《高压氧医学》选修课的教学实践与规范化建设

分析《高压氧医学》课程设置与规范化建设的重要性,论述教学实施过程中教材选择、教学内容安排、教学方法设计、考核方式及师资培训等方面的措施和经验,完善了《高压氧医学》课程的教学体系,为临床医学专业该课程建设提供参考。     

应用实时定量PCR进行肿瘤表达研究中内参基因的选择

实时定量PCR(real-time quantitative PCR,RT-qPCR)是检测肿瘤基因表达水平的一种有效方法,在其中应用较多的相对定量方法需要一种能够在不同的组织、甚至不同的实验条件下表达恒定的理想的内参基因.但是很多研究都已经表明内参基因的表达是可变的.所以为了获得适用于肿瘤表达研究的内参基因,越来越多的研究在近期涌现出来.该文将会对近期关于肿瘤表达研究中内参基因选择的文章进行综述.     

尿液特征组分与糖尿病早期肾损害的关系初探

目的对尿液特征组分与糖尿病早期肾损害的关系进行了初步探索。方法对2011年12月-2012年5月间28例2型糖尿病组、33例2型糖尿病肾病组及26例健康对照组尿液中尿蛋白含量和几种常见非蛋白氮物质,包括肌酸、尿囊素、肌酐、尿酸和假尿嘧啶核苷的浓度进行测定,采用多种归一化方法对数据进行对比分析,并通过t检验减少高效液相色谱测定的变量信息,保留P〈O．05的检出峰进行主成分分析,获得分类结果。结果采用体积归一化方法,发现健康对照组尿液中肌酸、尿囊素和尿酸的含量与2型糖尿病组和糖尿病肾病组相比,差异均有统计学意义（P〈0．05）,2型糖尿病组尿液中尿蛋白的浓度与糖尿病肾病组相比,差异有统计学意义（P〈0．05）。结论通过肌酸、尿囊素、尿酸和尿蛋白的联合测定为肾脏损伤程度的监测及疗效观察提供依据,为2型糖尿病患者肾功能损坏的早期预防与诊断进行初步判断提供了新的方法。     

点选式电子病历在治疗甲型H1N1流感中的应用

目的分析点选式电子病历在治疗甲型H1N1流感病例中的应用情况,了解其优势与不足。方法,选取2009年4月-7月北京佑安医院收治的甲型H1N1流感纸质病历117份,2009年7月～8月收治的甲型H1N1流感电子病历127份。对现病史中甲型H1N1流感常见症状发热、流涕、咳嗽、咳痰的描述情况进行统计,分析点选式电子病历与传统手写病历规范化差别。结果对发热的表现、最高体温、是否伴随畏寒、寒颤等因素进行记录,显示电子病历明显优于手写病历（P〈0．05）。结论点选式电子病历较传统手写病历对甲型H1N1流感病史收集记录更加全面、规范。     

CD率在归一分析法评价病床工作效率中的应用

目的病床使用率和床位周转次数结合疾病危重程度对某院2009年病床工作效率进行分析、评价,为医院管理决策提供科学依据。方法运用归一分析法并用CD率校正指标值,根据2009年医疗工作报表数据资料进行计算、分析。结果 2009年全院病床工作效率处于高效率运行,前三位的科室是重症监护室、儿科、内一科。结论采用CD率校正指标值能使评价结果较符合实际运行情况,可有针对性地调整各科室病床设置,保证床位合理、高效、安全的运行。     

The linear relationship between cigarette tar and nicotine yields: regulatory implications for smoke constituent ratios

Cigarette smoke analyte yields are often expressed as ratios relative to tar or nicotine yields, usually to compare different products or to estimate human uptake of smoke in relation to nicotine uptake measurements. The method, however, can lead to distorted interpretations, especially in the case of ratios from ultra-low tar yield cigarettes. In brief, as tar yields decrease below the 5–6 mg per cigarette range, the tar-to-nicotine ratio (TNR) decreases rapidly in a non-linear fashion. If, however, the nicotine yield, rather than the ratio, is plotted versus the tar yield, the non-linearity disappears and a straight line is obtained, with a slight positive intercept for nicotine on the ordinate. Unlike the ratio, the slope appears to depend only on the concentration of the nicotine in the blend and does not appear to vary with smoking parameters such as puff volume, puff interval or length smoked or with cigarette design parameters such as length, circumference or the amount of filtration or filter ventilation. Therefore, such a slope is analogous to the TNR although, unlike that ratio, it is invariant. Even more simply, the concentration of the nicotine in the blend, at least for American blend-style cigarettes, provides a similar index.     

