An approach to meeting the needs of medical students with learning disabilities

The Cognitive Skills Program at the Albert Einstein College of Medicine has identified 1% to 2% of students from several classes whose learning disabilities were previously undiagnosed. In three case studies, the importance of early identification and support during the preclinical years—and the impact of diagnosis, evaluation, and intervention—are illustrated. In each case, there was a dramatic improvement in performance when the student was made aware of his or her learning disability and when appropriate intervention was provided.     

经颅多谱勒超声在位置性缺血性眩晕中的应用

目的:探讨经颅多谱勒超声(TCD)在颈椎病(椎动脉型)所致位置性缺血性眩晕中的诊断价值.方法:利用TCD对颈椎病所致位置性缺血性眩晕76例患者进行双侧大脑后动脉(PCA)的平均血流速度分析,并结合转颈试验,探测双侧PCA平均血流速的动态变化情况.结果:颈椎病所致位置性缺血性眩晕患者当头侧向转动时,双侧PCA的平均血流速度暂时性降低,当头转回中立位时,平均血流速度逐渐回升.结论:TCD有助于识别位置性眩晕中的真性位置性缺血患者,是一种无创、简便、价廉、可靠,并可床旁操作和提供实时动态血流动力学资料的重要检查方法.     

糙海参皂苷Scabraside A、B的抗真菌和抗肿瘤活性

糙海参(Hlolthuria scabra Jaeger)属棘皮动物门、海参纲、楯手目、海参科,又名玉参、白参,广泛分布于我国海域.[1]     

奇乳海参中两个具有抗真菌活性的三萜皂苷

目的：研究奇乳海参体内的化学成分，寻找结构新颖具有抗真菌活性的三萜皂苷类成分。方法：应用多种色谱分离技术对奇乳海参体内的化学成分进行分离纯化，根据化合物的理化性质，波谱数据及化学方法鉴定其结构。结果：分离得到2个三萜皂苷化合物，分别为axilogoside A（1）和holothurin B（2），并对其抗真菌活性进行了研究（4≤MIC80≤16μg·mL^-1）。结论：化合物1为一新的三萜皂苷化舍物，化合物2为首次从奇乳海参中分离得到，它们均显示一定的抗真菌活性。     

内蒙古自治区智力残疾现患率调查及病因分析

目的:了解内蒙古自治区智力残疾(mental retardation.MR)的现患率及其分布特点,分析其主要致残原因构成特点,探讨预防治疗措施。方法:采用概率比例、多阶段分层整群抽样方法进行现况调查及病例对照研究,根据年龄分别使用丹佛发育筛查测验及《7岁以上人群残疾筛查问卷》筛查,分别使用Gesell发育诊断量表及韦氏儿童智力量表简式(WISC-CR),韦氏成人智力量表简式(WAIS-RC)进行智力诊断,采用SPSS11.0软件对数据进行统计分析。结果:①内蒙古自治区智力残疾患者的现患率为4.95‰,男性MR现患率高于女性(χ2=6.28,df=1,P<0.05),农村MR的现患率明显高于城市(χ2=60.035,df=1,P<0.01)。②内蒙古自治区智力残疾致残原因以疾病(29.26%)和遗传因素(23.79%)为主。③在18岁之前(智力发育期)发现智力残疾的占74.53%,且以0~3岁发现智力残疾的人数比例最高(48.84%)。结论:智力残疾的防治重点应在农村,预防应以疾病(主要包括脑疾病、内分泌障碍、惊厥性疾病)及遗传因素为主。强调早期发现、早期干预。     

几种表面活性剂对P-gp底物罗丹明123经肠黏膜透过性的影响

 目的观察低浓度表面活性剂聚氧乙烯蓖麻油,Labrasol和聚山梨酯80对肠黏膜P-gp的调控作用。方法使用体外扩散池法评价罗丹明123(R123)经空肠、回肠和结肠黏膜的经时经吸收方向和分泌方向的透过量和透过系数(P_app),并测定不同浓度表面活性剂对R123和荧光素钠(CF)经肠黏膜透过性的影响。R123和CF在接受室中的浓度用荧光分光光度法测定。结果R123经肠道黏膜的透过性存在部位差,即以空肠、回肠和结肠的次序透过性依次减少。另一方面,R123经肠道分泌方向的透过性显著地高于其吸收方向的透过性。低浓度的CEL和Labrasol可显著增强R123经吸收方向的透过性,减少经分泌方向的透过性;而低浓度的聚山梨酯80可显著增强R123经吸收方向的透过性,但对经分泌方向的透过性无显著影响。但实验浓度的表面活性剂对CF的肠道转运没有影响。结论低浓度的聚氧乙烯蓖麻油、Labrasol和聚山梨酯80可通过对P-gp功能的抑制而用于改善受P-gp介导药物的吸收,有望提高此类药物的口服生物利用度。     

Ten-year survival in 290 patients with endometrial cancer: prognostic factors and therapeutic approach

Summary. Between 1970 and 1976, 290 patients with endometrial cancer were treated at the 1st Obstetrics and Gynecology Clinic of the University of Milan. The median age was 62 years. Surgery was completed in 262 (90.3%) patients. Abdominal hysterectomy was used in 158 (70.9%) stage I and 40 (71.4%) stage II/III patients; vaginal hysterectomy in 55 (24.7%) stage I and nine (16.1%) stage II/III patients. Resection of the upper vagina was performed in 168 patients. Postoperative external beam radiotherapy was used in stage II/III patients and in 44 (19.7%) stage I high-risk patients. Ten-year survival, determined by the life-table method, was 84.8% in stage I (223 patients), 53.4% in stage II (37 patients), 64.4% in stage III (19 patients), and 9.1% in stage IV (11 patients). Factors associated with poorer prognosis were: late age at diagnosis (P<0.001); deep myometrial invasion (P<0.001); poorly differentiated histological grade ( P =0.11); lack of resection of the upper vagina ( P = 0.13). The role and importance of surgery is discussed, with special emphasis on the selective use of the vaginal route in aged, obese and medically high-risk patients.     

中医治疗糖尿病肾病近5年来的研究进展

综述近5年中医治疗糖尿病肾病在病因病机、辨证论治及实验研究方面取得的进展，提出了其存在的问题并分析了对策。