《处方管理办法》执行及认知情况问卷调查

目的了解陕西省19家医院《处方管理办法》部分内容的执行和认知情况。方法通过对药师进行问卷调查,对陕西省部分医疗机构的调查结果进行描述性统计分析。结果调查的19家医院中,已编写处方集共15家;病区用药医嘱单的格式与门诊处方格式一致的占65.9%;认为门诊处方与住院处方应该有统一内容和格式的占74.5%;进行处方适宜性审核时,不容易做出准确判断的方面是＂是否有潜在临床意义的药物相互作用和配伍禁忌＂,占76.0%;药品采购能够做到＂一品两规＂的占39.0%。结论陕西省有关医疗机构执行《处方管理办法》的整体情况较好。     

VEGF-C和VEGFR-3在非小细胞肺癌癌组织及癌旁组织中的表达及意义

目的通过对非小细胞肺癌患者肺癌组织中VEGF-C水平的表达以及对癌旁组织中淋巴管密度的测定来探讨VEGF-C和VEGFR-3在NSCLC肿瘤淋巴转移的意义。方法对55例无手术禁忌的NSCLC患者施行肺癌根治术,获得肺癌肿瘤组织,癌旁组织以及远离肿瘤的正常组织,应用VEGF-C抗体SP免疫组织化学等技术染色观察VEGF-C在细胞浆中的表达以及应用VEGFR-3抗体SP法标法淋巴管计数癌周组织中的微淋巴管密度（LMVD）。结果 （1）55例NSCLC患者癌组织中,40例VEGF-C呈阳性表达（占72.72%）,对照组正常组织中VEGF-C阳性仅5例（阳性率9.56%）,两者有显著差异（P〈0.005）。（2）55例癌旁组织中LMVD值为21.20±7.22个,而正常组织中LMVD值为9.48±5.52个,两者有显著差异（P〈0.01）。（3）试验组有肿瘤淋巴结转移者共计35例,其癌组织中VEGF-C阳性者为32例,3例为阴性;无肿瘤淋巴结转移者共计20例,12例阴性,8例阳性表达,两者有显著差异（P〈0.005）。（4）肺癌淋巴结转移者35例中,癌旁组织中LMVD值为27.42±6.38,比没有肺癌淋巴结转移者LMVD15.10±2.72亦显著增高（P〈0.05）。结论非小细胞肺癌组织中VEGF-C的高表达与癌旁组织淋巴管的高表达有密切关系,VEGFR-3的阳性脉管数与肺癌淋巴结转移相关联,可作为肺癌诱导生成淋巴管研究的量化指标。肿瘤组织的VEGF-C表达水平和对癌周组织淋巴管密度测定有助于对肺癌患者预后的判断和治疗方案的评价。     

The Short-term Pulsatile Ventricular Assist Device for Postcardiotomy Cardiogenic Shock: A Clinical Trial in China

Abstract:  Despite the recent advances in myocardial protection, surgical techniques, intra-aortic balloon therapy, and maximal pharmacological support, postoperative ventricular dysfunction continues to occur in 0.5–1.0% of all patients undergoing cardiac surgery. Ventricular assist device (VAD) is an important therapeutic adjunct in treating patients with profound ventricular dysfunction with postcardiotomy cardiogenic shock. The purpose of this report was to describe the clinical results with the China-made Luo-Ye VAD as a short-term circulatory support. From May 1998 to December 2006, 17 patients with postcardiotomy cardiogenic shock were supported by the Luo-Ye VAD. Of these patients, 10 were males and seven were females with a mean age of 49.6 years (range 36–68 years). All cases were supported by left VAD (LVAD). Mean duration of support was 46.3 h (range 13–113 h). A criteria of insertion was established to standardize implantation criteria. Among the 17 patients treated with LVAD, eight (47.1%) patients were weaned from support and seven (41.2%) patients were discharged from hospital. Ten (58.8%) patients died while on LVAD support (nine cases) or shortly after weaning (one case). The causes of death in the entire group were cardiac (40%), renal failure (20%), neurologic (10%), sepsis (10%), and multiple organ system failure (20%). The complications were represented by bleeding, renal failure, neurologic event, infection, ventricular arrhythmias, etc. The Luo-Ye VAD functioned well and proved to be useful in patients with postcardiotomy cardiogenic shock. It carries a less-postoperative anticoagulant and a low incidence of VAD-related complications. The survival rate was encouraging in our small cohort of patients.     

