四川省基层医疗卫生机构管理信息系统与县级区域卫生信息平台数据交换的设计与实现

为实现基层医疗卫生机构管理信息系统与县级区域卫生信息平台的数据交换,保证公民都享有基本医疗卫生服务,提高公众健康水平,以四川省卫生信息交换服务网络为依托,按照标准的医疗CDA文档格式,设计和构建了四川省基层医疗卫生机构管理信息系统。     

老年人脑出血后脑血流量改变的研究

目的研究老年人脑出血后脑血流量改变及影响因素。方法对４２例老年脑出血患者在发病１周内行单光子发射型计算机断层扫描（ＳＰＥＣＴ）、脑血流显像和ＣＴ扫描，部分进行动态观察。结果脑血流量下降范围１０例局限在病灶周围，３２例累及病灶以外区域，其中小脑失联络１１例，１～６个月复查仍见广泛的血流量下降，血流减少的范围及程度与出血部位、出血量密切有关。结论老年人脑出血后存在持久广泛的脑血流量下降。     

Atrial reentry in chronic repetitive supraventricular tachycardia

Atrial reentrance as a mechanism of the tachycardia was demonstrated in a 28-year-old patient suffering from chronic repetitive supraventricular tachycardia. Criteria for diagnosis included the following: (1) Repetitive supraventricular tachycardia was induced and terminated by properly timed atrial extrastimuli. (2) Return cycles of all atrial extrastimuli not abolishing the tachycardia were fully compensatory. (3) A-H prolongation was not a prerequisite to induce the tachycardia. (4) The contours of P and A waves during tachycardia differed from those in sinus rhythm, but atrial activation remained antegrade. (5) A concealed anomalous pathway could not be proved.     

Neurological Soft Signs Predict Auditory Verbal Hallucinations in Patients With Schizophrenia

Neurological soft signs (NSS) are well documented in individuals with schizophrenia (SZ), yet so far, the relationship between NSS and specific symptom expression is unclear. We studied 76 SZ patients using magnetic resonance imaging (MRI) to determine associations between NSS, positive symptoms, gray matter volume (GMV), and neural activity at rest. SZ patients were hypothesis-driven stratified according to the presence or absence of auditory verbal hallucinations (AVH; n = 34 without vs 42 with AVH) according to the Brief Psychiatric Rating Scale. Structural MRI data were analyzed using voxel-based morphometry, whereas intrinsic neural activity was investigated using regional homogeneity (ReHo) measures. Using ANCOVA, AVH patients showed significantly higher NSS in motor and integrative functions (IF) compared with non-hallucinating (nAVH) patients. Partial correlation revealed that NSS IF were positively associated with AVH symptom severity in AVH patients. Such associations were not confirmed for delusions. In region-of-interest ANCOVAs comprising the left middle and superior temporal gyri, right paracentral lobule, and right inferior parietal lobule (IPL) structure and function, significant differences between AVH and nAVH subgroups were not detected. In a binary logistic regression model, IF scores and right IPL ReHo were significant predictors of AVH. These data suggest significant interrelationships between sensorimotor integration abilities, brain structure and function, and AVH symptom expression.     

团体心理护理对尿道膀胱肿瘤电切术后行膀胱灌注化疗患者负性情绪和生活质量的影响

目的：探讨团体心理护理对尿道膀胱肿瘤电切术后行膀胱灌注化疗患者负性情绪和生活质量的影响。方法选择尿道膀胱肿瘤电切术后行膀胱内灌注化疗的膀胱癌患者80例,按随机数字表法分为观察组与对照组,各40例。对照组实施常规护理,观察组在常规护理的基础上进行团体心理护理。干预前后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和生活质量评定量表（EORTC QLQ－C30）比较两组患者的改善情况。结果团体心理干预后,观察组患者SAS、SDS评分分别为（42．42±3．12）,（44．11±4．43）分,均低于对照组的（52．34±4．11）,（56．25±5．13）分,差异有统计学意义（t值分别为3．586,3．264;P＜0．05）。观察组患者总体健康状况、认知功能、社会功能得分分别为（54．52±13．81）,（79．74±22．13）,（73．21±23．33）分,均高于对照组的（30．81±10．24）,（64．34±21．21）,（54．63±27．81）分,差异有统计学意义（t值分别为－12．124,－3．747,－3．614;P＜0．05）。结论团体心理护理能改善膀胱灌注化疗患者的焦虑、抑郁等负性情绪,提高患者的生活质量。     

血清肌钙蛋白I质控物的研究

目的评价自制血清肌钙蛋白I(cTnI)质控物均匀性和稳定性。方法按实验设计收集混合血清,分装-20℃贮存。参照CNAS-GL03《能力验证样品均匀性和稳定性评价指南》,对质控物的均匀性进行评价;运用恒温加速试验研究稳定性。结果质控物均匀性差异无统计学意义(P0.05)。恒温加速试验显示,血清cTnI降解随时间变化符合化学动力学一级反应,根据Arrhenius方程推测4℃贮存7d,-20℃贮存有效期为19个月;监测质控物9个月,与恒温加速试验结果一致。结论自制血清cTnI质控物均匀性、稳定性良好,可用于临床室内质量控制。     

