专家对"广州市社会医疗保险指定慢性病门诊医保待遇政策"评价

[目的]了解医保专家对广州市社会医疗保险指定慢性病门诊医保待遇政策（以下简称“待遇政策”）及相关规定各项目的可行性评价。[方法]问卷调查社会医疗保险管理专家19人。[结果]（1）“待遇政策”满意度总得分（满分为500分）中位数为363．1分,每一方面满意度得分（满分为100分）中位数均在60分以上;（2）“待遇政策”相关规定满意度总得分（满分为500分）中位数为389．3分,每一方面满意度得分（满分为100分）中位数均高于60分。[结论]专家对“待遇政策”及相关规定各方面评价均较好。     

临床小讲课对培养医学生临床思维能力的作用

临床思维能力是医学生必须具备的基本素质.在口腔医学专业临床实习教学中,中山大学光华口腔医学院附属口腔医院以学生为中心,以临床实际问题为中心,采用临床小讲课的教学方式,理论结合实际,激发学生的学习兴趣.实践证明,小讲课教学方式既注重了理论知识的传授,又加强了临床思维能力的培养,提高了医学生解决实际问题的能力,为培养适应现代医学发展需要的优秀医学人才奠定了基础.     

缬沙坦在治疗肾性高血压中的肾脏保护作用研究

目的：观察缬沙坦对慢性肾病继发高血压的降压作用。方法：96例肾性高血压患者随机分为两组,治疗组64例,应用缬沙坦;对照组32例,应用依那普利;观察两组用药前及用药8周后血钾、血钠、血氯、24h尿蛋白定量、血尿素氮、肌酐及血促红细胞生成素情况,应用）（2检验比较上述各因素用药前后的变化。结果：应用缬沙坦8周后,血钾、血钠、血氯、血尿素氮、肌酐及血促红细胞生成素无明显变化;24h尿蛋白定量减少,有显著性差异。结论：缬沙坦对慢性肾病继发高血压的降压作用中对血钾、血钠、血氯、血尿素氮、肌酐及血促红细胞生成素无明显影响,24h尿蛋白定量明显减少。     

重楼总皂苷对多发性创伤大鼠血清细胞因子水平的影响

目的:探讨重楼总皂苷(RPTS)对多发性创伤模型大鼠血清TNF-α、IL-1β及IL-6水平的影响。方法:将68只Wistar大鼠随机分成5组,除空白对照组外,其余各组按多发性创伤模型标准制模,制模成功后1h,除空白对照组和模型对照组外各组予以不同浓度的重楼总皂苷(RPTS)灌胃,干预后6h采血,以ELISA法检测血清中TNF-α、IL-1β及IL-6浓度。结果:重楼总皂苷(RPTS)干预组大鼠血清TNF-α、IL-1β及IL-6浓度非常显著地低于模型对照组(P<0.001)。结论:重楼总皂苷可以降低多发性创伤模型大鼠血清中的TNF-α、IL-1β及IL-6水平。     

罗格列酮对体外高糖培养乳鼠心肌细胞凋亡的影响

目的 探讨罗格列酮对体外高糖培养乳鼠心肌细胞凋亡的影响.方法 SD乳鼠进行原代心肌细胞培养48h后,换无血清的DMEM培养基并转移到24孔板上,随机分为3组,分为培养心肌细胞不加入葡萄糖组,加入25mmol/L葡萄糖组,加入25mmol/L葡萄糖以及10μmol/L罗格列酮组.48h后,分别测定各组心肌细胞乳酸脱氢酶含量;四唑盐比色法测定各组心肌细胞的生长情况及增殖活性;流式细胞仪检测各组心肌细胞的凋亡情况.结果 与正常对照组相比较,经过罗格列酮干预后,乳酸脱氢酶含量显著下降;四唑盐比色结果显示心肌细胞存活率增高;流式细胞仪检测发现坏死细胞和凋亡细胞明显减少.结论 罗格列酮能够抑制体外高糖培养的乳鼠心肌的细胞凋亡.     

静脉用右旋糖酐氢氧化铁注射液治疗缺铁性贫血108例分析

目的 探讨右旋糖酐氢氧化铁注射液(科莫非)治疗缺铁性贫血(IDA)的有效性、安全性与治疗疗程.方法 科莫非静点治疗IDA 68例,以右旋糖酐铁肌注治疗IDA 40例为对照,观察其补铁治疗前后血红蛋白(Hb)上升的幅度、时间以及不良反应等.结果 补铁1周后Hb上升,但治疗组明显高于对照组,到(17.5 ±4.1)d两组补铁完毕时(补铁总量相等),治疗组Hb为(107.5±8.9)g/L,已基本正常,而对照组Hb为(76.4 ±9.0)g/L(P<0.01),待(37.7±12.8)d时才达治疗组水平.治疗组未见明显不良反应,而对照组大部分出现注射部位疼痛及色素沉者.结论 科莫非治疗IDA疗效显著,且快速安全,在很大程度上代替了输血,减轻了患者的经济负担.     

