内蒙古宁城县乡镇卫生院新型农村合作医疗住院报销政策分析

目的:了解内蒙古宁城县乡镇卫生院新型农村合作医疗住院全报销政策实施情况,提出有效实施的建议,为其进一步推行提供参考。方法:通过机构调查法收集宁城县住院全报销政策的相关资料,并从政策分析的角度对其进行分析评价。结果:住院全报销政策起到了优化卫生资源、减轻农民治病负担和促进乡镇卫生院发展等积极作用;但也面临着医疗机构道德风险、患者过度利用医疗服务及乡镇卫生院服务能力低等问题。结论:政府应通过调整支付标准、加强监管及提高卫生院的服务能力等保障这一政策的有效实施。     

Genome-wide association meta-analyses identified 1q43 and 2q32.2 for hip Ward's triangle areal bone mineral density

Aiming to identify genomic variants associated with osteoporosis, we performed a genome-wide association meta-analysis of bone mineral density (BMD) at Ward's triangle of the hip in 7175 subjects from 6 samples. We performed in silico replications with femoral neck, trochanter, and inter-trochanter BMDs in 6912 subjects from the Framingham heart study (FHS), and with forearm, femoral neck and lumbar spine BMDs in 32965 subjects from the GEFOS summary results. Combining the evidence from all samples, we identified 2 novel loci for areal BMD: 1q43 (rs1414660, discovery p = 1.20 × 10^− 8, FHS p = 0.05 for trochanter BMD; rs9287237, discovery p = 3.55 × 10^− 7, FHS p = 9.20 × 10^− 3 for trochanter BMD, GEFOS p = 0.02 for forearm BMD, nearest gene FMN2) and 2q32.2 (rs56346965, discovery p = 7.48 × 10^− 7, FHS p = 0.10 for inter-trochanter BMD, GEFOS p = 0.02 for spine BMD, nearest gene NAB1). The two lead SNPs rs1414660 and rs56346965 are eQTL sites for the genes GREM2 and NAB1 respectively. Functional annotation of GREM2 and NAB1 illustrated their involvement in BMP signaling pathway and in bone development. We also replicated three previously reported loci: 5q14.3 (rs10037512, discovery p = 3.09 × 10^− 6, FHS p = 8.50 × 10^− 3, GEFOS p = 1.23 × 10^− 24 for femoral neck BMD, nearest gene MEF2C), 6q25.1 (rs3020340, discovery p = 1.64 × 10^− 6, GEFOS p = 1.69 × 10^− 3 for SPN-BMD, nearest gene ESR1) and 7q21.3 (rs13310130, discovery p = 8.79 × 10^− 7, GEFOS p = 2.61 × 10^− 7 for spine BMD, nearest gene SHFM1). Our findings provide additional insights that further enhance our understanding of bone development, osteoporosis, and fracture pathogenesis.     

新生儿呼吸窘迫综合征及支气管肺发育不良防治进展

新生儿呼吸窘迫综合征(NRDS)和支气管肺发育不良(BPD)常见于早产儿。近年来,随着围生期医疗技术水平的提高,NRDS早产儿的存活率也得以提升,但随着机械通气及高浓度氧疗的应用,BPD的发病率也逐渐升高。NRDS与BPD有着相同的基因因素,SP-B缺失与NRDS及BPD的发生发展均相关。两者在发病机制上也有所联系,规范防治NRDS可在一定程度上有效预防BPD。文章对NRDS与BPD防治的最新进展作一综述。     

S1PR1 expression correlates with inflammatory responses to Newcastle disease virus infection

Newcastle disease virus (NDV) is the causative agent of Newcastle disease, which is characterized by inflammatory pathological changes in the organs of chickens. The inflammatory response to this disease has not been well characterized. Previous reports showed that the sphingosine-1-phosphate-1 receptor (S1PR1), a G protein-coupled receptor, is important to the activation of inflammatory responses. To understand better the viral pathogenesis and host inflammatory response, we analyzed S1PR1 expression during NDV infection. We observed a direct correlation between chicken embryo fibroblast (CEF) cellular inflammatory responses and S1PR1 expression. Virulent NDV-infected CEF cells also had elevated levels of pro-inflammatory cytokines (IL-1β, IL-6 and IL-18). When S1PR1 was inhibited by using the specific antagonist W146, pro-inflammatory cytokine production declined. Overexpression of S1PR1 resulted in increased virus-induced IL-1β production. S1PR1 expression levels did not impact significantly NDV replication. These findings highlight the important role of S1PR1 in inflammatory responses in NDV infection.     