强脉冲光美容效果的评价

目的观察强脉冲光对皮肤表浅色素性和血管性疾病、寻常痤疮的疗效;评价其嫩肤美容及脱毛的疗效。方法采用GP666型强脉冲比（IPL）治疗仪对皮肤老化、面部色沉性皮损、皮肤毛细血管扩张、寻常痤疮及多毛症各20例共100例进行治疗,光子嫩肤每3周治疗1次,5次为1个疗程;脱毛每月治疗1次。结果经5次治疗,色素痫和血管痫有效率为90％,痤疮疗效为75%,美容效果为100％,脱毛效果为90％。无小可逆不良反膻发牛。结论IPL能有效治疗皮肤浅表色素沉着性皮损和毛细血管扩张;有较好的关容效果;脱毛效果肯定。     

陶瓷-陶瓷全髋关节置换术中困难及对策

目的分析陶瓷-陶瓷全髋关节置换术中可能出现的困难,研究避免其出现的对策.方法 2001年9月至2007年12月,我院共施行1019例陶瓷-陶瓷全髋关节置换术,其中男性585例,女性434例,平均年龄59.5岁(39～76岁);采用Stryker陶瓷-陶瓷全髋关节362例,普鲁斯陶瓷-陶瓷全髋关节544例,Lima陶瓷-陶瓷全髋关节(三明治型)113例;术前诊断显示股骨头缺血性坏死314例,发育性髋关节脱位268例,骨关节炎194例,强直性脊柱炎74例,类风湿性关节炎107例.股骨颈骨折Garden Ⅳ型62例.结果术中出现的技术性困难,包括术中因关节稳定性不佳,需要调整髋臼杯位置34例;置放陶瓷内衬不当,需要取出重新安装19例;髋臼内衬置放时碎裂3例;截骨位置过低造成超过0.5 cm肢体短缩31例.结论针对陶瓷-陶瓷全髋关节置换术假体材料的特性,在手术操作技术上做出相应的调整,可避免可能会出现的困难.     

Evaluation of sperm mitochondrial function using rh123/PI dual fluorescent staining in asthenospermia and oligoasthenozoospermia

Objective

The recent advent of flow cytometry (FCM), coupled with fluorescent dyes, has been successfully applied to assess mitochondrial function. The aim of this study was to investigate the feasibility and clinical significance of detecting sperm mitochondrial function and to evaluate sperm mitochondrial function by using Rhodamine 123/propidium (Rh123/PI) dual fluorescent staining and FCM in asthenospermia and oligoasthenozoospermia.

Methods

Twenty-five fertile men (with normal sperm parameters) and 230 infertile patients were examined. Fifty-five patients of the above 230 patients were selected for idiopathic infertility samples and were divided into two groups: asthenospermia (n = 30) and oligoasthenozoospermia (n = 25). Rh123/PI dual fluorescent staining and FCM were carried out to examine sperm mitochondrial function.

Results

Significant differences were found between the normal and abnormal semen samples (P < 0.05) when Rh123⁺/PI⁻, Rh123⁻/PI⁺ and Rh123⁻/PI⁻ sperm were examined by FCM, but there was no significant difference between the asthenospermia (P = 0.469) and oligoasthenozoospermia group (P = 0.950) when Rh123⁺/PI⁻ and Rh123⁻/PI⁺ sperm were then examined; however, a significant difference was found between the 2 groups (P = 0.003) when Rh123⁻/PI⁻ sperm were examined. There was no correlation between Rh123⁻/PI⁻ sperm and semen parameters in the normal group, but there was a significant negative correlation between the sperm concentration and Rh123⁻/PI⁻ sperm in asthenospermia and oligoasthenozoospermia patients (r = -0.509, -0.660; P = 0.018, 0.038).

Conclusion

Rh123/PI dual fluorescent staining and FCM can provide reliable information to assess the quality of sperm and reveal differences in mitochondrial membrane potential in asthenospermia and oligoasthenozoospermia.     

