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后医改时代药店的另类生存
关于医改方案如何表述药店定位,从猜测到传闻至尘埃落定,药店人经历了焦虑、窃喜、淡然等心路历程,可谓五味杂陈."尤其近一年,我们的情绪一直大起大落."北京好得快大药房总裁助理张捷感言.
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Objective Calibrated Automated Thrombogram(CAT) is a test to monitor the generation of thrombin. It can be described by four parameters:lag time, peak thrombin, endogenous thrombin potential (ETP) and time to peak (ttPeak). This study aims to determine the normal ranges of CAT parameters in Chinese, and evaluate whether thrombin generation is correlated with the concentration of heparin/low molecular weight heparin.
Methods Plasma from 120 healthy subjects were collected to determine the normal rangea of CAT parameters in Chinese. Normal plasma pool (NPP, n=25) spiked with different concentrations of heparin or enoxaparin were used to detecte CAT parameters. The overall and age specific normal ranges of CAT parameters were calculated using descriptive statistics method with mean±2SD. The correlation between CAT parameters and age or concentrations of heparin, enoxaparin were analyzed with linear regression model.
Results The normal ranges for lag time, peak thrombin, ETP, ttPeak in the subjects were 3.648±2.465 min, 367.39±151.93 nmol/L, 2277±1030 nmol/L·min and 6.372±4.280 min respectively. Age was linearly correlated with lag time (r=-0.6583, P<0.0001), peak thrombin (r=0.4863, P<0.0001), ETP (r=0.3608, P<0.0014) and ttPeak (r=-0.6313, P<0.0001). The values of ETP/peak ratio were linearly correlated with concentrations of heparin.
Conclusion The normal ranges of four CAT parameters for Chinese were determined. CAT parameters are associated with age. ETP/peak ratio could be used to monitor the process of anticoagulation therapy. -
"胎儿腹裂合并其他畸形:临床的重要性"点评
1原文Objective To report the prevalence of the association between gastroschisis and other anomalies,their prenatai characteristics and the postnatal follow-up.Methods Prenatal and postnatal data from all patients with gastroschis prenatally diagnosed between January 1998 and December 2006 were reviewed concerning the presence of associated anomalies.RtsultsGastroschisis was prenatally diagnosed in 108 fetuses.Associated anomalies were identified in 14 cases (prevalence of 13.O%),with prenatal diagnosis being made in 5(35.7%)patients.Postnatal examination revealed the association of other anomalies in nine other newborns not observed during prenatal examinations.Maternal age,parity,gestational age at diagnosis and birth,delivery mode and birth weight were similar in cases with‘isolated gastroschisis'and associated anomalies(p>0.05).Survival rates in the‘isolated gastroschisis group'and‘associated anomaly group'were 91.5 and 78.6%(P>0.05),respectively.The median time before oral feeding tended to be longer(but not statistical significantly)in the‘associated anomaly group'(32,range:5-720 days)compared to the ‘isolated gastroschisis group'(22,range:5-180 days;p=0.06),but with a significantly longer permanence in neonatal intensive care unit(p=0.04).Conclusion This study highlights the importance of identifyirig other anomalies when evaluating fetuses with gastroschisis to permit counselling concerning the postnatal outcomes.
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晚期早产儿的研究进展
当前国外把34周≤胎龄(gestational age,GA)<37周的早产儿视为早产儿亚群,定义为接近足月儿/晚期早产儿(Late Preterm Infants, LPIs)[1].因为"晚期早产儿"能更好地反映出接近足月儿人群有着较高风险的并发症,所以推荐使用"晚期早产儿"取代"接近足月儿"[2].虽然与出生体重600 g的微型儿相比,晚期早产儿的发病率很轻微,但其人数众多,却成了巨大的医疗负担[3].
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推动高质量的临床研究实现对儿童健康的承诺
Child health care in the 21st Century faces many new problems and challenges. By the year 2015, the mortality rate of children under the age of 5 years should be reduced by two thirds and the maternal mortality by three fourth[1], as proposed in the Millennium Development Goals by the World Health Organization and the United Nations Children's Fund. China is a large developing country with more than 300 million children. According to Outline of Health Care Development of the 11th Five-year Plan[2] , by 2010, China's infant mortality rate must be lowered to 14.9‰, the mortality rate of children under 5 years of age to 17.7‰, and maternal mortality under 0. 0004%. The realization of these objectives will be a comprehensive reflection of the child health policies of the 21st century in lowering child mortality rate, protecting children, and facilitating their development, as well as safeguarding and promoting children's health.
