医药类专业本科物理课程的设置及目标与定位探讨

目的：探讨物理课程在高等医药类专业教育中的作用与地位。方法：对全国部分城市不同类别医院从业医务工作者进行调查，综合国际医学教育标准和我国现实医学教育以及医疗服务行业状况进行分析。结果：探讨了我国高等医药类专业教育中物理课程的设置及目标与定位问题，给出了明确的课程定位与设置标准。结论：现代医学高等教育不应忽视或淡化物理课程在医学人才培养中素质教育和专业水平提高的积极作用与基础地位，在有限的学时空间内合理安排基础性内容和与专业素质培养相关的应用内容。     

人工晶体植入前后视觉诱发电位的临床分析

目的:(1)探讨白内障囊外摘除术前术后及人工晶体植入术后视觉诱发电位幅值及潜时变化特征;(2)探讨白内障囊外摘除术术前P—VEP,F—VEP,F—ERG联合预测的必要性。方法:采用重庆泰克医电仪器公司产TEC—100C视觉电生理仪。对白内障患者实行分组测量。术前均测F—ERG,P—VEP,部分病例增测F—VEP。结果:114例术前F—ERG正常,P—VEP测量其P_(100)波幅值潜时均异常:P_(100)波幅值降低,潜时延长,术后及人工晶体植入后幅值,潜时都有所改善,而并发性白内障,代谢性白内障变化不明显。结论:据视觉诱发电位的变化,老年性白内障组,外伤性白内障组术后应及时装入人工晶体,并发性白内障组,代谢性白内障组装入人工晶体临床意义不大。术前联合测试(VEP ERG)对视力预后、以及眼底病变的定量诊断意义重大。     

Analysis of fMRI data by blind separation of data in a tiny spatial domain into independent temporal component

Independent Component Analysis (ICA) is a promising tool for the analysis of functional magnetic resonance imaging (fMRI) time series. In these studies, mostly assumed is a spatially independent component map of fMRI data (spatial ICA). In this paper, we assume that the temporal courses of the signal and noises are independent within a Tiny spatial domain (temporal ICA). Then with fast-ICA algorithm, spatially neighboring fMRI data were blindly separated into several temporal courses and were preassumed to be formed by a signal time course and several noise time courses where the signal has the largest correlation coefficient with the reference signal. The final functional imaging was completed for the signals obtained from each voxel. Simulations showed that compared with the spatial ICA method, the new temporal ICA method is more effective than the spatial ICA in detecting weak signal in a fMRI dataset. As background noise, the simulations include simulated Gaussian noise and fMRI data without stimulation. Finally, vivo fMRI tests showed that the excited areas evoked by a visual stimuli are mainly in the region of the primary visual cortex and that evoked by auditory stimuli are mainly in the region of the primary temporal cortex.     

Local and systemic consequences of acute,low-dose ultraviolet B radiation are mediated by different immune regulatory mechanisms

Acute, low-dose ultraviolet B (UVB) radiation alters the local skin site such that epicutaneous application of hapten fails to induce contact hypersensitivity (CH), but induces tolerance in UVB-susceptible mice. Although the inability of irradiated skin to support CH induction may be a strictly local effect, there may also be systemic immune consequences of UVB radiation delivered in this manner. To examine this matter, abdominal skin of C57BL/6 mice was exposed to acute, low-dose UVB radiation. Dinitrofluorobenzene was immediately painted directly on the irradiated site, or at a distant (unirradiated) site. In separate experiments, epicutaneous application of the hapten on a distant site was delayed for 1–3 days. The mice were tested for acquisition of CH, and for tolerance, i.e. the capacity to become sensitized when exposed subsequently to hapten via normal body wall skin. It was found that, immediately after completion of the UVB regimen, CH was inducible via unirradiated, but not via irradiated, skin. At 3 days post-UVB exposure, CH was no longer inducible even through unirradiated skin. Mice that first encountered hapten via UVB-exposed skin developed tolerance, as did mice that first encountered hapten via unirradiated skin of UVB-treated mice. Neutralizing anti-tumor necrosis factor-α TNF-α antibodies failed (a) to restore the ability of unirradiated skin to support induction of CH, and (b) to interfere with tolerance induction, whether hapten was first painted on irradiated or unirradiates skin. The data indicate that the acute, low-dose regimen of UVB radiation produces effects on the immune system that are manifest locally as well as systemically. By demonstrating that the disruption of CH induction following UVB radiation is TNF-α dependent, whereas locally and systemically induced tolerance is not, our findings encourage further search for other UVB-related modulators of systemic immunity and tolerance.     

人体寄生虫学网络课程的应用与评价

目的对郧阳医学院人体寄生虫学网络课程的教学效果进行评价。方法选取2005级临床医学一系和二系分别作为实验组和对照组，对照组的人体寄生虫学采用传统教学方法教学，实验组采用传统教学和本课题组构建的人体寄生虫学网络课程平台进行辅助教学。结果实验组学生的人体寄生虫学理论课程考试成绩和实验课程考试成绩明显优于对照组学生（P〈0．05）。结论人体寄生虫学网络课程能够显著提高教学效果，对突破传统面授教学的局限性和帮助学生网上学习具有重要意义。     

