电子病历书写的质量管理与对策

目的 探讨和总结电子病历（Eleetronic Medical Record,EMR)使用中医生记录的质量控制方法。方法 对EMR中医生记录进行质量分析，找出存在的常见主观性和客观性错误，采用软件设计与建立管理制度的方法提高质量。结果 通过改进软件设计和建立健全规章制度可以达到EMR质量控制。     

化学诱导大鼠多发肾囊肿伴肾肿瘤及肾组织DNA损伤的表达

目的 观察化学药物大鼠多发肾囊肿伴肾肿瘤模型的诱发情况和ＤＮＡ损伤标记物８－羟基脱氧鸟苷（８－ＯＨｄＧ）在其肾组织的表达。方法 用２－氨基４,５－二苯噻唑（ＤＰＴ）和Ｎ－亚硝基吗啉（ＮＮＭ）诱发和人类获得性肾囊肿（ＡＣＤＫ）伴肾癌相似的大鼠动物模型,并用免疫组化方法（ＬＳＡＢ法）检查８－ＯＨｄＧ在大鼠肾组织的表达。结果在本实验中,ＮＮＭ组３／１０的大鼠诱发肾肿瘤出现,在ＤＰＴ／ＮＮＭ组的９只大鼠均     

Serum antibodies to JC virus, BK virus, simian virus 40, and the risk of incident adult astrocytic brain tumors.

Genomic sequences of the human polyomaviruses, JC virus (JCV) and BK virus (BKV), and simian virus 40 (SV40) have been reported from several types of human brain tumors, but there have been no population-based seroepidemiologic studies to evaluate the association between polyomavirus infection and brain tumors. We conducted a case-control study, nested within a prospective cohort, to investigate the association between antibodies to JCV, BKV, and SV40, as measured in serum collected 1-22 years before diagnosis and incident primary malignant brain tumors. Brain tumor cases (n = 44) and age-, gender-, and race-matched controls (n = 88) were identified from participants of two specimen banks in Washington County, Maryland. IgG antibodies to the capsid proteins of JCV and BKV were assessed using ELISAs. SV40-neutralizing antibodies were measured using plaque neutralization assays. Similar to the general population, the prevalence of JCV and BKV infection was high in our study population (77 and 85%, respectively). Antibodies to SV40 were less prevalent (11%). The odds ratio for subsequent brain tumor development was 1.46 [95% confidence interval (CI), 0.61-3.5] for JCV, 0.66 for BKV (95% CI, 0.22-1.95), and 1.00 for SV40 (95% CI, 0.30-3.32). Given the high prevalence of JCV and BKV infections and the millions who were potentially exposed to SV40 through contaminated polio vaccines, future studies should attempt to replicate these findings.     

STUDIES OF THE CHARACTERISTIC FEATURES OF KI-1 POSITIVE NON-HODGKIN'S LYMPHOMA

Ki-lantigen(CD3o)waslO5oOo/12oooOglycoproteindistinguishedbymonoclonalantibodyKi-lwhichwasmadefromHodgkin'sdisease(HD)cellsstrainL-428,'eXPressedonHDcellsandReed-Sternberg(R-S)cellsatfirstthoughtItwasfoundbySteinandothersinl985,whonamedKi-lstrongpositiveNHLasKi-llymphoma,thatKi-lantigenwasalsoexpressedonsomeNHL.2Theresearchesonthisspecialtypeoflymphomahavealreadyappearedabroad.WehavecollectedfivecasesofKi-lpositiveNHLandnowdiscusstheirclinicalhistopathologicalandimmunophenotypicfe…     

御感速袋泡剂质量标准的研究

御感速袋泡剂按新药审评标准进行了质量标准的研究，鉴别项下除建立了显微方法外还建立了柴胡皂甙ａ，ｄ，连翘甙，葛根素，青蒿的薄层鉴别方法。用ＨＰＬＣ对黄芩甙和葛根素进行了含量测定。     

