LAMR1与PER1蛋白作用位点的筛选

目的：筛选出与PER1蛋白相互作用的LAMR1的核心位点。方法：采用盒式定点突变法,对重组目的质粒pGADT7-Rec/Lamr1201-295的插入片段Lamr1201-295羧基末端的205-216氨基酸序列RDPEEIEKEEQA进行定点突变,并以hPER1蛋白的bHLH-PAS结构域为诱饵蛋白,通过酵母双杂交系统确定这4种不同的突变LAMR1201-295片段与hPER1的相互作用。结果：营养缺陷培养基筛选显示4种转化菌在二缺SD/-Leu/-Trp、三缺SD/-His/-Leu/-Trp和四缺SD/-Ade/-His/-Leu/-Trp固体培养基上都可以生长;β-半乳糖苷酶印膜法检测结果显示4种转化菌均可显色。结论：突变片段LAMR1-RDP,LAMR1-EEI,LAMR1-EKE和LAMR1-EQA都能够与hPER1的bHLH-PAS结构域在酵母中发生相互作用。提示LAMR1的205-216Aa可能不是其与hPER1相互作用的核心氨基酸序列。     

浅析临床输血不规范行为的对策及方法

目的:总结分析出临床输血中不规范的行为,并提出有效的解决对策与方法,从而降低临床输血安全隐患风险。方法:随机抽取我院100份输血病历,查看其护理输血病程及记录,统计分析出临床输血不规范行为。结果:经过统计分析,我院临床护理人员存在查对制度执行不严、血液在室温放置时间过久、不重视输血过程前15分钟观察、不正确的血液加温方法、不正确的加压输血等不规范的输液行为。结论:在临床输血过程中依然存在大量不规范行为,只有对不规范行为进行改正,才能避免临床输血安全隐患,保障患者生命安全,提高护理质量,减少医患纠纷,构建和谐的医患关系。     

门诊患者投诉“全记录”及其根本原因分析

目的 建立门诊患者投诉“全记录”制度,引入组织学习机制,不断改进服务质量。方法 2010年1—12月,在某门诊部记录所有患者的口头和书面投诉,对被记录的事件进行根本原因分析。结果（1）门诊投诉率为0.27‰;（2）平均每22.3例投诉就包含1例对患者造成直接身体伤害的事件;（3）大多数投诉涉及到个人,医生被投诉率最高,为44%;（4）被投诉3次及以上的医生占医生总数的17.6%,与其相关的投诉案例占总投诉量的20.9%。结论 尽管患者倾向于投诉个人,但是造成问题的原因主要依然归结于系统因素。建立门诊患者投诉“全记录”制度有利于早期发现患者安全隐患,加强针对系统的患者安全保障措施。

     

非医疗技术因素对门诊患者满意度的调查与分析

?????? 目的 了解门诊患者对于非医疗技术服务的满意度现状,探讨影响门诊患者满意度的非技术因素。方法 对广州市某三甲医院2012年3—6月就诊的208名门诊患者进行问卷调查。结果 与“等候时间”、“诊疗费用”相关的满意度水平显著低于“服务态度”、“环境设施”类,且满意度水平存在着社会人口学差异。结论 医院应注重非医疗技术服务的改进,可从营造舒适就诊环境、加强医患沟通、降低医疗费用及合理门诊布局等方面入手。同时,优化门诊预约服务可有效提高门诊患者满意度。     

眼科门诊患者的护理管理

眼睛是心灵的窗口,眼睛健康对于每个人都非常重要。对眼科门诊患者的护理管理是专科护理的重要内容。眼科门诊的特点是：患者诊疗数量大,时间比较集中,检查和治疗项目多,许多问题需要在短时间内解决。因此,护理人员必需具备眼科常见的基本知识,熟练掌握专科护理技能。     

5436 例性病门诊患者流行病学调查及心理状况分析

目的:调查本地区5436例性病(STD)门诊患者流行病学特征,并对患者心理状况进行分析。方法:对2012年1月~2014年12月本地区3家医院性病门诊5436例患者(观察组)的5种生殖器疱疹(GH)、生殖道衣原体感染(GCI)、尖锐湿疣(CA)、淋病(GU)、梅毒(SYP)常见性传播疾病的基本情况、流行病学特征进行记录分析。采用自制心理测评量表对其中250例STD患者的心理状况进行评估,并与250例同期门诊治疗的一般感冒患者(对照组)进行比较。结果:2012~2014年门诊5种常见STD患者就诊人数呈上升趋势,以GU下降最为明显,GCI逐渐上升较为明显;STD患者发病主要集中于26~35岁,以司机、低学历及未婚人群居多。心理测评结果显示,STD患者的抑郁、焦虑、回避治疗、性欲障碍等因子分均高于对照组,差异有统计学意义(P0.05);交往障碍、社会攻击等因子分与对照组比较差异无统计学意义(P0.05)。结论:本地区STD患病以性活跃年龄人群、司机、学历低及未婚人群为主,临床上治疗性病的同时,应重视STD患者的心理健康。     

