基于HIS系统的医保实时结算实施及应用

为提高医保患者的结算效率和医保中心的集中管理能力,使用隔离网闸,将医疗保险信息系统与医院信息系统(HIS)成功对接,并通过实时结算系统平台实现数据传输交互,实现了医保患者门诊特检、特治和住院费用的实时结算,极大地方便了医保患者医疗费用的实报实销。     

Molecular mechanism of Chuanxiong Rhizoma in treating coronary artery diseases

ObjectiveMost of the studies on the herb Chuanxiong Rhizoma (CR) have focused on the l-arginine-nitric oxide (NO) pathway, but the nitrate-nitrite-NO (NO₃⁻–NO₂⁻–NO) pathway was rarely investigated. Therefore, the aim of this study was to evaluate the effects and mechanisms of action of CR in coronary artery disease (CAD).MethodsThe NO₃⁻, NO₂⁻ and NO levels were examined in the NO₃⁻–NO₂⁻–NO pathway. High-performance ion chromatography was used to quantify NO₃⁻ and NO₂⁻ levels. Then, NO was quantified using a multifunctional enzyme marker with a fluorescent probe. The tension of aortic rings was measured using a multi myograph system.ResultsHigh content of NO₃⁻ and low content of NO₂⁻ was found in CR, and which could potently convert NO₃⁻ to NO₂⁻ in the presence of endogenous reductase enzyme. Incubating human coronary artery endothelial cells (HCAECs) with CR-containing serum showed that CR significantly decreased the NO₃⁻ content and increased the levels of NO₂⁻ and NO in the cells under hypoxic conditions. In addition, CR significantly relaxed isolated aortic rings when the l-arginine –NO pathway was blocked. The optimal concentration of CR for relaxation was 200 mg/mL.ConclusionCR supplements large amounts of NO in cells and vessels to achieve relaxation via the NO₃⁻–NO₂⁻–NO pathway, thereby making up for the deficiency caused by the lack of NO after the l-arginine-NO pathway is suppressed. This study also supports the potential use of a traditional Chinese herb for future drug development.     

不同肠内营养时机对老年高血压脑出血术后临床疗效分析

目的 :探讨老年高血压脑出血术后肠内营养应用的最佳时机。方法 :选取2011年2月~2014年2月我院收治的老年高血压脑出血术后患者90例,随机分为A、B、C三组,每组各30例,分别于术后24h、25~48h、49~72h开始建立肠内营养支持,检测并比较三组血清生化指标变化、并发症发生情况以及GCS评分。结果 :术后14d,B组血清白蛋白、血红蛋白水平较A、C两组高,A、B两组淋巴细胞水平显著高于C组,B组应激性溃疡、肺部感染发生率显著低于A、C两组,B组GCS评分显著优于A、C两组。结论 :对于老年高血压脑出血术后患者于术后25~48h建立肠内营养支持更能满足患者营养需求,降低并发症发生率,促进意识状态的恢复。     

解剖M型超声心动图对骨髓间充质干细胞移植前后心脏结构和功能的研究

目的:应用解剖M型超声心动图(AME)对猪急性心肌梗死(AMI)经骨髓间充质干细胞(MSCs)移植治疗前后左心室结构、局部及整体功能进行评价.方法:采用经冠状动脉丝线堵塞法制作小型猪AMI动物模型,造模2周后,经皮冠状动脉行移植MSCs治疗,于造模前、移植前后检测左心室16节段室壁运动搏幅(Am),左心室舒张末期内径(...     

神经酰胺参与II型CD20抗体诱导的细胞程序性死亡

目的：探讨II型CD20抗体诱导靶细胞程序性死亡的机制,为制备具有较强肿瘤杀伤能力的新型CD20抗体提供理论依据。方法：将淋巴瘤细胞Raji分别与 I型CD20抗体利妥昔单抗(Rituximab)和II型CD20抗体托西莫单抗(Tositumomab)孵育后,采用磷脂酰丝氨酸V(annexin V)和碘化丙啶(propidium iodide,PI)双染,流式细胞仪比较两种抗体处理后程序性死亡细胞所占比例;在CD20抗体处理前,用工作浓度的caspase抑制剂Z-VAD-FMK (carbobenzoxy-valyl-alanyl-aspartyl-[O-methyl]-fluoromethylketone)或伏马毒素(fumonisin B1,FB1)预处理Raji细胞,并采用流式细胞仪比较预处理组与未预处理组淋巴瘤细胞程序性死亡所占的比例。收集CD20抗体处理过的Raji细胞,应用高效液相色谱法检测不同的CD20抗体处理组间淋巴瘤细胞内神经酰胺(ceramide)的水平,并用相同方法检测FB1对Tositumomab引起淋巴瘤细胞内ceramide水平变化的抑制作用。用不同浓度的C2-ceramide与淋巴瘤细胞进行孵育,16h后用annexin V & PI双染检测其诱导靶细胞程序性死亡的能力。结果：10 µg/mL的I型抗体Rituximab几乎不能诱导Raji细胞的程序性死亡,而相同浓度的II型CD20抗体Tositumomab能够诱导(28.6±4.2)%的Raji细胞产生程序性死亡,两者差异有统计学意义(t=26.48,P<0.01),这种程序性死亡不能被caspase抑制剂Z-VAD-FMK所抑制(F=3.01,P>0.05)。Tositumomab处理后能够引起Raji细胞内ceramide水平的升高(t=28.48,P<0.01),且5~40 µmol/L的C2-ceramide能够通过剂量依赖性的关系诱导Raji细胞的程序性死亡(F=2.71,P>0.05)。Ceramide合成的FB1可以显著抑制Tositumomab引起的Raji细胞内ceramide水平的升高(F=20.18,P<0.01),进而显著抑制Tositumomab介导的程序性死亡(F=17.02,P<0.01)。结论：II型CD20抗体Tositumomab而非I型CD20抗体Rituximab可以通过介导靶细胞内ceramide水平的升高,诱导靶细胞的程序性死亡,这种程序性死亡与经典的caspase通路无关。     

