试论提高乡镇医院效益

通常乡镇医院的经济效益是由病人的经济支付能力,医院提供卫生服务的可及性和医生的作用三方面因素决定的。对此从理论和实践方面进行了探讨,得出”减轻病人负担,上门为群众提供多功能医疗服务,优势的医疗服务是提高乡镇医院效益的有效途径。     

新生儿唇腭裂危险因素的病例对照研究

目的探讨唇腭裂（CLP）的发病原因。方法采用1：1配对的方法,对90例唇腭裂患儿的母亲与非唇腭裂患儿的母亲进行了对照研究,调查范围包括母亲自身危险因素和环境中的危险因素两大方面。结果在所列的7种因素中,有6种因素表现出较高的危险度,依其危险度（OR值）大小排列为：孕期接触工业毒物（9．0）,孕期使用某些化学药物（8.0）,家中饲养猫、狗等宠物（6．0）,父母近亲结婚（6．0）,孕期内受病毒感染（4．5）和孕期内喷洒农药除草剂（4．0）。结论孕期内接触有害物质是CLP的重要致病因素。     

Characterization of a mouse Cx50 mutation associated with the No2 mouse cataract.

PURPOSE: Recently, a missense mutation in the mouse connexin 50 (Cx50) gene has been associated with the nuclear opacity 2 (No2) mouse cataract. This missense mutation (D47A) resulted in an aspartate-to-alanine substitution at amino acid position 47 in the first extracellular domain of Cx50. To better understand the role of Cx50 in the pathogenesis of congenital cataract, the functional consequences of the D47A mutation in the Xenopus oocyte expression system were studied. METHODS: D47A was constructed using polymerase chain reaction (PCR) mutagenesis. Xenopus oocytes were injected with in vitro transcribed cRNA encoding wild-type mouse Cx50 (Cx50wt), wild-type rat Cx46 (Cx46wt), D47A, or combinations of wild-type and mutant connexins. The oocytes were then devitellinized and paired. Gap junctional conductance (Gj) was measured using a dual two-microelectrode voltage-clamp technique. RESULTS: Homotypic oocyte pairs expressing wild-type Cx50 or Cx46 were well coupled. In contrast, oocytes injected with D47A cRNA did not form gap junctional channels when paired homotypically. To test whether the D47A mutation could interact with wild-type connexins in a dominant negative manner, oocytes were injected with equal amounts of mutant and wild-type connexin cRNA, mimicking the heterozygous condition. Expression of D47A did not inhibit the development of junctional conductance in paired oocytes induced by wild-type Cx50 or Cx46. CONCLUSIONS: These results indicate that the D47A mutation acts as a loss-of-function mutation without strong dominant inhibition. In No2 mice, the mutation would be predicted to result in a reduction in intercellular communication, leading to cataractogenesis. It may also cause other qualitative changes such as a change in permeability for small molecules.     

碱性成纤维细胞生长因子和胰岛素样生长因子—Ⅰ及其协同作用对？…

目的 研究碱性成纤维细胞生长因子（ｂａｓｉｃ ｆｉｂｒｏｂｌａｓｔ ｇｒｏｗｔｈ ｆａｃｔｏｒ,ｂＦＧＦ）、胰岛素样生长因子－１（ｉｎｓｕｌｉｎ－ｌｉｋｅ ｇｒｏｗｔｈ ｆａｃｔｏｒ－１,ＩＧＦ－１）及二者的共同作用对体外牛晶体上皮细胞（ｂｏｖｉｎｅ ｌｅｎｓｅｐｉｔｈｅｌｉａｌ ｃｅｌｌ,ＢＬＥＣ）增殖的影响。方法 ＢＬＥＣ原代培养,取第４例细胞种入２４孔板,加入不同浓度的ｂＦＧＦ、ＩＧＦ－１,     

B型超声检查对渗出型老年性黄斑变性的诊断价值

目的:探讨渗出型老年性黄斑变性(Age-related macular degeneration,AMD)的B型超声影象特征。方法:采用NIDEKUS-3300型超声诊断仪,对31例(54只眼)渗出型AMD进行了观察。结果:视网膜色素上皮脱离时,眼内后极部出现膜状弧形回声,光带与眼球壁之间,可见一个梭形透声区;渗出或出血未完全吸收阶段,呈混合性回声;渗出或出血逐渐吸收并为瘢痕组织所替代时,可见实体性小隆起物,强回声,形状似凸透镜或三角形,凸起端指向球后,玻璃体腔面平坦。结论:B型超声在渗出型AMD的诊断、治疗随访观察中具有实用价值。眼科学报1999;15:233-235。     

Current source-density analysis of light-evoked field potentials in rabbit retina.

