聚氨酯避孕套临床前使用可行性和可接受性分析

目的 对使用新型聚氨酯(Pu)男用避孕套的可行性和可接受性进行初步观察。方法 对30对健康已婚夫妇为期6周360次使用国产PU避孕套的效果进行问卷调查。结果 避孕套总破裂率(临床破裂 非临床破裂)为2．22％，临床滑脱率为16．5％，使用观察期间无意外妊娠发生。结论 新型PU避孕套的破裂率和滑脱率分别相近于和高于报道的乳胶避孕套使用情况，感官指标反映PU避孕套具有良好的可接受性。     

闭合复位空心钉治疗中老年股骨颈骨折后股骨头坏死的多元相关研究

目的探讨影响闭合复位空心钉治疗中老年股骨颈骨折后股骨头坏死的相关因素及其多元关系。方法对1999年5月～2004年5月间收治的300例中老年股骨颈骨折患者进行回顾性分析,所有患者均行闭合复位空心钉固定。对随访资料完整的99例患者资料运用SPSS10．0软件进行统计学分析,即对其年龄、性别、骨折类型、复位时间、复位质量、完全负重时间、内固定是否取出及术前是否行牵引等因素进行多因素分析。结果99例患者获平均24．5个月(8～60个月)随访。15例出现股骨头坏死,坏死率为15．2%,发生坏死的时间为术后8～50个月。由复位质量、术前牵引、年龄及年龄×取出内固定构成的多因素组对股骨颈骨折后股骨头坏死的影响最显著。结论闭合复位质量对股骨颈骨折预后的影响程度极大；不良位置的术前牵引可能加重股骨头坏死；年龄在多因素共同影响中的相对危险度不大；Garden分型是判断股骨颈骨折后股骨头坏死的一项重要指标,与骨折复位质量具有相关性,但其并非是多因素共同影响下造成股骨头坏死的危险因素。     

Changes in hippocampal neurons and memory function during the developmental stage of newborn rats with hypoxic-ischemic encephalopathy

BACKGROUND: Under the normal circumstance, there exist some synapses with inactive functions in central nervous system (CNS), but these functions are activated following nerve injury. At the early stage of brain injury, the abnormal functions of brain are varied, and they have very strong plasticity and are corrected easily. OBJECTIVE: To observe the changes of neuronal morphology in hippocampal CA1 region and memory function in newborn rats with hypoxic-ischemic encephalopathy(HIE) from ischemia 6 hours to adult. DESIGN: Completely randomized grouping, controlled experiment. SETTING: Taian Health Center for Women and Children; Taishan Medical College. MATERIALS: Altogether 120 seven-day-old Wistar rats, of clean grade, were provided by the Experimental Animal Center, Shandong University of Traditional Chinese Medicine. Synaptophysin (SYN) polyclonal antibody was provided by Maixin Biological Company, Fuzhou. METHODS: This experiment was carried out in the Laboratory of Morphology, Taishan Medical College between October 2000 and December 2003. ① The newborn rats were randomly divided into 2 groups: model group and control group, 60 rats in each group. Five rats were chosen from each group at postoperative 6 hours, 24 hours, 72 hours, 7 days, 2 weeks and 3 weeks separately for immunohistochemical staining. Fifteen newborn rats were chosen from each group at postoperative 4 weeks and 2 months separately for testing memory ability (After test, 5 rats from each group were sacrificed and used for immunohistochemical staining)② The right common carotid artery of newborn rats of model group was ligated under the anesthetized status. After two hours of incubation, the rats were placed for 2 hours in a container filled with nitrogen oxygen atmosphere containing 0.08 volume fraction of oxygen, thus, HIE models were created; As for the newborn rats in the control group, only blood vessels were isolated, and they were not ligated and hypoxia-treated. ③ Thalamencephal tissue sections of newborn rats of two groups were performed DAB developing and haematoxylin slight staining. Cells with normal nucleous in 250 μm-long granular layer which started from hippocampal CA1 region were counted with image analysis system under high-fold optical microscope (×600), and the thickness of granular layer was measured. The absorbance (A) of positive reactant of SYN in immunohistochemically-stained CA1 region was measured. Learning and memory ability were measured with step through test 3 times successively. ④ t test and paired t test were used for comparing intergroup and intragroup difference of measurement data respectively, and Chi-square for comparing the difference of enumeration data. MAIN OUTCOME MEASURES: Comparison of cytological changes in hippocampal CA1 region and memory ability at different postoperative time points between two groups. RESULTS: Totally 120 newborn rats were involved in the result analysis. ① Cell morphological changes in hippocampal CA1 region: In the control group, with aging, perikaryon, nucleus and nucleolus in cortex of parietal lobe were significantly increased, Nissl body was compacted, the amount of neurons was declined, but the A of SYN positive reactant was relatively increased. In the model group, at postoperative each time point, neurons were seriously shrunk and dark-stained, nucleus was contracted, chromatin was condensed, nucleolus was unclear, even cells disappeared, especially the cells in 6 hours and 24 hours groups. The amount of neurons with normal morphology in hippocampal CA1 region and granular layer thickness in the model group at postoperative each time point were significantly less or smaller than those in the control group at postoperative 6 hours respectively (t =3.002-1.254, P < 0.01). The A value of SYN positive reactant at postoperative 2, 3 and 4 weeks was significantly higher than that at previous time point (t =2.011－2.716,P < 0.05－0.01). ② Test results of learning and memory ability: In the first test, there was no significant difference in the ratio of rats which kept memory ability between two groups (P > 0.05); In the third test, the ratio of rats which kept memory ability in the model group was significantly lower than that in the control group at postoperative 4 weeks and 2 months[53%(8/15)，100%(15/15)；60%(9/15)，93%(14/15)，χ 2=2.863，2.901，P < 0.01]. CONCLUSION: The destroyed hippocampal structure induces the decrease of learning and memory ability of developmental rats. Early interference can increase the quality of neurons and also promote functional development of the nervous system.     

