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。     

应用抑制性消减杂交技术克隆筛选丙型肝炎病毒F蛋白结合蛋白2反式激活基因

目的:应用抑制性消减杂交(SSH)技术构建新基因丙型肝炎病毒F蛋白结合蛋白2(HCVFBP2)反式激活基因差异表达的cDNA消减文库,克隆HCVFBP2反式激活相关基因.方法:以HCVFBP2表达质粒pcDNA3.1(-)-FBP2转染HepG2细胞,以空载体pcDNA3.1(-)转染的HepG2细胞为对照;制备转染后的细胞裂解液,提取mRNA并逆转录为cDNA,经RsaⅠ酶切后,将实验组cDNA分成两组,分别与两种不同的接头衔接,再与对照组cDNA进行两次消减杂交及两次抑制多聚酶链反应(PCR),将产物与pGEM-Teasy载体连接,构建cDNA消减文库,转染大肠杆菌进行文库扩增,随机挑选克隆PCR扩增后进行测序及同源性分析.结果:成功构建人类新基因HCVFBP2反式激活基因差异表达的cDNA消减文库.文库扩增后选取48个克隆,进行菌落PCR分析,均得200～1000bp插入片断.挑取30个克隆进行测序,通过生物信息学分析获得28个已知功能基因序列和2个未知功能基因.结论:应用SSH技术成功构建了HCVFBP2反式激活基因差异表达的cDNA消减文库.该文库的建立为阐明HCVFBP2生物学功能提供理论依据.     

超重对青少年远期血压变化的影响

目的 探索超重对青少年远期血压变化及高血压发生的影响.方法 1987年在陕西汉中农村4623名6～15岁在校学生进行血压等相关因素调查的基础上,根据3次测量初始体质量指数(BMI)在其同年龄、同性别第90百分位(P90)以上者确定为超重肥胖组(42例),BMI在其同年龄、同性别第50百分位(P50)以下者为对照组(218例).2005年对该队列组样本进行随访.随访时间平均18年.结果 总随访率75.8%,其中超重组随访率71.4%,对照组随访率76.6%;无论基线还是随访血压,超重组均显著大于对照组,超重组18年后发生高血压(≥140/90 mm Hg)的几率有高于对照组的趋势但无显著性(30.0% vs 13.8% ,P>0.05);随访期间的BMI增加幅度在最高的4分位者,高血压发生率是最低的2个4分位者的4.5倍(37.9% vs 8.8%,P<0.01).结论 青少年时期BMI增长过快者远期随访血压增幅大,高血压发生率显著增加,是青年高血压发病重要易患因素.     

泰脂安对老年高脂血症患者C反应蛋白的影响

目的　 研究泰脂安对老年高脂血症患者C反应蛋白 (CRP)的影响。　 方法 　测定 45例老年高脂血症患者应用泰脂安治疗前后血脂、CRP水平的变化。　 结果 　经过 8周泰脂安治疗 ,总胆固醇、LDL、TG及CRP分别下降 2 8 13 % (P <0 0 1)、2 1 92 % (P <0 0 1)、13 3 7% (P <0 0 5 )及 13 75 % (P <0 0 5 ) ,而HDL升高 9 2 5 % (P >0 0 5 )。　 结论 　泰脂安不仅可调脂 ,也可降低CRP水平     

需要层次理论在糖尿病患者护理中的应用

目的 研究需要层次理论对糖尿病患者血糖水平及焦虑抑郁情绪的作用.方法 选择到铜川矿务局中心医院就诊的104例糖尿病患者,分为对照组及观察组,分别有51例、53例,分别采用常规护理及需要层次理论护理后检验血糖水平、SAS及SDS评分.结果 2组空腹血糖于干预后1周、2周后较干预前均有显著改善（P＜0.05）,2组餐后2h血糖于干预后1周、2周后较干预前均有显著改善（P＜0.05）;观察组干预后2周空腹血糖及餐后2h血糖较对照组同期均有显著性下降（P＜0.05）;观察组患者干预后1周、2周SAS评分、SDS评分较对照组有显著改善（P＜0.05）,且观察组干预后1周、2周较干预前有显著改善（P＜0.05）,对照组各时间点未见显著变化（P＞0.05）.结论 需要层次理论有助于在糖尿病患者护理中较好的控制患者血糖,并缓解焦虑、抑郁情绪.     

