摘要:Objective:An abundant class of non-coding small RNA molecules, 21-25 nucleotide in length, are widely found in animals and plants and named microRNA(miRNA)[1-2]. MiRNAs are highly evolutionarily conserved, expressing in specific tissue and timing[2], and negatively regulate the gene expressions at the posttranscriptional level[3], and subsequently control crucial physiological processes such as metabolism, amplification, differentiation, development and apoptosis[4-7]. Therefore, miRNAs could provide an access to many human diseases in theory. Recent evidence demonstrates that miRNAs play an important role in the initiation and progression of human cancer, mainly by interrupting the cell cycle at the cellular level and by interacting with signaling[7-11] The expression profiling of miRNAs can be used as a tool of diagnosis, staging, prognosis and biotherapy of some tumors, as has already been proven to have superiority to mRNA, in the categorization of tumors. This review focuses on the genesis, mechanism of action of miRNA and its relationship to tumors, detection methods and its potential effect on the diagnosis, staging, and biotherapy in esophageal carcinoma.

摘要:Objective:Gold nanoparticle Hepatitis B virus(HBV) DNA probes were prepared, and their application for HBV DNA measurement was studied. Methods:Alkanethiol modified oligonucleotide was bound with self-made Au nanoparticles to form nanoparticle HBV DNA gene probes, through covalent binding of Au-S. By using a fluorescence-based method, the number of thiol-derivatized, single-stranded oligonucleotides and their hybridization efficiency with complementary oligonucleotides in solution was determined. With the aid of Au nanoparticle-supported mercapto-modified oligonucleotides serving as detection probes, and oligonucleotides immobilized on a nylon membrane surface acting as capturing probes,HBV DNA was detected visually by sandwich hybridization based on highly sensitive aggregation and silver staining. The modified nanoparticle HBV DNA gene probes were also used to detect the HBV DNA extracted from serum in patients with hepatitis B. Results:Compared with bare Au nanoparticles, oligonucleotide modified nanoparticles had a higher stability in NaCl solution or under high temperature environment and the absorbance peak of modified Au nanoparticles shifted from 520nm to 524nm. For Au nanoparticles, the maximal oligonucleotide surface coverage of hexaethiol 30-mer oligonucleotide was(132 ± 10) oligonucleotides per nanoparticle, and the percentage of hybridization strands on nanoparticles was(22 ± 3%). Based on a two-probe sandwich hybridization/nanoparticle amplification/silver staining enhancement method, Au nanoparticle gene probes could detect as low as 10-11 mol/L composite HBV DNA molecules on a nylon membrane and the PCR products of HBV DNA visually. As made evident by transmission electron microscopy, the nanoparticles assembled into large network aggregates when nanoparticle HBV DNA gene probes were applied to detect HBV DNA molecules in liquid. Conclusion:Our results showed that successfully prepared Au nanoparticle HBV DNA gene probes could be used to detect HBV DNA directly. The detection-visuallized method has many advantages, including high sensitivity, simple operation and low cost. This technique has potential applications in many fields, especially in multi-gene detection chips.

摘要:Objective:To evaluate Tpeak-Tend (Tp-e) interval in surface standard ECG as a new risk factor for arrhythmic event in patient with Brugada syndrome. Methods: 23 male patients with Brugada syndrome and 20 male patients with paroxysmal supraventricular tachycardia (PSVT) as the control group were investigated in this study. Tp-e interval in surface standard ECG was compared between BrS and PSVT patients. Results: Tp-e interval in BrS patients was significantly longer than that in PSVT patients (109.57±22.86 ms vs. 88.50±13.08ms, P<0.05). There was significant difference in Tp-e interval between 16 BrS patients with arrhythmic events (including syncope, clinical ventricular fibrillation [VF] and programmed electrical stimulation [PES]-induced VF) and 7 BrS patients without arrhythmic events and PSVT patients(118.12±20.40ms vs. 90.00±15.27ms, P<0.05; 118.12±20.40ms vs. 88.50±13.08ms, P<0.05). However, Tp-e interval was similar in BrS patients without arrhythmic events and PSVT patients (90.00±15.27ms vs 88.50±13.08ms, P>0.05). Conclusion: The prolongation of Tp-e interval could serve as a new noninvasive event predictor for arrhythmic events in patients with Brugada syndrome.

摘要:Objective:To study the gene mutations of homeobox transcription factor(CSX/NKX2.5) associated with a Chinese family with secundum atrial septal defect(ASD). Methods:Polymerase chain reaction and DNA sequencing were used to check all the members in the family with ASD, and single strand conformation polymorphism analysis(SSCP) was used to check 126 normal control people for detecting the mutations of CSX/NKX2.5 gene. Results: Three mutations,G270A(Glu32Lys),G378A(Glu68Lys)andG390A(Glu72Lys)were identified in CSX/NKX2.5 gene of ASD patients. However, the other members in the family with ASD and the control did not have such gene mutations. Conclusion:These mutations of CSX/NKX2.5 gene, which were identified in a Chinese family, may be one of the secundum ASD etiologic causes.

摘要:Objective:To evaluate the association of the peripheral levels of the defined inflammatory markers with different types of acute coronary syndrome(ACS) and stable angina, and the role inflammation played in the pathogenesis of ACS. Methods:For understanding the variation of serum concentrations of matrix metalloproteinase-9(MMP-9), soluble intercellular adhesion molecule-1(sICAM-1),C-reactive protein(CRP), and white blood cell count(WBC) and their association with ACS, 90 patients with coronary heart disease (CHD) and 30 healthy volunteers were recruited. The enrolled people were assigned into four equal groups, including acute myocardial infarction (AMI) group, unstable angina pectoris(UAP) group, stable angina pectoris(SAP) group and healthy control group. The serum levels of MMP-9 and sICAM-1 were measured with ELISA kits, CRP were measured with immunoturbidimetric assay, and WBC number were assessed all before any treatment was administrated. Results:(1)The serum levels of MMP-9,sICAM-1,CRP and WBC in the patients with ACS were significantly higher than those in the control group(P < 0.01). (2)Compared with control group, patients with SAP only had higher serum level of sICAM-1(P < 0.01). While the levels of MMP-9, CRP, and WBC had no significant difference between them(P > 0.05 all). (3)Significant positive correlation between the serum levels of MMP-9 and sICAM-1 and CRP and WBC all were observed in the patients with ACS(P < 0.05). Conclusion: The elevation of serum concentrations of inflammatory markers including MMP-9, sICAM-1, CRP and WBC were associated with initiation and progression of ACS, and they may help predicting cardiovascular events.

