血清白蛋白水平对血液透析低血压发生的影响

目的了解血浆白蛋白水平对血液透析时低血压发生率的影响。方法按血清白蛋白水平分为三组:血清白蛋白>35g/L组、25-35g/L组和<25g/L组,观察三组在血透期间低血压的发生率。结果随着血清白蛋白水平的下降,低血压的发生率呈升高趋势,三组的发生率分别为4.8%,6.4%,25.7%,三组间有显著性差异(P<0.01)。结论血浆白蛋白在维持血透期间的血压起着重要的作用,低白蛋白血症,尤其白蛋白<25g/L时,易发生低血压,在拟定超滤方案时应充分考虑这一因素。     

安徽省1999～2003年化妆品卫生质量分析与评价

目的　评价我省化妆品卫生质量现况 ,为进一步开展化妆品监督监测工作提供参考。方法　依据《化妆品卫生规范》 ,对 1999～ 2 0 0 3年安徽省化妆品样品进行监测分析。结果　我省化妆品卫生监测合格率呈波浪式逐年上升趋势 ,但 2 0 0 3年有较大回落。结论　化妆品卫生监测力度应加大、能力需提高、方法要改进。     

全反式视黄酸对体外培养的人体大隐静脉内膜平滑肌细胞增殖与凋亡的影响

目的研究全反式视黄酸(atRA)对体外培养的人体大隐静脉内膜增厚、平滑肌细胞增生与凋亡的影响。方法30小段(1 cm长)人体大隐静脉(HSV),随机分成HSV组、atRA组和对照组(n=10),atRA组和对照组均体外培养14 d。atRA组:培养液中含atRA100μM;对照组:培养液中含同等量无水酒精(atRA溶剂)。对HSV组及培养后的atRA组、对照组标本进行取材固定,M asson染色,免疫组化测定增殖细胞核抗原(PCNA)及TUNEL法检测平滑肌细胞凋亡,计算机图象分析仪测量血管内膜厚度、计算内膜增生指数及细胞增殖和凋亡百分比。结果体外培养人体大隐静脉能产生明显的内膜增生和平滑肌细胞增殖(P<0.05);atRA组内膜厚度、增生指数及PCNA阳性细胞百分数均明显低于对照组(P<0.05)。而凋亡细胞百分数则明显高于对照组(P<0.05)。结论atRA可以抑制体外培养人体大隐静脉内膜增厚及平滑肌细胞增生,促进平滑肌细胞凋亡。     

清营汤对热盛阴虚证心力衰竭大鼠心肌微结构心肌细胞因子影响的实验研究

通过联用异丙肾上腺素和甲状腺素，分两步制备出大鼠热盛阴虚证心力衰竭模型，观察清营汤对热盛阴虚证心力衰竭大鼠心肌细胞因子、心肌病理微结构变化等方面的影响。实验结果显示：清营汤中、高剂量组具有较明显的改善热盛阴虚证心力衰竭大鼠心肌组织病理变化，以及降低大鼠心肌组织中TNF-αmRNA、IL-1βmRNA含量的作用，表明清营汤对热盛阴虚型心力衰竭有较明显的治疗作用。     

生育保险病种费用影响因素结构方程模型分析

目的:研究生育保险病种费用影响因素,为生育保险按病种付费提供依据.方法:抽取南京市4家医院2002/2004生育保险参保人员病历首页以及财务结算帐单1525份,用结构方程模型(SEM)方法分析.结果:临床特征、医护质量和社会经济特征三个隐变量对住院费用的影响系数分别为0.9334,0.3194,0.2230,病种临床特征对住院费用影响最大.结论:结构方程模型分析生育保险病种住院费用影响因素收到很好的效果.     

2014—2019年广州市耐多药肺结核管理策略实施效果分析

目的 评估广州市耐多药肺结核治疗管理策略实施的效果,为结核病防治提供依据。方法 选取2014年7月1日至2019年12月31日于广州市胸科医院纳入耐多药肺结核高危人群筛查的2417例患者为调查对象,收集其人口学特征及临床诊疗资料,获得耐多药肺结核者671例,截止到2019年12月31日有治疗结局者352例。其中,广州户籍患者(简称“户籍患者”)由专家组讨论治疗方案,纳入定点科室住院和耐多药门诊随访;非广州户籍患者(简称“非户籍患者”)自行选择医院诊疗。同时,收集2018年1—5月期间162例耐多药肺结核患者医疗费用调查资料。分析调查对象治疗及转归情况,影响治疗转归的因素,以及医疗经济负担。结果 671例耐多药肺结核患者中户籍患者303例,检出率为21.37%(303/1418),低于非户籍患者的36.84%(368/999),差异有统计学意义(χ²=69.93,P<0.01)。352例有治疗结局患者中治疗成功200例(56.82%),出现不良结局者152例(43.18%)。单因素分析显示,户籍患者治疗成功比例(69.23%,108/156)明显高于非户籍患者(46.94%,92/196),差异有统计学意义(χ²=17.59,P<0.01);41~60岁组和≥61岁组患者出现治疗不良结局的比例明显高于治疗成功组[52.00%(78/150)vs. 48.00%(72/150);56.82%(25/44)vs. 43.18%(19/44)],差异有统计学意义(χ²=18.45,P<0.01);2016年1月1日及以后开始治疗的患者治疗成功的比例(61.71%,166/269)明显高于此时间以前开始治疗者(40.96%,34/83),差异有统计学意义(χ²=11.13,P<0.01)。多因素logistic回归分析显示,出现治疗不良结局的危险因素为非户籍[OR(95%CI)=4.01(2.37~6.79)]、年龄>40岁[41~60岁组:OR(95%CI)=4.08(1.05~15.96);≥61岁组:OR(95%CI)=6.51(1.48~28.60)];而2016年1月1日及以后开始治疗为保护因素[OR(95%CI)=0.30(0.17~0.52)]。户籍患者经济负担总费用[M(Q₁,Q₃)]为24674(17466,49920)元,明显低于非户籍患者[100215(63858,133720)元],差异有统计学意义(Z=-7.80,P<0.01)。结论 广州市耐多药肺结核管理策略可提高户籍患者治疗成功率,降低患者经济负担;建议推广对耐多药结核病患者由专家组讨论方案,定点收治和随访,减免费用等管理策略。     

