The Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) collaborative quality improvement initiative in percutaneous coronary interventions

The past decade has been characterized by increased scrutiny of outcomes of surgical and percutaneous coronary interventions (PCIs). This increased scrutiny has led to the development of regional, state, and national databases for outcome assessment and for public reporting. This report describes the initial development of a regional, collaborative, cardiovascular consortium and the progress made so far by this collaborative group. In 1997, a group of hospitals in the state Michigan agreed to create a regional collaborative consortium for the development of a quality improvement program in interventional cardiology. The project included the creation of a comprehensive database of PCIs to be used for risk assessment, feedback on absolute and risk-adjusted outcomes, and sharing of information. To date, information from nearly 20,000 PCIs have been collected. A risk prediction tool for death in the hospital and additional risk prediction tools for other outcomes have been developed from the data collected, and are currently used by the participating centers for risk assessment and for quality improvement. As the project enters into year 5, the participating centers are deeply engaged in the quality improvement phase, and expansion to a total of 17 hospitals with active PCI programs is in process. In conclusion, the Blue Cross Blue Shield of Michigan Cardiovascular Consortium is an example of a regional collaborative effort to assess and improve quality of care and outcomes that overcome the barriers of traditional market and academic competition.     

散发性结直肠癌1号染色体等位基因杂合缺失

杂合缺失（LOH）是指来自父方或母方的一个等位基因的缺失.抑癌基因的LOH被认为是结直肠癌形成的关键步骤之一,一条等位基因已经异常的抑癌基因发生LOH可导致该基因失活,并进一步导致肿瘤形成.目前,通过微卫星DNA标记对散发性肿瘤进行LOH分析,找出其共同缺失的片段,这是对抑癌基因进行定位克隆的主要策略之一.本实验研究结直肠癌1号染色体LOH情况并探讨其意义。     

Difference between periportal and pericentral Kupffer cells in uptaking lipopolysaccharides in rats

ＤｉｆｅｒｅｎｃｅｂｅｔｗｅｅｎｐｅｒｉｐｏｒｔａｌａｎｄｐｅｒｉｃｅｎｔｒａｌＫｕｐｆｅｒｃｅｌｓｉｎｕｐｔａｋｉｎｇｌｉｐｏｐｏｌｙｓａｃｃｈａｒｉｄｅｓｉｎｒａｔｓＣＨＥＮＸｉａｎＭｉｎｇ１，ＬＩＵＪｉｎ＿Ｃｈｕｎ２，ＸＵＲｅｉＬｉｎｇ１，...     

Diagnosis of Helicobacter pylori infection:Ⅱ.a semi-quantitative methodand its application

ＤｉａｇｎｏｓｉｓｏｆＨｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉｉｎｆｅｃｔｉｏｎ：Ⅱ．ａｓｅｍｉｑｕａｎｔｉｔａｔｉｖｅｍｅｔｈｏｄａｎｄｉｔｓａｐｐｌｉｃａｔｉｏｎＣＨＥＮＲｕｉＣｈｕａｎ１，ＺＨＡＮＧＣｈａｎｇＧｏｎｇ１，ＺＨＯＮＧＹａｎ２，Ｙ...     

神经保护性免疫和帕金森病

帕金森病（PD）是黑质多巴胺（DA）能神经元变性所致的运动障碍疾病，以静止性震颤、僵直、运动迟缓和姿势反射异常为临床特征。PD中的免疫反应涉及到免疫细胞和免疫分子，以及复杂的调控网络。该免疫反应有神经损害和神经保护作用，我们就PD中的神经保护性免疫进行综述。     

Infliximab improves signs and symptoms of psoriatic arthritis: results of the IMPACT 2 trial

OBJECTIVES: To evaluate further in a phase III, double blind trial the efficacy of infliximab in patients with active psoriatic arthritis (PsA), as observed in the smaller IMPACT trial. METHODS: 200 patients with active PsA unresponsive to previous treatment were randomised to infusions of infliximab 5 mg/kg or placebo at weeks 0, 2, 6, 14, and 22. Patients with inadequate response entered early escape at week 16. The primary measure of clinical response was ACR20. Other measures included Psoriatic Arthritis Response Criteria (PsARC), Psoriasis Area and Severity Index (PASI), and dactylitis and enthesopathy assessments. RESULTS: At week 14, 58% of patients receiving infliximab and 11% of those receiving placebo achieved an ACR20 response and 77% of infliximab patients and 27% of placebo patients achieved PsARC (both p<0.001). Among the 85% of patients with at least 3% body surface area psoriasis involvement at baseline, 53/83 (64%) patients receiving infliximab had at least 75% improvement in PASI compared with 2/87 (2%) patients receiving placebo at week 14 (p<0.001). These therapeutic effects were maintained through the last evaluation (week 24). Fewer infliximab patients than placebo patients had dactylitis at week 14 (18% v 30%; p = 0.025) and week 24 (12% v 34%; p<0.001). Fewer infliximab patients (22%) than placebo patients (34%) had active enthesopathy at week 14 (p = 0.016); corresponding figures at week 24 were 20% and 37% (p = 0.002). Infliximab was generally well tolerated, with a similar incidence of adverse events in each group. CONCLUSIONS: Infliximab 5 mg/kg through 24 weeks significantly improved active PsA, including dactylitis and enthesopathy, and associated psoriasis.     

