实时组织超声弹性成像对肝硬化的应用价值研究

目的探讨实时组织超声弹性成像(Real-time tissue elastog-raphy,RTE)技术和常规超声检查(Routine ultrasonic inspection,RUI)对肝硬化的应用价值。方法选取2014年4月~2016年2月在本院进行入院治疗的肝硬化患者92例作为研究对象,根据其病情严重程度分为早期代偿期肝硬化组71例以及失代偿期肝硬化组21例。以肝组织取活检病理临床诊断结果作为金标准,应用SPSS 21.0统计学软件计算并采用Z检验比较常规超声积分和实时RTE技术诊断代偿期肝硬化、失代偿期肝硬化的ROC曲线下面积。结果将92例确诊的肝硬化患者作为肝硬化组,数据分析结果表明RTE技术诊断肝硬化的ROC曲线下面积(0.971)、敏感度(95.42%)、特异度(93.38%)均显著大于RUI积分诊断(依次为0.846、72.46%、86.61%),具有显著性差异(Z/χ2值依次为2.844、3.127、2.547,P0.05);RTE技术诊断早期代偿期肝硬化的ROC曲线下面积(0.956)、敏感度(94.58%)、特异度(93.07%)均显著大于RUI积分诊断(依次为0.738、51.65%、87.46%),具有显著性差异(Z/χ2值依次为3.639、5.174、2.429,P0.05);RTE技术诊断失代偿期肝硬化的ROC曲线下面积、敏感度、特异度与RUI积分诊断比较均不具有显著性差异。结论与RUI相比较,RTE技术诊断早期代偿期肝硬化具有显著优势,但对失代偿期肝硬化患者进行诊断时效果无明显差异。     

河南省药品批发企业新版GSP跟踪检查缺陷项目分析

目的：分析河南省药品批发企业实施新版《药品经营质量管理规范》（GSP）后跟踪检查中发现的共性问题,为今后制定有针对性的监管措施和企业避免出现类似问题提供参考。方法：对224家药品批发企业实施新版《药品经营质量管理规范》后跟踪检查中发现的缺陷项目进行统计,分析药品批发企业GSP质量体系存在的主要问题和原因,提出相应的解决措施。结果与结论：河南省药品批发企业在药品储存与养护、设施与设备、收货与验收、采购、人员与培训等方面还存在不足,企业应当持续不断地改进和完善质量管理体系;提高培训的针对性和实效性。     

ORAL MYOFUNCTIONAL AND ELECTROMYOGRAPHIC EVALUATION OF THE ANTERIOR SUPRAHYOID MUSCLES AND TONGUE THRUST IN PATIENTS WITH CLASS II/1 MALOCCLUSION SUBMITTED TO FIRST PREMOLAR EXTRACTION

Objective:

The aim of this study was to assess the existence of myofunctional alterations before and after first premolar extraction in Class II/1 malocclusion patients that could endanger the long-term dental arch stability.

Materials and Methods:

The study was performed by means of morphological, functional and electromyographic analyses in 17 Class II/1 malocclusion patients (group T) and 17 Class I malocclusion patients (group C), both groups with 12-30-year age range (mean age: 20.93 ± 4.94 years).

Results:

Data analyzed statistically by Student’s t-test showed a significant decrease in the maxillary and mandibular dental arch perimeters after orthodontic treatment (p<0.05). The Kruskal-Wallis test analyzed data from tongue posture at rest and during swallowing, not showing significant differences after treatment (groups Tb and Ta) (p>0.05). However, group T differed significantly from group C (p<0.05). The electromyographic data showed that the anterior right and left suprahyoid muscles acted synergistically in both groups, while having a lower myoelectric activity in group T during swallowing.

Conclusions:

Myofunctional alterations observed after the orthodontic treatment in Class II/1 malocclusion seemed to jeopardize the long-term orthodontic stability, making recurrence possible. Further research should be conducted to compare electromyographic data before and after orthodontic treatment in order to corroborate the results of the present investigation.     

