东北红豆杉中紫杉烷类化合物抑制人肺癌细胞增殖活性的研究

目的:通过研究东北红豆杉(Taxus cuspidata)中12种紫杉烷类化合物对人肺癌细胞增殖的影响,探讨这12种紫杉烷类化合物体外抑制人肺癌细胞增殖的作用以及这些化合物结构与活性之间的构效关系.方法:利用MTT法检测具有不同骨架结构的12种紫杉烷类化合物对5种人肺癌细胞株细胞增殖的抑制作用.结果:Taxinine和2α,10β-diacetyl-5-cinnamoyl-phototaxicin Ⅱ对5种实验用人肺癌细胞的增殖均有明显的抑制作用,其他10种化合物对5种实验用人肺癌细胞的增殖不显示抑制作用.结论:紫杉烷类化合物对人肺癌细胞的增殖抑制作用不仅与其骨架结构有密切关系,而且该类化合物对肿瘤细胞的抑制作用可能还与C-5位具有的肉桂酰基侧链有一定的相关性.     

不同辅料对通塞脉浸膏粉体物理性质及其微丸成型性的影响研究

目的:初步探讨通塞脉浸膏与不同辅料混合物的物理性质与其微丸成型性的相关性.方法:通过测定不同处方混合物的内聚力、塑性指数及所成微丸粉体学性质,运用主客观赋权法及多元回归分析其相关性.结果:混合物的塑性指数对微丸成型起主要影响,在所考察范嗣内呈正相关,内聚力与微丸成型呈负相关.结论:混合物的物理性质能显著地影响微丸成型.     

基于博弈分析的患者投诉管理策略

新时代背景下,公民的权利意识不断增强,患者投诉屡见不鲜.医患关系的紧张严重影响到社会医疗秩序,患者投诉逐渐成为医院发展关注的重点.作者从静态博弈和动态博弈两个角度分析医生、患者、医院三者之间的行为选择,分析各方在博弈中的策略选择及其得益,并提出规范患者投诉管理的对策.建议规范化管理患者投诉,畅通医院投诉渠道,加强对医生...     

孙兰军主任治疗更年期妇女胸痹经验

胸痹是指胸部闷痛,甚则胸痛彻背,喘息不得卧为主症的一种疾病,轻者仅感胸闷如窒,呼吸欠畅,重者则有胸痛,严重者心痛彻背,背痛彻心。胸痹最早见于《内经》,《素问.脏气法时论》说:"心病者,胸中痛,胁支满,胁下痛,膺背肩胛间痛,两臂内痛。"汉代张仲景《金匮要略》正式提出"胸痹"的名     

论单核苷酸多态性与中医证的个体差异

单核苷酸(nucleotide)是基因的基本组成单位，单核苷酸多态性(Single Nacl eotide Poly morPhism,SNP)是指任何两个不同个体之间的单核苷酸序列中均有不同的排列次序，导致遗传变异而形成不同个体的差异性和多样性。它是决定人的个体差异的主要因素，是遗传的变异性所引起。个体差异是个体机体功能相对偏差以保持动态稳定的特征，是潜在的病理因素，其发病具有质化特点。证以质为基础，质以证的形式表现出来，证的特征包含着质的特征，证往往随质而转移，证的个体差异与单核苷酸多态性有关，这是中西医结合研究的最佳切入点。建立证与药的单核苷酸组学，可阐明中医药防治疾病原理，实现个体化医学治疗的理想，体现中医治病求本和防治未病的思想。     

从“肺肠合病”模型大鼠血清TNF-α、IL-1含量变化探讨“肺与大肠相表里”

目的:建立肺病、肠病、肺肠合病大鼠病理模型,通过观察其血清TNF-αI、L-1含量情况,探索"肺与大肠相表里"相关病理机制。方法:实验设正常对照组、肺病组(过敏性哮喘)、肠病组(便秘)和肺肠合病组(过敏性哮喘合便秘)共4组。结果:与正常对照组比较,肺病组、肠病组、肺肠合病组大鼠血清TNF-αI、L-1含量均呈显著性差异(P<0.01);与肺病组比较,肺肠合病组大鼠血清TNF-αI、L-1含量呈显著性差异(P<0.01);与肠病组比较,肺肠合病组大鼠血清TNF-αI、L-1含量呈显著性差异(P<0.01)。结论:肺肠合病组大鼠血清TNF-αI、L-1含量均明显高于肺病组及肠病组,证实TNF-αI、L-1可能是肺与大肠相关的共同物质基础,为"肺与大肠相表里"理论提供一定的现代医学实验依据。     

