二甲双胍对糖尿病合并食管癌患者放疗效果分析

目的通过观察二甲双胍对糖尿病合并食管癌患者放疗效果,为糖尿病合并食管癌患者的治疗提供依据。方法选取2016年-2018年在该院确诊的糖尿病合并食管癌并口服二甲双胍降糖治疗的患者51例为观察组,同期诊断糖尿病合并食管癌并皮下注射胰岛素治疗的患者50例为对照组,所有的患者均实施内镜切除联合局部放疗治疗。治疗结束后随访1个月,根据RECIST标准对治疗效果进行评价两组患者的近期疗效。结果观察组患者近期疗效明显优于对照组(P<0.05)。结论二甲双胍可以提高食管癌患者的放疗效果。     

高校图书馆电子阅览室利用现状及其管理服务模式创新

以调查问卷的形式，从高校图书馆电子阅览室读者利用现状入手分析各种类型读者的需求，提出以读者为中心，从管理、沟通、宣传、培训、导读、构建学习平台、考研咨询等7个方面探索创新电子阅览室管理与服务的策略。     

阿米替林合并认知疗法治疗精神分裂症后抑郁的对照研究

目的　评价阿米替林合并认知疗法对精神分裂症后抑郁的治疗效果。方法　将符合CCMD 3诊断标准的 86例精神分裂症后抑郁患者随机分为治疗组和对照组 ,治疗组给予阿米替林合并认知治疗 ,对照组织给予阿米替林治疗 ,疗程 12周。采用汉密尔顿抑郁量表 (HAMD)、简明精神病量表(BPRS)、阴性症状量表 (SANS)评定临床疗效 ,采用副反应量表 (TESS)评定副反应。结果　在治疗的 4、8、12周末 ,HAMD评分治疗组优于对照组 ,显效率分别为 83 95 %和 6 1 90 % (u =5 .83,P <0 0 5 )。结论　阿米替林与认知治疗组结合治疗精神分裂症后抑郁疗效好于单用阿米替林治疗。     

Expression of cell cycle regulators in squamous cell carcinoma of maxillary sinus and their significance]

OBJECTIVE: To investigate the clinicopathlogical significance of cyclinE, cyclinD1, P21WAF1/CIP1 and P27KIP1 expression in squamous cell carcinoma of maxillary sinus. METHODS: The expression of cyclinE, cyclinD1, P21WAF1/CIP1 and P27KIP1 was examined by the method of immunohistochemistry in inflammatory mucosa of maxillary sinus(10), inverting papilloma of maxillary sinus(20) and squamous cell carcinoma of maxillary sinus (50). RESULTS: (1) In inflammatory mucosa, inverting papilloma and squamous cell carcinoma, the positive immunostaining rates of cyclinD1 protein were 10.0%, 25.0%, 48.0% respectively (P < 0.05); cyclinE protein was 20.0%, 35.0%, 58.0% respectively (P < 0.05); P21WAF1/CIP1 protein was 80.0%, 65.0%, 40.0% respectively (P < 0.05) and P27KIP1 protein was 70.0%, 75.0%, 40.0% respectively (P < 0.05). (2) There was no significance between the clinical type, T stage and clinical stage of carcinoma of maxillary sinus and the expression of cyclinD1, cyclinE, P21WAF1/CIP1 and P27KIP1 (P > 0.05). (3) P21WAF1/CIP1 positive expression in highly, moderately and poorly differtiated carcinomas were 73.2% (11/15), 58.9% (11/19), 25.0% (4/16) respectively (P < 0.05). CONCLUSION: (1) With the development of the lesion, the positive immunostaining rate of cyclinE and cyclinD1 protein increases, while the rate of P21WAF1/CIP1 and P27KIP1 protein decreases. (2) P21WAF1/CIP1 expression is associated with tumour cell differentiation. (3) The mutual mechenism of cell cycle regulators plays an important role in the squamous cell carcinoma of maxillary sinus. The quantity and the frequency of four kinds of gene expression increase with the progression of maxillary sinus carcinogenesis.     

