胃癌中B7-H4和B7-H3的表达及薏苡仁酯对表达的影响

目的：探讨共刺激分子B7-H4和B7-H3在胃癌中的表达,以及薏苡仁酯对这两种分子表达的影响。方法：应用免疫组织化学染色检测胃癌组织中B7-H4蛋白的表达,MTT法检测薏苡仁酯对胃癌细胞株BGC-823的生长抑制效应,RT-PCR检测胃癌组织、胃癌细胞株BGC-823中B7-H4mRNA及B7-H3mRNA的表达,Western Blot检测细胞的B7-H4蛋白及B7-H3蛋白的表达。结果：B7-H4蛋白在80例胃癌组织中有60例阳性表达,阳性率75%。B7-H4蛋白的表达与患者性别、年龄、组织类型、肿瘤大小、淋巴结转移、病理分期、浸润深度无关（P〉0.05）。在20例胃癌组织中,B7-H4mRNA表达明显高于癌旁正常组织,B7-H3mRNA表达明显低于癌旁正常组织（P〈0.01）。薏苡仁酯可抑制胃癌细胞株BGC-823的生长,呈时间-剂量依赖性,并下调B7-H4 mRNA及蛋白的表达,上调B7-H3mRNA及蛋白的表达（P〈0.01）。结论：B7-H4和B7-H3在胃癌异常的表达,可能是肿瘤免疫逃逸的原因之一;薏苡仁酯可影响胃癌细胞B7-H4、B7-H3的表达。     

72例老年腮腺肿瘤的临床诊治分析

目的：探讨老年人颌面腮腺肿瘤的临床特点,提高手术治疗的安全性。方法：对8年来72例老年腮腺肿瘤患者的临床资料进行回顾性分析。结果：老年腮腺肿瘤男：女=1.77：1,良恶性肿瘤比为3.24：1;良性肿瘤中以多形性腺瘤发病率最高,恶性肿瘤以侵润导管癌居首。术前两种及两种以上的并存病较多。术后并发症中以循环系统并发症较高。结论：老年腮腺肿瘤患者具有合并症多、术后并发症发生率高等特点,术前必须重视全身情况的评估,积极治疗合并病,制定合理的的手术方式;术后积极预防和治疗可能出现的并发症,可以降低手术风险。     

颌面颈部猫抓病11例误诊分析

目的：对颌面颈部猫抓病（cat-scratch disease,CSD）的临床表现、诊断和治疗进行探讨,以提高猫抓病的诊疗水平。方法：对2002—2009间收治的11例颌面颈部猫抓病的临床资料进行回顾性分析。结果：11例CSD患者误诊腮腺肿瘤2例,下颌下肿块1例,淋巴结炎3例,淋巴结核1例,恶性淋巴瘤2例,颈部肿块1例,颈部转移癌1例;误诊的主要原因为对CSD的临床认识不足,遗漏患者被猫、犬抓咬伤史以及医师习惯思维。结论：猫抓病的诊断较困难,应详细询问猫、犬抓伤病史和豢养史,病变淋巴结切除活检是诊治本病的关键。     

Case Report: Novel Swine-Origin Influenza A (H1N1) Virus-Associated Hemophagocytic Syndrome��A First Case Report

Secondary or reactive hemophagocytic syndrome (HPS) is frequently related to viral infections. However, the novel swine-origin influenza A (H1N1) virus associated HPS has never been reported. On October 10, 2009, a 17-year-old female child with no past medical history, complaining of severe asthenia, pneumonia, myalgia, and high fever, was admitted to our department, and H1N1 DNA was detected. Five days after her hospitalization, all signs and symptoms aggravated into HPS. After treatment for H1N1 influenza, the patient had a recovery and clearance of H1N1 infection 10 days after hospitalization. Three weeks later, the patient was discharged without any complaints, indicating the etiological role of H1N1infection in HPS.     

