高护生临床授课效果评价

高等护理毕业生应具备临床护理、护理教育、护理科研、护理管理、社区护理5方面的能力。其授课水平的高低将成为评价高护生护理教育能力的重要指标。我院从2002年起探讨对高护生临床授课的教学模式，以提高授课水平。笔者对2004年-2005年在我院实习的168名高护生进行调查，现将结果报告如下。     

THE PHENOTYPE OF MAST CELL IN PRIMARY ADENOID LIVER TUMOR OF RAT AND ITS RELATION TO TUMOR CELL

Mast cells in adenoid liver tumors of 32 rats induced with nitrosomorpholine were observed ultrastructurally, and among them, some were studied immunocytochemically via immunogold techniques. Data indicating that mast cells which located in tumor tissues presented positive expression of rat mast cell protein (RMCP) Ⅰ, Indicating origination from the mucosa mast cells, while those in the connective tissues around tumors were largely stained negatively with either RMCP Ⅰor RMCP Ⅰ antisera, with the exception of only a few cells showing positive RMCP Ⅰ staining. Ultrastructural observation showed that mast cells in tumon contacted closely with the tumor cells. Membranes of the intracytoplasmic granules in these mast cells were fusing together. The content inside the granules were discharged and spread along the intercellular space between the tumor cells. There was not any lesion observed uitrasructrually in the tumor cells contacting with the mast cells. The significance of mucosa mast cells in adenoi     

四君子汤对烧伤豚鼠早期代谢营养的影响

为探讨四君子汤对烧伤早期代谢营养的作用，采用３０％Ⅲ度烧伤豚鼠胃造口模型将４００ｇ左右豚鼠分别在喂养等量热卡、氮和自由进食两种膳食条件下，将３１只豚鼠分为四组，即喂养治疗组（ｎ＝７），喂养对照组（ｎ＝４），自食治疗组（ｎ＝９），自食对照组（ｎ＝１１）予以观察。结果发现：自由进食时，四君子汤能增加摄食量，减轻伤后体重丢失，改善氮平衡，增加肝、回肠粘膜含氮量，而躯壳重及腓肠肌含氮量增加不明显，但静息代谢率则增加；等量喂养时，四君子汤治疗组体重、躯壳重及腓肠肌含氮量显著低于对照组，而肝、肠粘膜重量及含氮量差异无显著意义。此外，四君子汤还可调整激素和内脏组织含水量。因此，我们认为四君子汤对改善烧伤后代谢营养及脏器功能可能是有益的     

Cytokine expression and endothelial cell and lymphocyte activation in human cardiac allograft rejection: an immunohistochemical study of endomyocardial biopsy samples.

We used monoclonal antibodies and immunohistochemical staining of frozen tissue sections to study the expression of cytokines in human cardiac allograft rejection. The 113 endomyocardial biopsy samples were stained for interleukin (IL)-2, IL-6, and interferon-gamma. The findings were compared to expression of the endothelial cell adhesion molecule ICAM-1, and the lymphocyte receptor for the adhesion molecule VCAM-1, VLA-4. Four biopsy samples from patients with idiopathic cardiomyopathy served as controls. IL-2 was not expressed in lymphocytes of controls and only occasionally in mild or moderate cellular rejection, humoral rejection, and Quilty lesions. IL-2 expression was prominent in severe cellular rejection. Interferon-gamma expression increased in proportion to the severity of cellular rejection and was not expressed in other conditions. IL-6 staining, which was only observed in occasional cases, was mild. Cytokine and adhesion molecule expression tended to increase with the severity of cellular rejection. This study shows that cytokine expression can be documented in human allograft endomyocardial biopsy samples with immunohistochemical techniques. The findings support the concept of an important role for cytokines in human cardiac allograft rejection.     

AC/A ratios in myopic and emmetropic Hong Kong children and the effect of timolol§

Purpose: Caucasian children with myopia have elevated response accommodative vergence to accommodation (AC/A) ratios. The purpose of this study was twofold: to determine if response AC/A ratios vary with refractive error and with myopic progression rate in Hong Kong Chinese children, and to determine the effect of beta‐adrenergic antagonism with topical timolol application on AC/A ratios. Methods: Thirty children aged eight to 12 years participated in the study. All refractive errors were corrected with spectacle lenses. Accommodative responses were measured using a Shin‐Nippon autorefractor and concurrent changes in vergence were assessed using a vertical prism and a Howell‐Dwyer card at three metres and 0.33 metre. Accommodative demand was altered using plus or minus two dioptre lenses and lens‐ and distance‐induced response AC/A ratios were calculated. Measurements were repeated 30 minutes after the instillation of topical timolol maleate (0.5 per cent). Results: AC/A ratios appeared higher in progressing myopic children but the difference was not statistically significant. Timolol application reduced accommodative convergence (AC) in the stable myopes (reduction = ‐3 ± 1.14^A) but not in the emmetropes (0.69 ± 0.9^P) or progressing myopes (0.16 ± 0.43^A) and this difference between refractive groups was statistically s ignificant (F^2,27= 3.766; P= 0.036). However, timolol did not produce a significant change in the accommodative response to positive or negative lenses or response AC/A ratios. Conclusions: We did not find that AC/A ratios in myopic Chinese children were elevated and therefore, it is unlikely that elevated AC/A ratios are responsible for the high levels of myopia that occur in Hong Kong. The finding that timolol reduced AC in the stable myopes suggests that the autonomic control of accommodative convergence in these children may be different from that in emmetropic children and those with progressing myopia.     

浙江医科大学附二院门诊处方中精神药物使用调查

本文对浙江医科大学附属二院１９９３年７月间３１３７８张合格处方进行统计分析，并用限定日剂量（ＤＤＤ）和药物使用指数（ＤＵＩ）为指标，分析镇静催眠药物使用情况。结果表明苯二氮　类药方２０６７张，占总处方量的６．５９％，巴比妥类药方４９张，占０．１６％，麻醉药方１１１张；占０．３５％。苯二氮　类药方中．女性处方量１２０２张，男性处方量８６５张，男、女组间比较有显著性差异。苯二氮　类药方多分布在神经内科，常用的药有舒乐安定和阿普唑仑。九种常用的苯二氮　类药和麻醉性镇痛药的ＤＵＩ均小于１。提示药物滥用现象少见，该院对这类药物的管理比较严格。麻醉性镇痛药中二氢埃托啡处方占６７．５７％。     

微波快速过氧化物酶染色法与灌注法用于微循环形态学研究之比较

以健康Ｗｉｓｔａｒ大白鼠为材料，对微波快速内源性过氧化物酶染色与灌注法显示微血管的方法进行了对比研究。结果，过氧化物酶组织化学法具有不用灌注，操作简单，所用时间短，对血管无扩张、破裂等人为改变的特点，保持了微血管真实的自然形态和管径大小，可以定量或半定量地判定组织器官活体时的血液循环状况。可以用于人及动物的大脑、脊髓、皮肤、耳及食管等组织内微血管形态学研究和定量分析。并对过氧化物酶显示微血管的原理和微波辐射促进染色的原理及特点进行了分析、讨论。