随访管理信息系统的设计与实现

开展出院后随访工作,一方面可以及时了解患者的病情并给予治疗建议,提高患者对医院的信任感。另一方面可以帮助医生积累临床经验,提高医疗水平。广州军区广州总医院通过建立患者随访信息系统,提高了病人满意度,同时为临床科研工作积累了宝贵资料。主要介绍医院随访信息系统的技术架构、主要功能、工作流程、接口设计及全院统一随访平台的系统结构。     

自拟远志枣仁汤治疗新生儿缺氧缺血性脑病后遗症疗效观察

目的:探讨自拟远志枣仁汤+康复训练治疗新生儿缺氧缺血性脑病后遗症的临床效果。方法:选取2007～2009年收治的新生儿缺氧缺血性脑病后遗患儿178例,年龄1～6岁,平均年龄2.3岁,178例患儿随机分为两组,治疗组采用康复训练+远志枣仁汤加减,小剂量,多次口服治疗,对照组临床只采用康复训练治疗。结果:治疗组患儿总有效率为96.6%,对照组总效率为85.2%,治疗组疗效优于对照组(P<0.05)。结论:自拟远志枣仁汤+康复训练可有效减少(轻)新生儿缺氧缺血性脑病神经系统后遗症和发育偏离程度,对患儿康复及正常生活起到积极作用。     

Meta-analysis of pregnancy outcomes in pooled randomized trials on a prophylactic adjuvanted glycoprotein D subunit herpes simplex virus vaccine

The primary objective of this investigation was to assess whether the AS04-adjuvanted herpes simplex virus (HSV) glycoprotein D candidate prophylactic vaccine against genital herpes disease increases the risk of spontaneous abortion associated with pregnancy conceived within the vaccination exposure window (vaccine dose received within the period starting 60 days before and ending 20 weeks post-conception day). We performed a meta-analysis of studies designed as part of the clinical development program for this vaccine, to examine the relative risk of abortion (spontaneous or elective) associated with unintended vaccination exposure during pregnancy. Nineteen studies, completed before September 2010, were eligible; 5 matched the inclusion criteria for this analysis (presence of a control arm and at least one adverse pregnancy outcome reported). All vaccinated women (N = 19,727) were included, of whom 660 reported a pregnancy during the study period. Overall, 13.3% of pregnancies in the HSV vaccine group and 11.0% in the control group resulted in spontaneous abortion; 24.2% and 20.0% resulted in elective abortion. Among 180 women with a first pregnancy conceived in the vaccination exposure window, 16.7% (HSV vaccine) and 9.5% (control) had a spontaneous abortion and 38.5% and 33.3%, elective abortion. The relative risk for spontaneous abortion associated with vaccine exposure during the risk period for abortion in the course of pregnancy was 1.7 (95% CI: 0.7–4.6). For all women receiving HSV vaccine, this relative risk was 1.3 (95% CI: 0.8–2.1). The corresponding relative risks for elective abortion were 1.2 (95% CI: 0.7–2.0) and 1.3 (95% CI: 0.9–1.8). There was no apparent relationship to dosing and no difference between groups in gestational age at the time of spontaneous or elective abortion. In conclusion there is no statistical evidence that the investigational HSV vaccine increased the risk of spontaneous or elective abortion.     

按审核日期统计的疫情报表重新生成问题浅见

目的为完善网络直报系统,使其生成的各种报表更加客观、真实、可信、可用。方法分析网络直报系统中按审核日期统计的报表生成时间,对不同时间生成的疫情报表数据进行对比、分析及统计学处理。结果按审核日期统计的报表都在年内生成后,年终重新生成。两次生成的报表,数据差异极大,存在一定的问题。结论年终重新生成按审核日期统计的疫情报表意义不大,并致使来年的疫情分析表产生传染病报告数比上年同期升高的错觉,建议网络直报系统年终不再重新生成按审核日期统计的报表。     

Identification of the date‐rape drug GHB and its precursor GBL by Raman spectroscopy

Gamma hydroxybutyric acid (GHB), also known as ‘liquid ecstasy’, has recently become associated with drug‐facilitated sexual assaults, known colloquially as ‘date rape’, due to the ability of the drug to cause loss of consciousness. The drug is commonly found ‘spiked’ into alcoholic beverages, as alcohol increases its sedative effects. Gamma hydroxybutyric acid and the corresponding lactone gamma‐butyrolactone (GBL) will reach an equilibrium in solution which favours the lactone in basic conditions and GHB in acidic conditions (less than pH 4). Therefore, we have studied both GHB and GBL, as a mildly acidic beverage ‘spiked’ with GHB will contain both GHB and GBL. We report the analysis of GHB as a sodium salt and GBL, its precursor, using bench‐top and portable Raman spectroscopy. It has been demonstrated that we are able to detect GHB and GBL in a variety of containers including colourless and amber glass vials, plastic vials and polythene bags. We have also demonstrated the ability to detect both GBL and GHB in a range of liquid matrices simulating ‘spiked’ beverages. Copyright © 2009 John Wiley & Sons, Ltd.     

