工作分析——医院人力资源管理的核心作业链

随着社会主义市场经济体制的建立和发展,医疗行业的市场化步伐日益加快,对医疗行业的传统管理模式带来了全方位、持久性的冲击和挑战。以人力资源为核心的现代医院管理模式是推动医院发展的决定性因素,而在现代医院管理模式中,只有运用好工作分析这条深化医院人力资源管理模式改革的核心作业链,才能从根本上将传统模式的人事管理机制调整到与社会主义市场经济相匹配的现代管理模式上来,成为医院整体战略目标实现的强有力支持。     

原位PCR检测肾组织内的乙型肝炎病毒

采用原位ＰＣＲ技术检测了肾小球肾炎患者活体组织。证实乙型肝炎病毒＜ＨＢＶ＞相关性肾脏中ＨＢＶ的存在。从分子病理学水平为探讨ＨＢＶ相关性肾炎发病机理提供了新的依据。     

Transplantation of Human Bone Marrow Mesenchymal Stem Cell Ameliorates the Autoimmune Pathogenesis in MRL/Ipr Mice

Recent evidence indicates that mesenchymal stem cells （MSC） possess immunosuppressive properties both in vitro and in vivo. We previously demonstrated the functional abnormality of bone marrow derived MSC in patients with systemic lupus erythematosus （SLE）. In this study, we aimed to investigate whether transplantation of human bone marrow derived MSC affects the autoimmune pathogenesis in MRL/Ipr mice. We found that human MSC from healthy donors reduced the proliferation of T lymphocytes from MRL/Ipr mice in a dose-dependent fashion. Two weeks after in vivo transfer of MSC, we detected significantly reduced serum levels of anti ds-DNA antibodies and 24 hour proteinuria in MRL/Ipr mice as compared with control groups without MSC transplantation. Moreover, flow cytometric analysis revealed markedly reduced number of CD4＋ T cells while increased Thl subpopulation in MSC group and MSC ＋ CTX group when compared with controls. Histopathological examination showed significantly reduced renal pathology in MSC-treated mice. Immunohistochemical studies further revealed reduced expression of TGF-~, FN, VEGF and the deposition of complement C3 in renal tissue after MSC and MSC ＋ CTX treatment. Taken together, we have demonstrated that transplantation of human MSC can significantly inhibit the autoimmune progression in MRL/Ipr mice. Cellular ＆ Molecular Immunology. 2008;5（6）：417-424.     

胸腺肽α1联合大剂量地塞米松治疗慢性特发性血小板减少性紫癜的疗效分析

目的探讨胸腺肽α1（Tα1）联合大剂量地塞米松（Dex）短程冲击治疗初治慢性特发性血小板减少性紫癜（ITP）的疗效及其细胞免疫机制。方法（1）66例初诊ITP患者口服Dex 40mg/d,连用4d;其中39例同时给予Tα1 1．6mg皮下注射,每周3次,连续应用4周。（2）ELISA法检测正常对照组20例及初诊ITP患者治疗前后血浆Tα1、IFNγ、IL-2、IL-4、IL-10及转化生长因子（TGF）-β1水平。结果（1）Tα1＋Dex联合治疗组与Dex单药治疗组,完全缓解（CR）率分别为76．9％（30／39）、44．4％（12／27）（P〈0．05）;长期反应率分别为61．5％（24／39）、34．6％（9／26）,复发率分别为38．5％（15／39）、65．4％（17／26）,差异均有统计学意义（P〈0．05）。（2）Tα1＋Dex治疗后Tα1水平为（1．83±1．22）μg/L较治疗前（2．43±1．47）μg／L明显降低（P〈0．05）。（3）Tα1＋Dex治疗后患者IFNγ和IL-2的血浆水平[（11．57±4．33）、（14．56±10．76）]ng／L均较治疗前[（22．71±7．98）、（28．42±11．27）]ng／L显著降低（P〈0．01）,且与正常对照组比较[（10．23±3．97）、（8．73±8．22）]ng／L,差异无统计学意义（P〉0．05）。IL-4和IL-10的血浆水平[（9．87±4．82）、（7．90±2．71）]ng／L均较治疗前[（5．93±3．85）、（3．24±1．36）]ng／L明显升高（P〈0．05）,且与正常对照组比较,差异无统计学意义（P〉0．05）。（4）Tα1＋Dex治疗后患者血浆TGF-β1水平（4．19±1．80）μg/L较治疗前（1．31±0．71）μg／L明显升高（P〈0．01）。（5）Tα1＋Dex治疗后患者Tα1水平与TGF-β1含量之间呈显著正相关（r=0．6028,P〈0．05）。结论（1）Tα1＋Dex联合治疗可以纠正ITP患者体内Th1／Th2平衡紊乱,减少血小板破坏,其CR率高、复发率较低且耐受性好,可作为ITP治疗的一种新的尝试。（2）Tα1＋Dex治疗后患者Tα1水平与作为Th3特异性标志的TGF-β1之间呈显著正相关,可能与NK细胞的生理性抑制功能上调有关。     