摘要:Objective:To overall evaluate the change of global cardiac systolic performance and diastolic filling in hypovoleamia by LBNP. Methods:10 healthy male subjects were placed in a standard LBNP chamber. Baseline haemodynamic and echocardiographic measurements were made after a period of least 10 min resting supine within the chamber. Pressure was then decreased to -10,-20 and -30 mmHg, with each pressure maintained for 15 min. The indices of four transvalvular and SVC flow were measured using Doppler echocardiography. Results:The results showed that S wave, Re wave,and VTI of SVC progressively decreased with increasing LBNP. At -30 mmHg stage, S wave decreased by 35.4 %(change of 0.21+0.03 m/s,P < 0.001). This reduction in pre-load was associated with a progressive decrease in SV(by 21.5 ± 4.5 ml at -30 mmHg,P < 0.001), decrease in CO(by 1.2 ± 0.2 L min-1 at -30 mmHg LBNP,P < 0.001). The diastolic filling of mitral and tricuspid flow also reduced significantly. At -30 mmHg stage, the E wave of MVF and TVF decreased 31% and 32% respectively(change of 0.23 ± 0.05 m/s,P < 0.001 and 0.18 ± 0.01 m/s,P < 0.001). VTI of MVF and TVF decreased 27% and 27.7% respectively(change of 5.55 ± 1.41cm,P < 0.01 and 4.25 ± 0.44 cm,P < 0.01). A wave of both sides did not change significantly. Conclusion:Doppler indices changes in different LBNP stage can roughly reflect the degree of hypovoleamia caused by blood volume redistribution. The indices of Doppler echocardiography are more sensitive than traditional physiological indexes in evaluating cardiovascular responses of LBNP. Echocardiography techniques overall can evaluate the global cardiac function including systolic performance and diastolic filling.

摘要:Objective:To elucidate whether cell multiplication, apoptosis, glucose intake and p-Akt protein expression of bone Mesenchymal Stem Cells(MSCs) of rats is influenced by a hypoxic environment ex vivo. Methods:Passage 3 of bone marrow MSCs taken from Wistar rats,were cultured in a culturing chamber with 94%N2,1%O2,5%CO2 at 37℃. At different hypoxia time points,0,0.5, 1,4 and 8 h, glucose uptake was assayed by using radiation isotope 3H-G, Apoptotic Rate(AR) and dead rate(DR) were analyzed by flow cytometry(FCM) after Annexin V/PI staining, cell multiplication(by MTT methods) and p-Akt protein by immunocytochemistry and western blot. Results:Assay for CD29+,CD44+,CD71+,CD34-, Tn T+(after 5-azacytidine agent inducing) and ALP+(after bone differentiation agent inducing) suggested these bone-derived cells were MSCs. The 3H-G intaking ratio(CPM/flask value:157 ± 11,110 ± 11,107 ± 13,103 ± 10,100 ± 9 and 98 ± 10) of MSCs at different hypoxia time points, significantly decreased compared to that of normoxia(P < 0.01) and tended to descend slowly with hypoxia time duration, for which there was no statistical significance(P > 0.05). The AR(0.09 ± 2.03%,12.9 ± 1.72%,13.7 ± 2.26%,13.8 ± 3.01%,14.1 ± 2.78% and 14.7 ± 4.01% at 0,0.5,1,4 and 8 h,respectively,P < 0.01) and DR(0.04 ± 1.79%,0.93 ± 1.85%,3.11 ± 2.14%,4.09 ± 2.36%,4.72 ± 2.05% and 4.91 ± 3.72% at 0,0.5,1,4 and 8 h, respectively, P < 0.05) at different hypoxia time points significantly increased compared to those time in normoxia; The AR further went up with time(P < 0.05), however there was no statistical significance (P > 0.05) for the DR. Optical absorption value of MTT methods at different hypoxia time points significantly decreased compared to those with a corresponding normoxia time(P < 0.01) and degraded with time (in an hypoxic environment -P < 0.01). IOD of p-Akt protein of MSCs at different hypoxia time points significantly increased(0.367 ± 0.031,0.556 ± 0.023,0.579 ± 0.013, 0.660 ± 0.024, 0.685 ± 0.039 and 0.685 ± 0.011, respectively) compared to their equivalents in normoxia (P<0.05), however, there was no statistical significance(P > 0.05) for different hypoxia time points. Hypoxia may result in ultramicrostructure changes, such as defluvium of Microvilli, apoptotic body, “margination” and so on and are further aggravated with hypoxia time stretching. Conclusion:Hypoxia may lead to a depression of MSCs intaking glucose, creep of cell multiplication, upregulation of p-Akt protein and apoptosis of MSCs ex vivo.

摘要:Objective:To evaluate the effect of osteogenic potential on human marrow mesenchymal stem cells(hMSCs) transferred with human vascular endothelial growth factor(VEGF) gene by adenovirus. Methods:hMSCs were isolated from human marrow, cultured in vitro and randomly divided into 3 groups:Ad-VEGF165 group: adding 1×1010OPU/ml Ad-VEGF in hMSCs culture fluid after incubating 24 hours, changing into ordinary complete culture and continuing culturing; Positive control group: Cultured hMSCs with 1 nmol/L dexamethasone,10 mmol/L glycerophosphate and 50 mg/L vitamin C,exchanging this conditioned medium twice a week; blank control group:no special treatment but culturing hMSCs in DMEM.To evaluate osteogenesis competence, Von Kossa＇s staining and a quantitative alkaline phosphates(ALP) activity analysis were performed after 2 weeks treatment. Results:The calcified nodes formed after 2 weeks treatment in Ad-VEGF165 group and Positive control group but not in blank control group. ALP activities in Ad-VEGF165 group,Positive control group and blank control group were(7.91 ± 0.90)u/L,(8.18 ± 0.76 u/L) and (3.46 ± 0.49)u/L respectively. The differences were no statistical significance between Ad-VEGF165 group and positive control group(P > 0.05), but Ad-VEGF165 group and Positive control group were significantly different with blank control group(P < 0.05). Conclusion:Adenovirus mediated VEGF165 gene can transfect hMSCs and promote osteogenesis of hMSCs.

