充分发挥绩效考核在医院内部分配中的作用

为深化卫生事业单位人事制度改革，建立具有激励作用的分配制度、真正体现按劳分配与按生产要素分配相结合的精神，切实打破目前分配中存在的平均主义、大锅饭现象，进一步调动广大卫生工作人员特别是专业技术人员的积极性、创造性，促进医疗卫生事业健康发展，我院自2002年2月份起根据中组部、人事部、卫生部《关于深化卫生事业单位人事制度改革的实施意见》，在推行以岗位绩效工资为主体的分配形式等方面做了一些有益的探索与实践。     

α-平滑肌肌动蛋白和β-肌动蛋白在瘢痕组织中的表达

目的 探讨α-平滑肌肌动蛋白(α-SMA)和β-肌动蛋白(β-actin)对增生性瘢痕形成的可能作用。方法 采用荧光定量PCR法检测10例增生性瘢痕和10例正常皮肤组织中α-SMA和β-actin的表达水平。结果 增生性瘢痕组织中α-SMA和β-actin表达水平均高于正常皮肤组织,差异有统计学意义(P<0.01)。结论 α-SMA和β-actin在瘢痕增生中起重要作用;由于β-actin在瘢痕组织和正常皮肤中的不恒定性,建议在瘢痕的mRNA定量研究中不作为内参照物。     

鞘内注射吗啡加可乐定对切口痛大鼠脊髓背角蛋白激酶A催化亚单位表达的影响

Objective To observe the effect of intrathecal clonidine plus morphine on expression of protein kinase A (PKA) catalytic subunit in the spinal dorsal horn in a rat model of incisional pain. Methods Eighty male Sprague-Dawley rats were divided randomly into five groups: sham group, control group, pre-incisional morphine 2.5 μg group, pro-incisional clonidine 5 μg group and preincisional morphine 2.5 μg plus clonidine 5 lag group (n=16). lntrathecal catheter and the model of incisional pain were pro-duced according to Yaksh and Brennan's described method respectively. Changes of pain behavior were assessed by mechanical with-drawal threshold (MWT) and thermal withdrawal latency(TWL). The expressions of PKA catalytic subunit in the spinal dorsal horn were assessed by immunohistochemical method and western blotting analysis. Results Compared with sham group, MWT and TWL in control group were decreased significantly at 2 h after incision (P<0.01) and the number of positive cells and protein expression of PKA catalytic subunit in the spinal dorsal horn were increased significantly in control group (P<0.01). Compared with control group, MWT and TWL in pre-incision morphine 2 μg plus clonidine 5 lag group were increased significantly at 2 h after incision (P<0.01) and the number of positive cells and protein expression of PKA catalytic subunit in the spinal dorsal horn were decreased significantly in pre-incision morphine 2 μg plus clonidine 5 μg group (P<0.01). However, MWT, TWL and the number of positive cells and pro-tein expression of PKA catalytic subunit in the spinal dorsal horn changed with no statistical significance in pre-incisional morphine 2.5 μg group and pre-incisional clonidine 5 μg group compared with control group. Conclusion lntrathecal clonidine significantly enhances the antinociceptive effect of intrathecal morphine in a rat model of incisional pain, which might be associated with inhibi-tion of the increased expression of PKA catalytic subunit in spinal cord.     

儿童胫腓骨骨折的治疗

目的探讨儿童胫腓骨骨折的治疗方法。方法应用手法复位石膏固定15例，手术切开复位钢板内固定39例。结果随访2—4个月，均获骨性愈合，无骨感染、骨外露、肢体肿胀、关节僵硬。结论手法复位、石膏固定和手术切开复位、钢板内固定疗效确切、操作简单、取材方便，适合于基层医院使用。     

发挥远程教育优势推进医学继续教育发展

《教育部关于加强高校网络教育学院管理提高教学质量的若干意见》中强调指出：高校网络教育学院要以在职人员的继续教育为主，要充分发挥网络教育的优势，为在职人员更新知识、增强技能、不断学习、不断提高提供良好的服务。然而，要使医学院校在开展继续教育中发挥更大的作用，推进医学继续教育的发展，远程教育不仅是解决这一问题的有效途径，而且将成为开展医学继续教育的强大动力。     

前列肿消栓的部分药理学及病理学研究

目的:探讨前列肿消栓治疗慢性前列腺炎的药理学作用。方法:1,急性毒性及直肠粘膜刺激性试验;2,对角叉菜所致小鼠足跖肿胀的影响;3,对非细菌性前列腺炎病理模型影响的预试验。结果:前列肿消栓对直肠粘膜无刺激性,最大给药量为233.8g/kg(原生药);该栓剂能明显抑制角叉菜所致小鼠足跖肿胀;病理检查结果显示:前列肿消栓能明显减轻前列腺腔内及间质的炎细胞浸润,抑制纤维母细胞的增生,改善腺腔的分泌。结论:前列肿消栓具有明显的抗炎作用;对直肠粘膜无刺激性,最大给药量为233.8g/kg(原生药),按成人体重60kg计算,小鼠最大给药量相当于成人日用量的139.5倍,可以提供临床应用。     

补中益气汤加味治疗5-HT3受体拮抗剂引起的便秘

化疗是晚期肿瘤患常用的治疗方法，但化疗易引起呕吐，严重频繁呕吐不能进食。新型止吐药5-HT，受体拮抗剂的副作用之一为便秘，1日内多次使用5-HT，受体拮抗剂易发生便秘。2002年6月～2004年6月，笔应用补中益气汤加味治疗5-HT，受体拮抗剂引起的便秘53例，取得了较好疗效，现报道如下。