强化胰岛素治疗的2型糖尿病患者胰岛素脱离与否相关因素分析

目的比较强化胰岛素治疗的2型糖尿病患者在脱离胰岛素治疗和继续胰岛素治疗时的临床特点,分析脱离胰岛素的相关因素。方法统计66例入院的2型糖尿病患者的患病时间,检测开始胰岛素强化治疗、治疗过程、治疗结束时的糖化血红蛋白(HbA1 c)、体重指数(BM I)、胰岛素用量,观察脱离胰岛素所需时间。结果34例患者脱离胰岛素治疗,32例继续治疗,两组患者在年龄、治疗开始时间、BM I、HbA1 c差异均无统计学意义,而患病时间比较差异有统计学意义(P<0.05),脱离时的胰岛素用量和HbA1 c比继续治疗患者显著减低(P<0.01)。结论患病时间长短是胰岛素脱离与否的重要因素,胰岛素投入量及HbA1 c数值对脱离胰岛素与否有积极作用。     

肝移植术后胆道并发症的介入治疗

目的 探讨原位肝移植术后胆道并发症的介入治疗疗效。方法 回顾性分析我院2002年6月至2005年9月诊治的173例原位肝移植患者的临床资料。结果 术后出现胆道并发症14例（8．1％），其中胆管狭窄6例．胆管狭窄合并胆漏1例，胆泥淤积或结石3例，肝断面胆漏2例（劈离式肝移植患者），T管拔除后胆漏1例，Oddi括约肌功能失常1例。除1例胆道狭窄再次行肝移植，因发生严重感染导致肝功能衰竭死亡外．其余患者经介入治疗均获得满意的效果。结论 介入治疗是诊断和治疗肝移植术后胆道并发症的首选方法。     

Expression of CⅡTA Gene in Five Human Malignant Hematological Cell Lines and Its Significance

The role of MHC class Ⅱ transactivator (CⅡTA) in constitutive or IFN-γ inducib|e expression of HLA molecules in human malignant hematological cell lines was investigated. The expression of HLA molecules and CⅡTA protein was detected by Western blot, immunohistochemistry and flow cytometry. The expression of CⅡTA gene was determined by RT-PCR. The capability of peripheral blood T cell reaction stimulated by tumor cells was monitored by mixed lymphocyte reaction. It was found that the HLA Ⅱ-positive tumor cells expressed the CⅡTA quite well, andthe expression of HLA Ⅰ＋Ⅱ was increased in the tumor cells with constitutive or inducible expression of CⅡTA after induced by IFN-γ. The tumor cells which did not express CⅡTA after in-duced by IFN-γ were not response to the expression of HLA Ⅱ promoted by IFN-γ. It suggests a correlation between the inability of some malignant hematological cell lines in response to IFN-γ for HLA expression and the deficiency in the inducible expression of CⅡTA, indicating CⅡTA might take part in the regu|ation of HLA Ⅰ＋Ⅱ expression in the tumor cells, which might p|ay an important role in tumor immunologic escape.     

岗位业绩导向的医院薪酬设计

基于现代管理理论和医院的实际情况，设计了一种以岗位和业绩为导向的医院薪酬制度。该设计的主要特点是：①薪酬结构以岗位工资和绩效工资为主体，同时兼顾稳定和逐步过渡原则，原档案工资的固定部分(约占档案工资的60％)保留。②岗位工资采用全院统一的等级薪酬结构，等级的评定基于全院统一的指标体系和权重，岗位工资每年随绩效考核结果在工资带宽中升降；③绩效工资与岗位等级和绩效考核紧密挂钩，考核的依据是全院统一模式的岗位绩效合同；④整个薪酬设计建立在岗位调查、岗位评价和岗位说明书等的科学规范的工作基础之上。     

重组耻垢分枝杆菌-Sj26GST疫苗的免疫保护作用研究

目的初步研究重组耻垢分枝杆菌疫苗rMc-Sj26GST(recombinant M.smegmatis mc2155-Sj26GST)对小鼠的免疫保护作用.方法用耻垢分枝杆菌重组疫苗rMc-Sj26GST免疫雄性BALB/c小鼠,检测小鼠淋巴细胞刺激指数(SI),腹腔巨噬细胞培养上清释放NO量,小鼠血清IFN-γ、IL-2的含量,并计数小鼠肝、肺活细菌数.结果小鼠脾淋巴细胞刺激指数(SI)为2.64±1.37,与Mc组(载体组)1.28±0.41相比,差异具有显著性;小鼠血清IFN-γ为196.43 pg*ml-1,与Mc组112.57 pg*ml-1相比,差异有显著性,较对照组高41%;小鼠血清中IL-2的浓度较对照组高.经rMc-Sj26GST疫苗免疫的小鼠受结核杆菌攻击后其肺、肝脏结核杆菌数较对照组少.结论耻垢分枝杆菌重组疫苗rMc-Sj26GST增强了小鼠细胞免疫功能,并使小鼠能抵抗结核杆菌的攻击.     

