慢性再生障碍性贫血患者外周血T淋巴细胞亚群改变与中医分型的关系

用McAb和ABC法测定了38例慢性再生障碍性贫血(CAA)患者外周血T淋巴细胞亚群(简称T亚群)。与健康人相比,CAA的Ts明显增高(P<0.001),Th/T5明显降低(P<0.001)。并发现外周血Hb水平、病程、疗效及中医证型与T亚群相关。按气血两虚肾阳虚、肾阴虚、肾阴阳两虚的顺序,患者Th逐渐降低,Ts逐渐升高,Th/Ts明显降低。后两组比前两组Th/Ts下降更显著(P<0.01),提示阳损及阴时机体免疫机能发生更大的改变,从T亚群水平揭示了中医证型特别是肾阳虚、肾阴虚的内涵。     

Link protein shows species variation in its susceptibility to proteolysis.

Human cartilage link protein exists as three native components, while equine, bovine, and porcine cartilage link protein exist as two and Swarm rat chondrosarcoma link protein exists as only one component. These nonhuman link protein components represent intact protein structures, and there is little evidence for proteolytically modified forms in nonhuman tissues. In human cartilage, the proteolytic production of modified link proteins increases with age, whereas high amounts of such products were not seen in the nonhuman tissues. However, the small amounts of link protein fragments that were observed in the nonhuman cartilages were of a similar size to their human counterparts. On digestion of human proteoglycan aggregate with stromelysin, rapid modification of the link protein components occurred, whereas the aggregates from nonhuman cartilages showed incomplete cleavage of their link protein components. The relative resistance of nonhuman link protein to stromelysin may in part be due to a unique amino acid substitution present near the enzymic cleave site.     

Lifetime and six-month prevalence of mental disorders in the Munich follow-up study

Summary The Lifetime and 6 month DSM-III prevalence rates of mental disorders from an adult general population sample of former West Germany are reported. The most frequent mental disorders (lifetime) from the Munich Follow-up Study were anxiety disorders (13.87%), followed by substance (13.51%) and affective (12.90%) disorders. Within anxiety disorders, simple and social phobia (8.01%) were the most common, followed by agoraphobia (5.47%) and panic disorder (2.39%). Females had about twice the rates of males for affective (18.68% versus 6.42%), anxiety (18.13% versus 9.07%), and somatization disorders (1.60% versus 0.00%); males had about three times the rates of substance disorders (21.23% versus 6.11%) of females. Being widowed and separated/divorced was associated with high rates of major depression. Most disordered subjects had at least two diagnoses (69%). The most frequent comorbidity pattern was anxietyand affective disorders. Simple and social phobia began mostly in childhood or early adolescence, whereas agoraphobia and panic disorder had a later average age of onset. The majority of the cases with both anxiety and depression had depression clearly after the occurrence of anxiety. The DIS-DSM-III findings of our study have been compared with both ICD-9 diagnoses assigned by clinicians independently as well as other epidemiological studies conducted with a comparable methodology.     

瑶族体型的Heath—Carter人体测量法研究

的　探讨瑶族成人体型的特点与规律。方法　应用Heath -Carter人体测量法 ,对广西田林县利周乡 2 18例(男 116 ,女 10 2 ) 2 0～ 45岁盘古瑶族成人体型进行活体测量。结果　瑶族平均体型男性为均衡的中胚层体型 ( 1.8-4 .9-2 .2 ) ,女性为偏内胚层的中胚层体型 ( 3 .1-4 .3 -1.9) ;瑶族男性 2 0～ 40岁间各年龄组 ,内因子值和中因子值变化不大 ,外因子值略有减少 ,内、中因子值的最小值及外因子值的最大值均在 40～ 45岁组 ;女性 2 0～ 45岁间各年龄组 ,随着年龄增加 ,外因子值明显增加 ,中、内因子值略有减少 ;瑶族男女间体型各年龄组比较差异均有显著性或高度显著性 ,P<0 .0 5或P <0 .0 1。结论　瑶族与其他群体体型比较 ,体脂少 ,骨骼肌肉较发达 ,身体线性度适中。     

Age estimation in biopsy specimens of dentin

Determination of age at death on the basis of aspartic acid racemization in dentin is one of the most reproducible and accurate methods. In Germany, age estimation by this method has so far generally not been applied to living persons, since the extraction of a tooth exclusively for age estimation when it is not medically indicated is regarded as ethically and legally problematic. The development of a biopsy technique applicable to dentin took place against this background. Testing the technique and analysis of dentinal biopsy specimens revealed that the biopsy technique is a low-risk procedure that causes only minor discomfort to the affected person. It is readily practicable and facilitates standardized specimen removal. The relationship between the extent of aspartic acid racemization in dentinal biopsy specimens and age is very close, facilitating age estimation. A prerequisite for accurate results is the performance of biopsies under strictly standardized conditions. If this is guaranteed, age determination on the basis of aspartic acid racemization in dentinal biopsy specimens appears to be superior in precision to most other methods in living persons and can be used for all age groups.     

