An overview of hospital accreditation in Taiwan, Republic of China

This paper examines the hospital accreditation system in Taiwan, Republic of China. The paper describes the historical evolution of accreditation; preliminary teaching hospital accreditation; hospital and teaching hospital accreditation; issues and problems; and perspectives and challenges.     

5－Fu佐剂包裹物的抗肿瘤作用的实验研究

本文作了福氏完全佐剂（Ｆｒｅｕｎｄ’ｓｃｏｍｐｌｅｔｅａｄｊｕｖａｎｔ,ＦＣＡ）包裹５－Ｆｕ的抗肿瘤作用的实验研究。在对小鼠Ｓ１８０肿瘤（腹水型）,ＥＡＣ肿瘤（腹水型）及Ｈ２２肝癌（腹水型）荷瘤鼠的治疗实验中,一次性腹腔注射２ｍｇ～６ｍｇ的５－Ｆｕ（相当于７０公斤人给予７７８～２３３４ｍｇ的剂量）均不能显著延长荷瘤鼠的存活期,盐水ＦＣＡ亦无治疗作用,而５－ＦｕＦＣＡ却显示出显著的治疗效果。４次实验,５－ＦＵ－ＦＣＡ治疗组荷瘤鼠平均存活期３０．６天～４８．３天,均显著长于同次实验的各对照组,且每次实验都有２／８至３／８的荷瘤鼠可完全治愈。     

Multiple effects on drug-sensitivity, genome stability and malignant potential by combinations of h-ras, C-myc and mutant p53 gene overexpression

Activation of specific oncogenes and inactivation of tumor suppressor genes play major roles in mechanisms leading to neoplastic transformation. The potential involvement of these genes in determining genome stability is an important issue. To examine the relationships between altered oncogene expression and the effects on genome stability, we have investigated the drug sensitivity properties of mouse 10T1/2 fibroblasts transfected with combinations of H-ras, c-myc and the proline 193 mutant form of p53. The relative colony forming efficiencies of these cells were investigated in the absence or presence of various concentrations of the chemotherapeutic agents, methotrexate, N-(phosphonacetyl)-L-aspartate (PALA) or hydroxyurea. The effects of altered oncogene expression were found to be drug and locus specific, and to lead to increased drug resistance (e.g. H-ras transfectants were significantly resistant to methotrexate or PALA), decreased drug resistance (e.g. H-ras/-myc transfectants were significantly less resistant to PALA or hydroxyurea than H-ras transfected cells), or to no significant change in drug sensitivity (e.g. H-ras transfected cells were not significantly different in sensitivity to hydroxyurea than non-transfected cells). Gene amplification was an important but not the only mechanism for drug resistance. Cells that were transfected with p53 (H-ras/p53 or H-ras/c-myc/p53) exhibited the greatest drug resistance properties with all three chemotherapeutic agents, in keeping with the important role of p53 in DNA repair and DNA amplification mechanisms. Although both H-ras/p53 and H-ras/c-myc/p53 groups exhibited very similar genome stability characteristics as determined by drug sensitivity results, they were significantly different in their abilities to produce transformed foci in vitro and lung metastases in vivo. The H-ras/c-myc/p53 transfected cells formed significantly higher numbers of transformed foci and exhibited a greater malignant potential. These results are consistent with observations that H-ras expression directly correlates with malignant potential, and that H-ras/c-myc/p53 transfected cells have higher H-ras expression than H-ras/p53 transfected cells. Alterations in genomic integrity through changes in onocogene expression play important roles in mechanisms determining drug sensitivity; in addition to genome destabilization, other events are critically involved in regulating transformed and malignant characteristics.     

工频电磁场对人体免疫功能的作用

目的　探讨工频电磁场对人体免疫功能的影响。方法　检测２５ 例长期工作在３ ×１０５ Ｖ超高压环境中的工作人员与５ 例正常对照者的外周血Ｔ 淋巴细胞分泌白细胞介素２（ＩＬ２） 活性,白细胞介素２ 受体（ＩＬ２Ｒ） 表达;单核／ 巨噬细胞抗体依赖的细胞介导的细胞毒（ＡＤＣＣ） 效应,白细胞介素１５（ＩＬ１５） 活性;血清中ＩｇＧ、ＩｇＡ、ＩｇＭ 的水平。结果　（１） 观察组ＩＬ２ 活性为（３６２ ±７８） Ｕ／ｍｌ,明显高于对照组［（２５４ ±６７）Ｕ／ｍｌ］ ,差异有显著性（ Ｐ ＜ ０ ．０５） 。（２） 观察组ＩＬ２Ｒ 表达比率为２８ ．４ ％ ±３ ．２ ％ ,对照组为２２ ．８ ％ ±１０ ．７ ％ ,差异无显著性（ Ｐ ＞ ０ ．０５） 。（３） 观察组单核／ 巨噬细胞ＡＤＣＣ 效应及ＩＬ１５ 分泌水平均有增强或增高的趋势,但差异无显著性（ Ｐ ＞ ０ ．０５） 。（４） 观察组血清中ＩｇＧ 水平为（１０ ．３７ ±１ ．２８）ｇ／Ｌ,明显高于对照组［（８ ．８９ ±１ ．８８）ｇ／Ｌ］ ,差异有显著性（ Ｐ ＜ ０ ．０５） ,而血清中ＩｇＡ、Ｉｇ Ｍ 水平与对照组比较,差异无显著性（ Ｐ ＞ ０ ．０５） 。结论　长期工作在工频电磁场环境中人员的Ｔ     

