虚拟现实技术在心理焦虑治疗中的应用

目前很多学生存在心理焦虑现象，这不仅影响他们的学习成绩，而且影响着他们的身心健康。传统的方法在治疗心理焦虑时效果会受到患者个人因素的影响，利用虚拟现实技术设计一套治疗方案，可以降低在治疗过程中患者个人因素的参与，增加患者对客观因素的感受，从而提高治疗效果。     

镁离子对妊娠期高血压疾病孕鼠胎盘电镜影响的观察

目的：探讨给孕鼠不同含量镁离子鼠粮喂养，观察妊娠期高血压疾病孕鼠的胎盘形态学有何变化。方法：将SD孕鼠于孕龄1-3d随机分成三组，正常孕鼠组、低镁妊高征组、高镁妊高征组，分别给与正常鼠粮、低镁鼠粮、正常鼠粮高镁灌胃喂养，于孕龄19d解剖取胎盘组织进行电镜观察。结果：高镁妊高征组胎盘超微结构与正常孕鼠相近未见明显改变。低镁妊高征组与正常组比较有明显的改变。结论：孕期补镁可逆转妊高征胎盘组织变化，避免妊娠期高血压疾病的发生。     

自体骨髓间充质干细胞移植治疗心肌梗死后心力衰竭的实验及临床研究

目的 观察自体骨髓间充质干细胞(MSCs)移植对心肌梗死后心力衰竭的疗效.方法 选择21只中国小型家猪,应用闭胸经股动脉介入法制作心肌梗死后心力衰竭模型,术后动物左室射血分数(LVEF)<45%、B型钠脲肽(BNP)水平>100pg·ml-1为心力衰竭建模成功.随机将动物分为实验组(n=11)和对照组(n=10),术后2周内实验组及对照组经冠状动脉途径分别移植MSCs及磷酸盐缓冲液,8周后,行心脏彩超、单光子发射型计算机断层扫描(ECT)及BNP检查,观察心功能的改变.同时,选择心肌梗死致心力衰竭[左室射血分数(LVEF)<45%,BNP>100pg·ml-1]患者8例,发病2周内经皮冠状动脉途径植入MSCs,术前及术后8周行心脏彩超、ECT及BNP检查,监测心功能的变化.结果 动物实验组和对照组分别有8头和7头猪造模成功;心脏彩超结果显示:实验组MSCs移植后LVEF由(39±1.70)% 增加至 (51±3.52)%,ECT心血池显像显示LVEF由(35.08±3.12)% 升高至 (52.15±1.21)%,BNP水平由移植前的(298±17)pg·ml-1下降至(87±15)pg·ml-1;对照组以上指标无明显改变.临床观察显示:MSCs移植后患者心脏彩超显示LVEF由(34.06±2.13)%增加至(52.08±1.02)%,ECT心血池显像显示LVEF由(34.12±3.09)%增加至(53.03±1.01)%,BNP水平由(326±34)pg·ml-1降低至(101±7)pg·ml-1.结论 自体MSCs移植是治疗急性心肌梗死后心力衰竭安全、有效的新方法.     

乙肝病毒前S1抗原、乙肝病毒血清标志物和HBV-DNA联合检测的临床应用

目的探讨乙肝病毒前S1抗原（PreS1）、乙肝病毒标志物（HBVM）与乙肝病毒DNA（HBV—DNA）检测三者之间的关系，判断乙肝病毒在体内的复制情况。方法对550例乙型肝炎患者血清，用ELISA方法检测PreS1、两对半标志物，用荧光定量PCR方法定量检测HBV—DNA并分析3者之间的关系。结果HBsAg（＋）、HBeAg（＋）、HBcAb（＋）的模式中，PreS1与HBV-DNA检出率分别为5213％与88．4％，HBsAg（＋）、HbeAb（＋）、HBcAb（＋）的模式中PreS1和HBV—DNA检出率分别为31．1％和47．5％，HBsAg（＋）、HBcAb（＋）的模式中PreS1和HBV-DNA检出率分别为47.3％和63．4％。结论PreS1能较好的反映HBV病毒感染及复制情况，可作为一种新的HBV血清标志物和监测指标，三者联合检测互相补充，更有助于临床疾病的诊治。     

培育医院精神 建设医院文化

医院精神是医院的灵魂和支柱。是医院文化建设的核心内容。本文通过对医院用培育医院精神来统领医院文化建设的回顾，分析了培育医院精神给医院带来的影响和变化，总结了打造“科教、道德、服务、环境”四个“文化”的成功经验和体会。     

Immunogenicity of recombinant GA733-2E antigen (CO17-1A, EGP, KS1-4, KSA, Ep-CAM) in gastro-intestinal carcinoma patients