Brain tyrosine hydroxylase in the catfish Heteropneustes fossilis: annual and circadian variations,and sex and regional differences in enzyme activity and some kinetic properties

Dynamics of tyrosine hydroxylase (TH) was studied in various brain regions and pituitary in relation to annual/seasonal and circadian variations in either sex of the catfish Heteropneustes fossilis. alpha-Methylparatyrosine inhibited TH activity significantly in a time-(in vivo study) and concentration-(in vitro study) dependent manner. The inhibition was higher in resting phase than preparatory phase and in females than males (time-course study). The apparent kinetic constant of inhibition (K(i)) varied both seasonally and regionally. The values were higher in resting phase and in the forebrain regions (telencephalon and hypothalamus) than medulla oblongata. No significant sex difference was noticed in the K(i) values in the same season. TH activity showed significant annual/seasonal variations with telencephalon and hypothalamus showing higher activity than medulla oblongata. The females showed significantly higher enzyme activity than males with a distinct activity peak in June (prespawning phase). Such an activity peak was apparently absent in males. TH activity showed significant circadian/diurnal variations, the highest activity was noticed at 12 h and the lowest at 24 h. The apparent Michaelis-Menten constant (K(m)) values (hypothalamic TH) for substrate (L-tyrosine) and cofactor (DMPH(4)) showed seasonal variations with the highest values in the resting phase, decreasing through preparatory and prespawning phases, to the lowest values in spawning phase. V(max) was the lowest in the resting phase and highest in the spawning phase. TH activity was low in the pituitary and could be detected in pooled samples from March (preparatory phase) to July (spawning phase). Activity showed significant variations, which could be correlated with the gonadosomatic index. The results show that TH activity could be positively correlated with the annual reproductive cycle. The enzyme activity could be also correlated with seasonal, sex, and regional variations in the apparent K(m) and V(max) values suggesting apparent differences in the affinity of the enzyme towards substrate and cofactor.     

Topographical variations in articular cartilage and subchondral bone of the normal rat knee are age-related

In osteoarthritis animal models the rat knee is one of the most frequently investigated joint. However, it is unknown whether topographical variations in articular cartilage and subchondral bone of the normal rat knee exist and how they are linked or influenced by growth and maturation. Detailed knowledge is needed in order to allow interpretation and facilitate comparability of published osteoarthritis studies. For the first time, the present study maps topographical variations in cartilage thickness, cartilage compressive properties and subchondral bone microarchitecture between the medial and lateral tibial compartment of normal growing rat knees (7 vs. 13 weeks). Thickness and compressive properties (aggregate modulus) of cartilage were determined and the subchondral bone was analyzed by micro-computed tomography. We found that articular cartilage thickness is initially homogenous in both compartments, but then differentiates during growth and maturation resulting in greater cartilage thickness in the medial compartment in the 13-week-old animals. Cartilage compressive properties did not vary between the two sites independently of age. In both age-groups, subchondral plate thickness as well as trabecular bone volume ratio and trabecular thickness were greater in the medial compartment. While a high porosity of subchondral bone plate with a high topographical variation (medial/lateral) could be observed in the 7-week-old animals, the porosity was reduced and was accompanied by a reversion in topographical variation when reaching maturity. Our findings highlight that there is a considerable topographical variation in articular cartilage and subchondral bone within the normal rat knee in relation to the developmental status.     

针刺足三里的静息态脑功能局部一致性研究简

目的观察针刺足三里的静息态脑区功能局部一致性（Reho）,探讨针刺穴位的作用机制。方法选择10例健康志愿者,其中男性4例,女性6例;年龄20～34岁,中位年龄23岁。利用GESigna HDxt3.0T磁共振成像系统对针刺前（对照组）、针刺足三里后分别进行静息态扫描,运用统计参数图（SPM8）软件,采用Reho的数据后处理方法,分析2组被试不同脑区Reho值的差异.并运用错误发现校正（FDR-corrected）,得到有统计学差异的脑区。结果针刺足三里组与针刺前相比,Reho值增高的脑区有右侧前扣带回（8.17）、左侧额中回（4.84）;Reho值减低的脑区有左侧小脑半球（-7.75）、右侧后扣带回（-6.66）、左侧豆状核（-6.87）、右侧岛叶皮层（-7.57）、左侧胼胝体（-5.71）、左侧楔前叶（-4.68）、右侧额叶内侧回（-8.59）。结论针刺足三里后造成局部脑组织血氧水平信号同步性改变,提示针刺足三里不仅有特异的脑功能激活区.而且引起的脑功能活动存在Reho差异。