医科院校师生对考试现状看法的调查与分析

医科院校的考试主要是学科考试。调查显示，教师和学生对目前的学科考试模式评价均不高，存在的最主要弊端是考试方法单一，考试管理不够科学、严谨，考风不好；认为作弊的主要原因在于学生自己学习不努力、社会风气影响以及学校对教师和学生要求不够严格。因此，要搞好考试改革，提高考试质量，必须着重从改革考试方法、加强考试管理的改革与研究、整顿考风、制定科学的成绩评定方法、加强能力考核、实施教考分离等方面进行探索与实践。     

大鼠室旁核内催产素免疫阳性细胞树突棘样结构在脱水状态下的改变

树突棘，室旁核，催产素，脱水，免疫组化，大鼠下丘脑内催产素大细胞神经分泌细胞与水盐代谢的调节有关，并伴有细胞形态的改变如细胞体积的增大及细胞膜与细胞膜间接触的增加和多突触的形成等。本文用免疫组化法发现在脱水状态下室旁核的催产素免疫阳性神经元上树突棘样结构有所增加。光镜观察并计算室旁核前大细胞亚核、内侧大细胞亚核及后大细胞亚核中含树突棘样结构的催产素神经元百分数变化，显示正常大鼠室旁核神经元树突棘样结构多位于树突干上，少数在胞体上。前大细胞亚核含树突棘样结构的细胞百分数为２１．２７％，内侧大细胞亚核为３０．２２％，后大细胞亚核为２０．２２％。轻度脱水大鼠室旁核含树突棘样结构细胞百分数显著增加（前大细胞亚核：２８．６５％，Ｐ＜０．０５；内侧大细胞亚核：３５．５３％，Ｐ＞０．０５；后大细胞亚核：３４．７８％，Ｐ＜０．０１）。细胞上树突棘样结构数也增加，其体积略为增大。重度脱水大鼠室旁核中树突棘样结构细胞百分数增加较小，仅后大细胞亚核内有显著变化（２７．１３％，Ｐ＜０．０５）。不同程度脱水组之间无显著变化。结果说明脱水可引起神经元膜结构的改变。树突棘样结构数变化是否与新突触的形成有直接关系？尚待进一步证实。     

Efficacy of lumiracoxib in relieving pain associated with knee osteoarthritis: a 6‐week,randomized, double‐blind,parallel‐group study

Aim: The aim of the current study was to assess the efficacy, safety, and tolerability of lumiracoxib 200 mg once daily (o.d.) in relieving osteoarthritis (OA) knee pain in patients in China, Taiwan, and South Korea. Methods: Patients of either sex (aged ≥ 18 years) with symptomatic, primary OA of the knee for ≥ 3 months were eligible for inclusion if they had OA pain intensity of ≥ 40 mm (100 mm visual analogue scale [VAS]) in the target knee joint during the previous 24 h. Patients were required to undergo regular non‐steroidal anti‐inflammatory drug therapy for ≥ 6 weeks. After 3–7 days of screening, patients were randomized (1 : 1) to receive either lumiracoxib 200 mg o.d. or celecoxib 200 mg o.d. The primary efficacy comparison between the study groups was overall OA pain intensity (VAS) in the target knee after 6 weeks of treatment. Results: The mean overall OA pain intensity (VAS) in the target knee after 6 weeks decreased from 60.6 mm to 35.7 mm and 60.5 mm to 36.1 mm in the lumiracoxib and celecoxib groups, respectively. Both study groups showed similar results in terms of improvement in both patient's and physician's global assessment of disease activity and functional health status. The percentage of adverse events (AEs) in the lumiracoxib and celecoxib groups (40.3% and 37.9%, respectively) was similar, as was the proportion of treatment‐related AEs (21.0% and 18.2%, respectively). Conclusions: Lumiracoxib 200 mg o.d. provided effective and well‐tolerated pain relief similar to that achieved with celecoxib 200 mg o.d. in knee OA patients.     

A case of Non-Hodgkin's lymphoma in a patient with Crohn's disease]

Although adenocarcinoma is a well known complication of chronic inflammatory bowel disease, primary gastrointestinal lymphoma occurring in Crohn's disease is rare. A 40-year-old man with 10 year-history of Crohn's disease had multiple longitudinal ulcerative lesions on descending colon in follow-up colonoscopic examination. Microscopic examination of proximal descending colon revealed peripheral T cell lymphoma and other site of the descending colon was consistent with Crohn's disease. The patient reached complete remission of malignant lymphoma after three cycles of combined chemotherapy. He has been well for 10 months with sulfasalazine maintenance therapy but was admitted to the hospital due to spontaneous bowel perforation of ascending colon. Right hemicolectomy was done, but the patient died of post-surgical recurrent mesenteric abscess and sepsis. To the best of our knowledge, this is the first case of Non-Hodgkin's lymphoma complicating Crohn's disease in Korea which was confirmed by immunohistochemical studies.     

