目的 探讨穿心莲内酯(AG)对人骨肉瘤细胞的影响及其分子机制.方法 分别以含有AG为0、5、10、20、50、100μmol/L(A、B、C、D、E、F组)的培养基培养人骨肉瘤细胞,倒置显微镜下计数各组细胞数,并计算各组细胞密度及细胞生存率;采用平板克隆实验观察AG对人骨肉瘤HOS和U2OS细胞增殖能力的影响;Transwell小室实验观察AG对人骨肉瘤HOS和U2OS细胞侵袭和迁移能力的影响;流式细胞术观察AG对人骨肉瘤HOS和U2 OS细胞周期分布的影响;Western Blot实验检测AG对鞘氨醇激酶(SphK1)以及黏着斑激酶(FAK)表达水平的影响.结果 组别、时间以及组别与时间交互作用均对人骨肉瘤HOS和U2OS细胞的生存率具有明显影响(F组别=9608.52、5409.49,F时间=8312.14、352.91,F时间?组别=18.06、3.55,P<0.05);使增殖能力呈浓度依赖性降低(FHOS=97.41,FU2OS=174.13,P<0.05);侵袭和迁移能力明显减弱(t=39.06～135.96,P<0.05);组别、周期及组别与周期交互作用均对人骨肉瘤HOS和U2OS细胞的细胞周期分布具有明显影响(F组别=35.05、8.24,F周期=3211.19、192.49,F周期?组别=75.96、140.97,P<0.05);SphK1和FAK的表达水平均下调(t=15.94～95.79,P<0.05).结论 AG对人骨肉瘤细胞有杀伤作用,其可能与AG影响SphK1信号通路有关.

Objective To explore the default mode network (DMN) of nonlesional epilepsy (NLE) patients using resting state functional MRI (rs-fMRI).Methods Clinical and rs-fMRI data of 20 patients with NLE and 22 normal volunteers were collected.Applying functional connectivity analysis,the DMN of two groups was observed and analyzed.Results Compared with normal control group,in NLE patients,the increased areas of brain region were in the right and left middle frontal gyrus,right and precentral gyrus,right postcentral gyrus,right and left middle temporal gyrus,left supramarginal gyrus and left tonsil of cerebellum.The weakened areas were in the right superior frontal gyrus,right angular gyrus,right precuneus and right anterior cingutate.Conclusion Under the resting state,default mode network function connection in nonlesional epilepsy patients exception occurs,the reasons might due to extensive brain damage-temporal lobe,frontal lobe,parietal lobe,precuneus and Iimbic lobe-caused by long-term abnormal discharge.

新媒体发展为医院宣传工作带来了新的契机与挑战,如何灵活运用新媒体这把"双刃剑"创新医院宣传是本文需要探讨的问题.

自2013年开始,青岛大学医学院附属医院实施“无障碍就医”以来,医院在各个方面都取得了显著成效.文章通过对“无障碍就医”工程实施的动因、意义、主要做法和成效进行剖析,为公立医院探索内部管理方式改革,实现患者便捷就医、安全就医的目标,缓解群众“看病难、看病贵”问题提供了有益的借鉴.

Objectives: To investigate training demands of hospital management staff and to give evidence on training. Methods: Questionnaire, Goldstein analysis model and gap analysis model were used for demands analysis from the aspects of organization, task point and individual. Results: Organizational analysis revealed the necessity and feasibility of training for managerial personnel in hospital. Task analysis identified 15 post competencies which were in urgent need of ascension by training, such as executive ability, detail management ability, innovation capability, etc. Personal analysis showed that 96.8 % of the managerial personnel needed for management training. The training contents with high approval rates were hospital culture, innovation awareness, strategy and target management, team construction, detail management, communication skills and medical quality management. The training ways with high approval rates were communication between units, teaching, experiences exchange and case analysis. The universal training forms were short-term intensive training and regular planned training. Conclusion: Training requirements analysis provided scientific basis for making training plans for managerial personnel and laid a good foundation for conducting training work.

Objective To establish scientific and reasonable head nurse management training system for improving their management level.Methods The questionnaire survey was carried on 76 head nurses.Goldstein analysis model and gap analysis model were used for training requirements analysis from organizational point,task point and personal point.The methods of pre-investigation and expert interview were adopted for training effect evaluation index system design.The indexes were screened by applying Delphi method.Analytic Hierarchy Process was used to set weight coefficient of each index.Results Training requirements analysis revealed the hospital management status and existing training needs,identified 7 post competencies of head nurses which were in urgent need of ascension by training,and made sure their training will,ideal training content,time and ways.On the basis of training needs analysis,the head nurse management training programs and courses were designed,which included 4 levels,11 Class Ⅰ indexes and 54 Class Ⅱ indexes.Conclusions The head nurse management training system is systematic,valid and feasible,which can provide scientific orientation for head nurse management training work.

