目的 分析病案库与Mini-CEX结合在神经内科教学中对学生职业能力影响.方法 选取2022年2—7月在齐齐哈尔医学院附属第一医院神经内科实习的60名2017级大五临床实习学生为研究对象;以自愿为原则进行分类,单一教学组30名,联合教学组30名;比较两组学生在实习后的Mini-CEX得分以及出科后的基础考核成绩与满意度.结果 培训后,联合教学组Mini-CEX考核得分以及理论成绩得分均高于单一教学组,差异有统计学意义(P<0.05);培训后,联合教学组的学生满意度96.67％明显高于单一教学组70.00％,差异有统计学意义(P<0.05).结论 通过病案库与Mini-CEX相结合的方案,可以明显提高实习学生的临床综合能力,培育临床思维与职业素养,有利于提高临床教学质量.

目的 探讨鹿茸多肽(VAP)32对Aβ25～35诱导的SH-SY5Y细胞阿尔茨海默病(AD)模型的建立及对其治疗作用.方法 以Aβ25～35诱导SH-SY5Y细胞,构建AD模型,分为正常(NOR)组,诱导(MOD)组和VAP32组.应用酶联免疫吸附试验(ELISA)检测丙二醛(MDA)水平及超氧化物歧化酶(SOD)酶活性.Western印迹测定BACE1与ADAM10的蛋白表达水平,RT-聚合酶链反应(PCR)检测p-JNK的基因表达水平.结果 0、50、100、200μg/ml VAP32加入后,随着培养时间的延长,细胞的活力差异无统计学意义(P>0.05).3组细胞凋亡率随时间的延长,均显著升高(均P<0.05).同一时间点,MOD组细胞凋亡率均显著高于NOR组和VAP32组(均P<0.05).与NOR组比较,MOD组SOD水平显著下降,而MDA水平显著上升(均P<0.05).与MOD组比较,VAP32组SOD水平显著上升,而MDA水平显著下降(均P<0.05).与NOR组p-JNK基因、BACE1表达水平比较,MOD组均显著升高(P<0.05),与MOD组比较,VAP32组均显著下降(P<0.05).与NOR组BACE1表达水平比较,MOD组显著升高,与MOD组BACE1表达水平比较,VAP32组显著下降(P<0.05).与NOR组ADAM10表达水平比较,NOD组显著下降,与MOD组ADAM10表达水平比较,VAP32组显著升高(P<0.05).结论 VAP32可治疗Aβ25～35诱导的AD.

OBJECTIVE To explore the clinical effect of chrono‐chemotherapy on patients with advanced small cell lung cancer so as to intensify the level of clinical diagnosis and treatment and extend the lives of the patients . METHODS A total of 130 patients with advanced small cell lung cancer who were treated from May 2010 to Aug 2013 were enrolled in the study and divided into two groups according to odd and even number of hospitalization , with 65 cases in each ;the control group was treated with conventional western medicine ,while the observation group was given the chrono‐chemotherapy ;the clinical effect and the incidence of infections were observed after the treatment .RESULTS As compared with the clinical effects ,the total effective rate was 33 .85% in the control group ,43 .08% in the observation group ;the progress rate was 44 .61% in the control group ,27 .69% in the ob‐servation group .As compared with the adverse reactions ,the incidence of leucopenia was 75 .38% in the control group ,50 .77% in the observation group ;the incidence of anemia was 47 .69% in the control group ,30 .77% in the observation group ;the incidence of thrombocytopenia was 63 .07% in the control group ,36 .92% in the obser‐vation group ;the incidence of nausea and vomiting was 69 .03% in the control group ,47 .7% in the control group ;the incidence of alopecia was 60 .00% in the control group ,3 .38% in the observation group ;the incidence of liver and kidney toxicity was 44 .61% in the control group ,30 .77% in the observation group ;the incidence of water and sodium retention was 23 .08% in the control group ,13 .85% in the observation group ;the incidence of infec‐tions was 33 .85% in the control group ,21 .54% in the observation group ,there was significant difference be‐tween the two groups (P<0 .05) .There was significant difference in the life quality score ,pain score ,length of hospital stay ,average survival time ,or immune function indicators between the two groups (P<0 .05) .CONCLUSION The chrono‐chemotherapy can improve the clinical effect ,reduce the incidence of infections ,and raise the life quality of the patients with advanced small cell lung cancer .

