水痘-带状疱疹病毒(VZV)的特异性细胞免疫(CMI)在带状疱疹的发病过程中起主要作用.当细胞介导的免疫功能减弱时,带状疱疹病毒重新激活,实体器官移植、造血干细胞移植患者等需要接受终身免疫抑制,该人群带状疱疹的发生率显著增加,本文对移植与带状疱疹的新进展进行综述.

差异表达分析常被用于各种疾病标志物的筛选研究中,如传统的t检验、显著性分析(significance of microarrays,SAM)检验、偏最小二乘(pa least square,PLS)等方法.然而,这些方法主要是通过比较不同分组之间基因表达均值的差异筛选标记物,忽视了物质之间的相互调控关系,致使研究结果不够稳定或检验效率低.在组学研究中,由于基因调控和蛋白质的互相作用,很有可能在表达量上还没有呈现出明显差别时,在调控关系上已经发生了一定的改变.差异网络分析方法更加注重不同分组情况下调控关系和网络拓扑结构的差别,并由此筛选出具有潜在生物学意义的标记物.本文提出DiffRank-RF差异网络分析方法,通过模拟实验评价该方法的准确性和适用条件,并与传统的变量筛选方法进行比较,最后应用于乳腺癌实际数据,得到相应的分析结果.

组学数据(omics data),如基因组、转录组、蛋白质组和代谢组等数据能够反映疾病的发生、发展和预后的情况.对于组学数据的分析,主要是筛选有用的生物标志物、分析调控网络和建立预测模型.一般是通过变量差异表达量分析不同类别之间的差别.但在实际中,也可能有这样一种情况,即在不同分类中,变量的量值变化不大,但其网络拓扑结构(network topology structure,NTS)却发生了变化,这种情况同样能反映不同的生物学特征,并据此发现重要的生物标记物.

目的 引入JIVE方法对多组学数据进行整合分析,并应用于肿瘤分子分型研究.方法 使用TCGA数据库中卵巢癌mRNA和miRNA的组学数据,应用JIVE方法整合分析两个组学数据,提取两不同组学数据的共同特征,然后通过对其具有共同结构的数据做主成分分析,给出卵巢癌miRNA分子分型的结果.结果 经过JIVE方法整合分析后,使miRNA数据具有明显与mRNA相一致的分型结构,从而进一步支持了mRNA的分型结果,同时揭示了两组学之间在组织分子分型上具有一定的调控关系.结论 JIVE方法可以用于提取组学之间存在的共同结构矩阵,从而进行多组学数据的整合分析.

目的 探讨基于贝叶斯准则的差异网络分析方法的性能,并将其应用于卵巢癌基因表达谱数据分析.方法 通过模拟实验评价其识别差异边及差异节点的准确性,并与传统方法做对比.同时应用上皮性卵巢癌基因组学数据,构建差异网络模型.结果 模拟试验结果表明,基于贝叶斯准则的差异网络分析方法识别差异边能力明显优于高斯图模型方法;实例分析结果表明,本文方法构建的差异网络模型具有实际意义.结论 应用基于贝叶斯准则的差异网络分析方法能得出准确度较高的差异网络,效果优于传统方法.

At present,the reform of public hospitals is deepening,and it isparticularly important to improve the management system of modern hospital,and the core of which is hospital internal post management.The article introduces the main practice of post management of The Fourth Affiliated Hospital of Harbin Medical University onthe basis of the necessity of hospital post management,and provides references for the exploration of public hospital reform.

The introduction to modem hospital management mechanism and performance management comprehensively improve the work enthusiasm,creativity and initiation of medical staff,and continuously increase the core competitiveness and sustainable development of hospitals.Improving the work enthusiasm is the key target of new medical reform through the performance management.The performance management had achieved the major attention among medical management staffs.However,the effect of performance management has not reached expectations because of different management styles,and has also reduced the quality of medical service.This paper introduces a series of matters related to performance management,aimed to explore the reasons and provide references of this phenomenon.

