鸟氨酸脱羧酶基因表达在卵巢肿瘤中的临床意义

目的研究鸟氨酸脱羧酶(ODC)在卵巢肿瘤中的表达情况,探讨ODC基因在卵巢肿瘤发生、发展中的作用及其在恶性卵巢肿瘤诊断中的价值。方法恶性卵巢肿瘤32例,良性卵巢肿瘤26例,正常卵巢17例,采用逆转录-聚合酶链反应(RT-PCR)方法。结果(1)良、恶性卵巢肿瘤组ODCmRNA表达量与正常卵巢组比较差异有统计学意义(P<0.05)。恶性卵巢肿瘤组与良性卵巢肿瘤组比较差异有统计学意义(P<0.05)。(2)不同病理类型的恶性卵巢肿瘤ODCmRNA表达差异无统计学意义(P>0.05),高分化组ODCmRNA表达低于中、低分化组(P<0.05),(Ⅲ+Ⅳ)期组ODCmRNA表达显著高于(Ⅰ+Ⅱ)期组(P<0.01)。结论卵巢肿瘤组织中ODC基因表达增高,而恶性肿瘤组织中异常高表达,并随着组织学分级、临床分期的增高递增,表明卵巢组织中ODCmRNA表达水平增高是促进肿瘤形成的重要因素,ODC基因表达增强与恶性卵巢肿瘤的发生与转移有关。     

增龄对牙周细胞覆盖体外创面的影响

目的:以长期培养的牙周膜和牙龈成纤维细胞模拟老化细胞,在体外创面模型中,就增龄对牙周细胞覆盖创面的影响进行评价。方法:以反复传代12代以上的牙周膜、牙龈成纤维细胞作为老化(实验组)细胞,5代以内的牙周膜、牙龈成纤维细胞作为正常对照组。4种细胞接种于盖玻片直至融合。机械方法刮除部分融合细胞,形成宽约7mm的无细胞条带,即体外创面。创面形成后继续培养2、6、9d,固定玻片并作结晶紫染色。以计算机辅助图像分析系统对细胞覆盖体外创面的面积进行百分比定量,采用SAS6.12软件包进行样本均数的t检验。结果:实验组与对照组比较,实验组的牙周膜、牙龈成纤维细胞覆盖创面面积明显较少,创面形成第6、9d,其覆盖创面面积显著低于对照组,差异有显著性(P<0.05)。实验组与对照组牙周膜、牙龈成纤维细胞覆盖创面面积存在差异,对照组创面形成后第9d牙龈成纤维细胞覆盖创面面积显著高于牙周膜细胞,差异有显著性(P<0.05)。结论:老化牙周膜、牙龈成纤维细胞覆盖创面的能力弱于正常细胞。增龄可能损害牙周细胞对创面的覆盖能力。     

5种着色剂对牙科氧化锆陶瓷色度的影响

目的:研究5种着色剂对牙科氧化锆陶瓷色度影响的规律,为量化着色剂的添加比例提供依据。方法:在纳米氧化锆粉体中掺入不同比例的5种着色剂,200MPa冷等静压成型,于高温烧结炉中烧结到1400℃并保温2h,将烧结体研磨至(1.0±0.1)mm厚。观察烧结体的色泽并用色度仪测试其色度值。结果:氧化铒(Er_2O_3)能够使氧化锆陶瓷呈红色,对烧结体的b*值和L*值无影响。氧化铈(CeO_2)和氧化镨(Pr_6O_(11))均能使氧化锆陶瓷呈黄色,而对烧结体的a*值和L*值无明显影响。氧化铁(Fe_2O_3)能使氧化锆陶瓷呈黄褐色,随着剂量的增加,a*和b*值均增大,L*值略有下降。氧化锰(MnO_2)能够有效降低氧化锆陶瓷烧结体的明度,对a*和b*值无明显影响。结论:5种梯度着色氧化锆陶瓷能够覆盖牙科陶瓷所需的色度范围,值得进一步的研究与开发。     

