创设情境法在食品卫生学实验教学改革中的应用研究

目的 探讨创设情境法在食品卫生学实验教学中的效果。方法 研究选择两级预防医学专业共170名学生作为研究对象。2016级学生为试验组（n=88），采用创设情境法教学；2015级学生为对照组（n=82），采用常规教学模式。通过比较两组学生的成绩，收集学生和听课教师对课程的评价，同时以学生和实习带教教师进行定性访谈为参考，从学生端和教师端对课程教学效果进行综合考评。研究采用SPSS 20.0进行t检验和卡方检验。结果 试验组实验报告的思考题分数（课程1，P=0.038；课程2，P=0.043）和食品卫生卷面成绩（P=0.034）高于对照组。80.00%听课教师[本系教师8人（80.00%），教学督导4人（80.00%）]认为创设情境法充分体现专业知识、技能和跨专业能力及综合实践能力维度的培养。学生认为专业知识、技能和跨专业能力及综合实践能力各方面自我掌握度合格率分别100.00%（80人）、100.00%（80人）和97.75%（79人）。学生对教学方式满意度达到90.00%（70人）。定性访谈的结果对创设情境法的应用给予了充分认可。结论 创设情境法在食品卫生学实验课的应用既提升了学生的课程成绩，也提高了学生对于课程的认可度，并且创设情境法的应用充分体现了预防医学专业学生核心能力的培养。     

乳房钼靶X线、超声波、粗针吸取芯组织活检对早期乳腺癌诊断的评价

目的:探讨早期乳腺癌的特点和比较三种常用诊断方法。方法:以病理诊断作为金标准,统计51例均经X 线、超声波和粗针吸取芯组检查患者,比较三种检查方法诊断的敏感性。结果:传统增感屏胶片系统钼靶X线摄影对早期乳 腺癌显像的敏感度约为37.3%,乳腺超声对<0.5cm肿物难作定性诊断,LCB的敏感度74%～89%。结论:针对性的采用多 种检查手段联合检诊,对不能明确者放宽手术活检指征,是早期发现乳腺癌的较为可靠方法。     

髓芯减压BMP植入治疗股骨头坏死的血流量及病理改变

目的：研究股骨头坏死的早期治疗方法。方法：选取6月龄健康新西兰白兔42只，随机分组，注射激素制作股骨头坏死模型，行髓芯减压加植骨、髓芯减压植骨加BMP治疗，SPECT观察血流量的改变。结果：随着激素应用时间的延长，股骨头局部核素吸收量逐渐减少。应用激素第4周血流量降至正常的72%，6周为69%，8周为56%。髓芯减压术后2周恢复至正常的82%，4周时恢复正常。髓芯减压加BMP骨泥治疗组4周后镜下改变为大量新生骨形成，爬行替代坏死的骨小梁，且在新生骨周围有大量的新生血管形成。结论：髓芯减压术能改善坏死股骨头的血运，骨诱导蛋白（BMP）对坏死的股骨头具有骨诱导作用，能刺激新生骨的形成，爬行替代坏死的骨小梁，而且能刺激新生血管形成。     

对抗肿瘤药物分级管理中三个核心问题的思考★

抗肿瘤药物临床应用的分级管理不仅是抗肿瘤药物管理的核心策略,同时也是目前抗肿瘤药物管理的热点和难点。本文结合国家相关政策及本院管理实践,针对抗肿瘤药物分级管理中的三个核心问题(抗肿瘤药物分级目录的制定、抗肿瘤药物处方权限分级授予条件及超说明书用药)进行了分析和探讨,并给出相关建议,以期为医疗机构抗肿瘤药物分级管理工作的开展提供一定的参考。     

糖尿病肾病大鼠肾脏cbfa1表达与钙化的关系

目的:探讨糖尿病肾病大鼠肾脏钙化与骨分化核心结合因子1(cbfa1)表达的关系。方法:用链脲佐菌素诱导糖尿病肾病大鼠模型,并以正常大鼠作为对照组,于第3、6月末分别采用Von Kossa染色观察肾脏钙盐沉积、肾脏免疫组化、RT-PCR、Wester Blot法观察肾脏cbfa1的表达水平。结果:糖尿病肾病大鼠肾脏有cbfa1的表达,且与钙盐沉积程度有关。正常大鼠肾脏没有发现cbfa1的表达。结论:糖尿病肾病晚期时肾脏出现钙盐沉积,肾脏cbfa1的表达水平与钙盐沉积程度呈正相关。     

Opioid site in nucleus accumbens shell mediates eating and hedonic ‘liking’ for food: map based on microinjection Fos plumes

