上海市某三甲医院放射防护管理工作的探索

作为医院诊疗的重要组成部分,随着现代医学技术的高速发展,越来越多的放射源和放射诊疗设备应用于临床,放射诊疗类别增加,放射工作人员数量增多,放射诊疗规模不断扩大,对放射防护管理工作提出了新的挑战,放射防护管理工作的系统性和整体性愈发重要.为加强医院放射防护管理,提高工作效率,保障放射工作人员职业健康,结合实际工作需求,本...     

An Engineering Model of Dynamic Cardiomyoplasty. II. Clinical Applications

Previously, a modification to the Sunagawa engineering model for the isolated left ventricle and arterial system was proposed and validated for dynamic cardiomyoplasty in an acute goat preparation. To test the hypothesis that this model may be applied to the clinical scenario in cardiomyoplasty patients, we predicted human stroke volume using the model with human clinical data from the literature. Predicted stroke volume correlated well with published stroke volume in patients who have had the dynamic cardiomyoplasty procedure. These results suggest that the modest hemodynamic improvement commonly reported after the procedure is performed may be due to diminished latissimus dorsi strength after transformation. The validity of both the original Sunagawa model and the previously proposed modification for dynamic cardiomyoplasty is further supported with these results. A nomogram methodology for predicting stroke volume after dynamic cardiomyoplasty for any particular patient is presented.     

2006年-2019年广东省中医医疗发展状况评价研究△

目的：了解2006年-2019年广东省中医医疗的发展状况,分析广东省中医药强省政策的实施成效,为广东省中医药事业持续健康发展提供参考。方法：选取《全国中医药统计摘编》和《广东省中医统计信息汇编》中广东省中医医疗发展状况的关键指标及其数据,与省内医疗发展状况的平均水平和国内中医医疗发展的平均水平对比。结果：2006年-2019年广东省建设中医药强省政策成效显著,中医药医疗服务能力稳步提升,但省内各地区间中医医疗发展水平仍存在明显差距,且广东省的中医卫生资源优势在全国范围内并不明显。结论：建议我省加大对发展中医药卫生事业的投入,鼓励卫生资源的分配向粤东、粤西和粤北等欠发达地区倾斜,补齐我省中医医疗服务的短板,缩小我省不同地区间中医医疗服务水平的差距。     

277例梅毒患者规范驱梅后血清TRUST转阴影响因素分析

目的探索梅毒患者血清TRUST转归的影响因素。方法对2011年4月—2014年6月深圳市南山区慢性病防治院首次确诊及治疗并随访24个月的277例梅毒患者进行调查,使用Cox比例风险回归模型分析梅毒患者血清TRUST转归的影响因素。结果不同性别、年龄、婚姻、文化程度和是否合并HIV感染的梅毒患者血清TRUST转阴情况之间差异均无统计学意义(P0.05);不同诊断分期和初始TRUST滴度梅毒患者转阴情况之间差异均有统计学意义(P0.05)。Cox比例风险回归模型分析结果显示:一期梅毒患者比隐性梅毒患者血清TRUST更易转阴(RR=3.04,95%CI:1.95~4.73;P0.05),初始TRUST滴度≤1∶8患者比滴度1∶8患者血清TRUST更易转阴(RR=2.34,95%CI:1.40~3.91;P0.05)。结论梅毒的诊断分期和初始血清TRUST滴度是影响梅毒预后的独立影响因素。     

Di(2‐ethylhexyl) phthalate induces apoptosis through mitochondrial pathway in GC‐2spd cells

Di(2‐ethylhexyl) phthalate (DEHP), a plasticizer of synthetic polymers, is a well‐known endocrine disrupting chemical (EDC) and reproductive toxicant. Addressing the unclear mechanism of DEHP‐induced reproductive dysfunction, this study used GC‐2spd cells to investigate the molecular mechanism involved in the DEHP‐induced toxicity in the male reproductive system. The results indicated that the apoptotic cell death was significantly induced by DEHP exposure over 100 μM. Furthermore, DEHP treatment could induce oxidative stress in GC‐2spd cells involving in the decrease of superoxide dismutase (SOD) activity (200 μM) and glutathione peroxidase (GSH‐Px) activity (50 and 100 μM). In addition, DEHP induction also caused the elevated ratios of Bax/Bcl‐2, release of cytochrome c and decomposition of procaspase‐3 and procaspase‐9 in GC‐2spd cells. Taken together, our work provided the evidence that DEHP exposure might induce apoptosis of GC‐2spd cells via mitochondria pathway mediated by oxidative stress. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 1055–1064, 2017.     

Role of midkine-progranulin interaction during angiogenesis of hepatocellular carcinoma

Midkine (MK) is a heparin-binding growth factor involved in growth, survival, migration, and differentiation of various target cells and dysregulation of MK signaling is implicated in a variety of inflammatory diseases and cancers. Although MK has been reported to act on endothelial cells and to have proangiogenic effects, the exact role of MK in angiogenesis is poorly defined. Progranulin (PGRN) is a secreted glycoprotein that functions as an important regulator of development, cell cycle progression, cell motility, tumorigenesis, angiogenesis. We screened the PGRN from the hepatic cancer cell cDNA library which was interacted with MK, and confirmed the binding by co-immunoprecipitation and co-localization. During our study, the interaction between MK and PGRN had the important role on the HUVECs proliferation, migration, and tubulogenesis, which indicated the interaction may regulate the angiogenesis, also the in vivo angiogenesis model CAM showed the promotion effect stimulated by MK and PGRN. These findings provide the first evidence linking the association of MK and PGRN and may identify the mechanism of MK during the hepatocellular carcinoma angiogenesis.     

血液病家族新成员——易栓症

易栓症（tromobophilia）一词于1965年由Egeberg在报道一个家族性抗凝血酶（AT）缺陷症时首先提出^[1]，意为血栓形成的倾向性增高。在相当一段时间内其成为遗传性抗凝功能缺陷的代名词，近些年来研究发现其发生多与机体的止凝血机制异常有关，故将其归类于血液病范畴。     

现代教学模式下中医院校超声医学教学经验探讨

在现代医学中，超声医学日渐重要，发展、知识更新迅速，学科的实践性和操作性较强，而中医院校学生西医基础学科相关知识的掌握还存在一定不足之处，因此进行临床教学极为关键，在实际教学过程中应当通过多样化的教学方式促使学生逐步提升自身能力，锻炼学生分析问题、解决问题的能力、应变能力、临床思维，并有效改善教学质量，为医学生后续走向临床奠定良好基础。     

Community-acquired pneumonia with Acinetobacter radioresistens bacteremia in an immunocompetent host:A case report

Rationale: Acinetobacter radioresistens is a non-fermentative Gram-negative coccobacillus that is environmentally ubiquitous and is an uncommon cause of pneumonia in an immunocompetent patient with no known chronic medical illness. Patient concerns: A middle-aged Asian male with a smoking history presented with fever and cough. Physical examination was unremarkable. Chest imaging was consistent with pulmonary parenchymal infection and blood culture grew Acinetobacter radioresistens. Diagnosis: Community acquired pneumonia with Acinetobacter radioresistens bacteremia.Interventions: The patient received a combination of intravenous and oral ampicillinsulbactam over 2 weeks.Outcomes: Repeat blood cultures showed resolution of bacteremia. Completion of antimicrobial treatment saw resolution of respiratory symptoms and radiological pneumonic changes. Lessons: Acinetobacter radioresistens causing community-acquired pneumonia in an immunocompetent host has never been described before. It may be a novel emerging infectious agent in pulmonary infections. Its clinical course in this immunocompetent patient appears to be relatively benign.