碱性成纤维细胞生长因子加速慢性难愈合创面愈合

目的　观察碱性成纤维细胞生长因子（ｂ Ｆ Ｇ Ｆ）对慢性难愈合创面（溃疡）的促修复作用并探讨其促修复机制。方法　２８ 例共３３ 个慢性难愈合创面,其中创伤性溃疡１２ 例（１４ 个创面）,压迫性溃疡 ９ 例（１２ 个创面）,糖尿病溃疡 ４ 例,放射性溃疡 ３ 例。所有创面经清创后用ｂ Ｆ Ｇ Ｆ 治疗（１５０ Ｕ／ｃｍ ２ 创面,每天１ 次）。结果　所有经ｂ Ｆ Ｇ Ｆ治疗的创面都产生了明显的愈合,其中２ 周内愈合者２０ 个创面,３ 周内愈合者 ３ 个创面,４ 周内愈合者８ 个创面,超过４ 周愈合者２个创面。４ 周内总愈合率为９３．９％ 。结论　ｂ Ｆ Ｇ Ｆ可以显著地加速慢性难愈合创面愈合,其可能的机制涉及外源性ｂ Ｆ Ｇ Ｆ能够补充内源性ｂ Ｆ Ｇ Ｆ 的不足或调控内源性ｂ Ｆ Ｇ Ｆ活性。     

2002～2007年海珠区居民户碘盐监测结果分析

目的了解和掌握广州市海珠区居民户食用碘盐的情况,为制订防治策略提供科学依据。方法2002～2007年共抽取54个监测点,每个监测点随机抽取32个食用加碘盐用户,共抽取1728户样品,用直接滴定法测定盐碘含量。结果2002-2007年共检测1728份居民户碘盐,合格1617份,居民的碘盐覆盖率为96.18%,合格碘盐食用率为97.29%;各年度的居民碘盐覆盖率、合格碘盐食用率均达到90%以上。结论广州市海珠区近六年的居民碘盐覆盖率、合格碘盐食用率符合国家消除碘缺乏病标准。要进一步加强食盐加碘消除碘缺乏病工作,打击私盐,确保持续的合格碘盐供应是消除碘缺乏危害的关键。     

金卫“军字一号”工程临床诊疗项目字典的初始化和更新维护

金卫“军字一号”工程在全军和地方医院中已陆续投入使用,其对推动我国卫生事业发展起到了很大的作用。做好诊疗项目字典初始化和更新维护,不仅是医院信息系统能否顺利开展应用的重点和难点,而且还是系统能否正常运行的关键工作,本文就有关临床诊疗项目字典的初始化及如何更新维护等方面内容做了探讨。     

PA317产生高滴度带有人TNF-α基因逆转录病毒的研究

逆转录病毒介导的基因转移技术要过渡到临床应用，主要解决如何使病毒载体具有高滴度而不具有复制活性．本文旨在探索建立一种合适的方法，能产生高滴度而且是安全的逆转录病毒载体。采用带有人肿瘤坏死因子基因的LXSN载体转染PA317包装细胞，建立产病毒的包装细胞株，结果表明：病毒载体滴度受包装培养液体积和胎牛血清浓度影响：包装细胞在32℃产生的病毒滴度比37℃高，而且比较稳定。产病毒包装细胞和被感染的靶细胞经PCR分析显示．被转染和被转导的细胞都有病毒基因的整合．而且包装细胞不会产生具有复制活性的逆转录病毒，因此能进一步用于临床研究．     

A case-control study on risk of changing food consumption for colorectal cancer

Objectives. To investigate the relative risk factor of food items for colorectal cancer in four time periods through a case-control study in a Chinese rural area.

Methods. Colorectal cancer patients diagnosed at a county cancer center, Hebei Province, China, and non-cancer outpatients with similar age, sex, and place of residence were selected for cases and controls, respectively. There were 102 (93.6%) colorectal cancer patients and 99 (90.8%) outpatients being the cases and controls, respectively in the present investigation, who agreed to be interviewed about their food intake, during a 20-year period, through a food frequency questionnaire. The risks of intake of different food items and lifestyle for colorectal cancer were compared between cases and controls.

