阿帕替尼联合替吉奥治疗晚期胃癌的临床疗效及对血清MMP-2、REGⅣ和SRF水平的影响

目的:探讨阿帕替尼联合替吉奥（tegio,S-1）治疗晚期胃癌的临床疗效及对血清基质金属蛋白酶-2（matrix metalloproteinase-2,MMP-2）、再生基因蛋白Ⅳ（regenerated gene protein Ⅳ,REGⅣ）和反应因子（serum response factor,SRF）水平的影响。方法:选取2017年01月至2018年04月在我院治疗的晚期胃癌患者107例,根据治疗方案分为观察组（n=49）和对照组（n=58）,观察组给予阿帕替尼联合S-1治疗,对照组给予S-1治疗,观察两组患者治疗疗效、生存时间、不良反应等,检测血清MMP-2、REGⅣ和SRF水平。结果:观察组患者治疗疗效优于对照组（P＜0.05）,其治疗总有效率为69.39%;观察组患者治疗后血清MMP-2、REGⅣ和SRF分别为（3 454.49±283.39）ng/L、（2.01±0.72）ng/L和（33.38±9.28）ng/mL,明显低于对照组（P＜0.05）;观察组患者中位生存时间为19.00个月,明显长于对照组（P＜0.05）;观察组和对照组患者不良反应发生率比较,差异无统计学意义（P＞0.05）。结论:阿帕替尼联合S-1治疗晚期胃癌有较好的临床疗效,可明显降低血清MMP-2、REGⅣ和SRF水平。     

台州市食源性金黄色葡萄球菌的主动监测及肠毒素基因分布研究

目的:了解台州市食源性金黄色葡萄球菌的污染状况及肠毒素基因的分布特征,为食品安全的风险评估和食源性致病菌的预防提供科学依据。方法:在2005年-2010年间按照监测网的工作要求对采集的各类食品样品进行金黄色葡萄球菌的定性检测,并对保存的菌株用多重PCR方法进行18种肠毒素基因(sea～seu)的检测分析。结果:380份食品样品中共有47份检出金黄色葡萄球菌,总检出率为12.4%,其中即食食品检出率最高为13.2%,生肉类为11.7%,豆制品为7.7%;保存的42株菌中共有22株菌检出12种肠毒素基因,基因携带率为52.4%,sea、seq、sei基因的检出率较高,分别为21.4%、16.7%、11.9%。结论:台州市市售食品中金黄色葡萄球菌的污染程度较高,肠毒素基因携带率较高,监测结果应引起食品监管部门的重视。     

Ghrelin基因Leu72Met多态性与2型糖尿病的相关性

目的探讨Ghrelin基因Leu72Met多态性与T2DM之间的相关性。方法采集316例T2DM患者和203名健康对照组（NGT组）人群的一般临床资料,利用PCR-RFLP进行Ghrelin基因Leu72Met的多态性分析。结果T2DM组的Leu72Met基因型分布及等位基因频率与NGT组相比差异无统计学意义。NGTMet72携带者血清LDL-C水平较同组Leu72纯合子个体增高（P〈0．05）。结论Ghrelin基因Leu72Met分布与等位基因频率在T2DM和健康人群无明显差异,该基因多态性在健康人群可能与血清LDL-C水平相关。     

胎盘蛋白13与妊娠相关疾病

胎盘蛋白13是56种广泛分布于胎盘组织的胎盘蛋白之一,与半乳凝素家族成员具有同源性.近年来,通过对胎盘蛋白13的分子结构、基因表达、生物学功能等方面研究,发现其对妊娠相关疾病有良好的预测作用.随妊娠的发展,母体血清中胎盘蛋白13的含量一般会缓慢上升,但孕中晚期发生子痫前期、宫内生长受限、早产的孕妇,其血清中胎盘蛋白13含量在妊娠6～13周明显降低,以孕中晚期发生子痫前期的孕妇下降最显著.因此深入地研究胎盘蛋白13对妊娠相关疾病的诊断、预测有重要的临床意义.     