门诊处方合理用药国际指标调研与分析

目的 根据合理用药国际指标和补充指标调研,分析门诊合理用药情况。方法 用合理用药国际指标和补充指标,对白银市第一人民医院2010年1—12月门诊处方进行调研,并统计、分析。结果 平均每张处方用药品种数为3.04种,抗菌药物使用率为25.82%,注射剂使用率为22.11%,通用名使用率为98.47%,抗菌药物的金额占处方总金额的百分率为28.81%,处方平均金额为47.65元。结论 采用合理用药国际指标评价医院门诊用药基本合理。     

上海市某区2009年社区卫生服务中心门诊用药状况分析

分析了上海市某区2009年各社区卫生服务中心门诊用药状况,从A区医院信息系统中提取所有社区卫生服务中心2009年门诊诊疗及西药、中成药的处方信息,并对门诊用药情况进行了评价。结果显示：2009年12所医疗机构门诊处方的平均药费、平均药物数、门诊药物次均费用分别为77.11元、2.30种、33.57元/药次。门诊处方中,诊断最多的是高血压,抗菌药物、针剂、基本药物使用次数比例分别是13.06%,15.03%,39.25%。总体而言,社区卫生服务中心门诊用药基本合理。

     

海捷亚联合倍他乐克治疗老年原发性高血压40例临床观察

目的:观察海捷亚联合倍他乐克治疗老年原发性高血压的疗效。方法:80例老年原发性高血压患者随机分成治疗组和对照组,治疗组使用海捷亚联合倍他乐克、对照组仅使用海捷亚连续治疗8周,并于用药后第2、4、6、8周测定所有患者收缩压和舒张压。结果:用药后,治疗组血压下降明显(P＜0．01);与同一时期对照组相比,用药后第2、4、6、8周治疗组收缩压和舒张压均偏低,差异具有显著性(P＜0．01)。结论:海捷亚联合倍他乐克治疗老年性高血压明显优于单纯运用海捷亚治疗,建议临床推广应用。     

音乐干预改善门诊痔疮手术患者心理状态临床研究

目的:探讨门诊手术室应用音乐干预护理痔疮手术患者的临床效果.方法:选取痔疮手术患者72例,随机分为试验组和对照组,各36例.对照组给予常规护理,试验组在对照组基础上进行音乐干预,观察2组患者生理指标的变化及疼痛的发生情况,并采用焦虑自评量表(SAS)评估两组患者焦虑情况.结果:试验组实施干预后,心率、血压、血浆皮质醇浓度低于对照组(P＜0.05),术中疼痛程度低于对照组(P＜0.01);试验组SAS评分明显低于干预前(P＜0.01),对照组治疗前后SAS评分比较无显著差异(P＞0.05),试验组干预后gAS评分低于对照组(P＜0.01).结论:门诊痔疮手术患者采用音乐干预,能缓解患者的紧张心理,减少术中并发症,有利于手术的顺利进行.     

Clock Genes Display Rhythmic Expression in Human Hearts

Thus far, clock genes in the heart have been described only in rodents, and alterations of these genes have been associated with various myocardial malfunctions. In this study, we analyzed the expression of clock genes in human hearts. Left papillary muscles of 16 patients with coronary heart disease, 39 subjects with cardiomyopathy, and 9 healthy donors (52 males and 12 females, mean age 55.7±11.2; 16–70 yrs) were obtained during orthotopic heart transplantation. We assessed the mRNA levels of PER1, PER2, BMAL1, and CRY1 by real time PCR and analyzed their rhythmic expression by sliding means and Cosinor functions. Furthermore, we sought for differences between the three groups (by ANOVAs) for both the total 24 h period and separate time bins. All four clock genes were expressed in human hearts. The acrophases (circadian rhythm peak time) of the PER mRNAs occurred in the morning (PER1: 07:44 h [peak level 187% higher than trough, p?=?.008]; PER2: 09:42 h [peak 254% higher than trough, p?<?.0001], and BMAL1 mRNA in the evening at 21:44 h [peak 438% higher than trough; p?<?.0001]. No differences were found in the rhythmic patterns between the three groups. No circadian rhythm was detected in CRY1 mRNA in any group. PER1, PER2, and BMAL1 mRNAs revealed clear circadian rhythms in the human heart, with their staging being in antiphase to those in rodents. The circadian amplitudes of the mRNA clock gene levels in heart tissue are more distinct than in any other human tissue so far investigated. The acrophase of the myocardial PER mRNAs and the trough of the myocardial BMAL1 coincide to the time of day of most frequent myocardial incidents.     