乳腺结节状病变的MRI诊断

  目的  探讨乳腺良、恶性结节病变的MRI诊断价值。  方法  回顾性分析来芜湖市第一人民医院就诊的乳腺疾病患者71例，均经过病理证实结节状病灶，术前均进行MRI多参数成像，选取动态增强（DCE-MRI）和DWI数据进行分析，经处理得到:时间-信号曲线（TIC），达峰时间（Tpeak），峰值强化率（PER），峰值（SImax）及表观扩散系数（ADC），结合形态学特征:边缘毛糙、环形强化、边缘毛刺征及分叶征进行分析。  结果  恶性病灶43例，良性病灶 28例。TIC时间-信号曲线Ⅰ型22个，以良性为主17例，恶性5例；Ⅱ型35例，恶性为主24例，良性11例；Ⅲ型14个，均为恶性；良、恶性病灶TIC曲线类型有差异，差异有统计学意义（P < 0.05）；良、恶性病变的峰时（Tpeak），峰值强化率（PER），峰值（SImax）及ADC有显著差异，差异有统计学意义（P < 0.05）。边缘毛糙33例，均为恶性；环形强化24例，良性5例，恶性19例；毛刺征29例，均为恶性；有分叶征42例，良性7例，恶性35例。良恶性病灶形态学，差异有统计学意义（P < 0.05）。  结论  磁共振动态增强扫描血流动力学参数、ADC结合形态学特征对乳腺结节状良、恶性疾病的诊断具有重要价值。     

Baicalin from the extract of Scutellaria baicalensis affects the innate immunity and apoptosis in leukocytes of children with acute lymphocytic leukemia

Scutellariae Radix (root of Scutellaria baicalensis) has a long history of application in traditional and in modern herbal medications. The major components of Scutellariae Radix are baicalin, baicalein, wogonoside and wogonin. Accumulating evidence demonstrates that Scutellaria has immunomodulatory effects and possesses compelling anticancer potential.Treatment of peripheral blood leukocytes (PBLs) with Scutellaria extract (SBE) enriched in baicalin, reduced viability of PBLs obtained from patients with acute lymphoblastic leukemia (ALL). SBE had no impact on the survival of healthy, control leukocytes. The immune system modulation by SBE resulted in increased production of IFNγ in PBLs, and reduced TNFα and IL-10 production in bone marrow cells (BMC), in ALL patients. SBE stimulated the nonspecific antiviral immunity, assessed by resistance of PBLs and BMC to vesicular stomatitis virus (VSV) infection. SBE showed pro-apoptotic activity in NALM-6 cell line (B-type human leukemia). The number of cells expressing annexin V increased from 6% in control cultures to 29% and 52% after treatment with 100 μg/ml and 200 μg/ml respectively. Increased percentage of apoptotic cells was observed when cells were treated with corresponding concentration of baicalin. SBE enhanced apoptosis of PBLs in BMC of leukemic children. The percentage of PBLs that underwent apoptosis and mean annexin V expression increased from 11% in the control to 17% and 24% for the doses of 100 μg/ml and 200 μg/ml respectively. Importantly, SBE did not induce apoptosis of PBLs in the healthy, control group.     

药师处方权认知度和支持度的初步调查

目的：了解医护人员、药师和公众对药师"部分"处方权的认知度和支持度。方法：对医护人员、药师以及公众进行问卷调查。结果：医生、护士和公众对药师"部分"处方权非常清楚或比较清楚的分别占35.70%、36.24%、33.44%，药师占57.05%，医生、护士和公众对赋予药师"部分"处方权完全同意或同意的分别占82.01%、76.74%、83.12%，药师占94.82%，而且认知度与支持度在0.01水平上显著相关，不同年龄、学历、职业、职称、医院级别等的支持度有统计学意义。结论：医护人员、药师和公众对于药师"部分"处方权的概念、资格准入等内容认知不足，但认可赋予药师"部分"处方权的好处，并且对赋予药师"部分"处方权持积极态度，认知情况越好支持度越高；医护人员、药师和公众对于赋予药师"部分"处方权的支持度，存在"老年高于青年，高职称高于低职称，高级别医院高于低级别医院，学历差异较大"等现象。