The author introduced the advanced concept and overall goal of establishing a research-oriented hospital,and proposed to focus on the construction of research-oriented department and the training of the talents,as well as the design and the construction of the research-oriented hospital.

医疗质量是医院建设发展的生命线,也是医院管理的永恒主题[1,2].近年来,我院在上级党委机关的正确领导下,深入贯彻科学发展观,紧紧抓住内涵质量建设这条主线,锐意改革、开拓创新、真抓实干,使医院全面建设保持着良好的发展势头.

目的观察肺炎支原体肺炎(MPP)患儿外周静脉血中C-反应蛋白(CRP)、P物质(SP)、降钙素原(PCT)和基质金属蛋白酶-9(MMP-9)的变化,以探讨其在肺炎支原体肺炎诊治中的意义。方法对33例MPP急性期患儿(观察组)和30例正常儿童(对照组)采用全自动生化分析仪检测外周静脉血CRP含量,放射免疫方法测定SP浓度、免疫荧光方法检测PCT水平,ELISA测定MMP-9变化。结果MPP患儿急性期外周静脉血CRP、SP、PCT和MMP-9含量与对照组比较显著增高(P<0.01),而恢复期相应指标均下降至正常水平,与对照组差异无统计学意义(P>0.05)。结论观察MPP患儿外周静脉血中炎性因子的变化情况对于MPP的诊治非常重要,而且对研究其发病机制也有帮助。

危重病历护理记录主要反映对危重患者的抢救、治疗、护理情况,它记录了危重患者的病情变化及治疗护理措施的落实等情况,是处理医疗纠纷的重要法律依据之一.为确保危重病历护理记录的准确性、及时性和完整性,我院质量管理科对2005年1月～2006年12月889份终末危重病历护理记录进行调查,现将结果分析如下.

高血压病是由机体内外环境因素及遗传因素相互作用所致的慢性疾病,也是脑卒中、冠心病的主要危险因素.我们通过对1603例老年离退休干部进行调查,探讨老年人高血压病患病因素及其与冠心病、脑卒中的关系.

为了探讨老年人心理-社会因素与健康及疾病的关系,我们调查了老年人6种心身疾病与心理-社会因素的关系,现报告如下.

OBJECTIVETo study the microbiology, clinical features and treatment outcomes of hospital-acquired pneumonia (HAP) caused by Acinetobacter baumannii.METHODSSix cases of HAP, caused by Acinetobacter baumannii producing PER-1 type extended-spectrum beta-lactamase verified by molecular biological methods, were studied in Bethune International Peace Hospital, from January to August 2005. Clinical data were collected and analyzed. Pulsed-field gel electrophoresis (PFGE) were used to analyze the homology of these strains. The genes of beta-lactamase (BLA), aminoglycoside-modifying enzymes (AME), resistant to disinfectant-sulfanilamide (qacEDelta1-sul1), and class 1 integrase (intl1) were analyzed using PCR and verified by DNA sequencing.RESULTSAmong these 6 strains of Acinetobacter baumannii, five were susceptible only to imipenem, and 4 were susceptible to meropenem. The PFGE types identified from these isolates were A1 (n=2) and A2-A5 (n=1, respectively). They all were positive for PER-1, TEM-1, and genes of qacEDelta1-sull and intl1. Three of them harbored genes of aac (3)-I and aac (6')-I. Two had aac (3)-I and ant (3'')-I. One had aac (3)-I. All the patients had severe underlying diseases, and had received mechanical ventilation. They all had received broad spectrum antibiotics within 15 days before Acinetobacter baumannii were identified. Although carbapenem and/or cefoperazone/sulbactam had been used, only 3 patients survived.CONCLUSIONThe 6 PER-1 type extended-spectrum beta-lactamase-producing Acinetobacter baumannii isolates were closely related and had complex mechanisms of drug resistance. The prognosis of patients infected by them was poor.

目的为了解多重耐药铜绿假单胞菌(MDRPA)β内酰胺类耐药相关基因、氨基糖苷类修饰酶基因(AMEs)、消毒剂与磺胺类耐药基因(qacE△1-sull)和质粒介导的氟喹诺酮类耐药基因(qnr)存在情况.方法对2005年1～10月份临床分离的36株多重耐药菌株(耐三类抗菌药物者),应用聚合酶链反应进行检测.结果 36株MDRPA中6株(9.7%)对受试的19种抗生素都不敏感.TEM、CARB、aac(6')-Ⅰ、aac(6')-Ⅱ和qacE△1-sul1扩增阳性株分别为4株(11.1%)、5株(13.9%)、4株(11.1%)、4株(11.1%)和8株(22.2%).OprD2基因缺失率为19.4%(7/36).而PER、OXA-23群、OXA-24群、GES、DHA、IMP、VIM、SPM、GIM和qnr扩增均阴性.结论MDRPA中qacE△1-sul1和CARB基因携带率高,OprD2基因缺失率高.

学科建设不仅代表着医院的技术水平和特色,还决定着医院的竞争力与发展后劲,是医院建设与发展的核心内容[1].通过开展学科评估,依据评估结果有针对性地加强学科建设,是提升学科整体水平,促进医院发展的重要措施[2].

观察干扰素α对慢乙肝患者肝组织纤维化程度的影响.16例肝组织病理诊断符合S3-S4期患者,干扰素治疗期前后三次行肝组织炎症程度及纤维化程度病理分析,免疫组化检查肝组织TGF-β1蛋白、Fas及HBcAg抗原,TUNEL方法检查肝细胞凋亡.干扰素连续6个月治疗肝组织炎症及纤维化程度逐渐改善;在S3-S4期,Fas、TGF-β1显著表达;干扰素α治疗3个月后Fas抗原、TGF-β1表达程度显著下降,P＜0.05;细胞凋亡程度减轻P＜0.05;肝组织HBcAg表达程度无显著改变.干扰素α有显著改善S3-S4期患者肝组织肝细胞凋亡和肝纤维化程度,但需要持续的疗程.

学科建设是医院建设的重要组成部分.集中力量突出抓好优势学科和特色技术建设,形成"拳头";并由此促进医院整体水平提高,是在市场经济条件下,提高医院综合竞争力的一条重要途径[1-2].

戊型肝炎(戊肝)是经肠道传播的病毒性肝炎,其临床表现与甲型肝炎(甲肝)相似,但肝功能损害更重.我科1995～2003年共收治散发性戊肝107例,现报告如下.

OBJECTIVE:To observe the histological changes in the fibrotic and inflammatory tissues in response to interferon alpha treatment in patients with chronic viral hepatitis B.METHODS:Sixteen patients with chronic viral hepatitis B in S3-S4 stages established by pathological examination were treated with interferon alpha for 6-9 months, and the degree of liver fibrosis and inflammation were examined 3 times during the treatment. The expression of Fas, transforming growth factor beta1 (TGFbeta1) and HBcAg in the liver tissues were detected by immunohistochemistry, and DNA fragmentation was examined by TUNEL assay. The levels of the serum markers for liver fibrosis and liver function were also measured.RESULTS:Patients with liver fibrosis in S3-S4 stages had high pathological expression of Fas and TGFbeta1 with severe DNA damage in the liver tissues. After 3 months of interferon therapy, the expression of Fas and TGFbeta1 were lowered (P<0.05), and further treatment till 3-9 months resulted in gradual decrease in the degree of hepatic fibrosis and cell apoptosis (P<0.05), with improved serum liver fibrosis indices and liver function.CONCLUSION:Interferon alpha may alleviate liver fibrosis and suppress cell apoptosis in patients in S3-S4 stages after a 6- to 9-month continuous treatment.