中西医结合治疗卵巢储备功能减退患者成功妊娠二例并文献复习

卵巢储备功能减退（diminished ovarian reserve,DOR）是卵巢因素所致不孕症的主要原因之一,西医临床治疗方法主要依赖于口服提高卵巢储备功能的药物、人工激素周期替代疗法和辅助生殖技术助孕,中医运用补肾健脾法治疗DOR具有不良反应少、疗效持久、治疗手段多样化等优势。报告2例在常规西医治疗基础上应用中医补肾健脾法综合治疗DOR患者成功妊娠的情况,强调个体化中西医结合治疗方案对于解决疑难病证的重要性,为临床应用中医药治疗DOR患者提供证据。     

脑卒中患者主要居家照顾者负荷及影响因素的研究

目的了解脑卒中主要居家照顾者的负荷水平及其影响因素。方法选择上海市社区脑卒中患者180例,调查患者的基本情况和功能独立性水平,调查主要照顾者的人口社会学资料、照顾相关资料、应对资源与负荷。对数据进行单因素分析和多元回归分析。结果主要居家照顾者负荷平均分为48.83±8.05。不同的文化程度、家庭经济情况、慢性病情况、每天照顾时间、照顾任务、陪伴患者时间、照顾意愿、自我效能、健康相关生活质量以及患者功能独立程度不同,主要照顾者的负荷差异有统计学意义(P<0.05)。以负荷总分为应变量,所有因素为自变量进行多元逐步回归,,照顾者健康相关生活质量、脑卒中患者的功能独立程度进入回归方程(P<0.001)。结论居家照顾脑卒中患者给其照顾者带来了较重的负荷。应充分重视提高患者的功能独立性水平,给予照顾者多方面的社会支持,提高其自我效能。     

Association between clustering of cardiovascular risk factors and resting heart rate in Chinese population: a cross-sectional study

BACKGROUNDEpidemiologic studies have explored the association between a single cardiovascular risk factor (CVRF) and resting heart rate (RHR), but the research on the relation of multiple risk factors with RHR remains scarce. This study aimed to explore the associations between CVRFs clustering and the risk of elevated RHR.METHODSIn this cross-sectional study, adults aged 35–75 years from 31 provinces were recruited by the China PEACE Million Persons Projects from September 2015 to August 2020. We focused on seven risk factors: hypertension, diabetes mellitus, dyslipidemia, obesity, smoking, alcohol use, and low physical activity. Multivariate logistic regression was used to calculate odds ratios (OR) for elevated RHR (> 80 beats/min).RESULTSAmong 1,045,405 participants, the mean age was 55.67 ± 9.86 years, and 60.4% of participants were women. The OR (95% CI) for elevated RHR for the groups with 1, 2, 3, 4 and ≥ 5 risk factor were 1.11 (1.08–1.13), 1.36 (1.33–1.39), 1.68 (1.64–1.72), 2.01 (1.96–2.07) and 2.58 (2.50–2.67), respectively (P_trend < 0.001). The association between the CVRFs clustering number and elevated RHR was much more pronounced in young males than in other age-sex subgroups. Clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR than those comprising more behavioral risk factors. CONCLUSIONSThere was a significant positive association between the CVRFs clustering number and the risk of elevated RHR, particularly in young males. Compared clusters comprising more behavioral risk factors, clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR. RHR may serve as an indicator of the cumulative effect of multiple risk factors.

