南京医科大学七年制临床医学专业人才培养效果评价

通过对毕业生及其培养或用人单位的问卷调查,本文分析了南京医科大学七年制临床医学专业人才培养的成效,以及江苏省医疗卫生事业发展对高层次医学人才的需求.结果 显示,临床实践能力和科研创新能力是医疗卫生事业发展所需要的高层次医学人才的重要能力;在三级甲等医院工作,具有硕士/博士学位、在专业技术岗位的被调查者更加看重医学生的科研创新能力;而在"1年通识教育、4年医学专业教育(含1年临床课程及见习、1年临床通科实习)、2年二级学科轮转"模式下培养的七年制临床医学专业毕业生的临床实践能力较强,但是科研创新能力不足,且学业负担偏重.因此,应当加强对七年制临床医学专业学生科研创新能力的培养和临床实践能力的通科训练.     

mIL-4-SA双功能融合蛋白的制备和活性测定

目的制备链亲和素标记的鼠白介素4(mIL-4-SA)融合蛋白,并研究其生物学功能。方法通过RT-PCR克隆mIL-4基因,构建mIL-4-SA-pET21表达质粒,并转化到大肠杆菌BL21(DE3)中,经IPTG诱导表达,对表达的融合蛋白采用镍金属螯合(Ni-NTA)色谱柱纯化、透析复性。MTT法检测融合蛋白对C57小鼠胸腺细胞的增殖作用,流式细胞仪分析融合蛋白对生物素化的B16F10细胞锚定修饰率。结果成功构建了mIL4-SA-pET21质粒,并在大肠杆菌中实现高效表达,表达量达菌体总蛋白质的35%,纯化后的mIL-4-SA融合蛋白纯度达95%,并具有双重活性,即mIL-4对C57小鼠胸腺细胞具有增殖作用和SA介导的高效结合至已生物素化的B16F10肿瘤细胞表面的功能(表面锚定修饰效率96.69%)。结论研制的mIL-4-SA融合蛋白具有双重活性,可为研制表面修饰的新型肿瘤细胞疫苗提供基础。     

蛛网膜下腔出血患者迟发性脑血管痉挛相关因素的临床分析

目的 探讨动脉瘤性蛛网膜下腔出血(SAH)患者迟发性脑血管痉挛(DCVs)的临床影响因素. 方法 回顾性分析南方医科大学珠江医院神经外科自2005年1月至2008年12月收治的74例动脉瘤性SAH患者的临床资料,判定DCVS,统计分析其影响因素. 结果年龄、出血次数、吸烟史、Hunt-Hess分级、Fisher分级、白细胞计数峰值与DCVS的发生具有明显相关性,其中年龄、出血次数、Hunt-Hess分级、Fisher分级是DCVS发生的独立影响因素. 结论 低年龄、出血2次以上及Hunt-Hess分级或Fisher分级Ⅲ级以上患者更易发生DCVS,临床上对此类患者应加强监测、及早发现和处理.     

介入治疗房间隔缺损临床研究

目的总结房间隔缺损介入封堵术的临床应用经验。方法选择57例先天性心脏病房间隔缺损患者,年龄3～56岁,平均(7±3.6)岁,成人及年长儿选择局麻,年幼儿选择全麻,根据心脏超声测量结果选择封堵器大小,在DSA和心脏超声辅助下实施介入治疗,释放封堵器。结果37例介入封堵均获成功,术后1周、3个月心脏彩超复查均无残余漏,周围瓣膜功能不受影响,无严重并发症发生。结论房间隔缺损介入封堵治疗是一种安全、有效的治疗方法,严格把握适应证、精确的术前及术中心脏超声诊断对介入封堵手术的成功至关重要。     

Superficial community-acquired skin infections: prevalence of bacteria and antibiotic susceptibility in France

Objective  Evaluation of the susceptibility to currently used antibiotics of bacteria, particularly S. aureus isolated from superficial community- acquired skin infection and to compare results with those from an earlier study.
Methods  Every dermatologist in community practice participating in the study was asked to include the first two patients consulting them for superficial cutaneous bacterial infection. Swab specimens collected from the skin infection were sent to a central laboratory.
Results  The dermatologist enrolled 390 patients in the study. The rate of positive culture was 49%, 259 bacterial strains were isolated. S. aureus was the major species (56.8% of all isolated strains). S. aureus was resistant to methicillin in 4%. All strains of S. aureus were susceptible to pristinamycin and mupirocin.
Conclusions  The results of the two epidemiological studies of superficial community acquired skin infections with a comparable methodology at a 6-year interval demonstrated that the prevalence of CA-MRSA skin infection remained low in this setting.     

A supervised land cover classification of a western Kenya lowland endemic for human malaria: associations of land cover with larval Anopheles habitats

Background  

A supervised land cover classification was developed from very high resolution IKONOS satellite data and extensive ground truth sampling of a ca. 10 sq km malaria-endemic lowland in western Kenya. The classification was then applied to an investigation of distribution of larval Anopheles habitats. The hypothesis was that the distribution and abundance of aquatic habitats of larvae of various species of mosquitoes in the genus Anopheles is associated with identifiable landscape features.     

伽玛刀与射频毁损丘脑中央中核在治疗癌症顽痛的初步对比研究

[目的]运用伽玛刀和射频热凝技术毁损癌症顽痛患者的丘脑中央中核（CM核）,初步探讨它们治疗顽固性癌痛患者的镇痛效果和并发症。[方法]伽玛刀组共15例,并与我们已报道的射频热凝（共90例）治疗相比较。采用世界卫生组织推荐的10分法评定手术前后的疼痛程度。[结果]两组患者术前疼痛计分均在7分以上,术后降至0～3分。伽玛刀组随访发现,4例（27%）患者有不同程度疼痛复发,术后仅并发轻度的头痛、头昏和呕吐。既往发表的射频热凝组随访,有24例（27%）患者有不同程度疼痛复发,两组计分均在5分以下;其余患者均持续止痛,有3例（3%）达2年多。术后并发症：嗜睡15例,尿失禁10例,语言错乱8例,一侧动眼神经麻痹3例。经对症处理后两组的并发症均消失。[结论]CM核毁损是治疗各类顽固性癌痛有效的方法,伽玛刀和热凝射频的效果大体相同,伽玛刀比射频热凝毁损的并发症相对较轻和少。     

Visual attention in children with migraine: a controlled comparative study

The aim of this study was to evaluate the visual attention of children with migraine and compare it with a control group. Thirty migrainous children and 30 controls without headache were subjected to a visual attention assessment with Trail Making Tests (TMT) A/B, Letter Cancellation Test, and the Brazilian computerized test Visual Attention Test, third edition. The migraine group was evaluated after 2 days without headache. The migraine group had an inferior performance compared with the control group on TMT A ( P  = 0.03) and B ( P  = 0.001), and more errors on tasks 1 ( P  = 0.032) and 2 ( P  = 0.015) of the Visual Attention Test, presenting difficulty with selective and alternate attention. Attention is a neurological function that depends on structures such as the brainstem, cerebral cortex and the limbic system and on neurotransmitters such as dopamine and noradrenaline. The neurochemical aspects involved in the physiopathology of migraine and attention mechanisms probably predispose these children to visual attention deficits.