计算机在医学领域中的应用及展望

对计算机在医学文献检索、医学统计软件包的编制、疾病诊断、医院管理等医学领域中的应用作了简要的综述，并对未来的发展进行了预测。     

解脲脲原体与自然流产关系的探讨

采用聚合酶链反应技术对３２例自然流产患者的宫颈粘液及其中２２例清宫组织进行解脲脲原体（ＵＵ）检测，并与３０例人工流产妇女比较。结果表明：自然流产与ＵＵ寄生于宫颈无关（Ｐ＞０．０５），与宫内感染ＵＵ明显相关（Ｐ＜０．０５）。     

季节因素对医疗卫生服务需求和利用的影响

本文通过对朝阳门社医连续性卫生服务调查的资料分析，探讨季节因素对医疗卫生服务供需的影响及连续性卫生服务调查方法在我国城市社医的应用。研究结果可为其他断面性卫生服务调查的数据调整提供依据。     

Harvey Cushing's postoperative sketches of pediatric brain tumors

Harvey Cushing was a man of many talents. Not only was he a premier surgeon and scientist, but a prolific author and artist as well. In this paper, we present two postoperative sketches of pediatric brain tumors drawn by Dr. Cushing. These sketches are representative of drawings which accompany many of his operative notes at the Peter Bent Brigham Hospital. About 25% of Cushing's surgical sketches depict operations performed on children. The most commonly drawn childhood tumors were craniopharyngiomas and gliomas of the brain stem and cerebellum. These drawings reveal how Cushing maintained detailed records of his surgical experience. It is clearly evident from these records that Dr. Cushing gained substantial experience in the treatment of pediatric brain tumors.     

医疗器械包装设计浅谈

本文介绍了医疗器械之无菌包装系统的设计之关键要素和要求,介绍了目前流行的灭菌方式以及对无菌包装系统的要求和影响。本文最后还列举了常见的医疗器械包装系统。     

A Subset of Patients With Recurrent Spontaneous Abortion Is Deficient in Transforming Growth Factor β-2-Producing “Suppressor Cells” in Uterine Tissue Near the Placental Attachment Site

PROBLEM : To determine if patients with unexplained recurrent miscarriage have a deficiency of decidual immunosuppressor cells that produce transforming growth factor β type 2, as has been found in mice with abortion due to rejection and/or trophoblast failure. METHODS : Decidual biopsy specimens were taken as near to the placental attachment site as possible under ultrasound guidance from first trimester legal termination (control) patients with recurrent miscarriage and non-viable pregnancy, and from patients with sporadic missed abortion. The tissue was tested for TGFβ-2⁺ suppressor cells by in situ hybridization, immunohistochemistry, and analysis of supernatants. RESULTS : TGFβ-2-related suppressor molecules similar but not identical to those identified in pregnant mice were released by decidual lymphoid cells. Fifty percent of 14 recurrent miscarriage patients showed a lack of suppressor cells and 59% were subnormal in comparison to 20 controls and 5 sporadic miscarriage patients, where 80–85% of the patients had detectable suppressor cells. CONCLUSIONS : Suppressor cell deficiency is compatible with a role for rejection and/or trophoblast failure in some patients with recurrent miscarriage. Presence of suppressor cells in most patients with missed abortion (4/5) is compatible with an alternative cause of fetal death, similar to findings reported in genetic fetal death mice.     

我国医疗保障制度改革中医院配套改革措施探讨

论述了医疗保障制度改革给医院带来的机遇与挑战,认为医院应采取调整结构,转换运行机制;完善补偿机制;加大宏观调控力度,制订和实施区域卫生规划等配套措施,来适应医疗保障制度的改革。     

Molecular interactions during pregnancy: Association between mannan binding protein deficiency and recurrent miscarriage

The distribution of mannan binding protein (MBP) in blood donorsera was determined by enzyme-linked immunosorbent assay toestablish normal concentrations. Abnormally low MBP concentrationswere found in 16% (21 out of 135) of female partners and 14%(15 out of 108) of male partners of couples experiencing recurrentmiscarriage, compared with <5% of obstetrically normal controls(P < 0.005). This relationship was even stronger (9.5 versus1.0%) and more significant (P < 0.002) when only subjectspresumed to be homozygous for the mutant allele responsiblefor MBP deficiency were considered. By immunohistochemistry,MBP could be demonstrated in first trimester placenta. We suggestthat low concentrations of MBP within the feto-placental unitincrease susceptibility to fetal loss, possibly via an infection-inducedplacental cytokine imbalance.     

分级诊疗背景下多病共存患者就医机构选择行为及其影响因素研究

背景 近年来,国内针对多病共存患者在分级诊疗背景下就医机构选择行为的研究较少,研究多病共存患者的就医机构选择行为有重要的现实意义。目的 以分级诊疗为视角,分析多病共存患者就医机构选择行为及其影响因素,为进一步落实分级诊疗制度和合理配置医疗资源提供研究参考。方法 采用随机抽样法,选取2019-06-01至2020-01-01在上海市杨浦区中心医院医疗联合体（上海市杨浦区中心医院和上海市杨浦区定海、延吉、长白社区卫生服务中心）就诊的多病共存患者为研究对象。采用自设问卷对其进行调查,收集多病共存患者的一般资料,了解其对分级诊疗政策的认知情况及实际遵守情况、在不同疾病控制状况下至社区卫生服务中心首诊的意愿,以及其选择就诊医疗机构时考虑的因素等。采用二分类Logistic回归分析多病共存患者此次因病就医是否选择至社区卫生服务中心首诊的影响因素。结果 共发放1 100份问卷,回收有效问卷1 072份,有效问卷回收率为97.45%。1 072例多病共存患者中,老年（≥60岁）多病共存患者占85.07%(912/1 072)。624例（58.21%）患者表示知晓分级诊疗制度;940例（87.69%）患...     

On a relaxation-labelling algorithm for quantitative assessment of tumour vasculature in tissue section images

Although tumour vasculature constitutes a biological factor playing a crucial role in the radiation response of tumours, the current procedures of assessment are semiquantitative, typically employing visual examination of stained histological material. Such techniques are also time consuming, and inefficient of extracting essential information on the vascular network. Image analysis has yet to contribute significantly in this direction, and most studies to date focus on blood vessel segmentation through empirical, user-selected thresholds. The present paper proposes an alternative segmentation approach, based on a probabilistic relaxation algorithm, applied in microscopic images of stained tissues. After image partitioning various information is obtained, such as vascular domains and geometrical characteristics of vessels.