可疑医疗器械不良事件上报管理的实践探索

PDCA循环圈理念是广泛应用于质量管理的科学管理工具。运用其管理理念,通过对医院医疗器械不良事件上报工作联络员的知识、态度、行为等情况进行调查,了解医院工作现状及存在的问题,制定干预措施;干预后再次进行评价。旨在提高医院可疑医疗器械不良事件上报管理工作的质量。     

提高木霉逆境适应性与生物防治效果的基因工程研究进展

木霉生存范围广、生长繁殖迅速,对其他真菌有一定的拮抗能力,并能促进植物生长、诱导植物对病原菌产生抗性,是迄今开发最成功的植物病害生防真菌。目前,运用基因工程的方法对木霉进行遗传改良,提高它对环境的适应性与对致病菌的防治能力,已经取得了很大的进展,就近年来采用基因工程的方法对木霉进行改良的研究进行综述。     

膀胱过度活动症的抗胆碱治疗及其不良反应

膀胱过度活动症(overactive bladder,OAB)是一种令人烦恼的疾病,它影响着人们生活的质量。病人常常表现为尿急,伴有或不伴有急迫性尿失禁,通常有尿频和夜尿的症状。虽然膀胱过度活动症的病因不是很明确,但是抗胆碱药物作为其治疗的基石,在减少膀胱储尿期的收缩,增加膀胱的容量,起着重要的作用。这类药物具有一定的安全性,副作用小,并且有着相似的疗效。尽管如此,当治疗膀胱过度活动时,抗胆碱药物种类的选择,其治疗的预期利弊平衡也应在考虑之中,尤其是合并有中枢神经系统或者心脑血管系统疾病的老年患者。本文通过查阅国内外新近相关的文献,从受体的选择,临床应用和不良反应等方面对7种抗胆碱药物进行综述。     

经寰枕间隙侧方穿刺移植人脐血单个核细胞对难治性神经系统疾病的疗效分析

目的探讨寰枕间隙侧方穿刺术移植人脐血单个核细胞治疗难治性神经系统疾病的可行性和安全性。 方法应用寰枕间隙侧方穿刺术对230例患者进行450次人脐血单个核细胞治疗,观察治疗中及治疗后有无不良反应和并发症,对比治疗前后血液分析、血沉、生化全项、出凝血机制和肿瘤标记物数值,同时观察患者治疗前后病情转归,采用配对比较t检验进行统计学分析。 结果所有患者治疗后均无头痛、感染、皮疹、血肿形成等不良反应和其它移植并发症出现。32例（7.1%）治疗后出现一过性血压升高,8例（1.8%）出现一过性发热,10例（2.2%）穿刺时诉穿刺处深部软组织胀痛,拔针后疼痛消失。患者白细胞计数治疗前（7.9±1.1）×10⁹个/?L和治疗后3个月（8.0±1.3）×10⁹个/L相比差异无统计学意义（t =?0.891,P?=?0.374）,谷丙转氨酶治疗前（31.9±5.8）U/L和治疗后3个月（32.4±6.2）U/L相比差异无统计学意义（t?=?0.893,P?=?0.372）,球蛋白治疗前（22.1±1.7）g/L和治疗后3个月（21.8±1.8）g/L相比差异无统计学意义（t?=?0.838,P?=?0.066）,AFP治疗前（9.9±1.6）μg/L和治疗后3个月（10.1±1.7）μg/L相比差异无统计学意义（t?=?1.299,P?=?0.195）,患者血液学指标（血常规+血沉、生化全项、全身肿瘤标记物、病毒筛查、出凝血机制）在治疗前后无统计学差异。183例患者治疗有效,有效率79.6%。 结论寰枕间隙侧方穿刺术移植人脐血单个核细胞治疗难治性神经系统疾病是安全可行并可能有效的。     

医学生学习激情现状及影响因素的研究

目的:测量医学生学习激情现状,探索相关人口学变量差异及影响因素作用机制.方法:通过网络问卷对1793名在校医学生进行问卷调查,回收有效问卷1218份,应用SPSS22.0软件对数据进行统计处理.结果:测量对象的学习激情处于中等偏上水平(4.37± 0.91);学习激情平均得分在性别(F=9.097,P＜0.05)、生源...     

花青素转录因子调控机制及代谢工程研究进展

花青素是广泛存在于植物中的一类重要的类黄酮化合物, 在植物生长发育和人类营养保健方面具有重要价值。花青素的生物合成途径已经解析得比较清楚, 但花青素的代谢调控网络还在不断完善。调控花青素生物合成的转录因子主要包括MYB、bHLH和WD40三大类, 这些转录因子通过激活或抑制CHS、ANS和DFR等花青素途径关键结构基因的表达水平, 进而决定花青素积累的部位与水平。该文结合国内外花青素生物合成与转录调控方面的研究进展, 简要介绍了花青素的生物合成途径, 归纳总结了模式植物中花青素代谢调控的分子机理, 尤其是MYB、bHLH和WD40三类主要转录因子的调控机理, 以及这些转录因子在观赏植物和水果等经济作物花青素代谢工程中的应用。该文将为系统阐明花青素的转录调控机制和利用代谢工程改良花青素的相关研究提供有益参考。     

Breaking the 10% Efficiency Barrier in Organic Photovoltaics: Morphology and Device Optimization of Well‐Known PBDTTT Polymers

With the advances in organic photovoltaics (OPVs), the invention of model polymers with superior properties and wide applicability is of vital importance to both the academic and industrial communities. The recent inspiring advances in OPV research have included the emergence of poly(benzodithiophene‐co‐thieno[3,4‐b]thiophene) (PBDTTT)‐based materials. Through the combined efforts on PBDTTT polymers, over 10% efficiencies have been realized recently in various types of OPV devices. This review attempts to critically summarize the recent advances with respect to five well‐known PBDTTT polymers and their design considerations, basic properties, photovoltaic performance, as well as device application in conventional, inverted, tandem solar cells. These PBDTTT polymers also make great contributions to the rapid advances in the field of emerging ternary blends and fullerene‐free OPVs with top performances. Addtionally, new challenges in developing novel photovoltaic polymers with more superior properties are prospected. More importantly, the research of highly efficient PBDTTT‐based polymers provides useful insights and builds fundamentals for new types of OPV applications with various architectures.     

