全科医学基层实践基地师资综合评价指标体系的构建

目的 构建一套科学、系统的全科医学基层实践基地师资综合评价指标体系,为全科基层实践基地的师资遴选、评价和考核提供参考。方法 在文献研究、专家咨询和小组讨论的基础上,初步构建全科基层实践基地师资原始指标体系。选择具有中级及以上职称,并长期从事医学教育管理、全科医疗与教学、基层医疗卫生服务与管理工作的32名专家,进行两轮德尔菲专家函询,并对函询结果进行统计分析,确定全科基层实践师资综合评价指标。运用层次分析法计算各指标权重并进行一致性检验。运用Yaahp统计学软件进行数据录入和处理。结果 构建出包含3个一级指标、12个二级指标和61个三级指标的全科医学基层实践基地师资综合评价指标体系。3个一级指标分别为师资遴选纳入标准、教学能力评价标准、师资考核标准;权重系数分别为0.334、0.525、0.142。结论 本研究构建的指标体系具有较好的科学性和系统性,为进一步加强全科基层实践基地师资队伍的建设和管理、提升全科住院医师培养质量,提供了理论依据。     

心房颤动治疗的未来发展方向——混合消融

心房颤动是临床常见的心律失常,已有研究证明其与严重不良心脑血管事件(心力衰竭、脑卒中和心肌梗死)有关,目前全球心房颤动的患病人数超过了3 300万,预计未来40年内其患病率将增加1倍以上。多年来,医学相关人员在探究心房颤动的病理生理机制及开创改进其治疗方法等方面付出了大量努力。目前心房颤动的治疗管理仍是临床医学上的一个难题,尽管心房颤动治疗的手术消融和导管消融技术已逐渐趋于成熟,但对于心房颤动最佳的治疗方式、消融能量的选择尚无统一定论。导管消融通常需要多次手术且成功率低,而手术消融术后不良事件发生率较高。近年来,鉴于心脏外科医生和电生理学家之间的密切合作,结合导管及微创手术消融诞生了一种治疗心房颤动的新型策略——混合消融模式。混合消融克服了导管消融和微创手术消融的缺点,减少了不良结局,在治疗持续性心房颤动,尤其是长期持续性心房颤动上取得了可观的成效。本文主要通过回顾心房颤动消融的研究进展,对比分析目前混合消融模式治疗心房颤动的现有研究成果,归纳总结这种新型心房颤动治疗策略的优势与挑战,以期为临床心房颤动的治疗提供更多选择。     

陡脉冲电场对荷瘤BALB/c小鼠癌细胞杀伤效应的实验研究

观测陡脉冲电场对荷瘤BALB/c小鼠癌细胞的杀伤效应。处理后的癌细胞在光镜下表现为细胞核固缩、核碎裂、核溶解;在电镜下表现为异染色质增加,边集,呈团块样改变,细胞质肿胀,脂滴数量增加,质膜破裂;核固缩,碎裂,线粒体肿胀。实验揭示了陡脉冲电场能有效地杀伤癌细胞,明显抑制了荷瘤小鼠恶性肿瘤的生长、增殖,有着良好的应用前景。     

Combined high resolution linkage and association mapping of quantitative trait loci

In this paper, we investigate variance component models of both linkage analysis and high resolution linkage disequilibrium (LD) mapping for quantitative trait loci (QTL). The models are based on both family pedigree and population data. We consider likelihoods which utilize flanking marker information, and carry out an analysis of model building and parameter estimations. The likelihoods jointly include recombination fractions, LD coefficients, the average allele substitution effect and allele dominant effect as parameters. Hence, the model simultaneously takes care of the linkage, LD or association and the effects of the putative trait locus. The models clearly demonstrate that linkage analysis and LD mapping are complementary, not exclusive, methods for QTL mapping. By power calculations and comparisons, we show the advantages of the proposed method: (1) population data can provide information for LD mapping, and family pedigree data can provide information for both linkage analysis and LD mapping; (2) using family pedigree data and a sparse marker map, one may investigate the prior suggestive linkage between trait locus and markers to obtain low resolution of the trait loci, because linkage analysis can locate a broad candidate region; (3) with the prior knowledge of suggestive linkage from linkage analysis, both population and family pedigree data can be used simultaneously in high resolution LD mapping based on a dense marker map, since LD mapping can increase the resolution for candidate regions; (4) models of high resolution LD mappings using two flanking markers have higher power than that of models of using only one marker in the analysis; (5) excluding the dominant variance from the analysis when it does exist would lose power; (6) by performing linkage interval mappings, one may get higher power than by using only one marker in the analysis.     

