从循证医学角度看阿尔茨海默病的治疗

目的:运用循证医学理论评价中西医疗法治疗阿尔茨海默病的证据强度,为未来的临床研究及决策提供参考依据。方法:依据制定的检索策略严格筛选评价合格文献。对所纳入的文献资料进行定性及定量分析,包括描述性分析、同质性检验、meta分析、敏感性分析及亚组分析。结果:目前,西医对阿尔茨海默病以神经传导介质类药物为主流,其疗效优于非神经传导介质类药物。中医治疗此病的优势尚需更多设计严谨的研究来证实。发表于2002年以后及以迷你心智状态检查表为疗效评价标准的研究同质性较高。比较性研究较试验性研究估算的比值比高1.5倍,以中医药学会制定的结果指标所估算的疗效为迷你心智状态检查表指标的2.58倍(4.79/1.86)。结论:符合纳入标准的试验不多,且入选的随机试验和(或)半随机试验质量不高,比较性研究之证据等级也不高,在此基础上的meta分析结果外在效度较低。中医药治疗阿尔茨海默病的有效性仍需要研究质量良好的随机对照试验之科研成果来支持。     

数据在生理学教学上的应用

从用数据论证理论或生理现象、用数据得出结论、用数据解释概念、用数据加深学生理解和记忆、用数据运算提高学生运用数据的能力几方面总结在生理学教学上数据应用的经验。     

现代设计的文化内涵

21世纪是设计的时代，市场竞争是设计的竞争，而设计竞争的背后则是文化的较量。文化是现代设计的源流，设计本身是一种文化现象，是文化的缩影和载体。这种文化既是对西方民族文化的理解融入，更是对中国传统文化的智慧、意境以及内在精神的深层次的领悟、继承和发扬。现代设计与文化是一种互动的关系，在设计实践中理性但又不缺乏创造性地应用文化，在对文化的继承、交融和创新中发展现代设计。     

A microcomputer data base system for an in vitro fertilization clinic programmed in BASIC

A computer program was developed for the IBM personal computer to be used for in vitro fertilization and gamete intrafallopian transfer clinics. This program, written in BASIC, allows input, editing, updating, sorting, and printing of patient data. Statistical functions permit summation of patient data based on various combinations of user-defined treatment cycles, diagnoses, and protocols, thus making possible comparison of pregnancy and other patient data between and among various treatment groups and diagnoses. The statistical information can be continually updated and revised when new data become available on patients (such as confirmation of pregnancy by ultrasound or live births) and at the end of each cycle. The formats used are useful in assimilating individual clinic data for various surveys and other reporting requirements. The program can be easily modified by anyone with minimal training in the BASIC programming language.     

Model of data structure and flow in general practice: a guide to evaluation of practice management software

Despite its benefits, the computerisation of Australian general medical practices has been delayed, partly due to user concerns about the format of data dictated by available software and the portability of such data. This article proposes certain essential criteria for practice management software, which may provide a framework for its evaluation by users. A set of simple guidelines for database maintenance is also proposed. The author believes that users should become familiar with basic software architecture and drive the market to develop packages that conform to these minimal criteria.     

一种颅脑外科手术路径规划系统的研制

系统以病人的ＣＴ／ＭＲＩ断层图像为依据,通过方便灵 交互式勾边功能,使医生可以方便的勾画出感兴趣的区域,用快速的判别手段,给出路径的代价值,最手用灵活多样的显示手段,提供直接的路径三维显示。     

Injuries in the tenth and eleventh years of life

Abstract From a sample of 803 children, 307 were involved in 413 separate incidents which resulted in injuries requiring medical attention. The most common injuries were lacerations, fractures, abrasions, and sprains. The majority of injuries were of minor severity. The most common incident resulting in an injury was a fall, followed by incidents where a child was struck by a person or object. A fifth of all falls was from bicycles. Sporting and playground equipment were associated with a large number of injuries, particularly at school. The study serves to highlight shortcomings in national injury data bases, in particular the absence of injury severity indices, codes for sports and recreation, and inadequate codes for falls. A case is made for integrating injury prevention within the school syllabus. The importance of bicycle injuries and the need for an injury surveillance based on accident and emergency centres is stressed.     

Findings in surgery for chronic otitis media. A retrospective data-analysis of 2225 cases followed for 2 years

Data on middle ear disease and follow-up was recorded and analysed in 2225 ears operated on for chronic otitis media between 1958 and 1975. The closure rate of tympanic membrane perforations (70–80%) was not influenced by the presence of otorrhoea, but it was significantly lower in patients aged below 15 or over 40 yr and especially when tympanic membrane homograft had been used. For all types of tympanoplasty the mean improvement in air-conduction threshold was most marked at the lower frequencies, being some 10 dB in Type I, 15 dB in Type II and 8 dB in Type III and IV and it decreased by some 3 dB per octave. The combination of cholesteatoma and tympanosclerosis appeared to be rare. The post-operative incidence of otorrhoea was 10–15% after modified radical mastioidectomy and 20–25%, after radical mastoidectomy.     

Modulation of the beta-adrenergic receptor system of vascular smooth muscle cells in vitro and in vivo by chronically elevated endothelin-1 levels

Endothelin-1 (ET-1) levels are chronically elevated in several cardiovascular diseases and correlate with an increased mortality. However, in contrast to acute biological activities such as vasoconstriction, little is known about long-term effects of ET-1. In this study we determined the effects of ET-1 on the beta(2)-adrenergic receptor (AR) system. Incubation of smooth muscle cells with ET-1 for 72 hr led to increased beta(2)AR density as determined by radioligand binding. Experiments with inhibitors of protein and RNA synthesis as well as RT-PCR revealed that beta(2)AR upregulation required de novo synthesis. In addition, protein kinase C but neither NO nor prostaglandin metabolism were involved in this effect. The enhanced expression of beta(2)AR was associated with an increased expression of its stimulatory G-protein and the receptor's ability to stimulate adenylyl cyclase. To study chronic effects of ET-1 in vivo, rats were infused with ET-1 for 3 weeks. Similarly as in cultured cells, prolonged ET-1 exposure led to increased betaAR expression in vivo. As a consequence, beta(2)AR-induced vasodilatation was increased in aortic rings from ET-1-treated animals. Our results therefore suggest that chronically elevated ET-1 levels in vitro and in vivo induce counterregulatory mechanisms by increasing betaARs that attenuate the vasoconstrictive effects of ET-1.