口服氯化汞对大鼠肾间质纤维化的作用

目的口服氯化汞(HgCl2)造成大鼠的肾间质纤维化模型并探讨相关机制。方法用不同剂量HgCl2[(A组为5mg/(kg·bw)、B组为10mg/(kg·bw)、C组为20mg/(kg·bw)]给大鼠灌胃1周,观察大鼠一般状况、肾功能和肾组织病理变化,免疫组化法观察肾组织纤维连接蛋白(FN)和α-平滑肌肌动蛋白(α-SMA)表达。结果模型大鼠体重下降,肾体比增加,肾功能损害和肾组织Hyp含量呈剂量依赖性升高,肾间质炎性细胞浸润,肾间质胶原沉积增加,肾间质FN和α-SMA表达增强,以C组病变最重。结论20mg/(kg·bw)剂量HgCl2灌胃1周可造成大鼠的肾间质纤维化病变,其部分机制在于HgCl2促使肾间质肌成纤维细胞活化和细胞外基质的生成沉积。     

病人选择就诊医院影响因素的logistic回归分析

目的了解病人选择就诊医院的影响因素，为医院领导决策提供科学的依据。方法采用随机抽样的方法，对病人进行问卷调查，数据的分析用logistic回归验证。结果医疗效果、医疗费用、医务人员的服务态度、就医过程中的方便性四个因素成为病人选择就诊医院着重考虑的问题，医务人员是否尊重病人的隐私和收受“红包”现象两个因素对病人的选择也有影响。结论掌握病人的医疗意向和医疗消费心理能够提高医院竞争力，保证医院的可持续发展。     

加强高职高专医学生公共卫生和临床医学整合教育的思考

文章讨论了由突发公共卫生事件引发的对构建现代公共卫生和临床医学整合教育模式的反思及其对策措施.透过SARS危机，暴露出我国现行医学教育体制上存在的医防分离的严重性，提示我们应借鉴21世纪医学生培养目标与要求，改革医学教育模式，促进多学科、跨专业的合作，建立以社区为目标、以问题为中心的公共卫生与临床医学整合教育的全新综合化课程体系;积极推广计算机辅助教育（CAI），加强运用现代化教学手段;建设以社区实践为主要内容的公共卫生和临床医学整合教育基地，加强高职高专医学生实践技能的培养，以构建新型高职高专医学人才培养模式，培养防治结合的新型实用型医学人才.     

欧洲医疗服务

“看病问题”成为近期老百姓关注的焦点,必竟健康对于每个人都是非常重要的,而疾病又是难以避免的,每个公民求医的权利都是应该受到保障与保护的。根据第三次全国卫生服务调查的结果,在城市中,将近50%的病人有病不去看病,这说明我们的医疗制度并没有行使好保障人民健康的任务。相比较,欧洲的医疗服务体制在经过了改革与实践后,已经发展得相当成熟了。抛开国家与国家之间的差异,它们对于医疗服务构建的经验,是可以被我们借鉴的。本文以图文的形式介绍了七种基本医疗服务的模型,希望能对我国卫生政策的研究者及制订者有所帮助。     

Brn-4在偏侧帕金森病大鼠模型纹状体中的表达变化

目的:探讨Brn-4在偏侧帕金森病大鼠模型纹状体中的表达变化。方法:用6-OHDA注入80只SD大鼠右侧前脑内侧束(medialforebrainbundle,MFB),行为学检测得成功PD模型48只,随机分成7d、14d、21d、28d4组,每组各12只。每组中的6只动物和6只正常对照大鼠的纹状体进行Brn-4Westernblot检测;另6只动物的纹状体进行Brn-4免疫组化染色。结果:Westernblot检测发现Brn-4的相对表达量(Brn-4/β-actin)正常对照组为0.123±0.02,7d组为0.538±0.04,14d组为0.192±0.05,21d组为0.122±0.02,28d组为0.084±0.02;而模型侧/正常侧纹状体Brn-4阳性细胞的比值7d、14d、21d和28d组分别为1.560±0.14,0.855±0.15,0.638±0.11和0.369±0.10。结论:PD大鼠模型纹状体中Brn-4蛋白于前脑内侧束注射6-OHDA后7d表达量急剧增高,而14d后则急剧下降,到28d时已低于正常水平。     

北京市某区肠道门诊现状和合理设置模式的研究

目的：了解并评价某一地区肠道门诊的现况。方法：定量描述2004年全区肠道门诊的地理分布、门诊量、硬件配备、消毒隔离、管理、病种分析等，对就诊的患者进行定性访谈。结果：全区共有31家肠道门诊，城区肠道门诊布局相对合理，农村地区肠道门诊的服务半径过大，平均38．6km^2；二级、三级医院的肠道门诊门诊量大、硬件配备较完善，而一级医院的肠道门诊门诊量较少、硬件配备不足，有11家医院全年门诊量不足60人；43％肠道门诊病人为普通肠炎，16％为痢疾。结论：政府对一级医院的肠道门诊资金投入不足；农村肠道门诊布局不合理；肠道门诊的常规检测项目不合理。     

