后循环缺血的研究进展

后循环又称为椎-基底动脉系统,由椎动脉、基底动脉、大脑后动脉及其各级分支组成,主要分支供应脑干、小脑、枕叶、颞叶后部和丘脑等。后循环缺血（PCI）是指供应脑部的椎基底动脉缺血引起的病变[1],是临床常见的缺血性脑血管病。     

在新形势下进一步加强医疗质量管理

医疗质量管理是医院各项管理工作的核心内容,是医院的生命线,在现代医院突飞猛进和社会医疗保障体制改革的今天,人们对医院的质量管理的优劣,越来越予高度的关注.我院近年来在提倡"以人为本"和"以章为纲"的管理模式中,始终把抓医疗质量管理作为医院工作中心来抓,以社会效益第一,医疗质量第一,提高医务人员的整体素质,加强医疗质量监督管理及提高医务人员的医疗质量意识、服务意识为切入点来提高医院的整体医疗质量.本文从强化管理意识,加强队伍建设;制定相应人才培养措施;重视急诊急救工作;重视新技术、新疗法;完善规章制度、加大质量监督;转变医务科职能、改进管理模式等七个方面对如何在新形势下进一步加强医疗质量管理进行了总结.     

亲水性软性角膜接触镜治疗角膜病的疗效分析

目的探讨配戴亲水性软性角膜接触镜对角膜病的治疗效果.方法治疗组70例(82只眼)角膜病患者采用连续配戴亲水性软性角膜接触镜联合抗生素眼药水和人工泪液治疗.对照组为常规药物治疗的64例(81只眼)角膜病患者.对两组中,角膜化学伤和热烧伤患者的治愈率,大泡性角膜病患者和干眼病患者的症状缓解率进行x2检验,平均治疗时间进行双样本t检验.结果化学伤和热烧伤后角膜上皮缺损或溃疡的治愈率治疗组为83%,对照组为57%.大泡性角膜病变和干眼病患者戴镜期间症状缓解率治疗组分别为100%和90%,对照组分别为50%和63.6%.治疗组中,3例(4只眼)爆炸伤的角膜上皮缺损和3例(3只眼)角膜移植手术后植片上皮缺损的患者均治愈,4例(4只眼)角膜穿孔伤的前房形成,伤口愈合;对照组中,2例(2只眼)眼部爆炸伤后角膜上皮缺损治愈1例(1只眼),4例角膜移植手术后移植片上皮缺损均治愈,2例(2只眼)角膜穿孔伤治疗无效,改为角膜清创缝合手术治疗.治疗组中,化学伤和热烧伤后角膜上皮缺损或溃疡的治愈率显著高于对照组(P＜0.05),大泡性角膜病变和干眼病患者的症状缓解率显著高于对照组(P＜0.05),治疗组的平均治疗时间14 d非常显著低于对照组26d(P＜0.01).结论亲水性软性角膜接触镜对化学烧伤、热烧伤、爆炸伤、角膜移植手术后的角膜上皮缺损或溃疡,以及小的角膜穿孔伤有明显促进愈合的作用,能有效缓解大泡性角膜病变和干眼病患者的症状.     

57例离休干部睡眠呼吸障碍的调查分析

目的:了解153名离休干部中睡眠呼吸障碍的发病率及该病的相关因素和防治情况。方法:查阅《干部保健病历》,并行多导睡眠监护仪检查。结果:153人中确诊为睡眠呼吸障碍者57人,其中男性52人,女性5人,总患病率为37.25%。其中70~79岁14人,患病率为15.22%;80~89岁41人,患病率为68.97%;90岁以上2人,患病率为100%。结论:本病发病率随年龄增大而增高,女性发病率可能高于男性。     

某三甲医院2006年-2010年医疗指标综合评价

目的应用主成分分析法对某三甲医院2006年-2010年的医疗质量进行综合评价。方法采用文献分析法,选用代表性好的指标。数据来自北京市某三级甲等医院的统计报表,选择其中具有代表性指标18项,构建综合评价指标体系。然后通过主成分分析法对各指标排序,进行综合评价。结果从18项代表性指标中提取了三个公因子,前三个因子的特征值均大于1,且其累计贡献率为94.705%,远大于70%,故考虑取前3个因子。该医院2006年-2010年综合得分分别为-0.52、-0.45、0.13、0.37、0.45。其得分与医院实际情况相符合,反映医院医疗质量呈逐年上升趋势。结论本文运用主成分分析法对医院的医疗指标进行了综合评价,主成分分析法能够客观、全面地反映医院各项指标的变化。可以为医院管理者提供科学管理的依据和参考。     

超氧化物歧化酶对骨骼肌I/R后粘附分子表达的影响

目的：探讨超氧化物歧化酶（SOD）在骨骼肌缺血再灌注（I／R）后对白细胞表面粘附分子CD11b/CD18和骨骼肌血管中细胞间粘附分子（ICAM）－1表达的影响。方法：建立大鼠后肢缺血再灌注模型,102只大鼠随机分为假手术组（Ⅰ组,n=6)、缺血组（Ⅱ组,n=6)、缺血再灌注组（Ⅲ组,n=30）、生理盐水组（Ⅳ组,n=30),SOD组（Ⅴ组,n=30)。Ⅱ组在缺血4h末,Ⅲ、Ⅳ、Ⅴ组分别于再灌注1、2、4、8、12h末,测定血浆中的丙二醛（MDA）、骨骼肌组织中的髓过氧化物酶（MPO）,白细胞上粘附分子CD11b/CD18和骨骼肌血管中ICAM－1的表达情况及各组的组织学改变。结果：Ⅲ组各时相点MDA、MPO、CD11b/CD18、ICAM－1的表达与Ⅰ组比较,差异有非常显著意义,骨骼肌组织损伤也随再灌注时间的延长而逐渐加重,Ⅴ组中则这种变化明显抑制（P＜0．05）。Ⅳ组和Ⅲ组之间比较,差异无显著意义。结论：粘附分子CD11b/CD18和ICAM－1与骨骼肌I／R损伤密切相关,SOD不仅可以清除I／R时产生的氧自由基,还可以抑制粘附分子的表达,减少白细胞在骨骼肌组织中的浸润,从而减轻骨骼肌I／R损伤。     

