Comprehensive seroprofiling of sixteen B. burgdorferi OspC: Implications for Lyme disease diagnostics design

Early diagnosis of Lyme disease (LD) is critical to successful treatment. However, current serodiagnostic tests do not reliably detect antibodies during early infection. OspC induces a potent early immune response and is also one of the most diverse proteins in the Borrelia proteome. Yet, at least 70% of the amino acid sequence is conserved among all 21 known OspC types. We performed a series of comprehensive seroprofiling studies to select the OspC types that have the most cross-reactive immunodominant epitopes. We found that proteins belonging to seven OspC types detect antibodies from all three infected host species regardless of the OspC genotype of the infecting strain. Although no one OspC type identifies all seropositive human samples, combinations of as few as two OspC proteins identified all patients that had anti-OspC antibodies.     

Nanoparticles: Emerging carriers for drug delivery

The core objective of nanoparticles is to control and manipulate biomacromolecular constructs and supramolecular assemblies that are critical to living cells in order to improve the quality of human health. By definition, these constructs and assemblies are nanoscale and include entities such as drugs, proteins, DNA/RNA, viruses, cellular lipid bilayers, cellular receptor sites and antibody variable regions critical for immunology and are involved in events of nanoscale proportions. The emergence of such nanotherapeutics/diagnostics will allow a deeper understanding of human longevity and human ills that include cancer, cardiovascular disease and genetic disorders. A technology platform that provides a wide range of synthetic nanostructures that may be controlled as a function of size, shape and surface chemistry and scale to these nanotechnical dimensions will be a critical first step in developing appropriate tools and a scientific basis for understanding nanoparticles.     

医学检验专业诊断学新教学方法的应用

目的提高医学检验专业学员对诊断学的学习兴趣,提高诊断学的教学效果。方法在坚持传统诊断学教学方法的基础上,根据医学检验专业学员的特点,采取了“增加诊断学医学检验实践”、“进行以实验室检查为线索的诊断学课程讨论”等新的教学方法的尝试。结果学员对诊断学的学习兴趣有了显著提高,并收到了良好的教学效果。结论针对医学检验专业学员,采取“有的放矢”的新的诊断学教学方法,是提高诊断学教学效果的有效途径之一。     

标准化病人在诊断学教学中的应用探索

诊断学是一门实践性和技能性很强的学科,采用标准化病人模拟临床场景对学生进行问诊、体格检查训练,在一定程度上缓解了临床教学资源不足的矛盾;提高了学生的各项临床技能;促进了医患沟通;有助于学生早期建立以病人为中心的临床思维方法,收到了较好的教学效果。     

肺血减少型先心病肺动脉发育情况的影像学诊断

目的比较不同影像学诊断技术在肺血减少型先心病肺动脉发育情况方面的诊断价值。方法对80例肺血减少型先心病病人,在手术前行心导管造影、MRA、CTA、超声心动图检查,分别测量肺动脉总干、左右肺动脉开口处内径、左右肺动脉远端内径,并与手术实测值之间行方差分析。结果除了超声心动图对左右肺动脉远端的检测率较低外,心导管造影、MRA、CTA均能清晰显示肺动脉总干及分支情况。超声、MRA、CTA对肺动脉内径的测量值与手术实测值相似（P〉0.05）。结论MRA、CTA是无创性评估肺动脉发育情况的良好方法。     

Diagnosis of asthma – new theories

Introduction: Recent studies have shown a remarkably high frequency of poorly controlled asthma. Several reasons for this treatment failure have been discussed, however, the basic question of whether the diagnosis is always correct has not been considered. Follow-up studies have shown that in many patients asthma cannot be verified despite ongoing symptoms. Mechanisms other than bronchial obstruction may therefore be responsible. The current definition of asthma may also include symptoms that are related to mechanisms other than bronchial obstruction, the clinical hallmark of asthma. Aim: Based on a review of the four cornerstones of asthma – inflammation, hyperresponsiveness, bronchial obstruction and symptoms – the aim was to present some new aspects and suggestions related to the diagnosis of adult non-allergic asthma. Conclusion: Recent studies have indicated that “classic” asthma may sometimes be confused with asthma-like disorders such as airway sensory hyperreactivity, small airways disease, dysfunctional breathing, non-obstructive dyspnea, hyperventilation and vocal cord dysfunction. This confusion may be one explanation for the high proportion of misdiagnosis and treatment failure. The current diagnosis, focusing on bronchial obstruction, may be too “narrow”. As there may be common mechanisms a broadening to include also non-obstructive disorders, forming an asthma syndrome, is suggested. Such broadening requires additional diagnostic steps, such as qualitative studies with analysis of reported symptoms, non-effort demanding methods for determining lung function, capsaicin test for revealing airway sensory hyperreactivity, careful evaluation of the therapeutic as well as diagnostic effect of corticosteroids and testing of suggested theories.     

技能考核在检体诊断学教学中的应用

目的 提高临床教学质量,培养学生的临床实践与思维能力。方法 随机选取2009 级七年制班37 人为对照组和2010 级七年制班37 人为实验组,在教学过程中,实验班在每部分教学内容讲授后2 周针对该部分内容进行一次技能考核,而对照班未进行同样的考核,利用期末临床实践技能考试与病历书写评分的方法,进行教学效果的评估。结果 与对照班学生相比,实验班学生的临床实践技能考试成绩与病历书写评分均明显提高,临床实践技能P＜0.01,病历书写P＜0.05。结论 强化技能考核在检体诊断学教学中的教学效果突出,不仅可以提高学生的临床实践能力,还可以增加学生的学习兴趣,培养良好的思维习惯,提升教学质量,使教与学更具有积极性和主动性。     

Fluorescence Imaging of Cutaneous Malignant Melanomas and Naevi

Fluorescence images of skin lesions of 140 patients were recorded in vivo, including 53 melanomas and 42 naevi. All lesions (140) were validated by histology. Fluorescence was excited at λ_ex=365 nm and observed within the optical band pass 450 nm<λ_obs<500 nm using a cooled CCD camera. For discrimination of melanomas and naevi, recorded fluorescence intensities were averaged over the lesions (I _lesion) and over selected areas of healthy skin (I _skin). Normalised cumulative frequencies of naevi and melanomas differ slightly, when plotted versus the ratio I _skin/I _lesion, with the cumulative frequency of melanomas shifted towards higher ratios. However, because of strong overlap, diagnosis of melanomas and naevi is not improved significantly contrary to reports in the literature. More specifically, 26% of melanomas (43% of naevi) are falsely classified as naevi (melanomas) when using the ratio I _skin/I _lesion exclusively. Furthermore, spatial distribution of fluorescence intensities (450 nm<λ_obs<500 nm) does not allow discrimination between melanomas and naevi. Paper received 19 September 1997; accepted after revision 7 April 1998.