如何解决临床实习与患者隐私权保护的予盾

针对当前临床实习与患者隐私权保护矛盾的日渐激烈现象,以临床实习医生365人为对象进行调查分析研究,提出解决矛盾的办法.     

肾移植组织配型管理软件的研究与开发思路

目的 开发肾移植组织配型管理软件并观察其临床实用性。方法 参考氨基酸残基配型及致敏性错配制定配型标准，采用Powerbuild系统编制同种异体肾移植组织配型管理软件，观察肾移植术前快速组织配型分析的可行性。结果 从筛选最佳供受者到列表打印结果仅需数分钟，历史数据可查询，界面简单，结果准确、可靠。配型标准可自行更改。结论 经国内8家移植中心使用，证明该软件设计科学合理，操作简便，运行稳定，实用性强，具有一定的推广价值。     

MiniQuest网络探究性学习研究

在介绍M iniQuest的基础上,对M iniQuest教学设计中的各个环节进行了分析。并通过一个完整的M iniQuest实例分析,探索了如何利用M iniQuest更好的进行网络研究性学习研究。     

整体教学法在大学英语阅读教学中的运用

大学阅读教学在英语习得中占举足轻重的地位,在大学英语阅读教学中引入整体性教学法可以有效地提高学生的阅读水平,本文从教师、学生和阅读技巧等方面阐述了整体性教学法在大学英语阅读教学中的作用,并提出一些具体方法。     

应重视类似股骨头坏死髋关节疾病的鉴别诊断

股骨头坏死（osteonecrosis of the femoralhead，ONFH）是骨科常见疾病，它由创伤和非创伤两大原因引起，前者主要由股骨颈骨折，髋脱位等造成，而后者在我国主要由皮质类固醇的应用及酗酒两大原因导致。据可靠依据推测，我国需治疗的ONFH患者在500～750万之间，     

移植前使用α干扰素对慢性粒细胞白血病患者非亲缘异基因骨髓移植预后的影响

目的 了解α干扰素（IFN—α）在移植前使用对慢性粒细胞白血病（CML）患者非亲缘异基因骨髓移植（URD—BMT）预后的影响。方法 分析总结行URD—BMT的CML第1次慢性期（CP1）患者53例，其中BMT前未用IFN—α治疗组23例，用IFN—α治疗组30例；其中疗程≤12个月22例，〉12个月8例。采用单因素分析和Cox比例风险模型分析移植前使用IFN—α对CML患者URD—BMT后植入效果、急性移植物抗宿主病（GVHD）发生及患者5年存活率的影响。结果 经Cox模型多元回归分析，患者年龄、性别、确诊至URD—BMT的时间、停IFN—α距URD—BMT时间对生存率无影响；各组的总生存率、无病生存率、非复发死亡率、植活率、复发率、植入失败率、急性GVHD和慢性GVHD发生率差异均无统计学意义均（P〉0．05）。结论 本文资料所列条件下，移植前使用IFN—α不会对URD—BMT产生不利影响。     

Chronic morphine exposure and the expression of heme oxygenase type 2

Heme oxygenase (HO) catalyzes the formation of carbon monoxide (CO) and other products from heme. The CO formed has been shown to function as a neurotransmitter, and may be involved in nociceptive signaling. Heme oxygenase type 2 (HO-2) is the predominant form of HO in the CNS. The expression of nitric oxide synthase (NOS) which catalyzes the formation of a similar neurotransmitter nitric oxide (NO) from arginine is increased in the spinal cords of animals chronically exposed to morphine and other opioids. In these studies, we examined changes in expression of HO-2 which occur in spinal cord tissue of morphine tolerant mice. After 5 days of exposure to morphine, mice were observed to be profoundly tolerant to the analgesic effects of morphine. In experiments using Northern blotting we observed a 2.7-fold increase in HO-2 mRNA in homogenized spinal cord tissue. Additional experiments revealed a 3.1-fold increase in HO-2 protein which seemed to result from the increased expression of HO-2 in neurons in the dorsal horn region of the spinal cord. To complement our expression studies measured HO enzymatic activity in spinal cord homogenates and found a 2.1-fold increase in the tolerant animals. The functional significance of this increased expression and activity is as yet unclear, but may be involved in the acquisition of analgesic tolerance to opioids, dependence on opioids, or perhaps the hyperalgesia reported after chronic exposure to opioids.     