摘要:Objective:To observe the tolerance and the dependence of endomorphin-1(EM-1) in rats and the possible mechanisms. Methods:Sixty Sprague-Dawley rats were randomly allocated into saline, acute EM-1-treated and chronic EM-1-treated groups. The rats were intracerebroventricularly injected with saline, acute EM-1 10 -滋g/kg 30 min prior to sacrifice,and chronic EM-1 by daily administration at 8:00 A.M. and 15:00 P.M. from 10 -滋g/kg on the 1st day to 50 -滋g/kg on the 9th day, respectively. In chronic EM-1-treated group, the median antinociceptive dose(AD50) and the catatonic median effective dose(ED50) were determined by the improved Dixon＇s method. Natural withdrawl test was used to assess the dependence of EM-1. Maximal binding capacity(Bmax) and dissociation constant(Kd) of 3H-DAMGO, binding to mu-opioid receptor(MOR) in brain tissue, was measured by Scatchard analysis. Gene expression of MOR was measured by reverse transcription-polymerase chain reaction(RT-PCR). Results:Tolerance of the antinociceptic and catatonic effects on the 3rd day(3.1-fold and 1.9-fold) and the 9th day(28.4-fold and 8.5-fold) were observed in chronic EM-1-treated group(P < 0.05). Jumping times and withdrawal scores of rats were significantly higher in the chronic EM-1-treated group than those in saline group on the 9th day(P < 0.05). Bmax and mRNA expression of MOR in cortex, midbrain and striatum were lower in chronic EM-1-treated group on the 9th day than the other two groups(P < 0.05), but Kd had no significant difference(P > 0.05). AD50,ED50,Bmax,Kd and gene expression of MOR were recorded. Conclusion: EM-1 possesses the tolerance and the dependence. After a long-term treatment, EM-1 down regulates the binding capacity and mRNA of MOR, which somewhat accounts for the dependence.

摘要:Objective:To investigate the apoptosis of dopaminergic neurons and the protective effect of nicotine in 1-methyl-4-phenyl-1, 2,3,6-tetrahydropyridine(MPTP)-induced mouse model of Parkinson′s disease. Methods:The mouse model of Parkinson＇s disease were formed by MPTP(30 mg/kg/d×7, i.p.); and the loss and apoptosis of dopaminergic neurons was observed by Tyrosine Hydroxylase(TH) and TUNEL stains.In “Nicotime plus MPTP” group, mice were pretreated with nicotine before MPTP injection. The putative protective effect of nicotine was analyzed. Results:The number of TH-positive cells decreased during MPTP treatment. Apoptotic neurons began to appear after three injections of MPTP and peaked on the 8th day. In the MPTP-intoxicated mice treated with nicotine, the loss of TH-positive cells was significantly less than that of MPTP-treated group(30 mg/kg/d×7)(P < 0.05). Conclusion:The chronic treatment of MPTP can induce the apoptosis of dopaminergic neurons in substantia nigra, and nicotine might have a neuroprotecitve effect on dopaminergic neurons against MPTP toxicity.

摘要:Objective:To evaluate the effect of HIF-1 α over-expression on angiogenesis in human prostate cancer cells. Methods:LNCaP cells(a human prostate cancer cell line) were transfected with the recombinant plasmid pcDNA3.1(-)-HIF-1α with Lipofectamine 2000 system. The positive clones were selected by G418 being further confirmed by Western blot and immunofluorescence. The expression levels of VEGF, iNOS and Ang-Ⅱ were determined. Results:The expression of HIF-1α in the LNCaP/HIF1α cells was significantly increased in transfected cells, which induced the up-regulation of VEGF, iNOS, whereas Ang-Ⅱ expression remained un- changed. Conclusion:Over-expression of HIF-1α can induce angiogenesis proteins and may improve the angiogenesis potency of prostate cancer.

摘要:Objective:To investigate the clinical effect of Daclizumab on preventing acute rejection in renal transplant recipients. Methods:71 patients were randomly divided into two groups:Daclizumab group(n =26) and control group(n = 45). Baseline regimen of mycophenolate mofetil(MMF), cyclosporin(CsA), methylprednisolone(MPD) and prednisone(Pred) were administered to all patients. The treatment of Daclizumab was based on baseline regimen. The Daclizumab group received Daclizumab twice before and after renal transplant. The occurrence of post-transplantation acute rejection, renal function and T lymphocyte subtypes were sequentially monitored; meanwhile adverse events, infection episode, and patient and graft survival were observed. All of patients received a follow-up of 12 months at least. Results:The occurrence of acute rejection in Daclizumab group in 1, 3, 6 and 12 months after renal transplantation was 7.7%, 19.2%, 23.1% and 30.8%, respectively,while it was 15.6%,28.9%, 35.6% and 46.7% in the control group. There was significant difference between the two group(P < 0.05). There was no difference in infection episodes and adverse events between the Daclizumab group and control group. One year patient survival was 92.3% in Daclizumab group, 91.1 % in control group(P > 0.05), compared with graft survival of 96.2 % and 93.3 % for Daclizumab and control group, respectively(P > 0. 05). The renal function in Daclizumab group in 1, 6 and 12 months after renal transplantation was better than that in control group(P < 0.05). The CD3+ and CD4+ subtypes decreased in both two groups after operation but no significant difference(P > 0.05). Conclusion:Daclizumab combined with MMF,CsA,MPD and Pred therapeutic regimen was effective to reduce the occurrence of acute rejection in renal transplant recipients and have no influence on T lymphocyte subtypes.

摘要:Objective:To investigate the role the lens dimensions played on the pathogenesis of primary angle-closure glaucoma. Methods:38 eyes of 20 patients with primary angle-closure glaucoma(PACG) and 35 eyes of 22 normal individuals without ocular abnormalities were examined. The anatomical parameters of the lens and other structures of the anterior segment were calculated using B ultrasound, computer image processing and ultrasound biomicroscopy(UBM). The parameters were compared between the patients and normal subjects. Correlation analysis was used to determine the relationship between the radii of curvature of the anterior lens surface(RCALS) and the other parameters of the anterior segment. Results:Compared with the normal eyes, the eyes of PACG had thicker lens, steeper curvature of anterior lens surface, decreased depth of the anterior chamber, narrower chamber angle, and more anterior position of the ciliary bodies and lens. All these differences were significant(P < 0.05 or P < 0.01). In the PACG group, the RCALS had significantly negative correlation with the central and peripheral lens thickness(P < 0.01 and P < 0.05 respectively), and had positive correlation with relative lens position, anterior chamber depth(ACD), angle-open distance at 500 um(AOD500), trabecular iris angle(TIA) and trabecular ciliary processes distance(TCPD, P < 0.05 or P < 0.01). Conclusion:The occurrence of PACG is relevant to the abnormal anatomical structures of the anterior segment. Among all factors, the lens parameters play an important role in the pathogenesis. Increased lens thickness, relative more anterior position of lens,especially steepened curvature of anterior lens surface are predisposing factors of the pathologic phenomenon in PACG including pupillary blockage, shallow anterior chamber, secondary closure of chamber angle and elevation of intraocular pressure.