A giant intrathoracic osteolipoma: A case report and review of the literature

IntroductionLipomas are ubiquitous and can occur anywhere in the body. Intrathoracic lipomata are rare benign lesions. However, a complete removal giant intrathoracic osteolipoma is achieved with only 18 cases previous cases described in medical literature from 1960 to 2008.Presentation of caseA 66-year-old female presented to our hospital suffered from mild chest pain and mild shortness of breath for more than 10 days. A subsequent chest X-ray and CT scans revealed a large homogeneous, low-attenuation fat density mass containing an oval calcification area in the center of the mass. Following surgical resection was performed successfully to remove the entire mass, which weighed a total of 1568 g and measured 26 cm × 19 cm × 12 cm in size. The histological analysis confirmed a giant intrathoracic osteolipoma without evidence of malignancy.DiscussionIntrathoracic lipomas are rare, slow-growing benign tumors without any symptom, which originate from the adipose tissue in submesothelial layers of the pleura parietalis, diaphragm, mediastinal and extrapericardial. They may extend into the chest cavity and fully encapsulate in most cases. Chest X-ray and CT and MRI scans are the most helpful tests in the diagnosis of intrathoracic lipomas. Complete enbloc removal of lipoma whenever possible, is the only definitive treatment option and the only way to prevent future recurrences.ConclusionThis case is the largest intrathoracic osteolipoma documented in the modern literature. Complete enbloc removal of lipoma whenever possible, is the only definitive treatment option.     

Baseline Sleep Disturbances Modify Outcome Trajectories in Adolescents With Chronic Pain Receiving Internet-Delivered Psychological Treatment

Over 50% of adolescents with chronic pain report comorbid sleep disturbances (eg, difficulties with falling asleep), which is associated with increased pain-related disability and poorer quality of life. However, limited longitudinal data are available to understand how sleep disturbance may impact response to psychological treatment. Our primary hypothesis was that baseline sleep disturbances would significantly modify how adolescents responded to an internet-delivered psychological intervention for chronic pain in terms of outcome trajectories. The sample included 85 adolescents, 12 to 17 years, with chronic pain recruited from a multidisciplinary pain clinic and headache clinic who received access to an internet-delivered psychological intervention for chronic pain. Baseline sleep assessment included actigraphy monitoring for 7 days and survey measures. Outcomes were assessed at baseline, 8 weeks, and 3 months including core pain-related outcomes, executive functioning, fatigue, positive and negative affect. Results demonstrated that greater baseline insomnia and poorer sleep quality was associated with worse outcome trajectories for pain-related disability, depression, anxiety, fatigue, negative affect, and executive functioning. Findings extend the limited studies that examine how sleep disturbance may modify effectiveness of psychological treatments for adolescent chronic pain and emphasize the importance of treating comorbid sleep disturbance. This trial was registered at clinicaltrials.gov (NCT04043962).PerspectiveOur study suggests that sleep deficiency, in particular insomnia and poor sleep quality, may modify the effectiveness of psychological treatments for chronic pain, highlighting the urgent need to screen youth for sleep problems prior to initiating treatment, and to consider implementation of sleep-specific treatments such as cognitive-behavioral therapy for insomnia.     

低温生物介电谱测试系统的研制及应用

本文利用ＭＣＳ－５１系列单片机成功地研制出了低温生物介电谱（ＣＤＳ）测试系统，实现了ＣＤＳ快速、动态的采集，解决了ＣＤＳ研究中的关键技术问题，使研究得以深入，并利用该测试系统研究了冻融速率对介电温谱的影响。     

卵巢肿瘤超声造影47例分析

目的观察卵巢肿瘤的声学造影特点,评价超声造影对卵巢肿瘤的诊断价值。方法采用低机械指数灰阶谐波超声造影技术,分析研究经手术、病理证实的47例卵巢肿瘤的超声造影强化特点。结果47例卵巢肿瘤中良性25例,恶性22例。25例良性肿瘤囊壁或内部造影剂缓慢强化或弱强化,22例恶性肿瘤内造影剂快速强化。与卵巢良性肿瘤相比,卵巢恶性肿瘤内造影强化的始增时间早,达峰时间早,灌注强度高,造影强化的时间-强度曲线上升支、下降支陡直,且47例卵巢良、恶性肿瘤之间造影强化特点存在统计学差异（P〈0.05）。结论超声造影在揭示卵巢小肿瘤及肿瘤内细小血管的血流灌注信息方面具有优越性,能提高卵巢肿瘤早期诊断及鉴别诊断水平,值得推广及应用。     

雌二醇预处理对离体大鼠缺血-再灌注心肌细胞Ca2+和肌钙蛋白Ⅰ的影响

目的探讨雌二醇预处理对离体大鼠缺血-再灌注心肌细胞Ca2+和肌钙蛋白Ⅰ(TnI)的影响.方法采用Langendorff装置建立大鼠离体心脏缺血-再灌注模型,将24只雄性大鼠随机分为对照、治疗及预处理组.治疗组在缺血期给雌二醇3.3 mg·L-1,预处理组于灌注期给予雌二醇3.3 mg·L-1,对照组不给药.观察心肌细胞内Ca2+含量和心脏灌洗液中TnI含量的变化.结果再灌注结束后,预处理组心肌细胞内Ca2+水平低于对照组和治疗组(P＜0.01或0.05).预处理组缺血早期心脏灌注液中TnI含量低于其他2组(P＜0.05),在缺血及再灌注期,预处理组及治疗组TnI含量均低于对照组.电镜观察预处理组心肌细胞损伤小于其他2组.结论雌二醇预处理对缺血-再灌注心肌具有更好的保护作用.