Spatial summation properties of the human ocular following response (OFR): evidence for nonlinearities due to local and global inhibitory interactions

Ocular following responses (OFRs) are the initial tracking eye movements that can be elicited at ultra-short latency by sudden motion of a textured pattern. A recent study used motion stimuli consisting of two large coextensive sine-wave gratings with the same orientation but different spatial frequency and moving in (1/4)-wavelength steps in the same or opposite directions: when the two gratings differed in contrast by more than about an octave then the one with the higher contrast completely dominated the OFR and the one with lower contrast lost its influence as though suppressed [Sheliga, B. M., Kodaka, Y., FitzGibbon, E. J., & Miles, F. A. (2006). Human ocular following initiated by competing image motions: Evidence for a winner-take-all mechanism. Vision Research, 46, 2041-2060]. This winner-take-all (WTA) outcome was attributed to nonlinear interactions in the form of mutual inhibition between the mechanisms sensing the competing motions. In the present study, we recorded the initial horizontal OFRs to the horizontal motion of two vertical sine-wave gratings that differed in spatial frequency and were each confined to horizontal strips that extended the full width of our display (45 degrees ) but were only 1-2 degrees high. The two gratings could be coextensive or separated by a vertical gap of up to 8 degrees , and each underwent motion consisting of successive (1/4)-wavelength steps. Initial OFRs showed strong dependence on the relative contrasts of the competing gratings and when these were coextensive this dependence was always highly nonlinear (WTA), regardless of whether the two gratings moved in the same or opposite direction. When the two gratings moved in opposite directions the nonlinear interactions were purely local: with a vertical gap of 1 degrees or more between the gratings OFRs approximated the linear sum of the responses to each grating alone. On the other hand, when the two gratings moved in the same direction the nonlinear interactions were more global: even with a gap of 8 degrees -the largest separation tried-OFRs were still substantially less than predicted by the linear sum. When the motions were in the same direction, we postulate two nonlinear interactions: local mutual inhibition (resulting in WTA) and global divisive inhibition (resulting in normalization). Motion stimuli whose responses were totally suppressed by coextensive opponent motion of higher contrast were rendered invisible to normalization, suggesting that the local interactions responsible for the WTA behavior here occur at an earlier stage of neural processing than the global interactions responsible for normalization.     

Bilateral Hippocampal Volume Loss in Patients with a History of Encephalitis or Meningitis

Volumetric analysis of high-quality magnetic resonance imaging (MRI) scans identifies asymmetric hippocampal atrophy in most patients with temporal lobe epilepsy. However, bilateral hippocampal atrophy can be missed by unnormalized volume measures. We considered two patient groups with temporal lobe epilepsy, one with a history of febrile convulsions (FC, n = 14) and one with a history of encephalitis or meningitis (E/M, n = 12), to compare the prevalence of bilateral volume loss between the groups. A volume normalization process defines a normal range of hippocampal volumes in control subjects (n = 32). Normalized volumes indicated that 11 of 14 subjects with a history of FC had unilateral hippocampal atrophy and 9 of 12 subjects with a history of E/M had bilateral hippocampal atrophy as compared with the controls. Visual assessments of unilateral hippocampal atrophy (n = 17) correlated well with measured unilateral volume loss (n = 14), but visual assessment of bilateral hippocampal atrophy (n = 3) correlated poorly with measured bilateral volume loss (n = 12). Mean age at seizure onset was lower in the FC group (7 years) than in the E/M group (13 years), but other clinical features were similar between the two groups. Hippocampal volume normalization is necessary to detect bilateral volume loss, which is common in patients with a history of encephalitis or meningitis.     

Empirical Bayes Gene Screening Tool for Time-Course or Dose–Response Microarray Data

Abstract

An efficient method to reduce the dimensionality of microarray gene expression data from thousands or tens of thousands of cDNA clones down to a subset of the most differentially expressed cDNA clones is essential in order to simplify the massive amount of data generated from microarray experiments. An extension to the methods of Efron et al. [Efron, B., Tibshirani, R., Storey, J., Tusher, V. (2001). Empirical Bayes analysis of a microarray experiment. J. Am. Statist. Assoc. 96:1151–1160] is applied to a differential time-course experiment to determine a subset of cDNAs that have the largest probability of being differentially expressed with respect to treatment conditions across a set of unequally spaced time points. The proposed extension, which is advocated to be a screening tool, allows for inference across a continuous variable in addition to incorporating a more complex experimental design and allowing for multiple design replications. With the current data the focus is on a time-course experiment; however, the proposed methods can easily be implemented on a dose–response experiment, or any other microarray experiment that contains a continuous variable of interest. The proposed empirical Bayes gene-screening tool is compared with the Efron et al. (2001) method in addition to an adjusted model-based t-value using a time-course data set where the toxicological effect of a specific mixture of chemicals is being studied.