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.     

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     

1例成人Still病的临床观察与护理

成人Still病(AOSD)又称变应性亚败血症,病因及发病机制不明,临床表现复杂多样,主要以弛张热、一过性多形性皮疹、关节痛为主要临床表现,并伴有周围血粒细胞增生,严重者可出现多脏器功能损害[1],激素治疗有效。该病临床较少见,早期临床表现缺乏特异性,所以极易误诊。我科2006年2月9日收治1例AOSD病人,现报告如下。1临床资料病人,男,18岁。于2006年1月3日无明显诱因出现咽痛、发热,体温最高达39.3℃,鼻塞,伴周身酸痛、关节疼痛,2006年1月7日晨起排血尿1次,门诊血常规检查:白细胞14.2×109/L,中性粒细胞0.918,淋巴细胞0.053,单核细胞0.029,…     

计算机体层成像多平面重建在评价椎间融合中的作用

目的 探讨计算机体层成像多平面重建(CTMPR)在评价椎间融合中的作用,寻找定量评价椎间融合的新方法.方法 13例行腰椎间融合的患者术后1周、3个月、6个月行CTMPR,行椎间融合器(Cage)内植骨CT值定量测量.结果 术后1周Cage内植骨CT值为(619.52±26.97)Hu,术后3个月为(628.69±42.60)Hu,术后6个月为(657.77±37.43)Hu.术后1周与术后3个月相比无显著性差异,与术后6个月相比有显著性差异.结论 CT值的测量在椎间融合的判断中具有高准确性.     

新城疫病毒W系疫苗抗小鼠移植瘤作用的实验研究

用新城疫病毒Ⅳ系疫苗免疫治疗小鼠腹水型肝癌移植瘤，结果：治疗组平均瘤重明显小于对照组（Ｐ＜０．０５）；治疗组淋巴细胞应答水平显著高于对照组（Ｐ＜０．０５）。表明新城疫病毒Ⅳ系疫苗具有抗移值瘤作用。