多层螺旋CT诊断乙肝后肝硬化的运用与临床价值分析

目的 分析多层螺旋CT在乙肝后肝硬化诊断中的运用与临床价值.方法 选取2018年2月至2019年6月于本院诊治的43例乙肝后肝硬化患者为研究对象(观察组),选取同期43例无肝脏病变或病史的健康志愿者为对照组.两组均采用多层螺旋CT检查,计算肝脏体积,分析肝脏血供情况,观察其诊断准确性.结果 观察组患者的平均肝脏体积显著...     

人卵黄囊间质干细胞的分离纯化及诱导成脂的实验研究

目的:分离纯化及体外定向诱导人卵黄囊间质干细胞(YS-MSC)分化为脂肪细胞。方法:显微分离人卵黄囊, 经酶消化得到卵黄囊细胞, 卵黄囊细胞经贴壁培养、传代纯化得到人YS-MSC, 流式细胞仪检测YS-MSC表面抗原表达, 钙钴法测定碱性磷酸酶(AKP)活性;地塞米松、消炎痛、胰岛素定向诱导YS-MSC分化为脂肪细胞。油红O检测中性脂肪。结果:人卵黄囊间质干细胞易于分离、纯化, 体外培养增殖潜能大。卵黄囊间质干细胞CD29、CD44、CD166及CD105表达阳性, CD34、CD45和CD86为阴性;AKP弱阳性。卵黄囊间质干细胞经成脂诱导转化为大小不等的园形或椭圆形细胞, 可见胞浆内有少量微小脂滴形成, 随时间延长, 胞浆中脂滴相互融合, 胞核被挤于细胞的一侧, 经油红O染色脂滴染橘红色, 符合脂肪细胞的生物学特征。结论:人卵黄囊间质干细胞与成体间质干细胞表型一致, 在体外可以分化为脂肪细胞。     

Epstein Barr virus latent membrane protein-1 in Hodgkin's lymphoma in Nigerians

Background

The burden of lymphomas on the health care system in Nigeria is enormous. Correct diagnosis and identification of aetiological factor are important steps in reducing this burden.

Methods

Eight cases diagnosed as HL within a period of six years at the Obafemi Awolowo University teaching Hospital, Ile-Ife, Nigeria by haematoxylin and eosin (Hand E) only were immunophenotyped using the indirect immunoperoxidase method. Epstein-Barr virus latent membrane protein-1 (LMP-1), CD15 and CD30 immunohistochemistry was also performed. The clinical characteristics of each patient were documented.

Objectives

To document the frequency of involvement of Epstein-Barr virus in cases of HL seen in a university hospital in Nigeria.

Results

Out of the eight cases diagnosed by H&E as HL immunophenotyping showed only five were HL. The rest were non-Hodgkin''s lymphoma (2 diffuse large B-cell and 1 null cell ALCL). All were cases of classical HL with 60% being of the mixed cellularity (MC) subtype. There were 2 males and 3 females with ages ranging from 7 years to 40 years. All presented with cervical lymphadenopathy and three had splenomegaly in addition. 60% of the tumour was EBV positive, all of the MC subtype. Three patients had chemotherapy. Eventually all were lost to follow-up. There was no case of the nodular lymphocyte predominance variant.

Conclusion

Mixed cellularity is the most common subtype and is the only subtype associated with EBV positivity in this study. Epstein-Barr virus probably plays an important role in the aetiology of HL in Nigerians.Running title: Epstein-Barr virus, Hodgkin''s lymphoma in Nigerians     

Scintigraphic pattern in missed testicular torsion

The testicular scintigraphic findings of nine patients with surgically and pathologically proved torsion of the testis of over 24 hours duration are reviewed. In the delayed blood-pool images each showed the classical avascular twisted testicle with a variable peripheral rim of hyperemia. In the dynamic blood-flow phase, eight revealed a perceptible increase of vascular perfusion in the scrotal region on the affected side, in addition to the testicular radionuclide angiogram peculiarities previously described for missed testicular torsion. This pattern of perfusion was seen only in torsion of over one day duration. A low salvage probability is expected in these cases.     

Association between cocaine abuse in pregnancy and placenta-associated syndromes using propensity score matching approach

Aims

We used propensity scores matching techniques to assess the association between maternal cocaine abuse in pregnancy and the occurrence of placenta-associated syndromes (PAS).

Study design

Mothers who abused cocaine (n = 5026) were matched to controls (n = 5026) from a sample of 1,693,197, unexposed mothers in Florida from 1998 to 2007. Cocaine abuse was identified using the ICD-9 principal and secondary diagnosis codes (304.2 for cocaine dependence and 305.6 for cocaine abuse). The outcome of interest, PAS, was identified as any indication in diagnosis field of ICD-9-CM codes for: placental abruption (641.2), oligohydramnios (658.0), placental infarction (656.7, 656.8, 656.9), gestational hypertension (642.3, 642.9), preeclampsia (642.4, 642.5, and 642.7) or eclampsia (642.6).