会计人员职业道德缺失的社会原因分析

随着会计活动中会计信息失真、会计人员违法犯罪行为的不断出现,会计人员职业道德缺失成为人们关注的重要问题之一。会计人员职业道德的缺失同会计人员的职业道德自律水平不高有关,但在某种程度上,会计人员职业道德缺失问题的解决仅靠自律是无法从根本上解决的。会计人员作为一个社会的人,其职业道德的缺失,不仅有个体的原因,还有深刻的社会原因,分析这些社会原因,会为会计人员职业道德的提升提供良好的外部环境。     

影响胃镜检查质量的多因素分析

目的调查反应胃镜检查质量的多项指标并分析其相关影响因素。方法采用前瞻性调查方式，将调查对象分为口头干预组、书面干预组和对照组。调查三组检查前后的生理指标、紧张不适程度和满意度，并分析其相关影响因素。结果在检查后收缩压、检查中紧张不适程度和总体满意度方面，口头干预组与对照组、书面干预组相比，差别均有统计学意义（P〈0．05或P〈0．01）。此外，女性、年轻受检者的紧张不适程度高（P〈0．05，P〈0．01），满意度较低（P〈0．05，P〈0．01）。文化程度高的紧张不适程度高（P〈0．05）。体型偏瘦者的收缩压升高幅度和紧张不适程度均偏高（P〈0．01，P〈0．01）。结论口头干预是一种积极主动的干预方式，可从多方面提高胃镜检查质量；女性、年轻、文化程度高和体型偏瘦者的胃镜检查整体质量较差，应给予积极主动的干预。     

Triamcinolone-assisted Pars Plana Vitrectomy for Retinal Disease

Purpose:To determine whether triamcinolone acetonide(TA)staining facilitates posterior hyaloid removal in patients undergoing pars plana vitrectomy (PPV) for retinal disease. Methods: A triamcinolone acetonide(TA)-assisted vitrectomy was performed on patients with the following disease: proliferative diabetic retionpathy(5eyes) , central retinal vein occlusion(5eyes) , macuar hole (3eyes) , and epiretinal membrane(2eyes). Eyes without apparent preoperative posterior vitreous detachment were enrolled in this study. After a core PPV, TA aqueous suspension (40 mg/ml) was injected into the mid vitreous cavity to visualize the posterior hyaloid, thus allowing a complete posterior hyaloid separation and removal. The visual acuity, intraocular pressure (IOP), tamponade, corneal pathology, after-cataract, vitreous hemorrhage, and necessity for reoperation were thereafter examined for at least 3 months after surgery. Results: In all patients, the vitreous body was clearly seen by means of triamcinolone during surgery, and complete removal of posterior hyaloid was facilitated and confirmed. Retina was attached in 14 of 15 eyes, and vision acuity was improved in 9 of 15 eyes. Two eyes showed transient postoperative IOP elevation, 2 eyes had after cataract formation and leye had cataract progression. Vitreous hemorrhage occurred in 1 eye. No eye had corneal pathology. Conclusion: Triamcinolone improved the visibility of the hyaloid and the safety of surgical procedures during PPV. No obvious adverse effect due to toxicity of TA accrued in TA-assisted PPV. Eye Science 2005;21:142-146.     

当归多糖的分离、纯化及分析鉴定

目的　从新鲜中国当归 [Angelica sinensis(Oliv)Diels]中分离纯化出多个多糖组分 ,并对其理化性质进行分析鉴定 .方法　采用水煮—乙醇沉淀法从新鲜当归中提取当归总多糖 AP- 0 ;AP- 0用 80 g· kg- 1十六烷基三甲基溴化铵(CTAB)沉淀得到当归多糖亚组分 AP- 1;CTAB处理后的上清用 10 g· kg- 1 H3BO3,2 mol· L- 1 Na OH处理得到当归多糖亚组分 AP- 2 ;所剩上清 ,用乙酸处理后 ,再用乙醇沉淀 ,得到当归多糖亚组分 AP- 3.总糖含量测定采用改良苯酚 -硫酸法 ;蛋白质含量测定采用 Serva Blue- G染料结合法 ;糖醛酸含量测定采用间羟基连苯法 .采用新华中速滤纸纸色谱和硅胶G薄层色谱分析多糖各组分的单糖组成 .高效凝胶过滤色谱和高效离子交换色谱分析多糖各组分的 Mr分布和电荷性质 .红外光谱法分析多糖各组分的糖苷键构成 .结果　 AP- 0总糖 970 g· kg- 1 ,其中糖醛酸 2 10 g· kg- 1 ,蛋白质 30g·kg- 1 ;AP- 1总糖 970 g· kg- 1 ,其中糖醛酸 172 g· kg- 1 ,蛋白质 30 g· kg- 1 ;AP- 2总糖 830 g· kg- 1 ,其中糖醛酸 2 5 7g·kg- 1 ,蛋白质 170 g· kg- 1 ;AP- 3总糖 970 g· kg- 1 ,其中糖醛酸 86 g· kg- 1 ,蛋白质 30 g· kg- 1 .AP- 0 ,AP- 1,AP- 2和 AP- 3主要由葡萄糖 ,阿拉伯糖和少量糖醛酸