硬化注射治疗直肠前突的临床研究

目的：探讨硬化注射法治疗直肠前突的有效性。方法：将80例中度及中度以上的直肠前突患者随机分成两组，各40例。试验组行硬化注射法治疗，对照组行经阴道切开修补，并观察两组的治疗效果及并发症。结果：治疗后患者症状评分较治疗前降低，两组治疗效果相比无统计学差异。但治疗组在术中出血、术后疼痛等并发症方面则优于对照组。结论：硬化注射法是一种简便有效的治疗直肠前突的方法。     

曲马朵预防瑞芬太尼麻醉后早期疼痛的体会

目的:探讨曲马朵预防瑞芬太尼麻醉后早期疼痛的疗效。方法:回顾性分析我院收治的90例手术治疗患者的临床资料。结果:观察组苏醒程度评分、镇痛效果评分均明显优于对照组(P<0.05)。结论:曲马多预防瑞芬太尼麻醉后早期疼痛效果明显,不良反应少,值得临床推广应用。     

“以学生为中心”教学模式在医学教育中的运用 FREE

“以学生为中心”教学模式是美国医学教育的基本点，是一种比较成功和有特色的教育模式［1］。笔者在美国加洲大学San Diego分校(UCSD)工作期间，通过与美国大学教师和学生的广泛接触，亲身感受到了中国医学教育与美国医学教育的差别，认为我国目前传统的医学教育与发达国家还存在很大的差别，主要表现在我国目前的教育模式从小学到大学，仍然为传统的“填鸭式”教学，即“以教师为中心”的教学模式，学生缺乏独立思考，自我表现，自我创新的机会。这在医学教育中表现尤其明显，学生很多时候并没有真正理解所学内容，为了考试去死记硬背。这样培养出来的学生往往高分低能，而很多有创造性的医学人才也不能脱颖而出。在美国笔者所在的大学，在生物和医学研究方面，有4位诺贝尔奖获得者，笔者感觉我们很多硬件并不逊于国外大学，而我们为什么没有诺贝尔奖获得者呢？其中一个很重要的原因就是我们培养的学生缺乏独立创造能力，在素质和能力方面远逊于国外大学。
鉴于“以教师为中心”的教学模式存在很多弊端，笔者在我校2004级临床医学7年制49名学生的传染病学临床教学中，大力推行了“以学生为中心”的教学模式，主要体现以下几方面。     

Colorectal Cancer Screening Pilot Program for Underserved Women in Cumberland County,Maine

Over 800 Maine residents will be diagnosed with colorectal cancer (CRC) this year, and nearly 300 will die from the disease. While CRC screening can reduce these rates, it is only among insured populations that screening rates exceed 50%. This project aimed to reduce barriers to, and increase rates of CRC screening among underinsured and uninsured women, ages 50 years and over, residing in Cumberland County, Maine. The existing network of the Maine Breast and Cervical Health Program (MBCHP) was used to reach the target population. A packet containing (1) an offer for no-cost fecal occult blood test (FOBT) screening and CRC-related educational materials, and (2) a stamped, addressed postcard specifying the woman’s interest in these resources, was mailed to 300 MBCHP enrollees residing in Cumberland County. Women requesting screening were contacted by phone to further determine eligibility. Ninety-three women (31%) requested FOBT kits and 29 of these women requested educational materials. Ten women were ineligible for screening because of previous colonoscopy. Fifty-two completed FOBT kits (63%) were returned; all were negative. An additional 42 (14%) women requested educational materials only. To reduce the burden of CRC in Maine and nationally, disparate populations must be reached with efficient and effective screening services. Established networks are proven means for reaching uninsured and underinsured individuals with education, screening services, and necessary follow-up care. This project serves as a model for the future development of similar programs statewide and nationally.     

阿弗菌素产生菌SIPI-AV-99081的选育

阿弗菌素链霉菌SIPI-AV-99081采用UV和NTG进行诱变处理。选育得到一高产菌株和几个典型的突变株。高产菌株AV-h-360的阿弗菌素B1的生产能力较出发菌株提高了3倍，AV-m-486和AV-m-796为阿弗菌素合成阻断突变株，它们都不能产生天然的阿弗菌素。     

Overview of Disease Management Approaches

Corporations have engaged in sponsorship of health management programs and, more recently, disease management programs to facilitate healthy and productive work environments. The purpose of this review is to examine the health and financial outcomes from these corporate-sponsored disease management programs. This article focuses on seven diseases or chronic conditions (arthritis, asthma, cancer, depression, diabetes mellitus, heart disease, and migraine) that potentially impact employee productivity (both in time away from work and in loss of effectiveness at work) and health status including medical and pharmaceutical utilization and costs.Corporate-sponsored disease management programs typically focus on education and screening for selected diseases or chronic conditions. Partnerships have been formed with health plans and third-party program providers to reach employees with interventions and treatment. The typical outcome measures from these programs have primarily been clinical indicators and medical utilization. Measures of productivity need to be incorporated as important outcome measures for disease management programs.The estimated financial opportunity for the corporation is a reflection of the cost differential for a given disease and the prevalence of that disease within the employee population. Primary diseases, chronic conditions, and health risks contribute to increased medical utilization and decreased productivity within the corporation. Promoting programs that focus on the whole person, including health risks, chronic conditions, and diseases, will likely increase the possibility of success in helping the employee to better self-manage their health conditions and consequently provide gains for both the individual and the corporation.     

Selective internal iliac artery oxaliplatin infusion: Another facultative treatment to unremitting hematuria in stage T4 bladder carcinoma

Objective  

To observe and evaluate the value of utilizing selective internal iliac artery infusion and selective internal iliac artery embolization for the treatment of unremitting gross hematuria of stage T4 bladder carcinoma.     

The study of diethylstilbestrol toxic effect in the mouse sertoli cell line by comparison of miRNA and mRNA expression

It is important to acknowledge the harmful effects of environmental chemicals in human’s lives. The toxic effects of Diethylstilbestrol (DES), one of the endocrine-disrupting chemicals (EDCs), have been documented in many studies. As expected, DES affect male gendal hormone as well as female’s; therefore, epigenetic study should be considered. In this study, microarray technology was used to study harmful effects on the level of genomics, and here, two types of microarray chips- the Agilent mouse genome 4 × 44 K array for gene expression profiling and the Agilent mouse miRNA v13 for miRNA expression profiling-was used to study the relation between gene and miRNA expression profiles. As a result, we identified 4 miRNAs (miR 203, 350, 421, and 466i) that were similarly expressed at 3 hrs and 24 hrs of DES treat times. Twenty one genes matched between predicted target for 4 miRNAs and 118 genes expressed similarly. These genes have functions related to cell differentiation and cell cycle. Therefore, DES affects cellular function and induces toxicity in TM4 cells. In future studies, it is necessary to find more related functions and mechanisms of DES in the system.