自体角膜缘上皮移植联合贝复舒治疗翼状胬肉的疗效观察

目的 观察自体角膜缘上皮移植联合贝复舒对角膜缘上皮修复的作用。方法 随机选择翼状胬肉患者98例(98只眼)，治疗组为自体角膜缘上皮移植联合贝复舒，对照组为翼状胬肉切除联合贝复舒。术后每日观察角膜上皮缺损区的修复情况，并随诊观察复发情况。结果 治疗组角膜缘上皮平均修复时间为3．1天，对照组4．2天，有显著差异性。随诊6个月发现对照组有一例复发，均未发现感染。结论 自体角膜缘上皮移植联合贝复舒可使角膜缘上皮修复时间快于翼状胬肉切除联合贝复舒。复发率均较低，表明自体角膜缘上皮移植联合贝复舒治疗翼状胬肉可以加快角膜缘上皮修复，减少复发及感染的机会。     

骨髓细胞移植上调血管内皮生长因子及其受体的表达并改善缺血心脏功能

目的：通过骨髓细胞移植对心肌梗死大鼠模型血管内皮生长因子及其受体表达的影响，探讨骨髓细胞移植改善缺血心脏功能的可能机制。方法：利用左前降支冠状动脉结扎术制备大鼠心肌梗死模型，然后行异体骨髓细胞移植；分别于术后1d，3d，7d，14d和28d取材；利用免疫荧光和RT—PCR技术分析细胞移植对血管内皮生长因子(VEGF)及其受体(Flk一1)表达的影响和移植细胞的分化情况；通过免疫组化计算血管数量；应用血流动力学检测大鼠心脏功能在术后各时间点的变化。结果：VEGF和Flk-1在移植组动物的心肌梗死区残存细胞、梗死周边区细胞以及部分移植细胞内表达。移植组VEGF和Flk-1的mRNA表达明显高于对照组。分别于术后3d和14d达到高峰，以后逐渐减弱。术后7d，14d和28d移植组血管数量较同期对照组明显增加，移植组心脏功能较对照组明显改善。术后14d可在部分移植细胞中检测到心肌细胞或血管内皮细胞特异性蛋白的表达。结论：骨髓细胞移植通过上调移植细胞及受者内源性VEGF和Flk—1的表达，促进血管新生，进而改善缺血心脏功能。     

A feasibility study on teaching evaluation system in medical education

The purpose of this study is to develop an evaluation instrument with high feasibility and acceptability, and to quantify the outcome of evaluation, in order to set up an efficient evaluation system. Teaching evaluation with questionnaire by students has been carried out in National Yang-Ming Medical College for two years. With the support of both teachers and students, the system has been established and conducted on a regular basis. The most important purpose of evaluation is to improve the quality of teaching. During the two academic years (Sep. 1986-June 1988) of the program, the overall response rate was 44.5%, the Department of Nursing had the highest response rate, followed by Dentistry, Medicine-Post Graduate, Medical Technology, and Medicine. Taking into consideration of the year and the class size, the regression analysis found that higher year or smaller size of the class had better response rate. The response rates dropped significantly after the first academic year regardless of department or year. A total of 23 classes were included in the evaluation program and 99 courses were evaluated. All questions in the questionnaire used a 0 to 4 ordinal scale, in which 0 (improvement needed) was the low end and 4 (excellent) the high end. The mean score of the seven questions of teaching evaluation was 2.47. As a whole, the students were satisfied with the teaching. As to the categories of courses, clinical courses had better mean score than basic medical courses, and basic medical courses had better mean score than common required courses. To evaluate the effectiveness of the teaching, students' achievement was used as the outcome variable. The most important predictive variable was the method of instruction, followed by the content of lecture such as degree of difficulty of the lecture and cognitiveness of the contents. The above 3 variables explained 76% of the variation of the students' achievement. However, the significant of teachers' speech, performance and attitude were not so influential. Analysis based on the characteristics of the teachers (sex, age, position, and teaching experience), the characteristics of students (department and year), teaching environments (time and place), and the 3 categories of courses (clinical, basic medical and common required courses) showed that all the above variables only explained less then 10% of the variation of the students' achievement.     

