甲基叔丁醚对大鼠的遗传毒性及脂质过氧化的影响

甲基叔丁醚 (ＭＴＢＥ)随着汽油无铅化需求的发展 ,已在世界范围内得到广泛的应用〔1〕。近年来我国已开始生产和使用ＭＴＢＥ ,目前我国已有 19家化工企业投产ＭＴＢＥ ,年产量达 30多吨〔2〕。因此 ,开展对国产ＭＴＢＥ的毒理学研究已成为必然。本文以经呼吸道染毒方法观察国产ＭＴＢＥ的遗传毒性 ,以及在这种染毒条件下对体内主要脏器超氧化物歧化酶 (ＳＯＤ)和丙二醛 (ＭＤＡ)水平的影响进行了研究。1　材料与方法1 1　材料　ＭＴＢＥ由上海高桥石化厂提供 ,比重 0 74 7,纯度为 98%。试验动物是由山西医科大学动物中心提供的成年健康雄…     

signa1.5TMR机(美国GE公司)一例故障分析

ｓｉｇｎａ１．５ＴＭＲ机（美国ＧＥ公司）一例故障分析大连医科大学一院宁殿秀，刘勤远，杜敏安故障现象：开机后只有配电柜（ＰＤＵ）和系统柜（ＳＹＳＴＥＭＣＡＢＩＮＥＴ）有电，其它几个柜均无电，各柜电源指示灯不亮。信息窗出现：ＳＰＩＭＤＳＬｉｎｋｆａｉｌｕ...     

宁波地区耐多药结核分枝杆菌乙胺丁醇耐药 犲犿犫犅基因突变研究

摘要：目的　分析宁波地区耐多药结核分枝杆菌（ｍｕｌｔｉｐｌｅｄｒｕｇ ｒｅｓｉｓｔａｎｔｔｕｂｅｒｃｕｌｏｓｉｓ,ＭＤＲ ＴＢ）临床分离 株的犲犿犫犅基因突变特征,探讨ＭＤＲ ＴＢ 对乙胺丁醇（ｅｔｈａｍｂｕｔｏｌ,ＥＭＢ） 耐药的产生与犲犿犫犅基因突变 的关系。方法　采用比例法对ＭＤＲ ＴＢ 临床分离株进行ＥＭＢ 敏感性检测, 应用ＤＮＡ 直接测序法检测 ＭＤＲ ＴＢ的犲犿犫犅基因突变情况。结果　１０６株ＭＤＲ ＴＢ 临床分离株中有４９株（４６．２３％） 对ＥＭＢ 耐药, ５７株（５３．７７％）对ＥＭＢ 敏感,５９ 株（５５．６６％） 发生了犲犿犫犅基因突变。在４９ 株ＥＭＢ 耐药菌株中, 犲犿犫犅基因突变的菌株为３４ 株（６９．３９％）, 在５７ 株ＥＭＢ 敏感菌株中,犲犿犫犅基因突变的菌株为２５ 株 （４３．８６％）,ＥＭＢ耐药菌株中的犲犿犫犅基因突变率高于敏感菌株（χ ２＝６．９５８,犘＜０．０５）。犲犿犫犅基因突变 类型有犲犿犫犅３０６,犲犿犫犅３５４,犲犿犫犅４０６,以犲犿犫犅３０６突变最多。犲犿犫犅３０６在ＥＭＢ耐药菌株中的突变率高于 ＥＭＢ敏感菌株（χ ２＝６．２７５,犘＜０．０５）。犲犿犫犅基因和犲犿犫犅３０６位点检测ＥＭＢ耐药的敏感度、特异度和准 确度分别为６９．３９％、５６．１４％、６２．２６％ 和６１．２２％、６３．１６％、６２．２６％。结论　宁波地区ＭＤＲ ＴＢ 对 ＥＭＢ耐药形势较为严峻,犲犿犫犅基因突变与ＭＤＲ ＴＢ对ＥＭＢ耐药相关。 关键词：耐多药结核分枝杆菌;乙胺丁醇;耐药;突变;犲犿犫犅基因 中图分类号：Ｒ３７８．９１　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１８）０７ ０５０５ ０４     

脑电地形图仪技术研究的现状及问题

脑电地形图仪技术研究的现状及问题北京回龙观医院（北京１０００８５）万振宽近年来，我国的脑电地形图（ＢＥＡＭ）的基础研究与临床应用技术得到了一些发展。由于ＢＥＡＭ是ＥＥＧ信号的二次处理，因此，ＢＥＡＭ的基本技术水平取决于构成ＢＥＡＭ的４个技术步骤水平，...     

