加强团队建设 培育团队精神

团队精神是现代医院精神的重要组成部分，是促进医院凝聚力、增强医院竞争力的精神力量。医院是人的集合，众多的人扮演不同的角色，从事各自不同的医疗活动，但又必须互相配合，去完成共同的目标，因而管理的效能往往并不是1+1=2，而是1+1>2或1+1<2。如果医院部门之间或者职工之间出现扯皮、摩擦，人为地造成大量的内耗，肯定1+1<2；真正科学的管理，正在于通过不断协调和整合，使医院形成一个紧密衔接、步调和谐的团队，创造出1+1>2的效能，这是团队精神最本质的要求。如何加强团队建设，培育团队精神，结合工作实际，谈几点看法。     

SARS病例的流行病学生存分析及对卫生检疫的影响

〔目的〕研究SARS病例生存时间的影响因素,并探讨对口岸卫生检疫的影响。〔方法〕对119例SARS病例进行描述性流行病学调查分析,运用统计学单因素方差分析、卡方检验、Kaplan-Meier和CoxRegession生存分析方法进行研究。〔结果〕119例SARS病例以发热(97.48%)和咳嗽(42.02%)为最常见始发症状,入院平均体温为38.28±0.86℃;平均住院时间是47.75d(95%的可信区间为43.50￣52.00d);男性与女性间平均住院时间的差异无统计学意义(P=0.1918);65岁(含65岁)以上年龄组及65岁以下年龄组死亡率分别为38.50%和4.72%,两者差异有极显著性(P<0.001)。〔结论〕SARS具有人群普遍易感性,以年龄对死亡的影响最为显著。对重点人群应加强口岸卫生检疫,完善口岸体温监测系统;检疫人员应做好个体防护。     

Interest of free flaps for cranial base reconstruction

We describe our experience in treating 7 patients who underwent skull base reconstruction with free flap (6 latissimus dorsi, 1 rectus abdominis) between October 1996 and November 1998. Four patients underwent temporal bone resection with auricular resection, 2 patients underwent anterior and middle cranial fossa resection, 1 patient underwent frontotemporal resection. There have been no failures of the free flaps and one cerebrospinal fluid leak. We advocate free flap reconstruction after temporal bone resection with auricular resection, and after anterior or middle cranial fossa resection when local flap options are not available or with complex dead space.     

甲状腺恶性肿瘤超声诊断的价值及误诊分析

目的 探讨超声诊断甲状腺恶性肿瘤的价值及误诊分析.方法 回顾性分析经病理确诊为甲状腺恶性肿瘤的152例患者的术前声像图资料,观察甲状腺病灶的二维图像及彩色多普勒血流分布情况,再结合同位素扫描和甲状腺功能测定结果对比研究,分析误诊原因.结果 ①152例患者超声提示甲状腺恶性肿瘤111例,诊断符合率73%,误诊率27%,其中微小癌误诊率最高,达71%.②超声显像甲状腺恶性肿瘤主要以实性结构低回声和混合性回声为主,低回声病灶内多见沙砾样钙化,部分伴颈部淋巴结肿大.彩色血流信号丰富,峰值血流速度(32.12±13.33)cm/s,阻力指数0.71±0.08.③核素扫描结果显示62%的甲状腺恶性肿瘤患者为冷结节.④97%的甲状腺恶性肿瘤患者甲状腺功能检查结果正常.结论 超声可作为甲状腺恶性肿瘤的首选诊断方法,综合分析临床资料果可提高对其鉴别诊断的准确率.     

