Beitrag zur Spirocidbehandlung der Kongenitalen Säuglingslues

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国际卫生保健体制中筹资方式的比较与思考

本文通过对美国、英国、新加坡、澳大利亚几种典型筹资方式的分析，结合中国历史、现状及存在问题，描述中国城市的公费、劳保医疗及农村的合作医疗的筹资方式及变迁。分析存在问题和挑战，提出设置卫生税、采用具有储蓄制的合作医疗制度，建立医疗救助基金。为探讨今后的筹资办法作一些有益的思考。     

影响医院业务收入因素的灰色关联分析

本文对影响医院业务收入的固定资产总值、专业设备资金、每门诊人次收费等八项主要因素运用灰色系统的理论加以分析,主要目的是找出对业务收入影响强弱的因素,分析原因,提出建议,旨在为领导制定计划、安排人员、分配物资等方面提供可靠的信息和依据。     

The remedial effect of soluble interleukin-1 receptor type Ⅱ on endometriosis in the nude mouse model

Objective： Recent studies have shown that the local expression of soluble interleukin （IL） -1 receptor type Ⅱ （slL-1 R Ⅱ ） in endometrial tissue of women with endometriosis is decreased, and the depression of IL-1 R Ⅱ was more significant in infertile women than that in fertile women with endometriosis. In this research, we investigated the remedial effect of slL-1-R Ⅱ administration on endometriosis in the nude mouse model. Methods： Nineteen nude model mice with endometriosis were randomly divided into three groups： group A was treated by intraperitoneal administration with only slL-1 R Ⅱ for two weeks, group B was similarly treated with only IL- 1, and group C （control） was administered saline. After 2 weeks, the size of the ectopic endometrial lesions was calculated, and the expression of vascular endothelial growth factor （VEGF） and B-cell lymphoma leukemia-2 （Bcl- 2） were detected by immunohistochemistry. The IL-8 and VEGF levels in the peritoneal fluid （PF） and serum were also measured by enzyme-linked immunosorbent assay （ELISA）. Results： The mean size of ectopic endometrial lesion did not differ between the three groups （P 〉 0.05）. Compared with the control, the expression of VEGF and Bcl-2 was significantly lower in group A, and higher in group B. In the three groups, the levels of IL-8 in the PF and serum were highest in group A, and lowest in group B. Conclusion： slL-1 R Ⅱ may suppresse hyperplasia of ectopic endometriosis, perhaps by reducing the expression of certain cytokines, such as VEGF, IL-8, and Bcl-2, which could provide a new clinical strategy for the treatment of endometriosis.     

Anemia and blood transfusion in critically ill patients

Context  Anemia is a common problem in critically ill patients admitted to intensive care units (ICUs), but the consequences of anemia on morbidity and mortality in the critically ill is poorly defined. Objectives  To prospectively define the incidence of anemia and use of red blood cell (RBC) transfusions in critically ill patients and to explore the potential benefits and risks associated with transfusion in the ICU. Design  Prospective observational study conducted November 1999, with 2 components: a blood sampling study and an anemia and blood transfusion study. Setting and Patients  The blood sampling study included 1136 patients from 145 western European ICUs, and the anemia and blood transfusion study included 3534 patients from 146 western European ICUs. Patients were followed up for 28 days or until hospital discharge, interinstitutional transfer, or death. Main Outcome Measures  Frequency of blood drawing and associated volume of blood drawn, collected over a 24-hour period; hemoglobin levels, transfusion rate, organ dysfunction (assessed using the Sequential Organ Failure Assessment score), and mortality, collected throughout a 2-week period. Results  The mean (SD) volume per blood draw was 10.3 (6.6) mL, with an average total volume of 41.1 (39.7) mL during the 24-hour period. There was a positive correlation between organ dysfunction and the number of blood draws (r = 0.34; P<.001) and total volume drawn (r = 0.28; P<.001). The mean hemoglobin concentration at ICU admission was 11.3 (2.3) g/dL, with 29% (963/3295) having a concentration of less than 10 g/dL. The transfusion rate during the ICU period was 37.0% (1307/3534). Older patients and those with a longer ICU length of stay were more commonly transfused. Both ICU and overall mortality rates were significantly higher in patients who had vs had not received a transfusion (ICU rates: 18.5% vs 10.1%, respectively; ² = 50.1; P<.001; overall rates: 29.0% vs 14.9%, respectively; ² = 88.1; P<.001). For similar degrees of organ dysfunction, patients who had a transfusion had a higher mortality rate. For matched patients in the propensity analysis, the 28-day mortality was 22.7% among patients with transfusions and 17.1% among those without (P = .02); the Kaplan-Meier log-rank test confirmed this difference. Conclusions  This multicenter observational study reveals the common occurrence of anemia and the large use of blood transfusion in critically ill patients. Additionally, this epidemiologic study provides evidence of an association between transfusions and diminished organ function as well as between transfusions and mortality.      

非吸烟烟草对BALB/3T3 A31—1—13细胞的转化活性

用体外细胞转化系统对嚼烟与含烟抽提物的转化活性进行了研究,发现两种烟草的抽提物均可使 BALB/3T3细胞发生形态学转化。酸化后的含烟抽提物和亚硝化后的嚼烟抽提物的转化活性高于未酸化或未亚硝化者。从转化集落分离出来的细胞具有肿瘤转化的某些特征,如细胞生长的接触抑制消失,饱和密度增高,获得锚独立性,细胞能在软琼脂上生长,形成克隆。本研究结果提示非吸烟烟草对使用者可能具有致癌危害作用.     

煤尘抽提物诱发BALB/3T3A31-1-13细胞系形态转化的研究

本文用 BALB/3T3 A31-1-13细胞系研究了煤尘抽提物的转化活性。亚硝化和未亚硝化的煤尘抽提物都能诱发细胞发生转化且有剂量反应关系.但亚硝化煤尘抽提物的转化活性比未亚硝化者高。从转化集落分离出来的细胞具有赘生转化的一些特征,如细胞生长迅速、接触抑制消失和停泊不依赖性生长等.本文结果看来支持煤矿工胃癌高发原因的煤尘假说。     

膀胱结石发病正走向高龄化

本文对66例膀胱结石患者的年龄分布及其与局部伴发疾病的关系进行了统计分析,结果表明,膀胱结石占同期尿路结石24.5％,其中小于10岁的儿童患者占总数日9.4％,50岁以上患者占33.3％,伴有局部因素者占42.4％,且以老年性前列腺肥大者居多。提示了我区膀胱结石不发病现状和高龄化趋势。     

大白鼠自身免疫性肾小球肾炎特殊病型

本文从NMC大白鼠肾皮质制作肾抗原性物质,分别注射于10只Wistar大白鼠,每只用4mg肾抗原性物质,只注射1次,结果全体先后出现轻度蛋白尿。在发病经过各时期,采取肾组织进行光镜、电镜病理形态观察,认为本病既不符合肾小管上皮(RTE)抗原感作而引起的Heymann肾炎,亦不与因GBM抗原感作而引起的Steblay肾炎完全一致,初步把它作为大白鼠自身免疫性肾小球肾炎的一种特殊病型。