135例恶性胆道梗阻的内镜姑息治疗

１３５例无手术指征的恶性胆道梗阻，其中８１例经内镜胆道塑料内置管引流（ＥＲＢＤ）。５４例经内镜胆道金属支架引流（ＥＭＢＥ）治疗。结果：引流２～３周ＥＲＢＤ组８８．９％、ＥＭＢＥ组９６１％病例胆红素降至正常，临床状况明显改善；ＥＲＢＤ组采用８Ｆ内置管者３０％、９Ｆ内置管者２５％，ＥＭＢＥ组３９％病例并发早期胆管炎；ＥＲＢＤ需３个月左右再梗阻前更换新管，ＥＭＢＥ５例（５６％）平均５８个月发生再梗阻。提示：ＥＲＢＤ、ＥＭＢＥ是无手术指征的恶性胆道梗阻的有效、安全的治疗方法。探讨了ＥＲＢＤ、ＥＭＢＥ的病例及引流部位选择问题。     

甲基叔丁基醚对原癌基因和功能基因表达的影响

甲基叔丁基醚（ＭＴＢＥ）是一种新型的汽油添加剂,被用来提高汽油燃烧效率,减少汽车尾气中有害物质的排放。ＭＴＢＥ具有一定的动物致癌性,但其机制目前并不清楚。本研究采用免疫组织化学方法,检测了ＭＴＢＥ对体外培养的ＮＩＨ３Ｔ３细胞中ｃ－ｍｙｃ和ｐ２１蛋白表达的影响;采用点杂交方法,从ＲＮＡ水平检测了ＭＴＢＥ亚慢性染毒大鼠肝组织中原癌基因ｃ－ｍｙｃ基因和功能基因ＧＳＴ－Ｐ基因的表达情况。免疫组化结果显示,ＭＴＢＥ可诱导ｃ－ｍｙｃ基因的高表达,对ｐ２１蛋白的表达未见明显影响。点杂交结果显示,ＭＴＢＥ可明显诱导大鼠肝组织中ｃ－ｍｙｃ基因的高表达,而对ＧＳＴ－Ｐ基因的表达未见明显影响。上述结果提示,ＭＴＢＥ可诱导细胞中ｃ－ｍｙｃ基因表达活性增高,可能是其动物致癌性的机制之一。     

高校公共卫生事业管理专业学生综合素质培养的研究

<正>我国许多医科院校纷纷设置了卫生管理专业,然而目前该专业设置时间短,基础薄弱,经验不足,办学的过程中存在较多的问题。本文就卫生管理专业人才的培养策略提出一些建议,以期对卫生管理人才的培养提供依据。     

EB病毒转化的永生性人B淋巴母细胞中的MTHFR基因的表达

为检测用ＥＢ病毒转化建立的永生性人Ｂ淋巴细胞株中Ｎ＾５,Ｎ＾１０－亚甲基甲氢叶酸还原酶（ＭＴＨＦＲ）基因的表达及其ｃＤＮＡ序列,用ＥＢ病毒转化人外周血Ｂ淋巴细胞,建立永生性细胞株后,从培养细胞中提取总ＲＮＡ,用ＲＴ－ＰＣＲ法扩增ＭＴＨＦＲ基因ｃＤＮＡ的不同片段,进行ＰＡＧＥ电泳分析和ｃＤＮＡ序列测定。结果显示永生性人Ｂ淋巴母细胞中有ＭＴＨＦＲ基因表达,其ｃＤＮＡ序列与文献报道的人肝脏ＭＴＡＨＦＲ基     