The composition, geographical variation and antimicrobial activity of Lippia javanica (Verbenaceae) leaf essential oils

Lippia javanica is widely distributed throughout South Africa where it is used extensively in traditional herbal preparations. An infusion of the leaves is commonly used as a decongestant for colds and coughs. A preliminary study indicated that the essential oil chemistry varies dramatically both within and between natural plant populations. As the antimicrobial activity may be directly related to the specific composition of the oil, the activity may also fluctuate. The aerial parts of Lippia javanica were collected from various localities in southern Africa to study the essential oil composition and the antimicrobial activity thereof. The hydrodistilled essential oils were analysed by GC/MS and a cluster analysis was performed on the essential oil dataset. From 16 samples (representing five natural populations), 5 chemotypes were identified; a myrcenone rich-type (36-62%), a carvone rich-type (61-73%), a piperitenone rich-type (32-48%), an ipsenone rich-type (42-61%) and a linalool rich-type (>65%). The myrcenone and linalool chemotypes have been mentioned in the literature but the carvone, ipsenone and piperitenone chemotypes have not previously been reported for Lippia javanica. Time kill studies were performed on three microbial respiratory isolates to document the scientific rationale of using Lippia to treat respiratory complaints in traditional herbal medicine. Klebsiella pneumoniae, Cryptococcus neoformans and Bacillus cereus showed reduction in microbial populations with the strongest bacteriostatic effect observed for Klebsiella pneumoniae.     

Effects of pesticides on human peripheral lymphocytes in vitro: induction of DNA damage

Because of the widespread use of pesticides for domestic and industrial applications the evaluation of their genotoxic effects is of major concern to public health. Although various experimental data have provided evidence that pesticides can possess genotoxic properties in animals and in in vitro test systems after acute and chronic exposure, the information on the genotoxic effects of some of pesticides is limited and inconsistent. In the present study, the genotoxic potential of commonly used pesticides (i.e., dimethoate and methyl parathion from the organophosphate class, propoxur and pirimicarb from carbamates, and cypermethrin and permethrin from pyrethroids) have been evaluated. The genotoxic effects of these substances were examined using the single cell gel electrophoresis (comet) assay in freshly isolated human peripheral lymphocytes. The cells were incubated with 10, 50, 100 and 200 µg/ml concentrations of the test substances for 0.5 h at 37°C and DNA damage was compared with that obtained in lymphocytes from the same donor not treated with substances. Hydrogen peroxide, 100 µM, was used as a positive control. Within the concentration ranges studied, no significant cytotoxic effects were observed. Dimethoate and methyl parathion at 100 and 200 µg/ml; propoxur at 50, 100 and 200 µg/ml, and pirimicarb, cypermethrin and permethrin at 200 µg/ml significantly increased DNA damage in human lymphocytes.     

Association of AGTR1 gene methylation and its genetic variant in Chinese farmer with hypertension: A case-control study

The objective was to determine the potential associations of the angiotensin II receptor type 1 (AGTR1) gene polymorphism, methylation, and lipid metabolism in Chinese farmers with hypertension.A case-control study was conducted in Wuzhi county of Henan province in China in 2013 to 2014. A total of 1034 local residents (35–74 years, 386 hypertensive cases, and 648 normotensive subjects) were enrolled in this study. Triglyceride (TG), total cholesterol (TC), high-density lipoprotein, and low-density lipoprotein were measured using automatic chemistry analyzer. The AGTR1 gene promoter methylation level was measured using quantitative methylation-specific polymerase chain reaction method. The single nucleotide polymorphism rs275653 was genotyped with TaqMan probe assay at an applied biosystems platform.The gender, body mass index (BMI), TG, TC, and family history of hypertension in the hypertension group were significantly higher than those in control group (P < .05). No significant difference was observed in the distribution of AGTR1 rs275653 polymorphism in the hypertension and controls (P > .05). The AGTR1 gene methylation in subjects carrying different genotypes was not significantly observed (P > .05). The logistic regression analysis found the AGTR1 gene methylation level was negative correlation with hypertension in the present study (odds ratio, 0.946, 95% confidence interval, 0.896–0.999) through adjusting for age, gender, BMI, education, smoking, alcohol drinking, fruit and vegetable intake, pickles intake, and family history of hypertension.The association of AGTR1 gene hypomethylation and essential hypertension was observed in Chinese farmers; no significant difference was observed in the distribution of AGTR1 rs275653 polymorphism.