Over the past several years, the rapid development of smart wrist-worn devices has resulted in a convenient approach to monitoring resting heart rate (RHR) in daily life. RHR is becoming a promising indicator of cardiovascular health. Observational studies have shown that elevated RHR is associated with increased all-cause and cardiovascular mortality in populations with or without cardiovascular disease (CVD).^[1,2] Elevated RHR has also been found to be associated with cardiovascular risk factors (CVRFs), such as hypertension, diabetes mellitus, dyslipidemia, low physical activity and smoking, indicating its potential to reflect total cardiac risk.^[3–7] There is abundant epidemiologic evidence supporting the association between a single CVRF and RHR, but studies exploring associations between multiple CVRFs and RHR are limited. CVRFs tend to cluster within individuals, and several weak risk factors combined may result in a much higher risk than that due to a single strong risk factor. According to a cross-sectional survey in China, more than 45% of Chinese adults have two or more coexisting CVRFs.^[8] Thus, it is important to consider the situation of multiple CVRFs clustering. However, very few studies have analyzed the association between CVRFs clustering and RHR, and several aspects remain unknown. Firstly, prior studies mainly focused on the relation between metabolic risk factors and RHR.^[9–11] Behavioral risk factors such as smoking, physical activity and alcohol use have rarely been considered, even though these risk factors also have a significant effect on heart rate.^[3,5,7] Secondly, most studies merely dealt with the relation of CVRFs clustering number with RHR, while regarding each number of risk factors, different combinations of risk factors have not yet been considered before.^[9,12] It is important to consider different CVRF clustering patterns since some risk factors combined may lead to a higher risk of elevated RHR than others, even if the number of CVRFs is the same. Thirdly, prior studies did not assess associations stratified by sex and age. It has been well documented that RHR levels differ by sex and age. The RHR in women was on average 2–7 beats/min higher than that in men, and there was a decrease in the RHR with age.^[13,14] As such, whether the associations of CVRFs clustering with RHR varied between sex and age remains unclear. Taking advantage of the large sample size in our study, we are able to include a wider range of CVRFs (metabolic and behavioral risk factors), comprehensively evaluate the association between these CVRFs clustering and RHR, and further explore sex and age differences. This finding may inform us whether RHR can be used as a simple and efficient metric for the identification of high-risk individuals who require more intensive risk factor evaluation and earlier cardiovascular health monitoring in resource-constrained countries with substantial CVD burdens, such as China. To bridge this knowledge gap, we used data from the China PEACE Million Persons Projects, a nationwide screening project, to explore (1) the association between the number of CVRFs clustering and elevated RHR in the overall population and populations stratified by age and sex; and (2) the associations between different CVRFs clusters and the risk of elevated RHR in the overall population and populations stratified by sex.     

以教学评估为契机培养高素质的药学人才

为迎接教学评估,培养高素质的药学人才,药学教学应从更新观念,加快师资队伍建设,改进人才培养模式,教学方法等方面入手。     

对接大健康产业发展的康复治疗学人才培养体系的构建

在大健康产业发展背景下,康复服务产业发展模式和服务理念逐步转变。康复人力资源是康复服务产业发展的基石,文章基于《国际功能、残疾和健康分类》(international classification of functioning,disability and health,ICF)康复科学理论体系,切合康复服务产业化和专业化需求,重构康复治疗学专业人才培养的课程体系,强化实践教学,探讨构建康复治疗学专业人才培养新模式。     

住培基地管理人员线上培训学习与启示

介绍了北京市2020年8月住院医师规范化培训（住培）基地管理人员能力提升培训班线上授课的主要内容：包括住培制度建立的背景及重要性,住培相关政策介绍;基地评估的5个一级指标、16个二级指标、39个三级指标（住培工作重点）的具体评分标准,其中包括13项核心指标,是基地建设的关键,以及基地评审注意事项;住培招录相关文件政策简介,招录实施注意事项,招录工作中常见问题与解答,招录流程的规范要求;培训轮转安排的原则：依据培训细则的规定,尽量先安排必转科室的轮转,按照分层递进式轮转安排;住培考核分为过程考核和结业考核,过程考核是重点,主要包括：日常考核、出科考核、年度考核,简要介绍出科考核小组人员构成及考核流程等;以及住培医师入院入科教育、住院医师及住院师资日常管理等内容。通过培训,提升住培师资综合素质,为提高住培质量,培养合格的临床医师奠定基础。     

基于“一动力三循环”管理模式的“3S”方法在临床研究生导师队伍建设中的应用

研究生教育是国家高水平教育的代表,也是医院发展的体现,在一定程度上可以看出医院的医疗、教学、科研、学术地位。研究生导师是高层次和高水平师资的主要代表,是一个医院提升自身教学实力、影响力、竞争力的关键。本文针对专科医院研究生导师队伍建设存在以下问题进行阐述：对外交流培训不足,师资队伍评价体系不科学,师资队伍结构不合理。基于“一动力三循环”管理模式,探索提出“3S”研究生导师队伍建设模式：加强对外交流与培训,建立科学的评价体系,建立结构合理的导师队伍,以优化研究生导师队伍建设为目标,打造一支业务能力专业、评价体系科学、师资结构合理的导师队伍,不断提升医院研究生导师队伍建设水平,是每个研究生培养单位的重要任务。同时概括了现阶段研究生导师队伍建设的成效和不足,并给予了反馈与意见。