细胞融合法转线粒体细胞模型的构建及鉴定

目的 探讨细胞融合方法建立转线粒体细胞(cybrid)可行性,并对融合后细胞内mtDNA进行鉴定.方法 采用细胞融合方法将正常人血小板与mtDNA缺失人肝癌细胞(ρ°SK-Hep1)融合,建立转线粒体细胞(SK-Hep1 Cyb),恢复细胞正常线粒体功能.并用PCR、Southern杂交、Western杂交及线粒体膜电位检测进行鉴定.结果 PCR、Southern杂交、Western杂交及线粒体染色证实成功建立了ρ°SK-Hep1细胞转线粒体模型SK-Hep1Cyb.结论 采用细胞融合法可以建立转线粒体细胞,融合细胞恢复线粒体功能,转线粒体细胞可稳定存活30d以上.     

关于中医本科教育的几点思考

中医本科教育依然是当今中医人才培养的主渠道,对于稳定中医队伍、持续开展中医理论研究和临床实践起着重要作用。但目前的中医本科教育依然存在课程体系缺乏传统中医特色,培养的学生缺乏文化底蕴,中医诊治思维能力下降,临床能力不强等现象。在此结合自身的办学实践对此提出几点思考。     

The subcellular localization of TRPP2 modulates its function

TRPP2, also known as polycystin-2, is a calcium permeable nonselective cation channel that is mutated in autosomal dominant polycystic kidney disease but has also been implicated in the regulation of cardiac development, renal tubular differentiation, and left-to-right (L-R) axis determination. For obtaining further insight into how TRPP2 exerts tissue-specific functions, this study took advantage of PACS-dependent trafficking of TRPP2 in zebrafish larvae. PACS proteins recognize an acidic cluster within the carboxy-terminal domain of TRPP2 that undergoes phosphorylation and mediate retrieval of TRPP2 to the Golgi and endoplasmic reticulum (ER). The interaction of human TRPP2 with PACS proteins can be inhibited by a Ser812Ala mutation (TRPP2(S812A)), thereby allowing TRPP2 to reach other subcellular compartments, and enhanced by a Ser812Asp mutation (TRPP2(S812D)), thereby trapping TRPP2 in the ER. It was found that the TRPP2(S812A) mutant rescued cyst formation of TRPP2-deficient zebrafish larvae to the same degree as wild-type TRPP2, whereas the TRPP2(S812D) mutant was significantly more effective in normalizing the distorted body axis of TRPP2-deficient fish. Surprisingly, the TRPP2(S812D) mutant rescued the abnormalities of L-R asymmetry more effectively than either wild-type or TRPP2(S812A), suggesting that the ER localization of TRPP2 plays an important role in the development of normal L-R asymmetry. Taken together, these findings support the hypothesis that TRPP2 assumes distinct subcellular localizations to exert tissue-specific functions.     

The clinical outcome of small (<20 mm) arterially enhancing nodules on MRI in the cirrhotic liver

OBJECTIVES: To evaluate the outcome of arterially enhancing nodules (AENs) measuring <20 mm detected on MRI in patients with cirrhosis. METHODS: Prospective analysis of 54 patients with a total of 161 AENs <20 mm on MRI. Inclusion criteria included a minimum of 12 months of MRI follow-up or histological evaluation of the AEN. Key exclusions were patients with an AEN >20 mm or prior diagnosis of HCC. Two radiologists blinded to the clinical and pathological data reviewed serial MRIs and classified the AENs as no longer visible, stable, increasing, or decreasing in size. RESULTS: A total of 161 AENs were identified and were followed by serial MRI for a mean of 24 months. Eighty (50%) AENs were no longer visible on repeat imaging, 42 (26%) remained stable, 1 of which was diagnosed as HCC on short-term follow-up, 8 (5%) increased in size and were subsequently diagnosed as HCC, and 24 (15%) decreased in size. In addition, 7 AENs (4%) were diagnosed on biopsy immediately following the initial MRI. Overall MR characteristics diagnostic of HCC were growth > or =2 mm and peripheral rim enhancement on initial MRI. CONCLUSIONS: The majority (90%) of AENs <20 mm in cirrhosis are benign. The presence of rim enhancement or interval growth of an AEN are suggestive of HCC.