Targeting the GA733 antigen (also known as CO17-1A, EGP, KS1-4, KSA, Ep-CAM) by monoclonal antibody CO17-1A or anti-idiotypic antibodies mimicking the CO17-1A or GA733 epitope has induced prolonged survival and specific immune responses to the antigen, respectively, in colorectal cancer (CRC) patients. In pre-clinical studies in mice and rabbits, recombinant baculovirus-derived GA733-2E antigen was superior to anti-idiotypic antibodies at modulating specific immune responses. Our aim was to evaluate the immunogenicity and potential toxicity of alum-precipitated GA733-2E in a phase I trial in patients with resected CRC or pancreatic cancer. Six patients with advanced pancreatic carcinoma and 6 with CRC Dukes' stage A, B or C received between 4 and 7 doses of alum-precipitated GA733-2E at 50, 200 or 800 microg/dose at monthly intervals. Antibody binding to GA733-2E or antigen-positive CRC cells was determined, as were antigen-specific proliferative, cytolytic T-lymphocyte and delayed-type hypersensitivity responses. Six of the 12 patients developed antigen-specific humoral immune responses after immunotherapy, and 8 developed cellular immune responses. The overall immune response rate, including patients with humoral and/or cellular immune responses, was 83%. Median overall survival of the CRC and pancreatic cancer patients was 39.8 and 11.2 months, respectively. Following 18 years of single-epitope targeting of the GA733 antigen, immunization of patients against multiple epitopes of the antigen frequently induces an immune response in the absence of significant toxicity, despite relatively widespread expression of this antigen on normal epithelial cells.     

经皮内窥镜引导下胃/肠造口术的临床应用

目的总结经皮内窥镜引导下胃/肠造口的经验,探讨内窥镜置管的技术操作及其适应证、禁忌证和并发症。方法回顾性分析了2001年7月～2007年12月在我院成功实施经皮内窥镜引导下胃/肠造口术的578例患者的临床资料,观察了置管的种类、目的、时间、成功率、并发症及留置时间。结果578例患者中,经皮内窥镜引导下胃造口(PEG)247例,经皮内窥镜引导下胃空肠造口(PEGJ)293例,经皮内窥镜引导下十二指肠造口(PED)4例,直接法经皮内窥镜引导下空肠造口(DPEJ)4例,经皮内窥镜引导下结肠造口(PEC)4例,PEG/J联合食管支架26例。其中,肠内营养329例,减压同时联合肠内营养133例,胃肠减压103例,肠内营养联合胆汁回输5例,围手术期应用4例,顺行灌肠4例。PEG平均操作时间为(7.5±1.9)min,PEGJ为(17.7±4.2)min,DPEJ为(14.8±2.1)min,PED为(12.3±2.5)min,PEC为(11.3±2.6)min,PEG/J联合支架为(30.2±5.2)min。技术成功率为98.0%(578/590),严重并发症发生率1.04%(6/578),轻微并发症发生率6.23%(36/578),平均留置时间(168.37±198.64)d。结论经皮内窥镜引导下胃/肠造口术操作简便、有效、并发症少,易于护理、患者耐受良好、易于接受、可长期带管,适用于肠内营养支持、胃肠减压、胆汁回输、围手术期应用等。     

Summary of Genetic Analysis Workshop 15: Group 9 linkage analysis of the CEPH expression data

Group 9 participants carried out linkage analysis of the Centre d'Etude de Polymorphism Humain (CEPH) expression data, using strategies that ranged from focused investigation of a small number of traits to full genome scans of all available traits. Results from five key areas encompass the most important results within and across the 17 participating groups. First, both extensive genetic heterogeneity and poor predictability of mapping results based on heritability have key implications for study design. Second, choice of the map used for linkage analysis is influential, with the implication that meiotic maps are preferable to physical maps. Third, performance of different analytic methods was in general fairly consistent, with the exception of one variance-component method that uses marker allele sharing as the dependent rather than independent variable. Fourth, multivariate analysis approaches did not generally appear to provide advantages over univariate approaches for linkage detection. Finally, there were computational and analytic challenges in working with a large public data set, along with need for more data documentation.     

对住院医师进行抗菌药物临床应用培训效果评价

目的：评价理论与互动相结合式抗菌药物培训效果,探索住院医师更易接受的培训方式,为更好执行《抗菌药物临床应用管理办法》提供参考。方法：对沧州市人民医院新入职住院医师进行理论与互动相结合式培训,比较培训前后抗菌药物考试成绩,在培训前后分别进行问卷调查,内容包括住院医师是否接受过抗菌药物培训、抗菌药物培训的必要性、对抗菌药物基础知识和法律法规的了解程度、培训满意度、哪种培训方式更容易接受等。结果：共83名新入职医师参加培训,回收有效试卷及调查问卷各76份。培训前平均成绩为（67.70±14.13）分,培训后为（94.54±4.84）分,较培训前平均提高39.65%（P < 0.01）。与单纯理论授课式、互动式培训相比,93.42%医师表示更容易接受二者相结合的培训模式,满意度为100%。结论：通过理论与互动相结合式抗菌药物培训,住院医师对抗菌药物认知水平明显提高,理论与互动相结合式抗菌药物培训更容易被住院医师接受。     

Tenecteplase vs. alteplase for the treatment of patients with acute ischemic stroke: a systematic review and meta-analysis

Journal of Neurology - At present, studies regarding the efficacy and safety of tenecteplase for the treatment of patients with acute ischemic stroke (AIS) are still limited and inconsistent. The...