某市2012年度婚检与孕前优生保健统计分析

目的：探讨我市2012年度婚检与孕前优生保健状况并进行分析,为提高优生优育提供依据。方法选择2012年1月～12月在我市婚姻民政登记中心的2281对新婚登记的新婚夫妇和2485例孕前优生保健妇女,按性别、年龄等对其优生保健状况及孕前全程检查率和TORCH进行分析。结果婚前总的体检率为91．71％（4184/4562）,其中女性体检率为95．35％（2175/2281）,高于男性88．08％（2009/2281）（P＜0．05）;男性生殖系统阳性率结果为7.27％（146/2281）,高于女性4．46％（97/2281）,差异具有显著性（P＜0．05）;≥30岁体检率为94．87％（573/604）,高于＜30岁体检率91．23％（3611/3958）,经统计学检验,差异具有显著性（P＜0．05）;体检结果阳性率为5．81％（243/4184）,婚前体检疾病阳性构成由高到低依次为生殖系统45．70％（111/243）、内科44．03％（107/243）、乙肝5．76％（14/243）和其他4．53％（11/243）;全程体检率为38．10％（947/2458）,其中≥30岁孕前全程体检率为44．06％（319/724）,高于＜30岁体检率35．66％（628/1761）,经统计学检验,差异具有显著性（ P＜0．05）;总体检正常率为84．35％（2096/2485）,且≥30岁和＜30岁两组体检正常率无显著性差异（P＞0．05）;TORCH各项指标比较,各种结果比较差异无显著性（P＞0．05）。结论婚前和孕前体检是优生优育重要环节,加强计划生育宣传和干预,提高生殖健康,促进优生优育。     

The Chemopreventive Effect of Tamoxifen Combined with Celecoxib on DMBA chemically-Induced Breast Cancer

Objective: To investigate the chemopreventive effect of tamoxifen combined with a COX-2 selective inhibitor, celecoxib, on breast cancer in rats chemically induced by 7,12-dimethylben (a)anthracene (DMBA). Methods:DMBA was irrigated into the stomaches of SD female rats to build breast cancer model. A total of 120 rats were divided into four groups: control group, tamoxifen group, celecoxib group and combined group. The incidence rate, latent period, number and volume of breast cancer were detected and analyzed. Results:The tumor incidence rate of tamoxifen group (48.15%, 13/27) and celecoxib group (50.00%,14/28) were lower than that of control group (85.71%, 24/28), but higher than that of combined group (21.43%, 6/28). The tumor's latent period of tamoxifen group (97.54±1.85 d) and celecoxib group (96.79±2.89 d) were longer than that of control group (89.50±5.99 d), but shorter than that of combined group (103.67±3.39 d). The average tumor number of tamoxifen group (1.77±0.73) and celecoxib group (1.71±0.61) were less than that of control group (3.50±1.62), but more than that of combined group ( 1.17±0.42 ). The average tumor volume of tamoxifen group (1.78±0.71 cm3) and celecoxib group (2.05±1.04 cm3) were smaller than that of control group (6.42±3.96 cm3), but bigger than that of combined group (0.71±0.96 cm3) (P ＜ 0.05 respectively).Conclusion:Celecoxib and tamoxifen are effective drugs in preventing the occurrence of rat breast cancer chemically induced by DMBA. Furthermore, combination of them has better chemopreventive effect.     

血三脂综合指数与冠心病之间关系的研究

目的：旨在探讨血三脂综合指数（甘油三脂总胆固醇／高密度脂蛋白胆固醇指数,ＴＧＴＣｈ／ＨＤＬ－Ｃ指数）与冠状动脉粥样硬化性心脏病（Ｃｏｒｏｎａｒｙｈｅａｒｔｄｉｓｅａｓｅ,ＣＨＤ）之间的关系。方法：ＣＨＤ患者行选择性冠状动脉造影术,ＴＧ、ＴＣｈ、ＨＤＬ－Ｃ以酶法测定。结果：ＣＨＤ患者血三脂综合指数水平及异常率明显高于对照组（Ｐ＜０．０１）;比值比（ＯＲ值）５．４９。结论：高ＴＧ、ＴＣｈ、低ＨＤＬ－Ｃ的联合作用较单一血脂异常对ＣＨＤ形成具有更大危险性。ＴＧＴＣｈ／ＨＤＬ－Ｃ指数可以做为评估ＣＨＤ风险性的较好指标。     

以科学发展观为指导 推进军队疗养院全面建设又好又快发展

本文立足当前军队疗养院建设发展实际,深入分析了疗养院发展现状和存在的一些普遍性问题,着眼于深入贯彻落实科学发展观,从5个方面入手,提出了理性的见解与思考,为新形势下进一步开创疗养院全面建设又好又快发展新局面提供借鉴。     

职工用药依从性调查分析

目的：调查我厂职工用药依从性。方法：编制、发放、统计分析用药依从性调查表。结果：职工的用药依从性不理想，和文化层次、年龄等有一定关系。结论：应对厂矿职工进行用药以及疾病治疗依从性进行有效的教育，以发挥更好的药物治疗作用。     

Integrated Care Management of Patients With Atrial Fibrillation and Risk of Cardiovascular Events: The ABC (Atrial fibrillation Better Care) Pathway in the ATHERO-AF Study Cohort

