波特竞争战略与现代医院战略管理

通过对现代企业战略界所所推崇的波特竞争战略的探讨,简单波特的三种竞争战略,分析了随着我国市场经济的建立,开放改革的不断深入,医院战略管理所面临的困惑,根据我国现代医院管理的实际,提供了波特竞争战略对医院战略的一些启示。     

儿童疾病单病种质量管理体系的研究

在总结分析武汉地区儿童疾病结构用度春诊疗规律的基础上,运用现代医院全面质量管理的理论,建立了以儿科常见病、多发 为主,兼纳部分专科疾病的２４个儿童疾病单病种质量控制标准及规范的组织管理和考核评价第统。形成以增强病种质量控制能力为核心的儿童疾病单病种质量管理体系。该管理体系运用后,医院医疗质量管理水平和社会、经济效益得到了同步提高,并了医务人员的医疗行为,使医院步入优质、低砂和高效的运营轨道。     

从部分贫困县住院分娩资料分析看农村地区围产保健对策

利用１９９６年在四川省和陕西省４个卫－Ⅵ项目县县乡两级医院,采用前瞻性研究方法收集的住院分娩资料,着重分析了产科床位使用率、产科接生工作负荷、产妇住院天数、剖腹产比例。结果显示：产科床位使用率不高,绝大多数医院都有５０％以上的产科床位日没有利用;接生工作负荷亦不高,各医院从事接生人员的１周平均接生数在０．５￣２．６之间;在一些乡卫生院产妇住院时间短,５０％以上的产妇住院不满１天;陕西的两县剖腹产比     

室内空气污染与女性肺癌

为探讨室内空气燃料污染,被动吸烟,烹饪与女性肺癌的关系。搜索经省级医院确诊的哈尔滨市女性原发性肺癌１１５例及对照１２４例进行调查及单因素Ｌｏｇｉｓｔｉｃ回归分析。结果表明冬天取暖和做饭室内有烟,被动吸烟年限均与女性肺癌有关系显著,女性患肺癌危险性与终动吸烟总量呈明显的剂量－效应关系。     

肺癌患者血清与支气管肺泡灌洗液四项放免肿瘤指标同步检测的结果分析

对３８例肺癌患者的血清和支气管肺泡灌洗液（ＢＡＬＦ）同步进行ＣＥＡ、ＣＡ－５０、ＡＦＰ、ＳＦ的检测。结果显示：肺癌ＢＡＬＦ的ＣＥＡ浓度测值７３％明显高于血清中ＣＥＡ浓度;ＣＡ－５０浓度测值６８％高于血清;ＳＦ９２％明显低于血清中测值;而ＡＦＰ在肺癌患者无论血清及灌洗液中,阳性率均低于７％,但仍是ＢＡＬＦ的浓度测值敏感于血清。提示支气管肺泡灌洗液的ＣＥＡ、ＣＡ－５０与血清的同步检测是目前肺癌早期诊断的主要优选方法之一。     

新生儿通气相关性肺炎

目的：探讨新生儿通气相关性肺炎病因、病原菌、耐药情况、相关防治措施。方法：分析１０３ 例新生儿通气相关性肺炎患儿痰培养结果、诊治情况。结果：醋酸不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌是三种主要致病菌,耐药率高,对泰能、环丙沙星最为敏感。结论：革兰阴性杆菌是新生儿通气相关性肺炎重要病原菌,耐药率高,治疗较为困难,应积极预防。     

白内障超声乳化,玻璃体切除及人工晶体植入联合手术的疗效

目的：探讨白内障超乳化摘除,睫状体平坦部下班体切割及人工晶体囊袋内植入联合手术的疗效及安全性。方法：对玻璃体视网膜病普合并白内障１８例（１８眼）施行该联合手术。其中糖尿病性视网膜病变,玻璃体出血伴白内障１０例;视网膜分枝静脉阻塞,玻璃体出血伴白内障４例;视网膜静脉周围炎,玻璃体出血伴白内障３例及特发性视网膜１例,术后随访２～１３个月（平均９月）。结果：术后视力均有不同程度提高。１２眼（６７％）术后     

