基于HL7标准与中间件技术集成方法的信息化平台

论述和总结了医院针对信息化建设中急待解决的医疗信息共享的问题,以中间件技术为解决方案,以XML和HL7为具体手段,加强信息平台建设,解决医院内部子系统之间,以及多家医院HIS与HIS的异构数据源环境下的数据集成与数据共享问题的思路与做法。     

恶性肿瘤患者尿液RBP和β2-MG检测的临床意义

视黄醇结合蛋白(RBP)是反映肾小管损伤的较新指标。β2-微球蛋白是证实肾脏损伤的经典指标。为了解肿瘤患者尿中RBP和β2-MG与恶性肿瘤患者肾损害的关系,分别采用ELISA和RIA技术检测208例恶性肿瘤患者尿RBP和β2-MG。结果其测定值明显高于正常对照组。RBP和β2-MG检测阳性率分别为625%和6202%(P>005)。研究还表明手术明显降低了患者β2-MG和RBP检测阳性率(P<005)。而化疗则对患者肾功改善无太大帮助(P>005)。这可能与损伤肾脏化疗药物的广泛应用有关。RBP检测较少受肾外因素影响、在尿液中较β2-MG更稳定,检测方法更简便。RBP可优先作为肿瘤患者肾损害的一个监测指标。     

针刺治疗脑卒中后遗症取穴规律探究

搜集近3年来针刺治疗脑卒中后遗症的相关文献32篇,对其取穴规律从中西医角度进行总结与分析发现,在针刺治疗脑卒中后遗症时,多数学者采用体针取穴,其中包括十四经选用合谷、曲池、肩、外关、阳陵泉、足三里等阳经腧穴,和醒脑开窍针法。部分学者采用头针运动区、感觉区取穴方法及腹针引气归元针法治疗脑卒中后遗症。亦有部分学者采用体针、头针、腹针结合的综合疗法。     

针灸和中医药在美国的发展现况

自上世纪末以来,由于美国民众对西医药治疗慢性病的不确定疗效的不满及长期服用西药所引起的副作用的忧虑,寻找一种安全而自然的替代疗法成为大势所趋.作为替代医学一部分的针灸和中医药被越来越多的美国民众所接受.本文介绍了自上个世纪末到目前的针灸和中医药(不含非药物疗法)在美国的发展背景;针灸和中医药所经历的立法情况,其中针灸的...     

mmp-14和CD34在青年乳腺癌演变过程中的表达及意义

目的：研究基质金属蛋白酶14（mmp-14）与CD34在≤35岁乳腺癌、乳腺良性肿瘤、乳腺增生症及乳腺癌旁组织患者中的表达及临床意义。方法采用免疫组织化学方法对30例乳腺癌、30例乳腺良性肿瘤、30例乳腺增生症及30例癌旁组织中乳腺终末导管及腺泡上皮细胞患者的mmp-14表达情况及CD34标记的间质血管数目进行检测。结果 mmp-14在4组导管及腺泡上皮细胞中的表达情况：乳腺癌组mmp-14高表达,与其他3组两两比较差异具统计学意义（P＜0.05）。CD34在4组中标记间质血管数目的情况：乳腺增生症组和乳腺癌组血管增生数目均高于良性肿瘤组,差异有统计学意义（P＜0.05）。结论乳腺终末导管及腺泡上皮细胞mmp-14的高表达和CD34标记的间质血管数目增加与青年乳腺癌的演变过程密切相关,有望成为青年乳腺癌早期诊断和治疗可靠的临床指标。     

美托洛尔基于循证的药物评价

目的：借鉴世界卫生组织及各国遴选基本药物时所依据的循证方法,对我国2009年版《国家基本药物目录》中关托洛尔进行综合评价,探索适合我国国情的基本药物遴选路径及评价方法。方法：采用系统评价方法,对美托洛尔的疗效及安全性进行评价。结果：共纳入4篇文献,分析结果显示：与安慰剂相比,美托洛尔虽然不良反应发生率偏高[RR=5．39,95％CI（2．11,13．80）,P：0．0004】,但不增加死亡风险啤R=0．84,95％CI（O．52,1．35）,P=0．47],且能显著降低心律失常复发率[RR=0．70,95％CI（O．61,0．82）,P〈0．000011。结论：按系统评价流程,结合经济学研究满足基本药物遴选安全、有效、经济的要求,值得推广。     

Moxibustion treatment increases the survival rate of lung infection of patients bed-ridden due to osteoporotic fracture of the spine via regulation of the inflammatory responses

IntroductionThis study aimed to investigate the potential role of moxibustion (MOX) in the treatment of lung infection in patients bed-ridden due to osteoporotic fracture of the spine.Methods96 senile patients with pulmonary infection who were bed-ridden due to osteoporotic fracture of the spine were grouped into a MOX (–) group and a MOX (+) group. An animal model was established as a SHAM group, a PRIMED group, a MOX 15’ group and a MOX 30’ group.ResultsFor the patients’ study, we found that the survival rate was higher for patients who received MOX. Moreover, tumor necrosis factor-α, interleukin (IL) 1β, IL-6 and IL-18 were down-regulated while IL-10 was up-regulated by MOX. MOX time-dependently increased the survival while reducing the bacteria left in infected mice.ConclusionsMoxibustion significantly alleviated the inflammatory responses, thus leading to a better survival rate of patients bed-ridden due to osteoporotic fracture of the spine.     

“Pincer movement”: Reversing cisplatin resistance based on simultaneous glutathione depletion and glutathione S-transferases inhibition by redox-responsive degradable organosilica hybrid nanoparticles

The therapeutic efficacy of cisplatin has been restricted by drug resistance of cancers. Intracellular glutathione (GSH) detoxification of cisplatin under the catalysis of glutathione S-transferases (GST) plays important roles in the development of cisplatin resistance. Herein, a strategy of “pincer movement” based on simultaneous GSH depletion and GST inhibition is proposed to enhance cisplatin-based chemotherapy. Specifically, a redox-responsive nanomedicine based on disulfide-bridged degradable organosilica hybrid nanoparticles is developed and loaded with cisplatin and ethacrynic acid (EA), a GST inhibitor. Responding to high level of intracellular GSH, the hybrid nanoparticles can be gradually degraded due to the break of disulfide bonds, which further promotes drug release. Meanwhile, the disulfide-mediated GSH depletion and EA-induced GST inhibition cooperatively prevent cellular detoxification of cisplatin and reverse drug resistance. Moreover, the nanomedicine is integrated into microneedles for intralesional drug delivery against cisplatin-resistant melanoma. The in vivo results show that the nanomedicine-loaded microneedles can achieve significant GSH depletion, GST inhibition, and consequent tumor growth suppression. Overall, this research provides a promising strategy for the construction of new-type nanomedicines to overcome cisplatin resistance, which extends the biomedical application of organosilica hybrid nanomaterials and enables more efficient chemotherapy against drug-resistant cancers.KEY WORDS: Cancer therapy, Cisplatin, Drug resistance, Glutathione depletion, Glutathione S-transferases, Disulfide bonds, Organosilica hybrid nanoparticles, Ethacrynic acid