血清幽门螺杆菌抗体检测与冠心病关系初探

观察６０例心病，４２例高血压患者和６０例正常人血清幽门螺杆菌抗体载脂蛋白Ｂ１００和脂刷 白（ａ）「Ｌｐ（ａ）」旨在探讨幽门螺杆菌感染在冠心病患者的感染情况以及同血脂代谢之间的关系。结论幽门杆菌菌感染可能是冠心病发病的独立危险因子，其机理可能是长甚是性感染引起ＡＰＯＢ１００、Ｌｐ（ａ）浓度增加，因而促发ＣＨＤ发生。     

糖尿病视网膜病变患者体液免疫状态研究

目的:探讨糖尿病视网膜病与机体体液免疫状态的关系。方法:应用日立7170A对30例正常对照组,30例单纯糖尿病(DM)组及30例糖尿病视网膜病变(DR)组的CIC、BF、C3、C4、IgG、IgA、IgM进行检测及分组比较。结果:DM组及DR组的BF、IgG、IgA均显著高于正常对照组(P<0.01);而IgM则显著低于正常对照组(P<0.01)。DR组CIC、C3、C4即显著高于DM组也显著高于正常对照组(P<0.01)。结论:DR、DM均存在体液功能紊乱但DR更甚,体液免疫功能紊乱可能成为DR毛细血管病变的原因之一。     

护士礼仪与护患关系

护士美的仪表、礼貌的语言、落落大方的礼节，可使患者感到被理解、被尊重，心理上得到慰藉，情感上获得愉悦，使护患交往在情感交融中进行。     

心肌组织和血浆IGF—Ⅰ的相关性

本研究采用放射免疫分析法测定自发性高血压大鼠(SHR)和正常血压的Witar—Kyoto大鼠(WKY)血浆和心肌组织中的IGF—Ⅰ水平,以心脏混重(HW)和心脏混生/体重(HW/BW)来判定心肌肥厚。结果显示:SHR的HW较WKY有显著升高(P<0.05),HW/BW则较WKY有高度显著升高(P<0.01)。两组大鼠心肌组织中IGF—Ⅰ与血浆中的IGE—Ⅰ显示正相关(WKY:r=0.8485,P<0.05;SHR:r=0.9529,P<0.005);试验结果提示不论心脏生理和病理情况下,心脏合成和分泌的IGF—Ⅰ对循环中的IGF—Ⅰ水平均有影响,而在心肌肥厚,心肌组织中的IGF—Ⅰ病理水平增高时,影响更为明显。     

2型糖尿病血浆同型半胱氨酸与代谢综合征及其组份的相关性

目的探讨2型糖尿病（T2DM）血浆同型半胱氨酸（HCY）与代谢综合征（MS）及其组份的相关性。方法 83例T2DM患者,将其中有MS的患者46例作为观察组,无MS的患者37例作为对照组,比较2组腰围、血压、血脂等指标,分析其相关性。结果观察组腰围、SBP、HBA1c、TG、24h尿Alb水平高于对照组,HDL-C低于对照组,差别均有统计学意义（P〈0.05和P〈0.01）,HCY2组比较差异无统计学意义（P〉0.05）。血糖≥9.7mmol/L者HCY为（10.8±3.2）μmol/L,血糖〈9.7mmol/L者HCY为（12.5±3.3）μmol/L,2者比较差异无统计学意义（P〉0.05）。HDL-C的降低及LDL-C的升高与HCY有显著相关性。结论 T2DM患者HCY与MS无相关性,而与HDL-C的降低及LDL-C的增高具有相关性。     

Report from the EPAA workshop: In vitro ADME in safety testing used by EPAA industry sectors

There are now numerous in vitro and in silico ADME alternatives to in vivo assays but how do different industries incorporate them into their decision tree approaches for risk assessment, bearing in mind that the chemicals tested are intended for widely varying purposes? The extent of the use of animal tests is mainly driven by regulations or by the lack of a suitable in vitro model. Therefore, what considerations are needed for alternative models and how can they be improved so that they can be used as part of the risk assessment process? To address these issues, the European Partnership for Alternative Approaches to Animal Testing (EPAA) working group on prioritisation, promotion and implementation of the 3Rs research held a workshop in November, 2008 in Duesseldorf, Germany. Participants included different industry sectors such as pharmaceuticals, cosmetics, industrial- and agro-chemicals. This report describes the outcome of the discussions and recommendations (a) to reduce the number of animals used for determining the ADME properties of chemicals and (b) for considerations and actions regarding in vitro and in silico assays. These included: standardisation and promotion of in vitro assays so that they may become accepted by regulators; increased availability of industry in vivo kinetic data for a central database to increase the power of in silico predictions; expansion of the applicability domains of in vitro and in silico tools (which are not necessarily more applicable or even exclusive to one particular sector) and continued collaborations between regulators, academia and industry. A recommended immediate course of action was to establish an expert panel of users, developers and regulators to define the testing scope of models for different chemical classes. It was agreed by all participants that improvement and harmonization of alternative approaches is needed for all sectors and this will most effectively be achieved by stakeholders from different sectors sharing data.     

公民健康权保障与药患关系刍议

在公民健康权保障体系中,医药资源配置的不合理以及效率失衡是导致现阶段我国公民健康权益保障不力与药患关系不和谐的重要原因。医疗机构药房或零售药店在促进医药资源合理配置并体现其公平性效率方面尚显不足。国家应积极运用法律、政策等手段,合理配置医药资源,以满足公民健康权的保障与和谐药患关系建设的需要。     

哈贝马斯交往行为理论语境下的和谐医患关系构建

造成医患关系紧张局面的根本原因是工具理性的张扬与交往理性的衰微。针对医患关系所处的困境,以交往行为理论消解工具理性的负面影响,是重构和谐医患关系的有效路径。     

敬业精神与医学人文教育

医生上岗,先学人文。作为一名医生不但要技术好,更要做人好。因此,我们要加强医生的人文素质教育,培养医生的敬业精神,改变和创新与患者的沟通方式,设身处地地为患者着想,把先进的医疗技术和人文关怀结合在一起,更好地为患者服务。     

精神科教学培训中“角色扮演”及“巴林特小组”的应用

精神科医师与患者的沟通内容多涉及患者隐秘的心理活动,应有较强的医学伦理学意识,而患者对于谈论自身心理活动又可能有所避讳,因此建立良好的医患关系极为重要,而对于精神科医师的培训更应注重提高建立良好医患关系的能力。“角色扮演”及“巴林特小组”是两种有效的教学方式。