Role and pitfalls of hepatic helical multi-phase CT scanning in differential diagnosis of small hemangioma and small hepatocellular carcinoma

AIM To compare and analyze the contrast enhancement appearance of small hemangioma (SHHE) and small hepatocellular carcinoma (SHCC) with helical multi-phase CT scanning so as to determine their roles and pitfalls in the differential diagnosis of SHHE and SHCC.METHODS The pre and postcontrast CT scanning of the liver in 73 cases (38 SHHE, 35 SHCC) were carried out. The first phase scan of the entire liver began at 30s after the injection of contrast medium, the second and third phases began at 70s, and 4min respectively. The contrast enhancement patterns and characteristics of all lesions were observed and compared.RESULTS In SHHE, 64.29% (27/42) had typical manifestations in two-phase dynamic scanning, such as peripheral dramatic high-density enhancement of the lesions with progressive opacification from the periphery toward the center, 30.95% (13/42) were hyperdense in both phases and 4.76% (2/42) were hypodense in both phases. In the third phase scanning, 96.67% (28/30) of SHHE were hyperdense and isodense. In SHCC 59.52% (25/42) presented typical appearances, such as hyperdense in the first phase and hypodense in the second phase, 23.81% (10/42) were hyperdense in the first phase and isodense in the second phase with 4.76% (2/42) of hypodense in both phases. In the third phase scanning, 85.71% (24/28) of SHCC were hypodense.CONCLUSION According to the contrast enhancement patterns of SHHE and SHCC in the two-phase or multi-phase scanning by helical CT, diagnosis can be established in the majority of lesions, while some atypical cases needed MRI for further investigation.     

Comparison of the biological activities of human immunodeficiency virus 1 P24 and GP41 expressed in Spodoptera frugiperda cells by use of bac-to-bac system

Recombinant transposing plasmids pFH24 and pFH41 were constructed by cloning the human immunodeficiency virus 1 (HIV-1) p24 and gp41 genes, respectively, into the transposing vector pFastBacHTa. Recombinant bacmids rBH24 and rBH41 were obtained by transposing pPolh/p24 and pPolh/gp41 expression cassettes from recombinant plasmids pFH24 and pFH41, respectively. Recombinant viruses rAcH24 and rAcH41 were generated by transfection of the Spodoptera frugiperda (Sf9) cells with the DNAs of plasmids rBH24 and rBH41, respectively. Analysis of the expressed p24 or gp41 proteins with an antiserum to HIV-1 (HIV-1 antiserum) by an enzyme-linked immunosorbent assay (ELISA) and dot blot assay showed high biological activity of these proteins; p24 was more active than gp41. Also a Western blot analysis showed stronger bands for p24 than for gp41. The high reactivities of p24 and gp41 with the HIV-1 antiserum suggest that these proteins could also be used as specific standard antigens in HIV-1 diagnostics.     

极晚发精神分裂症临床特征

目的探讨极晚发精神分裂症特点。方法对40例极晚发精神分裂症和随机抽取同期住院早发组、晚发组各40例的首发精神分裂症进行临床对照研究。结果极晚发组与早发组相比女性较多,感官缺陷多,文化程度低,病前婚姻、人际关系好,同住人口阔,临床症状以幻听、被害妄想、抑郁焦虑居多,残留阴性症状者少,疗效好,嫉妒妄想发生率为0;极晚发组与晚发组相比,除同住人口少,感官缺陷多,嫉妒妄想无外,无明显差异。结论三组精神分裂症可能属同源。     

睫状神经节甘油阻滞术治疗绝对期青光眼临床观察

目的探讨使用90％医用甘油进行球后注射阻滞睫状神经节,以减轻或缓解绝对期青光眼患者眼痛等临床症状的疗效。方法光感消失伴有药物不能控制临床症状的绝对期青光眼123例(123只眼),其中高眼压伴剧烈眼痛、头痛、恶心呕吐者102例(102只眼),伴大泡性角膜病变者17例(17只眼)。将医用纯甘油高压灭菌消毒后备用。按球后注射法一次注入甘油1．5-2．0ml。伴有大泡性角膜病变者,注射前表面麻醉下将大泡刺破或将内液抽除,随访6-24月。结果随访显示,75．38％-86．76％患者症状缓解,眼压降低。结论球后注射甘油进行睫状神经节阻滞是一种安全、操作简单、取材方便,患者无痛苦、易接受,可作为有症状绝对期青光眼的首选治疗方法。