煤焦沥青诱发大鼠肺癌的实验研究——Ⅱ.形态学观察

本文对煤焦沥青诱发大鼠肺癌过程中的病理形态学所见作了报道。整个过程可以分为三个阶段:1.异物反应阶段;2.异常增生和鳞状化生阶段;3.癌肿发生发展阶段。文中对每一个阶段的病理组织学改变做了详细描述。煤焦沥青诱发的大鼠肺癌的特征如下:1.癌肿全都发生在肺的周边部位;2.绝大多数癌肿的组织类型都是高分化鳞状细胞癌;3.多发性,数个至数十个大小不等的肿块布满全肺;4.癌变各个不同阶段的改变可在同一肺脏中出现;5.转移癌较少见。     

10个钨矿职工死因分析

对中南地区10个钨矿1972—1974年入矿(工龄至少1年)的在册职工28453人进行了队列研究。队列成员追访至1989年,死亡2870人,比全国居民死亡率计算的期望值略高(SMR=1.15,95％CI=1.11—1.19);主要是非恶性呼吸道疾病,特别是尘肺(SMR=66.79,95％CI=59.65—73.68)以及与呼吸道疾病相关的肺心病明显超高(SMR=8.19,95％CI=7.42—9.02),比全国居民死亡率高5倍。癌症死亡数在全死因中虽占第一位,但仅鼻咽癌轻度超高(SMR=1.73,95％CI=1.23—2.37),而肺癌死亡率明显偏低(SMR=0.53)。研究结果不支持矽肺与肺癌病因学相关的假说。     

Some investigations into the nature and cause of massive fibrosis (MF) in the lungs of South African gold, coal, and asbestos mine workers

Samples from fibrotic lung lesions greater than 1 cm in diameter macroscopically (by definition, massive fibrosis; MF) were taken from the lungs of 9 randomly selected post-mortem cases of mine workers all showing a background of a pneumoconiosis. These samples were studied histologically, biochemically, and by X-ray diffraction and electron microscopy. As controls for the biochemical and X-ray diffraction investigations, nonfibrosed lung tissue was taken from the same specimens. The findings suggest that the higher quartz content may be the primary cause responsible for the MF formation in this series of cases, while other factors such as tuberculosis may play a part according to some relevant literature on MF. Although an area of MF appears macroscopically to be a solid lesion, on microscopy this is not the case and the lesion is composed of dense and sparse collagen bundles and cellular elements.     

The structure of memorized knowledge in students and clinicians: an explanation for diagnostic expertise

This paper provides for the first time evidence of a consistent difference in the memory structures of novice and expert clinicians. The diagnostic performance of first- and third-year clinical medical students, senior house officers, registrars and consultants on four clinical problems in general medicine was studied. Comparisons were made of all diagnostic interpretations offered and the forceful features (personally important pieces of information which act as a key to particular memory structures which in turn give rise to the clinical interpretation) from which these were derived. Results demonstrate that the numbers of interpretations made and the numbers of forceful features identified did not differ significantly between groups (P greater than 0.05). However, the actual interpretations made in three out of four cases, and the actual forceful features identified in all cases, did differ significantly between groups (P less than 0.05). The numbers of interpretations made by all groups were large and demonstrated enormous variability. Highly individualized multiple responses to clinical information are associated with easy diagnoses. We conclude that there is no difference between groups of differing clinical experience in the breadth of thought but that there are marked differences in the precise content and structure of thought. This allows coherent explanation of variation in diagnostic expertise with clinical experience. The significance of the findings is discussed.     

Inappropriate social and sexual responses to a female student by male patients with dementia and organic brain disorder

Little attention has been directed toward inappropriate social and sexual approaches by patients with dementia diagnoses and organic disorders of the brain. A female student who approached patients who had dementia and organic brain disorders was frequently approached and touched in a sexual manner that was distressing to her and led her to believe that she was behaving in a manner that elicited these responses. It is recommended that students and volunteers be prepared for experience in settings with patients with these diagnoses through individual or group discussion, training and role playing as a way of enhancing their experiences and avoiding unnecessary feelings of guilt and embarrassment.     

