支气管哮喘患儿中性粒细胞胞外诱捕网水平与患者免疫功能及临床预后的关系

目的探讨支气管哮喘患儿中性粒细胞胞外诱捕网水平与患者免疫功能及临床预后的关系。方法选取本院2017年9月-2018年9月支气管哮喘患者80例作为观察组,并以同期健康体检的30例儿童作为对照组,采用pico Green dsDNA荧光染色定量检测支气管哮喘患者NETs水平,采用T淋巴细胞亚群评价患者免疫功能,对比不同NETs水平患者免疫功能及临床特点,采用Logistic回归分析探讨小儿支气管哮喘急性发作的风险因素。结果观察组白细胞、中性粒细胞、单核细胞、Cf-DNA/NETs水平均高于对照组(P <0. 05),而淋巴细胞水平低于对照组,差异均有统计学意义(P <0. 05)。Logistic回归分析显示,哮喘家族史、呼吸道感染、Cf-DNA/NETs水平上升、有害气体接触、被动吸烟均是支气管哮喘急性发作的独立危险因素(P <0. 05)。结论中性粒细胞胞外诱捕网水平与支气管哮喘患者免疫功能及预后密切相关,值得临床重点关注。     

医院图书馆人力资源开发和管理

探讨网络环境下医院图书馆人力资源开发和管理的重要性和必要性。指出文献、设备及人才是图书馆资源的三大部分 ,起着相互配合、相互支持的作用。人力资源的开发、利用程度 ,直接影响网络环境下医院图书馆职能的发挥和自身的建设与发展。提出增强医院图书馆人力资源管理效能和建设高素质人才队伍的方法和设想     

Health Care Markets, the Safety Net, and Utilization of Care among the Uninsured

Objective. To quantify the relationship between utilization of care among the uninsured and the structure of the local health care market and safety net.
Data Sources/Study Setting. Nationally representative data from the 1996 to 2000 waves of the Medical Expenditure Panel Survey (MEPS) linked to data from multiple secondary sources.
Study Design. We separately analyze outpatient care utilization and whether an individual incurred any medical expenditure among uninsured adults living in urban and rural areas. Safety net measures include distances between each individual and the nearest safety net providers as well as a measure of capacity based on local government and hospital health expenditures. Other covariates include the managed care presence in the local health care market, the percentage of individuals who are uninsured in the area, and local primary care physician supply. We simulate utilization using standardized predictions.
Principal Findings. Distances between the rural uninsured and safety net providers are significantly associated with utilization. In urban areas, we find that the percentage of individuals in the area who are uninsured, the pervasiveness and competitiveness of managed care, the primary care physician supply, and safety net capacity have a significant relationship with health care utilization.
Conclusions. Facilitating transport to safety net providers and increasing the number of such providers are likely to increase utilization of care among the rural uninsured. Our findings for urban areas suggest that the uninsured living in areas where managed care presence is substantial, and especially where managed care competition is limited, could be a target for policies to improve the ability of the uninsured to obtain care. Policies oriented toward enhancing funding for the safety net and increasing the capacity of safety net providers are likely to be important to ensuring the urban uninsured are able to obtain health care.     

医院网上预约挂号系统

目前，门诊一直是困扰医院提高服务质量的一个复杂环节，特别是医疗水平高、门诊量大的医院，门诊质量难以提高。此外，病人到医院就诊前对医院的相关信息了解不多，对所要挂的专科医生的情况又不太了解，具有较大的盲目性。随着互联网络的迅猛发展．我院的网站利用ASP技术以及ActiveX组件实现了网上预约挂号功能，用户可在网上通过浏览器很方便地查看医院介绍、专家、专科等具体的信息，通过这些措施可以正确引导病人选择所需的专家、专科或针对性强的医疗服务，提高医院门诊服务质量，为广大群众的就医提供了方便，取得良好的社会效益和经济效益。     

凯素灵胶悬剂浸泡蚊帐防治侵入实验小屋蚊虫的研究

1900年夏,在扬州市郊,利用特建的实验小屋,以牛为引诱动物,进行了凯素灵胶悬剂浸泡蚊帐对侵入室内蚊虫毒杀和兴奋驱避作用的研究。按40mg ai/m~2处理1～84天后,结果表明对中华按蚊和三带喙库蚊均有较好的毒杀作用。毒杀作用下降主要表现在对外逃蚊虫上,而对留存在室内的蚊虫,毒杀效果持久、稳定,试验期间,留存室内的中华按蚊的死亡率均达80％以上,结果优于三带喙库蚊和同等剂量的溴氰菊酯乳剂。结果还表明,侵入处理小屋蚊虫数比对照小屋减少,窗阱外逃率大大高于对照小屋,说明凯素灵胶悬剂浸泡蚊帐,对蚊虫具有兴奋驱避作用。     

Renal acid excretion in early infancy

In early infancy, complex disorders of acid base metabolism are more frequent than in any other age group, with a predisposition to metabolic acidosis due to an age-related low renal capacity for acid excretion and an unphysiologically high actual renal acid load in nutrition with common formulas. Recently in preterm and small-for-gestational-age infants, persistent maximum renal net acid excretion (NAE) with subnormal or normal blood acid base status, impaired weight gain, and adaptive hormonal reactions have been observed. Incipient late metabolic acidosis is one example of a mixed disorder of acid base metabolism with maximum renal NAE in early infancy. Alkali therapy is highly effective and can be realized both on an individual basis, using urine pH screening as a diagnostic criterium for maximum renal acid stimulation, or on a general preventive level using modified standard formula with a reduced actual renal NAE similar to that seen on alimentation with human milk. From an integrated point of view, the low glomerular filtration rate and renal capacity for acid excretion beyond the developmental age of more than 44 weeks, may well be interpreted as the result of a specific adaptation to breast feeding sparing energy, and thus an evolutionary advantage for the survival of mother and child. Received July 10, 1996; received in revised form and accepted October 7, 1996     

The perineuronal net in the fastigial nucleus of the rat cerebellum. A Golgi and quantitative study

Summary The morphological study of the rat fastigial nucleus with the Golgi-Rio Hortega method showed the presence of glial perineuronal nets surrounding the large neurons, but not the small ones. This perineuronal net appeared as a mesh of tenuous glial processes which covers the neuronal perikarya and proximal dendrites. The small alveolate compartments in this mesh seem to correspond to the holes for the synaptic boutons. Our results also indicate that the perineuronal net is derived from interneuronal protoplasmic and velate astrocytes.Using camera lucida drawings of this perineuronal net we have made a quantitative estimation of the size and density of synaptic boutons on these large neurons. The average numerical density of synaptic boutons was about 19 per 100 m² of the neuronal surface, the mean area of the synaptic holes being 2.5 m². Furthermore, the quantitative data evidence that about 52.5% of the neuronal surface is presumably occupied by synaptic boutons whereas the remaining 47.5% is covered by the glial processes of the perineuronal net.Semithin sections prepared from thick Golgi sections were used for the cytological study of the neurons surrounded by this glial pericellular network. The possible functional significance of the perineuronal net in the regulation of synaptic transmission in the fastigial cerebellar nucleus is briefly discussed.