子宫体三角形切除术的临床应用

目的:探讨子宫体三角形切除术的临床价值。 方法 :对子宫体三角形切除术组、子宫次全切除术组各6 4例进行回顾性分析。结果:两组的手术时间、出血量、术后排气时间等比较 ,差异无统计学意义 (P >0 .0 5 ) ,但子宫体三角形切除术组术后有少量月经。两组在性生活质量及更年期症状方面差异有统计学意义 (P <0 .0 1)。子宫体三角形切除术组的血清性激素水平手术前 FSH(7.0 5± 1.10 ) IU/ L、E2 (5 6 .4 0± 1.12 ) pm ol/ L,手术后 FSH(6 .88± 1.12 ) IU/ L、E2 (5 6 .2 8± 1.15 ) pm ol/ L,手术前后比较差异无统计学意义 (P >0 .0 5 )。子宫次全切除术组血清性激素水平手术前 FSH(5 .98± 1.15 ) IU/ L、E2 (5 6 .2 2± 1.10 ) pmol/ L,手术后 FSH(10 .6 6± 1.18) IU/ L、E2(47.4 5± 1.2 0 ) pmol/ L,手术前后比较差异有统计学意义 (P<0 .0 5 )。 结论:子宫体三角形切除术术式具有操作简单、易于掌握、不影响卵巢功能、术后恢复快等优点 ,能满足患者既去除疾病又保留子宫的生理和心理需要     

A randomized, double-blind, crossover comparison of risperidone and haloperidol in Korean dementia patients with behavioral disturbances.

OBJECTIVE: Behavioral disturbances in dementia are extremely prominent and distressful, and often result in serious physical, social, and economic consequences. The authors compared the efficacy and tolerability of risperidone and haloperidol in the treatment of behavioral and psychological symptoms of dementia (BPSD) in institutionalized elderly Korean patients with Alzheimer disease, vascular dementia, or mixed dementia. METHODS: This was an 18-week double-blind, crossover study involving 120 patients who were randomly assigned to receive flexible doses (0.5-1.5 mg/day) of risperidone or haloperidol. BPSD were assessed using the Korean version of the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD-K), the Korean version of the Cohen-Mansfield Agitation Inventory (CMAI-K), and the Clinical Global Impression of Change scale (CGI-C). Safety and tolerability assessments included the Extrapyramidal Symptom Rating Scale and the incidence of adverse events. RESULTS: Both risperidone and haloperidol were efficacious in alleviating BPSD. However, when receiving risperidone, patients showed significantly greater improvement than when receiving haloperidol in the total and subscale scores of the BEHAVE-AD-K, the total and subscale scores of the CMAI-K, and the scores on the CGI-C scale. Also, risperidone had an additional benefit on aggressiveness and anxieties/phobias. The risk of antipsychotic-induced parkinsonism throughout this study was significantly lower with risperidone than with haloperidol. CONCLUSION: Risperidone had a favorable efficacy and tolerability profile compared with haloperidol in the treatment of BPSD in this patient population.     

CT在诊断胸部结节病中的意义

结节病(sarcoidosis)是一种原因不明的疾病,全身多个器官均可受累,90%以上有肺的改变犤1犦,以病变处非干酪样上皮细胞肉芽肿形成为特征犤2犦。临床多无特异性症状,常规胸片为其基本诊断方法。随着螺旋CT、高分辨CT在临床中的     

单独肝尾状叶血管瘤切除术

肝尾状叶由于解剖位置特殊,位置深,难以显露,手术难度大,是肝脏外科领域手术操作的难点与研究热点.随着肝血流控制技术的发展、肝实质离断技术的提高,肝尾状叶肿瘤切除率明显提高[1].2006年4月至2008年10月,我科完成单独肝尾状叶血管瘤切除术9例,现将手术技巧与疗效报道如下.     

Poxvirus-based vaccine therapy for patients with advanced pancreatic cancer

Purpose  

An open-label Phase 1 study of recombinant prime-boost poxviruses targeting CEA and MUC-1 in patients with advanced pancreatic cancer was conducted to determine safety, tolerability and obtain preliminary data on immune response and survival.