重组人血管内皮抑制素的双抗体夹心ELISA特异性定量检测

建立了特异性检测重组人血管内皮抑制素(1)的双抗体夹心ELISA法,可区别内源性endostatin和1.1在7.8～1 000ng/ml浓度范围内线性良好,批内、批间RSD为3.9%～5.3%和4.4%～7.1%,平均回收率为97.70.     

医疗卫生服务公共政策研究

对不同收入的国家,医疗卫生改善健康的作用是不同的。而且医疗卫生对健康的影响是双刃剑,可能是促进性的,也可能是损害性的。我国是下中等收入国家,且医疗卫生服务滥用问题需要关注;相关公共政策的制定可以采取综合权衡、发挥潜能和消除隐患的基本思路。具体措施包括：进一步加大公共投入,新增投入主要用于普惠性服务,同时防止卫生总费用的过快增长;建立覆盖全民的公共卫生和基本医疗服务制度,建立以常住人口为基础的专门公共卫生体系,制定国家药物政策;建立和完善相关公共服务机构法人治理结构,建立有效的医疗监管框架和服务购买框架,适当提高我国医生的薪酬待遇。     

A prospective comparative study of the relationship between different types of ring and microbial hand colonization among pediatric intensive care unit nurses

Objectives

The aim of the study is to assess the effect of ring wearing and ring types on hand contamination and efficacy of alcohol-based hand disinfection among nurses working in intensive care settings.

Methods

Hand cultures were obtained from 84 nurses providing direct patient care in intensive care units of a pediatric hospital. Colony counts were compared depending on ring wearing and the type of ring worn. Twenty-eight nurses were asked to a wear plain wedding ring, 28 to wear rings with stones and 28 not to wear any rings, starting 15 days before and continuing throughout the study. Cultures were obtained by using sterile gloves containing phosphate-buffered-saline solution (PBS) after an alcohol-based hand disinfectant was used and bacteria were identified with standard laboratory tests.

Results

The nurses wearing rings had more Gram-positive, Gram-negative and total bacterial colonization on their hands than the nurses without rings despite using an alcohol-based rub (p = 0.001). When comparing the two groups with rings (plain wedding rings and rings with stones), colony counts of Gram-positive, Gram-negative and total bacteria did not differ (p > 0.05).

Conclusions

Ring wearing increases the bacterial colonization of hands and alcohol-based hand disinfection might not significantly reduce contamination of the ring-wearing hands. The type of ring did not cause any significant difference on the bacterial load. Wearing rings could increase the frequency of transmission of potential nosocomial pathogens.     

《中国病案》杂志刊登文章的统计分析

目的通过聚类分析,了解《中国病案》杂志2003年1月～2008年12月刊登2483篇文章,现将统计分析结果与大家共同探讨;方法将《中国病案》杂志2003年1月～2008年12月刊登文章目录进行归类统计,结果见统计表;结论文稿来源广泛,论述专业各抒己见,作者编者学者同心合力,愿本杂志创办的越来越好,真正成为专业论坛与研讨学术的园地。     

肛门直肠压力测定在直肠癌前切除术中的意义

目的: 探讨行直肠癌前切除术(Dixon)直肠癌患者的术前术后直肠和肛管功能变化.方法: 采用4通道水灌注式肛门直肠压力检测系统,对46例直肠癌患者进行Dixon术前术后直肠肛门压力测定.结果: Dixon术后粪便质地与术前比较,差异无统计学意义,排便次数较术前有所增加,里急后重感明显增加,控制排便的能力较术前有所减弱.肛管静息压、肛管最大收缩压、肛管最大收缩时间均较术前明显降低(均P<0.05).肛管直肠抑制反射均为阳性,但压力下降值及下降的百分比均较术前有所下降(均P<0.05).结论: 直肠癌患者Dixon术后肛管自制功能和肛管括约功能均有所下降.     

