医院中西药房合并的利弊分析与探讨

近年来，随着我国医疗市场的开放和竞争的加剧，医院的改革正逐步深入，从扩外延到抓内涵，从提高医技质量到改善服务水平，从整合科室结构到转变管理理念，一切紧紧围绕着市场对医疗水平的高质量需求而展开。药剂科作为医院医疗工作中的一个重要科室，其改革不但影响着医院的医疗质量，而且直接关系到医院改革的成败及医院的健康发展。     

CT联合模板引导放射性粒子植入治疗不可手术的早期非小细胞肺癌

目的 探讨CT联合模板引导放射性粒子植入治疗不可手术的早期非小细胞肺癌（NSCLC）的疗效和不良反应。方法 回顾性分析2010年12月到2016年10月间在天津医科大学第二医院接受CT引导下放射性粒子治疗的21例不可手术的T_1-2N₀M₀早期非小细胞肺癌患者。所有患者术前取得组织学病理,选用粒子活度18.5~29.6 MBq,处方剂量120~160 Gy,均在1次手术内完成粒子植入,术前及术后经TPS制定计划和质量验证。随访评价肿瘤局部控制率、总生存时间、无进展生存期、剂量验证满意率及不良反应。结果 中位随访时间为25.1个月（范围4.4~72.7个月）。1、2、3年的原发肿瘤局部控制率分别为100%、95.2%、95.2%。所有患者的中位总生存期为48个月,中位无进展生存期为43.4个月。1、2、3年生存率分别为100%、91.7%、72.9%。3年无进展生存率为70.2%。术后质量验证满意率为100%。与治疗相关的不良事件包括：气胸、支气管出血、胸膜出血、咳嗽、肺部纤维化及粒子移位。其中7例患者发生1级不良事件（33.3%）;4例患者发生2级不良事件（19%）。无3级或更高级别不良事件发生。结论 CT联合模板引导放射性粒子植入治疗T_1-2N₀M₀的NSCLC肿瘤局部控制率较高,治疗相关不良反应较少,可作为不可手术的早期非小细胞肺癌治疗的一种选择。     

急诊科医护人员过度氧疗知信行多中心调查及影响因素分析

目的 调查急诊科医护人员过度氧疗知信行现状,并探索其影响因素,旨在为临床开展氧疗相关培训、规范氧疗行为提供参考。 方法 采用急诊科医护人员过度氧疗知信行问卷,对全国10个省市20所二级及以上综合性医院的急诊科医护人员998人进行调查。 结果 急诊科医护人员过度氧疗知信行总分为（120.76±13.61）分,知识、态度、行为维度得分分别为（29.54±5.45）分、（41.60±4.44）分和（49.62±9.49）分。多元线性回归分析结果显示,急诊科医护人员过度氧疗知信行的主要影响因素为医院级别、近12个月内是否学习过相关文献、职业、是否参加过相关培训、职务等（均P＜0.05）。 结论 急诊科医护人员对过度氧疗知识、态度、行为水平均处于中等水平。医院管理者应针对影响因素对急诊科医护人员进行过度氧疗知识培训,改变氧疗观念,以规范临床用氧,提高氧疗质量。     

血液透析患者动静脉内瘘自我护理行为现状及影响因素研究

目的 调查血液透析患者动静脉内瘘自我护理行为现状并分析其影响因素,为临床护理干预提供理论依据.方法 采用便利抽样法,选取湖州市某三级甲等医院血液透析行动静脉内瘘患者118例为调查对象,采用一般资料调查表及血液透析患者动静脉内痿自我护理行为量表进行调查,运用单因素分析及多元线性回归分析其自我护理行为影响因素.结果 血液透...     

