幼兔缺血预处理在心肌保护第二窗期对未成熟心肌Bcl-2基因mRNA表达的影响

目的　观察幼兔心脏缺血预处理 2 4h对未成熟心肌缺血 /再灌注后Bcl -2mRNA表达的影响 ,探讨未成熟心肌保护第二窗形成的作用机理。方法　 18只 3～ 4周龄幼兔 ,随机分为 3组 ,每组 6只 :Ⅰ组 ,正常对照组 ;Ⅱ组 ,缺血 /再灌注损伤组 ;Ⅲ组 ,缺血预处理组。建立活体心脏缺血 /再灌注损伤模型 ,Maclab/8s系统监测左心室发展压 (LVDP)、左室压上升及下降最大速率 (+dp/dtmax,-dp/dtmax)变化 ,原位免疫杂交 (ISH)方法检测心肌细胞内Bcl-2mRNA的表达。结果　缺血再灌注前 ,各组间LVDP、±dp/dtmax无显著性差异 (P >0 .0 5) ;再灌注 1h后 ,Ⅱ组的LVDP、+dp/dtmax和 -dp/dtmax恢复率分别为 (42 .81± 12 .56) %、(3 0 .67± 16.2 2 ) %和 (2 9.49± 10 .13 ) % ;Ⅲ组LVDP、+dp/dtmax及 -dp/dtmax恢复率分别为 (84.15± 13 .56) %、(69.49± 10 .3 6) %和 (58.3 7± 12 .45) % ,两组间有显著性差异 (P <0 .0 1)。Ⅱ组、Ⅲ组Bcl -2mRNA表达阳性细胞面积百分数分别为 (8.3± 2 .5) %、(76.3±13 .5) % ,两组间有显著性差异 (P <0 .0 1)。结论　缺血预处理可上调Bcl -2mRNA表达 ,参与未成熟心肌保护第二窗的形成 ,促进未成熟心肌缺血 /再灌注后心室功能恢复     

市场机制下政府调节与医疗管制制度框架的构建

医疗机构分类管理的政策确定了我国医疗服务的市场取向.我国医疗市场服务因其特殊的技术经济特点也存在一般意义上的市场失灵,使政府管制这一非市场治理机制的产生与存在成为必要,以弥补与矫正市场缺陷,保证医疗服务市场的规范运行和卫生改革的顺利推进.     

医学遗传学教学中计算机辅助教学的应用

目的:探讨计算机辅助教学在医学遗传学教学中的作用.方法:将180名护理中专生按学年分为对照组和观察组,分别采用传统的教学方法和计算机辅助教学进行医学遗传学教学,并在学期末对两组学生进行理论与综合考试,并调查两组学生对各组教学方法的作用及满意度.结果:两组学生考试成绩比较,观察组明显好于对照组(P＜0.05);两组学生对各自所在组教学方法的作用及满意度比较,观察组好于对照组(P＜0.05),差异有显著性意义.结论:计算机辅助教学有利于增强学生的学习兴趣,提高学生的学习效果,是一种较好的医学遗传学教学方法.     

肺内源性和肺外源性呼吸衰竭机械通气的临床对比研究

目的探讨肺内源性和肺外源性呼吸衰竭机械通气时的肺保护性策略。方法通过25例呼吸衰竭中12例肺内源性和13例肺外源性机械通气临床资料的回顾性分析,对比研究两组呼吸力学差异时对通气模式选择、参数设置和调节的影响,以及肺保护的实施方法。结果在两组APACHE-Ⅱ评分、平均年龄和Vt设置无差异的条件(P>005)下,肺内源性组PEEP/CPAP、PSV、f的需设值均明显高于肺外源性组(P<001)。肺内源性组Pplat、PIP、Raw的监测结果大于肺外源性组,而Crs小于肺外源性组(P<001)。肺内源性组417%和肺外源性组154%因MOF而死亡(APACHE-Ⅱ评分均>20分),组间比较有显著差异(P<001)。结论肺内源性和肺外源性呼吸衰竭机械通气时,实施肺保护的方法不同。前者应首选压力预置通气模式,后者可首选容量预置通气模式。以设置中、小Vt为原则,按个体化的通气需求而设置f和加用恰当的PSV、CPAP/PEEP对减少VILI、病死率可能有益。     

New wound protection for rabbits

Rabbits are the experimental animals of choice in many studies including flaps, wounds, and topical trials for new pharmacological agents. Because the topical drugs and other materials used for dressing are irritating to the animal, they tend to remove dressings, bandages, drapes, insensate flaps, and also topical drugs by scratching, licking, and biting if they are within the reach of the animal. In this study, we report an easy to prepare, user-friendly, comfortable, and cheap dressing protector called a dressing shield to prevent these problems.     

阿片肽与缺血性脑损伤

阿片肽及其受体系统在缺血性脑损伤的病理生理发展过程中具有非常重要的作用。其在缺血性脑损伤中的作用尚存争议，本文综述了阿片肽及其受体系统在缺血性脑损伤中的作用及其可能机制，有助于探索阿片肽在围术期的合理应用，为缺血性脑损伤防治研究提供新方向。     

Undergraduate psychiatry teaching in Ethiopia

Many epidemiological studies have shown the magnitude and seriousness of mental disorders in developing countries. However, mental health care remains unsatisfactory owing to lack of skilled manpower and many other social and medical priorities. General practitioners and other health personnel can significantly help in extending mental health care provided they receive adequate training during their medical curriculum. With this aim, the Department of Psychiatry at Addis Ababa University runs a 6-week full-time course for undergraduate medical students. Its chief objectives, teaching methods, achievements and shortcomings are discussed in the paper.     

论医药卫生法学专业学生实务能力的培养

加强医药卫生法学专业学生实务能力的培养,是实现医药卫生法学专业培养目标的需要.在教学中,通过运用案例教学法、讨论式教学法,开展模拟法庭、第二课堂活动,组织临床见习、毕业实习等途径,培养即有法律知识又有医药卫生知识的复合型人才.     

Use of Fmoc-N-(2-hydroxy-4-methoxybenzyl) amino acids in peptide synthesis

The use of N, O-bisFmoc-N-(2-hydroxy-4-methoxybenzyl) amino acid derivatives in the synthesis of peptides with difficult sequences has already been described. With these amino acid derivatives the reversible protecting group 2-hydroxy-4-methoxybenzyl (Hmb) for the backbone amide bonds of peptide chains is introduced, and thus the aggregation due to hydrogen-bond interchain association is inhibited. This paper describes the synthesis and use of Fmoc-N-(2-hydroxy-4-methoxybenzyl)amino acid derivatives as an alternative means of introducing Hmb backbone protection. These new monoFmoc derivatives were obtained in higher yield than the bisFmoc derivatives. Coupling yields to the amino peptide resin were the same as those obtained with bisFmoc derivatives, under the TBTU/HOBt/DIEA conditions. We also compared different syntheses of a difficult peptide with the Fmoc approach [triple coupling, capping, use of chaotropic agents, backbone protection using monoFmoc (Hmb)Ala] and with optimized Boc chemistry. Both the backbone protection and optimized Boc chemistry approaches gave the desired product in excellent yield and purity. © Munksgaard 1997.