Synthesis and Study of Copolymers Bearing Two Coumarin Side Groups in Monomer Unit: Toward Photoalignment of Liquid Crystals

Photodimerization of coumarin derivatives in photoactive polymers under linearly polarized UV (LPUV) light irradiation is a photochemical reaction often used to prepare the surface alignment layer that can orient liquid crystals (LCs) due to the anisotropic interfacial interactions. Herein, the synthesis of a series of novel coumarin-containing copolymers and their use for the photoalignment surface layer of LCs is reported. These copolymers have the particular feature of bearing two coumarin side groups in each monomer unit, which is designed to have a high content of the chromophores. The alignment of LCs induced by the photoalignment layers of the coumarin-containing copolymers is investigated. It is found that the photoalignment layers can effectively induce orientation of LC molecules along the direction of the UV light polarization used to prepare the surface layers, with an order parameter of around 0.5 achieved by adjusting the preparation conditions. Moreover, the electro-optical behaviors of LC cells made with the photoalignment layers are investigated, confirming the alignment of LCs without the use of rubbed surfaces. Optically inscribing the photoalignment layer for nonuniform and organized LC alignment is also demonstrated.     

大鼠种植性CBRH-7919肝癌模型的MRI、数字减影血管造影及病理学表现

背景：大鼠种植性CBRH-7919肝癌模型是肝癌实验性治疗和影像学诊断研究重要的工具,但模型建立后如何对模型进行检测和验证鲜有报道。 目的：通过彩色超声、MRI及肝动脉血管数字减影血管造影检查的方法来检测和验证Wistar大鼠种植性CBRH-7919肝癌模型,并探讨大鼠种植性CBRH-7919肝癌模型的影像学及病理表现。 方法：CBRH-7919大鼠肝癌细胞瘤株接种裸鼠双侧肩胛部皮下,再将生成的肿瘤组织在开腹直视下移植接种于成年Wistar大鼠肝脏内,建立大鼠种植性CBRH-7919肝癌模型。模型建立4周后用彩超检查、筛选建模成功的Wistar大鼠进行MRI检查、肝动脉血管数字减影血管造影及病理学检查。 结果与结论：在建模成功的35只大鼠中,超声检查发现37个结节,MRI检查发现肝脏内共41个结节,较超声增加4个;最小的结节约3 mm,最大约8 mm。MRI扫描显示T1WI表现为低信号,T2WI及脂肪抑制序列表现高信号。肝动脉血管数字减影血管造影均表现由肝动脉供血的富血供结节。光学显微镜下观察可见肿瘤细胞呈巢状或条块状排列,周围伴行多条血管,肿瘤细胞体积大小不一致,核大而浓染,细胞质少,异型性明显。结果表明彩超和核磁共振扫描是大鼠肝癌检查简单而有效的方法,肝动脉血管数字减影血管造影可以了解肿块的供血动脉及其血供情况。通过对Wistar大鼠种植性肝癌模型的MRI及肝动脉血管数字减影血管造影表现能反映肿瘤的病理形态学和生物学行为改变。     

