High Expression of Insulin-like Growth Factor Ⅱ (IGF-Ⅱ) Using Bac-to-Bac Expression System

Ｈｕｍａｎｉｎｓｕｌｉｎ ｌｉｋｅｇｒｏｗｔｈｆａｃｔｏｒ Ⅱ (ＩＧＦ Ⅱ )ｉｓａ 6 7ａｍｉｎｏａｃｉｄｓｉｎｇｌｅ ｃｈａｉｎｐｅｐｔｉｄｅ ,ｗｈｉｃｈｉｓｉｎｖｏｌｖｅｄｉｎｆｅｔａｌｇｒｏｗｔｈａｎｄｄｅｖｅｌｏｐ ｍｅｎｔ[1] .Ｔｈｅｇｒｏｗｔｈ ｐｒｏｍｏｔｉｎｇｐｒｏｐｅｒｔｉｅｓｏｆＩＧＦ Ⅱ ,ａｓｗｅｌｌａｓｔｈｅｉｒｓｔｒｕｃｔｕｒａｌｈｏｍｏｌｏｇｙｔｏｐｒｏｉｎｓｕｌｉｎａｎｄＩＧＦ Ⅰａｒｅｒｅｆｌｅｃｔｅｄｉｎｔｈｅｎａｍｅｏｆｔｈｅｐｅｐｔｉｄｅｓ .Ｉｔｉｓａｌｓｏｈｅｌｐｆ…     

Perceptions on the influence of cost issues on quality improvement initiatives: a survey of Saudi health care managers.

OBJECTIVE: To determine (i) the cost issues which Saudi health care managers perceive to influence overall quality improvement initiatives, and (ii) the relationship between health care managers' satisfaction with such initiatives and their perceptions regarding the influence of different cost issues on the overall quality improvement initiatives. DESIGN: Data were collected through a self-administered questionnaire in August and September 1996 in the Western Region of the Kingdom of Saudi Arabia. The participants were 236 health care managers of private hospitals. Data was analysed using the chi2 test. RESULTS: Less than one-half of the health care managers surveyed were satisfied with their hospitals' overall quality improvement initiatives. The issue that was rated to have the most influence on such initiatives was the 'cost of malpractice lawsuits' followed by the budget for the quality assurance programme'. The issue that was perceived to have the least influence on overall quality improvement initiatives was 'data on cost allocation'. Of the 17 cost issues included in the study, eight had statistically significant influence on the health care managers' satisfaction with their hospitals' overall quality improvement initiatives. The most statistically significant was the 'measurement of the costs of quality-related actions'.     

胸锁乳突肌应用解剖学研究

了解胸锁乳突肌和副神经的解剖关系及在痉挛性斜颈中的作用,为手术治疗痉挛性斜颈的切口 和方法提供解剖依据。方法：观测活体成人男女各１００名例胸锁乳突肌长度、宽度,标本６５具（男３５具,女３０具） 该肌长、宽和厚度及其周围结构。结果：见乳突尖向胸锁乳突肌前缘４ ｃｍ（上 １／４下 ３／４交点）和向下至后缘５ ｃｍ （上中１／３交点）处连线深面有副神经（８０％±１５％）,该处是切断胸锁乳突肌及其副神经肌支的最佳部位之一。二腹 肌后腹深面为高位结扎切断副神经点,若再向上易伤颈内静脉。在胸锁乳突肌深面的副神经最大横径为（２．３± ０．５）ｍｍ。结论：沿副神经的体表投影线,设计出和投影线相应的手术切口,切断副神经和部分胸锁乳突肌是治疗痉 挛性斜颈的较好部位。     

抗病毒红藻多糖的提取与测定

从我国沿海红灌中撮的粗多糖,经ＤＥＡＥ－纤维素柱层析得到红藻多糖ＲＰ１实验证实有明显抗病毒作用。通过气相色谱、红外光谱、Ｙａｐｈｅ测定方法,证明红藻多糖ＲＰ１含硫酸基是一种硫酸酯化多糖,其单糖组成为半乳糖和３,６－内醚半乳糖,定量分析含量分别为半乳糖７０．０４％、３,６－内醚半乳糖９．５６％１硫酸基１７．３０％。     

