建设符合自身特点的品牌医院特色文化

本文简述了医院文化自身的特点，着重探讨打造符合自身特点的品牌医院特色文化的措施和途径。     

铁蛋白鉴别胸腹液良恶性质的临界值选择

探讨铁蛋白ferrztin,Ft在鉴别胸腹液良、恶性质的临界值。用RIA法测定218份由不同病因引起的胸腹液标本铁蛋白(pleuraleffusionferritin,PFt)及其同期血清铁蛋白(SFt)。依据临床确诊资料,将标本进行良、恶性病例分组,比较两组PFt、SFt,计算PFt/SFt比值,用ROC曲线选择PFt用于良、恶性质鉴别的最佳临界值。结果表明,良性组PFt为142.4±38.6μg/L,SFt为89.7±43.5μg/L,PFt/SFt为1.46±0.55;恶性组PFt为576.5±239.1μg/L,SFt为189.6±81.7μg/L,PFt/SFt为3.67±1.48;PFt用于鉴别胸腹液良、恶性质的临界值为400μg/L。以恶性积液PFt≥400μg/L、PFt/SFt≥3,良性积液PFt<400μg/L、PFt/SFt<3为实验诊断标准鉴别胸腹腔积液的良、恶性质,灵敏度为84.5%、特异性为87.5%,准确性为92.8%。     

Pathologic features of the femoral head in Mseleni disease

Severe but atypical osteoarthritic deformities were found in each of 12 femoral heads removed during total hip arthroplasty for Mseleni disease. Although degenerative and regenerative changes were present throughout the cartilage, there was a paucity of eburnation. Histomorphometric analysis of bone at the line of excision indicated that mild osteomalacia was present in four of the 12 specimens. The percentage of the endosteum occupied by osteoid was 9.7 +/- 7.96 (SD) in the patients with Mseleni disease, compared with 5.6 +/- 4.33 in seven African black and 4.1 +/- 2.13 in 13 American white control subjects. The mean thickness of the osteoid seams was not increased. The findings suggest that osteomalacia is not a major pathogenetic factor in Mseleni disease.     

Leydig cell types in primary testicular disorders

Ultrastructural study of testicular biopsy specimens from 67 adults with primary testicular disorders (Klinefelter's syndrome, XX male syndrome, Del Castillo's syndrome, and cryptorchidism) revealed the following four Leydig cell types: 1) normal or nearly normal Leydig cells with abundant smooth endoplasmic reticulum, mitochondria with tubular cristae, lipid droplets, and Reinke's crystals; 2) abnormally differentiated Leydig cells without either lipid droplets or Reinke's crystals but with altered mitochondria, concentric unfenestrated cisternae of smooth endoplasmic reticulum, and both paracrystalline and filamentous inclusions; 3) multivacuolated Leydig cells containing abundant lipid droplets; and 4) immature Leydig cells with scarce development of the smooth endoplasmic reticulum and mitochondria, and numerous cytoplasmic microfilaments. Abnormally differentiated Leydig cells might represent dysgenetic cells, whereas immature, normal, and vacuolated Leydig cells might represent three progressive stages in the Leydig cell cycle (undifferentiated, mature, and old involuting Leydig cells). An inverse correlation between the proportion of abnormal Leydig cells and testosterone levels was observed in each of these testicular disorders.     

Adrenaline turnover rates in the medial preoptic area and mediobasal hypothalamus in relation to the release of luteinizing hormone in female rats

The turnover rates of adrenaline in the medial preoptic area and mediobasal hypothalamus, areas which, respectively, include the cell bodies and terminals of luteinizing hormone-releasing hormone neurons, have been measured in female rats on pro-oestrus, the day of the preovulatory surge of luteinizing hormone, and on dioestrus, the preceding day. A rise in the rate of turnover was found in the medial preoptic area coinciding with the surge of luteinizing hormone in the late afternoon of pro-oestrus; the rate of turnover at this time was higher than at the same time on dioestrus. No changes in turnover rate were found in the mediobasal hypothalamus within either of these days.The results indicate that the adrenaline-containing projections to the preoptic area may be actively involved in the production of the spontaneous preovulatory surge of luteinizing hormone in rats.     

The response of dorsal horn neurones of the cat to intraarterial bradykinin and noxious radiant heat

In chloralose-anaesthetized or decerebrate cats intra-arterially administered bradykinin (BKN) and noxious radiant heat were tested on dorsal horn neurones characterized according to their responses to natural stimuli. Of the 28 neurones which were excited only to non-noxious forms of stimuli, BKN affected 4 while noxious radiant heat was ineffective. BKN also affected relatively few of the nociceptor-driven neurones (18 of 60) and most of these were inhibited, while noxious radiant heat excited the majority of these cells (47 of 60). Therefore, under our experimental conditions, noxious radiant heat would appear to be a more effective and specific noxious stimulus than BKN.     

The effect of 2-amino-4-phosphonobutyrate (APB) on acetylcholine release from the rabbit retina: evidence for on-channel input to cholinergic amacrine cells

The light-evoked release of acetylcholine (ACh) from the rabbit retina was taken as a measure of cholinergic amacrine cell activity. The glutamate analogue DL-(+/-)-2-amino-4-phosphonobutyric acid (APB) prevented the light-evoked release of ACh and also selectively abolished the ON-responses of ganglion cells and the ERG b-wave. It is concluded that the input to cholinergic amacrine cells involves mainly the depolarizing bipolar cells, which subserve ON-channels. L-(+)-stereoisomer of APB was 15 times more potent than the D-(-)-isomer in suppressing ACh release and the b-wave, suggesting that the mechanism of action of APB does not involve antagonism of excitatory amino acids.     

Relationship between muscle fatigue and oxygen uptake during cycle ergometer exercise with different ramp slope increments

Summary The surface electromyogram (EMG) from active muscle and oxygen uptake ( ) were studied simultaneously to examine changes of motor unit (MU) activity during exercise tests with different ramp increments. Six male subjects performed four exhausting cycle exercises with different ramp slopes of 10, 20, 30 and 40 W · min^–1 on different days. The EMG signals taken from the vastus lateralis muscle were stored on a digital data recorder and converted to obtain the integrated EMG (iEMG). The was measured, with 20-s intervals, by the mixing chamber method. A non-linear increase in iEMG against work load was observed for each exercise in all subjects. The break point of the linear relationship of iEMG was determined by the crossing point of the two regression lines (iEMG_bp). Significant differences were obtained in the exercise intensities corresponding to maximal oxygen uptake ( ) and the iEMG_bp between 10 and 30, and 10 and 40 W · min –1 ramp exercises (P < 0.05). However, no significant differences were obtained in and corresponding to the iEMG_bp during the four ramp exercises. With respect to the relationship between and exercise intensity during the ramp increments, the -exercise intensity slope showed significant differences only for the upper half (i.e. above iEMG_bp). These results demonstrated that the and at which a nonlinear increase in iEMG was observed were not varied by the change of ramp slopes but by the exercise intensity corresponding to and the iEMG_bp was varied by the change of ramp slopes. In addition, the significant differences in the exercise intensity slopes for the upper half of the tests would suggest that the recruitment patterns of MU and/or muscle metabolic state might be considerably altered depending upon the ramp slope increments.