医院网站建设的实践

医院网站是医院对外交流和对外宣传的主要窗口之一，是反映医院各项建设成果的发布平台，是整体反映医院和各学科形象的主要媒体之一。建好医院网站，对宣传医院建设发展的成就，扩大医院在国内外的影响和知名度，提高人才培养质量，推介各种岗位上的优秀人才，加强和充分利用信息资源等具有重要意义。本文结合所在医院实际，介绍了网站建设的经验与体会，为其他医院提供可借鉴的经验。     

白细胞介素-10在系统性红斑狼疮中的表达及意义

目的探讨白细胞介素-10(inter leukin-10,IL-10)在系统性红斑狼疮(systemic lupus trythematosus,SLE)中的表达及其临床意义。方法54例SLE患者按SLE活动性指数(systemic lupus erythematosus disease activity index SLEDAI)积分分为活动组(27例)和稳定组(27例);对照组为30例健康人。采用双抗体夹心酶联免疫吸附试验(ELISA)检测血清IL-10水平,并分析其与SLEDAI积分之间的关系。结果活动组SLEIL-10水平([52.13±10.24)pg/ml]显著高于稳定组SLE([19.55±8.76)pg/ml]和正常对照组[(13.25±3.12)pg/ml](<0.01);并且IL-10表达量与SLE活动组SLEDAI积分呈高度正相关(=0.7946,<0.01),与SLE稳定组SLEDAZ积分呈低度正相关(=0.3872,<0.05)。结论IL-10的表达水平和SLE的病情呈正相关;检测IL-10对SLE病情的判断及指导治疗有一定的价值。     

管理你的身心健康

随着就业压力日益增大、竞争愈来愈激烈、工作压力全面扩散，职场人士频繁出现职业倦怠、职业枯竭、亚健康甚至“过劳死”等身心健康问题。本文从职场人士的身体、心理、工作三方面，提出了具体管理的措施，希望有助于保障职场人士生命与工作健康。     

丙种球蛋白无反应性川崎病的特点和治疗探讨

目的探讨大剂量丙种球蛋白（IVIG）初治无效的川崎病的特点及再治疗方法的选择。方法分析总结1996年1月-2008年1月在本院收治的川崎病患儿的病历资料。IVIG无反应性定义为首次IVIG治疗36h后体温仍超过38．5℃。初治有效者为敏感组。无效者为无反应组,对二组患儿临床表现及实验室数据进行统计分析。结果328例符合川崎病的诊断标准并于起病10d内应用IVIG治疗,44例对首次IVIG无反应,发生率13．4％,无反应组热程较短．血白细胞（WBC）、血沉（ESR）、乳酸脱轻酶（LDH）明显升高,血红蛋白（Hb）及白蛋白（ALB）明显降低（P〈0．05或P〈0．01）,冠脉病变发生率明显升高（P〈0．05）;再治疗选择中,大剂量甲泼尼龙冲击治疗优于IVIG重复治疗,且冠脉病变发生率降低（P〈0．05）。结论IVIG无反应川崎病发生率约13．4％,具有热程较短,WBC、ESR、LDH较高,Hb、ALB较低的特点,冠脉病变发生率高。对初次IVIG无效患儿推荐使用大剂量甲泼尼龙冲击治疗。     

围孕期妇女529例营养状况调查

调查孕前、孕期女性的饮食习惯、营养摄入,旨在更好地了解女性经历特殊生理时期的营养状况、本地区女性的饮食习惯、活动量以及基本的体质状况,发现不良膳食习惯,提出孕前、孕后的不同时期干预措施,做好出生缺陷一级预防,减少对孕妇以及其孕育的胎儿长期、远期的不利影响。结果报告如下。     

急性脑梗死患者血清基质金属蛋白酶-9水平的变化及三七皂苷对其的影响

目的探讨急性脑梗死患者血清基质金属蛋白酶-9(MMP-9)水平的变化及三七皂苷对其影响。方法选取65例急性脑梗死患者检测三七皂苷治疗组和常规治疗组发病第1天、第2天、第5天、第10天血清MMP-9水平,与25例健康者(对照组)比较。并对三七皂苷治疗组和常规治疗组于治疗前和治疗后2周分别进行神经功能评分。结果三七皂苷治疗组和常规治疗组发病第1天、第2天MMP-9水平均较对照组差异有统计学意义(P<0.05),而第5天后,三七皂苷治疗组MMP-9水平与对照组之间差异无统计学意义(P>0.05)。三七皂苷治疗组和常规治疗组的评分减少值间差异有统计学意义(P<0.05)。结论急性脑梗死患者发病早期血清MMP-9水平明显升高,提示MMP-9可能参与了急性脑梗死的发病机制。三七皂苷能降低MMP-9的表达,且治疗效果优于常规治疗,可能减轻脑缺血再灌注后的损伤和血-脑脊液屏障的破坏程度。     

