北京市暗娼人群生殖道感染影响因素分析

目的 了解暗娼人群生殖道感染症状发生率及其影响因素,以便评估暗娼人群健康需求.方法 根据<国家级HIV综合监测点监测方案>,于2006-2008年对北京市可能提供商业性性服务的娱乐休闲场所进行分层随机抽样,采用一对一方式,对其中的暗娼进行问卷调查.结果 2006,2007,2008年北京市暗娼人群生殖道感染症状发生率分别为46.9%,37.1%,37.3%;首次商业性服务年龄(OR=0.97)、最近1个月商业性行为坚持用安全套(OR=0.77)、最近1周嫖客人数≥7个(OR=1.19)、与固定性伴最近1个月性行为有时使用安全套者(OR=1.23),与固定性伴最近1个月性行为时每次都不使用安全套(OR=1.35)、最近1个月曾冲洗阴道(OR=1.75)、同居(OR=1.35)等因素与暗娼发生生殖道感染症状有关.结论 暗娼人群中生殖道感染症状发生率较高,存在着较大的医疗卫生服务需求.     

肺透明膜病早产儿尸检肺组织肺表面活性蛋白-C及Ki67的表达

Objective To determine the expression of surfactant protein-c (SP-C) and Ki67 in autopsy lung tissues of premature infants died of hyaline membrane disease (HMD) who were exposed to mechanical ventilation and high oxygen concentrations/pulmonary surfactant (PS). The possible influence of surfactant on the expression of SP-C and Ki67 was also investigated. Methods Thirty preterm infants diagnosed as HMD by clinical data and pathology were selected. Mechanical ventilation and supplemental oxygen (FiO2 0.6-1.0) were given to these infants within 6 hours after birth. According to the duration of ventilation at high oxygen concentrations, all subjects were diveded into four groups: ventilation for 1-3 days, 4-8 days, 9-16 days and >16 days. Five premature infants died within 1 day after delivery for none pulmonary reasons served as controls. The expression of SP-C and Ki67 in lungs were detected by immunobistochemistry. Results The pulmonary pathology in these HMD infants at different phases was consisitent with the main features of different stages during the progress from HMD towards bronchopulmonary dysplasia. The positive staining of SP-C was restricted to type Ⅱ alveolar epithelial cells, and Ki67 positive were preferentially localized in nuclei of alveolar and bronchiolar epithelial cells and fihroblasts. Compared with the control group, the expression of SP-C and Ki67 in HMD infants decreased significantly after 1-3 days of ventialation, but increased after 4 days and reached the peak value after 9-16 days. The expression of SP-C and Ki67 in control group, 1-3 days and 9-16 days of ventialation were 0. 1891±0. 0253, 0. 1576±0. 0327 and 0. 2271±0. 0238 for SP-C and 0. 2297±0. 0380, 0.1929±0. 0403 and 0. 2849±0. 0368 for Ki67, respectively. No significant difference in the expression of SP-C and Ki67 was found between infants treated with PS and those without (P>0.05). Conclusions SP-C and Ki67 may have participated in the pulmonary pathological process in ventilated/oxygen treated preterm infants with HMD, and exogenous surfactant had no effect on the expression of SP-C and Ki67.     

激励理论在护理管理中的应用

建立激励管理新理念，提升护理管理者的管理水平，调动全体护士参与护理质量管理，培养她们积极向上的工作作风，激发其工作潜能，最大限度地调动被管者的积极性、主动性和创造性，有效地提高护理服务质量和患者满意度。     

高氧对早产新生大鼠肺组织细胞色素b、三磷酸腺苷合成酶6表达的影响

目的探讨高浓度氧暴露对早产新生大鼠肺组织细胞色素b(Cyt b)、ATP合成酶6(ATPase 6)动态表达的影响。方法早产新生SD大鼠生后1 d随机分为空气组、高氧组。高氧组持续暴露于常压氧舱中,氧质量浓度>85%;空气组置于同一室常压空气中。两组分别于高氧或空气暴露后1、4、7、101、4 d提取肺组织RNA,采取半定量逆转录聚合酶链反应(RT-PCR)测定Cyt b、ATPase 6 mRNA表达;应用免疫组化方法检测肺组织切片Cyt b。结果1.与空气组比较,高氧暴露14、d Cyt b mRNA含量及其表达显著增强(P<0.05);7 d后Cyt b呈下降趋势,其表达较空气组减弱,但两者比较无显著性差异(P>0.05)。2.高氧组与空气组比较,ATPase 6 mRNA表达于1 d时显著增强(P<0.05),4 d虽无显著改变(P>0.05)但仍增强;7、10 d时减弱;14 d又极显著增强(P<0.01)。3.随日龄变化高氧暴露后,肺组织Cyt b免疫组化结果与Cyt b mRNA表达相似。与空气组比较,高氧暴露14、d肺组织Cyt b表达显著增强(P<0.05);7 d后Cyt b呈渐下降趋势,其表达较空气组减弱,但7、10 d两者比较无显著性差异,14 d极显著减弱。结论线粒体呼吸链中Cyt b、ATPase 6在肺发育中起重要作用。高氧诱导线粒体呼吸链中Cyt b、AT-Pase 6结构和功能改变,导致氧化磷酸化解耦联,参与高氧肺损伤的发病机制。     