局麻关节镜下清理术治疗踝关节大骨节病的疗效分析

目的分析关节镜清理治疗踝关节大骨节病的近期疗效。方法 2000年7月至2012年3月关节镜治疗踝关节大骨节病共44例(48踝),包括左踝18例,右踝22例,双侧4例。男性26例,女性18例,平均年龄36(23~57)岁。采用美国足踝外科协会(AOFAS)踝-后足评分系统、疼痛视觉模评分(VAS)、踝关节背伸活动度(ROM)对术前和术后3、6、12、24个月进行随访时的功能状态进行评价。结果 VAS评分术前(6.8±0.9)分,术后3、6、12、24个月时分别为(1.9±0.7)、(2.2±0.9)、(2.9±1.2)、(4.8±2.1)分,手术前后差异有统计学意义(P<0.05);AOFAS评分术前(53.6±7.4)分,术后各时间点分别为(86.6±4.9)、(83.4±6.4)、(77.0±4.7)、(67.0±5.3)分,手术前后差异有统计学意义(P<0.05);术后踝关节背伸及下蹲显著改善,关节绞锁症状消失,疼痛得到缓解,6踝术后负重行走疼痛无改善。结论局麻关节镜下清理治疗踝关节大骨节病可显著缓解踝关节疼痛,改善行走功能,延缓疾病进展,提高患者生活质量。     

Correlation of oxygen free radical items between blood and kidney of chronic renal failure rat

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多种媒体技术在高职隐性知识习得过程中的应用

在介绍隐性知识最新研究成果基础上,从高职学生个体角度探讨了高职隐性知识的分类,重点阐述了利用现代信息技术创设适合高职隐性知识传授的学习环境,及其四类学习支持工具：沟通交流讨论工具、多元符号表达工具、重复编辑记录处理工具、情境创设工具。     

Isolation of human antibodies against hepatitis E virus from phage display library by immobilized metal affinity chromatography

Objective To isolate human antibodies against hepatitis E virus from phage display library by a new method of panning phage antibody library based on immobilized metal affinity chromatography （1MAC）. Methods Phage antibody library was allowed to mix with hex-His tagged expressed HEV specific antigen, NE2, in solution for adequate binding before affinity resin for hex-His was added. The non-specific phage antibodies were removed by extensive washing and the specific bound phage antibodies could then be eluted to infect TG1 or repeat the binding process for subsequent rounds of purification. The specificity of the selected human antibodies were tested by antigen competitive ELISA, human sera blocking ELISA, scFv expression, and sequence analysis. Results His-NE2 specific recombinant phages were successfully enriched after panning procedure. Two individual phage clones, 126 and 138, showed 50% inhibition in NE2 antigen competition ELISA and obvious blocking effect by HEV positive serum in blocking ELISA. Soluble scFv of 126, 138 bound to NE2 specifically. Conclusion Two specific human phage antibodies against hepatitis E virus （HEV） from phage display library were isolated by immobilized metal affinity chromatography. The immobilized metal affinity chromatography applied to phage antibody selection was a helpful supplement to the selection in solution.     

健脾消癌方干预结肠癌细胞外泌体MIF调控肝Kupffer细胞TGF-β1表达的研究

目的 通过细胞实验研究健脾消癌方干预结肠癌细胞外泌体(CT26-exo)中巨噬细胞迁移抑制因子(MIF)对肝Kupffer细胞转化生长因子-β1(TGF-β1)表达的影响。方法 采用CT26-exo干预肝Kupffer细胞,反转录酶-聚合酶链反应(RT-PCR)法检测肝Kupffer细胞中TGF-β1 mRNA表达;进一步采用小干扰核糖核酸(siRNA)干扰技术敲低CT26细胞MIF基因表达后,用其外泌体干预Kupffer细胞,RT-PCR及酶联免疫吸附测定(ELISA)检测Kupffer细胞TGF-β1表达;用不同浓度的健脾消癌方含药血清干预后,采用RT-PCR及蛋白免疫印迹法(WB)检测CT26细胞及其外泌体中MIF表达;用含药血清干预后的CT26-exo干预Kupffer细胞,RT-PCR及ELISA检测Kupffer细胞TGF-β1表达量。结果 CT26-exo干预后,小鼠Kupffer细胞TGF-β1 mRNA表达升高(P<0.05);敲低CT26细胞MIF基因表达后,其外泌体对Kupffer细胞中TGF-β1的上调作用减弱(P<0.05);20%的健脾消癌方含药...