Objective To establish scientific and reasonable evaluation index system of hospital management training effect.Method The methods of pre-investigation and expert interview were adopted for index system design.The indexes were screened by applying Delphi method.Analytic Hierarchy Process(AHP)was used to set weight coefficient of each index.Result The system included 4 levels,11 ClassⅠ indexes and 54 ClassⅡ indexes.The weight of indexes were identified,CR0.100.The respond rates of two-round questionnaire were all higher than 90%.The authority coefficient of experts was beyond 0.8.The indexes variation coefficient were 0.08 ～ 0.22.Coefficient of Kendall's W was significant by inspection(P0.001).Conclusion Hospital management training effect evaluation index system has a clear hierarchical structure,moderate number of indicators,reasonably stable weight and good workability,which can work as an effective tool for training effect evaluation.

Starting from organization supervision and management,guiding mechanism,plan generation mechanism,the mechanism of training and operating management,the mechanism of effect evaluation and the mechanism of training safeguard,the writers analyze the existing problems in present training mechanism,put forward the goals of hospital management training,discuss the principles of training practice and make a deeper probe into the ways of creation and the improvement in hospital management training.

Objective To investigate the roles of connexin43(Cx43) expression in the pathogenesis of different kinds of erectile dysfunction(ED).Methods Total of 125 Wister rats were divided into DM factor group(n=35),vessel factor group(n=31),nerve factor group(n=28)and control group(n=31),the former three groups were made experimental models of DM by injecting intraperitoneally with streptozotocin(STZ),ligaturing internal iliac artery,dissociating and cutting off the cavernous nerves.Penile erection of the rat models were observed by apomorphine test 3 weeks after the moulding;The CX43 expression was examined with immunohistochemistry method,on the 8 th,12 th and 16 th week from the 4 th day of STZ injection.Results The ratio and frequency of erection in the former three groups were significantly lower than those in the control group,the Cx43 expression level was significantly lower than that in the control group(P0.01),especially in the DM factor group(P0.05).Conclusions The decrease of Cx43 expression play important roles in ED caused by different factors,especially in DM-associated ED.

我国医药卫生体制改革及医院管理的发展新趋势,对医院管理人员的素质水平和职业化程度提出了更高的要求.由于目前我国医院管理人员的培训尚未进入规范化轨道,致使现行的医院管理队伍无法满足现代医院管理的实践性与创新性要求.因此,加强医院管理人员培训,树立素质学习、科学学习及终身学习的理念,提高管理人员卫生政策研究分析能力及解决实际问题的综合能力,成为医院事业发展中亟待解决的关键问题.本文探讨了医院管理人员培训的必要性,分析了医院管理人员培训现状与存在的问题,提出了规范医院管理人员培训的建议。

OBJECTIVE:To construct functional tissue-engineered bone with cell sheet technology and method of traditional bone tissue engineering.METHODS:Canine bone marrow mesenchymal stem cells (BMSCs) were isolated with the method of density gradient centrifugation and cultured. BMSCs were induced to differentiate into osteoblasts and cultured in temperature-responsive culture dishes at 37 degrees C, 5% CO2 and saturated humidity. BMSCs cell sheet was prepared when temperature was changed to 20 degrees C. Demineralized bone matrix (DBM) and platelet-rich plasma (PRP) were prepared, and complex of DBM/PRP/BMSCs cell sheet/BMSCs was construsted and implanted under the left latissimus dorsi muscle. Complex of DBM/PRP/BMSCs was implanted under the right latissimus dorsi muscle.RESULTS:When temperature dropped at 20 degrees C, BMSCs detached automatically from the temperature-responsive culture dishes and formed an intact cell sheet. The osteogenesis of the DBM/PRP/BMSCs cell sheet/BMSCs group was better than that of the DBM/PRP/ BMSCs group.CONCLUSION:Cell sheet technology combined with traditional bone tissue provides a new way for construction of ideal functional tissue-engineered bone.

Objective: To investigate the need of nursing management training, the working system of hospital and working evaluation of nursing manager, and to provide basis for nursing management training. Method: 74 nursing manager were investigated by selfdesigned questionnaire. Results: There were deficiencies in hospital culture construction and nursing managers lacked modern hospital management knowledge. Conclusion:The hospital should strengthen hospital culture construction and understand nursing manager's overall quality and managment level to develop nursing management training work.

As professional development of hospital managers became an inevitable trend,hospital management staff training was on the agenda.In order to better carry out hospital management staff training,effective path of hospital management staff training,which included establishing advanced training ideas,following appropriate training principles,constructing systemic training system,implementing effective training effectiveness evaluation and improving relevant training mechanism was explored.

