小康型乡镇卫生院特色专科创建模式初探

目的探讨适合我国经济较为发达的小康型农村地区的乡镇卫生院特色专科创建模式。方法通过文献分析、现场调查、定性访谈、小组讨论、专家咨询等多种方法,了解四川省双流县乡镇卫生院特色专科创建现状、存在的问题以及专家意见,讨论制定切实可行的小康型乡镇卫生院特色专科创建模式。结果提出了小康型乡镇卫生院创建特色专科的条件、如何创建和管理特色专科的模式。结论特色专科的创建需具备内外环境条件,专科方向和诊疗项目的确定需结合当地实际情况,突出特色、强化管理是特色专科可持续发展的保障。     

Identifying Optimum Performance Trade‐Offs Using a Cognitively Bounded Rational Analysis Model of Discretionary Task Interleaving

We report the results of a dual‐task study in which participants performed a tracking and typing task under various experimental conditions. An objective payoff function was used to provide explicit feedback on how participants should trade off performance between the tasks. Results show that participants’ dual‐task interleaving strategy was sensitive to changes in the difficulty of the tracking task and resulted in differences in overall task performance. To test the hypothesis that people select strategies that maximize payoff, a Cognitively Bounded Rational Analysis model was developed. This analysis evaluated a variety of dual‐task interleaving strategies to identify the optimal strategy for maximizing payoff in each condition. The model predicts that the region of optimum performance is different between experimental conditions. The correspondence between human data and the prediction of the optimal strategy is found to be remarkably high across a number of performance measures. This suggests that participants were honing their behavior to maximize payoff. Limitations are discussed.     

常用医学网络教学资源及特点分析

通过对常用医学网络教学资源及特点分析,研究Internet对现代医学教育的影响,以及如何利用Internet更好地为医学教育服务,探讨Internet上的医学信息资源对现代医学教学的改革及发展的作用。     

梅花鹿鹿角托盘蛋白SDS-聚丙烯酰胺凝胶电泳指纹图谱研究

目的建立梅花鹿鹿角托盘蛋白SDS-聚丙烯酰胺凝胶电泳（SDS-PAGE）指纹图谱,为鹿托盘药材的质量评价提供新方法。方法采用SDS-PAGE法得到梅花鹿鹿角托盘蛋白的电泳胶片,通过凝胶电泳图像分析软件生成图谱后,经计算机辅助相似度评价系统进行评价并得到对照指纹图谱。结果梅花鹿鹿角托盘蛋白有6个特征带峰,14批样品指纹图谱相似度较高,方法稳定性、精确度、重现性良好。结论该方法实验简单易行、灵敏度高、专属性强,可用于梅花鹿鹿角托盘药材的质量评价。     

Identification of metabolic pattern and bioactive form of resveratrol in human medulloblastoma cells

Cancer preventive reagent trans-resveratrol is intracellularly biotransformed to different metabolites. However, it is still unclear whether trans-resveratrol exerts its biological effects directly or through its metabolite(s). This issue was addressed here by identifying the metabolic pattern and the bioactive form of resveratrol in a resveratrol-sensitive human medulloblastoma cell line, UW228-3. The cell lysates and condition media of UW228-3 cells with or without 100 μM resveratrol treatment were analyzed by HPLC and LC/MS which revealed (1) that resveratrol was chemically unstable and the spontaneous generation of cis-resveratrol reduced resveratrol's anti-medulloblastoma efficacy and (2) that resveratrol monosulfate was the major metabolite of the cells. To identify the bioactive form of resveratrol, a mixture-containing approximately half fraction of resveratrol monosulfate was prepared by incubating trans-resveratrol with freshly prepared rat brain lysates. Medulloblastoma cells treated by 100 μM of this mixture showed attenuated cell crisis. The overall levels of the three brain-associated sulfotransferases (SULT1A1, 1C2 and 4A1) were low in medulloblastoma cells in vivo and in vitro in comparison with that in human noncancerous and rat normal cerebella; resveratrol could more or less up-regulate the production of these enzymes in UW228-3 cells but their overall level was still lower than that in normal cerebellum tissue. Our study thus demonstrated for the first time that trans-resveratrol is the bioactive form in medulloblastoma cells in which the expression of brain-associated SULTs was down-regulated, resulting in the increased intracellular bioavailability and anti-medulloblastoma efficacy of trans-resveratrol.     

