滋养层细胞侵入相关基因在先兆子痫胎盘中的表达

探讨与滋养层侵入有关的细胞外基质分子相关基因在先兆子痫胎盘中的表达，采用分别点样有220余种人细胞因子相关基因和人类激素相关基因cDNA片段的两款基因芯片，检测经过严格配伍的先兆子痫和正常胎盘组织的基因表达谱差异。结果显示：钙粘蛋白、胶原、整合素、选择蛋白等18种细胞外基质分子基因的表达在先兆子痫和正常胎盘组织间相差2倍以上，且全部表现为在先兆子痫胎盘中的表达增强。先兆子痫患者的胎盘组织中基质金属蛋白酶(MMP)-10、-13、-15和金属蛋白酶组织抑制因子(TIMP)-2、TIMP-3、纤溶酶原、纤溶酶原激活物等的表达均较正常者高。提示胎盘中细胞外基质分子及其降解酶基因表达异常可能与先兆子痫的病理发生关系密切。     

我国医保医用耗材管理机制变革及对医疗机构的影响分析

近年来,我国医用耗材管理机制改革不断深入。基于对我国医用耗材管理现况和新医保政策动向的分析,探讨了既往管理模式的弊端和医保部门在耗材目录、定价、采购、支付、监管等方面的政策进展。建议医疗机构和医务人员要正视耗材改革的推进,积极优化临床诊疗工作流程,追求医疗质量和成本控制之间的平衡,以适应新的政策环境,促进我国医疗卫生事业健康发展。     

输卵管通液术与子宫内膜异位症的关系

目的：探讨输久管通液术与子宫内膜异位症的关系。方法：直视下对104例输卵管性不孕患地输卵管通液术,收集输卵管流出液作巴氏染色进行宫内膜细胞的检查。结果：发现子宫内膜异位症29例（27．88％）,检出宫内膜细胞60．67％（63／104）,对月经周期中不同时间通液进行比较,发现各时间段宫内膜细胞的检出率之间差异无显性意义（P＞0．05）。结论：通液术将宫内膜细胞带入盆腔可能是造成子宫内膜异位症的原因,但不同时间通水宫内膜细胞的检出无显差异。     

中药治疗脂肪肝57例临床体会

1　临床资料1 .1　一般资料　共 57例 ,其中男 42例 ,女 1 5例 ,年龄最小 2 9岁 ,最大 69岁 ,病程 1个月～ 8年。脂肪肝诊断分轻、中、重三度 ,57例中重度脂肪肝 2 5例 ,中度脂肪肝 32例 ,未将轻度脂肪肝患者纳入观察病例中。伴有糖尿病者 8例 ,有肝炎病史 1 2例 ,胃炎病史 32例 ,血脂升高者 47例 ,43例患者有长期嗜酒的习惯。1 .2　病例纳入条件　共 57例患者均具备以下条件 :(一 )临床表现 :乏力 ,纳差 ,右上腹不适 ,胀闷或胀痛 ,可伴腹胀 ,肋下可及肝脏或未及。 (二 )均有肝功能异常。 (三 ) B超或 CT检查均呈典型的脂肪肝表现 ,且按 B…     

Nd：YAG激光泪道疏通及圆锥形硅胶棒植入治疗泪道阻塞

目的：评价Nd:YAG激光泪道疏通并圆锥形硅胶棒植入治疗阻塞性泪道疾病的疗效。方法：82例,91眼泪道阻塞及泪囊炎激光泪道疏通后植入硅胶棒,结果：泪道阻塞27眼,泪囊炎64眼,阻塞部位依次为鼻泪管68眼,泪总管31眼,泪小管21眼,1处及2处阻塞各35眼,3处以上21眼,首次硅胶棒留时间12－180d,平均41．74d,一次性治愈68例,好转5眼,无效18眼,有效率80．22％,14眼经二次硅胶棒植入,最终治愈78眼,好转5眼,无效8眼,总有效率91．21％,18眼19次复发,复发率20．88％,16眼泪点撕裂,是最常见的并发症,结论：该方法安全简便,疗效及可重复性好。     

高胆汁酸血症对肝脏能量代谢的影响

目的：探讨高胆汁酸血症单一因素对肝脏能量代谢的影响。方法：经Wistar大鼠颈内静脉持续给阳外源性胆汁酸,升高其外周血清中胆汁酸浓度,模拟阻塞性黄疸患者外周血清中胆汁酸的变化规律。观察腹腕动脉酮体比值及肝组织能荷变化,时间一周。结果：随外周血清中胆法 酸浓度的升高,腹腔动脉血酮体比值,肝组织能荷均呈进行性下降,结论：高胆汁酸血症时肝脏能量代谢受损,表明在阻塞性黄疸患者肝功能损害中高胆汁酸血症起了重要作用。     

