医院图书馆员继续教育若干问题研究

在分析医院图书馆员继续教育的核心内容和主要形式的基础上,作者探讨了医院图书馆员继续教育的途径。     

An Analytic Model of Subminiature Auditory Sensation System for Sound Source Localization

It is reported that some types of insects have a remarkable ability to detect the direction of an incident sound even though its acoustic sensory organs are in very close proximity each other. Maybe the ears are jointed by a cuticular structure with which the separated motions can be coupled mechanically and thus be magnified. In this paper, a detailed model is setup to describe the principle of this type of localization using a mechanical coupled structure. The transfer functions and the responses of the model in terms of time and frequency are analyzed to describe the mechanism of its ability of directional hearing. This analytical model provides a method to design the experimental model for the predetermined incident sound pressure, and the analysis of this model shows that this structure have the ability to determine the direction of the incident stimulus.     

大鼠腰髓背角星形胶质细胞及神经元对一侧胫、腓骨骨折的反应及其相互关系

目的 研究大鼠脊髓内星形胶质细胞及神经元对一侧胫、腓骨骨折的反应及相互关系。方法 应用细胞免疫组织化学方法，观察脊髓内胶质原纤维酸性蛋白(GFAP)、Fos蛋白双标记以及蛋白激酶C(PKC)在左侧胫、腓骨骨折后不同时程的表达变化。结果 1．左侧胫、腓骨骨折后，GFAP阳性反应产物主要分布于同侧腰髓背角的星形胶质细胞胞浆，Fos阳性产物在其胞核也有表达，且以浅层为主，神经元的胞核也有Fos阳性产物；2．Fos—LI神经元与GFAP／Fos-LI星形胶质细胞的分布基本一致，两者关系密切；3．GFAP／Fos—LI星形胶质细胞表达高峰期在骨折后45min，而Fos—LI神经元的表达高峰期在骨折后90min；PKC—LI星形胶质细胞出现及达到高峰的时间比PKC—LI神经元要早。结论 腰髓背角的星形胶质细胞参与了下肢骨折伤害性刺激的应激反应及调节过程，而且Fos—LI、PKC-LI的表达早于神经元，可能主动地影响神经元的活动。     

Trends in human reproductive wastage in relation to long-term practice of inbreeding

The trends in reproductive performance and wastage are studied in relation to consanguinity of marriage and age of women on a population sample of 20,626 women, from the rural and urban areas of North Arcot District in South India. Data were collected by qualified women investigators using intensive interveiw techniques and specially developed questionnaires. Adequate quality control mechanisms were set up to ensure reliability of information gathered. For each marriage, a family pedigree was drawn extending upwards to two early generations on the side of each spouse in order to determine the existence and type of consanguinity married, 80% or more of such between an uncle and a niece or between first cousins. Altogher 70 161 total pregnancies were recorded for the 20,626 women. The differences between consanguineous and non-consanguineous marriages in terms of total foetal loss, perinatal, neonatal, postneonatl and infant mortality rates showed only marginal differences that attain statistical significance only because of the large sample size involved. No consistent relationships were observed between the degree of consanguinity and these reproductive losses. These actual differences were more marked in the older age-groups of women and declined to rather insignificant proportions as the age groups became younger. Taking into consideration the various socio-demographic factors, the narrowing differentials in the reproductive wastage between consanguineous and non-consanguineous marriages from the oldest to the youngest women confirm the tapering effects of continued inbreeding practices on the reproductive wastage. Further studies on these lines are still in progress.     

铜绿假单胞菌外毒素A的表达、纯化与生物学活性研究

目的利用基因工程技术制备铜绿假单胞菌外毒素A(PE),为深入研究PE的致病机理和免疫防治奠定基础。方法应用PCR技术从铜绿假单胞菌基因组中扩增外毒素A全长结构基因,将其克降于原核表达载体pQE-31中,所构建的重组质粒经测序鉴定后转化大肠埃希菌JM109, IPTG诱导表达;制备融合蛋白包涵体,并采用Ni-NTA柱亲和层析、葡聚糖凝胶过滤和阴离子交换层析分离和纯化目的蛋白;采用透析法对纯化后的目的蛋白进行复性,MTT法测定复性后的重组PE对L929细胞、B16黑素瘤细胞的细胞毒活性。结果通过对PCR反应体系的优化,扩增到了PE全长结构基因。所构建的pQE-PE重组质粒经酶切及测序鉴定与设计序列一致;转化E.coli JM109后,IPTG诱导目的蛋白表达率约为25%;SDS-PAGE初步测定目的蛋白的相对分子质量(M_r)约为66×10~3,与理论预期值一致;破菌后电泳证实目的蛋白主要以包涵体形式表达。经亲和层析、葡聚糖凝胶过滤和阴离子交换层析后蛋白纯度大于95%。MTT法测得重组PE对L929细胞和B16黑素瘤细胞的半数抑制浓度(IC_(50)值)分别为2.13μg/ml、2.58μg/ml。结论通过对PE的表达纯化,获得了具有细胞毒活性的重组PE,为利用基因工程手段大量制备PE的工作奠定了基础。     

