全科医学基层实践基地师资综合评价指标体系的构建

目的 构建一套科学、系统的全科医学基层实践基地师资综合评价指标体系,为全科基层实践基地的师资遴选、评价和考核提供参考。方法 在文献研究、专家咨询和小组讨论的基础上,初步构建全科基层实践基地师资原始指标体系。选择具有中级及以上职称,并长期从事医学教育管理、全科医疗与教学、基层医疗卫生服务与管理工作的32名专家,进行两轮德尔菲专家函询,并对函询结果进行统计分析,确定全科基层实践师资综合评价指标。运用层次分析法计算各指标权重并进行一致性检验。运用Yaahp统计学软件进行数据录入和处理。结果 构建出包含3个一级指标、12个二级指标和61个三级指标的全科医学基层实践基地师资综合评价指标体系。3个一级指标分别为师资遴选纳入标准、教学能力评价标准、师资考核标准;权重系数分别为0.334、0.525、0.142。结论 本研究构建的指标体系具有较好的科学性和系统性,为进一步加强全科基层实践基地师资队伍的建设和管理、提升全科住院医师培养质量,提供了理论依据。     

疾控人员职业倦怠潜在剖面分析及与工作特征的关系

目的 通过对疾控(CDC)人员职业倦怠进行潜在剖面分析识别不同的职业倦怠类别,探讨工作特征各维度与职业倦怠类别间的独立效应。 方法 采用中文版职业倦怠量表(MBI-GS)、工作特征量表和自编一般资料调查表对943名疾控人员进行调查。使用潜在剖面分析方法识别疾控人员职业倦怠潜在类别,多分类Logistic回归分析探讨工作特征各维度与不同职业倦怠类别间的独立效应。 结果 疾控人员职业倦怠存在3种类别:低倦怠型(Ⅰ,54.7%)、高倦怠型(Ⅱ,24.1%)和成就感低落型(Ⅲ,21.2%)。高工作反馈、高工作意义是个体进入高倦怠型组的独立保护因素(OR=0.561;OR=0.612),高工作负荷、高工作对个体控制及情绪表达的要求是个体进入高倦怠型组的独立风险因素(OR=1.693;OR=1.770);高工作自主性是个体进入成就感低落型组的独立风险因素(OR=1.810),高工作对个体控制及情绪表达的要求是个体进入成就感低落型组的独立保护因素(OR=0.582)。 结论 疾控人员可区分出3种潜在职业倦怠类别,工作特征不同维度与潜在职业倦怠类别间存在独立效应。     

Selection for increased pheromone response in the male pink bollworm,Pectinophora gossypiella (lepidoptera: Gelechiidae)

The genetic basis of the duration and incidence of male wing fanning to pheromone in the pink bollworm moth,Pectinophora gossypiella (Saunders), was examined by artificial selection. Using a still-air bioassay, males from a laboratory colony were selected for increased duration of wing fanning when exposed to a 6535 blend of (Z,E)- and (Z,Z)-7,11-hexadecadienyl acetates. The mean (±SE) duration of wing fanning in the selected line increased from 5.4±1.4 to 17.4±2.7 s after six generations. The increase in wing fanning duration was the result of an increase in response duration among responders and not the percentage of males that responded. Realized heritability of wing-fanning duration was 0.16±0.02. The amount and ratio of pheromone produced by females in the male-selected line did not change.This research was supported in part by NSF Grant PCM-8309398 and a University of Massachusetts Biomedical Research Grant.     

抗乙酰胆碱受体单链抗体对致病性抗体结合活性的抑制作用

为探讨单链抗体 (ScFv )对重症肌无力 (MG )的特异性免疫治疗作用 ,从分离自MG患者胸腺的抗乙酰胆碱受体(AchR )抗原结合片段Fab6 37构建单链抗体ScFv6 37。应用放射免疫测定法测定了ScFv6 37与刺激抗原人AchR的特异性结合活性以及与相关抗原大鼠AchR和电鳐AchR的交叉反应 ,应用竞争性ELISA测定抑制致病性抗AchR完整抗体IgG6 37与人AchR结合活性。结果发现ScFv6 37只能与人AchR结合 ,不能与大鼠和电鳐的AchR结合。对IgG6 37与人AchR结合的抑制率为 17 5 %～ 32 9%。表明单链抗体对AchR具有一定的“保护”作用。     

Thymic stromal cell specialization and the T-cell receptor repertoire

Ten years ago, we proposed a model for thymus function in which thymic epithelial cells are primarily responsible for imprinting major histocompatibility complex (MHC)-restricted specificity, and bone marrow-derived macrophages or dendritic cells are responsible for the induction of self-tolerance. Since then, transgenic and knockout models have allowed for a dissection of thymic stromal components in vivo, leading to a new understanding of their specialized functions. We have determined that with regard to class II-restricted CD4 T-cell development, two distinct subsets of thymic epithelium help shape the repertoire: Cortical epithelium appears solely responsible for positive selection, whereas a fucose-bearing subset of medullary epithelium is specialized for negative selection. This absolute separation of positive and negative selection into two distinct spatial and temporal compartments leads to a much simpler view of the process of repertoire selection. Finally, a novel view of the function of the thymic medulla is discussed.     