BACKGROUND:Traditional bone tissue engineering faces shortcomings in harvesting or transferring cells.Cell sheet technology is a new skill for cell harvesting or transferring.OBJECTIVE:To construct tissue-engineered bone using cell sheet technology and method of traditional bone tissue engineering.METHODS:Canine bone marrow mesenchymal stem cells (BMSCs) were isolated with the method of density gradient centrifugation and cultured.BMSCs were induced to differentiate into osteoblasts and cultured in temperature-responsive culture dishes at 37℃,5% CO2 saturated humidity.BMSCs cell sheet was prepared when temperature was changed to 20℃;demineralized bone matrix and platelet rich plasma (PRP) were prepared.The complex of DBM/PRP/BMSCs cell sheet/BMSCs was construsted and implanted under the left latissimus dorsi muscle.The condition of osteogenesis was observed at 4,8 and 12 weeks after operation.RESULTS AND CONCLUSION:When temperature dropped at 20℃,BMSCs detached automatically from the temperature-responsive culture dishes and formed an intact cell sheet.The osteogenesis of the DBM/PRP/BMSCs cell sheet/BMSCs group was better than that of the DBM/PRP/BMSCs group.Cell sheet technology combined with traditional bone tissue provides a new way for construction of functional tissue-engineered bone.

Objective To investigate the requirements of training heads of clinical department and medical laboratory,so as to provide evidence for further development of this work.Methods A questionnaire method was carried out in 136 heads of clinical and laboratory departments.Goldstein analysis model and gap analysis model were used to analyze the requirements from aspects of organization,task,and individual.Results An analysis from the aspect of organization revealed the necessity and feasibility of training administrators of clinical and laboratory departments at this hospital;from task analysis,eight items-reserve talents,innovative competence,administration of medical safety and details,ability of comprehensive management,ability to develop discipline,ability of team construction,leaven and affinity,ability of encouragement-were determined,and to be developed through training;from individual aspect,59.7% of the heads had not attended training on administration in the last three years,and94.5% of them thought such training was a must;the training contents that generally agreed were communication skills,team construction,quality management of medical treatment,hospital culture and innovation consciousness.More of the heads surveyed preferred symposium,lecturing,analysis of cases,and inter-unit exchange as the way of training.Conclusion This analysis provides a scientific basis for making a plan to train heads of clinical departments,which establishes a good foundation for carrying out the work of training.

Objective To construct the vascularization tissue engineered bone(VTEB) and evaluate its effect in the reanstructive surgery of mandibular defect.Methods 12 dogs were randomly divided into 4 groups.Bone defects with size of 30 mm×15 mm were made at the mandibular body of dogs on two sides.The defect on one side was implanted with PRP/PLA/rhBMP/BMSc in group A,PLA/rhBMP in group B,PLA /BMSc/PRP in group C and PLA in group D.At 4,8,12 weeks after implantation,the effectiveness of bone formation was evaluated by histological,radiological observation and imaging density analysis.Results After implantation,new bone began to form in the defects of 4 groups,bulk bone could be obviously observed and many osteoblasts could be seen in the bone matrix.Vascularization degree of tissue engineered bone in group A>C>B>D in time-dependent manner(P<0.05).Conclusions The VTEB constructed in this study can build new bone fastly and improve its vascularization,with no eyewinker reject reaction and toxic,side-effect.PRP/BMSc /rhBMP/ PLA can induce mandibular bone cells regeneration and can be used as a good material for bone defect reconstruction.

血管瘤是颌面部常见的先天性良性肿瘤或血管畸形.传统的治疗方法很多,包括手术切除、放射治疗、低温冷冻、激光治疗、硬化剂注射治疗等,但各有其局限性,特别是对较大的混合型血管瘤(毛细血管瘤与海绵状血管瘤共存)治疗多不尽人意.自2005年以来,我们采用直流电铜针、平阳霉素注射及整张全厚皮片移植等综合技术治疗颌面部混合型血管瘤16例,疗效满意,现报告如下.

过敏性紫癜又称出血性毛细血管中毒症,是儿童时期最常见的血管炎之一,以双下肢对称性皮肤紫癜、腹疼、关节疼、便血、肾脏损害为主要临床表现.近几年发病有明显增加趋势.

<正>西方学者从营销学角度于20世纪70年代首先提出用顾客满意程度作为评价服务质量的标准。自从1985年顾客满意度的理论由美国学者提出以后,在国外已有近20年的发展

2003年1月～2007年12月,我院共收治小儿过敏性紫癜(HSP)患儿221例,现将护理体会报告如下.