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1.
医院搭建并应用12582120医疗信息服务平台,对于健康咨询、就医指导、疑难病会诊及预约挂号管理都具有重要意义。主要介绍搭建12582120医疗信息服务平台,包括12582120医疗服务热线平台、易农宝手机APP预约挂号系统、远程医疗服务平台、农村平价医药平台和易复诊医患信息管理APP系统平台为会员服务情况,并针对平台运用中存在的问题提出整改措施,使平台功能最大化,以利于推进分级诊疗体系建设,从而达到方便患者就医的目的。  相似文献   

2.
目的 分析预约挂号是否缩短门诊患者的等候时间。方法抽取医院某一周全部患者挂号记录49 147条,通过秩和检验方法,分析预约挂号与非预约挂号患者的候诊时间的差异,比较不同预约方式对患者候诊时间是否存在影响。结果 预约挂号平均候诊时间为50分钟,非预约挂号患者平均候诊时间为111分钟,不同预约方式的患者候诊时间存在统计学上的差异。结论 预约挂号能够有效缩短门诊患者的候诊时间,其中复诊预约患者候诊时间最短,应鼓励患者预约就诊,复诊患者应鼓励进行复诊预约。  相似文献   

3.
目的 为预约挂号患者提供出票服务,分流挂号窗口排队人群。方法 设计预约挂号出票客户端,自助服务与人工服务相结合,合理规划业务流程。结果 预约挂号患者不需在挂号窗口排队,可为预约挂号患者提供24小时多地点自助出票服务,同时实现医院对预约挂号第三方支付的财务监管。结论 预约挂号出票客户端极大地方便了患者及医院,具有较好的可行性。  相似文献   

4.
随着国家医疗改革的不断深入,卫生部针对国内大部分综合性医院门诊挂号拥挤的现象和因此导致的众多问题,推出了预约挂号的新政。预约挂号实行以来减轻了门诊拥挤,提高了诊疗效率,方便了患者就诊,但在实际推广仍有不足,因此需要推广实名制挂号、构建统一预约挂号平台、加强信用建设、完善医院管理创新、试行社区预约转诊等,实现预约挂号的"人性化、精细化、信息化、社会化"。  相似文献   

5.
6.
目的 改进医院预约挂号服务工作,完善预约挂号流程,进一步满足患者需求。方法 以2011年6月对通过网络、电话预约挂号的方式成功挂号的患者为调查对象,采用问卷调查方法,由经过培训的调查员进行调查,采用Epidata3.0软件进行数据录入,采用SPSS13.0进行统计分析。结果 对网络、电话预约挂号不满意的有57.4%,不满意的原因主要集中在取号环节上,80%多的患者是通过媒体和医院的宣传知道预约挂号的,但外地患者不足10%。结论 医院试行的网络、电话预约挂号方式具有一定的现实可行性,但是在取号环节及宣传预约挂号的方面,具有一定的欠缺,需要进一步完善和优化。  相似文献   

7.
为优化门诊流程,北京同仁医院开展非急诊挂号全面预约工作,拓展了多种预约途径,利用信息系统进行门诊流程的改造。改革实施6个月,每日利用各种途径预约挂号量显著提高,同时诊间复诊预约量持续增加。  相似文献   

8.
??????? 目的 初步探讨影响专家预约挂号率的原因及相应对策。方法 以SPSS 13.0软件分析2012年4月—2013年1月专家门诊情况与预约挂号率的关系。结果 不同门诊时间(季度、周别、午别)、不同专科、不同专家、不同门诊级别以及挂号率与号源使用率对我院专家门诊预约挂号率均有影响。结论 影响专家门诊预约挂号率的因素是多方面的,需采取综合措施,加强医院核心竞争力才是根本。  相似文献   

9.
通过对2007—2010年挂号、退号数据的分析研究,得出导致退号的原因中,医疗资源不足、病患家长不愿意长时间等候是首要原因,其他原因既有病患方面的,也有医院管理方面的。通过对各种原因的综合分析,提出改进医院门诊挂号管理的建议:预约挂号——按时间段实名制预约挂号,错峰门诊,以此促进医疗效率的提高。  相似文献   

10.
按照北京市医院管理局工作的要求,我院推进实行非急诊全面预约挂号,在多渠道预约挂号、号源梳理、流程再造、便民措施方面重点展开工作,有效改善了既往门诊服务中“三长一短”的现状,提升了患者满意度及一定的社会效益。  相似文献   

11.