日本的循证医学

木之下正彦在《呼与循》 2 0 0 0年 4 8(11)期10 87页上撰文 ,介绍了在日本开展循证医学的情况。以日本循环器官学会制定心肌梗塞二级预防和慢性心衰治疗指针为契机 ,提出了循证医学 (Ｅｖｉ ｄｅｎｃｅ -ＢｚｓｅｄＭｅｄｉｃｉｎｅ (ＥＢＭ) )。ＥＢＭ首先是在 1999年 7月由日本的朝日新闻 ,读卖新闻作为特殊消息提出。在流行病学领域ＧｏｒｄｏｎＨｇｕｙａｔｔ,ＤａｖｉｄＬＳａｃｋｅｔｔ非常广泛交替使用ＥＢＭ的广告。虽然ＥＢＭ在医疗上已进行大规模临床试验 ,但ＥＢＭ的宗旨是根据最可靠和直接的证据 ,依据患者个体临床状态与价值…     

甲基叔丁基醚遗传毒性研究

甲基叔丁基醚（ＭＴＢＥ）是一种新型的汽油添加剂，被用来提高汽油辛烷值和减少汽车尾气中有害物质的排放。我们采用Ａｍｅｓ试验、程序外ＤＮＡ合成（ＵＤＳ）试验和细胞微核试验等反映不同遗传学终点的系列试验，检测了国产ＭＴＢＥ的遗传毒性。在Ａｍｅｓ试验（ＴＡ９８和ＴＡ１００菌株）中，在加和不加Ｓ－９的情况下，ＭＴＢＥ均未表现出致突变性。大鼠肝细胞ＵＤＳ试验显示，ＭＴＢＥ具有轻微的ＤＮＡ损伤作用。在ＮＩＨ３Ｔ３细胞微核试验中，ＭＴＢＥ呈现阴性结果。上述结果提示，ＭＴＢＥ在ＤＮＡ水平具有一定的遗传毒性     

生物医学工程产业发展与生物医学工程技术人才培养

结合我国生物医学工程产业发展、技术人员队伍建设以及高等医学院校生物医学工程教育的现状，阐述了医科院校生物医学工程教育的特点和规律。结合我国医院生物医学工程技术人员队伍建设以及高等医学院校生物医学工程教育存在问题的分析，提出了推动当前我国生物医学工程技术人员建设以及医学院校生物医学工程高等教育改革的一些思考。     

卫勤指挥网络课程训练体系设计

在建成的校园网基础上，根据卫勤指挥专业学科群各课程特点，进一步开发相应的学科网络训练平台是高等院校信息技术开发的一个重要任务。本文详细阐述了相关网络训练平台的设计原则及平台的系统构架和用户界面的设计，提出建设网络训练平台是顺应卫勤指挥专业人才培训新模式的重要举措。     

生物医学工程技术人员现状与生物医学工程教育

医学工程在现代医院起着越来越重要的作用。本文结合医学工程技术队伍建设现状，特别是知识结构、年龄结构、学历结构、继续教育以及社会需求情况等进行分析，认为医学院校生物医学工程教育对生物医学工程技术高素质人才的培养至关重要。为适应医学工程的发展，必须对医学院校BME高等教育的目标培养、课程设置、培养模式、管理机制专业设置进行改革和完善。     

医学院校培养生物医学工程人才的特点

根据国家现代化建设和当代科学技术快速的需要，结合十几年多层次生物医学工程教育的实践，从知识结构，专业课程设置，教学特点三个方面论述了医学院校生物医学工程教育培养人才的特点。     

超声技术在医学领域的应用与发展

超声医学技术是通过超声波与组织的物理(力学)特性发生作用而对组织成像或进行手术治疗的技术。它是继X线技术后,在医学中发展最为迅速,应用又十分广泛的,多学科渗透的生物医学工程分支。因为无损伤、无痛苦、可以反复进行检查和治疗的优点使得其特别适合针对软组织操作。近年来,医用超声仪器受到普遍重视,发展迅速。本文阐述了超声技术在临床医学的应用及其基本原理和发展前景。     

