苏州工业园区推行新型农村合作医疗制度实践与体会

苏州工业园区是中新两国合作开发的国家级经济开发区。在开发建设、经济发展的同时，按照树立和落实科学发展观的要求，十分注重经济与社会的协调发展，不断研究致富农民的新办法，积极探索农民医疗保障新思路，坚持把建立和完善新型农村合作医疗制度，进一步解决和防止农村居民因病致贫、因病返贫的社会问题，作为实践“三个代表”的重要举措，使广大农民分享到了开发建设的丰硕成果。     

对医院药品采购与药库管理的几点看法

在医院的经济收入和支出中，中西药占全部资金约40％～60％，中小医院约70％～80％，所以应尽可能地增加收入，减少支出，达到节支开源，提高经济效益和社会效益的目的。因此，做好药品的采购和提高药库管理水平，值得重视与研究。     

中西医结合治疗单纯疱疹病毒性角膜炎53例疗效观察

目的:观察中西医结合治疗单纯疱疹病毒性角膜炎的疗效。方法:将106例患者随机分为2组各53例,治疗组用辨证分型中药治疗,配合0.1％无环鸟苷眼液滴眼和三氮唑核苷注射液结膜下注射;对照组仅用西药治疗。结果:治愈率治疗组82.8％,对照组53.7％(P<0.01);平均治愈时间治疗组13.2天,对照组22.3天(P<0.01);随访14～24月,复发率治疗组12.5％,对照组46.9％(P<0.01)。结论:中西医结合治疗单纯疱疹病毒性角膜炎,可提高治愈率,缩短治疗时间,并可降低复发率。     

大数据时代下区域医疗的思考与探索

本文阐述了利用大数据优势推动区域医疗发展的必要性，从细致深入做好疾病预防、全面了解治疗进度、努力实现无差别就医三个方面，探讨了大数据时代区域医疗的应用方向，希望对促进大数据时代下区域医疗的快速发展有所裨益。     

超声刀与高频电刀在甲状腺切除术中安全性以及近期和远期治疗效果的评估研究

目的探讨超声刀和高频电刀在甲状腺切除术中的安全性及近远期疗效。方法将我院普外科择期甲状腺切除术的甲状腺癌患者120例采用随机数字表法分为超声刀组和高频电刀组各60例。比较两组手术相关指标、近远期并发症发生率,术前和术后1年发放生活质量评价量表(SF-36)评估生活质量。结果超声刀组手术时间、术中出血量、术后24 h引流量少于高频电刀组,切口长度短于高频电刀组,术后出血、暂时性低血钙症发生率低于高频电刀组(P0.05);两组术后1年SF-36量表亚型评分均明显改善,与术前比较差异有统计学意义(P0.05),但两组间术后1年比较差异无统计学意义(P0.05)。结论与高频电刀相比,甲状腺切除术中应用超声刀有利于减少手术时间、术中出血量,且对甲状旁腺功能损伤小,可降低术后近期并发症发生率,安全性较高。     

耐力运动对雌激素依赖性乳腺癌小鼠肿瘤血管生成的影响

摘要 目的：探讨耐力运动对雌激素依赖性乳腺癌肿瘤血管生成的影响。 方法：40只雌性BALB/c小鼠随机分为2组,一组小鼠在跑台上进行8周持续耐力运动,另一组不进行运动。之后给予2组小鼠注射雌激素依赖性MC4L2癌细胞,肿瘤形成后,随机再将这两组小鼠以每组10只,分为4组,即：运动-肿瘤-运动组（A）;运动-肿瘤-休息组（B）;休息-肿瘤-运动组（C）和休息-肿瘤-休息组（D）。A、C组小鼠进行为期6周的耐力运动,每周运动5天。期间,每周测量肿瘤体积。最后,处死小鼠,摘除肿瘤组织,制成匀浆ELISA定量法测量细胞因子白细胞介素-6（IL-6）和血管内皮生长因子（VEGF）的表达水平。 结果：A、C组与B、D组相比,IL-6（P=0.001）、VEGF（P=0.0001）和肿瘤体积（P=0.0001）显著降低。 结论：运动可致使乳腺癌细胞致瘤小鼠的肿瘤组织内促炎症细胞因子水平降低,抑制肿瘤血管生成因子表达增加。因此,运动对雌激素依赖的乳腺癌可能有一定的辅助治疗与预防作用。     