Background

X11-family proteins, including X11, X11-like (X11L) and X11-like 2 (X11L2), bind to the cytoplasmic domain of amyloid β-protein precursor (APP) and regulate APP metabolism. Both X11 and X11L are expressed specifically in brain, while X11L2 is expressed ubiquitously. X11L is predominantly expressed in excitatory neurons, in contrast to X11, which is strongly expressed in inhibitory neurons. In vivo gene-knockout studies targeting X11, X11L, or both, and studies of X11 or X11L transgenic mice have reported that X11-family proteins suppress the amyloidogenic processing of endogenous mouse APP and ectopic human APP with one exception: knockout of X11, X11L or X11L2 has been found to suppress amyloidogenic metabolism in transgenic mice overexpressing the human Swedish mutant APP (APPswe) and the mutant human PS1, which lacks exon 9 (PS1dE9). Therefore, the data on X11-family protein function in transgenic human APP metabolism in vivo are inconsistent.

Results

To confirm the interaction of X11L with human APP ectopically expressed in mouse brain, we examined the amyloidogenic metabolism of human APP in two lines of human APP transgenic mice generated to also lack X11L. In agreement with previous reports from our lab and others, we found that the amyloidogenic metabolism of human APP increased in the absence of X11L.

Conclusion

X11L appears to aid in the suppression of amyloidogenic processing of human APP in brain in vivo, as has been demonstrated by previous studies using several human APP transgenic lines with various genetic backgrounds. X11L appears to regulate human APP in a manner similar to that seen in endogenous mouse APP metabolism.
  相似文献   

12.

Background

Retrograde transport of several transmembrane proteins from endosomes to the trans-Golgi network (TGN) occurs via Rab 5-containing endosomes, mediated by clathrin and the recently characterized retromer complex. This complex and one of its putative sorting receptor components, SorLA, were reported to be associated to late onset Alzheimer's disease (AD). The pathogenesis of this neurodegenerative disorder is still elusive, although accumulation of amyloidogenic Abeta is a hallmark. This peptide is generated from the sucessive β- and γ- secretase proteolysis of the Alzheimer's amyloid precursor protein (APP), events which are associated with endocytic pathway compartments. Therefore, APP targeting and time of residence in endosomes would be predicted to modulate Abeta levels. However, the formation of an APP- and retromer-containing protein complex with potential functions in retrieval of APP from the endosome to the TGN had, to date, not been demonstrated directly. Further, the motif(s) in APP that regulate its sorting to the TGN have not been characterized.

Results

Through the use of APP-GFP constructs, we show that APP containing endocytic vesicles targeted for the TGN, are also immunoreactive for clathrin-, Rab 5- and VPS35. Further, they frequently generate protruding tubules near the TGN, supporting an association with a retromer-mediated pathway. Importantly, we show for the first time, that mimicking APP phosphorylation at S655, within the APP 653YTSI656 basolateral motif, enhances APP retrieval via a retromer-mediated process. The phosphomimetic APP S655E displays decreased APP lysosomal targeting, enhanced mature half-life, and decreased tendency towards Abeta production. VPS35 downregulation impairs the phosphorylation dependent APP retrieval to the TGN, and decreases APP half-life.

Conclusions

We reported for the first time the importance of APP phosphorylation on S655 in regulating its retromer-mediated sorting to the TGN or lysosomes. Significantly, the data are consistent with known interactions involving the retromer, SorLA and APP. Further, these findings add to our understanding of APP targeting and potentially contribute to our knowledge of sporadic AD pathogenesis representing putative new targets for AD therapeutic strategies.  相似文献   