The technique of current source-density analysis was applied to several components of the light-evoked field potentials (electroretinogram) from the retina of the superfused eyecup of rabbit. The depth distributions of the major current sources and sinks were: b-wave--sink at outer plexiform layer, source at inner plexiform layer; M-wave--sink at inner plexiform layer, source at retinal surface; and slow PIII--source near outer plexiform layer, sink at retinal surface. These distributions, along with the sensitivities of these responses to certain pharmacological agents, support earlier studies that Müller cells generate the M-wave and slow PIII, but that depolarizing bipolar cells directly generate the b-wave.     

Neuropharmacological assessment of potential dopamine D4 receptor-selective radioligands

Radiolabeled dopamine D4 receptor-selective agents ([3H]1-benzyl-4-[ N-(3-isopropoxy-2-pyridinyl)-N-methyl]-aminopiperidine maleate; [3 H]PNU-101958. and [125I]1-[4-iodobenzyl]-4-[ N-(3-isopropoxy-2-pyridinyl)-N-methyl]-aminopiperidine; [125I]RBI-257) were prepared and characterized. With D4.2- and D2L receptor-transfected cell membranes, [3H]PNU-101958 showed high dopamine D4 receptor affinity and selectivity, and potent inhibition by dopamine D4 receptor-selective compounds. However, its binding with rat brain homogenates showed little regional selectivity, and pharmacology inconsistent with selective dopamine D4 receptor labeling. Autoradiography indicated partial displacement of [3H]PNU-101958 by unlabeled dopamine D4 receptor ligands without regional selectivity, and lack of selective labeling with [125I]RBI-257. The results encourage further efforts to develop better dopamine D4 receptor-selective radioligands.     

Gene cloning and sequencing of BmK AS and BmK AS-1, two novel neurotoxins from the scorpion Buthus martensi Karsch.

Based on the known amino acid sequences of BmK AS and BmK AS-1, the gene specific primers were designed and synthesized for 3' and 5' RACE (Rapid Amplification of cDNA Ends). Their partial cDNA fragments obtained by 3' and 5' RACE were cloned and sequenced, and the full length cDNA sequences of BmK AS and BmK AS-1 were then completed by overlapping their two partial cDNA sequences, respectively. The predicted amino acid sequences both consist of 85 amino acid residues including a putative signal peptide of 19 residues and a mature toxin of 66 residues. They are different in 17 amino acid residues, among them 11 residues in the mature toxin. The predicted amino acid sequences of BmK AS and BmK AS-1 were almost consistent with those determined and revised (personal communication), only different in one and two residues at their COO-terminal parts, respectively. Based on the determined cDNA sequences, and using the total DNAs isolated from the scorpion venom glands as a template, the genomic DNAs of BmK AS and BmK AS-1 were also amplified by PCR and sequenced. It showed that no intron was inserted in their open reading frames, while in the exon of signal peptide sequences of other Na+, K+ and Cl- channel toxins from the same scorpion, an intron is usually found. However, the Northern blot hybridization results indicated that the sizes of their mRNA should be around 800 bp. Their extra sequences around 400 bp which might function as an intron should be located at their 5' untranslated regions.     

Molecular characterization of a new excitatory insect neurotoxin with an analgesic effect on mice from the scorpion Buthus martensi Karsch.

Besides the neurotoxins active on mammals, a new excitatory insect selective toxin with a mice analgesic activity was found and purified from the venom of the scorpion Buthus martensi Karsch (BmK) (Ji, Y.H., Mansuelle, P., Terakawa, S., Kopeyan, C., Yanaihara, N., Hsu, K., Rochat, H., 1996. Toxicon 34, 987; Luo, M.J., Xiong, Y.M., Wang, M., Wang, D.C., Chi, C.W., 1997. Toxicon 35, 723.). This peptide (designated as BmK IT-AP) is composed of 72 amino acid residues. Its primary structure was determined by automated Edman degradation of the N-terminal part of the reduced and S-carboxamidemethylated protein and its lysylendopeptidase degraded fragments. Based on the determined sequence, the gene specific primers were designed and synthesized for 3' and 5' RACE (rapid amplification of cDNA ends). Their partial cDNA fragments obtained by 3' and 5' RACEwere cloned and sequenced and the full length cDNA sequence of BmK IT-AP was then completed by overlapping their two partial cDNA sequences. It encodes a precursor of 90 amino acid residues: a signal peptide of 18 residues and a mature peptide of 72 residues which are consistent with the determined protein sequence of BmK IT-AP. The genomic DNA of the peptide was also amplified by PCR from the scorpion genomic DNA and sequenced, which is a first report on the genomic structure of a scorpion toxin specific for insects. Its sequence revealed an intron of 590 bp inserted in the end part of the signal peptide. The peptide caused a fast excitatory contraction paralysis on house fly larvae. Furthermore, the peptide also showed an obvious analgesic effect on mice, as assayed by using a twisting test model. This effect of BmK IT-AP well characterized at molecular level is first reported among the known scorpion insect neurotoxins.