摘要:Objective:To investigate glucose metabolism in women with multiple ovarian follicles(MOF) and explore the relationship between glucose metabolism, insulin resistance and body weight. Methods:We evaluated 46 women with MFO and 30 normal women as controls. All the subjects were given 75g of glucose orally in order to perform the oral glucose tolerance test (OGTT) and insulin releasing test(IRT), and they were also evaluated for insulin resistance using the insulin resistance index with homeostatic model assessment(HOMA). Results:The occurrence of impaired glucose tolerance in women with MOF was 10.87%, which was significantly higher than that in the control group(3.33%,P < 0.05). The rate of insulin resistance was 30.43% in the study group as compared to 10.00% in the control group. The results showed that there was significant difference between the two groups(P < 0.05). The levels of FSH,LH,PRL,E2,T and P between the two groups had no significant difference(P > 0.05). BMI in women with impaired glucose tolerance was correlated positively to insulin resistance(r = 0.567, P < 0.05). Conclusion:Abnormal glucose metabolism was observed in women with unitary multiple ovarian follicles, and this could be attributed to obesity and insulin resistance. Women with MOF and associated obesity should be subjected to OGTT so that their glucose levels can be monitored as a preventive measure.

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摘要:Objective:To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods:Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results:Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion:The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.

摘要:“丈夫拒签字致妻儿死亡事件”暴露出患者知情同意权之代理行使法律规制的缺陷与不足。完善法律制度与相关规范是杜绝此类事件再次发生的根本。

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摘要:由于血液检测存在“漏检率”和“窗口期”，即使血站和医疗机构严格按规定采、供血和输血，极少部分患者仍会因输血而感染传染性疾病。目前解决这一社会问题的办法还不完善，还不能有效地保护患者、血站和医疗机构的合法权益。文章提出进一步完善社会保障机制和推进输血保险制度，以便更好地解决因无过错感染而引起的医患纠纷。

摘要:非人类中心主义的兴起引发了学术界关于动物是主体抑或客体的激烈论争。动物主体论者力争主体不是专属于人的概念，试图颠覆和消解现行的主体标准。动物客体论者针锋相对地反驳道：主体就是专属于人的概念，主体大厦不是轻易能摧毁的，动物主体论的实质终究是一种以人类为中心的手法。

摘要:从价值论意义而言，当代中国正在进行的法治建设应该是良法之治。为了确保所创制的法律为良法，必须科学设定良法的应然性目标体系，有效推进价值和规范层面的道德向法律的转化，这是良法生成的路径所在。

摘要:目的：探讨高糖对人肾小球系膜细胞细胞间黏附分子1（ICAM-1） 表达的影响及茶多酚对其干预作用。方法：将培养的系膜细胞分为正常对照组、高糖组、茶多酚干预组和茶多酚对照组，分别在0、12、36 h采用RT-PCR 法和免疫细胞化学法检测茶多酚对高糖条件下系膜细胞内ICAM-1 mRNA及蛋白表达的影响。结果：高糖组系膜细胞ICAM-1 mRNA和蛋白的表达比正常对照组均增加（P < 0.05）；茶多酚干预组比高糖组有明显下降（P < 0.05）。结论：高糖可导致人肾小球系膜细胞ICAM-1表达的增加，而茶多酚可有效干预此效应。

摘要:当前的医患冲突越来越激烈，与和谐社会构建音符极不吻合。文章试从医患纠纷产生的原因、特点，相关机构的一些做法，来探讨以预防为主，加强沟通，积极调解，构建和谐医患关系的对策。

摘要:目的：探讨动脉硬度指数（Arterial stiffness index ASI）与冠状动脉粥样硬化程度的相关性。方法：396例行冠状动脉造影的患者，采用CardioVision MS-2000动脉硬度测量仪测定ASI作为反映动脉弹性的指标。根据ASI水平分为三组：Ⅰ组（ASI 0-70，186例），Ⅱ组（ASI 71~140，108例），Ⅲ组（ASI > 140，102例）。冠状动脉病变严重程度用冠脉病变支数来评价。结果：三组间年龄、高血压史、糖尿病史、收缩压及冠状动脉病变严重程度有显著的差别，平均病变血管支数Ⅲ组>Ⅱ组>Ⅰ组（P < 0.05）。单因素相关分析显示，年龄、收缩压、高血压史、糖尿病史、脂蛋白（a）、尿酸、ASI与病变血管支数呈正相关，高密度脂蛋白胆固醇与病变血管支数呈负相关（P < 0.05）。多因素Logistic回归分析结果表明ASI、高密度脂蛋白胆固醇、脂蛋白a是冠心病的独立相关因素。结论：ASI是一种评价动脉弹性功能的良好指标，可以提供冠状动脉病变严重程度的信息。

摘要:疾病诊断相关分组（ＤＲＧｓ）被广泛证明应用于医疗保险支付制度中对控制医疗费用不合理的上涨具有重要的现实意义。文章在介绍ＤＲＧｓ在我国医疗保险领域的实践状况的基础上，结合国外经验，对制定中国版ＤＲＧｓ进行了探析，提出在医疗保险制度中实施ＤＲＧｓ支付方式的要点以及相关的解决对策，即通过规范疾病诊断和编码、制定临床诊疗规范、建立科学的病种成本核算系统和完善医疗质量监督机制，实现ＤＲＧｓ在我国医疗保险支付制度中的应用。

摘要:目的：应用速度向量成像（ＶＶＩ）技术评价正常人左室各室壁心肌节段运动在时间上的协调性。方法：采用Siemens公司生产的Sequoia 512 超声诊断仪及VVI技术对35例健康志愿者左室各节段收缩期达峰值速度、75％速度、50％速度的时间定量分析。结果：前间隔、后间隔和前壁的心尖段达50％速度时间均比同一室壁基底段和中间段迟，差异有显著性意义（P ＜ 0.05）。左室短轴二尖瓣水平，下壁径向收缩达75％速度、50％速度时间迟于前间隔、前壁、侧壁，差异有显著性意义（P ＜ 0.05）。结论：ＶＶＩ技术能够无创、定量、准确和快速评价心肌运动的协调性。

摘要:文章探讨了加强现代医院财务管理、实现财务管理目标的几层环环相扣的关键面：在资产清查、建立实物管理制度、健全医院财务管理制度的基础上，开展科室、项目、病种成本核算，建立成本管理系统， 推行以成本预测、决策、计划、核算、控制、分析及考核为主要内容的成本管理；以沉淀的成本数据为依据，实现全面预算管理，对医院的各项经济活动进行统筹安排和全面控制；建立绩效考核分配体系，以此为激励杠杆，确保成本管理及全面预算的实施；引入“资金成本”、“风险”观念，加强医院的筹资、投资、运营等资金运作。