Infective endocarditis at a Hospital of the University of Kiel, 1958–1987

Summary The clinical courses of 214 patients with infective endocarditis treated between 1958 and 1987 at the First Medical Hospital of the University of Kiel (FRG) were analyzed retrospectively. A decrease in the incidence of endocarditis occurred during the 30-year observation period. The mean age of patients was 48 years, and men were more frequently affected than women. In the course of the investigation, a rise in isolated aortic valve disease was noted, whereas the number of patients with isolated involvement of the mitral valve and combined mitral-aortic valvular defects declined. Streptococci (57%) were the most frequent pathogens isolated; as opposed to their increase, the percentages ofStaphylococcus aureus and enterococci decreased. Otolaryngological, dentogenic and urogenital diseases were most frequently held to be responsible for the development of infective endocarditis. Prior cardiosurgical interventions became increasingly significant as a cause of the disease. In this connection, a rising percentage of endocarditis cases was linked with prosthetically replaced heart valves. Complications and concomitant symptoms of endocarditis included the development of heart failure, cerebral embolism and encephalitis, splenomegaly, and renal inflammation. Finally, the marked decrease in mortality contrasted with a simultaneous rise in the number of endocarditis cases achieving full recovery.     

SARS病人外周血T淋巴细胞的动态变化及其在发病进程和发病机理中的意义

目的 :通过研究严重急性呼吸综合征 (SevereAcuteRespiratorySyndrome,SARS)患者外周血免疫细胞的动态变化 ,探讨外周血免疫细胞在SARS发病进程中的意义 ,初步探讨SARS的发病机理 ,并为SARS的诊断和治疗提供有力的实验室依据。方法 :回顾性动态观察我院收治的已治愈SARS病例和SARS死亡病例外周血CD4 + 和CD8+ T淋巴细胞 ,评估外周血免疫细胞在SARS发病进程及预后中的作用。实验方法为流式细胞术检测和分析免疫细胞表面特异性荧光抗体标记 ,T细胞表面标志组合为CD3 CD8 CD4 5 CD4。结果 :所有治愈的SARS病人的CD4 + 和CD8+ T淋巴细胞都有不同程度的可逆性下降 ,而所有的死亡病例有不可逆性显著下降 ,直至死亡。T细胞下降程度和维持的时间与病情密切相关。普通型SARS病例最低CD4 + T淋巴细胞数为 30 5± 15 0cells μl(P <0 .0 0 1)、重型为 139± 6 9cells μl(P <0 .0 0 1) ,普通型SARS病例最低CD8+ T淋巴细胞数为 2 2 3± 89cells μl(P <0 .0 0 1)、重型为 171± 92cells μl(P <0 .0 0 1)。所有普通型病例和大部分重型病例T淋巴细胞恢复正常 ,个别重型病例低于正常或接近正常 ,恢复后普通型平均为 991± 2 86cells μl,重型平均为 5 4 5± 2 2 5cells μl。恢复时间有所不同 ,普通型平均为 17± 5天     

Blockade of CD40-CD40 ligand pathway induces tolerance in murine contact hypersensitivity

Interactions between CD40 on antigen-presenting cells and its ligand (CD40L) on T cells has been implicated in T cell-mediated immune responses. Previously, we have shown that contact hypersensitivity (CHS), a cell-mediated cutaneous immune response in reaction to haptens, could be subclassified based on whether the hapten primed for Th1 or Th2 cytokines in cells isolated from draining lymph nodes. We also found that tolerance to a Th2-priming hapten could be induced only by simultane blockade of the CD40-CD40L and B7-CD28 at the time of sensitization. Here we demonstrate that blockade of CD40-CD40L signaling alone induces long-lasting unresponsiveness to the Th1 hapten 2,4-dinitrofluorobenzene (DNFB), and inhibits antigen-specific T cell proliferation in vitro. We find that CD40-CD40L signaling is required in the sensitization but not elicitation phase of DNFB-induced CHS, as treatment of mice with anti-CD40L monoclonal antibody (mAb) does not affect the response to hapten challenge in previously sensitized and untreated animals. Examination of cytokine production shows that anti-CD40L mAb decreases interferon-γ production by draining lymph node cells from DNFB-sensitized mice, and reciprocally increases interleukin (IL)-4 production. Consistent with this Th1 to Th2 immune deviation, anti-CD40L mAb prevents the induction of IL-12 mRNA in regional lymph nodes, an event which is normally seen within 12 h following hapten sensitization. In contrast, suppression of CHS by CTLA4Ig decreased the production of all cytokines by draining lymph node cells. Together, these data show that blockade of the CD40-CD40L pathway by itself is sufficient to induce tolerance to DNFB-induced CHS, and that this is associated with blockade of IL-12 induction and Th1 to Th2 immune deviation.     

Ectopia lentis in Loeys‐Dietz syndrome type 4

Loeys‐Dietz syndrome is a heritable disorder of the connective tissue leading to multisystem involvement including craniofacial features, skeletal abnormalities, cutaneous findings and early‐onset and aggressive disease of the aorta and its branches. There are multiple types of Loeys‐Dietz syndrome related to pathogenic variants in TGFBR1, TGFBR2, SMAD3, TGFB2, and TGFB3. Individuals with Loeys‐Dietz syndrome may be misdiagnosed as having Marfan syndrome due to shared phenotypic features and aortic root dilation. However, ectopia lentis has been an important discriminating feature, being unique to Marfan syndrome and not reported to be associated with Loeys‐Dietz syndrome. We report the case of a 46‐year‐old woman with Loeys‐Dietz syndrome type 4 due to a pathogenic variant in TGFB2 who was diagnosed with ectopia lentis at age 44. The patient underwent whole exome sequencing and no other pathogenic variants were found to explain the ectopia lentis. Our findings indicate that ectopia lentis may be an uncommon finding in Loeys‐Dietz syndrome type 4 and emphasize the importance of genetic testing in familial thoracic aortic aneurysm disease.