探究医院电子信息交换标准HL7

医药信息学在医学应用中的最大领域就是医院信息系统(Hospital Infornation System,HIS),随着HIS的快速发展,需要我们有一个开放的,统一的HIS开发和交换的标准.HL7是1987年开始发展起来的一个专门规范医疗机构用于临床信息,财务信息和管理信息电子信息交换的标准.它特别适合于解决不同厂商开发的医院信息系统、临床实验室系统及药学信息系统之间的互连问题.HL7在国内的发展刚刚起步,但是我国医疗卫生信息化发展很快,尤其是医疗保险、社区医疗和区域卫生信息系统等,都十分需要标准化的支持,HL7将成为建设这些系统的重要基础和关键技术.     

中医情志的发生机制刍议

在情志学说和脑主神明理论指导下对情志产生的生理机制作新的诠释。认为脑神的气化出入及整合作用是情志发生的生理基础 ;五脏所化的气血精津为情志发生的物质基础     

初次献血对红细胞膜Na+-K+-ATP酶活性的影响

目的探讨初次献血对红细胞膜Na+-K+-ATP酶活性的影响.方法应用比色法分别检测50例符合献血条件的健康初次献血者献血前后的红细胞膜Na+-K+-ATP酶活性,并对结果进行分析.结果初次献血者献血前后红细胞膜Na+-K+-ATP酶活性分别为3.121±0.441和2.907±0.397 μmol.Pi/107 RBC.h,两者比较无明显差异(P＞0.05).结论初次献血对红细胞膜Na+-K+-ATP酶活性无影响,献血不会造成红细胞功能损伤.     

冠心病危险因素与冠状动脉病变程度的相关性研究

目的:探讨冠心病危险因素与冠状动脉病变程度的关系.方法:选取150例冠心病患者行冠状动脉造影术及各项化验检查,冠状动脉病变程度以Gensini积分值表示,对冠心病危险因素和冠状动脉病变程度进行统计分析.结果:经多因素线性回归证实:非高密度脂蛋白胆固醇为冠状动脉病变程度的独立危险因素(P=0.030),而性别、年龄、空腹血糖、糖尿病、高血压、吸烟、家族史及甘油三酯、低密度脂蛋白胆固醇均与冠状动脉病变程度无明确相关.结论:非高密度脂蛋白胆固醇对冠状动脉病变严重程度具有重要的影响.     

加强学科建设提高中医儿科教学质量

中医儿科是河南省重点学科,加强学科管理,健全各项管理规章制度,科学合理设置儿科课程,实现理论与实践的结合,课堂与临床见习的结合;提高教师人文素质、教学水平,是保证儿科教学质量的关键.     

17β-雌二醇对子宫内膜异位症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响

目的研究17β-雌二醇(17β-E2)对子宫内膜异位症(内异症)患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响,探讨Wnt/β-catenin信号通路在介导雌激素促进内异症发生发展的作用。方法体外分离培养内异症患者在位子宫内膜间质细胞。用不同浓度17β-E2处理子宫内膜间质细胞48 h;此后选用10-10mol/L 17β-E2处理子宫内膜间质细胞12、24和48 h,逆转录聚合酶链反应(RT-PCR)和免疫印迹法(Western blotting)检测17β-E2处理前后子宫内膜间质细胞β-catenin mRNA和蛋白的表达水平。同法分析雌激素受体拮抗剂ICI182,780(10-6mol/L)对17β-E2促进β-catenin mRNA和蛋白表达的影响。免疫组织化学染色观察17β-E2作用后β-catenin在子宫内膜间质细胞中的定位。结果17β-E2能明显促进内异症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白的表达,并呈剂量和时间依赖性,于10-10mol/L作用48 h最明显。雌激素受体拮抗剂ICI182,780能明显抑制17β-E2对子宫内膜间质细胞β-catenin mRNA和蛋白的表达。免疫组织化学染色发现17β-E2能促进β-catenin在子宫内膜间质细胞核内的表达。结论雌激素可能通过激活Wnt/β-catenin信号通路促进内异症在位子宫内膜的异位种植。     

Cementless total hip arthroplasty in the treatment of severe hip dysplasia or dislocated hips