The affiliated hospitals of colleges and universities with strong comprehensive strength and competitive advantage have profound historical background,distinctive culture and excellent value system.To raise the management level,gather development strength and improve hospital comprehensive strength,the hospitals should strengthen hospitals' culture construction.Cultural research and construction of hospitals has been a pressing problem,with the increase in the number of affiliated hospitals in China's colleges and universities,which is also a basic,strategic and forward-looking work.The cultural construction of affiliated hospitals of universities and colleges in China is generally confused with ideological and political work,seriously disjointed from the culture of colleges and universities.Its implementation process is often in the form of surface.The correct understanding of the cultural connotation of universities hospital needs to learn from the advanced experience at home and abroad,organically integrate the campus culture and hospital culture,and improve the system to better adapt to the field of biomedical and medical market facing opportunities and challenges,and to promote the progress and development of life science and medical security.

Objective:To build a competence model of management personnel working at logistics department in public hospital.Methods:318 staffs working at logistics department in public hospital were employed with a convenience sampling.The questionnaire survey was used to collect data,and the exploratory factor analysis method was performed with SPSS19.0 software to build the competence model.Results:Results of exploratory factor analysis showed that the competence model was consisted of 7 dimensions that including servant characteristic,professional knowledge,organization and coordination,striving for excellence,office skills,observe discipline and professionalism,and 27 items of competence were reserved in model.Model had a good construct validity and internal consistency reliability.Conclusion:In this study,a groundbreaking competence model of management personnel working at logistics department in public hospital was built,which could be used on several aspects,such as recruitment,promotion and evaluation of one's performance and so on.

Objective: To describe the real life and feeling experience of the patient with unilateral enucleation of eyeball.To provid a therapy for the patients with enucleation of eyeball in rehabilitation stage.Methods: Using qualitative research method,we had 8 patients with unilateral enucleation of eyeball were taken in-depth interviews,collection of data,analysis of Colaizzi data.Results: The real life and feeling experience of the patient with unilateral enucleation of eyeball is: ①negative conflicting emotions.②The value of life experience.③negative coping behavior.④The burden of family and medical is overweight.⑤Social family role change.⑥demand for rehabilitation information.Conclusions: Nursing staff and family members should understand deeply the psychological state of existence,influenced by eyeball loss of the patient's with unilateral enucleation of eyeball,to improve quality of care,improve patient and family education guidance,so that the patient in and out of the hospital has remained the best recovery status.Targeted,continued and effective medical service should be provided for at least one year for rehabilitation of patients.

<正>当今社会日趋信息化、现代化,如何在日益激烈的竞争中与时俱进地适应时代变革是各行各业面临的一个首要问题。数字化建设无疑是解决这个问题的先行兵。为求切实做到提升服务质量、提高工作效率,现代化医院必须进行数字化建设。

随着我国经济体制的改革和发展,人民的生活水平有了极大的提高,人们对医院和医务人员提供服务的要求也日益提高,多数患者已不满足于仅仅得到及时、正确的诊断和治疗,还希望医务人员有良好的服务态度,便利、整洁的就医环境,良好的医息沟通以及合理的医疗服务价格.

目的总结人工血管重建术治疗肾动脉平面以下腹主动脉瘤的临床经验。方法对38例肾动脉平面以下的腹主动脉瘤行人工血管重建手术,其中9例采用直桶形人工血管,29例采用“人”字形分叉人工血管。分别采用保留后壁或完全切断瘤颈的方法吻合近心端,对于远心端根据病情分别吻合在腹主动脉末端、髂总动脉或髂外动脉。重建髂内动脉8支,结扎髂内动脉3支。依据术中测压结果重建肠系膜下动脉11支,缝扎21支。结果术后死亡1例,于手术后6d发生结肠破裂,14d死于感染性休克;二次开腹止血1例,37例患者痊愈出院,并分别随访3个月-2.5年,1例于术后2年死于心肌梗死。其余患者预后良好,无人工血管内血栓形成、吻合口假性动脉瘤和移植血管感染等中、远期并发症发生。结论人工血管重建术是腹主动脉瘤最彻底、有效的治疗方法,正确选择手术适应证、良好的手术设计、手术技巧以及重视并发症的防治是保证手术成功的重要因素。