国产房水引流物置入术治疗难治性青光眼远期疗效观察

１９９３年７月～１９９８年１月为１０３例（１０６只眼）难治性青光眼患者施行国产房水引流物（ＨＡＤ）置入术。术后平均随访３２８月。术后１年时平均眼压２２±１．４ｋＰａ。术后１～５年的手术成功率分别为８３８％,８０４％,７７１％,７１０％及６４３％。术中联合应用丝裂霉素Ｃ的病例,其术后１年时的成功率为８９５％。术后常见的并发症有持续性浅前房,局限性脉络膜脱离及眼压升高等。认为ＨＡＤ可用于治疗难治性青光眼。     

Patient,Provider, and Treatment Factors Associated with Poor-Quality Care for Schizophrenia

Interventions are needed to improve the quality of care for schizophrenia. However, in designing these interventions it would be helpful to understand better which patients are at highest risk for poor-quality care and why care for this disorder is often of poor quality. We study the extent to which patient and treatment factors are associated with poor-quality care in 224 patients randomly sampled from two mental health clinics. Quality of medication management is evaluated using an established method based on national treatment recommendations. Multivariate regression is used to study the effect of patient and treatment factors on treatment quality, controlling for provider. Risk for poor-quality care was greater for patients who were more severely ill, older, and less compliant with treatment recommendations. There were trends toward poor management of symptoms in men and substance abusers, and poor management of side effects in Black patients. Provision of poor-quality care was associated with failure to document symptoms and side effects in the medical record. Interventions to improve care for schizophrenia should attend to the need for accurate clinical assessment and strategies for managing challenging clinical situations.     

带泵肝胆肿瘤病人再手术时泵的处理

皮下埋藏全植入式抗癌药泵是一种行区域性化疗的装置,术后定期经泵注药,其特点是提高已切除或晚期不能切除瘤灶区域的药物浓度,减少全身副反应,给药方便,自１９９３年８月至１０月完成肝胆恶性肿瘤中埋泵２０５例,其中８例肿瘤复发再次手术,本文介绍再手术时动脉静脉泵和导管处理的经验教训以及泵体的合理安放,避免埋泵的失败。     

视网膜与松果体相关关系研究现状

就近年关于对视网膜与松果体在胚胎期的发生与形成、在成年时期的结构与功能等诸多方面的相似性进行了探讨，同时对两者的相互关系与相互影响进行了分析。随着对该领域不断深入的探讨，将有益于对视觉的重新认识和眼科临床的发展。     

IL-2活化瘤苗对胃癌术后复发和转移的抑制作用

目的观察用细胞因子活化的特异性瘤苗辅助常规化疗,治疗外科手术后临床Ⅲ～Ⅳ期胃癌患者,抑制肿瘤术后复发、转移的临床疗效。方法于外科术后常规化疗结束后2周,用患者自体肿瘤细胞抗原致敏、IL-2活化的树突状细胞(DC)作为瘤苗给患者四肢皮下多点免疫注射1×106/(ml·次),每周1次,每疗程注射4次,0.5年后强化1次。定期胃镜、影象学和肿瘤标志物检查,随访至手术后第2年,观察生存期和生存率。结果经瘤苗治疗后,患者的免疫功能显著改善。术后24个月,瘤苗联合化疗组患者的生存率为50%,血清中CEA和CA724分别为(10±1.5)ng/ml和(5.5±1.5)U/ml,而单纯化疗组患者的生存率为10%,CEA和CA724的水平分别为(77.0±9.4)ng/ml和(55.0±7.6)U/ml;P<0.001。结论特异性瘤苗免疫治疗,能增强胃癌患者术后的特异性抗肿瘤免疫功能,提高手术后化疗疗效,抑制肿瘤复发和转移,能延长患者生存期,提高生存率。