ObjectiveTo investigate the impact on cardiovascular events (CVEs) in a real-world population of patients with atrial fibrillation (AF) by implementing the Atrial fibrillation Better Care (ABC: A, Avoid stroke with anticoagulation; B, better symptom management; C, Cardiovascular and comorbidity risk management) pathway.Patients and MethodsThis prospective single-center cohort study included 907 consecutive patients with nonvalvular AF on vitamin K antagonists from February 2008 to December 2016. The A, B, and C groups were defined as follows: “A” by a Time in Therapeutic Range ≥65%; “B” by a European Heart Rhythm Association (EHRA) symptom scale I-II, and “C” as optimized cardiovascular comorbidity management. Primary end point was a composite outcome of CVEs.ResultsDuring a median follow-up of 36.9 months (interquartile range [IQR] 20.0-57.5; 3022 patient-years), 118 CVEs occurred (3.9% per year; 95% confidence interval [CI], 3.2-4.7). Symptomatic patients (EHRA III-IV) had a higher risk of CVEs compared with those in EHRA I (hazard ratio [HR], 2.73, 95% CI, 1.61-4.63, P<.001). Optimally managed patients in the ABC group (n=198) had a lower risk of CVEs (1.8 [95% CI, 0.9-3.0] vs 4.5% [95% CI, 3.7-5.5] per year, P=.001) compared with those presenting with at least 1 suboptimal ABC factor (HR, 0.40, 95% CI, 0.22-0.74, P=.003). This association was evident using multivariate Cox proportional regression analysis (HR, 0.44, 95% CI, 0.24-0.80, P=.007).ConclusionIntegrated care management according to the ABC pathway resulted in a significantly lower rate of CVEs, suggesting a clear benefit of a holistic approach to optimize the management of patients with AF.Trial Registrationclinicaltrials.gov Identifier: NCT01882114     

实习护生与新护士人格特征分析

目的探讨实习护生和新护士人格特征,优化其个性。方法采用卡特尔16种个性因素量表对实习护生和新护士进行测试。结果①实习护生与新护士在聪慧、稳定、有恒、世故、忧虑、自律性6项主要人格因素存在显著差异,在适应与焦虑、心理健康因素、创造能力、新环境成长能力4项次级因素也存在显著差异。②新护士与实习护生同样存在低敢为性、低独立性、低世故性及低心理健康因素,忧虑、怯懦不果断。结论新护士与实习护生独立和适应能力低,不善于表达,处理问题和心理耐受调节能力差,在实践中需加强其个性特征培养和优化。     

以科学发展观为指导 推动贫困地区县级医院又好又快发展

回顾分析宕昌县人民医院发展历程中存在的困难,阐明县医院又好又快发展的根本原因是遵循了科学发展的规律。贫困地区县级医院只有正视现实,用科学的眼光谋求发展,认真实施＂管理、项目、人才＂不放松的发展战略,才能实现真正意义上的科学发展。     

中药生肌液对体外培养兔骨髓间充质干细胞成骨活性的影响

背景：在临床工作中，外用中药生肌膏能治疗感染开放性骨折引起的骨缺损。其机制可能为生肌膏中作者前期实验从生肌膏的原料生药中提取了生肌液，并证实不同浓度的生肌液对骨髓间充质干细胞的增殖活性影响不同。有效成分促进骨髓间充质干细胞的增殖，并诱导其向成骨细胞转化。目的：观察生肌液对体外培养的兔骨髓间充质干细胞成骨活性的影响。设计：单一样本实验。单位：天津市天津医院骨科研究所。材料：实验于2004—10／2005—12在天津市天津医院骨科研究所细胞工程室完成。骨髓间充质干细胞取自5只3月龄的雄性健康日本大耳白兔。浓度为5×10^2g／L生肌液从生肌象皮膏（由天津市中药饮片厂提供。原料生药当归、生地、龟板、象皮、血余）提取。方法：将25，8．3，5g／L的生肌液作用于兔骨髓间充质干细胞，以不含生肌液的基础培养液为空白对照，以含地塞米松10^-8mol／L，维生素C0．05g／L，β-甘油磷酸钠10mmol／L的基础培养液为标准对照。将不同干预条件下传代后的骨髓间充质干细胞接种在培养板中培养二三周，采用荧光倒置显微镜下观察钙结节形成情况，采用四环素标记及胶原Ⅰ免疫组织化学染色观察细胞的表达情况，取细胞培养液测定胞外及胞内碱性磷酸酶、骨钙素、乳酸脱氢酶含量，将细胞内外碱性磷酸酶、骨钙素、乳酸脱氢酶数量各自加和，计算碱性磷酸酶，乳酸脱氢酶、骨钙素，乳酸脱氢酶值。主要观察指标：培养2，3周兔骨髓间充质干细胞钙结节形成、四环素标记及胶原Ⅰ免疫组织化学染色结果及碱性磷酸酶，乳酸脱氢酶、骨钙素，乳酸脱氢酶值。结果：①细胞钙结节观察结果：除了标准对照细胞外，不同浓度生肌液条件下细胞随培养时间延长，胞体先后出现拉长，聚集生长，随后中心细胞增殖、重叠，细胞之间界限模糊，逐渐形成多个散在的细胞结节，钙沉积逐渐出现，最终形成钙化结节。②四环素标记及胶原Ⅰ免疫组织化学染色：除了基础培养液组外，各实验组四环素标记呈阳性的细胞及钙结节在荧光激发下呈黄绿色，空白对照细胞为阴性；除了标准对照细胞外，不同浓度生肌液条件下细胞胶原Ⅰ免疫组织化学染色呈阳性，棕黄色深染颗粒位于细胞胞浆中。③碱性磷酸酶，乳酸脱氢酶、骨钙素，乳酸脱氢酶检测结果：条件培养后2，3周，25g／L生肌液作用下细胞碱性磷酸酶，乳酸脱氢酶、骨钙素，乳酸脱氢酶比值高于其他条件下两种含量比值，差异具有统计学意义（P〈0．05）。结论：生肌液对体外培养的兔骨髓间充质干细胞的诱导成骨作用肯定，且高浓度时诱导成骨作用较强。