Microinjection of opioid agonists, such as morphine, into the nucleus accumbens shell produces increases in eating behavior (i.e. ‘wanting’ for food). This study (1) reports direct evidence that activation of accumbens opioid receptors in rats also augments food ‘liking’, or the hedonic impact of taste, and (2) identified a neural site that definitely contains receptors capable of increasing food intake. Morphine microinjections (0.5 μg) into accumbens shell, which caused rats to increase eating, were found also to cause selective increases in positive hedonic patterns of behavioral affective reaction elicited by oral sucrose, using the ‘taste reactivity’ test of hedonic palatability. This positive shift indicated that morphine microinjections enhanced the hedonic impact of food palatability. The accumbens site mediating morphine-induced increases in food ‘wanting’ and ‘liking’ was identified using a novel method based on local expression of Fos induced directly by drug microinjections. The plume-shaped region of drug-induced increase in Fos immunoreactivity immediately surrounding a morphine microinjection site (Fos plume) was objectively mapped. A point-sampling procedure was used to measure the shape and size of ‘positive’ plumes of Fos expression triggered by microinjections of morphine at locations that caused increases in eating behavior. This revealed a functionally ‘positive’ neural region, containing receptors directly activated by behaviorally-effective drug microinjections. A subtraction mapping procedure was then used to eliminate all surrounding regions containing any ‘negative’ Fos plumes that failed to increase food intake. The subtraction produced a conservative map of the positive site, by eliminating regions that gave mixed effects, and leaving only a positive region that must contain receptors capable of mediating increases in food intake. The resulting mapped ‘opioid eating site’ was contained primarily within the medial caudal subregion of the nucleus accumbens shell, and did not substantially penetrate either into the accumbens core or into other subregions of the shell. Several other structures outside the nucleus accumbens (such as rostral ventral pallidum), immediately medial and adjacent to the shell, also appeared to be included in the functional site. Opioid receptors within this site thus are capable of mediating morphine-induced increases in eating, in part by enhancing the hedonic reward properties of food.     

Identification of in vivo interaction between Hepatitis C Virus core protein and 5′ and 3′ UTR RNA

Here, we investigated the ability of the Hepatitis C Virus (HCV) core protein to interact specifically with the 5′ and 3′ untranslated regions (UTRs) of HCV using an in vivo cell-based translation inhibition assay. HCV core protein interacts weakly but specifically with the SLIII stem loop in the 5′ UTR in which the SLIIIb subdomain is the major determinant and the SL2 loop in the X region of the 3′ UTR. These results revealed for the first time in vivo interaction of the core protein with 5′ and 3′ UTRs involved in the viral life cycle. This system provides a useful tool for further investigating interactions between the HCV core protein and 5′ and 3′ UTRs.     

Core Beliefs and History of Major Depressive Episodes in Currently Non-depressed University Students

The current study examined the association between negative core beliefs and a past history of major depressive episodes (MDE) in currently non-depressed university students. Sixty-three university students completed self-report measures assessing current depressive symptoms. They also completed a semi-structured interview assessing current and past histories of MDE. The presence of negative core beliefs was identified through an examination of participants’ life stories. Negative core beliefs were associated with a past history of MDE in non-disordered participants. Further, analyses revealed that the content domains of (1) disconnection/rejection and (2) overvigilance/inhibition were significantly associated with a past history of MDE whereas the content domains of (1) impaired autonomy/performance, (2) impaired limits, and (3) other-directedness were not. Findings provide preliminary support for recent theoretical models highlighting the potential importance of core beliefs in the etiology of depression.     

Artificial bone grafting [calcium hydroxyapatite ceramic with an interconnected porous structure (IP-CHA)] and core decompression for spontaneous osteonecrosis of the femoral condyle in the knee

We employed a new surgical method for the treatment of spontaneous osteonecrosis of the medial femoral condyle of the knee joint. Twelve spontaneous osteonecrosis patients of Koshino's classification stage 2 or 3 underwent core decompression curettage with an artificial bone graft [hydroxyapatite ceramic with an interconnected porous structure (IP-CHA)]. The mean age at surgery was 69.6 years and the mean follow-up term was 24.6 months. All patients reported a decrease in knee pain, immediately after surgery. The Japanese Orthopaedic Association (JOA) scores of all the patients also improved post-surgery; X-ray and MR imaging indicated no worsening of the osteoarthritis, and smooth surfaces at the grafted areas of the artificial bone. No severe complications appeared in the patients. Our procedure was, therefore, less invasive and achieved results comparable to those involving traditional, more invasive methods. We recommend our novel procedure as a treatment for spontaneous osteonecrosis of the femoral condyle.     

Joint hypermobility as a distinctive feature in the differential diagnosis of myopathies

Congenital and adultonset inherited myopathies represent a wide spectrum of syndromes. Classification is based upon clinical features and biochemical and genetic defects. Joint hypermobility is one of the distinctive clinical features that has often been underrecognized so far. We therefore present an overview of myopathies associated with joint hypermobility: Ullrich congenital muscular dystrophy, Bethlem myopathy, congenital muscular dystrophy with joint hyperlaxity, multi-minicore disease, central core disease, and limb girdle muscular dystrophy 2E with joint hyperlaxity and contractures. We shortly discuss a second group of disorders characterised by both muscular features and joint hypermobility: the inherited disorders of connective tissue Ehlers-Danlos syndrome and Marfan syndrome. Furthermore, we will briefly discuss the extent and pattern of joint hypermobility in these myopathies and connective tissue disorders and propose two grading scales commonly used to score the severity of joint hypermobility. We will conclude focusing on the various molecules involved in these disorders and on their role and interactions in muscle and tendon, with a view to further elucidate the pathophysiology of combined hypermobility and myopathy. Hopefully, this review will contribute to enhanced recognition of joint hypermobility and thus be of aid in differential diagnosis.