Evaluation of the Safety and Immune Efficacy of Recombinant Human Respiratory Syncytial Virus Strain Long Live Attenuated Vaccine Candidates

Human respiratory syncytial virus(RSV) infection is the leading cause of lower respiratory tract illness(LRTI), and no vaccine against LRTI has proven to be safe and effective in infants. Our study assessed attenuated recombinant RSVs as vaccine candidates to prevent RSV infection in mice. The constructed recombinant plasmids harbored(5' to 3') a T7 promoter, hammerhead ribozyme, RSV Long strain antigenomic cDNA with cold-passaged(cp) mutations or cp combined with temperature-sensitive attenuated mutations from the A2 strain(A2cpts) or further combined with SH gene deletion(A2cpts△SH), HDV ribozyme(δ), and a T7 terminator. These vectors were subsequently co-transfected with four helper plasmids encoding N, P, L, and M2-1 viral proteins into BHK/T7-9 cells, and the recovered viruses were then passaged in Vero cells. The rescued recombinant RSVs(rRSVs) were named rRSV-Long/A2 cp, rRSV-Long/A2 cpts, and rRSV-Long/A2 cpts △SH, respectively, and stably passaged in vitro, without reversion to wild type(wt) at sites containing introduced mutations or deletion. Although rRSV-Long/A2 cpts and rRSV-Long/A2 cpts △SH displayed temperature-sensitive(ts)phenotype in vitro and in vivo, all rRSVs were significantly attenuated in vivo. Furthermore, BALB/c mice immunized with rRSVs produced Th1-biased immune response, resisted wt RSV infection, and were free from enhanced respiratory disease.We showed that the combination of △SH with attenuation(att) mutations of cpts contributed to improving att phenotype,efficacy, and gene stability of rRSV. By successfully introducing att mutations and SH gene deletion into the RSV Long parent and producing three rRSV strains, we have laid an important foundation for the development of RSV live attenuated vaccines.     

军队医院医疗质量管理存在的问题及对策

随着我国医疗体制改革的不断推进,医院面临着自身管理体系和管理方式的重要革新。在新形势下,如何保证医疗质量管理更加规范、管理体系更加完善是医院管理者普遍重视的问题。医疗质量是医疗技术和医疗服务的核心、是医院竞争力的实质、是医院发展的根本。医院医疗质量的水平直接影响着患者的受益程度,也影响着医院自身的声誉和效益。因此,加强医疗质量管理可以有效地保证患者的利益,提高医院竞争力,促进医院可持续发展。随着社会的发展、科技的进步、医学模式的转变及国防建设的需要,军队医院的职能和作用也发生了变化,其不仅为军人提供医疗服务,也为地方群众就医提供便利。军队医院的医疗质量管理直接关系着军人的健康保障,也影响着地方群众的治疗效果。本文通过分析军队医院医疗质量管理存在的问题提出相应的对策,部队医院医疗质量管理部门应与时俱进,顺应国家医药卫生体制改革的同时,着眼于未来发展,建立健全医疗质量管理体系,改进管理模式,从而提高医疗质量,创造更高的经济效益和社会效益,以实现科学的可持续发展。     

林木抗病虫基因工程的现状和问题

本文综述了林木抗虫、抗病毒、抗细菌和抗真菌的基因工程的途径、研究现状及发展前景。并提出了林木抗病虫基因工程方面存在的问题。     

A Physician's Perspective on the Incorporation of Pictograms as a Supplement to Medical Instructions in Chile: A Pilot Study

Introduction and objectivesCurrent models of health care are progressively migrating to more participatory models, where for treatment to achieve results that last over time, there must be effective communication between the patient, his or her caregivers, and health professionals. Although the use of pictograms in the context of medical instructions has been widely studied, in our country, there are no studies about their usefulness, or which set of symbols should be used by the systems. This work aims to present the first step towards the development of platforms that automatically suggest pictograms to supplement medical instructions for primary care settings in Chile.Materials and methodsIn this pilot study, we collected and analyzed the physicians' opinions on the selection of medical instructions that later will automatically be supplemented by the software that is under construction. We designed an expert validation survey using a set of 66 medical instructions with pictograms. This survey provided three rating options for each medical instruction: Not necessary (supplementing the instruction with a pictogram does not carry any value), Useful (supplementing the instruction with a pictogram may help patients to understand and remember the instruction), and Essential (supplementing the instruction with a pictogram is essential). Seventy-one physicians responded to the survey.Results22 out of 66 medical instructions were considered “essential” by >=51% of the experts, and 12 of the 66 were considered to be “useful but not essential” by >=51% of the experts.ConclusionResults of our survey validate the potential use of pictograms as a complement to better comprehension of medical instructions in our country.