螺旋CT对大面积脑梗死的诊断与鉴别诊断

目的探讨大面积脑梗死的螺旋CT诊断与鉴别诊断。方法回顾性分析45例大面积脑梗死患者完整资料,其中27例大面积脑梗死是脑血管栓塞引起,12例是其它部位栓子脱落引起,6例是由于外伤性血管损伤引起。45列患者均在临床症状出现后2 h²4 d内行头颅CT平扫,经积极治疗后均行头颅CT复查。结果 45例患者均在脑实质内出现大片状低密度影,累及脑灰白质。结论螺旋CT能准确诊断大面积脑梗死,特别是外伤后出现的大面积脑梗死时,为该病的治疗提供有价值的数据和资料支持,避免医疗引纷的发生。     

锆离子对牙髓干细胞增殖及成骨分化的影响

目的研究Zr4＋对大鼠牙髓干细胞增殖及矿化功能的影响。方法四甲基偶氮噻唑盐（MTT）检测Zr4＋对牙髓干细胞增殖的影响,碱性磷酸酶活性测定法检测其对牙髓干细胞成骨分化的影响。结果Zr4＋在1×10-9-1×10-5m01／L的浓度范围内均能够促进牙髓干细胞的增殖及分化。结论锆离子对牙髓干细胞的增殖和分化具有促进作用,含锆物质适于应用于口腔护理。     

火龙果对高血脂模型大鼠的降脂作用实验研究

目的研究“紫红龙”火龙果对高血脂SD大鼠的降脂作用。方法根据TG水平将50只雄性SD大鼠随机分为5组,每组10只,设为阴性对照组、高脂模型对照组、火龙果：7．5、10．0、15．0g／kgbw3个剂量组。剂量组灌胃不同浓度的火龙果果浆,两个对照组灌胃同体积的蒸馏水。3个剂量组、高脂模型对照组动物自由进食高脂饲料,阴性对照组自由进食基础饲料。实验进行45d后处死大鼠取血清测定各组大鼠的甘油三酯（TG）、总胆固醇（CHO）、高密度脂蛋白（HDH—C）、低密度脂蛋白（LDH—C）、谷丙转氨酶（ALT）、谷草转氨酶（AST）,取肝脏称重,计算肝／体重比值,并做病理切片。结果火龙果中剂量组、高剂量组大鼠的TG、CHO、LDH—C较高脂模型组明显降低,差异有统计学意义（P〈0．05）;谷草转氨酶（AST）、肝实质重量、肝／体比值结果表明：高脂饮食除能引起大鼠的血脂升高,还能损害机体的肝脏实质,引起AST升高、肝脏增大;但随火龙果的剂量增加,肝脏受损害的程度逐渐减轻,特别是AST指标,火龙果的高剂量组已恢复至阴性组水平。结论“紫红龙”火龙果对高血脂sD大鼠具有明显的降脂作用。     

某平板电脑显示模组项目职业病危害控制效果评价

目的为预防控制职业病危害、保护劳动者健康,对某平板电脑显示模组生产企业进行职业病危害控制效果评价。方法采用职业卫生调查、职业健康检查、职业卫生检测和检查表等方法对某平板电脑显示模组项目进行职业病危害定性和定量评价。对无接触限值、无检测方法的物质进行风险评估。结果该项目存在的职业病危害因素为：甲苯、甲醇、丙酮、丁酮、环己酮、甲缩醛、N,N-二甲基丙烯酰胺（DMAA）、氢氧化钠、氢氧化钾、氟化氢、乙酸、粉尘（其他粉尘）、矽尘、噪声、高温、工频电场、激光等。噪声合格率为84.4%,其余各种职业病危害因素检测结果均符合国家卫生标准。结论该建设项目职业病危害较重,针对各职业病危害因素采取了相应的防护措施,产生的职业病危害因素可得到预防和控制。