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Alzheimer’s disease is a neurodegenerative disorder characterized by progressive cognitive impairment and neuropathology. Recent preclinical and epidemiological studies proposed statins as a possible therapeutic drug for Alzheimer’s disease, but the exact mechanisms of action are stil unknown. Biliverdin reductase-A is a pleiotropic enzyme involved in cel ular stress responses. It not only transforms biliverdin-IX alpha into the antioxidant bilirubin-IX alpha but its serine/threonine/tyrosine kinase activity is able to modulate cel signaling networks. We previously reported the beneficial effects of atorvastatin treatment on biliverdin reductase-A and heme oxygenase-1 in the brains of a well characterized pre-clinical model of Alzheimer’s disease, aged beagles, together with observed improvement in cognition. Here we extend our knowledge of the effects of atorvastatin on inducible nitric oxide synthase in parietal cortex, cerebel um and liver of the same animals. We demonstrated that atorvastatin treatment (80 mg/day for 14.5 months) to aged beagles selectively increased inducible nitric oxide synthase in the parietal cortex but not in the cerebel um. In contrast, inducible nitric oxide synthase protein levels were significantly decreased in the liver. Significant positive correlations were found between biliverdin reductase-A and inducible nitric oxide synthase as wel as heme oxygenase-1 protein levels in the parietal cortex. The opposite was observed in the liver. Inducible nitric oxide synthase up-regulation in the parietal cortex was positively associated with improved biliverdin reductase-A functions, whereas the oxidative-induced impairment of biliverdin reductase-A in the liver negatively affected inducible nitric oxide synthase expression, thus suggesting a role for biliverdin reductase-A in atorvastatin-dependent inducible nitric oxide synthase changes. Interestingly, increased inducible nitric oxide synthase levels in the parietal cortex were not associated with higher oxidative/nitrosative stress levels. We hypothesize that biliverdin reductase-A-dependent inducible nitric oxide synthase regulation strongly contributes to the cognitive improvement observed fol owing atorvastatin treatment.
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脑血流速度和血管搏动指数与年龄的关系
为探讨脑血流速度和血管搏动指数(PI)与年龄的关系,我们采用经颅多普勒(Transcranial Doppler,TCD)超声技术,对年龄21~69岁的2 228名健康查体者进行了TCD检测并进行分析.
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年龄对住院冠心病病人健康功能损失程度的影响
冠心病是目前发病率和病死率均很高的疾病之一[1],严重影响了病人的健康功能和生活质量.随着年龄的增加,冠心病的发病率也在逐步增高,老龄化作为冠心病的独立危险因素存在已成公认的事实[2].目前,年龄对冠心病病人健康影响程度的具体量化研究较少.本研究旨在量化分析年龄差异对住院冠心病病人健康功能损失程度的影响,从而为临床个体化护理干预提供科学依据.
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社区已婚育龄期女性常见妇科病现状调查及其原因分析
随着社区医疗的飞快发展及城镇医疗卫生体制不断改革,城市社区卫生服务已步入全面建设服务体系阶段.而自生殖健康一词于1994年由WHO正式定义以来,生殖健康已成为一个备受关注的议题.次年,世界卫生大会提出"2015年人人享有生殖健康".我国对社区卫生服务也一直十分重视,出台了一系列关于发展城市社区卫生服务的政策措施及意见,各地社区卫生服务中心的功能和网络也在积极地进展和完善中[1].社会、经济、文化因素通过影响个体的知识态度和社区卫生保健水平而间接影响妇女生殖健康[2].随着这一目标时间越来越接近,我们就社会经济文化、婚育状况及个体行为对女性生殖健康的影响进行调查分析.
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高血糖对血管内皮功能影响的研究进展
葡萄糖及其代谢产物能影响多个细胞通路,从而影响血管内皮功能.在糖尿病患者中,高血糖直接或间接造成了血管内皮功能的异常.本文主要阐述糖基化终末产物(AGE)、多元醇通路活化、DAG-PKC通路的活化以及高血糖本身对内皮细胞功能的影响.