13.
The amyloid precursor protein (APP) is implied both in cell growth and differentiation and in neurodegenerative processes in Alzheimer disease. Regulated proteolysis of APP generates biologically active fragments such as the neuroprotective secreted ectodomain sAPPα and the neurotoxic β-amyloid peptide. Furthermore, it has been suggested that the intact transmembrane APP plays a signaling role, which might be important for both normal synaptic plasticity and neuronal dysfunction in dementia. To understand APP signaling, we tracked single molecules of APP using quantum dots and quantitated APP homodimerization using fluorescence lifetime imaging microscopy for the detection of Förster resonance energy transfer in living neuroblastoma cells. Using selective labeling with synthetic fluorophores, we show that the dimerization of APP is considerably higher at the plasma membrane than in intracellular membranes. Heparan sulfate significantly contributes to the almost complete dimerization of APP at the plasma membrane. Importantly, this technique for the first time structurally defines the initiation of APP signaling by binding of a relevant physiological extracellular ligand; our results indicate APP as receptor for neuroprotective sAPPα, as sAPPα binding disrupts APP dimers, and this disruption of APP dimers by sAPPα is necessary for the protection of neuroblastoma cells against starvation-induced cell death. Only cells expressing reversibly dimerized wild-type, but not covalently dimerized mutant APP are protected by sAPPα. These findings suggest a potentially beneficial effect of increasing sAPPα production or disrupting APP dimers for neuronal survival.The amyloid precursor protein (APP)4 is known both for its important role in the development and plasticity of the nervous system (16) and for its involvement in Alzheimer disease (AD) (7, 8). Despite intensive research efforts, the initial events that lead to the prevalent sporadic, i.e. non-familial, forms of AD are still unclear. Furthermore, although a higher gene dose of APP (9) or the presence of pathological APP mutations is sufficient to induce familial AD (for review, see Ref. 10), the exact pathological mechanism that is triggered by APP is still under debate.Some fragments of APP, such as the β-amyloid peptide (Aβ), are thought to contribute to synaptic dysfunction and neurotoxicity (11, 12). On the other hand, the α-secretase-derived extracellular fragment of APP (sAPPα), which is present at lower levels in AD patients than in controls (13), has been shown to be beneficial for memory function, to possess neuroprotective properties, and to counteract the effects of Aβ (1418).Signaling by transmembrane APP may directly contribute to neurodegeneration in AD (1924); however, the signal transduction pathway for transmembrane APP remains unknown, although several potential regulatory proteins, glycosaminoglycans, and metal ions are known to bind with high affinity to APP and sAPPα (25, 26). The most common form of signal transduction for single-pass transmembrane proteins is the ligand-induced perturbation of a monomer/dimer equilibrium. Indeed, the dimerization of transmembrane APP has been implied several times in the past. Several studies have investigated the effects of presumed dimer-breaking perturbations on biological read-outs, such as the production of Aβ (27, 28), but without directly measuring the APP aggregation state, or have investigated the aggregation state of APP subdomains, often reconstituted in cell-free systems (2732). Dimerization interfaces in both the extracellular and the transmembrane domain have been suggested.In the studies investigating the aggregation state of full-length APP, most of the employed methods, such as chemical cross-linking and co-immunoprecipitation, do not lend themselves readily to a rigorous quantitative analysis of the abundance of potentially instable dimers (31, 33), whereas in other cases the use of chimeras may have influenced the dimerization potential or precluded the search for a natural stimulus (23, 34). The only previously reported direct observation of APP dimerization by Förster resonance energy transfer (FRET) microscopy uses an assay in which the FRET efficiency varies with the level of overexpression (35). Therefore, a concentration-dependent FRET component due to nonspecific stochastic encounters cannot be excluded in this study.Most importantly, as none of the published procedures permitted the selective detection of APP dimers on the surface of live cells, where they would encounter ligands, they could not differentiate between subpopulations of APP. This may be one reason why no natural ligand of APP has ever been shown to signal via modulation of its monomer/dimer equilibrium.Another elusive goal is the identity of the receptor for neuroprotective sAPPα (3639). The ligand-dependent dimerization of sAPPα in solution (40) and its origination from transmembrane APP suggest that APP might serve as receptor for sAPPα, but this binding has never been experimentally shown.  相似文献   

14.
Processing of amyloid precursor protein (APP) into amyloid‐β peptide (Aβ) is crucial for the development of Alzheimer's disease (AD). Because this processing is highly dependent on its intracellular itinerary, altered subcellular targeting of APP is thought to directly affect the degree to which Aβ is generated. The sorting receptor SorCS1 has been genetically linked to AD, but the underlying molecular mechanisms are poorly understood. We analyze two SorCS1 variants; one, SorCS1c, conveys internalization of surface‐bound ligands whereas the other, SorCS1b, does not. In agreement with previous studies, we demonstrate co‐immunoprecipitation and co‐localization of both SorCS1 variants with APP. Our results suggest that SorCS1c and APP are internalized independently, although they mostly share a common post‐endocytic pathway. We introduce functional Venus‐tagged constructs to study SorCS1b and SorCS1c in living cells. Both variants are transported by fast anterograde axonal transport machinery and about 30% of anterograde APP‐positive transport vesicles contain SorCS1. Co‐expression of SorCS1b caused no change of APP transport kinetics, but SorCS1c reduced the anterograde transport rate of APP and increased the number of APP‐positive stationary vesicles. These data suggest that SorCS1 and APP share trafficking pathways and that SorCS1c can retain APP from insertion into anterograde transport vesicles.