Platelet Function and Genotype after DES Implantation in East Asian Patients: Rationale and Characteristics of the PTRG-DES Consortium

PurposePlatelet function test (PFT) results and genotype hold unique prognostic implications in East Asian patients. The aim of the PTRG-DES (Platelet function and genoType-Related long-term proGnosis in Drug-Eluting Stent-treated Patients with coronary artery disease) consortium is to assess the clinical impact thereof on long-term clinical outcomes in Korean patients with coronary artery disease during dual antiplatelet therapy (DAPT) including clopidogrel.Materials and MethodsSearching publications on the PubMed, we reviewed clopidogrel treatment studies with PFT and/or genotype data for potential inclusion in this study. Lead investigators were invited to share PFT/genotype results, patient characteristics, and clinical outcomes to evaluate relationships among them.ResultsNine registries from 32 academic centers participated in the PTRG-DES consortium, contributing individual patient data from 13160 patients who underwent DES implantation between July 2003 and August 2018. The PTRG-PFT cohort was composed of 11714 patients with available VerifyNow assay results. Platelet reactivity levels reached 218±79 P2Y12 reaction units (PRU), and high on-clopidogrel platelet reactivity based on a consensus-recommended cutoff (PRU >208) was observed in 55.9%. The PTRG-Genotype cohort consisted of 8163 patients with candidate genotypes related with clopidogrel responsiveness. Of those with cytochrome P450 (CYP) 2C19 genotype, frequencies of carrying one and two loss-of-function allele (s) (^*2 or ^*3) were 47.9% (intermediate metabolizers) and 14.2% (poor metabolizers), respectively.ConclusionThe PTRG-DES consortium highlights unique values for on-clopidogrel platelet reactivity and CYP2C19 phenotype that may be important to developing optimal antiplatelet regimens in East Asian patients.Trial RegistrationClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT04734028","term_id":"NCT04734028"}}NCT04734028.     

The East Africa Consortium for human papillomavirus and cervical cancer in women living with HIV/AIDS

The East Africa Consortium was formed to study the epidemiology of human papillomavirus (HPV) infections and cervical cancer and the influence of human immunodeficiency virus (HIV) infection on HPV and cervical cancer, and to encourage collaborations between researchers in North America and East African countries. To date, studies have led to a better understanding of the influence of HIV infection on the detection and persistence of oncogenic HPV, the effects of dietary aflatoxin on the persistence of HPV, the benefits of antiretroviral therapy on HPV persistence, and the differences in HPV detections among HIV-infected and HIV-uninfected women undergoing treatment for cervical dysplasia by either cryotherapy or LEEP. It will now be determined how HPV testing fits into cervical cancer screening programs in Kenya and Uganda, how aflatoxin influences immunological control of HIV, how HPV alters certain genes involved in the growth of tumours in HIV-infected women. Although there have been challenges in performing this research, with time, this work should help to reduce the burden of cervical cancer and other cancers related to HIV infection in people living in sub-Saharan Africa, as well as optimized processes to better facilitate research as well as patient autonomy and safety.

KEY MESSAGES

• The East Africa Consortium was formed to study the epidemiology of human papillomavirus (HPV) infections and cervical cancer and the influence of human immunodeficiency virus (HIV) infection on HPV and cervical cancer.
• Collaborations have been established between researchers in North America and East African countries for these studies.
• Studies have led to a better understanding of the influence of HIV infection on the detection and persistence of oncogenic HPV, the effects of dietary aflatoxin on HPV detection, the benefits of antiretroviral therapy on HPV persistence, and the differences in HPV detections among HIV-infected and HIV-uninfected women undergoing treatment for cervical dysplasia by either cryotherapy or LEEP.

     

脂多糖及前炎症细胞因子诱导人原代气道上皮细胞β防御素-2表达的实验研究

目的观察脂多糖（LPS）及前炎症细胞因子白细胞介素1w（IL-1β）、肿瘤坏死因子α（TNF—α）诱导人原代气道上皮细胞人β防御素-2（hBD-2）的表达,探讨呼吸道先天性病原体防御机制。方法LPS、IL-1β及TNF-α刺激培养人原代气道上皮细胞后,RT-PCR法检测hBD-2mRNA的表达,Westernblot和免疫组化法检测hBD-2mRNA蛋白的表达。结果正常人原代上皮细胞有微量hBD-2mRNA表达,不同质量浓度的12S、IL-1β及TNF-α刺激细胞后,hBD-2mRNA表达呈剂量依赖性增加,与对照组差异显著。0．1μg／mL的LPS、1ng／mL的IL-1β和10ng／mL的TNF-α刺激上皮细胞4h后,细胞均可见hBD-2蛋白表达。结论一定剂量的12S及前炎症细胞因子可诱导人气道上皮细胞hBD-2表达,且诱导hBD-2表达时间较短,hBD-2的表达可能是气道最初的防御反应。     

Ginger (zingiber officinale) might improve female fertility: A rat model

Background

Ginger (Zingiber officinale) is a well known and extensively used antioxidant in traditional remedies. In this study, we aimed to investigate the effects of ginger powder on ovarian folliculogenesis and implantation in rats.