急性冠脉综合征行急诊冠状动脉搭桥的疗效

目的评价急诊冠状动脉搭桥(CABG)治疗急性冠脉综合征的疗效。方法对24例急性冠脉综合征患者行急诊CABG,观察手术效果及术后并发症发生情况,并进行随访。结果体外循环时间为(89±26)min,主动脉阻断时间为(47±19)min。每例患者搭桥支数为(3．1±1．2)支,总搭桥支数为74支。共9例患者置入主动脉内球囊反搏(IABP),其中5例于术后24 h内拨除,4例于术后48 h内拨除。本组无手术死亡,无围术期心肌梗死及低心排血量综合征,亦无脑出血或栓塞并发症。术后出现胸腔积液3例、肺部感染2例,经相应治疗后均治愈。术后平均纵隔心包引流量为(548±339)mL,仅3例引流量较大,达1 100～1 400 mL,其中2例应用止血药等治疗后出血逐渐减少至停止,1例行再次开胸止血。患者出院前行运动试验,均为阴性。出院后所有患者经12～34个月的随访,平均为(18±2)个月,均无心绞痛发作,运动耐量接近正常,恢复正常生活。结论在心肌梗死尚未发生时对急性冠脉综合征患者及时行急诊CABG,有利于改善预后。     

人体食指长、中指长与身高相关关系的研究

目的:探讨人体食指长、中指长与身高的相关关系。方法:对489名男女青年进行了食指长、中指长与身高的测量,并记录相关数据,将测量数据输入计算机中进行回归分析,得出食指长、中指长推测身高的直线回归方程。结果:利用食指长推测身高:男性:y=108.61+8.76x。女性:y=142.13+2.72x;利用中指长推测身高:男性:y=94.85+9.47x;女性:y=129.89+4.08x。结论:人体食指长、中指长与身高存在一定的线性关系。     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

Objective To evaluate the clinical application of automated urine formed elements analyzer and/or urine dipstick analyzer for examination of urinary formed elements in screening urinary tract infection (UTI). Methods 148 fresh midstream clear-catch urine samples from the UTI patients and 284 fresh midstream clear-catch urine samples from non-UTI subjects were selected. Bacteria culture was performed for bacterial colony counting and identification. Bacteria counts ( BACT), yeast-like fungus and WBC were performed by UF-looOi automated urine formed elements analyzer. Leukocyte esterase test (LEU) and nitrite test (NIT) were performed by URISYS 2400 urine dipstick analyzer. We evaluated data obtained from urine dipstick analyzer, UF-1000i and combination of UF-1000i with urine dipstick analyzer and the results was compared with those obtained from quantitative bacterial culture. Then we evaluated the sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results Among the 148 patients with UTI, the positive rate of the quantitative bacterial culture was 73.6% (109/148), the positive rate of LEU and NIT detected by dipstick test 26. 4% (39/148).There was significantly statistical difference between bacterial culture and strip test(χ2 = 55.68 ,P < 0. 05 ). The positive rate of urine flow cytometry by UF-1000i with either positive of BACT and WBC was 91.2%(135/148), which was higher than the positive rate of the quantitative bacterial culture. There was significant difference between two methods (χ2 = 14. 70, P < 0. 05 ). The positive rate of anyone positive among BACT, WBC, LEU and NIT was 94. 6% (140/148) when detected with combination of dipstick test and UF-1000i, which was higher than the positive rate of the quantitative bacterial culture. And there was significant difference between two methods (χ2 = 20. 45, P < 0. 05 ). The sensitivity of dipstick test was low (26. 4% ,39/148 ), and specificity was high ( 99. 3%, 282/284 ) . The sensitivity, specificity, positive predictive value, negative predictive value of BACT detected by UF-1000i in diagnosing urinary tract infection were 92. 6% ( 137/148 ), 39. 8% ( 113/284 ). 44. 5% ( 137/308 ) and 91.1% ( 113/124 ), respectively. If the dipstick test was combined with UF-1000i, the sensitivity, negative predictive value, specificity, positive predictive value and accuracy were 98.0% ( 145/148 ), 97.1% ( 100/103 ). 35.2% (100/284) ,44. 1% (145/329) and 56. 7% (245/432), respectively. Conclusions The combination of urine dipstick test and automated urine formed elements analyzer UF-1000i plays an important role in early diagnosis of UTI. And it has significant value in diagnosis of UTI, especially for the patients with negative bacterial cultures of urine sample.