胃肠道恶性肿瘤术后腹腔热灌注联合全身化疗的疗效观察

1999年2月至2002年5月选择我院Ⅱ～Ⅲ期胃肠道恶性肿瘤术后患者101例,随机分为治疗组（51例）和对照组（50例）,观察两组患者腹腔复发率、肝转移率及1、3、5年生存率。结果示治疗组腹腔复发率及肝转移率明显低于对照组（25．5％比50．0％,13．7％比30．0％,P〈0．05）,治疗组1、3及5年的生存率明显高于对照组（P〈0．05）。提示胃肠道恶性肿瘤术后腹腔热灌注联合全身化疗,能有效降低胃肠道恶性肿瘤术后腹腔复发及肝转移,而且提高患者的生存率。     

单管等位基因特异性扩增法同时测定多重单核苷酸多态性

目的:建立了一种单管等位基因特异性扩增法同时测定多重单核苷酸多态性(SNP).方法:以TYP基因外显子1上的3个SNP位点(71G>A、425A>T和758G>A)为例,首先采用PCR预扩增得一段含所有待测SNP位点的长片段;然后用限制性内切酶将其消化成短片段,在连接酶的作用下与设计的DNA适配器相连;以此连接产物为模板,在单个PCR管中加入一种适配器特异性通用引物和所有等位基因特异性引物进行PCR扩增;最后用琼脂糖凝胶电泳法分离检测PCR扩增产物,并根据扩增片段的大小判断SNP的类型.结果:采用该法成功测定了30名健康中国人的TYP基因中的3个SNP位点,与限制性片段长度多态性法(RFLP)测定结果完全一致.结论:该方法特异性高、结果准确、检测成本低,可用于同时测定多个SNP位点.     

雌激素在大鼠颈椎间盘退变中的作用

目的:研究雌激素在SD大鼠颈椎间盘退变过程中的作用。方法:30只8月龄雌性SD大鼠随机平分为对照组、模型组、实验组,通过切除双侧卵巢和颈后肌肉创建雌激素缺乏大鼠颈椎动静失衡模型,实验组补充外源性雌激素。造模后3月通过观察颈椎间盘形态、细胞凋亡率及测量蛋白多糖含量来比较3组之间颈椎间盘退变程度。结果:形态学观察比较实验组椎间盘退变程度重于对照组而轻于模型组;椎间盘细胞凋亡率模型组>实验组>对照组,3组之间具有显著差异(P<0.01);蛋白多糖含量模型组<实验组<对照组,3组之间具有显著差异(P<0.01)。结论:雌激素对大鼠颈椎间盘退变具有抑制作用,能够延缓椎间盘的退变进程。     

Prognostic value of N-terminal pro-B-type natriuretic peptide in patients with active infective endocarditis

Our aim was to determine whether N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and cardiac troponin I (cTnI) levels are valuable for predicting prognosis in patients with infective endocarditis (IE). We analyzed measured plasma NT-pro-BNP levels at admission in 45 patients with definite IE. The primary end point was early surgery or in-hospital death. The other data recorded were baseline clinical, echocardiographic, and laboratory parameters. Thirty patients underwent early surgery, and 9 died in hospital. Univariate analysis revealed that log NT-pro-BNP, cTnI > or =0.03 ng/ml, New York Heart Association functional class III to IV symptoms, left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and severe valvular regurgitation were associated with increased risk of reaching the primary end point. Cox proportional hazard regression analysis identified log NT-pro-BNP (hazard ratio 1.5; 95% confidence interval 1.2 to 1.9, p <0.001) as the only independent predictor of the primary end point. The log NT-pro-BNP cut-off value with the highest sensitivity (97%) and specificity (92%) for predicting primary end point was 7.2 (1,500 pg/ml). Patients with NT-pro-BNP level > or =1,500 pg/ml had significantly lower event-free survival than others. In conclusion, admission NT-pro-BNP is of prognostic value in patients with IE. The combination of admission NT-pro-BNP and cTnI levels appears to have even greater value for risk stratification in this patient group.     

Comparison of C-reactive protein levels in patients who do and do not develop atrial fibrillation during electrophysiologic study

C-reactive protein (CRP) was increased in patients with atrial fibrillation (AF). The aim of this study was to evaluate CRP after inducing AF in 39 patients undergoing electrophysiologic study (EPS). After a diagnostic EPS, programmed atrial stimulation with 3 extra stimuli from the right atrium was performed in all patients. CRP was measured before and 6 and 24 hours after the procedure. Patients in whom AF was induced were monitored for 24 hours. AF was induced in 18 of 39 patients. Twenty-one patients without a tachyarrhythmia constituted the control group. Groups were similar with regard to age, gender, incidences of hypertension and diabetes, and history of coronary artery disease. On average, AF lasted 4.8 hours, and spontaneous conversion to sinus rhythm was observed in all patients. There were no statistically significant differences with respect to baseline and 6-hour CRP values between groups. However, mean CRP at 24 hours was significantly higher in patients with AF compared with controls (10 +/- 11 and 3.9 +/- 4.2 mg/L; p = 0.04). In conclusion, induction of AF during EPS led to increased CRP. This finding suggested that increased CRP may be the consequence of AF.