运用精益生产管理理念稳定发展护理队伍初探

分析目前国内护理队伍组织管理方面存在的不足,总结目前医院日常管理存在的关键问题,提出了运用精益生产管理理念来实施"禀议制度"、"轮调制度"、"年功序列制"等7条具体措施以稳定发展护理队伍并取得了较好效果,提高了护士积极性和主动性,稳定了护理队伍发展。     

miRNA分子在肺结核患者单核细胞中的表达及意义

目的分析肺结核患者(TB)外周血单核细胞中miR-34a-5p和miR-708-5p的表达水平,并探讨其临床诊断价值。方法选取TB患者和健康对照(HD)各25例,应用Taq Man q PCR技术测定两组人群外周血单核细胞中miR-34a-5p和miR-708-5p表达水平,以U6 sn RNA作为内参。应用ROC曲线评价miR-34a-5p和miR-708-5p诊断TB的临床意义。结果 miR-34a-5p在TB患者中的表达水平为(10.08±0.68),显著高于HD的(7.67±0.36),差异有统计学意义(P<0.01);miR-708-5p在TB患者中的表达水平显著高于HD的(13.52±0.98 Vs 7.71±0.57),差异有统计学意义(P<0.01)。ROC曲线分析表明在肺结核诊断中,miR-34a-5p的敏感性、特异性分别为72%、76%;miR-708-5p的敏感性、特异性为76%、76%。结论 miR-34a-5p和miR-708-5p分子在TB患者外周血单核细胞中异常表达,对TB辅助诊断具有一定参考价值。     

Minocycline Attenuates Microglial Response and Reduces Neuronal Death after Cardiac Arrest and Cardiopulmonary Resuscitation in Mice

The possible role of minocycline in microglial activation and neuronal death after cardiac arrest(CA) and cardiopulmonary resuscitation(CPR) in mice was investigated in this study. The mice were given potassium chloride to stop the heart beating for 8 min to achieve CA, and they were subsequently resuscitated with epinephrine and chest compressions. Forty adult C57BL/6 male mice were divided into 4 groups(n=10 each): sham-operated group, CA/CPR group, CA/CPR+minocycline group, and CA/CPR+vehicle group. Animals in the latter two groups were intraperitoneally injected with minocycline(50 mg/kg) or vehicle(normal saline) 30 min after recovery of spontaneous circulation(ROSC). Twenty-four h after CA/CPR, the brains were removed for histological evaluation of the hippocampus. Microglial activation was evaluated by detecting the expression of ionized calcium-binding adapter molecule-1(Iba1) by immunohistochemistry. Neuronal death was analyzed by hematoxylin and eosin(H&E) staining and the levels of tumor necrosis factor-alpha(TNF-α) in the hippocampus were measured by enzyme-linked immunosorbent assay(ELISA). The results showed that the neuronal death was aggravated, most microglia were activated and TNF-α levels were enhanced in the hippocampus CA1 region of mice subjected to CA/CPR as compared with those in the sham-operated group(P<0.05). Administration with minocycline 30 min after ROSC could significantly decrease the microglial response, TNF-α levels and neuronal death(P<0.05). It was concluded that early administration with minocycline has a strong therapeutic potential for CA/CPR-induced brain injury.     

细胞因子CCL25对鼻咽癌CNE-2细胞迁移的影响

目的:研究CCL25是否影响鼻咽癌CNE-2细胞的迁移。方法:采用Transwell实验,上室中加入CNE-2细胞,下室中加入不同浓度的CCL25,观察其对CNE-2向下室迁移的影响。另外同时在下室中加入anti-CCR9,再观察CNE-2向下室的迁移情况。结果:CCL25具有趋化CNE-2细胞的作用,同空白对照组相比,50ng/ml的CCL25能明显增强CNE-2细胞的迁移率(P<0.01)。而1μg/ml的anti-CCR9能逆转CCL25对CNE-2细胞的促迁移作用(P<0.05)。结论:CCL25具有趋化CNE-2细胞,促进CNE-2细胞迁移的作用。Anti-CCR9能阻断CCL25对CNE-2细胞的促迁移作用。     

生物羊膜移植与带角膜缘的自体结膜移植治疗翼状胬肉的疗效观察

目的 观察生物羊膜移植和带角膜缘的自体结膜移植两种手术方式治疗翼状胬肉的疗效.方法 77例(101只眼)患者随机分为两组,A组40例(52只眼)行翼状胬肉切除联合生物羊膜移植,B组37例(49只眼)行翼状胬肉切除联合带角膜缘的自体球结膜移植,术后炎症明显者加用0.02％丝裂霉素C点眼.术后随访10～36个月,观察两组复发率,比较两组角膜创面修复时间和术后使用丝裂霉素C的情况.结果 A组8只眼复发,复发率15.38％,B组2只眼复发,复发率4.08％;A组术后角膜创面平均修复时间(4.48 ±0.87)d,B组术后角膜创面平均修复时间(4.04±1.10)d,二者间差异有统计学意义(t=2.23,P＜0.05);A组术后使用丝裂霉素C 14只眼(26.9％),B组术后使用丝裂霉素C3只眼(6.12％),二者间差异有统计学意义(x2=7.80,P＜0.01).结论 生物羊膜或者是带角膜缘的自体结膜移植,联合术后丝裂霉素C点眼均能减少翼状胬肉切除术后复发,但带角膜缘的自体球结膜移植术后角膜修复时间更短,局部炎症反应更轻.     