儿童肾病综合征患者血小板和血浆von Willebrand因子的变化

目的：观察儿童肾病综合征患者血小板计数和血浆von Willebrand因子的变化,方法,采用ELISA法检测58例NS患儿血浆vWF及血小板计数,并与正常对照组进行比较,结果：NS患儿vwF水平及血小板计数均明显高于正常对照组,两组有显著性差异（P＜0．01）,结论,血浆vWF与血小板计同步升高与NS患儿的高凝状态及血栓形成有一定的关系。     

氢化可的松注射液在光作用下的稳定性研究

目的　用灯光为光源研究药物在自然光照射下的稳定性。方法　采用自制的光量累积仪 ,用脉冲计数法对自然光进行累积计量 ,研究氢化可的松注射液在灯光及自然光照射下的含量变化规律 ;探讨不同光源对该药物稳定性的影响 ;并预测该药物在室内自然光照射下的贮存期。结果　氢化可的松注射液在光照试验中的含量变化遵从零级动力学规律 :C=C0 - k Et;在无外包装条件下 ,室内自然光照射下的贮存期约为 36天 ,与留样测得的结果 35天基本一致。结论　采用灯光照射实验可研究药物在自然光照射下的稳定性。     

基于“病-药-量”探讨《中华医典》含竹沥中药方剂相应规律的数据挖掘

目的 分析《中华医典》中含有竹沥中药方剂“病-药-量”的相应规律,为竹沥的临床诊疗应用及深入研发提供参考。方法 收集整理《中华医典》中含有竹沥的中药方剂,录入Excel 2016构建临证方药数据库,对其病症、证型、药物使用频次、功效类别、性味归经、剂型及用量等进行统计分析,运用SPSS Statistics 22.0、IBM SPSS Modeler 18.0软件进行关联规则、聚类分析等数据挖掘。结果 共收集含竹沥方剂349首,主治病证分类共99种,其中高频病证（≥20次）主要为“中风”“痰饮”“咳嗽”,治疗“中风”证型以风痰瘀阻为主,“痰饮”以饮停胃肠为主,“咳嗽”以痰热郁肺为主;组方中使用频次≥50次的药物有19味,使用频次较高的有生姜、甘草、茯苓、陈皮等,药物功效种类以化痰止咳平喘药、补虚药、清热药为主;药性使用频次最高的为寒性药,其次为温性药,药味多选用甘、苦、辛味,药物归经以脾、胃、心经为主;高频病症剂型及药物用量分析显示,治疗“中风”时,剂型多为汤剂,竹沥用量多为100 mL,核心药物配伍重用防风以祛风化痰,改善脑络痹阻;治疗“痰饮”时,剂型多为丸剂,竹沥用量为200 mL...     

The impact of the COVID-19 pandemic on the mental health of young people: A comparison between China and the United Kingdom

Purpose: As COVID-19 spreads globally and affects people''s health, there are concerns that the pandemic and control policies may have psychological effects on young people (age from 17 to 35 years). This psychological impact might vary in different countries, and thus we compared the prevalence of selfreported psychological distress, loneliness and posttraumatic stress symptoms (PTSS) among young people in the United Kingdom (UK) and China at the beginning of the COVID-19 pandemic. Methods: Data of this study came from two sources. One source was the first wave of COVID-19 study in Understanding Society, a special wave of the UK household longitudinal study, which provided the highquality, national-wide representative panel data. The sample comprised 1054 young people. The other source was an online survey on the mental health of 1003 young people from Shanghai, a highly developed area in China. The questionnaire included questions on the prevalence of common mental disorders (cut-off score ≥ 4), loneliness and potential PTSS (cut-off ≥ 33). Univariable analyses were conducted to test the differences in the self-reported prevalence of psychological distress and loneliness between the two groups. Multivariable logistic regression analyses were run to explore the predictors of psychological distress and loneliness among all the young people from England and Shanghai. Results: Among the samples with self-reported psychological distress, the UK sample accounted for 34.4% (n = 1054) and the Chinese sample accounted for 14.1% (n = 1003). The difference between the two groups was statistically significant (p < 0.001). Additionally, 57.1% of people in the UK and 46.7% in China reported that they sometimes or often felt lonely, of which the difference is statistically significant (p < 0.001). Regression analysis of the entire samples showed that nationality, gender, psychotherapy and loneliness were significant predictors of 12-item General Health Questionnaire scores, while the variables of age and living alone were not. Significant predictors of self-reported loneliness were the nationality, gender, age, living alone and psychotherapy. In China, 123 (12.3%) young people, 49 men (11.3%) and 74 women (13.0%), met the criteria of PTSS symptoms (cut-off scores ≥ 33). These scores were only collected in China. Conclusion: This evidence suggests that mental health and loneliness reported by young people were lower in China than that in the UK during the studied period. More research is needed to understand these differences. If the differential negative psychological impacts are confirmed, country-specific measures of prevention and intervention should be adopted to improve the mental health of young people under the ongoing impact of the pandemic.