  相似文献   


15.
The amyloid precursor protein (APP) undergoes "alternative" proteolysis mediated by caspases. Three major caspase recognition sites have been identified in the APP, i.e. one at the C terminus (Asp720) and two at the N terminus (Asp197 and Asp219). Caspase cleavage at Asp720 has been suggested as leading to increased production of Abeta. Thus, we set out to determine which putative caspase sites in APP, if any, are cleaved in Chinese hamster ovary cell lines concurrently with the increased Abeta production that occurs during apoptosis. We found that cleavage at Asp720 occurred concurrently with caspase 3 activation and the increased production of total secreted Abeta and Abeta1-42 in association with staurosporine- and etoposide-induced apoptosis. To investigate the contribution of caspase cleavage of APP to Abeta generation, we expressed an APP mutant truncated at Asp720 that mimics APP caspase cleavage at the C-terminal site. This did not increase Abeta generation but, in contrast, dramatically decreased Abeta production in Chinese hamster ovary cells. Furthermore, the ablation of caspase-dependent cleavage at Asp720, Asp197, and Asp219 (by site-directed mutagenesis) did not prevent enhanced Abeta production following etoposide-induced apoptosis. These findings indicate that the enhanced Abeta generation associated with apoptosis does not require cleavage of APP at its C-terminal (Asp720) and/or N-terminal caspase sites.  相似文献   

16.
Accumulation of the amyloid β (Aβ) peptide derived from the proteolytic processing of amyloid precursor protein (APP) is the defining pathological hallmark of Alzheimer disease. We previously demonstrated that the C-terminal 37 amino acids of lipoprotein receptor-related protein (LRP) robustly promoted Aβ generation independent of FE65 and specifically interacted with Ran-binding protein 9 (RanBP9). In this study we found that RanBP9 strongly increased BACE1 cleavage of APP and Aβ generation. This pro-amyloidogenic activity of RanBP9 did not depend on the KPI domain or the Swedish APP mutation. In cells expressing wild type APP, RanBP9 reduced cell surface APP and accelerated APP internalization, consistent with enhanced β-secretase processing in the endocytic pathway. The N-terminal half of RanBP9 containing SPRY-LisH domains not only interacted with LRP but also with APP and BACE1. Overexpression of RanBP9 resulted in the enhancement of APP interactions with LRP and BACE1 and increased lipid raft association of APP. Importantly, knockdown of endogenous RanBP9 significantly reduced Aβ generation in Chinese hamster ovary cells and in primary neurons, demonstrating its physiological role in BACE1 cleavage of APP. These findings not only implicate RanBP9 as a novel and potent regulator of APP processing but also as a potential therapeutic target for Alzheimer disease.The major defining pathological hallmark of Alzheimer disease (AD)2 is the accumulation of amyloid β protein (Aβ), a neurotoxic peptide derived from β- and γ-secretase cleavages of the amyloid precursor protein (APP). The vast majority of APP is constitutively cleaved in the middle of the Aβ sequence by α-secretase (ADAM10/TACE/ADAM17) in the non-amyloidogenic pathway, thereby abrogating the generation of an intact Aβ peptide. Alternatively, a small proportion of APP is cleaved in the amyloidogenic pathway, leading to the secretion of Aβ peptides (37–42 amino acids) via two proteolytic enzymes, β- and γ-secretase, known as BACE1 and presenilin, respectively (1).The proteolytic processing of APP to generate Aβ requires the trafficking of APP such that APP and BACE1 are brought together in close proximity for β-secretase cleavage to occur. We and others have shown that the low density lipoprotein receptor-related protein (LRP), a multifunctional endocytosis receptor (2), binds to APP and alters its trafficking to promote Aβ generation. The loss of LRP substantially reduces Aβ release, a phenotype that is reversed when full-length (LRP-FL) or truncated LRP is transfected in LRP-deficient cells (3, 4). Specifically, LRP-CT lacking the extracellular ligand binding regions but containing the transmembrane domain and the cytoplasmic tail is capable of rescuing amyloidogenic processing of APP and Aβ release in LRP deficient cells (3). Moreover, the LRP soluble tail (LRP-ST) lacking the transmembrane domain and only containing the cytoplasmic tail of LRP is sufficient to enhance Aβ secretion (5). This activity of LRP-ST is achieved by promoting APP/BACE1 interaction (6), although the precise mechanism is unknown. Although we had hypothesized that one or more NPXY domains in LRP-ST might underlie the pro-amyloidogenic processing of APP, we recently found that the 37 C-terminal residues of LRP (LRP-C37) lacking the NPXY motif was sufficient to robustly promote Aβ production independent of FE65 (7). Because LRP-C37 likely acts by recruiting other proteins, we used the LRP-C37 region as bait in a yeast two-hybrid screen, resulting in the identification of 4 new LRP-binding proteins (7). Among these, we focused on Ran-binding protein 9 (RanBP9) in this study, which we found to play a critical role in the trafficking and processing of APP. RanBP9, also known as RanBPM, acts as a multi-modular scaffolding protein, bridging interactions between the cytoplasmic domains of a variety of membrane receptors and intracellular signaling targets. These include Axl and Sky (8), MET receptor protein-tyrosine kinase (9), and β2-integrin LFA-1 (10). Similarly, RanBP9 interacts with Plexin-A receptors to strongly inhibit axonal outgrowth (11) and functions to regulate cell morphology and adhesion (12, 13). Here we show that RanBP9 robustly promotes BACE1 processing of APP and Aβ generation.  相似文献   

