补液所需天数,均比对照组明显缩短(P＜0.05);脱水纠正所用时间比对照组短,但两组间比较无明显差异(P＞0.05).结论α-干扰素治疗轮状病毒肠炎虽然不能缩短脱水纠正所需时间,但可明显改善症状、缩短病程,治疗有效,有临床实用价值,而且安全可行.     

异种无细胞真皮基质与薄自体皮复合移植后细胞外基质的变化

目的观察异种无细胞真皮基质与薄自体皮复合移植后细胞外基质的动态变化。方法以SD大鼠为动物模型,在其背部造成4 cm×5 cm的全层皮肤缺损。大鼠分为薄自体皮移植组和猪无细胞真皮基质+薄自体皮移植组,分别于移植后1,2,3,4,8,12,16周取标本,检测羟脯氨酸含量、Ⅰ/Ⅲ型前胶原mRNA的表达、透明质酸含量及纤维连接蛋白的变化。结果猪无细胞真皮基质与薄自体皮复合移植后,各时相点羟脯氨酸含量、Ⅰ型前胶原mRNA的表达均低于薄自体皮移植组(P<0.05);Ⅲ型前胶原mRNA的表达与薄自体皮移植组差异无统计学意义(P>0.05);透明质酸含量高于薄自体皮移植组(P<0.05);而纤维连接蛋白的表达在早期高于薄自体皮移植组,后期则低于薄自体皮移植组(P<0.05)。结论猪无细胞真皮基质与薄自体皮复合移植后能够减少胶原合成和Ⅰ型前胶原mRNA的表达,增加皮肤中透明质酸含量,从而减轻瘢痕增生。纤维连接蛋白早期表达增高有利于创面愈合及基底膜的重塑,而后期表达降低有助于减轻瘢痕增生。     

内蒙古地区居民膳食谷氨酸及其盐暴露风险评估

目的 了解内蒙古地区食品添加剂谷氨酸及其盐的使用现状,评估内蒙古地区人群膳食谷氨酸及其盐的暴露水平。方法 采集内蒙古地区12个盟市主要添加谷氨酸及其盐的14类食品,进行含量检测。根据消费量数据计算我区人群膳食谷氨酸及其盐的暴露量,与欧洲食品安全局（EFSA）提出的健康指导值（ADI:30 mg/kg bw）进行比较。结果 抽检样本中谷氨酸及其盐的检出率为70.70%,平均含量为1.78×104 mg/kg;内蒙古地区全人群及高消费人群（P95）膳食谷氨酸及其盐平均暴露量均未超过ADI;在监测的食品中,对内蒙古地区居民膳食谷氨酸及其盐暴露贡献率最高的食品是调味品类（75.08%）;结论 检测结果表明,蔬菜类谷氨酸及其盐平均含量最低,为1.42 mg/kg;评估结果表明,内蒙古地区居民膳食谷氨酸及其盐平均暴露量及高端暴露量均低于ADI,其健康风险无需过度关注。     

A Simple Modified Framingham Scoring System to Predict Obstructive Coronary Artery Disease

Development of simple non-invasive risk prediction model would help in early prediction of coronary artery disease (CAD) reducing the burden on public health. This paper demonstrates a risk prediction scoring system to predict obstructive coronary artery disease (OCAD) in CAD patients. A total of 13,082 patients, referred for coronary angiography (CAG) in TRUST trial, were included in the development of a multivariable diagnostic prediction model. External validation of the model used 1009 patients from PRECOMIN study. The occurrence of OCAD was observed in 73.1% and 75.1% patients in TRUST (development) and PRECOMIN study (validation) cohorts, respectively. Good discrimination and calibration were obtained in both development and validation datasets (C-statistics 0.686 and 0.677; Hosmer–Lemeshow χ²?=?5.19, p?=?0.74 and χ²?=?8.60, p?=?0.38, respectively). The simple risk prediction model and risk scoring system developed on the basis of routine clinical variables showed good performance for estimation of OCAD in relative high-risk patients with suspected CAD.     

癌痛消方对DEN诱癌大鼠不同时间点凋亡相关蛋白的影响

目的 通过分析癌痛消方(AP)干预二乙基亚硝胺(DEN)诱癌大鼠模型在不同时间点的肝脏组织病理变化、细胞凋亡的相关蛋白表达变化,来探讨癌痛消方治疗原发性肝癌的机制.方法 将50只♂ Wistar大鼠随机分为预防组、模型组(每组20只)和空白对照组(10只),预防组和模型组的大鼠以64 ppm DEN饮水饲养,连续16周.同时,自诱癌之日起,预防组大鼠予以AP灌胃0.2 g·(100 g)-1,qd,每周连续用药6d,给药周期为18周;模型与空白对照组正常饮食,饮水(自来水).分别在4、8、12、16、18周时,随机各取预防组和模型组的4只大鼠、2只空白对照组的,断颈处死,取肝组织(阳性部位)免疫组化法检测Bax、Bcl-2、survivin、Fas、Fasl、caspase-3蛋白的表达情况.结果 空白对照组未见survivin、casepase-3、Fas/Fasl、Bax、Bcl-2蛋白的表达;模型组各时间点均可见凋亡相关蛋白的表达,以凋亡抑制蛋白Bcl-2、survivin表达量较多;AP干预过程可以全程下调survivin、Bcl-2蛋白的表达,上调Fas、casepase、Bax蛋白的表达.结论 AP可以促进受损肝细胞或癌细胞凋亡,其预防和治疗肝癌机理是上调促凋亡蛋白、下调抑凋亡蛋白的表达,促进炎症细胞或肿瘤细胞凋亡.     

Park-Use Behavior and Perceptions by Race,Hispanic Origin,and Immigrant Status in Minneapolis,MN: Implications on Park Strategies for Addressing Health Disparities

The study examines the connections between minority status, park use behavior, and park-related perceptions using recent survey data from three low-income neighborhoods in Minneapolis, MN. Blacks and foreign-born residents are found to underutilize parks. Blacks, Asians, and American Indians perceive fewer health benefits of parks than whites, including the benefits of parks for providing exercise/relaxation opportunities and family gathering spaces. Foreign-born residents, blacks, and Hispanics perceive greater and unique barriers to park use in terms of not feeling welcome, cultural and language restrictions, program schedule and pricing concerns, and/or facility maintenance and mismatch concerns. When designing park strategies for addressing health disparities, we recommend to focus the efforts on increasing awareness of park-related health benefits and removing specific park use barriers among minority and foreign-born communities.     

The influence of panic attacks on response to phenelzine and amitriptyline in depressed outpatients

A total of 169 depressed outpatients completed a 6-week double-blind study designed to compare the relative efficacy of a tricyclic antidepressant (amitriptyline) with a monoamine oxidase inhibitor (phenelzine). Various "target" symptoms reported to predict preferential response to monoamine oxidase inhibitors were assessed. The major finding within the whole patient sample, based on results from serial self-report and interviewer-rated scales, was that phenelzine-treated patients showed greater improvements in anxiety symptoms than did patients treated with amitriptyline. Because of the heterogeneity of the sample, patients were classified into homogeneous subgroups of clinical interest. Data analyses of these subgroups detected important drug treatment differences not discernible by analysis of data from the overall sample. Panic attacks and corresponding anxiety symptoms were reported by about one third of the patients, more often by patients with major depression than with minor depression. Patients who reported "spells of terror or panic" responded preferentially to phenelzine on several measures, particularly on items measuring anxiety. Results suggest that phenelzine may be a preferred drug for treating depressed patients with panic attacks.