一个医学生眼里的医学伦理学教育

主要通过医学生的视角，从教学内容、教学方法等方面谈了对医学伦理学教育的感受和一些建议，并通过医学生的声音反映医学伦理学教育的成果以及存在的一些问题。     

Diabetes Education: Whose Priorities Are Met?

Two hundred Type 2 diabetic patients newly referred to the diabetes centre at a large university teaching hospital were studied over an 8-month period. Patients completed a diabetes knowledge questionnaire, and specified their educational priorities by selecting six diabetes-related topics from a list of 14. After giving 1 h of individual education and using the same list, the educators selected six topics which they considered to be most important for that particular patient to know. Choice of educational priorities differed between the patients and the corresponding educator (p less than 0.001). In only 38% of cases did the educators' first three priorities coincide with those of the patients. The major discrepancies were in the selection of 'sick day management' and 'complications', especially favoured by patients, as against 'oral hypoglycaemic agents' and other therapy-related topics, especially favoured by educators. Diabetes knowledge was a determinant of educational priority for patients (p less than 0.001) but not educators. In contrast, only the educators' overall choices were affected by duration of diabetes (p less than 0.001). Diabetes treatment type influenced both patients' and educators' selection of priorities (p less than 0.001). We conclude that an educational strategy which relies on health professionals' perceptions to determine what diabetic patients need to know may be inadequate.     

Studies on monoclonal anti-isotypic and anti-idiotypic antibodies against leukemia and myeloma: IV modulation of membrane fluidity of leukemic cell lines and tonsillar cell stimulated with McAbs

Summary In this study the technique of labelling the cell membrane with DPH fluorescence polarization was used to observe the membrane fluidity of B lymphocytic cell lines and tonsillar cells from healthy persons; the modulation effect on membrane-fluidity induced by McAbs against isotypic and idiotypic determinants of IgM from patients with leukemia was studied as well. The expression of the corresponding isotypic and idiotypic determinants of IgM on the cell membrane was determined. The results show that the membrane fluidity of leukemic cell lines is remarkably higher than that of tonsillar cells from healthy persons, and McAbs against isotypic determinants of leukemic IgM can enhance the membrane fluidity of all kinds of cells mentioned above. However, the anti-idiotypic monoclonal antibody increased only the membrane fluidity of leukemic cell lines. These results indicated that there was a close relationship between the effect of McAbs on cell membrane fluidity and the expression of corresponding isotypic and idiotypic determinants of IgM on the cell membrane.     

Chemical constituents of Hedysarum polybotrys Hand.-Mazz]

Butanedioic acid was isolated from the ethyl alcohol extract of Hedysarum polybotrys. The methylated carboxylic acid was identified by GC-MS method.     

胶体金免疫层析法检测尿hCG的质量控制方法探讨

目的通过对胶体金免疫层析法（GICA）试纸条评价,建立该方法的检测尿hCG的室内质控.方法利用hCG不同浓度的标准品评价试纸条的敏感性、重复性、稳定性、检测范围,检测温度及时间对试纸条检测尿hCG结果的影响等.结果GICA的检测范围25-100万mlU/ml,最低检出限达25mIU/ml,大于200万mIU/ml时存在后带现象.试纸条反应5分钟后呈色均一,最佳检测温度为4-30℃.结论灵敏度检测可作为GICA室内质控的主要指标,它能保证检测结果的准确性.     

Twinblock矫治器早期治疗安氏Ⅱ^1的软硬组织变化

目的研究早期应用Twinblock治疗安氏Ⅱ1前后牙面软硬组织的变化并探讨相互关系。方法对16例应用Twinblock治疗前后的912岁安氏Ⅱ1病例X线头颅侧位定位片进行分析,共测量18项硬组织和15项软组织项目,分析治疗前后软硬组织的变化。结果矫治后的硬组织改变主要为SNB角的增大和ANB角的减小,提示下颌骨的生长,面角增加和颌突角减小,上前牙轻度内收和下前牙少量唇倾。软组织面凸角减小,软组织面角和Z角增加,反映出软组织侧貌突度的减小。结论对安氏Ⅱ1病例早期应用Twinblock能够产生下颌骨的骨骼改变,并达到相应的软组织侧貌美观改善。     

肝病患者血清中总胆汁酸测定的意义

采用全自动酶法分析法 ,测定 32 1例各种肝病患者血清总胆汁酸 (TBA)。结果表明 :血清总胆汁酸是一种较灵敏的肝功能指标。在各类肝病中 ,尤其是急性肝炎、肝硬化、肝癌患者的总胆汁酸 (TBA)浓度均明显高于正常对照组 (P<0 .0 1) ,并在肝功能常规指标改变不明显时对肝脏疾病的诊断有一定的价值