广东汉族人β2-肾上腺素能受体基因Gln27Glu多态性

目的 探讨β2-AR 16位点基因多态性在广东汉族人群中的分布．方法 应用聚合酶链反应技术对122例正常人β2-肾上腺素能受体基因Gln27Glu进行扩增并进行图谱分析．并结合文献进行了不同种族间的分析比较．结果 广东汉族人群β2-AR基因27位点多态性分布频率：Gln／Gln基因型占36．88％，Gln／Glu基因型占52．46％，Glu／Glu基因型占10．66％．结论 广东汉族人群存在出β2-AR Gln27Glu基因多态性，其分布频率与英美高加索人群有一定差异．     

复数菌与单菌血流感染患者临床特征及预后影响因素

 目的 调查复数菌与单菌血流感染患者的临床特征及预后的影响因素。方法 回顾性分析某三甲医院2017年1月-2021年12月临床和病原学确诊的血流感染患者的病历资料,依据检出病原菌种数分为单菌组和复数菌组,研究结局为住院期间全因死亡率。比较两组患者的临床特征及复数菌患者预后的影响因素。结果 共有430例患者血培养阳性。单菌血流感染367例(85.3%),复数菌血流感染63例(14.7%)。复数菌组患者医院感染所占比率较单菌组高(76.2% VS 56.9%),差异有统计学意义(P=0.003);复数菌组患者下呼吸道感染比率较单菌组高(44.4% VS 29.2%),差异有统计学意义(P=0.018)。复数菌组患者住院时间较单菌组高[24(16~39) VS 19(13~26) d],差异有统计学意义(P=0.002)。复数菌组患者病死率高于单菌组(12.7% VS 3.8%),且住院时间延长,差异均有统计学意义(均P<0.05)。多因素分析显示,复数菌感染(OR=3.24,95%CI:1.20~8.75)、消化道肿瘤(OR=3.28,95%CI=1.21~8.84)、有创机械通气(OR=3.40,95%CI=1.22~9.42)、深静脉置管(OR=2.76,95%CI=1.00~7.64)、留置导尿管(OR=3.28,95%CI=1.04~10.40)是血流感染患者死亡的独立危险因素。相较于单菌组,复数菌组送检时间至出院时间间隔显著延长[20(15~36) d VS 16(10~22) d,P<0.001]。单菌组与复数菌组患者检出的金黄色葡萄球菌、溶血葡萄球菌和大肠埃希菌的构成比较,差异均有统计学意义(均P<0.05)。结论 住院患者复数菌血流感染死亡风险显著增加,消化道肿瘤、有创机械通气、深静脉置管、留置导尿管是血流感染患者死亡的独立危险因素,应引起临床的重要关注。     

先天性心脏病儿童白细胞介素2活性及膜表面白细胞介素2受体的研究

目的 研究先天性心脏病（先心病）患儿的免疫功能状态。方法 采用间接免疫荧光检测膜表面白细胞介素2受体（Tac）、植物血凝素刺激后的膜表面白细胞介素2受体（Tac-a),MTT比色法检测白细胞介素2活性（IL－2）。结果 与健康儿童比较,先心病患儿IL－2活性和Tac-a都显著降低（P＜0．01）;与非紫绀型先心病患儿比较,紫绀型先心病患儿IL－2活性显著降低（P＜0．01）。结论 先心病患儿免疫功能缺陷可能是其易患感染性疾病的原因之一,增强免疫治疗对预防先心病患儿感染十分必要。     

1—丙二烯基—2，3，4，6—四—氧—乙酰基—β—D—吡喃糖苷的合成及应用机理

分别采用化学、声化学及光辐射等方法合成了1-丙二烯基-2,3,4,6四-氧-乙酰基-β-D-吡喃糖苷,结果表明声化学方法最有效、快速;借助电子自旋共振（ESR）技术及相关实验,证实此类糖苷的生成为一离子消除反应,所合成的糖苷化合物脱去乙酰基后对T、B淋巴细胞具有体外免疫调节作用。     

基于熵权法评价干燥方法对经典名方华盖散基准样品质量属性的影响

目的 优选经典名方华盖散基准样品的干燥方法。方法 采用真空干燥、真空带式干燥、喷雾干燥、冷冻干燥方法制备华盖散基准样品,应用扫描电子显微镜、差式扫描量热分析、HPLC等方法测定基准样品的质量属性,以得粉率、玻璃化转变温度及成分含量转移率等为评价指标,运用熵权法对各指标赋予权重进行综合评价。结果 喷雾干燥基准样品粒子呈类球形、粒径最小,冷冻干燥基准样品不规则、蓬松、溶化性好。指标成分盐酸麻黄总碱、苦杏仁苷、橙皮苷、甘草苷、甘草酸转移率分别为85.66%～104.78%、90.81%～104.16%、91.42%～94.86%、83.98%～94.69%、87.85%～94.45%,指纹图谱相似度均大于0.9。结论 经综合评价得出冷冻干燥方法最佳,3批验证工艺重复性、可行性较好,为经典名方基准样品质量属性研究提供了理论依据和实践价值。