加强中小型医院档案管理工作

探讨中小型医院档案管理工作.通过分析中小型医院档案工作现状,进而从软硬件两个方面就如何提高中小型医院档案管理工作的服务和指导功能作了一定阐述.     

p21对缺血-再灌注损伤后肾小管上皮细胞演变的影响

目的 探讨p21对缺血-再灌注损伤（IRI）后肾小管上皮细胞演变的影响。方法 选择低龄（2个月龄）和高龄（12个月龄）p21（＋／＋）和p21（-／-）鼠，建立左肾IRI模型。于IRI后0、1、3、7d及1、3、6个月光镜下观察肾小管组织学变化，采用免疫组化法检测肾小管上皮细胞增殖细胞核抗原（PCNA）表达，组织化学染色观察肾小管上皮细胞衰老相关β-半乳糖苷酶（SA-β-gal）活力，末端脱氧核糖转移酶介导的生物素化脱氧尿嘧啶缺刻标记技术（TUNEL）检测肾小管上皮细胞凋亡。结果 IRI后0d，肾小管以坏死为主，高龄鼠比低龄鼠严重、p21（-／-）鼠比p21（＋／＋）鼠严重（P均〈0．05）。肾小管上皮细胞凋亡在IRI 1d后出现，7d达高峰，且高龄鼠比低龄鼠明显、p21（-／-）鼠比p21（＋／＋）鼠明显（P均d0．05）。低龄鼠IRI后1个月出现SA—β-gal染色阳性的肾小管上皮细胞，而对侧肾此时未见衰老细胞，3和6个月时衰老的肾小管上皮细胞显著增多，且p21（＋／＋）鼠比p21（-／-）鼠明显（P〈0．05）；p21（＋／＋）高龄鼠IRI后0d双肾即可见大量的SA-β-gal染色阳性肾小管上皮细胞，且较p21（-／-）鼠显著增多（P〈O．05），但1d后，p21（＋／＋）和p21（-／-）鼠IRI肾衰老细胞均明显减少（P均〈0．05），1个月后又呈进行性增加，且p21（＋／＋）鼠始终比p21（-／-）鼠严重。高龄和低龄p21（＋／＋）鼠PCNA阳性染色细胞出现的几率差异无显著性（P〉0．05），但低龄鼠细胞增殖能力要强于高龄鼠；而p21（-／-）鼠的细胞增殖能力明显强于p21（＋／＋）鼠，低龄鼠更为显著（P均〈0．05）。对高龄鼠IRI后1d细胞衰老和凋亡进行相关分析显示，二者呈显著负相关Cp21（＋／＋）鼠：r=-0．82，P〈0．001,p21（-／-）鼠：r=-0．76，P〈0．0013。结论 ①IRI可促进正常肾小管上皮细胞衰老的进程；②已经进入衰老状态的肾小管上皮细胞在遭受IRI刺激后，更易走向死亡[坏死和（或）凋亡]；③p21在IRI所致肾小管上皮细胞演变过程中发挥重要的调控作用。     

颈动脉粥样硬化超声检查在脑梗塞诊治中的应用

目的探讨颈动脉粥样硬化脑梗死的相关性。方法60例脑梗死患，均经头颅CT证实，年龄在48～72岁之间，采用SONELINE VersaPro彩色多普勒超声诊断仪，诊断颈动脉粥样斑块增厚情况及颈动脉狭窄程度。结果有22例颈动脉内粥样斑块合并颈动脉中重度狭窄，占37％；全部22例颈动脉中重度狭窄的病例中有19例同侧有脑梗死，占86％。结论颈动脉超声检查对脑梗死的临床治疗和预防具有重要意义。     

手指离断再植术后护理

目的 探讨断指再植护理措施。方法 采用指体的摆放，病房适宜温度20～25℃，烤灯局部保温，术后观察血运指标，小儿特殊护理及康复指导。结果 成活优良率91．6％，住院天数平均16天，功能恢复满意率75％。结论 护理措施恰当，可显降低并发症的发生，提高治愈率。     

长链核酸扩增技术评价病毒灭活效果的研究

目的:探讨用长链核酸扩增技术评价病毒灭活效果的可行性.方法:针对伪狂犬病毒(pseudorabies virus,PRV)糖蛋白gD基因前后的保守区设计预计产物长短不一的5对引物,用半巢式PCR技术扩增经低pH法(4.0±0.1)、巴氏消毒法[(60±1.0)℃]和s/D法(有机溶剂/洗涤荆)处理后的PRV核酸,同时以细胞感染法做平行对照.结果:低pH对PRV核酸有破坏作用,处理时间越长,核酸损伤程度越明显,处理60 min时,6.62 lgTCID50的PRV完全被灭活.5条不同长度PCR扩增产物中,只有3.9 kb的长片段检出与细胞培养结果一致.7.25 lgTCID50的PRV经(60±1.0)℃处理20 min后即被完全灭活,7.13 lgTCID50的PRV经s/D法处理1 h后被完全灭活,但各长度核酸片段扩增均为阳性,与细胞感染试验结果不符.结论:低pH对PRV核酸的损伤程度随处理时间的延长而增加;用长链PCR(3.9 kb)技术来评价经低pH法灭活病毒的效果是可行的,而该法不适合评价巴氏消毒法和S/D法灭活病毒的效果.     