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不同年龄段女人的家居风情
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C-型利钠肽与骨龄变化
C-型利钠肽(C-type natriuretic peptide,CNP)是在软骨内成骨过程中具有重要作用的多肽类物质,在软骨内成骨过程中发挥重要作用,主要通过CNP内源性配体系统发挥其成骨作用.由于CNP在软骨内成骨中的特殊作用,渴望通过检测CNP来r解成骨状况及建立骨龄评估的新方法,将为临床骨龄评估提供一种更科学简便的检测手段,即通过血液检测,就可以判定和评价儿童骨骼的发育状况,可为临床及运动医学提供更科学准确的评估指标.
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谈谈人的年龄
年龄是大家都熟悉的名词,但在日常生活与工作中常常表达不够准确.本文运用文献调查的方法详细地介绍了年龄的定义,从文化和科学两个层面叙述了年龄的计算方法、年龄的分段及年龄与寿命,其目的在于对年龄的概念有一个比较准确的认识,以便在科学研究及日常生活中正确使用,这对医学、体育科学、法医学和考古学等都有重要意义.
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Treatment for Maxillary Vertical Excess With Tilt of Face: A Review literature
With progress of the age, more and more adult patient require orthodontic.However, Adult patients with skeletal malocclusion usually require a combination of orthodontic and orthognathic surgical treatment.Surgery can solve difficult patients on orthodontic.The article describes orthognathic surgical treatment maxillary vertical excess with tilt of face and documentary review.
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6月龄内婴儿麻疹142例分析
麻疹是儿童常见的急性呼吸道传染病之一,6月龄内婴儿因为有母传麻疹抗体的保护一般很少发病.但近年来发现6月龄内婴儿麻疹病例明显增多[1].为了提高对6月龄内婴儿麻疹的诊治水平,现对我院2008年1-6月收治的142例 6月龄内麻疹患儿进行流行病学、临床特点及预后分析.
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1~6岁儿童血铅水平7832例调查
铅是多亲和性毒物,它几乎可以引起所有器官的功能紊乱,主要累及神经、造血和免疫系统,严重影响儿童的生长发育,特别是铅中毒对脑的损害一旦发生,即难以逆转.随着城市化、工业化的发展以及交通运输事业的迅猛发展,环境铅污染已严重影响儿童的健康与发育.为了解本地区学龄前儿童血铅水平及铅中毒状况,以便及时采取有效措施.我们于2007年4月对衢州市7 832名儿童进行了血铅检测,并对相关因素进行分析.
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The Femoral Hernia-a rare hernia and its treatment
IntroductionHernias age protrusions through weak areas of our abdominal wall.The most common hernia is Inguinal Hernia in men.A rather rare hernia is the Femoral Hernia,a protrusion into the femotal canal next to the blood vessels in our groin (Picl).
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生活方式对亚洲男性性激素、性活动以及老龄化的调节作用
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体重指数及血脂水平与血清前列腺特异抗原的关系:一组中国50岁以下人群的研究
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The usefulness of diffusion-weighted magnetic resonance imaging (DWI) in the evaluation of scrotal pathology has recently been reported. A standard reference of normal testicular apparent diffusion coefifcient (ADC) values and their variations with age is necessary when interpreting normal testicular anatomy and pathology. We evaluated 147 normal testes using DWI, including 71 testes from 53 men aged 20-39 years (group 1), 67 testes from 42 men aged 40-69 years (group 2) and nine testes from six men older than 70 years (group 3). DWI was performed along the axial plane, using a single shot, multislice spin-echo planar diffusion pulse sequence and b-values of 0 and 900 s mm-2. The mean and standard deviation of the ADC values of normal testicular parenchyma were calculated for each age group separately. Analysis of variance (ANOVA) followed by post hoc analysis (Dunnett T3) was used for statistical purposes. The ADC values (× 10-3 mm2 s-1) of normal testicular tissue were different among age groups (group 1:1.08 ± 0.13;group 2:1.15 ± 0.15 and group 3:1.31 ± 0.22). ANOVA revealed differences in mean ADC among age groups (F=11.391, P<0.001). Post hoc analysis showed differences between groups 1 and 2 (P=0.008) and between groups 1 and 3 (P=0.043), but not between groups 2 and 3 (P=0.197). Our ifndings suggest that ADC values of normal testicular tissue increase with advancing age.