妇产科见习带教中运用模拟病人配合典型病例讨论初探

为解决妇产科学教学病源匮乏,促使学生掌握病史采集、分析等基本功,培养学生临床思维能力,运用模拟病人配合典型病例讨论的见习方式,发挥了学生学习的积极主动性,培养了临床思维、操作技能以及人际沟通能力,同时也解决了教学条件有限、临床病例不足、病人不满意等问题。     

100例SARS患者外周血T淋巴细胞亚群分析

目的 :探讨SARS患者外周血T淋巴细胞亚群变化。方法 :采用流式细胞仪检测10 0例SARS住院患者外周血T淋巴细胞亚群。结果 :与正常组比较 ,SARS组白细胞总数显著下降 ,淋巴细胞百分数和绝对数显著下降 ,粒细胞绝对数显著下降 ,CD3 、CD4 、CD8 细胞绝对数显著下降 ,CD4 细胞百分数 ,CD8 细胞百分数及CD4 /CD8 比值差异无统计学意义。比较SARS患者各病程CD3 、CD4 、CD8 ,于病程第一至第三周较第四周下降明显 (P <0 .0 5 ) ,病程第一至第三周之间差别无显著性 (P >0 .0 5 ) ;结论 :SARS患者外周血T淋巴细胞亚群的变化对阐明SARS的发病机制有一定意义。     

胆囊壁厚度的超声测量对急慢性胆囊炎诊断的临床意义（附660例分析）

对我院因急慢性胆囊炎、胆囊结石、胆囊息肉样病变而作胆囊切除术660例胆囊壁厚度的超声测量与术后病理诊断进行对照研究．报告如下。资料与方法我院1992年5月至1996年5月住院作胆囊切除术患者，男195例，女465例，年龄12～87岁．平均489岁。     

吗啡预处理-后处理对大鼠离体心脏缺血再灌注损伤的影响

Objective To evaluate the effects of morphine preconditioning-postconditioning on ischemia-reperfusion (I/R) injury in isolated rat hearts. Methods Male SD rats weighing 180-200 g were killed after intraperitoneal injection of heparin 500 U/kg. The hearts were immediately removed and perfused in a Langendorff apparatus with K-H solution gassed with 95%O2-5%CO2 .HR and left ventricular systolic pressure (LVSP) were measured from a fluid-filled latex balloon in the left ventricle. Global myocardial ischemia was induced by interrupting perfusion for 45 min followed by 60 min reperfusion. Forty isolated rat hearts were randomly divided into 5 groups (n = 8 each): group 1 (I/R); group II morphine preconditioning (M1 ); group Ⅲ morphine postconditioning (M2); group IV M1 + M2; group V 5-hydroxydecanoate (5-HD) + M2. Group M1 was perfused with K-H solution containing morphine 3.0 μmol/L for 20 min 30 min before ischemia followed by 10 min normal K-H solution perfusion. Group M2 was perfused with K-H solution containing morphine 3.0 μmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Group 5-HD + M2 was perfused with K-H solution containing morphine 3.0 μmol/L+ 5-HD 10-4 mmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Myocardial CK-MB activity was measured and myocardial infarct size (IS/AAR) detennined (by 2,3,5-triphenyl tetrazolium staining) at the end of 60 min reperfusion. Results The preconditioning, postconditioning and combination of preconditioning and postconditioning with morphine 3.0 μmol/L perfusion for 10 min all provided cardio-protective effects in terms of IS/AAR and myocardial activation of CK-MB. Conclusion Although the combination of morphine preconditioning and postconditioning can protect the heart against I/R injury, the effects are similar to those of either of them alone, and the reason may be that either of them alone protects the heart against I/R injury via activating mitoKATP .     