17.
Summary 1. The amyloid precursor protein (APP) is widely distributed among eukaryotic cells, however, its precise role in cellular functioning is not fully clarified. APP is glycoprotein membrane constituent and it may facilitate membrane associated functions.2. The aim of the present study was to examine the possibility that APP may play a role in mediating cellular trophic responses. The methods made use of an antisense oligonucleotide that was prepared to the 5 terminus of APP and shown specifically to reduce the level of APP isoforms.3. In sequential mixing experiments it was observed that the APP antisense oligonucleotide did not significantly modify the trophic response of PC12 cells pretreated with nerve growth factor (NGF). However, pretreatment of cells with the antisense oligonucleotide diminished NGF-induced increases in cellular size and neurite length.4. These observations suggest that APP may play a role in modulating the trophic response. The combined use of APP antisense oligonucleotides and neurotrophic agents may find clinical utility in the treatment of Alzheimertype dementia since it is known that NGF normally causes increases in APP levels.  相似文献   

18.
Zhang W  Shao J  Liu G  Tang F  Lu Y  Zhai Z  Wang Y  Wu Z  Yao H  Lu C 《Proteome science》2011,9(1):32-11

Background

Actinobacillus pleuropneumoniae (APP) is one of the most important swine pathogens worldwide. Identification and characterization of novel antigenic APP vaccine candidates are underway. In the present study, we use an immunoproteomic approach to identify APP protein antigens that may elicit an immune response in serotype 1 naturally infected swine and serotype 1 virulent strain S259-immunized rabbits.

Results

Proteins from total cell lysates of serotype 1 APP were separated by two-dimensional electrophoresis (2DE). Western blot analysis revealed 21 immunoreactive protein spots separated in the pH 4-7 range and 4 spots in the pH 7-11 range with the convalescent sera from swine; we found 5 immunoreactive protein spots that separated in the pH 4-7 range and 2 in the pH 7-11 range with hyperimmune sera from S259-immunized rabbits. The proteins included the known antigens ApxIIA, protective surface antigen D15, outer membrane proteins P5, subunit NqrA. The remaining antigens are being reported as immunoreactive proteins in APP for the first time, to our knowledge.

Conclusions

We identified a total of 42 immunoreactive proteins of the APP serotype 1 virulent strain S259 which represented 32 different proteins, including some novel immunoreactive factors which could be researched as vaccine candidates.  相似文献   

19.
Seasonal change in the abundance of autotrophic picoplankton (APP) was investigated once or twice a week in relation to some environmental variables in a hypereutrophic pond, from July 1999 to June 2000. Cell density of APP ranged between 0.3×105 and 10.1×105 cells ml–1, overlapping the lower range of APP abundances given in the literature for hypereutrophic systems. The pattern of seasonal change in concentration of dissolved inorganic phosphorus (0.3–20.3 mol P l–1) was similar to that of cell density of APP, suggesting that phosphorus limitation on APP abundance. By contrast, nitrogen limitation seemed unlikely since the pattern of seasonal change in concentration of dissolved inorganic nitrogen was different from that of APP cell density. We could not find any coupled oscillations between APP abundance and heterotrophic nanoflagellates, or between that of APP and ciliates. The dominant ciliate taxa, based on their cell densities, were Cinetochilum margaritaceum, Cyclidium glaucoma, Halteria grandinella, Strobilidium sp. and Urotricha spp. The relative contribution of the <2 m fraction to total chlorophyll concentration was seasonally high (up to 16.2%), indicating seasonal importance of APP abundance as food for heterotrophs.  相似文献   

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