孕早期血清HCY及叶酸水平与原因不明自然流产的关系

目的探讨孕早期血清同型半胱氨酸(homocysteine,HCY)及叶酸水平与原因不明自然流产的关系。方法分析2013年1月至2014年1月深圳市妇幼保健院接受常规孕检的1 315例孕早期(孕周≤10周)孕妇的临床资料,按是否出现原因不明自然流产,将孕妇分为观察组(82例)和对照组(1 233例),采用单因素分析及多因素Logistic回归分析原因不明自然流产危险因素;以对照组血清HCY及叶酸水平的第10或90百分位数为界值,比较不同水平组原因不明自然流产的发病风险。结果年龄、孕次、自然流产史、孕前低体重、高HCY血症(OR=2.667,P0.05)为原因不明自然流产危险因素,围孕期服用叶酸、高血清叶酸水平(OR=0.228,P0.05)为其保护因素。血清叶酸低水平或血清高HCY水平的孕妇,其原因不明自然流产危险性均高于相关指标正常孕妇(OR=2.4、1.7,P0.05)。结论孕早期高血清HCY、低血清叶酸水平均可能导致原因不明自然流产发生危险增加,联合检测两项指标可能有助于识别高危孕妇。     

多层螺旋CT灌注成像对脾脏疾病诊断的应用研究

目的研究多层螺旋CT灌注成像对脾脏疾病诊断的应用价值。方法选择我院2013年4月至2014年8月肝硬化门脉高压脾大患者16例设为A组;脾脏结节或肿块患者19例为B组,其中脾脏淋巴瘤6例为B1组,白血病脾浸润患者5例为B2组,脾脏转移瘤8例为B3组;同时选择健康体检者20例为对照组。比较正常脾脏组织和脾脏疾病的血流灌注特点,分析CT灌注成像的检出率,并比较各组脾脏肿块患者的血流灌注参数。结果 A组门脉和脾脏灌注量明显高于对照组(P<0.05)。CT灌注成像检出率明显高于CT平扫(P<0.05)。脾脏肿块患者TIP、MTT明显高于对照组,BF、PEI、BV明显低于对照组,各组与对照组比较差异具有统计学意义(P<0.05)。结论多层螺旋CT灌注成像对脾脏疾病诊断具有较高的临床应用价值。     

Interlayer coupling and the phase transition mechanism of stacked MoS2/TaS2 heterostructures discovered using temperature dependent Raman and photoluminescence spectroscopy

Ultrathin 1T (tetragonal)-TaS₂ and monolayer MoS₂ heterostructures were prepared to study their phase transition (PT) mechanisms and band structure modulation. The temperature dependency of photoluminescence (PL) and Raman spectra was utilized to study interlayer coupling and band structure. The PL results indicate that the band structure of MoS₂/TaS₂ heterostructures undergoes a sharp change at 214 K. This is attributed to the PT of 1T-TaS₂ from a Mott insulator state to a metastable state. In addition, the temperature dependency of the MoS₂/TaS₂ Raman spectra illustrates that the phonon vibration of the heterojunction is softened due to the effect of interlayer coupling. The present work could provide an avenue to create material systems with abundant functionalities and physical effects.

The important interlayer coupling of the MoS₂–TaS₂ heterostructure and the phase transition mechanism of ultrathin 1T-TaS₂ are described.     

辽宁省2009～2013年疑似预防接种异常反应监测分析

目的分析辽宁省2009~2013年疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)的发生特点,评价AEFI信息管理系统(Information Management System,AEFIIMS)运转质量和上市后疫苗的安全性。方法采用描述流行病学方法对辽宁省2009~2013年AEFIIMS个案数据进行分析。结果辽宁省2009~2013年报告AEFI5548例。其中一般反应占93.35%,异常反应占4.74%;治愈或好转的病例占93.96%;发生在婴儿的占69.05%;不良反应发生在接种后≤1天的占75.78%。辽宁省2009~2013年预防接种异常反应估算报告发生率为4.49/100万剂~9.14/100万剂。结论辽宁省2009~2013年AEFIIMS运转质量逐年提高。主要为预后较好的一般反应;常发生在1岁儿童;接种后≤1天;为监测重点。各疫苗预防接种异常反应估算报告发生率低于预期水平。