成分输血在临床中的应用

成分输血是现代输血学的重要标志之一。临床医生要了解成分输血的知识,遵循科学用血、合理用血、节约用血的原则,根据病情有针对性地开展成分输血。成分输血的重点,应当是血液的有形成分,即以红细胞和血小板为主的成分输血。本文就成分输血的特点与临床应用等有关问题进行综述。     

缝-脊5-羟色胺痛调制系统的形态学鉴定

<正> 在内源性痛调制系统中,中缝大核(NRM)及邻近结构的神经元轴突行向脊髓后角,其释放的5-羟色胺(5-HT)可能对后角内痛敏神经元,中间神经元以及初级传入     

A Qualitative Study: Perceived Barriers and Facilitators to Nutrition Standard Adherence by In-home Childcare Providers

BackgroundThe Child and Adult Care Food Program (CACFP) nutrition standards may present food purchasing, preparation, and feeding challenges for caregivers of young children.ObjectiveTo elucidate perceived barriers and facilitators faced by in-home childcare providers to following the CACFP food and beverage nutrition standards.DesignVirtual, semistructured individual interviews elicited perceptions from a cross section of low-income, in-home childcare providers in Michigan.Participants/settingsTwenty childcare providers of various races, ethnicity, urban and rural residence, and licensure status.AnalysisThematic coding analysis with NVivo (ver12.0) to organize and interpret data.ResultsFour primary barriers to adhering to the CACFP nutrition standards emerged including (1) noncompliant food preferences of children and providers; (2) higher cost and lower availability of CACFP-approved items; (3) celebrations and food rewards; (4) excessive time and effort needed to prepare foods and beverages, especially with dietary restrictions for some children. Ten perceived facilitators included (1) using nutrition education available through community organizations; (2) finding convenient and easy ways to prepare foods and beverages; (3) using CACFP and Special Supplemental Nutrition Program for Women, Infants, and Children guidelines and funding; (4) increasing variety of foods and beverages by using a menu or recalling items recently served; (5) modeling eating healthful foods and encouraging sampling of new foods and beverages; (6) mixing preferred foods/beverages with less preferred; (7) using nutrition information available from social media and from peers; (8) allowing children to choose foods and beverages; (9) serving the same eligible food and beverages to all children; and (10) provider concern about impact of foods and beverages on children’s health and behavior.ConclusionsResults from this study can inform nutrition education from community organizations that occurs in tandem with CACFP sponsor organizations. In addition, they can be utilized to address state-level licensure regulations and quality improvement rating systems that include nutrition standards childcare providers are encouraged or required to follow.     

新工艺制备的β—TCP陶瓷小鼠肌肉内种植后的变化

目的：检测新工艺制备的β－磷酸三钙（β－TCP）的生物相容性,方法：将自制β－TCP植入小鼠股后肌袋。术后24,72h,1,2,4,8周分别取材做组织学检查,2,4周取材部分标本做扫描电镜（SEM）观察。结果：随着时间推移,β－TCP逐渐被纤维组织分割包围,但是无软骨,骨和坏死组织形成,结论：新工艺制备的β-TCP具有良好的组织相容性。     

医学院校教师血压水平及高血压病患病率的调查

为探讨医学高教职业对教师血压的影响,我们对我院579名在职教师的血压及其高血压患病率进行了统计分析,并同对照组进行了比较。结果表明,高教教师无论在总体上,还是与相同工龄段的其他人群相比较,其血压水平及高血压患病率均显著增高(P<0.05,P<0.01),而且随高教教龄的延长,血压及高血压患病率均有明显增高的趋势(P<0.05,P<0.01);中青年高级职称者血压水平较非高级职称者明显增高(P<0.01)。从而提示高教职业长期紧张、高负荷、大工作量的特点是高教教师高血压病患病率增高的重要因素,高教教师尤其高教龄教师是高血压病的高危人群。