The effect of latanoprost and brimonidine on rabbit subconjunctival fibroblasts

PURPOSE: Subconjunctival fibroblasts play a critical role in scarring and treatment failure in fistulizing surgery for glaucoma. The proliferation of subconjunctival fibroblasts appears to be modulated by topical glaucoma medications. This study was conducted to evaluate the effects of latanoprost and brimonidine on subconjunctival fibroblast proliferation in rabbit eyes. METHODS: Twelve pigmented Dutch-belted rabbits were divided into treatment groups of four: latanoprost 0.005%, brimonidine 0.2%, or balanced saline solution (BSS) each were administered to one treatment group, both eyes of each rabbit, twice a day, 6 days a week for 10 weeks. The eyes were then enucleated along with the conjunctiva, fixed, processed, and evaluated by light microscopy and immunohistochemistry using anti-proliferating cell nuclear antigen (PCNA) and anti-muscle-specific actin antibody (HHF-35). Fibroblast cell counts were performed at magnification x40. RESULTS: In all groups, few inflammatory cells were seen in the subconjunctival space under light microscopy. PCNA staining revealed a statistically significant increase in the mean number of labeled fibroblasts in the group receiving brimonidine compared with the control (BSS) group. The group receiving latanoprost also had a significantly higher mean number of labeled fibroblasts than the groups receiving brimonidine or BSS. Only a few fibroblasts stained positively with the anti HHF antibody. Eyes treated with latanoprost, however, had significantly higher numbers of positively labeled cells than eyes treated with brimonidine or BSS. CONCLUSION: When applied to rabbit eyes, latanoprost and brimonidine appear to increase the number of positively labeled proliferating subconjunctival fibroblasts.     

Discovery and structure-activity relationships of imidazole-containing tetrahydrobenzodiazepine inhibitors of farnesyltransferase

2,3,4,5-Tetrahydro-1-(imidazol-4-ylalkyl)-1,4-benzodiazepines were found to be potent inhibitors of farnesyltransferase (FT). A hydrophobic substituent at the 4-position of the benzodiazepine, linked via a hydrogen bond acceptor, was important to enzyme inhibitory activity. An aryl ring at position 7 or a hydrophobic group linked to the 8-position through an amide, carbamate, or urea linkage was also important for potent inhibition. 2,3,4, 5-Tetrahydro-1-(1H-imidazol-4-ylmethyl)-7-(4-pyridinyl)-4-[2-(t rifluo romethoxy)benzoyl]-1H-1,4-benzodiazepine (36), with an FT IC(50) value of 24 nM, produced 85% phenotypic reversion of Ras transformed NIH 3T3 cells at 1.25 microM and had an EC(50) of 160 nM for inhibition of anchorage-independent growth in soft agar of H-Ras transformed Rat-1 cells. Selected analogues demonstrated ip antitumor activity against an ip Rat-1 tumor in mice.     

Therapeutic intervention with complement and beta-glucan in cancer.

Complement (C) has two major effector systems available for host defense. The membrane attack complex (MAC) generated from components C5-C9 can form membrane-penetrating lesions that lead to cell death by causing a rapid loss of cytoplasmic components. The MAC is only effective against pathogens with outer phospholipid membranes, and cannot kill gram-positive bacteria or yeast whose membranes are protected by cell walls. The most important effector mechanism of C is the opsonization of microbial pathogens with the serum protein C3 that leads to their high avidity attachment to the C3-receptors of phagocytic cells. Pathogens that activate complement are first coated with the C3b fragment of C3, which is rapidly proteolyzed into the iC3b fragment by serum factor I. These iC3b fragments serve to promote the high avidity attachment of the 'iC3b-opsonized' pathogens to the iC3b-receptors (CR3, CD11b/CD18) of phagocytic cells and natural killer (NK) cells, stimulating phagocytosis and/or cytotoxic degranulation. Host cells, including neoplastic tumor cells, have been endowed with natural mechanisms for self-protection against both the MAC and the cytotoxic activation of CR3. This review discusses a novel type of immunotherapy for cancer that uses soluble yeast beta-glucan to override the normal resistance of iC3b-opsonized tumor cells to the cytotoxic activation of phagocyte and NK cell CR3, allowing this important effector mechanism of the C system to function against tumor cells in the same way that it normally functions against bacteria and yeast. Moreover, the cytotoxic activation of beta-glucan-primed NK cell CR3 by iC3b-opsonized tumors is shown to be accompanied by a tumor-localized secretion of the cytokines TNFalpha, IFNalpha, IFNgamma, and IL-6.