电子病历书写的质量管理与对策

目的 探讨和总结电子病历（Eleetronic Medical Record,EMR)使用中医生记录的质量控制方法。方法 对EMR中医生记录进行质量分析，找出存在的常见主观性和客观性错误，采用软件设计与建立管理制度的方法提高质量。结果 通过改进软件设计和建立健全规章制度可以达到EMR质量控制。     

多肿瘤组织芯片在评价肿瘤细胞增殖与凋亡状态研究中的作用

目的 :研究多种常见肿瘤组织芯片在观察癌细胞增殖和凋亡中的作用。方法 :在病理档案材料中选取 10种常见恶性肿瘤及其癌旁或正常组织的石蜡包埋标本 ,HE染色切片定位穿刺部位 ,每一蜡块穿取直径 0 6mm大小组织柱 ,排布成 196点列阵的芯片 ;用ki 67、p5 3、rasp2 1、bcl 2和bax单抗SP法进行免疫组化染色 ,对各切片阳性细胞进行计数观察。结果 :组织芯片经染色后结构完整 ,在肿瘤组织中ki 67、p5 3和rasp2 1标记的阳性细胞比癌旁和正常组织明显增高 ;而大多数肿瘤中bcl 2和bax表达呈负相关 ,即bcl 2阴性或低表达者 ,则bax呈不同程度阳性表达 ,反之则相反。结论 :组织芯片技术可以同时用于评价多种不同类型肿瘤样本的增殖活性和凋亡状态 ,为临床预后判断提供资料     

颅内黑色素瘤的诊断与治疗--附五例临床分析及文献复习

为讨论颅内黑色素瘤的临床表现、影像学特征及治疗方法 ,对本科近 13年来治疗的 5例颅内黑色素瘤进行回顾性分析。结果示颅内黑色素瘤的临床表现不具有特征性。影像学上CT表现为高密度或混杂密度 ,增强扫描呈不同程度强化。核磁共振检查 (MRI)表现为短T1短T2 信号 ,也可以因顺磁性黑色素含量不同和瘤内有无出血 ,表现为高、低或混杂信号 ,注射二乙胺五乙酸钆 (GD DTPA)后出现不同程度的强化。 5例患者中 ,3例手术全切 ,1例大部分切除 ,1例未手术。初步研究结果提示 ,颅内黑色素瘤的预后差 ,主张在手术基础上进行包括放疗及化疗的综合治疗     

咳尔康口服液体外抑菌作用的研究

Objective To analyze the effect of Kecrkang oral Liquid on extracorporeal bacteriostasis. Methods Tube dilution method was adopted to test the effect of different concentrations of Keerkang oral liquid on bacillus coli, klebsiella pneumoniae, bacillus aeruginosus, staphylococcus aureus, staphylococcus epidermidis, β-Streptococcus hemolyticus, streptococcus pneumoniae, haemophilus influenzae and candida albicans. Results Keerkang Oral Liquid has obvious inhibited effects to all the bacteria that mentioned above. Conclusion Keerkang Oral Liquid has obvious extracorporeal bacteriostasis and resistance to fungi.     

CT模拟机的质量控制和质量保证检验

虚拟模拟定位过程涉及放射诊断影像、放射治疗计划设计和放射治疗定位等技术.文章主要论述了放射治疗虚拟定位对CT模拟机质量保证工作中影像质量检验和定位精度检验的要求与方法.     

肾上腺素诱导兔血小板聚集的实践与理论探讨

目的创建以Ａｄｒ诱导兔血小板聚集的方法，并对受体分子特性作初步探讨。方法以高Ｋ＋缓冲液等取代兔ＰＲＰ中血浆，以Ａｄｒ诱导聚集，以Ａｐｙｒ证实结果。结果兔血小板悬浮于高Ｋ＋缓冲液时Ａｄｒ能单独诱导真正的聚集。结论由此推测血小板膜上α２肾上腺素受体分子可能为由两种亚单位组成：促聚亚单位和辅助亚单位。人辅助亚单位当Ａｄｒ浓度高达聚集阈值以上时可被激活，与促聚亚单位结合为活性的二聚体，与Ａｄｒ进一步结合发生聚集作用。兔辅助亚单位则还需要高Ｋ＋方能被激活     

Platelet proteins as autoantibody targets in idiopathic thrombocytopenic purpura

Idiopathic thrombocytopenic purpura (ITP), caused by autoantibodies directed against certain platelet antigens, is the most common entity of the immune thrombocytopenias. ITP is an acquired disorder and can affect both children and adults. However, the clinical syndromes of ITP are distinct between children and adults. Childhood (acute) ITP characteristically is acute in onset, occurs within 1-2 weeks of an infection, usually of viral origin, resolves spontaneously within 6 months. Adult (chronic) ITP has an insidious onset and rarely resolves spontaneously. Over the last decade considerable new information has accumulated as to the pathophysiological mechanisms of immune thrombocytopenias. In addition, most of the knowledge on this disorder has been obtained from studies of adult patients with chronic ITP. The present work gives an updated overview of the platelet autoantigens and the molecular immunological reactions in ITP.     