Safety of an injection with a mixture of extracts from Herba Artemisiae annuae, Fructus Gardeniae and Flos Lonicerae

Objective This study aimed to evaluate the safety for an injection with a mixture of extracts from Herba Artemisiae annuae, Fructus Gardeniae and Flos Lonicerae and to determine the risk factors that may affect its adverse drug reactions. Methods A drug-oriented prospective observational study was performed. Physicians filled in clinical observation forms with detailed information of the patients including general information, drug information, therapeutic effects and adverse drug events. The adverse drug reaction factors were analyzed by both mono-factor and multiple-factor logistic regression methods. Results From April to July 2007, we collected 12,427 observation forms from 46 hospitals in Jiangsu Province of China. Among the 11,707 observation forms we analyzed, 8,074 patients were children younger than 14 years old (69%). Among 51 reported adverse drug events, 45 cases were adverse drug reactions. The total adverse drug reaction incidence of the injection was 0.38%. While most adverse drug reactions were previously known (e.g., rash, pruritus, vomiting and diarrhea), we observed three new ADR symptoms: shiver, phlebitis and anhelation. All the adverse drug reactions were controlled very well through the follow-up therapy, and none of them was life threatening. The mono-factor analysis showed that adverse drug reactions of the injection were significantly correlated with total medication dose (P = 0.0049) and combination medication (P = 0.0143), especially with antimicrobial drugs (P = 0.0079) and macrolides (P = 0.0017). The multiple factor analysis confirmed these results: medication dosage and combination medication had a crucial impact on adverse drug reactions of the injection; the risk was increased by 24.8% (the estimated value of relative risk was 1.248, 95% confidence interval: 1.054–1.479) and 89% (1.890, 1.001–3.566), respectively. Conclusion The total adverse drug reaction incidence of the injection was 0.38% and lower than we expected. Moreover, we observed three new adverse drug reactions, none of which was severe.

高校医院在健康管理中的作用探讨

本文根据我国慢性病管理的现状及高校医院的特点,论述了高校医院开展健康管理的理论与实践。探讨如何开展健康管理和慢性病干预的对策和做法：收集服务对象的个人健康信息;对个人的综合健康及疾病危险性进行评估与定性定量分析,对危险因素采取干预措施,包括生活方式、膳食营养、心理健康等进行个体化指导;定期进行跟踪观察及效果评价,并制定未来的保健计划等。文章还针对存在的问题提出建议。     

妇幼保健筹资机制选择的东西部比较研究——基于省际数据的实证分析

妇幼保健水平的提高是促进以人为本和谐社会建设的重要目标。本文首先对东西部妇幼保健整体水平做一对比,并从筹资结构入手,结合实地调研,揭示了我国妇幼保健事业已呈现东、西部非均衡发展态势。再通过对我国31个省市自治区截面数据的实证分析发现,各地人均收入、财政卫生支出、GDP增长等因素对其妇幼卫生水平影响显著。最后本文针对地区差别的成因,提出东、西部妇幼保健应分别选择不同的筹资机制：在东部以＂补需方＂为主,在西部则以＂补供方＂为主。     

鱼腥草药材挥发油的指纹对照法研究

目的：建立鱼腥草药材中挥发油成分的指纹图谱,对各产地药材实现定性定量地评价,并对挥发油中主要成分进行鉴别。方法：采用气相色谱-氢离子火焰检测（GC-FID）技术测定不同产地的13批鱼腥草药材挥发油成分GC指纹图谱。以甲基正壬酮为对照品,以内标法估算各产地药材中各成分的相对含量,以夹角余弦和相对欧氏距离为参考指标进行评价;利用气相色谱-质谱-计算机检索技术（GC-MS-DS）对各色谱峰进行鉴别。结果：建立的鱼腥草药材挥发油成分指纹图谱确立23个共有峰,方法学考查显示各特征指纹峰保留相对稳定,经考察甲基正壬酮在6．6-660μg／ml内线性关系良好,经空白回收率校正后加样回收率为93．46％（n=6）。经鉴定识别其中24种主要成分。结论：建立的鱼腥草药材挥发油成分指纹图谱重复性好,综合了指纹对照法、定性和定量相似度,能更好地评价鱼腥草药材的质量。