农村卫生人员继续教育的实践与思考

结合甘肃省农村卫生队伍的实际状况，坚持学历教育与岗位培训并举，分层次、分阶段培训的原则，建立农村卫生人员继续教育网络，构建“自学-培训-评价”三位一体的农村卫生人员继续教育体系。从中认识到：建立继续教育网络是农村卫生人员继续教育的基础工程；提高服务能力是农村卫生人员继续教育的主旋律；构建“自学-培训-评价”三位一体的继续教育体系是农村卫生人员继续教育的质量保证。     

妊娠合并血小板减少112例临床分析

目的:探讨妊娠合并血小板减少的发病机制及围生期的处理方法。方法:回顾分析天津医科大学总医院1992年至2002年间112例妊娠合并血小板减少患者的病因及临床处理经验。结果:112例孕妇中特发性血小板减少性紫癜27例,占24.1%;子痫前期44例,占39.3%;妊娠期特发性血小板减少40例,占34.8%;血栓性血小板减少性紫癜1例,占0.89%。阴道分娩27例,剖宫产85例。产后出血13例,产褥感染1例。结论:多种原因可以导致妊娠妇女血小板减少。如无产科指征,以阴道分娩为宜;血小板<50×109/L时,在血源充足时行剖宫产。不主张采用侵入性检查方法确定胎儿血小板水平。     

急性中毒患者血液毒鼠强的GC/MS检测及临床应用

目的利用气相色谱-质谱（GC/MS）建立一种快速检测中毒患者血液毒鼠强的方法.方法考察5种有机溶剂液-液法提取血液毒鼠强的回收率,研究毒鼠强的线性方程、最低检测限及精密度.结果乙酸乙酯提取毒鼠强的回收率为90.40%,RSD=2.8%,n=5;毒鼠强线性方程为y=156.5x＋236.1,R=0.9988;最低检测限为4ng/ml;日内精密度为RSD为4.3%,日间精密度为RSD为6.7%.解析了毒鼠强质谱图的主要碎片归属.结论所建方法简单快速,灵敏度高,选择性好,可用于临床中毒患者血液毒鼠强的检测.     

硝苯地平制剂的溶出度测定方法

目的测定硝苯地平制剂的溶出度。方法在溶出介质中加入非离子表面活性剂吐温-80,使硝苯地平的溶解度增加至86μg·ml-1。结果及结论此方法完全符合溶出度测定的漏槽条件。     

The association of XRCC1 haplotypes and chromosomal damage levels in peripheral blood lymphocyte among coke-oven workers.

Theoretically, a haplotype has a higher level of heterozygosity than individual single nucleotide polymorphism (SNP) and the association study based on the haplotype may have an increased power for detecting disease associations compared with SNP-based analysis. In this study, we investigated the effects of four haplotype-tagging SNPs (htSNP) and the inferred haplotype pairs of the X-ray cross-complementing group 1 (XRCC1) gene on chromosome damage detected by the cytokinesis-block micronucleus assay. The study included 141 coke-oven workers with exposure to a high level of polycyclic aromatic hydrocarbons and 66 nonexposed controls. The frequencies of total MN and MNed cells were borderline associated with the Arg(194)Trp polymorphism (P = 0.053 and P = 0.050, respectively) but not associated with the Arg(280)His, Arg(399)Gln and Gln(632)Gln polymorphisms among coke-oven workers. Five haplotypes, including CGGG, TGGG, CAGG, CGAG, and CGGA, were inferred based on the four htSNPs of XRCC1 gene. The haplotype CGGG was associated with the decreased frequencies of total MN and MNed cells, and the haplotypes TGGG and CGAG were associated with the increased frequencies of total MN and MNed cells with adjustment for covariates among coke-oven workers. This study showed that the haplotypes derived from htSNPs in the XRCC1 gene were more likely than single SNPs to correlate with the polycyclic aromatic hydrocarbon-induced chromosome damage among coke-oven workers.     