沟通合作———医学人文的表达与实现

医务工作环境复杂,医生接触的人群多样且难以预见。通过沟通合作将医学人文素养进行表达和实现,有助于医生临床工作决策和合作,对顺利有效处理医疗事务、提高医疗工作效率和改善患者就医体验非常关键。在此探讨了更加契合医生的沟通新定义,并根据医生沟通合作的对象不同分别进行了分析。医患沟通应着眼未来,携手并进。同行沟通要互相尊重,求同存异。社会沟通掌握界限,消除偏见。只有像这样在沟通合作中运用一定的技巧,才能良好表达和实现医学人文素养,为稳定我国医疗环境作出贡献。     

医患沟通对患者依从性的影响机制探索

目的/意义探索医患沟通对患者依从性的影响机制。方法/过程通过问卷星平台随机搜集样本,利用SmartPLS软件构建结构方程模型,分析医患沟通情况对依从性的影响路径及其显著性。结果/结论医患沟通通过患者对医生的信任度、患者就诊满意度、患者感知信息不对称的中介作用,对患者依从性产生正向影响。     

测定抗-HBs的两种方法在不同温育时间的结果比较

目的探讨检测乙型肝炎（下称乙肝）病毒表面抗体（抗-HBs）两种方法在不同温育时间的结果差异。方法采用免疫酶法（EIA）一步法、时间分辨荧光（TRF）法检测抗-HBs,OD值在0．056-0．380之间标本温育时间变化而造成的结果值的差异。结果用30min EIA一步法检测抗-HBs,结果37例弱阳性和59例阴性,再用60min EIA一步法抗-HBs检测,结果41例呈弱阳性和55例阴性。用TRF两步法抗-HBs测定出42例弱阳性和54例阴性,发现有6例标本不同于温育30min的EIA一步法抗-HBs检测的结果。结论酶联免疫吸附试验作为一种固相免疫测定,抗原抗体的结合反应在固相上进行,要使液相中的抗原或抗体与固相上的特异抗体或抗原完全结合,必须在一定的温度、时间条件下反应。温育所需时间与温度成反比,尤其在冬天,标本从室温到恒温箱这一过程很容易造成实际测定温育时间不够,也是造成灰区误差的原因之一。     

Addressing social inequity through improving relational care: A social–ecological model based on the experiences of migrant women and midwives in South Wales

BackgroundMigrant and ethnic inequalities in maternal and perinatal mortality persist across high‐income countries. Addressing social adversity and inequities across the childbirth trajectory cannot be left to chance and the good intentions of practitioners. Robust, evidence‐based tools designed to address inequity by enhancing both the quality of provision and the experience of care are needed.MethodsAn inductive modelling approach was used to develop a new evidence‐based conceptual model of woman–midwife relationships, drawing on data from an ethnographic study of relationships between migrant Pakistani women and midwives, conducted between 2013 and 2016 in South Wales, UK. Key analytic themes from early data were translated into social–ecological concepts, and a model was developed to represent how these key themes interacted to influence the woman–midwife relationship.ResultsThree key concepts influencing the woman–midwife relationship were developed from the three major themes of the underpinning research: (1) Healthcare System; (2) Culture and Religion; and (3) Family Relationships. Two additional weaving concepts appeared to act as a link between these three key concepts: (1) Authoritative Knowledge and (2) Communication of Information. Social and political factors were also considered as contextual factors within the model. A visual representation of this model was developed and presented.ConclusionsThe model presented in this paper, along with future work to further test and refine it in other contexts, has the potential to impact on inequalities by facilitating future discussion on cultural issues, encouraging collaborative learning and knowledge production and providing a framework for future global midwifery practice, education and research.Patient or Public ContributionAt the outset of the underpinning research, a project involvement group was created to contribute to study design and conduct. This group consisted of the three authors, an Advocacy Officer at Race Equality First and an NHS Consultant Midwife. This group met regularly throughout the research process, and members were involved in discussions regarding ethical/cultural/social issues, recruitment methods, the creation of participant information materials, interpretation of data and the dissemination strategy. Ideas for the underpinning research were also discussed with members of the Pakistani community during community events and at meetings with staff from minority ethnic and migrant support charities (BAWSO, Race Equality First, The Mentor Ring). Local midwives contributed to study design through conversations during informal observations of antenatal appointments for asylum seekers and refugees.