摘要:目的：探讨可溶性IL-1Ⅱ型受体（sIL-1RⅡ）对人白细胞介素1α（IL-1α）诱导子宫内膜异位症（EMs）在位内膜基质细胞（ESC）表达白细胞介素8（IL-8）的影响。方法：体外培养EMs在位内膜基质细胞，分别以含不同浓度IL-1α（0、0.1、1.0、10、100 ng／ml）的DMEM／F12培养基孵育24 h，利用RT-PCR和ELISA法从转录和蛋白翻译水平分别检测IL-8的表达情况。选取能显著刺激IL-8升高的IL-1α浓度，作用于EMs在位内膜基质细胞不同时间，RT-PCR和ELISA法检测IL-8的表达情况。并检测1.0 μg／ml的sIL-1RⅡ对不同浓度IL-1α诱导EMs在位内膜基质细胞表达IL-8的影响。结果：未刺激时，EMs在位内膜基质细胞能表达低水平IL-8，经IL-1α刺激后IL-8 mRNA及蛋白表达均升高，并呈剂量和时间依赖性，差异有统计学意义（P < 0.01）。1.0 μg／ml sIL-1RⅡ能拮抗低浓度IL-1α的刺激效应。结论：IL-1α能以时间剂量依赖方式刺激EMs在位内膜基质细胞表达IL-8，促进EMs的发生发展，sIL-1RⅡ能一定程度拮抗此作用，为EMs的生物治疗提供了理论基础。

摘要:附属医院是医学院校的重要组成部分，医学院校的人才培养离不开附属医院，附属医院的建设发展也离不开大学的支撑。所以在文化建设上，附属医院文化也成为大学文化的重要内容，大学文化时刻影响着附属医院文化，使附属医院文化建设有了更深的内涵、更广的平台、更强的生命力。大学文化对其附属医院文化的影响是通过高等医学教育、学科建设、医学人才培养、医学自身的规律、科研和教学等多种途径来实现的。新时期附属医院文化在建设过程中只有不断吸收大学文化，才能使医院文化建设更有内涵。

摘要:目的：探讨儿童过敏性紫癜（HSP）肾脏损害的临床相关因素。方法：初发HSP患儿206例，分为尿检正常组（128例）及紫癜肾组（78例）；紫癜肾组分为一过性尿异常组（40例）及持续性尿异常组（38例）。检测临床指标，进行统计学分析，并对尿检正常组及紫癜肾组患者，以疾病分类为应变量，以有显著性差异的临床指标为自变量，进行二分类逐步logistic回归分析。结果：40项指标中，尿检正常组及紫癜肾组单因素方差分析，有11项存在显著性差异（P﹤0.05），logistic回归分析显示，外周血中性粒细胞百分比、血白蛋白、血总胆固醇对疾病分类有显著影响（P﹤0.05）。一过性尿异常组及持续性尿异常组在年龄、皮疹持续时间等8项指标中存在显著性差异（P﹤0.05）； 结论：外周血中性粒细胞百分比升高、血白蛋白降低、血总胆固醇升高是儿童HSP肾脏受累的危险因素，而年龄增长、皮疹持续、血尿合并蛋白尿、大量蛋白尿、外周血白细胞计数升高、血总蛋白、白蛋白、IgG降低，可能与肾脏持续受累有关。

摘要:医德医风建设是构建和谐医院的必不可少的内容，直接关系到和谐医院构建的成功与否。文章通过研究当前医德医风建设中存在的突出问题，深入探究这些问题产生的原因，从体制、机制、认识、权益、发展、制度等六个方面进一步揭示和谐医院建设的难点，并从转变理念、转变机制、强化制度、强化责任等四个方面为构建和谐医院提出了若干思路与对策。

摘要:临床检验信息系统作为优化检验科室管理模式的一种方法，不仅提高工作效率和工作质量，也是检验科室由经验管理向科学管理、规范化管理发展的需要。文章介绍了临床检验信息系统实现的关键因素，并对比前后的工作流程，阐述了其在检验科室管理的过程中起到了非常重要的作用，及目前存在且需亟待解决的问题和对检验信息系统今后发展方向的思考。

摘要:目的：了解重症监护病房（ICU）下呼吸道感染病原菌流行及耐药现状的特点，为临床合理应用抗菌药物提供依据。 方法：用WHONET 5.3软件统计分析2004年南京医科大学第一附属医院ICU住院患者399份痰液标本培养及药敏结果，并与同期普通病房住院患者的结果进行比较。结果：ICU病原菌流行谱与普通病房有显著差异。ICU常见病原菌对各类抗生素耐药率ICU也明显高于普通病房。革兰阴性菌超广谱β-内酰胺酶（ESBLs）检出率为27.4%，耐甲氧西林葡萄球菌（MRS）占所有葡萄球菌的78.6%，对大部分抗生素出现高度耐药。结论：目前ICU下呼吸道感染病原体中条件致病菌及多重耐药菌比例逐年上升。对ICU的铜绿假单胞菌建议使用哌拉西林／他唑巴坦，产ESBLs菌株建议选用碳青霉烯类、哌拉西林／他唑巴坦，MRS推荐用万古霉素。

摘要:市场经济、信息时代，医院营销对于县级妇幼保健院的发展起着举足轻重的作用。文章分析了医院营销对县级妇幼保健院发展的作用和在县级妇幼保健院中存在的模糊认识，提出了应对县级妇幼保健院正确定位、差异化服务等营销策略。

摘要:目的：探讨一个遗传性听神经病家系的听力学特征。方法：对23名家系成员（直系亲属21人，配偶2人）进行病史采集、体格检查及系统的听力学检测，包括纯音测听、声导抗、听性脑干反应（auditory brainstem response, ABR）、耳蜗微音器电位（cochlear microphonics, CMs）及诱发性耳声发射（evoked otoacoustic emissions, EOAEs）。对其中2名患者进行纯音听力随访。结果：7名家系成员符合听神经病诊断。其中 6人于9岁前发病，1~2年内快速发展为重度聋；纯音测听为双耳对称的重度~极重度感音神经性听力损失，高频下降型曲线；镫骨肌反射及ABR引不出，而CMs、EOAEs正常或基本正常。1例无听力障碍主诉，言语识别率正常；纯音测听显示双耳对称的轻度高频感音神经性听力损失，镫骨肌反射及ABR引出，EOAEs及CMs正常。2例患者纯音测听随访显示听力损失进行性加重。所有患者无耳聋外表现。结论： 该听神经病家系的听力学表型特征是：非综合征型、双侧对称性、高频下降为主的感音神经性听力损失，患者可表现为早年发病并快速进展的重度~极重度耳聋，或成年后发病并缓慢进展的轻度听力下降。

