IEC 60601-2-57:2011《医用电气设备第2-57部分:治疗、诊断、监测和美容/美学使用的非激光光源设备的基本安全和主要性能专用要求》转化的探讨

本文通过对IEC60601-2-57:2011标准内容的解读,提出了该标准转化的重要性及转化方式。     

军队疗养院质量效益建设的着力点

军队疗养院建设要紧紧围绕主题主线,坚持服务创精、技术创牌、队伍创强、文化创特、管理创优,加快推进转型转变,不断提升内涵建设水平,实现高质量高效益可持续发展。     

Cost Estimates for Operating a Primary Care Practice Facilitation Program

PURPOSE

Practice facilitation is widely recognized as a promising method for achieving large-scale practice redesign. Little is known, however, about the cost of providing practice facilitation to small primary practices from the prospective of an organization providing facilitation activities.

METHODS

We report practice facilitation costs on 19 practices in South Texas that were randomized to receive facilitation activities. The study design assured that each practice received at least 6 practice facilitation visits during the intervention year. We examined only the variable cost associated with practice facilitation activities. Fixed or administrative costs of providing facilitation actives were not captured. All facilitator activities (time, mileage, and materials) were self-reported by the practice facilitators and recorded in spreadsheets.

RESULTS

The median total variable cost of all practice facilitation activities from start-up through monitoring, including travel and food, was $9,670 per practice (ranging from $8,050 to $15,682). Median travel and food costs were an additional $2,054 but varied by clinic. Approximately 50% of the total cost is attributable to practice assessment and start-up activities, with another 31% attributable to practice facilitation visits. Sensitivity analysis suggests that a 24-visit practice facilitation protocol increased estimated median total variable costs of all practice facilitation activities only by $5,428, for a total of $15,098.

CONCLUSIONS

We found that, depending on the facilitators wages and the intensity of the intervention, the cost of practice facilitation ranges between $9,670 and $15,098 per practice per year and have the potential to be cost-neutral from a societal prospective if practice facilitation results in 2 fewer hospitalizations per practice per year.     

Y盒结合蛋白1与上皮-间质转化

在上皮-间质转化（EMT）过程中,细胞间连接被破坏,细胞失去顶一底极性,获得抗凋亡能力及迁移、侵袭能力。Y盒结合蛋白1（YB-1）是冷休克蛋白超家族的一员,包含结构和功能高度保守的冷休克结构域。研究表明,YB-1可以通过调控EMT促进肿瘤的发生发展。在YB-1介导的EMT中,多种转录因子及信号通路发挥着重要作用。     

Achieving Value in Primary Care: The Primary Care Value Model

The patient-centered medical home (PCMH) model provides a compelling vision for primary care transformation, but studies of its impact have used insufficiently patient-centered metrics with inconsistent results. We propose a framework for defining patient-centered value and a new model for value-based primary care transformation: the primary care value model (PCVM). We advocate for use of patient-centered value when measuring the impact of primary care transformation, recognition, and performance-based payment; for financial support and research and development to better define primary care value-creating activities and their implementation; and for use of the model to support primary care organizations in transformation.     

1023中药合剂对口腔癌前病变的治疗和阻癌作用的临床研究

目的：探讨1023对口腔白班（OLK）、口腔扁平苔藓（OLP）和盘状红斑狼疮（DLE）等癌前病变的治疗作用和阻断癌变的作用。方法：将1023合剂用于48例OLK、139例OLP和38例DLE，并设对照组，实验组和对照组均接受相同的常规治疗。结果：1023对OLK和OLP治疗有明显的效果，其有效率明显高于对照组（P＜0．05），而OLK的癌变率明显低于对照组（P＜0．05）。结论：1023合剂对OLK和OKP均有治疗作用，对OLK有阻止癌变的作用。     

结肠癌组织中LKB1的表达及其与上皮-间质转化的关系

目的探讨LKB1在结肠癌组织中的表达及其与肿瘤上皮-间质转化的关系。方法采用免疫组化法检测75例结肠癌组织及对应癌旁正常结肠组织中LKB1、上皮-间质转化(epithelial mesenchymal transformation,EMT)相关标志物E-cadherin、N-cadherin、vimentin的表达,分析LKB1表达与结肠癌临床病理特征及EMT的关系。结果 49例结肠癌组织中LKB1低表达,55例正常结肠组织中LKB1高表达;LKB1表达降低与淋巴结转移、TNM肿瘤分期相关(P0.05);E-cadherin、N-cadherin、vimentin分别在25例、48例、26例结肠癌组织中高表达,LKB1表达与E-cadherin表达呈正相关(r=0.648,P0.05),与Ncadherin(r=-0.891,P0.05)和vimentin(r=-0.660,P0.05)表达呈负相关。结论 LKB1在结肠癌组织中表达下调,与EMT的发生呈正相关,可作为结肠癌转移发生的预测指标。     

A genome-wide nanotoxicology screen of Saccharomyces cerevisiae mutants reveals the basis for cadmium sulphide quantum dot tolerance and sensitivity

The use of cadmium sulphide quantum dots (CdS QDs) is increasing, particularly in the electronics industry. Their size (1–10?nm in diameter) is, however, such that they can be taken up by living cells. Here, a bakers’ yeast (Saccharomyces cerevisiae) deletion mutant collection has been exploited to provide a high-throughput means of revealing the genetic basis for tolerance/susceptibility to CdS QD exposure. The deletion of 112 genes, some associated with the abiotic stress response, some with various metabolic processes, some with mitochondrial organization, some with transport and some with DNA repair, reduced the level of tolerance to CdS QDs. A gene ontology analysis highlighted the role of oxidative stress in determining the cellular response. The transformation of sensitive mutants with centromeric plasmids harbouring DNA from a wild type strain restored the wild type growth phenotype when the complemented genes encoded either HSC82, DSK2 or ALD3. The use of these simple eukaryote knock-out mutants for functional toxicogenomic analysis will inform studies focusing on higher organisms.     

口腔黏膜下纤维性变癌变的发生机制研究进展

口腔黏膜下纤维性变(oral submucous fibrosis, OSF)是口腔鳞状细胞癌(oral squamous cell carcinoma, OSCC)的主要癌前病变之一,其癌变过程复杂,癌变机制尚不明确。本文从咀嚼槟榔与OSF恶性进展、低氧与血管生成、上皮-间质转化和表观遗传调控等方面,对OSF癌变机制的最新研究进展作一综述。     

Cancer: A reproductive strategy of "ultra-selfish" genes?

A hypothesis is presented in which the process of "malignant transformation" which ultimately results in the rapidly dividing tumor(s)(cells) causing "cancer", is regarded as an evolved reproductive strategy of "ultra-selfish" (proto-)(onco-)genes, already present in the genome, or introduced by a virus.