叶酸拮抗同型半胱氨酸诱导的内皮细胞凋亡的作用机制

目的： 明确同型半胱氨酸（Hcy）对内皮细胞凋亡的影响以及叶酸的拮抗作用，阐明Bax和Bcl-2在同型半胱氨酸诱导内皮细胞凋亡及叶酸拮抗中的作用。方法: 用不同浓度的Hcy处理内皮细胞后，应用末端转移标记技术（TUNEL）以及Annexin V/PI染色加流式细胞术了解细胞凋亡状态，免疫组化方法检测Bax、Bcl-2的表达。结果: Hcy能促进细胞凋亡，叶酸具有拮抗作用。Hcy能促进细胞Bax、Bcl-2的表达，上调Bax/Bcl-2比值，叶酸能减少细胞表达Bax及Bcl-2，下调Bax/Bcl-2比值。结论: Bax、Bcl-2参与了Hcy诱导内皮细胞凋亡以及叶酸拮抗作用的过程。     

Iloprost对内皮细胞抗血栓功能的影响

以体外培养的猪主动脉内皮细胞（ＥＣ）为模型研究Ｉｌｏｐｏｓｔ对ＥＣ抗血栓功能的影响。用放免法、发色底物法测定培养液中６－酮－ＰＧＦ１α（６－ｋｅｔｏ－ＰＧＦ１α），血栓素Ｂ２（ＴＸＢ２）含量，纤溶酶原激活物（ＰＡ），纤溶酶原激活物抑制物（ＰＡＩ）活性及ＥＣ环磷酸腺苷（ｃＡＭＰ）含量。结果表明：Ｉｌｏｐｒｏｓｔ中以使ＥＣ生成６－ｋｅｔｏ－ＰＧＦ１α，ｃＡＭＰ含量显著增多，ＴＸＢ２含量显著减少，并使Ｐ     

Linkage and association of adrenergic and dopamine receptor genes in the distal portion of the long arm of chromosome 5 with systolic blood pressure variation

Elevated blood pressure is an important risk factor for renal-, cerebro- and cardiovascular diseases. We used an efficient discordant sib-pair ascertainment scheme to investigate the impact of the distal end of the long arm of human chromosome 5 (chromosomal region 5q31.1-qter) containing genes for the alpha1B and beta2 adrenergic receptors and the dopamine receptor type 1A on variation of systolic blood pressure in young Caucasians. We measured eight highly polymorphic markers spanning this positional candidate gene-rich region in 427 individuals from 55 three-generation pedigrees containing 69 discordant sibling pairs, and calculated multipoint identity by descent (MIBD) probabilities. The results of genetic linkage and association tests indicate that the region between markers D5S2093 and D5S462 is significantly linked to one or more polymorphic genes influencing interindividual variation in systolic blood pressure levels. Since the alpha1B adrenergic receptor and dopamine receptor type 1A genes are located close to these markers, these data suggest that genetic variation in one or both of these G protein-coupled receptors, which participate in the control of vascular tone, plays an important role in influencing interindividual variation in systolic blood pressure levels.      

Identification of two groups of smoldering multiple myeloma patients who are either high or low producers of interleukin-1.

Interleukin-1beta (IL-1beta) is abnormally expressed by the plasma cells obtained from myeloma patients, and it is a potent inducer of the important myeloma growth factor, IL-6. We investigated whether levels of IL-1beta biologic activity might distinguish different groups of patients with smoldering multiple myeloma (SMM). We measured the ability of IL-6 production by bone marrow stromal cells to serve as a surrogate marker for IL-1beta biologic activity. Using this IL-1beta bioassay, we found that it is sensitive at < 1 pg/ml of recombinant IL-1beta and that IL-1beta biologic activity is detectable with either mature or pro-IL-1beta-transduced myeloma cell lines. Patients with active myeloma induced quantitatively higher levels of stromal cell IL-6 production when compared with those with monoclonal gammopathy of undetermined significance (MGUS). The bioassay distinguished two groups of SMM patients, those who were high producers, similar to patients with active MM, and those who were low producers, comparable to MGUS patients. IL-1 antagonists inhibited the paracrine IL-6 production by > or = 90% in the majority of patients with an elevated IL-6 level. Based on such studies, it may be possible to predict patients that will progress to active MM and to delay or prevent this progression with IL-1 antagonists.     

FD-1冷冻干燥机的研制及生物材料的冷冻干燥

观察自制冷冻干燥机冷冻干燥生物材料的效果。采用 R5 0 2压缩机和制冷剂制成 FD- 1冷冻干燥机。本实验冷冻干燥了胶原海绵、菌种及去纤酶。在冻干箱负载或空载情况下蒸发冷凝器温度均可达到 - 4 5℃ ,小冰箱可达到 - 30℃ ,冻干的胶原海绵具有许多孔洞的结构 ,冻干的菌种和去纤酶性能保持良好。 FD- 1冷冻干燥机适用于生物样品中小批量的冷冻干燥     

氧离子注入增强人工关节软骨材料-UHMWPE的耐磨性

用高能离子注入机对超高分子量聚乙烯 (U HMWPE)进行了 O+注入改性 ,注入能量为 4 5 0 ke V和 10 0ke V,剂量分别为 1× 10 1 5/cm2 ,5× 10 1 5/cm2和 1× 10 1 6 /cm2。以 Si3N4 球为上销样 ,UHMWPE为下盘样组成摩擦副 ,在销盘摩擦试验机上评价它们在干摩擦和蒸馏水润滑条件下的磨损性能。结果表明 ,几种注入工艺均增强了UHMWPE的耐磨性 ,但提高了其摩擦系数 ,其中以能量为 4 5 0 Ke V,剂量为 5× 10 1 5/cm2的注入样品耐磨性最好。未注入 U HMWPE的磨损主要表现为黏着、塑性变形和犁沟 ,注入 U HMWPE的磨损主要为表面硬化层疲劳裂纹的萌生、扩展、剥落及磨粒磨损