摘要:经营权与所有权分离的医院委托管理模式是医疗卫生体制改革中的一种尝试。文章对医院托管的基本模式及医院托管后人才队伍的建设问题进行探讨和分析，指出医院托管后加强人才队伍建设显得尤为重要。

摘要:近年来，伴随着人才测评技术的快速发展，许多测评技术在医学院校人才引进工作中得到应用，但由于学科特点、人才素质的多样性、外部环境的影响等因素，医学院校引进人才评价体系的构建还面临着许多难题，对这些难点的研究和探索有益于引进人才评价体系的健全和完善。

摘要:目的：探讨更昔洛韦联合丙种球蛋白治疗加早期干预对新生儿巨细胞病毒感染（CMVI）脑损伤预后的影响。方法：97例CMVI脑损伤患儿分干预组44例（甲组），未干预组53例（乙组），并以正常足月儿30例（丙组）为对照。甲、乙两组的基本情况无明显差异（P均 > 0.05）。甲组予更昔洛韦联合丙种球蛋白治疗加早期干预。结果： 18个月时身长、体重、头围、智力发育指数（MDI）、心理运动发育指数（PDI）甲组高于乙组（P < 0.01），运动落后、听力障碍、语言落后甲组均低于乙组（P < 0.01）。结论：更昔洛韦联合丙种球蛋白治疗及早期干预可以改善新生儿CMVI脑损伤的预后。

摘要:目的：探讨突触素（SY）和Cajal间质细胞 （ICCs）在无肛畸形儿直肠肠壁的变化和临床意义。方法：采用兔抗人单克隆突触素抗体和鼠抗人单克隆c-kit抗体，应用免疫组化技术观察20例无肛畸形患儿（高位畸形4例、间位畸形8例、低位畸形8例）和5例正常对照儿直肠SY和ICCs的分布情况。结果：无肛畸形患儿直肠盲端肠壁内SY和ICCs分布均比对照组明显减少，低位组盲端近段直肠壁SY和ICCs数量与对照无明显差异，间位和高位组盲端近段直肠壁SY和ICCs数量比对照组少，畸形位置越高越明显，但随着远离盲端，SY和ICCs出现并逐渐增多。结论：突触素和Cajal间质细胞的分布异常是无肛畸形儿直肠盲端肠壁重要病理改变之一，这种改变可能引起或加剧排便过程异常。

摘要:高层次医学人才评价是医学院校建设人才队伍的重要环节。文章提出了构建医学院校人才评价机制的目标和原则，探讨了高层次人才的评价标准制定、方式改革、程序设计、配套制度、环境支持等内容，以期对高等医学院校的人才队伍建设工作提供有益的借鉴。

摘要:目的：探讨下肢缺血性疾病综合性介入治疗的应用价值。方法：28例急、慢性下肢缺血患者分别采用经导管局部尿激酶溶栓术、经导管血栓抽吸术、血管腔内成形术、血管内支架植入术多种介入治疗方法。结果：7例急性患者行持续导管内溶栓+经导管血栓抽吸术，6例血栓48 h内完全溶解，血管再通，1例部分再通；21例慢性患者，6例行球囊成形术，2例术后12 h血管再次闭塞，最后行内支架植入术，1例行髂动脉支架植入术+股动脉腘动脉人工血管搭桥术，其余15例共植入内支架22枚。结论：下肢缺血性疾病的血管内治疗应综合应用多种介入治疗方法。

摘要:我国高等教育事业的改革与发展赋予了高校管理工作新的内涵。文章在分析我国高校管理干部工作能力现状、存在的问题，以及新时期对高校管理干部工作能力提出的新要求基础上，提出通过加强管理干部思想政治教育，优化管理干部专业知识结构，科学运行干部管理制度，制定管理干部培训制度等途径，不断提升高校管理干部的工作能力。

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摘要:独立学院是高等教育改革创新的组织形式之一。文章从公共服务和非营利组织理论的视角出发，通过分析独立学院非营利性组织的定位，论证其固有的公益性、公平性等特点，从而指出在我国高等教育大众化进程中，独立学院具有不可替代的积极作用。

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摘要:医学无人文则野，提高医学生人文素养是适应现代医学发展的一项长期而艰巨的使命。文章分析了当今医学面临的挑战及医学生人文素养教育的现状，认为卫生法学教育在提高医学生人文素养方面有着独特的地位和作用，并提出提高医学生人文素养的基本途径。

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摘要:医学生道德良知的培养在道德教育中具有基础性的地位和作用，医学生道德良知的培养主要在于医德教育，只有通过医德认识、医德情感和医德行为三位一体相互作用才能生成医学生道德良知，文章在探讨国外医学生道德教育模式的经验基础上，对我国医德教育模式在医学生道德良知培养上进行若干反思。

摘要:目的：构建靶向EBV阳性淋巴瘤且携带野生型P53基因的重组腺病毒。方法：构建重组质粒pDC311.orip-CMV.P53.IRES-EGFP，后将该质粒与腺病毒骨架质粒PBHGE3共转染293细胞，包装成rAd5.orip-CMV.P53。PCR方法对病毒鉴定后，TCID50法测定其滴度，同时用该病毒分别感染EBV阳性Raji细胞和EBV阴性Jurket细胞，以观察病毒的特异性。结果：成功地构建了能表达P53靶向EBV阳性淋巴瘤的重组腺病毒，病毒的滴度为3.6 × 1012pfu／L。体外细胞实验显示该病毒具有一定特异性。结论：成功构建rAd5.orip-CMV.P53载体，为靶向治疗EBV阳性淋巴瘤奠定基础。

摘要:培养研究生的创新能力是研究生教育的核心，也是评价研究生教育质量的根本标准。在影响研究生创新能力的诸多因素中，导师队伍是根本性因素。培养具有创新型的研究生需要导师具备优秀的学术道德、精湛的业务素质、严谨求实的科学态度、锲而不舍的科学精神、洞悉把握研究方向的发展趋势和立志创新的意识。文章从导师自身素质、导师学术水平、导师道德品质及其人格等方面，阐述导师因素在研究生创新能力培养过程中的作用。

摘要:本科生导师制是我国高等教育发展的必然趋势，文章结合笔者所在学院本科生导师制的实施办法和效果分析了本科生导师制在大学教育中的作用， 并重点探讨了实施本科生导师制面临的主要问题以及完善导师制的一些设想。