We present our experience over 6 years with the use of uncemented total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH) with a mean follow-up of 3 years. In a 6-year period, 26 THAs were performed in 19 patients with Hartofilakidis grades 2 and 3 dislocation of the hips. Out of 19 patients, seven had bilateral dislocations. Uncemented acetabular and femoral components were used in all patients. Patients with a minimum follow-up of 1 year were included in the study. The average age at the time of surgery was 38 (range 20–69) years. Approaches used include trochanteric osteotomy in 14 (54%) patients and a lateral approach in 12 (46%) patients. In addition, subtrochanteric osteotomy was performed in four (15%) patients. A Mallory-head femoral stem was used in 15 (58%) patients; a DDH femoral stem was in nine (35%), and the S-ROM femoral prosthesis in two (8%). A Mallory head acetabular shell was used in all cases, a 22.2-mm chrome cobalt head was used in 18 (69%), and a 28-mm chrome cobalt head was used in eight (31%). The average follow-up was 3 (range 1–6) years. The Harris hip score (HHS) improved in the cohort from a mean preoperative score of 51 to a mean postoperative score of 86 (p<0.05). The mean preoperative SF36v2 score was 42 compared to postoperatively of 67(p<0.05). The complication rate was 11% with nonunion of a subtrochanteric osteotomy in one patient, dislocation in one, and trochanteric bursitis due to fracture of Dall-Miles cables in one. THA for DDH is a technically demanding procedure. This short-term follow-up of THA for DDH using uncemented implants is encouraging for arthrosis secondary to DDH. It provides better function compared to arthrodesis or excision arthroplasty, especially in young individuals. A long-term follow-up is required in order to establish the role of this management strategy.     

发育性髋脱位的影像学研究进展

发育性髋脱位是一种常见的小儿骨科疾病。临床表现较隐匿,影像学检查对其诊断有重要价值。本文对X线、造影、超声、CT、MRI等影像检查方法对发育性髋脱位的诊断应用进行综述,探讨各种方法的优缺点及对发育性髋脱位的诊断价值。     

Association between cord blood IgE and genetic polymorphisms of interleukin-4, the β-subunit of the high-affinity receptor for IgE, lymphotoxin-α, and tumor Necrosis factor-α

High cord blood immunoglobulin E (cbIgE) is known to be associated with increased risks of atopic diseases in childhood. The relationship between genetic polymorphisms and high cbIgE has not been well documented. A cross-sectional study was conducted to assess the association between cbIgE and genetic polymorphisms of interleukin (IL)-4 -590C/T, the beta-subunit of the high-affinity receptor for IgE (FcepsilonRI-beta) E237G, lymphotoxin (LT)-alphaNcoI alleles, and tumor necrosis factor (TNF)-alpha -308G/A. A total of 320 mother-neonate pairs were recruited from four maternity hospitals from different locations of Taiwan. Cord blood was obtained and assayed for cbIgE. Polymerase chain reaction followed by restriction fragment length polymorphism was used to assess the genotypes. Three hundred pairs of mothers and neonates were included in the final analysis. Infants with IL-4 -590 C allele were found to have higher risk of elevated cbIgE (> or =0.35 IU/ml, 24.3%) (p = 0.004). After adjusting for gender, birth order, maternal age, and history of allergic disease in maternal and paternal families, odds ratios for CC and CT genotypes were 4.41 and 3.16 (95% confidence interval 0.78-22.67, and 1.66-6.13), respectively, using TT genotype as reference. The genotypes of FcepsilonRI-beta, LT-alpha, and TNF-alpha were not associated with cbIgE before or after the adjustment. Our finding suggested a significant association of cbIgE with genetic polymorphism of IL-4 -590C/T, but not with the genotypes of FcepsilonRI-beta, LT-alpha, and TNF-alpha.     

腹腔镜治疗精索静脉曲张235例

目的探讨腹腔镜治疗精索静脉曲张的疗效. 方法回顾分析1993年9月～2003年7月235例经腹腔镜精索静脉高位结扎术的临床资料. 结果 235例手术均获成功,手术时间5～20 min,平均12 min.术后住院2～5 d,平均3 d.210例随访6～18个月,9例复发,复发率4.3%(9/210),不育11例术后6～12个月后其妻受孕. 结论腹腔镜精索静脉高位结扎术微创、美观、疗效好,对双侧精索静脉曲张、开放性手术后复发和有腹股沟区手术史者尤为适用.