滁菊定植模式的研究

目的:探讨不同定植时期、不同定植密度以及不同次数摘心处理对滁菊产量与品质的影响,为滁菊的产业化栽培提供依据。方法:采用5个定植期、3个定植密度共15个处理以及3种摘心方案进行滁菊的栽培试验,定植期分别为5月4日(A1)、5月17日(A2)、5月31日(A3)、6月9日(A4)、6月24日(A5);定植密度株行距分别为40 cm×40 cm(B1)、50 cm×50 cm(B2)、60 cm×60 cm(B3);摘心方案分别为自然生长、摘心1次、摘心2次。分别于现蕾期、盛花期测量株高、冠幅、茎粗、一级分枝数、二级分枝数及植株老化程度,于收获期统计一茬花数、二茬花数、三茬花数、无效花蕾数并进行单株计产以比较不同栽培措施对滁菊生长及产量的影响。结果:随着定植期的推移,株高和冠幅有下降趋势,A4和A5两个定植期的株高和冠幅显著小于A1、A2和A3定植期,A1、A2和A3之间株丛的冠幅差异不显著;定植期为A2和A3,定植密度为B2时单株产量、花的品质最高,而定植密度为B1时亩产量最高。经过2次摘心的滁菊,二级分枝数显著增加,株型更加紧凑,单株产量最高。结论:定植时期在5月17日至5月31日之间,定植密度株行距为40 cm×40 cm,摘心2次,滁菊的亩产量最高;定植期不变,定植密度株行距为50 cm×50cm时,单株产量最大,总体品质最佳。两种栽培方案可在滁菊的生产上供选用、推广。     

触诊为肿块的乳腺腺病的动态增强MRI诊断

目的 探讨触诊为肿块的乳腺腺病的动态增强磁共振扫描(DCE-MRI)的表现特点.方法 搜集27例临床触及乳腺肿块而经病理证实为乳腺腺病的患者术前一周内行DCE-MRI的影像资料,回顾分析经多平面重组(MPR)、最大密度投影(MIP)、时间-信号曲线(TIC)等方法处理后的图像,从形态学和血流动力学两方面探讨病变特点.结果 21例(77.8％)表现为非肿块样强化,其中19例表现为多发斑点状、结节状强化,2例表现为局限性强化;6例(22.2％)表现为肿块样强化.TIC:17例(63.0％)表现为早期缓慢流人,10例(37％)表现为早期中度流入.延迟期19例(70.4％)表现为Ⅰ型曲线(渐进型),8例(29.6％)表现为Ⅱ型曲线(平台型).结论 触诊为肿块的乳腺腺病的MRI表现多为双侧乳腺多发斑点状、结节状强化,体积均较小,强化程度低,TIC早期缓慢或中度流入,延迟期以流入型为主.     

Protective efficiency of Ashrasi date palm hydroalcoholic extract against diabetes‐induced testicular toxicity: A biochemical and stereological study

The present study was designed to investigate the protective effects of hydroalcoholic extract of Ashrasi date palm (ADP) on diabetes‐induced testicular injuries. Adult male rats were randomly allocated into five groups (n = 8 in each group): 1: control; 2: diabetic; 3: diabetic + 30 mg/kg of ADP extract; 4: diabetic + 90 mg/kg of ADP extract; and 5: diabetic + 270 mg/kg of ADP extract. Diabetes was induced by a single dose of streptozotocin (55 mg/kg) intraperitoneally. Testicular changes were assessed quantitatively using stereological method followed by measuring antioxidant enzymes including catalase, superoxide dismutase and glutathione peroxidase and serum testosterone level. Malondialdehyde (MDA) and Bcl‐2 expression were also evaluated in tissue samples. Diabetes resulted in significant deleterious alterations in the architecture of testicular tissue, suppressed antioxidant enzymes and testosterone levels and increased lipid peroxidation. The expression of Bcl‐2 was downregulated in diabetic testis and resulted in enhanced apoptosis. Eight weeks of ADP extract treatment especially at higher doses could markedly improve structural changes of testis and restore the antioxidant defence and testosterone levels in testicular tissue. In conclusion, this findings showed that ADP extract can play as a potent antioxidant and can attenuate the adverse effects of diabetes on male reproduction.     

四种药食同源材料中总糖含量的测定

目的为了明确枸杞、香菇、茯苓及红枣几种药食同源材料中总糖含量及其在煮制中的变化。方法采用苯酚硫酸法测定总糖含量。先以四种原料的混合物为研究对象考察了料液比、超声波功率以及超声波时间对混合物中总糖提取效果的影响,再通过正交试验进行优化试验。结果混合物中总糖提取的最佳条件为,料液比为1∶20、超声波功率200 W及超声波时间为30 min,用该条件测得这四种富含糖类物质混合后在经煮制和未经煮制两种情况下总糖含量非别为41.51%和51.36%。结论这四种药食同源材料经过混合煮制后总糖含量有所增加。     

胞磷胆碱钠片的稳定性研究

目的通过试验得出不同环境下胞磷胆碱钠片的稳定性数据,为药品储存、有效期的确定提供实验依据。方法采用高效液相色谱法测定胞磷胆碱钠片中胞磷胆碱钠的含量,通过光照试验、高温试验、高湿试验、加速试验和长期试验,应用动力学公式Arrhenius方程及统计学原理计算出K25℃和预测药品有效期。结果胞磷胆碱片稳定性好,预测有效期与长期试验结果相吻合。结论胞磷胆碱钠片在室温条件下储存的有效期为36个月。