示范区创建活动与社区卫生服务长效机制的建立和可持续发展对策的思考

通过第三方评估全国社区卫生服务示范区是我国社区卫生服务发展史上的一大创举。此项活动的开展,极大的提高了各地政府对发展社区卫生服务的思想认识、政策理解和经费投入力度。通过创建和评估活动,系统总结了各申报地区社区卫生服务的经验和特色,分析了存在的问题和不足,提出了发展社区卫生服务的对策和建议,制定了社区卫生服务可持续发展的长效机制,取得了预期效果,达到了预期目的。随着《国务院关于发展城市社区卫生服务的指导意见》的出台,示范区的典型示范效应会日益凸显出来,对我国社区卫生服务的发展将起到不可估量的作用。     

化学气相淀积过程中钛酸丁酯热解反应机理及动力学

利用热解-色质联用分析系统,对文题进行了研究,发现其热解过程是一个复杂的多元反应过程。在500～800℃,钛酸丁酯(Ⅰ)热解尾气产物主要是烯烃、醇、醚和醛类化合物。经热解机理分析,发现Ⅰ的重排断裂反应是整个热解过程的主反应,其反应动力学常数为3.87×10~5,活化能为69.3 kJ/     

Loss of constitutional heterozygosity in human astrocytomas

Summary Inactivation of tumour suppressor genes or anti-oncogenes as well as activation of dominant acting oncogenes seem to be important mechanisms in the pathogenesis of gliomas. We compared constitutional and tumoural genotypes at different restriction fragment length polymorphism loci (RFLP) on chromosomes 10 and 17 in 15 unrelated individualsLoss of heterozygosity (LOH) pointing to chromosomal loss or deletions was detected for at least one chromosme 17 marker in 11 gliomas (astrocytomas grades I–III and glioblastoma multiforme), whereas LOH for chromosome 10 loci was only detected in 3 out of 9 cases of glioblastoma multiforme and was not detected in low grade gliomas. Since LOH for chromosome 10 loci seems to be restricted only to glioblastoma multiforme, it is possible that recessive mutations on chromosome 10 are engaged in tumour progression from astrocytomas to glioblastoma multiforme. As LOH of chromosome 17 markers occurs in astrocytomas as in glioblastoma multiforme, chromosome 17 loci probably are involved in early tumour development.     

Evidence for a reflex provoking contraction of the renal pelvis (with some comments on its clinical implications)

The effect of swallowing a small quantity of water or of solid food (biscuit) on the renogram curve was observed in 177 patients. Swallowing provoked contraction of the renal pelvis in 63% of the kidneys with a pelvicalyceal system which was neither obstructed nor dilated, with expulsion of a substantial fraction of the contents within 30 s. This did not occur in obstructed or denervated kidneys, nor in patients with a high transection of the spinal cord. Evidence is adduced that this contraction is mediated reflexly. This effect may be used diagnostically to distinguish physiological dilatation from obstruction. The implications when performing and interpreting renography are discussed. Correspondence to: M.V. Merrick     

Expanding Our Strategies to Study the Process of Change

The conceptual and methodological framework proposed by Doss (this issue) makes valuable suggestions for strategic choices in future research. This commentary addresses conceptual and terminological distinctions adopted by Doss, as well as his criticism of add-on/ dismantling studies. We also suggest research topics and methodological developments that could be integrated in Doss's framework to further expand understanding of therapeutic change.     

医院管理"四部曲"

结合医院管理实际,实施管理四部曲。即:完善机制、教育先行、督察到位、奖惩分明。阐明持续改进是完善机制的内在需求;及时清理是完善机制的有力保障;易于操作是完善机制的必备条件。同时,突出教育的基础性地位;强调监督的关键性环节;放大奖惩的激励性效应。     

A new nematode, <Emphasis Type="Italic">Pongobius hugoti</Emphasis> gen. et sp. n. from the orangutan <Emphasis Type="Italic">Pongo abelii</Emphasis> (Primates: Hominidae)

Summary Light and scanning electron microscopical examination and molecular analysis of pinworm samples collected from the Sumatran orangutan (Pongo abelii) from Sumatra (Indonesia) revealed the presence of a new taxon, Pongobius hugoti gen. et sp. n. (Oxyuridae: Enterobiinae). The monotypic genus Pongobius is characterised by the presence of a triangular mouth, three rounded teeth and three chisel-like inner teeth in the buccal cavity, an oesophagus with a long pharyngeal part, corpus posteriorly slightly enlarged and continuing as a pyriform bulb, isthmus absent. These features differentiate P. hugoti from all members of the subfamily Enterobiinae. The male has a long caudal appendix (> 50% of total tail length). Molecular analysis of the new taxon is presented for more precise identification.     

结直肠癌淋巴结转移与部分肿瘤分子标志物表达的相关性研究

目的 探讨部分肿瘤相关分子标志物免疫组织化学的表达与结直肠癌淋巴结转移的相关性.方法 应用免疫组织化学技术检测65例结直肠癌手术标本Ki-67、p53的表达情况,对照手术所见和手术标本的病理检查结果 ,研究这些肿瘤相关分子标志物与肿瘤的生物学特性如浸润和淋巴结转移等的关系.结果 65例结直肠癌手术标本Ki-67、p53免疫组织化学的表达与肿瘤肠壁浸润深度无明显相关性(P＞0.05).Ki-67的表达及Ki-67标记指数的表达与淋巴结转移及Dukes分期有明显的相关性(P＜0.01);p53标记指数的表达与淋巴结转移有相关性(P＜0.05),与Dukes分期有明显的相关性(P＜0.01).结论 作为反应细胞增殖活性的肿瘤相关分子标志物Ki-67,其免疫组织化学的表达程度可间接反映结直肠癌淋巴结转移状况,可能成为反映淋巴结转移的一个标志物.     

sFGFR1基因的克隆与在RTS系统中的高效表达

目的：克隆sFGFRl(soluble fibroblast growth factors receptor-1)基因，并在RTS(rapid translation system)系统中高效表达相应蛋白．方法：培养Swiss rat 3T3 fibroblast细胞株，提取总RNA，用RT—PCR方法获取鼠sFGFR1 cDNA片段，酶切后克隆到pIVEX2．3d载体并进行序列分析；采用Roche RTS ProteinMaster500系统，高效表达sFGFR1蛋白并用Western Blot鉴定表达的蛋白．结果：克隆了sFGFR1基因，测序证实序列正确；Western Blot证实sFGFR1蛋白在RTS系统中高效表达．结论：克隆了sFGFR1基因并在RTS系统获得高效表达．     

低分子肝素钙联合辛伐他汀治疗不稳定型心绞痛疗效观察

目的探讨低分子肝素联合辛伐他汀治疗不稳定型心绞痛的疗效。方法将100例不稳定型心绞痛患者随机分为对照组50例和观察组50例。对照组仅采取常规治疗（硝酸酯类、β-受体阻滞剂、钙拮抗剂、阿司匹林等），观察组在常规治疗的基础上加用低分子肝素和辛伐他汀，观察比较各组的疗效。结果观察组总有效率为90．0％，对照组总有效率为60．0％，两组疗效比较差异有显著性意义（P〈0．05）。结论低分子肝素联合辛伐他汀治疗不稳定型心绞痛取得满意的疗效。