深化计量管理的探索与实践

提高医疗质量,有赖于完善计量管理.提升计量管理水平,没有现成的模式和样板可以借鉴,要大胆创新.勇于探索与实践.对计量执法检查中出现的问题重视程度不够,看似小问题,但影响医院整体.找出症结,对症下药,深化管理.计量统计报表采用网络化,提升计量管理水平.     

Synthesis and biological activity of a focused library of mitogen-activated protein kinase phosphatase inhibitors

Mitogen-activated protein kinase phosphatase 1 is a tyrosine phosphatase superfamily member that dephosphorylates and inactivates mitogen-activated protein kinase substrates, such as p38, c-Jun-N-terminal kinase, and extracellular signal-related kinase. These mitogen-activated protein kinase substrates regulate many cellular processes associated with human diseases. In spite of this potential as a molecular target for chemotherapy, however, pharmacologically tractable inhibitors of mitogen-activated protein kinase phosphatase-1 have yet to be developed. Based on the results from a high-throughput screen for small molecule inhibitors of mitogen-activated protein kinase phosphatase-1, we designed, synthesized, and evaluated a focused library in an effort to further understand the structural requirements for mitogen-activated protein kinase phosphatase-1 inhibitory activity.     

Is subvalvular repair worthwhile in severe ischemic mitral regurgitation? Subanalysis of the Papillary Muscle Approximation trial

Objective

The symmetry of mitral valve tethering and regional left ventricle wall dysfunction are reported to play a fundamental role in the outcomes and long-term durability of surgical repair in ischemic mitral regurgitation (IMR). We recently demonstrated in a randomized clinical trial (the Papillary Muscle Approximation trial) the superiority of papillary muscle approximation (PMA) in combination with standard restrictive annuloplasty (RA) in severe IMR over annuloplasty alone in terms of adverse left ventricular remodeling and mitral regurgitation (MR) recurrence. This approach, however, failed to produce a survival advantage and was still plagued by a high incidence of reoperation. We therefore performed a subanalysis of the PMA trial on the basis of preoperative parameters to elucidate the value of subvalvular surgery in certain subcategories of patients with the aim of creating a decisional algorithm on the best operative strategy.

太原市2005—2007年法定传染病网络报告质量分析

目的对太原市2005年上半年～2007年上半年的法定传染病网络报告质量进行分析，找出影响报告质量的因素，为提高传染病网络报告质量提供依据。方法通过《中国疾病预防控制信息系统》的子系统《疾病监测信息报告管理系统》获取太原市2005年上半年～2007年上半年各区、县（市）疾控中心（卫生防疫站）及所辖医疗机构（采供血机构、卫生检疫机构）报告的法定传染病报告卡，导出Excel格式，用SPSS软件进行报告审核及时性、报告准确性、报告完整性方面的统计分析。结果太原市法定传染病网络报告质量2007年最好，但有些指标在3年中有所波动。结论太原市的法定传染病报告质量需进一步提高，应加强对相关人员的培训与技术指导并给予支持，只有领导重视，工作人员认真负责，才能使太原市的传染病报告质量不断提高。     

Racial disparities in the development of comorbid conditions after preterm birth: A narrative review

Despite recognition and attempts to reduce racial disparities in perinatal outcomes, Black infants are still disproportionately represented among those who are born preterm. Postnatal investigations of racial disparities in comorbidities and outcomes after preterm birth are increasing, although their results and interpretations are conflicting. In the present review, we 1.) identify important methodological limitations of that literature 2.) summarize the conflicting literature investigating racial disparities, specifically Black-white differences, in postnatal comorbidities and outcomes after preterm birth 3.) describe mechanisms by which racism operates to contextualize our understanding to inform future work to actively reduce disparities in preterm birth and subsequently, its complications.     

基于网络药理学探究清幽养胃胶囊治疗Hp感染慢性萎缩性胃炎的作用机制＊

目的 通过网络药理学预测清幽养胃胶囊治疗Hp感染慢性萎缩性胃炎有效成分、作用靶点及相关信号通路并通过分子对接技术验证。方法 利用TCMSP数据库、SwissTargetPrediction、STITCH数据库获得药物的有效成分以及靶点。通过GeneCards、OMIM数据库获得疾病靶点。用String数据库构建PPI网络，用软件Cytoscape 3.7.2构建活性成分－靶点－药物－疾病网络关系，用R语言进行生物功能和通路分析。运用PDB 数据库、PubChem数据库、AutoDuck软件等工具进行关键靶蛋白与相关化合物的分子对接，以验证其治疗作用。结果 预测得到清幽养胃胶囊治疗Hp感染慢性萎缩性胃炎的206个成分，涉及119个靶点，跟PI3K/Akt、IL-17、TLR等信号通路有关，并发现AKT1、IL6、ALB、CASP3、VEGFA等关键靶点。分子对接表明关键靶蛋白与相关活性成分结合程度较好，且绝大多数优于阳性对照药。结论 清幽养胃胶囊通过多成分、多靶点的形式治疗Hp感染慢性萎缩性胃炎，为进一步探究其机制打好基础。     

Lower airway bacterial microbiome may influence recurrence after resection of early-stage non–small cell lung cancer

ObjectiveThe lower airway bacterial microbiome influences carcinogenesis and response to immunotherapy in non–small cell lung cancer (NSCLC). We investigated the association of this microbiome with recurrence in early NSCLC.MethodsMicrobiomes of presurgery bronchoalveolar lavage (BAL) and saliva, and resected stage I NSCLC tumor and adjacent lung tissues of 48 patients were examined by 16S gene sequencing. Tumor gene expression was measured by RNA sequencing.ResultsSpatial relationships of the different biospecimen types was reflected in their microbiomes, with microbiomes of BAL intermediate to those of saliva and lung tissue. BAL and saliva microbiomes were less dissimilar in patients with high α-amylase levels in BAL, indicating oral aspiration as a source of lower airway microbiota. BAL microbiomes of patients with recurrence within 32 months of surgery differed from those without recurrence during ≥32 months of follow-up (n = 18 each), despite no difference for age, sex, smoking history, and tumor histology and grade. The recurrence-associated BAL microbiome signature was present in 16 of the 18 recurrence cases but in only two of the others. Signature presence was associated with shorter recurrence-free survival (log-rank test P < .001; hazard ratio = 14.5), and greater expression in tumors of genes for cell proliferation and epithelial mesenchymal transition. Immune cellular composition of the tumor microenvironment was not different between patients with and without the signature.ConclusionsPresurgery composition of lower airway microbiome may be associated with recurrence of early NSCLC. This association may reflect an influence of the microbiome on tumor biology.