一个医学生眼里的医学伦理学教育

主要通过医学生的视角，从教学内容、教学方法等方面谈了对医学伦理学教育的感受和一些建议，并通过医学生的声音反映医学伦理学教育的成果以及存在的一些问题。     

煤焦沥青烟雾提取物的细胞毒性和遗传毒性研究

采用人外周血淋巴细胞非程序DNA合成(UDS)试验和人胚肺成纤维细胞转化试验,测试了煤焦沥青烟雾提取物(ECTPF)对人体细胞的细胞毒性和遗传毒性。UDS试验结果表明,ECTPF可使淋巴细胞UDS值明显增加,并有剂量一反应关系。引起半数淋巴细胞死亡的浓度(LC50)为33.8μg/ml。细胞转化试验表明,ECTPF能诱发人胚肺成纤维细胞明显的形态学转化,且转化细胞具有部分恶性转化细胞的特性。引起半数人胚肺成纤维细胞生长抑制的浓度为41.3μg/ml。实验结果提示,ECTPF是一种具有细胞毒性和遗传毒性的物质。     

煤烟型大气污染对儿童肺功能的影响

为观察煤烟型大气污染对儿童健康的影响 ,选择了太原市 3个污染程度不同地区的 45 0名儿童进行肺功能测试和问卷调查。研究结果显示 ,儿童呼吸功能表现为重度污染区 <中度污染区 <相对清洁区 ;肺通气功能阻塞性异常率表现为重度污染区 >中度污染区 >相对清洁区 ;Logistic回归分析发现肺通气功能阻塞性异常率与小学生家庭的取暖方式、厨房和卧室是否分开以及污染物的水平有关 ;多元线性回归分析显示重度污染区儿童的FVC、FEF5 0与相对清洁区相比分别减少了 65 80ml、119 2 7ml,中度污染区儿童的FVC、FEF5 0与相对清洁区相比分别减少了 5 7 2 8ml和 114 2 9ml;Ln(SO2 )每升高一个单位 ,FVC和FEF5 0分别减少69 10ml和 119 79ml,Ln(PM1 0 )每升高一个单位 ,FVC、FEF5 0等分别减少了 193 5 0ml和 171 69ml。结果提示 ,太原市煤烟型大气污染对儿童呼吸系统产生了危害。     

荧光光谱法分析煤焦油组分

研究煤焦油组分时,为了防止组分相互之间的干扰,在测定前用几种不同极性的溶剂:石油醚;80%石油醚-20%甲苯;60%石油醚-40%甲苯;40%石滑醚-60%甲苯;20%石油醚-80%甲苯;甲苯;氯仿;50%氟仿-50%甲醇;甲醇进行洗提,从煤焦油中得到9个级分。然后用荧光法从9个级分中鉴定出28个组分:茶、苊、联苯、三甲基酚、菲、异喹啉、芴、对氨基酚、联苯胺、蒽醌、四氢萘、2,5-二甲酚、蒽、咔唑、间苯二酚、二乙基苯胺、喹啉、吲哚醌、1,3,5-三甲苯、1,2,4-三甲苯、萘醌、菲醌、窟、苾、氧芴、1,2-苯并蒽、2,3-苯并蒽、3,4-苯并苾。同时定量了氯仿和甲醇级分中氧芴、(艹屈)、联苯胺、苾、菲、蒽、咔唑、四氢蔡咔、四氢萘、苯醌、喹啉、8-羟基喹啉等12个组分的含量。     

社区传染性疾病技能培训问题调查

背景 社区卫生服务机构作为传染病防控工作的最基层单位,是传染病防治的前沿阵地和重要关口,基层医务工作者承担着辖区内疫情监测、预防接种、健康宣传及协助疾控部门调查处置暴发疫情和突发公共卫生事件等职责,在疾病群防群控、易感人群保护、传染源控制及健康宣教等方面发挥着积极作用,同时对有效防控传染病发挥关键作用。目的 了解基层医务工作者社区传染病的诊治能力,分析存在的问题和薄弱方面,有针对性地设计及开展传染病相关系列培训,提高基层传染病防控能力。方法 2021年11月—2022年3月以香港大学深圳医院全科医学科在2021年11月举办的国家级社区传染性疾病继续教育会议的所有参会者为研究对象。会前、会后通过问卷星二维码向参会者发放调查问卷,会前问卷内容包括参会者人口学特征,工作后是否参加过社区传染病培训,社区传染病诊治开展情况,社区传染病防治的主观态度（是否愿意管理社区传染病、对自己传染病诊治能力满意度）,传染病防治专业知识及会议内容相关知识,对慢性乙型肝炎的态度。会后问卷内容主要为会议内容相关知识、对慢性乙型肝炎的态度以及对本次线上会议满意度调查。会前共有301名基层医务工作者完成调查问卷,会前及...