摘要:目的：检测不同乳腺癌细胞系中肿瘤干细胞相关亚群含量，并探讨使乳腺癌细胞系MCF-7中肿瘤干细胞相关亚群富集的方法。方法：利用流式细胞仪检测3种乳腺癌细胞系MCF-7、MDA-MB-231、MDA-MB-435s中SP细胞（side population cells）比例及CD44+CD24-／low细胞比例。用Percoll不连续密度梯度法分离MCF-7细胞亚群，利用流式细胞仪筛选出SP细胞富集的亚群。用添加生长因子的无血清培养液培养MCF-7，检测其中CD44+CD24-／low细胞的比例。结果：MCF-7、MDA-MB-435s中SP细胞比例分别为3.61%和2.72%，MDA-MB-231中未检测到SP细胞。3种细胞系中CD44+CD24-／low细胞比例分别为0.87%、0.59%和94.04%。MCF-7经Percoll分选，D亚群SP细胞富集，比例高达25.23%。MCF-7中CD44+CD24-／low细胞比例随着无血清培养时间的增加而增加，3周时达29.35%。结论：SP检测与CD44+CD24-／low细胞检测是目前乳腺癌干细胞检测的两种常用方法，但两者在同一乳腺癌细胞系中的检测结果并不一致，两种方法均有一定的局限性。另外，Percoll分选或无血清培养均能使MCF-7中肿瘤干细胞相关亚群（SP细胞或CD44+CD24-／low细胞）富集。

摘要:文章以《临床检验病原生物学》教材编写过程中的创新与实践，探讨如何以教材编写内容、编写形式和出版手段的创新，推动ＰＢＬ教学、双语教学和立体化教学等教学改革。

摘要:为了提高眼科临床见习教学质量，改革传统教学方法，文章对１３２名２００２级学生按专业分组后，分别施之以问题为基础的（ＰＢＬ）教学法和以授课为基础的（ＬＢＬ）教学法进行眼科临床见习教学，比较评价两种教学法的教学效果。结果表明，采用ＰＢＬ教学法的学生测验平均成绩和高分人数及学生对教学效果评价指标的优良率均明显高于采用ＬＢＬ教学法，从而说明ＰＢＬ教学法的教学效果明显优于ＬＢＬ教学法，ＰＢＬ教学法值得在眼科临床见习教学中推广应用。

摘要:目的：探讨P16INK4A、CDK4和细胞周期蛋白D1（cyclin D1）在子宫平滑肌肿瘤中的表达及意义。方法：应用免疫组化SP法及原位杂交法检测P16INK4A、CDK4和cyclin D1蛋白和P16INK4A mRNA在21例子宫平滑肌肉瘤（leiomyosarcoma，LMS）、34例子宫平滑肌瘤（leiomyoma，LMA）和22例正常子宫平滑肌组织中的表达情况。结果：P16INK4A、CDK4和cyclin D1蛋白在LMS、LMA和正常平滑肌组织中的阳性率分别为62%、90%、57%；15%、26%、53%；10%、10%、0%。P16INK4A、CDK4在LMS和LMA间的表达差异均有统计学意义（P ＜ 0.05）；cyclin D1蛋白在LMS和LMA中的表达率均明显高于正常平滑肌组织，而在LMS和LMA间表达率差异无显著性。原位杂交结果与免疫组化结果基本一致。结论：P16INK4A、CDK4在肉瘤发生过程中具有重要作用；cyclin D1过表达是常见的分子水平改变，且可能出现较早；检测P16INK4A、CDK4蛋白有助于鉴别子宫平滑肌肉瘤和平滑肌瘤。

摘要:经过多年的研究与探索，肇庆医专已初步建立起一个适合临床医学专业内科社区实践教学的模式，即医院见习与社区见习相结合、社区见习与社区服务相结合，三者并重的教学模式。实施证明，该模式能有效弥补传统临床实践教学模式的不足，提高见习质量；提高医学生的岗位技能、社区卫生保健意识及能力；促进了社区卫生保健的发展。

摘要:目的：探讨表皮生长因子（epidermal growth factor，EGF）对激素非依赖性前列腺癌（hormone refractory prostate cancer,HRPC）PC-3细胞中内皮素-1（endothelin-1，ET-1）分泌和mRNA表达的影响。方法：EGF干预后，RT-PCR测定PC-3中ET-1 mRNA的表达；放免检测ET-1蛋白分泌；不同剂量EGF干预后，放免检测ET-1分泌量的变化。结果：EGF干预后，ET-1mRNA表达上调，ET-1蛋白分泌增加，与对照组比较，差异有显著性（P ＜ 0.05）；不同剂量EGF干预后，ET-1分泌随EGF浓度增加而增加，单因素方差分析表明，不同剂量的EGF对PC-3 细胞ET-1分泌的影响不同，差异具有显著性（P ＜ 0.05）。结论：EGF可上调激素非依赖性前列腺癌PC-3细胞中ET-1mRNA表达及蛋白分泌，在前列腺癌的进展中起协同作用，为HRPC的治疗提供了分子生物学基础。

摘要:隐喻是汉语中时间表达的重要手段。人们通过其他具体形象的概念来认知时间这一抽象概念，实体隐喻、空间隐喻和结构隐喻是时间隐喻的主要方法。汉语时间表达的隐喻性从一个方面证明了隐喻在人类语言中占有重要地位。

摘要:目的：观察交替半身照射联合利妥昔单抗（美罗华）治疗对弥漫性大B细胞淋巴瘤（DLBCL）的影响。方法：将3例DLBCL患者采用美罗华配合CHOP 方案以及交替半身照射治疗，评价患者的近期疗效、生活质量、毒副反应。结果：治疗后患者近期疗效有上升趋势，无明显毒副反应。结论：交替半身照射联合美罗华治疗弥漫性大B细胞淋巴瘤有明显的增效、减毒及改善患者生活质量的作用。