正交试验法优选D-氨基半乳糖敏化小鼠的内毒素休克模型

目的:建立D-氨基半乳糖敏化小鼠内毒素休克的规范化模型.方法:选择对内毒素休克小鼠死亡率有影响的3个因素:D-氨基半乳糖增敏剂量、内毒素攻击剂量及其给药途径,每个因素选取3个水平,按L9(34)正交试验表安排试验.以小鼠48 h死亡率为评价指标,并通过验证试验,优化与实验要求相符的造模条件.结果:各因素对动物死亡率影响程度依次为:D-氨基半乳糖增敏剂量＞内毒素给药途径＞内毒素攻击剂量.采用D-氨基半乳糖600 mg·kg-1敏化小鼠,腹腔注射内毒素0.5 mg·kg-1的给药方案为佳.结论:规范内毒素休克模型的复制条件,将有利于科学评价药物的抗内毒素活性.     

脓毒症心肌损害新生大鼠模型的建立

【摘要】 目的 建立一种具有良好稳定性及重复性的能模拟新生儿脓毒症（NS）心肌损害的新生大鼠动物模型,为研究NS致病机制及防治提供模型动物。方法 选取出生10天的健康雄性SD新生大鼠54只,随机分为正常对照组、假手术组（Sham组）、盲肠结扎穿孔术组（CLP组）,每组各18只。通过观察血培养菌落生长,采用酶联免疫吸附法（ELISA）对血清肌钙蛋白I（cTNI）浓度、心肌组织肿瘤坏死因子α（TNF α）和白细胞介素1β（IL 1β）含量进行检测,光镜下观察HE染色后心肌组织的病理变化。结果 正常对照组和Sham组新生大鼠的血培养结果均为阴性,CLP组新生大鼠的血培养中检出以大肠杆菌为主的菌落。正常对照组新生大鼠的血清cTNI浓度、心肌组织TNF α和IL 1β含量和Sham组比较差异无统计学意义（P＞0.05）;CLP组新生大鼠的血清cTNI浓度、心肌组织TNF α和IL 1β含量较Sham组明显增加（P＜0.05）。正常对照组和Sham组的心肌组织HE染色示心肌细胞均未出现炎性改变,但CLP组心肌细胞周围出现了炎性细胞浸润等病理改变。结论 通过盲肠结扎穿孔可建立较为理想的脓毒症心肌损害新生大鼠模型。     

The Effects on Transient Evoked Otoacoustic Emissions Following Changes in External Auditory Canal Acoustic Impedance

The form of the transient evoked otoacoustic emission (TEOAE) generated by an acoustic impulse and recorded in the external auditory canal is dependent on many factors. Of these, the acoustic impedance of the external canal is possibly the most important. The effect of a change of acoustic impedance on the TEOAEs, induced by filling the external canal with helium or sulphur hexafluoride gas, is measured in a group of normal hearing subjects. The fundamental frequency of the TEOAEs is found to depend upon the density of the gas in the external canal. Compared to that of air (density 1.29 g/1) the frequency increased with helium (density 0.178 g/1) and decreased with sulphur hexafluoride (density 6.6 g/1). The amplitude of the TEOAEs was also found to depend upon the density of the gas in the canal, decreasing with helium and increasing with sulphur hexafluoride. These results suggest that the TEOAEs observed in the group of subjects tested arose within the external auditory canal. This does not imply that cochlear emissions are not generated in response to transient acoustic impulses, rather it implies that this study failed to show the presence of a cochlear-mediated emission.     

Antibody repertoire development in fetal and neonatal piglets. XV. Porcine circovirus type 2 infection differentially affects serum IgG levels and antibodies to ORF2 in piglets free from other environmental factors

Porcine circovirus type 2 (PCV2) is an important pathogen in the porcine respiratory disease complex (PRDC) and its persistence may be due to dysregulation of systemic immunity. We examined this contention using isolator piglets. We present data on Ig levels in serum and bronchio-alveolar lavage (BAL), on antibody response to PCV2 and to TNP conjugates used as model antigens in 48 PCV2-infected isolator piglets. We compared these to data from TNP-immunized isolator piglets colonized with a probiotic flora, those infected with swine influenza (S-FLU) and those infected with porcine respiratory and reproductive syndrome virus (PRRSV). We found that PCV2 infection does not cause generalized hypergammaglobulinemia that characterizes PRRSV infections, but causes an unexplained increase in serum IgA. All animals had serum IgG to the ORF2 gene product of PCR2, but neither IgA nor IgG anti-ORF2 responses in BAL. PCV2 infection is a poor adjuvant since only natural anti-TNP antibodies were found. Unexpectedly, immunization appeared to result in lower Ig levels and lower anti-ORF2 responses. There was extreme variation in serum Ig levels in response to infection that could in part be traced to genetic and gender differences. These data suggest that non-replicating vaccines are unlikely to result in a significant primary antibody response but may prime the system for a secondary antibody and cytotoxic response following actual infection. In any case, developers may have to contend with significant genetic differences in the response of piglets to PCV2.