广东省SARS流行株M基因序列分析

目的：测定广东省不同流行时期13份SARS病毒(SARS CoV)标本的M基因序列，通过分析该基因序列的变异情况，初步了解广东省SARS病毒在流行过程中是否发生了变异。方法：提取病毒RNA，用M基因特异引物进行RT-PCR，将产物纯化后直接测定核苷酸序列。结果：13份标本M基因核苷酸序列同源性很高，为99．7％～100％，M基因核苷酸序列只在2个位点(80和203位)发生变异，1株80位点的变化引起编码的氨基酸从苯丙氨酸(F)变为半胱氨酸(C)，3株203位变化为无义突变。结论：M基因核苷酸序列变异不大，初期和后期M基因核苷酸序列与流行高峰期的毒株相差1个碱基，但氨基酸序列相同；从香港感染病人分离的1株病毒M基因与广东本地感染分离株存在1个氨基酸的差异。     

各具特色的国外妇幼保健工作

本文通过对国际上几个主要国家的妇幼保健工作的介绍,使人们对不同特色的妇幼保健事业有所了解,他山之石,可以攻玉,希望能够对我国妇幼保健工作的发展提供借鉴。     

不同起搏模式对病人生存质量影响的调查研究

[目的]探讨不同起搏模式对病人生存质量（QOL）的影响。[方法]以健康调查问卷（SF一36量表）对112例不同起搏模式病人进行问卷调查，比较3种起搏模式下病人的QOL水平。[结果]除机体疼痛、角色情绪2个维度外其余6个维度（生理功能、角色限制、活力、社会功能、精神健康、总体健康）3种起搏模式间比较差异有统计学意义（P〈0．05）。[结论]应用AAI型、DDD型起搏器的病人生存质量优于VVI型起搏。     

外语多媒体软件界面设计的认知策略模式

外语学习软件界面的设计除了应注意实现软件功能的技术因素、表现媒体的物理性状以及信息内容的学科把握 ,还应对软件界面的内容组织方略、交互通达方式、语用认知功能等方面提出要求。界面设计的出发点 ,应该是学生、学习任务及其相应的学习活动。应该根据需求分析、学习者分析、任务和内容分析来确定目标和步骤。外语教学应以语言能力、交际能力、学习策略能力为目标 ,界面设计应以此为据选择表现媒体、结构层次、交互方式和技术手段。     

Indikation für eine immunsuppressive Therapie bei chronisch entzündlichen Darmerkrankungen

Zusammenfassung Der immunsuppressiven Therapie kommt bei chronischen Darmerkrankungen gro?e Bedeutung zu, insbesondere dort, wo die Standardtherapie nicht den gewünschten Erfolg zeigt. Als Therapie der ersten Wahl gelten bei Colitis ulcerosa 5-Aminosalizyls?ure-freisetzende Medikamente, bei Morbus Crohn Kortikosteroide. Innerhalb der Gruppe immunsuppressiver Pr?parate gibt es erhebliche Wirkungsunterschiede. Darüber hinaus ist die Immunsuppression auch mit ernstzunehmenden Nebenwirkungen belastet. über den Stellenwert der Immunsuppression als Erg?nzung, m?gliche oder bei Unvertr?glichkeit notwendige Substitution der Standardtherapien von Colitis ulcerosa und Morbus Crohn wird hier eingehend referiert. Auch die Behandlung dieser Erkrankungen in der Schwangerschaft wird dabei erl?utert.     

Decision making about mode of delivery among pregnant women who have previously had a caesarean section: A qualitative study

Objective  To explore prospectively women's decision making regarding mode of delivery after a previous caesarean section.
Main outcome measures  The evolution of decision making, women's participation in decision making, and factors affecting decision making.
Design and methods  A qualitative study using diaries, observations and semi-structured interviews. Data were analysed thematically from both a longitudinal and a cross-sectional perspective.
Setting  An antenatal unit in a large teaching hospital in Scotland and participants' homes.
Sample  Twenty-six women who had previously had a caesarean section for a nonrecurrent cause.
Results  Women were influenced by their own previous experiences and expectations, and the final decision on mode of delivery often developed during the course of the pregnancy. Most acknowledged that any decision was provisional and might change if circumstances necessitated. Despite a universal desire to be involved in the process, many women did not participate actively and were uncomfortable with having responsibility for decision making. Feelings about the amount and quality of the information received regarding delivery options varied greatly, with many women wishing for information to be tailored to their individual clinical circumstances and needs. In contrast to the impression created in the media, there was no evidence of clear preferences or strong demands for elective caesarean section.
Conclusion  Women who have had a previous caesarean section do not usually have firm ideas about mode of delivery. They look for targeted information and guidance from medical personnel based on their individual circumstances, and some are unhappy with the responsibility of deciding how to deliver in the current pregnancy.     

广东省结核病流行菌株研究

目的：从分子流行病学的角度探讨广东省结核分支杆菌菌株流行的分布。方法：构建广东省74株临床分离的以RFLP为基础的结核分支杆菌的IS6110 DNA指纹图谱技术，确诊结核分支杆菌菌株的流行分布。结果：24．3％（18／74）的结核菌株的IS6110 DNA指纹相似值在1－0．65之间，鉴定结果为它们均是“北京家族”结核分支杆菌菌株。结论：广东省结核菌株流行主要存在着遗传关系接近，在基因水平上相关程度较高的“北京家族”结核分支杆菌菌株，且该家族菌株正以一定的比例在我省流行。     

医学双语教学的实践与建议

目的：建议在5年制和7年制医学生中开设双语试点班的教学模式。方法：在医学本科扣7年制英语班学生中开设系统的医学专业课试点班。试点班经自愿报名考试择优组成。每年考试择优班级重组。所有医学专业课尽可能多学科扣尽可能大比重的进行英语授课，形成以英语为主体的专业语言环境。     

The Effect of 50 Hz External Electrical Interference on Implanted Cardiac Pacemakers

The effects of injected 50 Hz alternating current on the function of cardiac pacemakers has been observed in 18 patients with implanted unipolar VVI units. Current, in the range 0-600 microA was applied via electrodes attached to the patients' upper body and feet and fed from a specially designed current injection unit at the bedside. Most implanted pacemakers reverted to interference mode in the current range 29-250 microA. At current levels just below the reversion current all units developed irregular and inappropriate pacing. This current level was pacemaker dependent and varied in the range 27-246 microA. The total reversion current depended on the location of the injecting electrodes and on the patients' posture. The sensitivity of the units to injected interference was increased by deep inspiration. Temporary pacing catheters fitted to an additional ten patients were used to monitor the interference voltage which would be sensed by an implanted unit. This voltage was similarly dependent on patient posture and on deep respiration. Current injection has proved to be a safe, controllable and reproducible method of testing the sensitivity of implanted pacemakers to 50 Hz external interference.