吗啡预处理-后处理对大鼠离体心脏缺血再灌注损伤的影响

Objective To evaluate the effects of morphine preconditioning-postconditioning on ischemia-reperfusion (I/R) injury in isolated rat hearts. Methods Male SD rats weighing 180-200 g were killed after intraperitoneal injection of heparin 500 U/kg. The hearts were immediately removed and perfused in a Langendorff apparatus with K-H solution gassed with 95%O2-5%CO2 .HR and left ventricular systolic pressure (LVSP) were measured from a fluid-filled latex balloon in the left ventricle. Global myocardial ischemia was induced by interrupting perfusion for 45 min followed by 60 min reperfusion. Forty isolated rat hearts were randomly divided into 5 groups (n = 8 each): group 1 (I/R); group II morphine preconditioning (M1 ); group Ⅲ morphine postconditioning (M2); group IV M1 + M2; group V 5-hydroxydecanoate (5-HD) + M2. Group M1 was perfused with K-H solution containing morphine 3.0 μmol/L for 20 min 30 min before ischemia followed by 10 min normal K-H solution perfusion. Group M2 was perfused with K-H solution containing morphine 3.0 μmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Group 5-HD + M2 was perfused with K-H solution containing morphine 3.0 μmol/L+ 5-HD 10-4 mmol/L for 10 min at the beginning of reperfusion followed by 50 min normal K-H solution perfusion. Myocardial CK-MB activity was measured and myocardial infarct size (IS/AAR) detennined (by 2,3,5-triphenyl tetrazolium staining) at the end of 60 min reperfusion. Results The preconditioning, postconditioning and combination of preconditioning and postconditioning with morphine 3.0 μmol/L perfusion for 10 min all provided cardio-protective effects in terms of IS/AAR and myocardial activation of CK-MB. Conclusion Although the combination of morphine preconditioning and postconditioning can protect the heart against I/R injury, the effects are similar to those of either of them alone, and the reason may be that either of them alone protects the heart against I/R injury via activating mitoKATP .     

PGC—1的研究进展

过氧化物酶体增生激活受体γ协同刺激因子(PGC)-1是一种近年来发现的转录协同刺激因子，被认为与内分泌疾病密切相关。PGC-l能够调节适应性产热及线粒体的生成而影响肥胖的发生，还通过增加葡萄糖转运体(GLUT)4的表达增强葡萄糖的转运及激活糖异生的关键酶，与糖尿病的发生、发展密切相关。故通过调节其生理功能来治疗肥胖及糖尿病已成为研究热点。     

32例结核性胸水的治疗及体会

全球已有17亿人感染了结核菌，每年增加新病例约800万,800万新病例中2／3在亚洲。肺结核占结核病的绝大部分，是当今最重要的慢性传染病之一。结核性渗出性胸膜炎占内科住院患者的3．5％．其中有少数结核性渗出性胸膜炎，虽然经过抗结核治疗．胸水仍形成包裹、不吸收、胸穿排液后反复生长。我院自2002年1月以来．对排液、化疗等效果不佳的结核性胸膜炎病人．应用高聚金葡素（HAS）胸腔内注射和（或）静脉滴注、肌肉注射．取得了满意的疗效．现报告如下：     

自然流产夫妇淋巴细胞染色体脆点的研究

本文对85例核型正常和30例核型异常的自然流产夫妇与20例正常夫妇进行淋巴细胞脆点的研究。通过三组互相比较，发现核型正常组和正常对照组的染色体畸变率、脆点表达率二项有显著差异；核型异常组和正常对照组的二项有极显著差异；核型正常组和核型异常组的二项有显著差异。并发现20个脆点与核型异常部位相一致，一致率为36．36％。说明脆点可能引起生殖细胞染色体断裂或重排。淋巴细胞染色体畸变率和脆点表达率升高是反映染色体稳定性的指标，染色体稳定性降低可能是引起自然流广的原因。     

小班上课与影像学教学质量的关系

2004年9月7日参考消息转载的一篇法国《世界报》的章，讲述了法国经济学家托马．皮凯蒂的研究成果，即：缩小班级规模确实对学生成绩有影响，对那些成绩不好的学生来说尤其如此，它是减少学校不平等现象的一种有效工具。托马．皮凯蒂研究、跟踪了不同年级的升学成绩和大小班的教学效果，人数较少的班级的成绩明显好于人数多的班级。     

成人感染人类细小病毒B19的临床研究

人类细小病毒 (HPY)B1 9是一种细小DNA病毒。其基因组为单链DNA ,长 5 6Kb。它是现已知的唯一感染人类的细小病毒。 1 975年Cossart等在正常献血员的血清中发现了此病毒。被认为与此病毒有关的第一种疾病是镰状细胞贫血出现的再障危象。不久 ,HPV B1 9又被证实可以导致儿童的传染性红斑 (第五病 ,fifthdisease)、妊娠期妇女的致命水肿和流产。近来 ,研究结果显示HPV B1 9与许多种疾病或病理状态相关。然而 ,在日本尚未有人对成人感染HPV B1 9的临床表现作出深入研究。因此 ,本报道对我门诊就诊的 2 1例此类患者的临床征象进行了…