城市住宅新区医疗卫生服务需求的现状与对策

目的:了解城市住宅新区医疗卫生服务供给与需求的现状,为决策部门合理分配卫生资源提供参考依据。方法:根据浙江省城市地理位置和经济文化、发展程度,在全省范围内选择有代表性的城市,采用城、区街(居委会)住户4个层次随机抽样方法调查4810户家庭。结果:住宅新区个人和家庭医疗卫生服务需求大于供给,希望社区提供全天候卫生服务。医疗费用支出占家庭收入的6.20％,绝大多数家庭能承担各项医疗费用,家庭每年最多能支出医疗保健服务费用平均为2565.15元。     

逆转录—聚合酶链反应在丁型肝炎病毒感染的应用及意义

本项技术选取丁型肝炎病毒（ＨＤＶ）ＲＮＡ的非抗原编码区的相对保守区为靶序列,设计两对引物,进行巢式聚合酶链反应（ＰＣＲ）扩增ＨＤＶＲＮＡ。血清及肝组织采用蛋白酶消化法提取ＲＮＡ。结果发现９８例各型病毒性肝炎血清中,ＨＤＶ—Ｍ阳性组ＨＤＶＲＮＡ检出率为５６６％（３０／５３）,ＨＤＶ—Ｍ阴性组为８９％（４／４５）（Ｐ＜００１）;ＨＤＡｇ或／及抗ＨＤＩｇＭ阳性血清测定ＨＤＶＲＮＡ的阳性率为５７１％（２８／４９）,抗ＨＤ阳性血清的阳性率为５００％（２／４）;９例ＨＤＶ—Ｍ阳性肝组织测定ＨＤＶＲＮＡ阳性者６例,２例ＨＤＶ—Ｍ阴性肝组织均阴性。本项技术是在分子水平上检测病毒核酸、操作简便、稳定、可靠、特异性高、重复性好,可以作为ＨＤＶ血清学指标的佐证和补充,肝组织ＨＤＶＲＮＡ的测定可应用于回顾性研究,在临床病原诊断、抗病毒疗效判定、病毒复制、重叠感染等研究方面提供重要实验依据。     

云南元江流域现行疟疾媒介防制措施执行情况及效果评价圹

目的了解元江流域疟疾流行现况、媒介防制措施执行情况及效果.方法采用面上调查、实验室和现场观察相结合的方法,对元江流域的媒介防制措施执行情况及效果进行综合评价.结果目前元江流域疟疾媒介控制措施仍以DDT滞留喷洒为主;该措施能有效控制主要媒介微小按蚊,但不能控制次要媒介中华按蚊,而且对按蚊有兴奋驱避作用;按使用DDT滞留喷洒计算,目前购买杀虫剂的投入仅能满足42.83%的需求,但按使用溴氰菊酯浸泡蚊帐计算,仅用现在杀虫剂费用的50.75%就可满足需要.结论基于DDT滞留喷洒的效果、经费和操作不便的限制,DDT滞留喷洒措施应该逐渐被其它控制措施替代.     

uPAR mRNA测定及其在U937细胞中的表达

目的 研究凝血酶、ＴＮＦ－α、ＩＦＮ－γ等对Ｕ９３７细胞表达ｕＰＡＲ ｍＲＮＡ的影响,观察凝血系统、炎症介质与纤溶功能变化间的关系。 方法 建立并应用逆转录ＰＣＲ（ＲＴ－ＰＣＲ）法测定培养Ｕ９３７细胞的ｕＰＡＲ ｍＲＮＡ。 结果：１．经测定批间变异系数（ＣＶ间）确认了ＲＴ－ＰＣＲ法测定ｕＰＡＲ ｍＲＮＡ的稳定性;２．以不同浓度凝血酶刺激２４ｈ,对Ｕ９３７细胞表达ｕＰＡＲ ｍＲＮＡ有抑制和促进两种不     

新生儿严重脑室内出血连续腰穿的疗效

目的为了治疗和预防脑室内出血后脑积水的发生和发展,改善新生儿严重脑室内出血的不良预后。方法1989年以来,对19例在出生后早期经头颅B超诊断为严重脑室内出血（IVH）患儿进行了连续腰穿（LP）治疗。结果有效16例,自动出院1例,失败2例。有效率为84．2％。有效16例初次LP日龄为14．6±5．7d,疗程23．4±12d,平均LP次数9．3±4．7次,平均LP间隔期3．1±1．6d,平均每次放液量6．7±2ml,LP治疗后起效天数为10．1±7．8d。2例在连续LP的同时联用乙酰唑胺治疗亦取得显著疗效。16例平均随访月龄为3．2±1月,体格发育均正常,B超显示12例脑室形态正常,4例脑室呈稳定的轻度增大。失败的2例初次LP迟,初期LP间隔期延长为7－9d,放液量＜5ml。同期另有17例严重IVH患儿未予LP治疗。其中4例并发脑积水,5例自动出院,4例早期死亡,余4例其后脑室形态稳定。结论连续LP不失为治疗新生儿严重IVH实用安全有效的方法,LP疗效欠佳时可联用乙酰唑胺治疗。