Platelet proteins as autoantibody targets in idiopathic thrombocytopenic purpura

Idiopathic thrombocytopenic purpura (ITP), caused by autoantibodies directed against certain platelet antigens, is the most common entity of the immune thrombocytopenias. ITP is an acquired disorder and can affect both children and adults. However, the clinical syndromes of ITP are distinct between children and adults. Childhood (acute) ITP characteristically is acute in onset, occurs within 1-2 weeks of an infection, usually of viral origin, resolves spontaneously within 6 months. Adult (chronic) ITP has an insidious onset and rarely resolves spontaneously. Over the last decade considerable new information has accumulated as to the pathophysiological mechanisms of immune thrombocytopenias. In addition, most of the knowledge on this disorder has been obtained from studies of adult patients with chronic ITP. The present work gives an updated overview of the platelet autoantigens and the molecular immunological reactions in ITP.     

Unusual features in children with inv dup(15) supernumerary marker: a study of genotype-phenotype correlation in Taiwan

Recent molecular cytogenetic studies have elucidated the origin and nature of extra structurally abnormal chromosomes (ESACs) or small supernumerary chromosomes, which are often associated with developmental delay and malformations. We studied the prevalence of inv dup(15) in a nationwide screening programme for mentally retarded children in Taiwan and tried to correlate the genotype and phenotype in those patients. Fluorescence in situ hybridization (FISH) analysis using D15Z, D15Z1, and the cosmids from the Prader-Willi/Angelman syndrome chromosome region (PW/ASCR) was performed on 54 patients (0.45%) with ESACs from 11893 probands within a 5-year period. Of them, inv dup(15) was confirmed in 25 children (46.3%) by FISH analysis. The PW/ASCR probes were used to clarify the size and DNA composition of the markers. Patients with inv dup(15) chromosomes, containing only the heterochromatin or little euchromatin of the proximal 15q (i.e., pter→q11:q11→pter) may have a rather mild or nearly normal phenotype (group 1). Only one patient had some features suggestive of Angelman syndrome, but was considered to be a result of deleted (15)(q12) in the chromosome 15 homologue. Additional copies within D15S11 through GABRB3 (15q11.2-13) resulted in an abnormal phenotype which involved mental and developmental delay but was different from the classical phenotype of PW/AS (groups 2, 3). Signs of autistic behavior did occur in each group. FISH combined with microsatellite analyses showed that the marker was often of maternal origin in de novo cases (n = 12, 86%), or inherited from the mother in only one familial case. Down-inv dup(15) was mentioned in two cases. Unusual features including diaphragmatic eventration, hyperlaxity of joints, arachnodactyly, brain atrophy, epilepsy (particularly infantile spasm), ataxia, genital abnormalities, and cleft lip/palate were noted in those patients. This observation expands the range of phenotypic expression associated with this relatively common ESAC. Conclusion Marked phenotypic diversities exist in children with inv dup(15), dependent upon the size or genetic composition of the markers, degree of mosaicism, parental origin and familial occurrence or not. Patients with a larger inv dup(15) marker chromosome including the PW/ASCR may have a higher risk of abnormalities, but not the typical Prade-Willi/Angelman syndrome phenotype. Received: 11 February 1997 and in revised form: 20 May 1997 / Accepted: 20 May 1997     

Spectrum of point mutations in the coding region of the hypoxanthine- guanine phosphoribosyltransferase (hprt) gene in human T-lymphocytes in vivo