肺癌组织中黑色素瘤抗原-A3基因mRNA的表达及其序列点突变分析

目的检测肺癌组织中黑色素瘤抗原-3基因(MAGE-A3)mRNA的表达。方法用逆转录-套式聚合酶链反应(RT-PCR)对31例肺癌患者癌组织和相应癌旁组织MAGE-A3mRNA表达情况进行测定;PE-377DNA测序仪对5例10个RT-PCR扩增产物中的目的基因片段进行DNA序列测定。结果31例肺癌患者癌组织中26例表达MAGE-A3mRNA,阳性率为83.9%;相应的癌旁组织均未表达。DNA序列测定证明PCR扩增产物中目的基因片段均为MAGE-A3cDNA序列,所测5例样本中4例样本有两个相同位置的碱基发生了点突变(C2773→T2773;G2807→A2807),导致一个氨基酸残基改变(E143→K)。结论MAGE-A3mRNA在肺癌中呈高比例表达,提示此抗原有可能作为肺癌患者免疫治疗的靶抗原。我国肺癌患者中存在MAGE-A3基因个别位点的变异。     

中西医结合治疗输卵管阻塞性不孕症

陈益昀主任中医师是全国第二、三批中医药专家学术经验继承指导老师，临床悬壶五十余载，治学严谨，注重实际。几十年的临床实践加之深厚扎实的理论功底，尤其能够结合现代医学知识，使其在治疗疾病，立法用药上独树一帜。笔者有幸随师学习，获益匪浅，兹将陈老师运用中西医结合治疗输卵管阻塞性不孕症的经验总结介绍如下：     

夏至草提取物对急性血瘀大鼠淋巴微循环的作用

目的:观察夏至草提取物(HLE)对急性血瘀大鼠淋巴微循环的作用.方法:(Dextran)以10ml/kg经静脉注射,1 min注完,诱导大鼠急性血瘀症模型,6 min后治疗组按1.0g/kg(含生药)从颈静脉注射HLE,对照组颈静脉注射等量的生理盐水,通过显微电视录像观察肠系膜微淋巴管(ML)收缩性的变化.结果:夏至草提取物使ML自主收缩频率、收缩活性指数(Index Ⅰ)、总收缩活性指数(IndexⅡ)、淋巴动力学指数(LD-Index)和血压显著高于对照组(P《0.05～0.01).结论:夏至草提取物对急性血瘀大鼠淋巴微循环障碍有非常好的改善作用.     

王不留行对家兔离体主动脉环张力的影响及其机制

目的:研究王不留行水煎液(DSC)对兔离体主动脉环张力的影响及其机制.方法:采用家兔离体主动脉环张力记录法.结果:DSC可浓度依赖性地引起动脉血管静息张力的增加.用10-7mol/L酚妥拉明、10-5mol/L异搏定、10-6mol/L苯海拉明或无钙K-H液温育后均可明显减弱DSC的收缩作用;而去除内皮细胞后,10-7mol/L阿托品则无明显影响.结论:DSC可引起主动脉环收缩,其机制可能与平滑肌细胞上的肾上腺素能α受体、异搏定敏感的Ca2 通道、细胞外Ca2 以及组胺H1受体有关,而与血管内皮细胞和胆碱能M受体无关.     

Phacoemulsification in eyes with corneal opacities after deep anterior lamellar keratoplasty

To evaluate the maneuverability and efficacy of phacoemulsification and intraocular lens (IOL) implantation in eyes with corneal opacities after deep anterior lamellar keratoplasty (DALK), twelve eyes of 12 patients with mild to moderate corneal opacities after DALK and coexisting cataracts were analyzed retrospectively. Phacoemulsification and IOL implantation assisted with anterior capsule staining, as well as non-invasive optical fiber illumination, were performed on all eyes. No intraoperative or postoperative complications were noted. Mean corrected distance visual acuity (logMAR) improved from 1.24±0.17 to 0.73±0.22. Post-phaco intraocular pressure was maintained between 13 to 20 mm Hg in all cases throughout the follow-up period. Mean endothelial cell density decreased from 2258.42±205.94 to 1906.25±174.23 cells/mm2. Phacoemulsification and IOL implantation are safe and valid in eyes with mild to moderate corneal opacities after DALK and coexisting cataracts when assisted with anterior capsule staining and non-invasive optical fiber illumination.