Results

Nearly 6% of mothers in the study sample experienced a condition associated with PAS prior to matching. Women who abused cocaine were 58% more likely to have PAS when compared to women who did not (OR = 1.48, 95% confidence interval: 1.33, 1.66). Women who abused cocaine were at elevated odds for placental abruption, placenta infarction and preeclampsia with the most pronounced odds noted for placental abruption (OR = 2.79, 95% confidence interval: 2.19, 3.55).

Conclusions

These findings indicate that cocaine abuse during pregnancy is associated with more placenta-related disorders than previously reported.     

城镇医疗保险与社区卫生服务的政策对接研究

城镇医疗保险与社区卫生服务的政策对接是新医改的突破口。文章论证了城镇医疗保险与社区卫生服务的政策对接的重要意义,分析了城镇医疗保险与社区卫生服务的现状及存在的问题,提出了政策建议:确立医疗保险与社区卫生服务对接的法律地位,发挥法制的强制作用;加大政府的资金投入;统一管理机构;加强监督审核;发挥社区卫生服务与基本医疗保险的互补优势;进一步扩大基本医疗保险范围。     

《医院会计制度》修订应体现行业特点

随着公共财政体制各项政策的建立,医疗卫生体制改革的不断深入,对10年前制定的医院会计制度进行适时修订,能够满足推进公立医院改革和加强公立医院财务管理的需要。但《医院会计制度》的修订,不宜过度借鉴国际通行做法和企业会计制度经验,应体现我国医院行业的特点,才能指导会计核算工作,增加适应性和可操作性。     

成人阻塞性睡眠呼吸暂停低通气综合征患者的人格特征分析

目的　调查成人阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的人格特征及生活质量,了解该患病群体的心理健康情况。方法　采用明尼苏达多项人格测量表（Minnesota multiphasic personality inventory,MMPI）和简明健康状况调查表（the MOS item short from health survey,SF-36）分别对98例成人OSAHS患者及100例单纯鼾症志愿者进行问卷调查,评价OSAHS患者的人格特征及生活质量情况并进行对照性研究。结果　在MMPI调查中,OSAHS患者在抑郁、疑病、精神衰弱、情绪不稳定、精神分裂临床量表T分高于单纯鼾症组,差异具有统计学意义（P＜0.05）,其中OSAHS组中女性患者的抑郁、疑病、精神衰弱、情绪不稳定、精神分裂、社会内向临床量表T分高于男性患者,差异具有统计学意义（P <0.05）。在SF-36调查中,OSAHS患者在生理职能、一般健康状况、躯体疼痛、精力、社会功能、情感功能、精神健康7个维度的平均评分低于单纯鼾症组,差异具有统计学意义（P＜0.05）。结论  OSAHS患者有较多的心理健康问题,表现更多的易疲劳、注意缺陷,生活质量更低,OSAHS病情越重,心理健康问题越大,女性患者尤重。     

提高口腔医护人员手卫生依从性的实践研究

目的提高口腔医护人员的手卫生依从性,降低医院感染率。方法通过临床调查了解口腔医护人员手卫生执行状况,分析手卫生执行欠佳的原因并针对原因采取解决措施。结果口腔医护人员的手卫生依从性逐年上升,手卫生执行正确率分别从2006年的60.8%、68.9%与70.3%上升到2009年的96.2%、99.1%与95.2%,手消毒液的使用率由51.2%上升至100%。x2=16.7p〈0.01,差别有高度显著意义。结论通过具体分析原因,从主观及客观两方面提高口腔医护人员的手卫生依从性是切实可行的。     

5-脂氧合酶激活蛋白抑制剂MK886对人食管癌细胞系增殖和凋亡的影响

目的 5-脂氧合酶活化蛋白（FLAP）抑制剂MK886对人食管癌细胞系（KYSE-150和TE-3）增殖和凋亡的影响及作用机制。方法用2.5、5、10、20、40和80μmol/L的MK886干预体外培养的KYSE-150和TE-3细胞;xCELLigence RTCA系统实时测定细胞增殖抑制率,同时确定半数抑制浓度(IC₅₀)。流式细胞测量术检测食管癌细胞的细胞周期。Western blot检测细胞凋亡和自噬相关蛋白的表达。结果人食管癌细胞系（KYSE-150和TE-3）的增殖抑制率随着MK886浓度增加而增强（P<0.05）,KYSE-150组的IC₅₀浓度为29.11μmol/L,TE-3组的IC₅₀浓度为27.47μmol/L。当MK886浓度增加至25μmol/L时,食管癌细胞G₀/G₁期滞后增加明显（P<0.001）,MK886处理浓度增加到50μmol/L时,食管癌细胞G₂/M期增加明显（P<0.001和P<0.05）...