Intolerance of ambiguity in students entering medical school

Intolerance of ambiguity is the perception of ambiguous situations as a threat. Medical students with differing levels of intolerance of ambiguity may select medical specialties based upon the amount of ambiguity existing in the practice of each specialty. A cross-sectional survey at one state university administered Budner's Intolerance of Ambiguity Scale to all entering first-year medical students for four consecutive years (N = 609) to investigate patterns of intolerance of ambiguity in relationship with demographic variables and initial medical specialty preference. The medical students in this study were more intolerant of ambiguity than those first studied by Budner in 1962. Students entering in 1985 were slightly more intolerant of ambiguity than students in 1988. Students age 23 and older were less intolerant of ambiguity than students 18-22 years old. Men and students with natural/physical science undergraduate majors were more intolerant of ambiguity than their counterparts. However, medical specialty preference was not related to intolerance of ambiguity. Intolerance of ambiguity may be a personality trait or a learned characteristic, and needs further investigation.     

Physician Volunteerism: Thanking You for the Joy of Being Honored

Medical faculties have traditionally relied on gratuitous contributions of both university affiliated and community-based physicians to fulfill important goals and objectives. This phenomenon is likely to assume increasing importance as new assessment tools for student evaluation are developed and as modifications to curricula, such as the shift to ambulatory teaching sites, are introduced. There is a paucity of information regarding the characteristics of physician volunteerism. This study examines the prevalence of specific motivating factors in the context of recruitment of physician examiners for an OSCE jointly administered by a medical school and the Medical Council of Canada. Altruistic motives, such as the opportunity to contribute to the medical profession and to the educational process at the university and identification with institutions were more important than external rewards in promoting physician participation. The motivating factors were similiar in all groups of physicians and were generally independent of gender, specialty, university affiliation and practice profile. This revised version was published online in June 2006 with corrections to the Cover Date.     

The influence of medical school clinical experiences on career preferences: a multidimensional perspective

This study examines the multiple influences of medical school clinical experiences on student career preferences. The analysis of responses to pre-clerkship and post-clerkship questionnaires administered to the 1983 graduating class of a well-established medical school in the Great Lakes region of the United States indicates significant changes in career plans: away from primary care practice towards the surgical specialties; away from office-based practice towards clinical practice in a university medical center; and away from practice in small towns and communities towards locations in larger cities. These changes in the last 2 years of medical school appear to stem from an increased exposure to research and sophisticated medical technology. If allowed to continue, this trend in medical education will contribute further to the clinical specialty and geographic maldistribution problems of medicine in the United States.     

Computerized administrative monitoring system for interns and residents

During the last decade, the role of the government and the professional corporations in approving graduate programmes, licensing interns and residents and requesting statistical information has expanded greatly. The result has been a dramatic increase in administrative workload. At McGill University, the response of the Faculty of Medicine was the introduction of a Computerized Administrative Monitoring System (CAMS) for interns and residents, which provides immediate access, via a video display terminal, to any applicant's or trainee's information file. CAMS also provides timely reports on the status of administrative requirements for both the specialty programmes and the interns and residents assigned to them. The design and implementation of CAMS on the central university time-sharing computer system is described. Some measures of the effort to design, implement and run the system are included, along with an indication of the benefits to the clerical and medical staff who administer the 40 specialty programmes and some 1000 medical trainees.     

Benchmarking physician performance, Part 1

The performance of 16 primary care physicians in the same medical specialty and university clinic is compared using data envelopment analysis (DEA) efficiency scores. DEA is capable of modeling multiple criteria and automatically determines the relative weights of each performance measure. In this research, the performance measures include physician work relative value units (RVUs) as an input variable and patient satisfaction and total billable charges as the two output variables. The results provide insights into: 1. Who are the best-performing physicians? 2. Who are the underperforming physicians? 3. How can underperforming physicians improve? 4. What are the underperformers' performance targets? 5. How do you deal with full- and part-time physicians in a university setting? This research also provides a preliminary framework for how work measurement and DEA analysis can be used as a basis for a medical team or physician compensation system.