Results. During the 20-year period, diets of both cases and controls changed with increase in intake of animal foods and fruits, and alcohol consumption tended to increase. In the food items, milk intake showed a protective effect in both males and females, and the odds ratios were 0.38 (95% CI 0.16-0.90) and 0.28 (95% CI 0.10-0.81) for males and females, respectively. A reduced risk of fruit intake could be seen in males, while a reduced risk of vegetables could be observed in females. Meat intake and saturated fats were the prominent risk factors for colorectal cancer in males and females, respectively. A comparison of life habits, showed that tea drinking had a consistent protective effect in females, and the odds ratios were 0.21 (0.08-0.58), 0.23 (0.08-0.67), 0.25 (0.10-0.64), and 0.11 (0.04-0.30) for periods of 20-, 10-, 5-years ago, and current time, respectively.

Conclusions. These findings indicate that change in food consumption is strongly associated with a change in risk of colorectal cancer, and dietary meat has increased the risk of colorectal cancer. Increase in the consumption of milk and fruits may be a significant measure for colorectal cancer prevention in low-incidence areas.     

同源异形盒Gax基因重组腺病毒载体的构建及其鉴定

目的:构建同源异形盒Gax基因的复制缺陷型腺病毒载体,并对其是否重组成功进行鉴定。方法:采用两步CaC l2转化法的DNA细菌内同源重组技术,PCR扩增小鼠Gax基因,将Gax基因克隆于腺病毒穿梭质粒pAdTrack-CMV,转染含有5型腺病毒骨架质粒pAdeasy-1(33.5 kb)的B J5183细菌,经细菌内同源重组产生携带Gax基因的重组腺病毒载体pAd-Gax,经限制性内切酶BstⅨ和PacⅠ鉴定正确后,用脂质体法转染293细胞,包装产生携带Gax基因的重组腺病毒Ad-Gax。利用GFP的表达鉴定Ad-Gax。结果:构建了表达Gax基因的复制缺陷型腺病毒,病毒滴度达4×1010pfu/L。结论:成功地构建了表达Gax基因的复制缺陷型腺病毒载体,为进一步研究Gax基因在心血管病中的作用提供了实验基础。     

Comparison of health-related quality of life questionnaires in ambulatory oncology

The purpose of this study is to compare three commonly used health-related quality of life (HR-QOL) questionnaires for their ease of use, accuracy, and patient preference; identify factors related to patient preference; identify differences in patient completion rates; and to identify factors associated with patient completion of these questionnaires. Three psychometrically sound measures, the Symptom Distress Scale (SDS), Medical Outcome Study Short Form-36 (SF-36), and Functional Assessment of Cancer Therapy (FACT), were tested. Seventy-nine patients completed questionnaires in the ambulatory oncology setting. No significant differences in patient ratings were found in ease of use and accuracy among the questionnaires. All of the questionnaires were rated as easy to use and accurate. Patient ratings on preference were marginally significant (p=0.07). Forty-six percent of participants indicated that they preferred the SDS, whereas 27 and 39 preferred the SF-36 and the FACT. No significant differences in patient completion rates were found among the questionnaires. One hundred percent completion rates ranged from 88.6 for the SDS to 78.5 for the SF-36, and 80 completion rates ranged from 98.7 for the SDS to 94.9 for the SF-36. Administration of standardized HR-QOL questionnaires is feasible in the clinical setting.This research was supported by an American Cancer Society Institutional Research Grant (IRG 58-012-42) through Yale Comprehensive Cancer Center and a grant from Bayer Pharmaceutical Company.     

Item Analysis to Improve Reliability for an Internal Medicine Undergraduate OSCE

Utilization of objective structured clinical examinations (OSCEs) for final assessment of medical students in Internal Medicine requires a representative sample of OSCE stations. The reliability and generalizability of OSCE scores provides validity evidence for OSCE scores and supports its contribution to the final clinical grade of medical students. The objective of this study was to perform item analysis using OSCE stations as the unit of analysis and evaluate the extent to which OSCE score reliability can be improved using item analysis data. OSCE scores from eight cohorts of fourth-year medical students (n = 435) in a 6-year undergraduate program were analyzed. Generalizability (G) coefficients of OSCE scores were computed for each cohort. Item analysis was performed by considering each OSCE station as an item and computing the corrected item-total correlation. OSCE stations which negatively impacted the reliability were deleted and the G-coefficient was recalculated. The G-coefficients of OSCE scores from the eight cohorts ranged from 0.48 to 0.80 (median 0.62). The median number of OSCE stations that negatively impacted the G-coefficient was 3.5 (out of a median of 25 total stations). When the ‘‘problem stations’’ were deleted, the median G-coefficient across eight cohorts increased to 0.62--0.72. In conclusion, item analysis of OSCE stations is useful and should be performed to improve the reliability of total OSCE scores. Problem stations can then be identified and improved.