异位性皮炎血清嗜酸细胞阳离子蛋白水平的检测及意义

目的探讨异位性皮炎(AD)患者的血清嗜酸细胞阳离子蛋白(ECP)、总IgE和外周血嗜酸细胞计数(EOS)之间和疾病严重程度之间的相关性。方法选择门诊就诊的50例AD患者,设30例正常人为对照,同期检测ECP、TIgE和EOS,并对疾病严重程度评分。结果AD患者血清ECP和TIgE水平均明显高于正常对照组(P<0.05)。患者EOS在正常范围之内。ECP与TIgE、EOS之间无相关性,疾病严重程度评分与ECP之间呈正相关(r=0.764,P<0.05),而与TIgE和EOS则无相关性(P>0.05)。结论AD患者血清ECP水平是反映嗜酸粒细胞活化和过敏状态的敏感指标,可更为有效而可靠地监测AD患者病情活动及疗效。     

rhBMP-2、胶原、珊瑚复合人工骨临床研究

目的探讨 rh BMP- 2 /胶原 /珊瑚复合人工骨临床应用的骨修复能力。方法将 rh BMP- 2 /胶原 /珊瑚复合人工骨植入阻生智齿拔除后的牙槽窝内 ,并设单纯珊瑚和空白对照组 ,术后进行临床和 X线检查 ,记录邻近的第二磨牙远中牙槽嵴的高度和第二磨牙的松动度。结果术后 12周复合骨组牙槽窝骨缺损和牙槽嵴高度均得到良好的恢复 ,珊瑚骨组得到较好的恢复 ,而空白对照组结果不明显。结论 rh BMP- 2 /胶原 /珊瑚复合人工骨植入智齿牙槽窝可较好的修复牙槽窝骨缺损。这种新型的复合骨可能是临床应用的一种较理想的生物性植骨材料。     

Preconditioning with hyperbaric oxygen and hyperoxia induces tolerance against spinal cord ischemia in rabbits

BACKGROUND: The aim of this study was to determine if the ischemic tolerance could be induced in the spinal cord by pretreatment with hyperbaric oxygen (HBO) and what components of HBO (hyperoxia, hyperbaricity, and combination of these two) were critical in the induction of tolerance against ischemic injury. METHODS: In experiment 1, 21 rabbits were randomly assigned to one of three groups (n = 7 each): animals in the control group received no HBO before spinal cord ischemia; animals in the HBO-1 and HBO-2 groups received HBO (2.5 atmosphere absolute [ATA], 100% O2) pretreatment 1 h/day for 3 and 5 days before ischemia, respectively. In experiment 2, 48 rabbits were randomly assigned to one of four groups (n = 12 each): the control group received no HBO (21% O2, 1 ATA, 1 h/day, 5 days) before spinal cord ischemia; the HB group received 1-h treatment in 21% O2 at 2.5 ATA each day for 5 days; the HO group received 1-h treatment in 100% oxygen at 1 ATA each day for 5 days; and the HBO group received HBO (2.5 ATA, 100% O2) treatment 1 h/day for 5 days. Twenty-four hours after the last treatment, spinal cord ischemia was induced by an infrarenal aorta clamping for 20 min. Forty-eight hours after reperfusion, hind-limb motor function and histopathology of the spinal cord were examined in a blinded fashion. RESULTS: In experiment 1, the neurologic outcome in the HBO-2 group was better than that of the control group (P = 0.004). The number of normal neurons in the anterior spinal cord in the HBO-2 group was more than that of the control group (P = 0.021). In experiment 2, the neurologic and histopathologic outcomes in the HBO group were better than that of the control group (P < 0.01). The histopathologic outcome in the HO group was better than that in the control group (P < 0.05). CONCLUSIONS: Serial exposure to high oxygen tension induced ischemic tolerance in spinal cord of rabbits. Simple hyperbaricity (2.5 ATA, 21% O2) did not induce ischemic tolerance.     

红霉素环11,12-碳酸酯与罗红霉素双盲双模拟随机对照治疗细菌性感染的临床及细菌学评价

目的 评价红霉素环11，12—碳酸酯治疗呼吸系统和皮肤细菌性感染的安全性与有效性。方法 采用多中心、区组随机化、双盲双模拟对照试验设计，选用罗红霉素作对照药。试验药：红霉家环ll，12—碳酸酯片剂，250～500mg/次，每日2次。对照药：罗红霉素片剂，150～300mg/次，每日2次，疗程均为5～10d。结果 实验组28例(呼吸系统感染17例，皮肤软组织感染ll例)与对照组29例(呼吸系统感染17例，皮肤软组织感染12例)临床总有效率分别为85．71％与82．76％，细菌清除率分别为76％与83．33％，细菌敏感百分率分别为89．36％与72．34％，不良反应发生率分别为12．1％与12．5％，两组比较无统计学差异。结论 红霉素环11，12—碳酸酯治疗细菌性感染安全有效。