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摘要:目的：采用免疫荧光组织染色方法，以ＧＡＤ６７-ＧＦＰ基因敲入小鼠为实验动物，系统地观察了小鼠脑干内5-羟色胺（5-HT）与γ-氨基丁酸（GABA）的共存情况，为中枢神经系统内５-ＨＴ与ＧＡＢＡ共存神经元的分布提供形态学证据。方法： 应用免疫荧光组织染色技术，对ＧＡＤ６７-ＧＦＰ基因敲入小鼠脑干内５-ＨＴ与ＧＡＢＡ免疫荧光双重染色，观察双重标记神经元在５-ＨＴ细胞群（Ｂ１-Ｂ９）中的分布情况并计数。结果：在所有脑干的５-ＨＴ细胞群中，双重标记神经元在中缝大核区域内所占的比率最高，平均为10.0%，其次是中缝苍白核和中缝隐核，分别为1.8%和1.4%。中缝桥核与中缝背核所含的共存神经元比例小，仅0.9%和0.3%。而在其他细胞群即B4，B6和B8-9细胞组，未观察到双重标记神经元。结论：在中枢神经系统内，只有部分延髓中线核团的５-ＨＴ能神经元同时含有ＧＡＢＡ，而中脑中线核团和脑干的其他非中线５-ＨＴ细胞群内未见这种共存神经元的存在。

摘要:目的：观察糖尿病雄性SD大鼠阴茎海绵体组织中核因子-κB（NF-κB）活性的变化以及分布，探讨糖尿病性勃起功能障碍（ED）发病机制。方法：将成年雄性SD大鼠40只分为3组：A组为正常对照组（10只），B组为糖尿病4周组（14只），C组为糖尿病12周组（16只），采用腹腔注射STZ法制作糖尿病模型。B组大鼠于4周后，A组、C组大鼠于12周后通过注射阿朴吗啡后评价勃起功能，并取阴茎海绵体组织免疫组化EnVision法分析NF-κB的分布与表达，同时采用电泳迁移率变动分析法（EMSA）进行NF-κB 活性检测。结果：B组、C组大鼠勃起功能水平较A组显著降低（P < 0.05），其海绵体组织中NF-κB 活性显著高于A组（P < 0.05），且NF-κB表达随病程延长呈现逐渐增强趋势；糖尿病性大鼠阴茎海绵体组织中NF-κB主要分布在内皮细胞中，平滑肌细胞和其他细胞中分布较少。结论：糖尿病大鼠阴茎海绵体组织中NF-κB 活性及分布与正常相比有明显差异，且与糖尿病病变程度有密切关系， 提示NF-κB 在糖尿病性ED 发病中可能起重要作用。

摘要:目的：研究99mTc标记的抗心肌肌钙蛋白Ⅰ单克隆抗体（AcTnIMA）在实验性急性心肌损伤大鼠体内的分布，探讨99mTc-AcTnIMA是否可以作为心脏放射免疫显像剂。方法：实验组：20只急性心肌损伤大鼠注射99mTc-AcTnIMA 0.2mci，分别于注射后2、4、6、8 h处死（每次5只），取血液、肝、脾、肾、正常肌肉、肺和心脏，以计算每克组织放射性计数占总注入计数的百分比（ID％／g）及心-肺ID％／g比（HLR）。药物对照组：20只急性心肌损伤大鼠注射99mTc标记的非特异性免疫球蛋白（N-IgG）0.2mci，处死方法同实验组。取肺及心脏，计算ID％／g及HLR；空白对照组：20只正常大鼠注射99mTc-AcTnIMA 0.2mci，处理方法同药物对照组。结果：急性损伤心肌对99mTc-AcTnIMA为特异性摄取，摄取的高峰时间为4 h。结论：99mTc-AcTnIMA有望作为心脏放射免疫显像剂诊断急性心肌损伤。

摘要:目的：研究依达拉奉对原代培养海马神经元缺氧复氧损伤的保护机制。方法：建立离体海马神经元缺氧复氧的细胞损伤模型，实验分组为正常对照组、缺氧复氧组、依达拉奉干预组，其中依达拉奉干预浓度分为1、10、100和300 μmol／L。观察海马细胞四甲基偶氮唑盐（MTT） 代谢率、丙二醛（MDA） 含量及一氧化氮合酶（NOS） 活性的变化，流式细胞仪观察细胞凋亡。结果：与缺氧复氧组相比，依达拉奉100 μmol／L组和300 μmol／L组的MTT 代谢率显著增高（P < 0.01） ，MDA 含量降低（P < 0.05），NOS活性降低（P < 0. 05），细胞凋亡率降低（P < 0. 01）。结论： 依达拉奉能够有效地抑制脂质过氧化作用，降低MDA及NOS活性，减少细胞凋亡率，对缺氧损伤的神经元具有显著的神经保护作用。

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摘要: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年生育保险参保人员病历首页以及财务结算帐单1 525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：SEM分析生育保险病种住院费用影响因素收到很好的效果。

摘要:目的：将HACCP原理运用于花生“从种植到生产加工出口”的整个商品流程，以确定预防和控制花生黄曲霉毒素污染的关键点和措施。方法：根据花生黄曲霉毒素污染的高风险的特点，以及影响花生黄曲霉毒素的主要因素，根据炒制花生果商品流程，运用HACCP危害分析原理，分析了在花生的商品流程图的各个环节中黄曲霉毒素危害情况，并有针对性地提出了预防控制措施。结果：在种植、收获、原料储存、加工、成品存放及运输等全过程，花生均可能污染霉菌，导致黄曲霉毒素超标。花生黄曲霉毒素污染的发生往往与霉变粒、受损伤、发育不良粒等有关。因此，以减少黄曲霉毒素污染水平和预防黄曲霉毒素再污染的步骤宜作为关键控制点；控制花生水分含量和去除霉变、受损伤、发育不良和异色花生粒等措施，作为花生中黄曲霉毒素危害的预防和控制措施。结论：运用HACCP原理分析花生黄曲霉毒素危害，可以确定其预防和控制的关键控制点和措施。

摘要:目的:探讨Staheli槽式髋臼延伸术治疗儿童Perthes病的手术适应证及治疗经验-方法:回顾分析2004年1月以来本院采用Staheli槽式髋臼延伸术治疗儿童Perthes病26例-其中,男22例,女4例-右侧18例,左侧8例-手术年龄6岁1个月~14岁3个月,平均7岁2个月-按Catterall分级,Ⅱ级3例-Ⅲ级12例-Ⅳ级11例-结果:术后随访6个月~3年,平均2年1个月-按Mckay标准评定髋关节功能,询问有无髋关节疼痛-跛行,检查髋关节活动程度以及Trendelenburg征,术后优良率达98.16%-X线片随访,采用Willett等正位骨盆片对比测量法,测量骺高比-髋臼覆盖率-CE角-Sharp角,观察Shenton线连续性-股骨头形态-骺高比-髋臼覆盖率-CE角明显增大,Sharp角明显减小,Shenton线连续性-股骨头形态均明显好转-结论:Staheli槽式髋臼延伸术治疗儿童Perthes病手术疗效满意,为治疗儿童Perthes病的一种理想术式-