A history of the University of Oklahoma College of Medicine: perspectives on funding the educational mission

This paper discusses the history of the University of Oklahoma College of Medicine. The history from the perspective of the political environment has been published by Mark R. Everett and Alice A. Everett, and the third edition of that series will be published soon by Regents Professor Mark Allen Everett, MD. These volumes are essential reading for a thorough understanding of the history of the college. In this paper, I will concentrate on the history of funding the educational mission. It is an interesting study of the politics of a state institution and reflects the history of the chronic underfunding of higher education in the state of Oklahoma.     

以蛋白尿为首发症状的多发性骨髓瘤61例临床和病理分析

多发性骨髓瘤(multiple myeloma,MM)是克隆性浆细胞异常增生性疾病,随着人口老龄化,MM的发病率呈上升趋势.据国内外统计,多发性骨髓瘤肾损害发生率为60%～90%.蛋白尿是MM肾病早期的表现,部分患者仅表现为蛋白尿,数年后才出现骨髓瘤的其他症状或肾功能不全,故易误诊为肾小球肾炎、无症状性蛋白尿或隐匿性肾炎.本研究回顾了我科自1996年至今以蛋白尿为首发症状的MM患者61例的临床资料,旨在提高肾内科医生对该病的认识,避免漏诊和误诊.     

A 34-year-old man with Darier-White disease: a case report and review of the literature

Darier-White disease is an uncommon genodermatosis that is commonly under-recognized and is characteristically refractory to treatment. It is most frequently due to an autosomal dominant mutation in an intracellular calcium pump. It can be associated with severe cutaneous infections requiring hospitalization as well as neurologic and psychiatric comorbid disease. There are many treatment modalities described in the literature and systemic retinoids are the most effective. An increased clinical suspicion could possibly lead to a decreased delay in the diagnosis of this disease and an increased quality of life for these patients. We report a case of a man with Darier-White disease followed by a review of the current literature on the pathogenesis, clinical features, diagnosis, and treatment of this cutaneous malady.     

舒芬太尼对老年下肢骨折患者炎症及疼痛介质的影响

【摘要】〓目的〓观察舒芬太尼对老年下肢骨折患者炎症介质和疼痛介质的影响,为有效控制骨折疼痛提供临床依据。 方法〓选取2014年1月~2017年1月在南充市中心医院接受治疗的68例老年下肢骨折患者为研究对象,根据术后选择不同的止疼药物分为观察组与对照组,观察组25例患者使用舒芬太尼,对照组23例患者使用芬太尼,在术后24h和3d时比较两组患者的炎症介质因子白细胞介素2、6、10（IL 2、IL 6、IL 10）及疼痛介质血清5 羟色胺（5 HT）、一氧化氮（NO）、前列腺素E2（PGE2）的变化。结果〓①术后24h和3d时两组患者的IL 2、IL 6、IL 10指标水平均明显降低,而观察组降低更为明显（P＜005）。②术后观察组患者的5 HT、NO、PGE2表达水平逐渐降低并低于对照组（P＜005）。结论〓老年骨折患者术后采用舒芬太尼镇痛可使患者的炎症介质和疼痛介质明显的降低,镇痛效果显著,维持机体内细胞因子的相对平衡,对减少术后应激反应有积极的作用。     

首诊胸痛患者血清载脂蛋白B与冠状动脉病变的相关性分析

目的观察首诊胸痛患者血清载脂蛋白B(ApoB)与冠状动脉病变严重程度的相关性。方法选取2018年3月—2019年3月武汉大学人民医院心内科因首次胸痛(发现胸痛时间≤3个月)住院患者296例作为研究对象,以冠状动脉造影结果分为非冠心病组(86例)和冠心病组(210例),同时冠心病组按狭窄血管支数分为单支(82例)、双支(68例)和三支(60例)3个亚组,比较各组血脂差异,并分析ApoB和低密度脂蛋白胆固醇(LDL-C)与冠状动脉病变支数及Gensini评分的相关性。结果 3亚组血脂水平比较,随着冠状动脉血管病变支数增加,血清TC、LDL-C、小而密低密度脂蛋白胆固醇(ds-LDL)、ApoB及ApoA1/ApoB的水平逐渐升高(P <0.01)。在未服用降脂药的首诊胸痛患者中,LDL-C和ApoB与冠心病的发生呈正相关(r/P=0.236/0.011、0.275/0.009);而ApoB及LDL-C水平与病变血管支数呈正相关(r/P=0.315/0.007、0.224/0.012)。当采用Gensini评分作为冠状动脉病变严重程度的指标时,ApoB与Gensini评分的相关性(r=0.778,P=0.016)大于LDL-C(r=0.681,P=0.021)。结论 ApoB、LDL-C均与冠心病的发生呈正相关,而且ApoB与冠状动脉病变严重程度的相关性较LDL-C更为密切。