21世纪医学发展对医学教育的影响

21世纪的医学发展将呈现高度社会化和高度综合的趋势,21世纪的医学教育必然会顺应医学发展的需要,转变教 育观念,调整教育内容,扩充教育内涵,更新教育目标,为医学发展培养高素质综合型医学人才。     

QQS因子在文献知识发现中的碰撞或核裂变作用

从馆员或读者的研究性阅读角度,阐释了建构问题和问题解决(QQS)因子思想火花碰撞或核裂变的知识发现模式,描述了在实施脑内与文献内的互动碰撞和发现新知识以及增加知识总量的核裂变过程中,研究性阅读产生QQS因子思想火花碰撞或核裂变的有效运作要求.     

吸入NO治疗急性缺氧性肺动脉高压的实验研究

了解NO吸入治疗急性缺氧性肺动脉高压的效果以及不同模式吸入NO对血流动力学的影响。给10条杂种犬吸入12％氧和88％氮混合气建立缺氧性肺动脉高压的动物模型，采用自身对照法，观察吸入（25—30）×10－6NO前后血流动力学的变化以及换用不同通气模式对以上各指标的影响。吸入12％氧和88％氮混合气30min后平均肺动脉压上升至基础值的206.13％，吸入NO1～2min内平均肺动脉压开始下降，5min后处于稳定状态，从（2.02±0.99）kPa降至（1．23±0．35）kPa（P＜0．02），基本恢复至缺氧前的基础值。在此过程中心输出量从（1．35±0．62）L／min至（1．34±0．62）L／min（P＞0.05）、体循环阻力从（1075.02±565．08）（kPa·S）/L至（1072.85±525．30）（kPa·s）／L（P＞005）均无明显改变。此外，在不同通气模式中（间歇正压通气-IPPV、双水平气道正压通气-BiPAP、压力释放通气-APRV、反比通气-IRV）配合吸入NO均可观察到以上现象，各模式之间相互比较对血流动力学的影响基本无差别。吸入NO可以选择性降低急性缺氧性肺动脉高压而不影响心输出量、系统循环阻力，不同通气模式并不影响NO的上述作用。     

Stability of EEG Laterality Effects

Task related interhemispheric asymmetries of ongoing EEG activity (alpha band) were tested for stability across three separate occasions. Seven cognitive tasks, presumed to differentially engage either the left or right cerebral hemisphere, were presented to 6 subjects. Involvement with the tasks was determined by evaluation of performance and with a subjective report on degree of involvement. Bilateral EEG was recorded over the parietal areas referenced to an ipsilateral ear, vertex and a central placement, on separate channels. Spectral intensity estimates of 8–13 Hz activity were used to form left/right ratios for determination of asymmetry. Intra-subject stability of alpha band activity was found to improve with the establishment of task validity and to be related to the electrode placement used.     

胃癌原发灶的形态学与腹膜转移、肝转移的关系(附248例分析)

本文对248例胃癌的病理组织类型,肉眼分型、间质反应与肝转移、腹膜转移的关系进行了研究。结果表明,癌间质反应程度与转移方式之间的关系比前二种因素更为密切。肝转移率随间质反应程度加强而下降,腹膜转移率则随间质反应程度加强而上升,均有明显统计学意义(P<0.001)。     

The Coffin-Lowry Syndrome: Four New Cases In Three Families

Four Japanese boys with the Coffin-Lowry syndrome in three unrelated families were reported. Three of the four patients aged2–8 years had typical features of the syndrome including severe mental retardation, coarse facies, tapered fingers, and distal phalangeal tufting, while the remaining patient, examined at the age of seven months because his eldest brother was affected, had less characteristic features. As mentioned by many authors, clinical manifestations of the three patients had developed with age, so then the features in the youngest patient may progress in his childhood. All of the three mothers had variable features that were moderate to normal. Tapered fingers and tufting of distal phalages were the most common features among them and would be most diagnostic for the detection of affected females.     

REPDOSE: A database on repeated dose toxicity studies of commercial chemicals--A multifunctional tool

A database for repeated dose toxicity data has been developed. Studies were selected by data quality. Review documents or risk assessments were used to get a pre-screened selection of available valid data. The structure of the chemicals should be rather simple for well defined chemical categories. The database consists of three core data sets for each chemical: (1) structural features and physico-chemical data, (2) data on study design, (3) study results. To allow consistent queries, a high degree of standardization categories and glossaries were developed for relevant parameters. At present, the database consists of 364 chemicals investigated in 1018 studies which resulted in a total of 6002 specific effects. Standard queries have been developed, which allow analyzing the influence of structural features or PC data on LOELs, target organs and effects. Furthermore, it can be used as an expert system. First queries have shown that the database is a very valuable tool.     

Lymphatic metastasis

Summary Lymphatic metastasis is an important mechanism in the spread of human cancer. During its course, tumor cells first penetrate the basement of membrane of the epithelium, in which they arise, and then the underlying connective tissue, carried partly by hydrostatic pressure. They enter the lymphatic partly by active movement, pass up the lymphatic trunk; they then settle and proliferate in the subcapsular sinus, penetrate its endothelium and proliferate and destroy the node. There are varied forms of immune response in the node and in human nodes often a complex fibrous and vascular response. The degree of lymphocytic response may be important for prognosis. The nodal reaction may be stimulated by release of antigens from the tumor.One of the most studied animal models of lymphatic metastasis is that which occurs in the politeal node after injection of tumor into the footpad. This model has been used to show that tumor cells enter lymphatics through gaps in endothelium, probably between endothelial cells, and that lymph nodes can destroy small numbers of tumor cells. Local immunotherapy and chemotherapy can sterilize a lymph node of tumor cells; the modes of treatment used have included intralymphatic injection and encapsulation of chemotherapeutic agents in liposomes. Prior radiotherapy may accelerate metastasis possibly by making tumor cells shed into lymphatic vessels. Lymph nodes are rather poor barriers to tumor cells. The prognostic significance of lymph node metastasis varies within tumor type; if hematogenous metastasis is early, then the presecce of lymph node metastasis is of lesser prognostic significance. Lymph nodes can probably destroy only small numbers of tumor cells.Tumor cell heterogeneity is of importance in many aspects of metastasis; while clonal variation may be of importance in determining lymph node metastasis, it is not yet clear how important this is, nor whether specific clones metastasize specifically to lymph nodes.Lymphography is well established in diagnosis of lymphatic metastasis. A recent interesting development has been to inject antibodies labeled with a radioactive label, and image the label in lymph nodes with a gamma-camera. If anti-tumor antibodies are used in this way it may be possible to detect lymph node metastasis.Within the expanding field of tumor metastasis, lymphatic metastasis needs much more attention, particularly in relation to the diagnosis and treatment of the lymphatic spread of human cancer.     

中风病中医临床研究的新模式

总结归纳了符合卒中单元理念的中风病急性期综合治疗模式,该模式以良好的服务设施、标准化的评估、准确的诊断、精确规范的治疗为基础,以个体化治疗为理念,既符合中医药临床研究特点,又遵循现代医学方法和要求,提高了辨证论治综合治疗的整体疗效。     

医学教育要注重学生"大医观"的培养

医学高等教育应与时俱进地树立“大医”教育观,即人才培养要求上体现德馨、知广、技强、心高.