新生儿败血症单个核细胞产生肿瘤坏死因子α的能力及意义

探讨新生儿败血症患儿单个核细胞产生肿瘤坏死因子α（TNFα）的能力及意义。方法用ELISA法检测TNFα，用内毒素（LPS）体外诱导单个核细胞产生TNFα检测单个核细胞产生TNFα的能力。结果新生儿败血症患儿病程＜4d者血浆中可测到TNFα，而＞4d者及健康对照者未能测到。单个核细胞产生TNFα的能力，病程＜4d者与＞4d者无差异，二者均低于健康对照。存活儿及死亡儿出院或临终前血浆TNFα均测不到，而单个核细胞产生TNFα的能力，死亡者低于存活者及健康对照，后二者无差异。结论TNFα可能仅在败血症早期起作用。起病后败血症患儿继续产生TNFα的能力将降低，且单个核细胞产生TNFα的能力与病情变化一致。对判断新生儿败血症患儿的预后有重要价值。     

Unusual features in children with inv dup(15) supernumerary marker: a study of genotype-phenotype correlation in Taiwan

Recent molecular cytogenetic studies have elucidated the origin and nature of extra structurally abnormal chromosomes (ESACs) or small supernumerary chromosomes, which are often associated with developmental delay and malformations. We studied the prevalence of inv dup(15) in a nationwide screening programme for mentally retarded children in Taiwan and tried to correlate the genotype and phenotype in those patients. Fluorescence in situ hybridization (FISH) analysis using D15Z, D15Z1, and the cosmids from the Prader-Willi/Angelman syndrome chromosome region (PW/ASCR) was performed on 54 patients (0.45%) with ESACs from 11893 probands within a 5-year period. Of them, inv dup(15) was confirmed in 25 children (46.3%) by FISH analysis. The PW/ASCR probes were used to clarify the size and DNA composition of the markers. Patients with inv dup(15) chromosomes, containing only the heterochromatin or little euchromatin of the proximal 15q (i.e., pter→q11:q11→pter) may have a rather mild or nearly normal phenotype (group 1). Only one patient had some features suggestive of Angelman syndrome, but was considered to be a result of deleted (15)(q12) in the chromosome 15 homologue. Additional copies within D15S11 through GABRB3 (15q11.2-13) resulted in an abnormal phenotype which involved mental and developmental delay but was different from the classical phenotype of PW/AS (groups 2, 3). Signs of autistic behavior did occur in each group. FISH combined with microsatellite analyses showed that the marker was often of maternal origin in de novo cases (n = 12, 86%), or inherited from the mother in only one familial case. Down-inv dup(15) was mentioned in two cases. Unusual features including diaphragmatic eventration, hyperlaxity of joints, arachnodactyly, brain atrophy, epilepsy (particularly infantile spasm), ataxia, genital abnormalities, and cleft lip/palate were noted in those patients. This observation expands the range of phenotypic expression associated with this relatively common ESAC. Conclusion Marked phenotypic diversities exist in children with inv dup(15), dependent upon the size or genetic composition of the markers, degree of mosaicism, parental origin and familial occurrence or not. Patients with a larger inv dup(15) marker chromosome including the PW/ASCR may have a higher risk of abnormalities, but not the typical Prade-Willi/Angelman syndrome phenotype. Received: 11 February 1997 and in revised form: 20 May 1997 / Accepted: 20 May 1997     

Compatible leaching effect of Concha Ostreae and some commonly-used Chinese medicinal materials]

OBJECTIVE: Based on a study of Concha Ostreae, to provide some reference for the rational approach to leaching mineral drugs. METHOD: Taking the change rates of compatible leaching and value of A as targets, the compatible leaching effect of Concha Ostreae with Radix et Rhizoma Rhei Praeparata, Radix Scutellariae, Pollen Typhae and Fructus Aurantii lmmaturus was studied. RESULT: If Concha Ostreae and the above cited medicinal herbs are decocted together, the yield of extract may be reduced to a certain extent, but the target composition of Radix et Rhizoma Rhei Praeparata and Fructus Aurantii lmmaturus remains intact, only the content of Radix Scutellariae baicalin may be influenced. CONCLUSION: The relationship of technology with preparation must be taken into consideration when making choice of the proper way to leach Concha Ostreae.