伴随诊断试剂的监管浅析

目的：介绍伴随诊断试剂的历史、发展以及各国的监管政策,为我国体外诊断试剂行业相关从业人员提供参考信息。方法：从美国伴随诊断试剂的发展、监管政策的发展、相关指导原则、监管面临的挑战以及各国的监管现状等五个方面,浅析伴随诊断试剂的监管情况。结果与结论：伴随诊断试剂能精准地评估不同患者对个体化药物的治疗受益程度以及潜在副作用与风险,对于保证个体化药物的安全性与有效性至关重要,此外还能够加快新的个体化药物研发流程、缩短临床试验时间以及降低研发成本。因此,越来越多的制药公司与体外诊断试剂公司积极推进"个体化药物-伴随诊断试剂"联合研发,各国监管部门也积极响应行业和市场的需求。根据伴随诊断试剂的特点制定合理的监管政策,有助于伴随诊断试剂的发展及精准医学的普及。     

新型阳离子(苯乙烯—丙烯酰胺)共聚物的研究 Ⅱ.阳离子(苯乙烯——丙烯酰胺)共聚物与染料的相互作用

以P(St-Am·MG)对染料活性艳红(X-3B)溶液进行絮凝试验,考察了高聚物剂量及外加盐对絮凝效果的影响,并与无疏水基团的阳离子聚丙烯酰胺PAm·MG的絮凝能力进行了比较。发现絮凝体系无外加盐时,高聚物与染料的作用主要是通过静电力;有外加盐时,高聚物的电荷受到屏蔽,高分子链卷曲,PAm·MG的絮凝效果受到较大影响。而P(St-Am·MG)与X-3B之间存在疏水相互作用,受影响较小,此时P(St-Am·MG)的絮凝性能优于PAm·MG。用平衡渗析法研究了不同温度时甲醇和脲存在下P(St-Am·MG)与X-3B相互作用的热力学。证明了它们之间确实存在疏水相互作用。     

Three-dimensional honeycomb-like porous carbon derived from corncob for the removal of heavy metals from water by capacitive deionization

In this study, porous carbon (3DHPC) with a 3D honeycomb-like structure was synthesized from waste biomass corncob via hydrothermal carbonization coupled with KOH activation and investigated as a capacitive deionization (CDI) electrode material. The obtained 3DHPC possesses a hierarchal macroporous and mesoporous structure, and a large accessible specific surface area (952 m² g⁻¹). Electrochemical tests showed that the 3DHPC electrode exhibited a specific capacitance of 452 F g⁻¹ and good electric conductivity. Moreover, the feasibility of electrosorptive removal of chromium(vi) from an aqueous solution using the 3DHPC electrode was demonstrated. When 1.0 V was applied to a solution containing 30 mg L⁻¹ chromium(vi), the 3DHPC electrode exhibited a higher removal efficiency of 91.58% compared with that in the open circuit condition. This enhanced adsorption results from the improved affinity between chromium(vi) and the electrode under electrochemical assistance involving a non-faradic process. Consequently, the 3DHPC electrode with typical double-layer capacitor behavior is demonstrated to be a favorable electrode material for capacitive deionization.

A porous carbon electrode with a 3D honeycomb-like structure demonstrates a high removal efficiency for the removal of chromium(vi) from water.     

Real-time elastography evaluation of differential penetrating liver trauma in a rabbit model

Background

Real-time ultrasound elastography (RTE) is used to examine liver fibrosis and benign and malignant lesions, but its use for the diagnosis of liver trauma has not been examined. The purpose of this study was to examine the use of RTE for the evaluation of differential penetrating liver trauma in a rabbit model.

Paclitaxel-induced stress granules increase LINE-1 mRNA stability to promote drug resistance in breast cancer cells

Abnormal expression of long interspersed element-1 (LINE-1) has been implicated in drug resistance, while our previous study showed that chemotherapy drug paclitaxel (PTX) increased LINE-1 level with unknown mechanism. Bioinformatics analysis suggested the regulation of LINE-1 mRNA by drug-induced stress granules (SGs). This study aimed to explore whether and how SGs are involved in drug-induced LINE-1 increase and thereby promotes drug resistance of triple negative breast cancer (TNBC) cells. We demonstrated that SGs increased LINE-1 expression by recruiting and stabilizing LINE-1 mRNA under drug stress, thereby adapting TNBC cells to chemotherapy drugs. Moreover, LINE-1 inhibitor efavirenz (EFV) could inhibit drug-induced SG to destabilize LINE-1. Our study provides the first evidence of the regulation of LINE-1 by SGs that could be an important survival mechanism for cancer cells exposed to chemotherapy drugs. The findings provide a useful clue for developing new chemotherapeutic strategies against TNBCs.