Heroin-induced neuronal activation in rat brain assessed by functional MRI

The present study demonstrates the application of fMRI technology to neuropharmacology and the interaction of drug/receptor in the rat brain. Specifically, we have observed two different types of fMRI signal changes induced by acute i.v. heroin administration in rat brains under conditions of spontaneous and artificial respiration. Under spontaneous respiration, a global decrease in fMRI signal was observed; under artificial respiration, a region-specific increase in fMRI signal was identified and the activation sites are consistent with the distribution of opiate mu-receptors in rat brain as previously reported by autoradiography. Both heroin-induced fMRI signal changes were suppressed by pretreatment of naloxone, an opiate mu-receptor antagonist, and reversed by injection of naloxone following heroin infusion. These results suggest that fMRI has specific advantages in spatial and temporal resolution for studies of neuropharmacology and drugs of abuse.     

Neuroprotection achieved with a novel proteasome inhibitor which blocks NF-kappaB activation

Activated NF-kappaB contributes to cerebral infarction by triggering a neuro-inflammatory response. Rats subjected to 90min middle cerebral artery occlusion developed a cortical infarct of 20+/-4% of hemispheric volume (n = 8). Treatment with the proteasome inhibitor CVT-634 resulted in a significantly smaller infarct of 13+/-2% (n = 7, p<0.01) and 12+/-2% (n = 8, p<0.001) of hemispheric volume at 1 day and 7 days, respectively. Since regional cerebral blood flows for the core and penumbral regions were not affected, we concluded that all animals received the same ischemic insult The reduction in infarction persisted for 7 days. This is the first indication that a proteasome inhibitor can reduce infarct volume in a focal model of cerebral ischemia.     

Comparison of the costs and recovery profiles of three anesthetic techniques for ambulatory anorectal surgery

BACKGROUND: Given the current practice environment, it is important to determine the anesthetic technique with the highest patient acceptance and lowest associated costs. The authors compared three commonly used anesthetic techniques for anorectal procedures in the ambulatory setting. METHODS: Ninety-three consenting adult outpatients undergoing anorectal surgery were randomly assigned to one of three anesthetic treatment groups: group 1 received local infiltration with a 30-ml mixture containing 15 ml lidocaine, 2%, and 15 ml bupivacaine, 0.5%, with epinephrine (1:200,000) in combination with intravenous sedation using a propofol infusion, 25-100 microg. kg-1. min-1; group 2 received a spinal subarachnoid block with a combination of 30 mg lidocaine and 20 microg fentanyl with midazolam, 1-2-mg intravenous bolus doses; and group 3 received general anesthesia with 2.5 mg/kg propofol administered intravenously and 0.5-2% sevoflurane in combination with 65% nitrous oxide. In groups 2 and 3, the surgeon also administered 10 ml of the previously described local anesthetic mixture at the surgical site before the skin incision. RESULTS: The mean costs were significantly decreased in group 1 ($69 +/- 20 compared with $104 +/- 18 and $145 +/- 25 in groups 2 and 3, respectively) because both intraoperative and recovery costs were lowest (P < 0.05). Although the surgical time did not differ among the three groups, the anesthesia time and times to oral intake and home-readiness were significantly shorter in group 1 (vs. groups 2 and 3). There was no significant difference among the three groups with respect to the postoperative side effects or unanticipated hospitalizations. However, the need for pain medication was less in groups 1 and 2 (19% and 19% vs. 45% for group 3; P < 0.05). Patients in group 1 had no complaints of nausea (vs. 3% and 26% in groups 2 and 3, respectively). More patients in group 1 (68%) were highly satisfied with the care they received than in groups 2 (58%) and 3 (39%). CONCLUSIONS: The use of local anesthesia with sedation is the most cost-effective technique for anorectal surgery in the ambulatory setting.