游离股前外侧组织瓣修复全舌或近全舌切除术后组织缺损

目的探讨游离股前外侧组织瓣在全舌或近全舌切除术后组织缺损修复的治疗效果。方法2015年3月-2018年5月,收治15例舌癌(全舌或近全舌切除)患者,肿瘤根治术后应用股前外侧组织瓣同期修复,皮瓣大小为6 cm×10 cm^8 cm×15 cm,对其临床资料进行回顾性分析,术后要求患者定期到门诊复查。结果15例皮瓣均成活,术后发生血管危象1例,经探查及相应处理后完全成活。术后于门诊随访12~48个月,平均30个月,舌部受区皮瓣成活良好,术后6个月患者张口度、咀嚼功能恢复良好,但是吞咽及语音功能欠佳;大腿供区运动功能良好,无麻木、疼痛不适。结论全舌或近全舌切根治术后遗留的组织缺损,以游离股前外侧组织瓣进行修复重建,可以较好的恢复舌的部分功能及外形。     

药品检验标准电子管理方式研究

目的：研究对药品检验用标准管理的新思路。方法：通过对现行的药品检验标准管理方式进行研究与分析,阐述其中存在的问题与难点,制订电子管理的思路与方法。结果：电子管理药品检验标准,可有效解决传统管理方式中遇到的问题,可大幅提高药品标准管理的效率。结论：通过建立标准管理信息系统,可及时提供药品检验所需标准,并保证其有效性,这些对药品检验工作均大有裨益。     

药品应急检验管理理论基础研究

近年来我国药品突发事件频发,药品检验机构作为药品监管的技术支撑,迫切需要提升此方面的应对能力。通过从应急管理、药品常规检验、应急检验等3方面对药品应急检验管理的理论基础进行研究,阐释了应急管理在药品应急检验中的运用思路,为制定处置应急检验事件的有效措施打下坚实基础。     

Tongue pressure during swallowing is decreased in patients with Duchenne muscular dystrophy

Although dysphagia is a life-threatening problem in patients with Duchenne muscular dystrophy (DMD), the pathophysiology of oral stage dysphagia is yet to be understood. The present study investigated the tongue motor deficit during swallowing in patients with DMD and its relationship with disease-specific palatal morphology. Tongue pressure during swallowing water was recorded in 11 male patients with DMD and 11 age- and sex-matched healthy subjects using an intra-oral sensor with five measuring points, and the state of tongue pressure production was compared between the groups. Palatal morphology was assessed by a non-contact three-dimensional scanner on maxillary plaster models. In patients with DMD, the normal sequential order of tongue-palate contact was lost and the maximal magnitude and integrated value of tongue pressure on the mid-anterior part of palate were smaller than those in healthy subjects. The width of the palate in patients was greater than that in healthy subjects and the depth of the palate in patients had a negative correlation with tongue pressure magnitude on the median palate. Our results suggested that the deteriorated tongue motor kinetics prevented tongue movement during swallowing that was appropriate for the depth of the palate and affects the state of tongue pressure production during swallowing.     

卫生电子监管的内涵、重点领域与发展建议

本文从中国卫生监督面临的突出问题出发,讨论了卫生电子监管的概念、特点、意义,认为饮用水水质、公共场所室内空气质量和游泳场馆水质是当前卫生电子监管的重点领域,建议发挥各级政府以及经营管理者的积极作用,并采用法制手段推动卫生电子监管进程。     

浅谈构建药品应急检验管理体系的措施

目的:提出构建药品应急检验管理体系的措施。方法:对我所2012年经历的应急检验事件进行分析和总结,从应急意识、技术储备、沟通合作、检验方案和信息系统5个方面提出了构建应急检验管理体系的具体措施。结果与结论:应急检验在药品安全突发事件中是食品药品检验所的职责。在目前药害事件时有发生的形势下,应通过培养应急检验意识,提前做好技术、物质和设备的储备,构建以省级药品检验所为中心的应急检验合作平台,优化检验方案,完善信息系统等措施,构建完善的药品应急检验管理体系。     

药检机构实验室信息化建设中ELN系统应用的探讨

目的探讨药检机构实验室信息化建设中电子实验室记录本（ELN）系统的选型和实施。方法结合我国药检机构实验室信息化平台建设的现状,论述ELN系统的意义和具体功能,并提出如何在药检系统信息化中进行ELN系统的选型。结果作为第三方检测实验室的药检机构,在ELN的选型上应该区别于医药生产行业的ELN选型方式,需要选择一款灵活的ELN,同时选择适应日常检验和分析的ELN产品。结论选择灵活的可定制的ELN产品,能够满足药检实验室日常检验和分析的需求,适用于药检行业分析实验室的解决方案。