维甲酸通过MAPKs信号通路减轻早产大鼠AECⅡ高氧性损伤

 目的： 探讨高氧暴露对原代培养的早产大鼠肺泡Ⅱ型上皮细胞（AECⅡ）增殖和凋亡的影响以及维甲酸（RA）的保护作用机制。方法：建立原代培养的早产大鼠高氧暴露AECⅡ模型，采用流式细胞术（Annexin V-PI双标记）检测AECⅡ凋亡，Western blotting检测其磷酸化和总的ERK1/2、JNK1/2和p38表达以及增殖细胞核抗原（PCNA）和caspase-3表达。结果：高氧暴露12 h，Annexin Ⅴ（+）PI（-）和Annexin Ⅴ（+）PI（+）标记的AECⅡ数均显著高于空气组（P<0.01），RA具有明显下调作用；同时，高氧暴露显著提高AECⅡ 磷酸化ERK1/2、JNK1/2和p38表达以及caspase-3活性片段表达（P<0.01），明显降低其PCNA表达（P<0.01）；RA则显著下调高氧暴露下AECⅡ磷酸化JNK1/2和p38表达以及caspase-3活化片段表达（P<0.01），明显提高磷酸化ERK1/2和PCNA表达（P<0.01）。结论：高氧暴露，导致AECⅡ大量凋亡、坏死，增殖受到抑制；RA通过下调JNK1/2和p38磷酸化水平、上调ERK1/2磷酸化水平，降低AECⅡ坏死、凋亡，促进其增殖，从而发挥拮抗高氧肺损伤的作用。     

病毒载量检测鉴别诊断HIV早期感染

目的 研究病毒载量检测在鉴别诊断HIV早期感染中的应用.方法 对13份HIV抗体检测结果高度提示为早期感染的样本进行病毒载量检测,并对这些个体进行随访和抗体检测以证实其感染状况.结果 13份样本中,有12份病毒载量阳性,随访确定1例HIV抗体阳性婴幼儿感染者,11例窗口期感染者;1例HIV抗体呈阳性的婴幼儿,病毒载量阴性,随访证实未感染.病毒载量检测结果与最终的感染状况相符.结论 通过病毒载量检测能够有效鉴别诊断早期感染中的婴幼儿感染(18个月以内抗体呈阳性)和窗口期感染者.病毒载量检测可以作为HIV感染早期不确定样本的诊断依据.     

早期干预对中重度新生儿缺氧缺血性脑病预后的影响

探讨早期干预对中、重度新生儿缺氧缺血性脑病(HIE)预后的影响。方法：将36例中重度HIE患儿分为早期干预组20例和非干预组15例。对早期干预组从1个月起接受以家庭为中心的早期训练至24个月，所有病例均于生后每隔3～6月进行智能发育检测。结果：早期干预组12月、18月、24个月时智力发育指数(MDI)、运动发育指数(PDI)比非干预组高(P(0．01)，干预组预后不良发生率10．0％．而非干预组为33．3％。提示早期干预可促进HIE患儿智力及体格发育，有效地防治HIE所致的后遗症。     

儿童传染性非典型肺炎病例流行病学分析

传染性非典型肺炎(Infectious Atypical Pneumonia，IAP)，WHO称为严重的急性呼吸综合征(Severe Acute Respiratory Syndromes，SARS)，是一种由新型冠状病毒引起的以肺炎为主要临床表现的呼吸道传染病。由于“传染性非典型肺炎”是一种新发现的传染性疾病，它在儿童中的感染率水平、感染来源目前尚无定论。本文通过对15岁以下患者流行病学分析，旨在探索该病在此类人群的分布特点，为今后相关防治策略的制定提供科学依据。     

肺透明膜病早产儿尸检肺组织肺表面活性蛋白-C及Ki67的表达

Objective To determine the expression of surfactant protein-c (SP-C) and Ki67 in autopsy lung tissues of premature infants died of hyaline membrane disease (HMD) who were exposed to mechanical ventilation and high oxygen concentrations/pulmonary surfactant (PS). The possible influence of surfactant on the expression of SP-C and Ki67 was also investigated. Methods Thirty preterm infants diagnosed as HMD by clinical data and pathology were selected. Mechanical ventilation and supplemental oxygen (FiO2 0.6-1.0) were given to these infants within 6 hours after birth. According to the duration of ventilation at high oxygen concentrations, all subjects were diveded into four groups: ventilation for 1-3 days, 4-8 days, 9-16 days and >16 days. Five premature infants died within 1 day after delivery for none pulmonary reasons served as controls. The expression of SP-C and Ki67 in lungs were detected by immunobistochemistry. Results The pulmonary pathology in these HMD infants at different phases was consisitent with the main features of different stages during the progress from HMD towards bronchopulmonary dysplasia. The positive staining of SP-C was restricted to type Ⅱ alveolar epithelial cells, and Ki67 positive were preferentially localized in nuclei of alveolar and bronchiolar epithelial cells and fihroblasts. Compared with the control group, the expression of SP-C and Ki67 in HMD infants decreased significantly after 1-3 days of ventialation, but increased after 4 days and reached the peak value after 9-16 days. The expression of SP-C and Ki67 in control group, 1-3 days and 9-16 days of ventialation were 0. 1891±0. 0253, 0. 1576±0. 0327 and 0. 2271±0. 0238 for SP-C and 0. 2297±0. 0380, 0.1929±0. 0403 and 0. 2849±0. 0368 for Ki67, respectively. No significant difference in the expression of SP-C and Ki67 was found between infants treated with PS and those without (P>0.05). Conclusions SP-C and Ki67 may have participated in the pulmonary pathological process in ventilated/oxygen treated preterm infants with HMD, and exogenous surfactant had no effect on the expression of SP-C and Ki67.