左氧氟沙星片剂绝对生物利用度研究

目的 在中国健康志愿者中进行左氧氟沙星(可乐必妥)500mg片剂药代动力学研究,并以左氧氟沙星500mg(100ml)注射液为对照,研究口服片剂的绝对生物利用度.方法 10名受试者分别单剂空腹口服左氧氟沙星500mg片剂和单次静脉滴注500mg(100ml)注射液.以高效液相色谱(HPLC)-荧光法测定血、尿样中左氧氟沙星药物浓度.结果 受试者单剂空腹口服左氧氟沙星500mg片剂后平均C_(max)实测值为(6.20±2.51)mg/L,T_(max)为(0.91±0.54)h,t_(1/2)为(6.71±0.88)h,AUC_(0-∞)为(41.88±5.72)mg·h/L,24h内尿中平均累积排出率为(69.40±7.27)%,其与注射液相比绝对生物利用度几何均数比为107.5%(以AUC_(0-∞)计),90%可信区间为(97.72～118.25)%.结论 左氧氟沙星500mg片剂单次口服给药后吸收迅速,且吸收完全.提示临床可以每日一次,500mg顿服,用于左氧氟沙星先静脉给药,继以口服的序贯疗法.     

复方丹参片的HPLC特征图谱研究

目的采用HPLC测定复方丹参片的甲醇提取液的特征图谱,为复方丹参片在定性定量质量控制方面奠定基础。方法采用HPLC法建立复方丹参片特征图谱,并进行方法学考察,以丹参酮ⅡA为参照峰,计算各特征峰的相对保留时间,考察不同色谱柱各特征峰的相对保留时间的RSD、不同柱温条件下各特征峰的相对保留时间的RSD;建立10批复方丹参片的HPLC特征图谱。结果不同色谱柱各特征峰的相对保留时间RSD均小于3%;不同柱温各特征峰的相对保留时间的RSD均小于2%;10批复方丹参片的HPLC特征峰的相对保留时间的RSD均小于1%。以丹参酮ⅡA为参照峰,计算得到的相对保留时间,求取平均值作为特征峰,分别是0.44(峰1)、0.60(峰2)、0.70(峰3)。结论特征图谱及特征峰作为复方丹参片质量控制方法,操作简单,适用性强。     

胃肠间质瘤的多层螺旋CT表现

目的分析胃肠间质瘤（GIST）的多层螺旋CT表现及病理学表现,评价MSCT对该肿瘤的诊断价值。方法回顾性分析21例经病理证实的胃肠间质瘤的螺旋CT表现,将CT表现与生物学危险性进行对比研究。结果 21例GIST发生于胃12例,小肠7例,大肠2例。6例向腔内生长,15例腔外或同时向腔内外生长。8例肿瘤最长径≥50mm,13例肿瘤最长径〈50mm;14例边界清楚,7例边界不清;平扫密度均匀10例,不均匀11例;增强扫描动脉期轻中度强化18例,3例明显强化。高度危险4例,中度危险7例,低度危险8例,极低危险2例。结论 GIST的CT表现具有一定特征性,多层螺旋CT能准确诊断GIST,并判断其危险程度,对设计治疗方案及预后评估有重要价值,肿瘤最长径≥50mm、形状不规则、边界不清、密度不均匀、呈不均匀明显强化多为中、高度危险性;最长径〈50mm、形状规则、边界清楚、密度均匀、呈均匀强化的病灶多为中度以下危险性。     

生脉散传统汤剂及其配方颗粒的特征图谱比较

目的:分析生脉散汤剂及其配方颗粒主要指标性成分的差异,并应用HPLC色谱法建立配方颗粒的特征图谱,为中药配方颗粒能否代替复方汤剂提供依据。方法:采用HPLC色谱法,比较生脉散配方颗粒和传统汤剂两者特征图谱的差别,并通过相似度软件分析两者的相似性。结果:本色谱条件下生脉散配方颗粒各成分得到较好的分离,特征图谱有9个特征峰组成,汤剂中五味子醇甲等指标性成分与配方颗粒接近。结论:本方法可同时分离生脉散及其配方颗粒中各特征成分,配方颗粒与传统剂型成分差异统计学意义。     

不同类型社区卫生服务中心居民对中医服务认知情况比较

目的对不同类型社区卫生服务中心社区居民对中医服务认知情况比较,为国家有关部门制定相关中医药参与社区卫生服务的政策提供参考依据。方法2008年调查以中医治疗为主和以西医治疗为主的不同类别的社区卫生服务中心。结果中医特色社区卫生服务中心的居民在患病后更能接受中医药技术,并且大多吃过中药,接受中药治疗,更能正确看待中医药适宜技术的治疗花费。并且中医特色社区卫生服务中心的居民对本社区的“软件方面”更满意,如服务质量、服务态度等。结论中医是社区卫生服务的主要内容,是构建健康守门人的重要方面。进一步加强社区卫生服务机构中医药特色建设,发挥中医药服务在健康维护中的重要地位。