Comparison of redox and D29 phage methods for detection of isoniazid and rifampicin resistance in Mycobacterium tuberculosis

Rapid, accurate and inexpensive methods are essential to detect drug-resistant Mycobacterium tuberculosis and allow timely application of effective treatment and precautions to prevent transmission. The proportion method, the MTT and Alamar Blue redox methods, and the D29 mycobacteriophage assay, were compared for their ability to detect resistance to isoniazid and rifampicin. When tested against a panel of known M. tuberculosis strains, the redox methods and the D29 assay showed good sensitivity and specificity compared to the proportion method, suggesting that they could be useful alternatives for identifying multidrug resistance in M. tuberculosis.     

Expression of Na+/HCO3− co‐transporter proteins (NBCs) in rat and human skeletal muscle

Aim: Sodium/bicarbonate co‐transport (NBC) has been suggested to have a role in muscle pH regulation. We investigated the presence of NBC proteins in rat and human muscle samples and the fibre type distribution of the identified NBCs. Methods and results: Western blotting of muscle homogenates and sarcolemmal membranes (sarcolemmal giant vesicles) were used to screen for the presence of NBCs. Immunohistochemistry was used for the subcellular localization. The functional test revealed that approximately half of the pH recovery in sarcolemmal vesicles produced from rat muscle is mediated by bicarbonate‐dependent transport. This indicates that the NBCs are preserved in the vesicles. The western blotting experiments demonstrated the existence of at least two NBC proteins in skeletal muscle. One NBC protein (approximately 150 kDa) seems to be related to the kidney/pancreas/heart isoform NBC1, whereas the other protein (approximately 200 kDa) is related to the NBC4 isoform. The two NBC proteins represent the electrogenic isoforms named NBCe1 and NBCe2. Membrane fractionation and immunofluorescence techniques confirmed that the two NBCs are located in the sarcolemmal membrane as well as in some internal membranes, probably the T‐tubules. The two NBCs localized in muscle have distinct fibre type distributions. Conclusions: Skeletal muscle possesses two variants of the sodium/bicarbonate co‐transporter (NBC) isoforms, which have been called NBCe1 and NBCe2.     

火药爆炸复合烧伤大鼠血浆CK-MB与心肌MDA变化

目的 探讨烟花火药爆炸复合烧伤大鼠血浆肌酸激酶心肌同工酶(CK—MB)与心肌丙二醛(MDA)含量的变化。方法 Wistar大鼠128只，随机分为正常对照组(n=8)、烧伤组(n=40)、爆炸伤组(n=40)和复合伤组(n=40)，分别致伤形成大鼠20％体表面积Ⅲ度烧伤、火药爆炸伤和两者复合伤。动态观察大鼠伤后1、3、6、12、24h血浆CK—MB，心肌MDA含量并进行相关分析。结果 复合伤组较单因素致伤组大鼠血浆CK—MB升高明显，心肌组织MDA含量呈类似变化，CK—MB与MDA有相关性。结论 烟花火药爆炸复合烧伤对大鼠心肌的损害较单纯烧伤或爆炸伤更为严重，提示烧伤和爆炸伤有协同致伤作用，氧自由基代谢紊乱参与烟花火药爆炸复合烧伤后心肌的损伤。     

检测幽门螺旋杆菌感染的几种方法的比较

目的 :评价几种诊断幽门螺杆菌 (Hp)感染的检测方法 .方法 :对 386例患者行胃镜钳取胃窦粘膜 ,分别经改良Giemsa染色、快速尿素酶 (RUT)试验、14 C 尿素呼气试验 (14 C UBT)检查及HpIgG血清学检查 ,与细菌培养结果对照 ,用 χ2检验进行对比评价 .结果 :RUT ,14 C UBT和改良Giemsa染色的敏感性、特异性较高 ,与细胞培养的符合率相近 ,其中14 C UBT和改良Giemsa染色联合检测的符合率更相近 (99.7% ) ;HpIgG血清学检查的敏感度虽和其余检测方法无差别 ,但其特异度较低 ,尤其是复诊组的特异度 ,与其他检测方法有显著差异 (P <0 .0 1) ,而且与初诊组相比也有差异 (χ2 =35 .18,P <0 .0 1) .结论 :HpIgG血清学检查可用于Hp感染的筛查 ,而不能作为疗效判断的指标 ,14 C UBT和改良Giemsa染色联合检测是较可靠的Hp检测方法     

The ordered transmission disequilibrium test: detection of modifier genes

We consider the problem of detection of modifier genes that lead to variations in a disease‐related continuous variable (DRCV), such as the age of onset or a measure of disease severity, in a strategy of candidate genes. We propose a novel method, the ordered transmission disequilibrium test (OTDT), to test for a relation between the clinical heterogeneity expressed by a DRCV and marker genotypes of a candidate gene. The OTDT applies to trio families with one patients and his parents, all three genotyped at a bi‐allelic marker M. The OTDT aims to find a critical value of the DRCV which separates the sample of families in two subsamples in which the transmission rates are significantly different. We investigate the power of the method by simulations under various genetic models and covariate distributions and compare it with a linear regression analysis. Genet. Epidemiol. 2008. ©2008 Wiley‐Liss, Inc.