岛状皮瓣静脉淤血再通后对大鼠全身情况的影响

目的：探讨岛状皮瓣静脉淤血再通后对全身多脏器的影响。方法：按静脉淤血时间的不同将大鼠分为4组。观察耳部微循环的改变，测量术后肿瘤坏死因子α(TNFα），白细胞介素10（IL－10）的动态变化，观察心，肺，肝，肾，小肠及耳部血管等组织结构及中性粒细胞浸润数目。结果：皮瓣原位缝合组及静脉淤血2h组，耳部微循环、TNFα、IL-10浓度基本保持不变，各脏器结构改变较轻，中性粒细胞浸润数目少。静脉淤血6、10h组，微循环，肺，小肠，血管则有明显组织学改变，大量中性粒细胞浸润其中，但心，肝，肾组织学改变较轻。TNFα浓度再灌注1h达到高峰，其后逐渐下降，IL－10浓度3h达到最低，然后逐渐上升。结论：皮瓣静脉淤血再通后可造成肺、小肠及血管器官损伤，静脉淤血时间越长，再通后则损伤程度越重。全身微循环的改变，中性粒细胞在肺、小肠中的浸润，与血管内皮细胞的粘附及细胞因子TNFα与IL－10的浓度失衡是重要的操作原因。     

The effects of literacy and education on the quantitative and qualitative aspects of semantic verbal fluency.

Semantic verbal fluency tasks are commonly used in neuropsychological assessment. Investigations of the influence of level of literacy have not yielded consistent results in the literature. This prompted us to investigate the ecological relevance of task specifics, in particular, the choice of semantic criteria used. Two groups of literate and illiterate subjects were compared on two verbal fluency tasks using different semantic criteria. The performance on a food criterion (supermarket fluency task), considered more ecologically relevant for the two literacy groups, and an animal criterion (animal fluency task) were compared. The data were analysed using both quantitative and qualitative measures. The quantitative analysis indicated that the two literacy groups performed equally well on the supermarket fluency task. In contrast, results differed significantly during the animal fluency task. The qualitative analyses indicated differences between groups related to the strategies used, especially with respect to the animal fluency task. The overall results suggest that there is not a substantial difference between literate and illiterate subjects related to the fundamental workings of semantic memory. However, there is indication that the content of semantic memory reflects differences in shared cultural background--in other words, formal education--, as indicated by the significant interaction between level of literacy and semantic criterion.     

甲醛固定源同种异体骨移植材料的体外实验研究

OBJECTIVE: To conduct an in vitro study to assess the preliminary possibility of using formalin-fixed, instead of fresh, human bone tissues for allografting. METHODS: Fresh cadaveric bone tissues were fixed by formalin for more than 6 months and dissected into 5 mmx5 mmx5 mm pieces and 5 mmx5 mmx40 mm sticks, followed by chemical treatments to prepare the allograft bone materials. When alls treatments were completed, the bone grafts were centrifuged and their properties and cellular compatibility assessed in comparison with the currently used bone grafts clinically. RESULTS: The residual formaldehyde of the fixed allograft bone material was much below the controlled level and no significant differences were noted between the bone graft materials tested in regard to the chemical and mechanical properties and biocompatibility. CONCLUSION: This material we have prepared may meet the clinical demands for bone grafting, with good biocompatibility and less chance for infection by pathological agents.     

截骨矫形"∩"形钉内固定治疗关节畸形55例

目的探讨肘、膝、踝关节内外翻畸形的治疗方式。方法对55例8～16岁的关节内、外翻畸形患儿(肘关节30例，膝15例，踝10例)，采用肘外侧切口，踝、膝内外侧切口，截骨矫形，1枚或2枚“∩”形钉内崮定治疗，术后石膏托外固定4周，结果随访50例，随访时间3～24个月，截骨均达到骨性愈合，无一例发生感染，内固定松动临床疗效优48例(96％)，良2例(4％)。结论用“∩”形钉作为截骨矫形内固定材料．具有操作简单、损伤小、效果好的优点。     

Parvalbumin 3 is an Abundant Ca2+ Buffer in Hair Cells

Ca2+ signaling serves distinct purposes in different parts of a hair cell. The Ca2+ concentration in stereocilia regulates adaptation and, through rapid transduction-channel reclosure, underlies amplification of mechanical signals. In presynaptic active zones, Ca2+ mediates the exocytotic release of afferent neurotransmitter. At efferent synapses, Ca2+ activates the K+ channels that dominate the inhibitory postsynaptic potential. A copious supply of diffusible protein buffer isolates the three signals by restricting the spread of free Ca2+ and limiting the duration of its action. Using cDNA subtraction and a gene expression assay based on in situ hybridization, we detected abundant expression of mRNAs encoding the Ca2+ buffer parvalbumin 3 in bullfrog saccular and chicken cochlear hair cells. We cloned cDNAs encoding this protein from the corresponding inner-ear libraries and raised antisera against recombinant bullfrog parvalbumin 3. Immunohistochemical labeling indicated that parvalbumin 3 is a prominent Ca2+-binding protein in the compact, cylindrical hair cells of the bullfrog's sacculus, and occurs as well in the narrow, peanut-shaped hair cells of that organ. Using quantitative Western blot analysis, we ascertained that the concentration of parvalbumin 3 in saccular hair cells is approximately 3 mM. Parvalbumin 3 is therefore a significant mobile Ca2+ buffer, and perhaps the dominant buffer, in many types of hair cell. Moreover, parvalbumin 3 provides an early marker for developing hair cells in the frog, chicken, and zebrafish.