Antibiotic resistance in Staphylococcus aureus colonising the intestines of Swedish infants

Staphylococcus aureus has become a frequent coloniser of the intestinal tract of infants, but the health effects of such colonisation are not clear. In this study, the antibiotic resistance patterns of 116 S. aureus strains from the commensal intestinal microflora were determined. The strains were obtained from 81 Swedish infants who had been followed with regular stool samples and registration of antibiotic usage during their first year of life. The faecal population levels of the individual strains and the duration of their persistence in the microflora had been determined previously. The prevalence of antibiotic resistance among the 116 strains was modest: methicillin, 0%; penicillin G, 78%; erythromycin A, 3%; tetracycline, 2%; clindamycin, 0.9%; and fusidic acid, 0.9%. Colonisation by antibiotic-resistant strains was unrelated to antibiotic consumption by individual infants. Antibiotic-resistant strains were as capable of persisting in the intestinal microflora and reaching high faecal population levels as fully susceptible strains. No strain lost or acquired resistance during the colonisation period. Thus, antibiotic-resistant strains of S. aureus seem to be as fit for competition in the large bowel microflora as susceptible strains, even in the absence of selective pressure from antibiotics. This may aggravate the ecological consequences of antibiotic resistance development.     

Classification of Breast Masses Using Selected Shape,Edge-sharpness,and Texture Features with Linear and Kernel-based Classifiers

Breast masses due to benign disease and malignant tumors related to breast cancer differ in terms of shape, edge-sharpness, and texture characteristics. In this study, we evaluate a set of 22 features including 5 shape factors, 3 edge-sharpness measures, and 14 texture features computed from 111 regions in mammograms, with 46 regions related to malignant tumors and 65 to benign masses. Feature selection is performed by a genetic algorithm based on several criteria, such as alignment of the kernel with the target function, class separability, and normalized distance. Fisher's linear discriminant analysis, the support vector machine (SVM), and our strict two-surface proximal (S2SP) classifier, as well as their corresponding kernel-based nonlinear versions, are used in the classification task with the selected features. The nonlinear classification performance of kernel Fisher's discriminant analysis, SVM, and S2SP, with the Gaussian kernel, reached 0.95 in terms of the area under the receiver operating characteristics curve. The results indicate that improvement in classification accuracy may be gained by using selected combinations of shape, edge-sharpness, and texture features.     

Characterization of Thymic Nurse-Cell Lymphocytes,Using an Improved Procedure for Nurse-Cell Isolation

Thymic nurse cells (TNC), multicellular complexes consisting of lymphoid cells enclosed within cortical epithelial cells, were isolated from mouse thymus by a modified procedure allowing immunofluorescent labeling and flow cytometric analysis of their lymphoid contents (TNC-L). Collagenase was the only protease used for tissue digestion, to ensure that surface antigen markers remained intact. Zonal unit-gravity elutriation was used to enrich the TNC on the basis of their high sedimentation rate, followed by immunomagnetic bead depletion to remove residual mononuclear cell contaminants and a density separation to remove debris. The TNC-L were then released from inside TNC by a short period of culture. The measured contamination of TNC-L with exogenous thymocytes was around 0.5%. Three-color immunofluorescent labeling revealed that TNC-L included, as well as a maiority of immature CD4⁺8⁺3^low thymocytes, about 12% of apparently mature CD4⁺8^-3^high and CD4^-8⁺3^high thymocytes. TNC are located in the cortex, where mature cells are rare; the occurrence of mature phenotype cells within these structures suggests that they represent a microenvironment for the selection and generation of mature T cells.     

Selection for high and low mating propensity inDrosophila ananassae

InDrosophila ananassae, artificial selection was carried out for high and low mating propensity for 15 generations. Response to selection was from about F₅, with rapid divergence in mating frequencies in replicates of both fast and slow lines. To assess the effect of selection on the two sexes, females and males of the selected lines were tested against their respective counterparts of the control line after 15 generations. Significant differences in mating propensity were observed when selected males were tested against the control females, which suggests that males were much more affected by selection than females. After 15 generations the fast and slow lines (both replicates) were crossedinter se and mating frequencies of F₁ hybrids were studied in the same way as during the selection experiment. F₁ flies had a higher mating activity compared to their parental lines when males were derived from fast lines to produce hybrids. On the other hand, F₁ hybrids produced by crossing slow-line males with fast-line females showed mating frequencies similar to those of the slow parental lines. These findings suggest that mating propensity inD. ananassae is under the control of polygenes. Furthermore, the significant differences in mating propensity of hybrids produced by the fast and slow males indicate the possibility of a Y-linked influence on mating propensity inD. ananassae.The present investigation was carried out during the tenure of a senior research fellowship of the CSIR, New delhi, to S.C.     

Cloning and analysis of Trypanosoma (Nannomonas) congolense ILNat 2.1 VSG gene

Genes encoding various Trypanosoma (Trypanozoon) brucei variable surface glycoproteins (VSGs) show considerable conservation among different members of this species, known as isotypes. The occurrence of isotypes in other salivarian trypanosomes has not been well documented. We have cloned sequences encoding Trypanosoma (Nannomonas) congolense ILNat 2.1 VSG, and used it in DNA blot hybridization analyses of this and other T. congolense clones originating from geographically separate regions of East Africa. The data indicate that the expression of ILNat 2.1 VSG gene proceeds by duplicative transposition resulting in the presence of an extra expression-linked copy in the expressing clones examined. Furthermore the ILNat 2.1 VSG gene sequence is absent or has greatly diverged, in all other T. (N.) congolense clones that belong to different serodemes. This suggests that some T. (N.) congolense VSGs may be limited to their respective antigen repertoires. The data are discussed in the light of their implications for antigenic variation in T. (N.) congolense, and parasite epidemiology.