Bryan颈人工椎间盘置换术失败原因分析

Objective To analyze the failed Bryan cervical disc arthroplasty and to improve its re-sults. Methods From October 2004 to October 2007, 48 patients underwent Bryan cervical disc arthro-plasty. All patients were followed up 2 to 38 months(mean 18 months). Among them, 4 failed cases were an-alyzed, which include 1 male and 3 females, with the age of 42, 51, 40, 49 years. Results Case 1 reported the brachial plexus injury as the result of the patient's shoulders being overstretched while fixing his position during operation, the muscular power of both upper extremities declining to degree Ⅱ and Ⅲ upon operation completion, which was restored to degree 4 when discharged from hospital (45 days after operation). Case 2 reported the compression on the spinal cord as the result of failure to remove the ossification of posterior lon-gitudinal ligament (OPLL) which had been identified by the preoperative CT; the patient complained of no release of symptoms after the operation and postoperative CT showed that compression still existed. Case 3 reported incomplete spinal cord injury caused by massive bleeding during decompression, a function of ex-tremely small vertebral canal anteroposterior diameter (5 mm shown in preoperative MRI); the muscular pow-er of left extremity dropped to degree 0 upon operation completion; the patient could walk with crutch 10 days after operation. Case 4 reported'heterotopic ossification (OP) which occurred 1 year after operation and became deteriorated 2 years later, but did not affect the motion of prosthesis. Conclusion Bryan disc arthroplasty is being extensively used as an effective procedure for decompression and reconstruction of the cervical disc. Excellent clinical results are related to strict selection of indications, perioperative manage-ment, and the experience and surgical technique of the surgeon are also important to the final outcome.     

中心静脉压测定的影响因素及护理对策

为减少中心静脉压（CVP）测定时的影响因素，提高CVP值的准确性和可靠性，现分析影响CVP因素并探讨护理对策。     

瑞芬太尼在诱导插管中的应用研究

瑞芬太尼具有起效迅速、作用时间短、大剂量长时间应用无蓄积等诸多优点,国内外已有很多应用报道.本文旨在探讨瑞芬太尼联合应用在全麻诱导气管内插管时的可行性及用量.     

Bryan颈人工椎间盘置换术失败原因分析

Objective To analyze the failed Bryan cervical disc arthroplasty and to improve its re-sults. Methods From October 2004 to October 2007, 48 patients underwent Bryan cervical disc arthro-plasty. All patients were followed up 2 to 38 months(mean 18 months). Among them, 4 failed cases were an-alyzed, which include 1 male and 3 females, with the age of 42, 51, 40, 49 years. Results Case 1 reported the brachial plexus injury as the result of the patient's shoulders being overstretched while fixing his position during operation, the muscular power of both upper extremities declining to degree Ⅱ and Ⅲ upon operation completion, which was restored to degree 4 when discharged from hospital (45 days after operation). Case 2 reported the compression on the spinal cord as the result of failure to remove the ossification of posterior lon-gitudinal ligament (OPLL) which had been identified by the preoperative CT; the patient complained of no release of symptoms after the operation and postoperative CT showed that compression still existed. Case 3 reported incomplete spinal cord injury caused by massive bleeding during decompression, a function of ex-tremely small vertebral canal anteroposterior diameter (5 mm shown in preoperative MRI); the muscular pow-er of left extremity dropped to degree 0 upon operation completion; the patient could walk with crutch 10 days after operation. Case 4 reported'heterotopic ossification (OP) which occurred 1 year after operation and became deteriorated 2 years later, but did not affect the motion of prosthesis. Conclusion Bryan disc arthroplasty is being extensively used as an effective procedure for decompression and reconstruction of the cervical disc. Excellent clinical results are related to strict selection of indications, perioperative manage-ment, and the experience and surgical technique of the surgeon are also important to the final outcome.     

"推脊整复"疗法治疗颈腰疾病

推脊整复疗法,也称"整脊"疗法,意在"正脊".这一疗法古朴简便,属传统医学的一支.是指通过术者的手法推拿和带功操作,使因病所致的脊柱形态改变尽快得到整复,恢复到正常解剖位置,从而达到脊正经通,通则不痛,手到病除的效果.     

医院文化对入力资源管理的导向作用及其实现

医院文化是现代医院管理的重要内容，是医院可持续发展的动力源泉，是医院综合实力的重要标志，对医院建设发展的各个方面都有重要作用。现就其对医院人力资源管理的导向作用及实践应用进行探讨。[第一段]