对高等教育大众化背景下中医药高等院校专业建设问题的思考

中医药高等院校专业建设应随着社会的进步发展和社会的需求而不断拓宽、延伸其专业领域，本文从中医药高校的专业延伸的必要性、建设原则以及专业延伸的思路等三个方面对中医药高等院校的专业建设工作提出了几点思考。     

Complications Related to Dapsone Use for Pneumocystis Jirovecii Pneumonia Prophylaxis in Solid Organ Transplant Recipients

Dapsone, used for prevention of Pneumocystis jirovecii infections, has been reported to cause hemolytic anemia and methemoglobinemia; its tolerability in solid organ transplant recipients is not well described. We investigated dapsone-related adverse events in patients undergoing solid organ transplantation from 1999 to 2004. Transplant providers identified patients for the investigators who then reviewed the patients' hospital and outpatient records. Sixteen solid organ transplant recipients fit case definitions for dapsone-related hemolytic anemia (n = 11) or methemoglobinemia (n = 5). Median time from event to dapsone discontinuation was 15 days; all patients improved after drug discontinuation. G6PD enzyme activity was normal in all patients whose test results were available. Dapsone may be associated with hemolytic anemia or methemoglobinemia, even with normal G6PD levels. These events are often not promptly recognized, and drug discontinuation is delayed. Dapsone-related hemolytic anemia or methemoglobinemia should be considered in solid organ transplant recipients with unexplained anemia or hypoxia.     

The epithelial-mesenchymal transition induces aggressivity of mucinous cystic neoplasm of the pancreas with neuroendocrine component: An immunohistochemistry study

Background

Pancreatic mucinous cystic neoplasms (MCN) are rare tumors that are usually diagnosed in females.

探讨文明创建对医院发展的作用

“全国文明单位”称号是国家综合评比一个单位精神文明建设成果的最高褒奖。良好的医院形象是提升医院综合实力、增强其竞争力的重要手段。医院每年制定文明创造重点,明确文明创造的目标、任务和重点,将文明创造工作与业务工作结合起来进行规划、实施、考核和奖惩。医院设有精神文明建设领导小组和办公室,隶属党办,负责精神文明建设的日常协调和指导工作。文明永无止境。文明创造是一项系统工作,它整合全院资源,整合党、工团、妇委会等各种力量,“青年文明号”“巾帼文明岗”不断树立品牌支持创建工作。医院积极营造“文明单位、共建共享、全员参与、人人受益”的良好氛围。文明建设扎实推进,医院建设更加健康有序。结合福建省肿瘤医院连续三届获评“全国文明单位”的创建经验,从医院人员素质、中心工作、社会责任、文化、决策和环境等方面入手,阐述医院文明创建对医院发展的作用。     

益气养阴通络方联合康复训练治疗气阴两虚型帕金森病临床研究

目的：观察自拟益气养阴通络方联合康复训练治疗气阴两虚型帕金森病（PD）的临床疗效。方法：将120例PD患者纳入研究,按随机奇偶数法分为对照组和治疗组各60例。对照组给予多巴丝肼片治疗,治疗组采用益气养阴通络方联合康复训练治疗。治疗3个月后评定2组临床疗效、颤证功能障碍积分、自主神经症状自评量表（SCOPA-AUT）评分、PD运动功能量表（MDRSPD）评分及血清神经营养因子[脑源性神经营养因子（BDNF）、胰岛素样生长因子1 (IGF-1)、人神经营养因子3 (NT-3)]水平。结果：治疗组总有效率为93.33%,高于对照组80.00%,2组比较,差异有统计学意义（P<0.05）。治疗前,2组颤证功能障碍积分比较,差异无统计学意义（P>0.05）;治疗后,2组颤证功能障碍积分均较治疗前降低（P<0.05）,且治疗组颤证功能障碍积分低于对照组（P<0.05）。治疗前,2组SCOPA-AUT、MDRSPD评分比较,差异无统计学意义（P>0.05）;治疗后,2组上述2项评分较治疗前明显降低（P<0.05）,且治疗组2项评分均低于对照组（P<0.05）...     

Mendelian randomization suggests a potential causal effect of eosinophil count on influenza vaccination responsiveness

Currently, the clinical factors affecting immune responses to influenza vaccines have not been systematically explored. The mechanism of low responsiveness to influenza vaccination (LRIV) is complicated and not thoroughly elucidated. Thus, we integrate our in-house genome-wide association studies (GWAS) analysis result of LRIV (N = 111, Ncase [Low Responders] = 34, Ncontrol [Responders] = 77) with the GWAS summary of 10 blood-based biomarkers (sample size ranging from 62 076−108 794) deposited in BioBank Japan (BBJ) to comprehensively explore the shared genetics between LRIV and blood-based biomarkers to investigate the causal relationships between blood-based biomarkers and LRIV by Mendelian randomization (MR). The applications of four MR approaches (inverse-variance-weighted [IVW], weighted median, weighted mode, and generalized summary-data-based MR [GSMR]) suggested that the genetically instrumented LRIV was associated with decreased eosinophil count (β = −5.517 to −4.422, p = 0.004−0.039). Finally, we conclude that the low level of eosinophil count is a suggestive risk factor for LRIV.     

72例转移性鼻咽癌的预后分析

目的：探讨转移性鼻咽癌预后的相关因素。方法：分析2004年9月至2008年9月我科确诊的72例转移性鼻咽癌患者的预后因素,其中男性62例,女性10例,中位年龄50岁（28-81岁）。比较单发转移组（14例）与多发转移组（58例）、转移合并局部复发组（14例）和转移无局部复发组（58例）以及综合治疗组（61例）和单纯支持治疗组（11例）间的生存率。Kaplan-Meier法计算生存率,log-rank检验各组生存率,Cox逐步回归模型进行多因素分析。结果：转移合并局部复发组1年、2年生存率14.3%、1.1%,中位生存期8.2个月,较转移无局部复发组生存率及中位生存期（38.5%、20.3%、11.6m）低,P〈0.05。单发转移组与多发转移组1年、2年生存率分别为47.5%、20.0%与37.5%、12.5%,P〉0.05。综合治疗组与支持治疗组1年、2年生存率分别为47.2%、16.1%与40.0%、12.0%,P〉0.05。两组间生存率无统计学差异。多因素分析显示性别（P=0.026）、合并局部复发（P=0.020）是影响转移性鼻咽癌预后的独立因素。结论：转移性鼻咽癌以化疗为主的综合治疗并未提高总生存率。性别、有合并局部复发是影响转移性鼻咽癌预后的独立影响因素。     

高原军事卫生防护任职教育教学效果调查与思考

的　了解高原军事卫生防护任职教育教学效果,为教学方法改革提供依据。方法　采用调查问卷的方法,调查对象为2015至2017年参加高原军事卫生防护培训班的55名学员,调查内容包括教学效果、课程设置、教学方法以及意见建议。调查结果使用SPSS 18.0进行数据处理,结果以人数和率来表示。结果　发放问卷55份,有效问卷回收率100%。69.1%的学员认为参加该培训班很有收获,67.3%的学员认为参加该培训班对提高岗位任职能力很有帮助,71.8%的学员认为知识模块的设置很有必要。学员希望采取的授课方式依次是案例教学、实训教学、研讨交流、教员讲授、参观教学、装备教学、文献学习。结论　高原军事卫生防护培训班课程设置比较合理、对提高岗位任职能力很有帮助,任职培训学员更希望采取灵活多样的授课方式。高原军事卫生防护任职培训班人数不多,适合尝试教学方法改革。