口腔鳞癌肿瘤浸润淋巴细胞的Fas/FasL表达

目的研究口腔鳞状细胞癌肿瘤浸润淋巴细胞(TIL)Fas/FasL的表达及其临床病理学意义。方法采用免疫组织化学方法和脱氧核糖核酸末端转移酶(TDT)介导的原位末端标记(TUNEL)技术,对38例口腔鳞癌TIL的Fas/FasL表达及TIL和癌细胞的凋亡进行检测,观察TIL的Fas/FasL表达与TIL和癌细胞凋亡的关系。结果TIL的Fas和FasL均有广泛的表达,TILFas表达阳性组的TIL凋亡指数(AI)明显高于Fas表达阴性组(P<0.05),TILFasL表达阳性组的癌细胞凋亡指数与FasL表达阴性组差异无显著性(P>0.05)。结论口腔鳞癌TIL的Fas阳性表达与其凋亡有密切关系,而FasL的阳性表达则与癌细胞凋亡无关。癌细胞可能通过Fas凋亡系统诱导TIL的凋亡并通过某种机制逃避TIL的杀伤。     

Improvement of the function of islet beta and alpha cells by intervention against glucotoxicity: experiment with rats

OBJECTIVE: To investigate the effects of intervention against glucotoxicity on improvement of the function and pathological changes of islet beta and alpha cells. METHODS: Thirty-six male Sprague Dawley rats were randomly divided into four equal groups: normal control (NC) group, fed with standard chow, high-fat (HF) group, fed with extra high-fat chow; diabetes mellitus (DM) control group, fed with high-fat chow for 8 weeks followed by 30 mg/kg streptozotocin injection to establish DM models; and insulin (INS) group, treated with subcutaneous injection of long-acting insulin (glargine, 0.5 U x kg(-1) x d(-1)) for 4 weeks after the establishment of DM models. 48 h, 2 weeks, and 4 weeks after the STZ injection to the 2 DM groups oral glucose tolerance test (OGTT) was performed to all rats. Peripheral blood samples were collected from the caudal vein. Serum insulin level was assayed by radioimmunoassay. Total serum cholesterol (TC) and triglyceride (TG) were measured by enzyme-colorimetric method. By the end of experiment the rats were killed with their pancreases taken out. Immunohistochemistry was used to observe the morphological changes of the islet beta and alpha cells. Beta cell and alpha cell masses were calculated by the proportions of positive area in the islet. Proinsulin mRNA level was detected by RT-PCR. Insulin protein content in islets was detected by Western blotting. RESULTS: Four weeks after the insulin intervention against glucotoxicity, the fasting blood glucose and blood glucose 2 h after sugar-taking of the INS group were both significantly lower than those of the DM group (both P < 0.01). The relative beta cell mass of the INS group was 0.38 +/- 0.08, significantly bigger, 2.45 times, that of the DM group (0.11 +/- 0.05, P < 0.01). The relative alpha cells mass in islets of the INS group was 0.16 +/- 0.04, significantly lower, by 43%, than that of the DM group (0.28 +/- 0.15, P < 0.01). The insulin contents in beta cells of the INS group was 0.58 +/- 0.03, significantly higher, by 70.6%, than that of the DM group (0.34 +/- 0.14, P < 0.01). The proinsulin mRNA level of the INS group was 1.52 +/- 0.14, significantly higher, by 20.6%, than that of the DM group. CONCLUSION: The morphology of islet beta, alpha cells in diabetic rats was improved by four weeks of Intervention against glucotoxicity improves the pathology of islet beta and alpha cells in diabetic and insulin synthesis.     

地震灾区伤病员现场急救手术的麻醉处理

目的 探讨地震现场急救手术麻醉处理的特点和方法.方法 回顾性分析了52例患者现场手术的麻醉,其中局部浸润麻醉12例、神经阻滞麻醉18例、硬膜外麻醉5例、蛛网膜下腔麻醉1例、非气管插管静脉麻醉15例、气管插管加静脉麻醉1例,采用腕式血压计和掌式氧饱和度仪分别监测血压和氧饱和度.结果 1例患者出现心脏停跳,1例硬膜外麻醉穿破了硬脊膜,其余患者麻醉完善、手术顺利.结论 在灾区现场进行麻醉,首选除硬膜外麻醉和蛛网膜下腔麻醉外的区域神经阻滞麻醉,还可以采用咪唑安定、氯胺酮和少量芬太尼进行无需气管插管的全身麻醉,同时配备口咽通气道、喉罩和简易呼吸囊等简易的辅助通气工具.这样既能保证手术快速进行,又能满足灾区现场急救手术的麻醉需要.