Medical education for minorities at a US medical school

The University of Washington School of Medicine (UWSM) has initiated new efforts to build a regional minority applicant pool and to expand its educational programmes to accommodate students from disadvantaged backgrounds. Specific interventions include: establishment of medical career planner position to coordinate region-wide outreach; pre-entry education; and support activities once enrolled. This study describes specific services and presents sociodemographic and performance data on 56 minority and 280 majority students entering the UWSM between 1981 and 1985. Economic status and educational background of minority students were significantly below that of majority students, several flexible academic policies enabled most students to achieve mastery in courses and to progress through the curriculum. The educational data base utilized in this study, and those at other institutions, can assume important roles in the identification of problem areas in the education of disadvantaged students and in evaluation of the interventions attempted.     

潘库溴铵在婴幼儿、儿童和成年人的药代动力学

研究观察年龄对潘库溴铵药代动力学的影响，选择24例施择期整形外科手术的患者，根据年龄分成三组：1组为5例婴幼儿，年龄0．75－2．95岁；2组为13例儿童，年龄4－14岁；3组为6例病人，年龄16－27岁，静注潘库溴铵100ug/kg后用改良蒌光法测定其血浓度，潘库溴铵的体内过程能用二室开放模型完整描述，年龄愈小，分布容积愈大，血浆清除率愈高，潘库溴铵的血药浓度愈低，V1（中央室分布容积），V2（周边室分布容积），Vdss(稳态分布容积），C1（血浆清除率）和AUC（曲线下面积）在三相间有明显差别，1组的T1／2β和MRT明显比2，3组长，但T1／2α和K21在三组间无明显差别。     

西藏那曲地区藏族学生恒牙龋病现状调查

目的了解那曲地区藏族学生龋病患病情况,为当地制定口腔预防保健措施提供基线资料。方法采用单纯随机抽样方法,按照WHO 1997年的《口腔健康调查基本方法》,对12～17岁的471名藏族学生进行恒牙龋病检查。结果藏族学生恒牙总患龋率为56.7%,男生患龋率为53.9%,女生患龋率为59.1%,差异无统计学意义(χ2=1.258,P=0.262);龋均为(4.09±2.11),男生龋均为(4.04±2.10),女生龋均为(4.13±2.11),差异无统计学意义(t=-0.646,P=0.518)。结论那曲地区藏族学生恒牙龋病患病率较高、程度较重,预防治疗措施急需加强。     

Seizure Disorders: The Changes With Age

Summary: Age has a profound influence on our approach to the convulsive disorders. Age is a variable which is an important determinant for risk factors for epilepsy. Age, as a surrogate of brain maturation, is a determinant of the specific characteristics of the seizure disorder in those with epilepsy, and age-related changes in these manifestations can be identified. Age is a determinant for the occurrence of acute symptomatic seizures in several types of metabolic or central nervous system insults. Age is a determinant for prognosis, whether one considers remission, medication withdrawal in those entering remission, relapse following prolonged remission, or mortality. Last, age per se seems to be a risk factor for epilepsy independent of other factors. This seems particularly true for partial seizures.     

Teaching Culturally Appropriate Care: A Review of Educational Models and Methods

The disparities in health care and health outcomes between the majority population and cultural and racial minorities in the United States are a problem that likely is influenced by the lack of culturally competent care. Emergency medicine and other primary-care specialties remain on the front lines of this struggle because of the nature of their open-door practice. To provide culturally appropriate care, health care providers must recognize the factors impeding cultural awareness, seek to understand the biases and traditions in medical education potentially fueling this phenomenon, and create a health care community that is open to individuals' otherness, thus leading to better communication of ideas and information between patients and their health care providers. This article highlights the rationale for and current problems in teaching cultural competency and examines several different models implemented to teach and promote cultural competency along the continuum of emergency medicine learners. However, the literature addressing the true efficacy of such programs in leading to long-lasting change and improvement in minority patients' clinical outcomes remains insufficient.