布鲁菌病研究进展

布鲁菌病是最常见的人畜共患病之一,呈全球范围流行,而我国近年来布鲁菌病发病率不断上升,给公众健康和社会经济带来的严重危害。布鲁菌病可以累及全身各个系统,若治疗不及时或不规范易复发或者呈现慢性化,甚至可以发生各种并发症而严重影响患者预后,故早诊断和早治疗至关重要。本文就布鲁菌病的病原学、流行现状、各系统临床表现以及实验室诊断和并发症的治疗进展进行综述。     

Distant metastases of adenoid cystic carcinoma of the salivary glands and the value of diagnostic examinations during follow-up

BACKGROUND: Adenoid cystic carcinoma (ACC) accounts for approximately 10% of all neoplasms of the salivary glands. Late distant metastases and local recurrences are responsible for a rather low long-term survival rate. AIM: To study the metastasizing pattern of ACC of the salivary glands in 51 patients. METHOD: Fifty-one patients with an ACC in the intraoral/sublingual salivary glands (n = 30), parotid gland (n = 8), submandibular gland (n = 2), maxillary sinus (n = 6), and nasal cavity (n = 5) have been studied. The male-female ratio was 1:1, the mean age was 54.3 (range, 19-81) years. In 30 cases treatment consisted of surgery and radiotherapy. In 13 cases surgery alone was carried out. The average follow-up time was 117.8 (range, 1-171) months. RESULTS: In 28 cases (54.9%) distant metastases occurred, and in 3 patients (5.8%) regional lymph node metastases occurred. In 12 of the 28 patients with distant metastases (42.8%), only the lungs were involved, whereas in 5 of the 28 patients (17.8%), the distant metastases occurred in other organs (eg, bones and brain). In 11 of the 28 patients (39.2%) metastases were found both in the lungs and other organs. Twenty-four of the 51 patients (47.0%) died because of their tumor. The average time between the occurrence of lung metastases and death was 32.3 months and between the occurrence of metastases elsewhere and death 20.6 months. CONCLUSION: Distant metastases of ACC of the salivary glands occur most often in the lungs. Although these lung metastases are the first to occur, these patients die later than patients with distant metastases in other organs. The value of annual chest films or other tests for the presence of distant metastases during follow-up after surgical removal of an ACC seems rather questionable.     

Motor abilities and anthropometrics in youth cross‐country skiing

The purposes were to validate whether general motor abilities and anthropometrics are determinants of youth cross‐country (XC) skiing performance; evaluate gender‐specific differences; and to establish noninvasive diagnostics. Fifty‐one youth XC skiers (34 boys; 13.8 ± 0.6 years and 17 girls; 13.4 ± 0.9 years) performed motor skill and laboratory tests, and anthropometric data were collected and correlated with XC skiing performance. Anthropometrics and maturity status were related to boys but not to girls XC skiing performance. Push‐ups and 20‐m sprint were correlated to XC skiing performance in both boys and girls. XC skiing performance of boys was predominantly influenced by upper body and trunk strength capacities (medicine ball throw, push‐ups, and pull‐ups) and jumping power (standing long and triple jump), whereas XC skiing of girls was mainly influenced by aerobic capacities (3000‐m run). Laboratory measures did not reveal greater correlations to XC skiing performance compared with simple test concepts of speed, strength, and endurance. Maturity was a major confounding variable in boys but not girls. Use of noninvasive simple test concepts for determination of upper body strength, speed, and endurance represent practicable support for ski clubs, schools, or skiing federations in the guidance and evaluation of young talent, being aware of the effect of maturity especially in boys.     

多形式教学方法及教学软件系统在诊断学教学中的应用

为解决现阶段临床医学教育所面临的问题,培养和提高学生临床操作技能和综合诊断技能,在诊断学教学实践中将录像教学,以问题及学生为中心教学、网络互动式教学尤其是仿真电子术模拟病人等教学方法应用于诊断学教学的各环节,充分调动了学生学习的积极性,提高了学生的各项临床技能及沟通技巧和综合诊断能力,从而提高了教学效果。     

《临床诊断学》课堂双语教学初探

在预防医学本科临床诊断学教学中开展了双语教学,并通过问卷的方式调查分析学生对开展临床医学双语教学的态度和要求,旨在进一步进行双语教学的改革,探索提高临床双语教学质量的方法。     

检体诊断的系列研究与实践

针对目前我国医学教育存在的学生多、病人少的现状以及我校诊断学见习存在的弊端,在检体诊断教学中先后开展专科负责的教学方法、建立和完善典型阳性体征的病例档案及其在检体诊断教学中的应用、序贯教学方法等一系列研究,并分别与传统的教学方法进行比较,探讨新的教学方法与传统带教方法的教学效果差异。结果表明：上述教学方法既能较大程度缓解学生多病人少的矛盾,减少SARS或其他突发事件对诊断学教学的严重影响,也能促使学生重视基本技能训练,调动学生学习的积极性和主动性,提高检体诊断教学质量。     

执业医师技能考试及其引发的思考

执业医师资格考试制度的实施对提高医师队伍的素质起着重要作用。本文针对近年来执业医师技能考试中发现的问题,探讨了提高医学生临床技能的方法和途径。     

临床诊断学教学中问题讨论式教学法的应用

物理诊断学是一门操作性和实践性都很强的课程．作为桥梁课程，物理诊断学的学习直接影响到以后临床课程的学习和将来的临床实习，乃至今后的临床工作．本文从临床诊断学教学问题讨论式教学法探讨了如何提高物理诊断学的教学质量，努力培养高质量、高素质的21世纪医学专业人才的问题．     

Advances in multiplex nucleic acid diagnostics for blood-borne pathogens: promises and pitfalls - an update

Introduction: Multiplex nucleic acid diagnostics for blood-borne pathogens have moved closer to clinical application in the two years since we first reviewed this topic.

Areas covered: A new emphasis on detecting pathogens directly in a blood sample without culture, coupling PCR amplification to microfluidic devices and higher multiplexing in isothermal amplification are some of the advances. A wholly new approach of correlating host gene expression response with specific infectious agents opens another opportunity for multiplex detection. Established microarrays, which had been the highest multiplicity platform, are being displaced by Next Generation Sequencing (NGS) having potentially no limit to the number of pathogens that it can identify. Greater accessibility of sequencing devices, standardization of bioinformatic analysis pathways and increased acceptance from regulatory authorities are driving this technology.

Expert commentary: The landscape of traditional diagnostics for detection of blood-borne pathogens has changed in the last 5 years. There is no doubt that NSG is recognized as a disruptive technology with a growing repertoire of tools, such as subtyping, resistome analysis, etc., available for clinical microbiology. Increasing acceptance indicates the dominating position of NGS as the future of multiplex molecular diagnostics for blood-borne pathogens.