急性脑血管病患者血清及脑脊液髓鞘碱性...

Myelin basic protein (MBP) was measured in the serum and CSF of patients with acute cerebrovascular disease (CVD, 34 cases), demyelinating disorders (DMD, 30 cases) and other neurological diseases (OND, 26 cases) by using a double antibody radioimmunoassay (RIA). Patients with acute CVD had a mean serum MBP concentration and positivity rate much higher than those with DMD and OND. The differences were significant (P < 0.05). In CSF, MBP levels in patients with acute CVD and patients with DMD were significantly greater than those in OND patients (P < 0.05). The results also show that there was a linear relationship between the CSF MBP levels and the serum MBP levels in patients with acute CVD (r = 0.72, P < 0.01), but no such relationship in patients with DMD and OND. The amount of serum MBP was also significantly correlated to the severity of acute CVD, to the level of consciousness disorder and limb paralysis, and to the extent and site of the cerebral lesion at CT-scan (P < 0.05). This study shows that the measurement of brain specific MBP in serum as a marker of cerebral damage may have clinical value in the diagnosis and prognosis of patients with CVD.     

重症肌无力病人乙酰胆碱受体抗体的测定及临床意义

用ＥＬＩＳＡ（固相酶联免疫吸附）法测定１７２例ＭＧ病人血清乙酰胆碱受体抗体（ＡｃｈＲａｂ），结果显著高于健康献血员组和非ＭＧ病人组。不同性别、病程及临床类型与ＡｃｈＲａｂ无相关性，但４１～５０岁组的显著高于其他年龄组。６７例类固醇激素治疗组、２２例大剂量两种球蛋白治疗组、１２例胸腺切除术组及３例ＭＧ危象病人２４次血浆交换疗法（ＰＥ）组，治疗后伴随肌无力症状的好转，ＡｃｈＲａｂ均显著低于治疗前。结果表明：ＡｃｈＲａｂ测定为ＭＧ诊断提供了可靠的实验依据，为类固醇激素、大剂量丙种球蛋白、胸腺切除术和ＰＥ等治疗ＭＧ提供理论依据和疗效评定的实验指标，进一步证实了ＭＧ免疫学发病机理。     

Correlation between Cyclin A Gene Expression in Adult Patients with Acute Leukemia and Drug Resistance

Adultacuteleukemia (AL)isoneofthemostcommonmalignanttumorsofhematology .Withtherecentprogressinchemotherapyandsupportivether apy ,theremissionandsurvivalrateinALhavebeenmarkedlyimproved .However ,drugresistanceandrelapsearestillimportantfactorsaffectinglongsur vivalofthese patients .Theabnormalregulationofcellcycleisanotherfactorthatcannotbeignoredex ceptformultipledrugresistance (MDR) .WedetectcyclinA ,multidrugresistantgene (mdrl) ,topoiso meraseⅡα(TopⅡα)andbcl 2inadultpatientswithA…     

Vaccination of Lewis rats with temperature-sensitive mutants of Mycoplasma pulmonis: adoptive transfer of immunity by spleen cells but not by sera.

Temperature-sensitive mutant vaccines protect rats against Mycoplasma pulmonis infection. The role of the humoral or cellular immune response in resistance to mycoplasma infection was investigated by adoptive-transfer experiments. Spleen cells from Lewis rats vaccinated but not challenged with wild-type organisms (vaccinated) and spleen cells from rats vaccinated (or not) and challenged were effective in preventing syngeneic recipients from developing respiratory disease. There was also a significant reduction in the incidence and number of challenging organisms in the respiratory system. In contrast, sera from the same donors had no detectable effect on the number of mycoplasmas recovered or on lesion development in the respiratory tract. We conclude that cellular immunity rather than humoral immunity generated in vaccinated rats confers protection against subsequent infection.     

Magnetic resonance imaging and single-photon emission computed tomography changes in hypoglycemia-induced chorea.

We present two case studies, one of generalized chorea and one of hemichorea, both after severe hypoglycemia episodes. Both cases showed hyperperfusion in their SPECT scans. The MRI and SPECT findings serve as clues regarding the role of basal ganglion dysfunction associated with chorea.