Association of a nonsynonymous polymorphism in PER 1 with diurnal preference in Korean adults

No nonsynonymous single-nucleotide polymorphism (SNP) in PER1 has been reported with respect to diurnal preference. We aimed to determine whether a functional polymorphism in PER1 is involved in diurnal preference. Forty-seven morning-type (MT, age: 44.57 ± 12.33 years), 59 neither-type (NT, age: 35.20 ± 9.53 years), and 50 evening-type (ET, age: 28.96 ± 8.03 years) subjects were included in the final analysis. A synonymous (PER1 2485 C/T, rs2735611) and nonsynonymous (PER1 2495 G/T, rs138577469) polymorphism at 10-bp away from the PER1 2485 C/T were investigated as candidate SNPs. For the PER1 2485C/T SNP, no significant genotype distribution was observed among the three groups. For the PER1 2495G/T, the MT group showed significantly higher genotype distribution, T allele frequency, and proportion of T allele-positive subjects when compared to the combined group of NT and ET. Our findings suggest that a nonsynonymous polymorphism in PER1, which has only been found in Korean adults, is associated with morning preference.     

The median preoptic nucleus exhibits circadian regulation and is involved in food anticipatory activity in rabbit pups

Rabbit pups are a natural model to study food anticipatory activity (FAA). Recently, we reported that three areas in the forebrain – the organum vasculosum of lamina terminalis, median preoptic nucleus (MnPO) and medial preoptic area – exhibit activation during FAA. Here, we examined the PER1 protein profile of these three forebrain regions in both nursed and fasted subjects. We found robust PER1 oscillations in the MnPO in nursed subjects, with high PER1 levels during FAA that persisted in fasted subjects. In conclusion, our data indicate that periodic nursing is a strong signal for PER1 oscillations in MnPO and future experiments are warranted to explore the specific role of this area in FAA.     

Impact of Ataxin-2 knock out on circadian locomotor behavior and PER immunoreaction in the SCN of mice

In Drosophila melanogaster, Ataxin-2 is a crucial activator of Period and is involved in the control of circadian rhythms. However, in mammals the function of Ataxin-2 is unknown despite its involvement in the inherited neurogenerative disease Spinocerebellar Ataxia type 2 in humans. Therefore, we analyzed locomotor behavior of Atxn2-deficient mice and their WT littermates under entrained- and free-running conditions as well as after experimental jet lag. Furthermore, we compared the PER1 and PER2 immunoreaction (IR) in the SCN. Atxn2^?/? mice showed an unstable rhythmicity of locomotor activity, but the level of PER1 and PER2 IR in the SCN did not differ between genotypes.     

Analysis of Synonymous Codon Usage Bias in 09H1N1

A novel subtype of influenza A virus 09H1N1 has rapidly spread across the world. Evolutionary analyses of this virus have revealed that 09H1N1 is a triple reassortant of segments from swine, avian and human influenza viruses. In this study, we investigated factors shaping the codon usage bias of 09H1N1 and carried out cluster analysis of 60 strains of influenza A virus from different subtypes based on their codon usage bias. We discovered that more preferentially used codons of 09H1N1 are A-ended or U-ended...     

Haloperidol,but not olanzapine,may affect expression of PER1 and CRY1 genes in human glioblastoma cell line

Background: There is barely any evidence of antipsychotic drugs affecting the molecular clockwork in human, yet it is suggested that clock genes are associated with dopaminergic transmission, i.e. the main target of this therapeutics. We decided to verify if haloperidol and olanzapine affect expression of CLOCK, BMAL1, PER1 and CRY1 in a human central nervous system cell line model. Methods: U-87MG human glioblastoma cell line was used as an experimental model. The cells were incubated with or without haloperidol and olanzapine in the concentration of 5 and 20 μM for 24 h. Real-time quantitative polymerase chain reaction with the ΔC_T analysis was used to examine the effect of haloperidol and olanzapine on the mRNA expression of the genes. Results: At 5 μM, haloperidol decreased expression of CRY1 almost 20-fold. There was nearly a 1.5-fold increase in expression of PER1. Considering the 20 μM haloperidol concentration and both olanzapine concentrations, no other statistically significant effect was observed. Conclusions: At certain concentration, haloperidol seems to affect expression of particular clock genes in a human central nervous system cell line model, yet mechanism underlying this phenomenon remains elusive.