The hypoxanthine-guanine phosphoribosyl transferase (hprt) locus in 6- thioguanine (TG) resistant T-lymphocytes is a useful target for the study of somatic in vivo mutagenesis, since it provides information about a broad spectrum of mutation. Mutations in the hprt coding region were studied in 124 TG-resistant T-cell clones from 38 healthy, non- smoking male donors from a previously studied population of bus maintenance workers, fine-mechanics and laboratory personnel. Their mean age was 43 years (range 23-64) and their hprt mutant frequency was 9.3 +/- 5.2 x 10(-6) (mean +/- SD, range 1.4-22.6 x 10(-6)). Sequence analysis of hprt cDNA identified 115 unique mutations; 76% were simple base substitutions, 10% were +/-1 bp frameshifts, and 10% were small deletions within exons (3-52 bp). In addition, two tandem base substitutions and one complex mutation were observed. Simple base substitutions were observed at 55 (20%) of 281 sites known to be mutable in the hprt coding sequence. The distribution of these mutations was significantly different than would be expected based upon a Poisson distribution (P < 0.0001), suggesting the existence of 'hotspots'. All of the 87 simple base substitutions occurred at known mutable sites, but eight were substitutions of a kind that have not previously been reported at these sites. The most frequently mutated sites were cDNA positions 197 and 146, with six and five independent mutations respectively. Four mutations were observed at position 131, and three each at positions 143, 208, 508 and 617. Transitions (52%) were slightly more frequent than tranversions (48%), and mutations at GC base pairs (56%) more common than mutations at AT base pairs (44%). GC > AT was the most common type of base pair substitution (37%). The majority of the mutations at GC base pairs (78%) occurred at sites with G in the non-transcribed strand. All but one of eight mutations at CpG- sites were of the kind expected from deamination of methylated cytosine. Deletion of a single base pair (-1 frameshift) was three times more frequent than insertion of a single bp (+1 frameshift). Almost half (6/13) of the small (3-52 bp) deletions within the coding sequence clustered in the 5' end of exon 2. Short repeats and other sequence motifs that have been associated with replication error were found in the flanking regions of most of the frameshifts and small deletions. However, several differences in the local sequence context between +/-1 frameshift and deletion mutations were also noticed. The present results identify positions 197, 146 and possibly 131 as hotspots for base substitution mutations, and confirm previously reported hotspots at positions 197, 508 and 617. In addition, the earlier notion of a deletion hotspot in the 5'end of exon 2 was confirmed. The observations of these mutational cluster regions in different human populations suggest that they are due to endogeneous mechanisms of mutagenesis, or to ubiquitous environmental influences. The emerging background spectrum of somatic in vivo mutation in the human hprt gene provides a useful basis for comparisons with radiation or chemically induced mutational spectra, as well as with gene mutations in human tumors.      

Compatible leaching effect of Concha Ostreae and some commonly-used Chinese medicinal materials]

OBJECTIVE: Based on a study of Concha Ostreae, to provide some reference for the rational approach to leaching mineral drugs. METHOD: Taking the change rates of compatible leaching and value of A as targets, the compatible leaching effect of Concha Ostreae with Radix et Rhizoma Rhei Praeparata, Radix Scutellariae, Pollen Typhae and Fructus Aurantii lmmaturus was studied. RESULT: If Concha Ostreae and the above cited medicinal herbs are decocted together, the yield of extract may be reduced to a certain extent, but the target composition of Radix et Rhizoma Rhei Praeparata and Fructus Aurantii lmmaturus remains intact, only the content of Radix Scutellariae baicalin may be influenced. CONCLUSION: The relationship of technology with preparation must be taken into consideration when making choice of the proper way to leach Concha Ostreae.     

银杏叶提取物EGb761通过caspase-3抑制TNF-α诱导HeLa细胞凋亡

目的探讨caspase-3的活化在银杏叶提取物EGb761对肿瘤坏死因子-α(TNF-α)诱导HeLa细胞凋亡中的影响.方法采用流式细胞术检测细胞凋亡,Western blot检测caspase-3 p20活性片段,Caspase-3 Colorimetric Assay试剂盒测定caspase-3活性.结果流式细胞术分析结果显示,EGb761在10～40 mg/L终浓度范围内对重组人肿瘤坏死因子-α(rhTNF-α)诱导的HeLa细胞凋亡均有显著的抑制作用(P＜0.01),呈剂量依赖关系;Western blot检测显示,rhTNF-α诱导的HeLa细胞caspase-3 p20活性片段水平增高,能被不同剂量EGb761(10～40 mg/L)明显抑制,且随EGb761浓度增加抑制效果增强;caspase-3活性测定结果显示,EGb761对rhTNF-α诱导的caspase-3活化有显著的抑制作用,且随剂量增加抑制作用增强.结论结果提示,EGb761抑制TNF-α诱导的HeLa细胞凋亡可能与其抑制caspase-3活化有关.