目的 探讨化疗联合重组人血管内皮抑制素治疗晚期非小细胞肺癌(NSCLC)的临床疗效.方法 将54例NSCLC患者随机分为观察组(28例)和对照组(26例),观察组患者采用长春瑞滨和奥沙利铂联合恩度方案治疗,对照组患者采用多烯紫杉醇和奥沙利铂联合恩度方案治疗,比较两组患者的治疗效果和不良反应.结果 54例患者均完成2个周期化疗后进行疗效评定,观察组无完全缓解(CR)患者,部分缓解(PR)13例,病情稳定(SD)11例,疾病进展(PD)4例,有效率(RR)为46.4％.对照组患者无完全缓解,(PR)5例,(SD)10例,(PD)11例,有效率为19.2％.两组有效率比较,差异有统计学意义(P＜0.05).两组患者的主要不良反应为白细胞减少、血小板减少和恶心呕吐.两组患者不良反应发生率比较,差异无统计学意义(P＞0.05).结论 长春瑞滨和奥沙利铂联合恩度治疗晚期NSCLC近期疗效显著,是一种安全、有效的治疗方案,值得临床进一步推广.

Objective To analyze the pathogen distribution of lower respiratory tract infection and drug resistance of bacteria in senile lung cancer patients.Methods Specimens isolated from 407 cases and their culture were studied for the susceptibility to antimicrobial agents by retrospective research.Results A total of 238 strains were obtained from lower respiratory tracts of senile lung cancer patients,including 163 strains(68.78%) of Gram negative bacteria,33 strains(13.87%) of Gram positive bacteria,and 42 strains(17.65%) of Fungi.The predominant pathogens were Klebsiella pneumoniae(36.73%) and Escherichia coli(28.85%) respectively.Conclusion Microecological disturbance occurred in senile lung cancer patients due to long-term use of antibiotics.Gram negative bacilli were the major pathogens and their drug resistance were increased.ESBLs strains isolated from Klebsiella pneumoniae and Escherichia coli were increased.All Gram positive bacteria were sensitive to Vancomycin.Drug resistance tests should be carried out so as to use antibiotics rationally and contol nosocomial infection.

目的 探讨糖尿病健康教育在治疗中的作用.方法 将100例脑梗死伴糖尿病患者随机分成两组,治疗组经过糖尿病+脑梗死健康教育,对照组只进行脑梗死健康教育进行对比.观察两组血糖控制率;新并发症发病率.结果 治疗组糖尿病患者血糖控制率;新并发症发病率与对照组相比有显著差异(P＜0.05).结论 脑梗死伴糖尿病患者施行糖尿病健康教育,可以很好的控制血糖、减少了并发症的发生和发展.糖尿病健康教育在脑梗死伴糖尿病病人治疗的作用至关重要.

目的观察紫龙金片联合化疗治疗中晚期非小细胞肺癌的临床疗效。方法将48例中晚期非小细胞肺癌患者随机分为2组:治疗组(25例)给予紫龙金片联合多西他赛加顺铂方案化疗,对照组(23例)给予单纯多西他赛加顺铂方案化疗。治疗2个周期进行疗效评价。结果治疗组在KPS评分、体质量、细胞免疫功能及化疗毒副作用方面与对照组比较差异有统计学意义(P<0.05)。结论紫龙金片联合化疗治疗非小细胞肺癌,可以改善患者的生活质量,减轻化疗的毒副作用。

目的探讨治疗脑梗死的有效方法。方法83例脑梗死患者随机分为两组,疏血通治疗组41例和血栓通对照组42例。治疗组静脉滴注疏血通6ml/d,对照组静脉滴注血栓通10ml/d,1次/d,14 d为1个疗程。结果治疗组总有效率为95.12%,对照组为78.57%,两组比较有显著性差异(P<0.05)。结论疏血通注射液治疗脑梗死的临床疗效显著。

Objective This study was designed to examine the impact of HIF-la expression,to reveal the relationship between its positive expression and postoperative radiotherapy of glioma and to find whether HIF-la could be a marker for predicting prognosis of glioma.Methods Immunohistochemistry streptavidin-peroxidase(S-P)was used to examine the expression of HIF-la in 52cases of glioma.Among them,18cases were postoperative radiotherapy and 34cases were operation only.Results The positive rate of HIF-la expression was 65.39%.The expressions of HIF-la were significantly correlated with the curative effect of postoperative radiotherapy.Conclusions The HIF-la gene may be activated by hypoxia,the over expression of HIF-la was quite important in glioma;HIF-la can be a marker for predicting prognosis of glioma.