重点高中新生心理健康调查与分析

目的通过对云南省省属重点中学住校新生的心理健康状况进行调查研究，有针对性地制定心理健康教育工作方案。方法用周步成的心理健康诊断测验方法，对来自全省的512名住校中学生进行调查。结果有21．9％的学生存在不同程度的心理问题；男生问题率是17．6％，女生问题率是27．7％，在学习焦虑、自责倾向、恐怖倾向和冲动倾向方面性别差异显；汉族学生心理健康水平比少数民族学生略高；昆明市市区与昆明市周边县、昆明市周边县与地州县市的学生之间各项指标均无显差异；昆明市市区学生在学习焦虑、对人焦虑、自责倾向和过敏倾向上均显好于地州县市学生；父母化程度高低对子女心理健康影响较大，母亲化差异对子女心理健康的影响高于父亲。结论重点中学高一住校生有一定比例的人存在心理健康问题，性别、生源及父母的化程度影响学生的心理健康。     

丙二醇用量对湿疹喷雾剂透皮作用的影响

目的为提高湿疹喷雾剂对皮肤的渗透能力，增强疗效。方法采用定制的改良Franz扩散池，大鼠腹皮作透皮试验，一阶导数光谱法测定本制剂中黄芩苷的含量，考察不同浓度的丙二醇对黄芩苷经皮渗透的影响。结果各种浓度的丙二醇累积渗透百分率达5％所需时间T5由短(快)到长(慢)顺序为8．0％、7．0％、5．0％、6．0％、15．0％、10．0％；经皮渗透5小时内累积渗透百分率Q5h由大到小依次为7．0％、6．0％、5．0％、8．0％、15.0％、10．0％。结论丙二醇在湿疹喷雾剂中促渗作用最佳浓度为体积分数的7．0％-8.0％。     

32464例病案首页数据质量分析报告

对32464份病历病案首页缺陷进行统计分析,结果显示,病案首页基本缺陷的构成比最高,其它依次为缺主任签名,缺术前诊断与术后诊断符合情况,缺手术情况等等,并就导致缺陷的原因进行探索和提出相应的对策。     

A similar high level of immunoglobulin A and immunoglobulin G class milk antibodies and increment of local lymphoid tissue on the duodenal mucosa in subjects with cow's milk allergy and recurrent abdominal pains

In previous studies, we have reported endoscopic and histological alterations locally on the gastrointestinal (GI) tract associated with a gastrointestinal type of cow's milk allergy. In this study, we sought to further characterize endoscopic, and immunological findings in these children. We also hypothesized that the same type of immune responses might also be found in children with unexplained and recurrent abdominal pains. We did a gastroduodenoscopy for persistent GI symptoms, examined the mucosal histology of the small intestine and measured the antibodies to whole cow's milk and its fractions with an enzyme‐linked immunosorbent assay (ELISA) in a consecutive series of 22 subjects with untreated and 14 with treated cow's milk allergy (CMA) and 44 with recurrent abdominal pains (RAP). The immunological findings of the study subjects were compared with 54 controls. Lymphonodular hyperplasia (LNH) of the duodenum was the main endoscopic finding in 11 subjects (50%) with untreated and 5 (36%) with treated CMA. It was also found in 6 of 44 subjects with RAP. Compared with the controls, the patients with CMA showed significantly higher levels of IgA class antibodies to whole milk (p = 0.003) and βLG (p < 0.0001). Of the IgG class antibodies to βLG (p = 0.032), BSA (p < 0.0001) and αCAS (p < 0.0001) were significantly higher. The patients with LNH of the duodenal bulb as the main endoscopic finding showed significantly higher values of IgG class antibodies to βLG (p = 0.01) and αCAS (p = 0.005). Interestingly, the patients examined for RAP showed a similar increment in the pattern of whole milk and specific milk protein antibodies as the CMA children. In conclusion this study showed that gastrointestinal CMA beyond infancy is significantly associated with high levels of IgG and IgA class antibodies to milk and its fractions. As high levels of these antibodies and LNH of the duodenal bulb were also found in subjects with RAP, the study further suggests that gastrointestinal CMA might be one major reason for RAP.     

Improved detection of melanoma antigen-specific T cells expressing low or high levels of CD8 by HLA-A2 tetramers presenting a Melan-A/Mart-1 peptide analogue.

MHC class I tetramers containing peptide epitopes are sensitive tools for detecting antigen-specific CD8(+) T-cell responses. We demonstrate here that binding of HLA-A2 tetramers to CD8(+) T cells specific for the melanoma-associated antigen Melan-A/MART-1 can be fine-tuned by altering either the bound peptide epitope or residues in the alpha 3 domain of HLA-A2, which is important for CD8 binding. Antigen-specific T cells expressing high levels of CD8 could be detected using HLA-A2 tetramers containing the peptide AAGIGILTV, an epitope which is naturally processed and presented from Melan-A/MART-1. In contrast, low CD8-expressing, antigen-specific T cells could be detected efficiently only by using a mutated HLA-A2 tetramer with an altered CD8 binding site or, less efficiently, using the wild-type HLA-A2 tetramer loaded with the peptide analogue ELAGIGILTV, which is superior in stimulating antigen-specific T-cell responses. Our results suggest ways to optimize the identification and expansion of antigen-specific T cells with different requirements for the costimulatory CD8 molecule in facilitating T-cell receptor binding to peptide variants.     

双钉合术行直肠癌前切除低位保肛的治疗体会

[目的]评估使用双钉合术行直肠癌低位前切除保肛手术的临床价值，并探讨其注意事项。[方法]我科自1998年1月至2001年11月间对54例直肠癌病人以双钉合术行直肠癌前切除低位保肛手术。[结果]全组均痊愈出院，其中出现术后并发症有：吻合口瘘5.6%(3/54)，吻合口狭窄3.7%(2/54)，1年内出现前切除（术后）综合征66.7%(36/54)，术后尿潴留5.6%(3/54)，均经治疗后好转，随访2年无死亡。[结论]双钉合术对直肠癌前切除低位保肛是安全、方便的。     

Erweiterte Diagnostische Laparoskopie (EDL)

Zusammenfassung   Grundlagen: Die sogenannte erweiterte diagnostische Laparoskopie (EDL) ist ein minimal-invasiver chirurgischer Eingriff, der die Exploration des gesamten Bauchraumes erm?glicht und somit das pr?therapeutische Staging bei malignen Erkrankungen erheblich verbessern kann. Methodik: Die EDL umfa?t die visuelle Inspektion mit gezielter Pr?paration aller relevanten Areale, die laparoskopische Ultraschalldiagnostik und die Gewinnung von Zytologie-Biopsiematerial. Ergebnisse: Beim Magenkarzinom konnten in einer eigenen Studie durch die EDL in 40,5 % der F?lle therapierelevante Zusatzinformationen gewonnen werden. Eine ?hnliche Bedeutung k?nnte die EDL auch für die Diagnostik des Adenokarzinoms der Speiser?hre gewinnen, m?glicherweise auch bei Malignomen von Leber und Pankreas. Schlu?folgerungen: Das Komplikationsrisiko der EDL ist gering; die Gefahr einer Tumorzellverschleppung durch den diagnostischen Eingriff ist jedoch nicht ganz auszuschlie?en, so da? die Indikation nur unter der Voraussetzung einer therapeutischen Konsequenz gestellt werden sollte.      

数字化医院建设与医信人才培养模式初探

本文结合目前医疗卫生领域信息化、数字化的发展环境，提出对医务人员及医学院校学生应该具备的IT知识与技能要求。结合国际上已经建立“医信教育”制度的经验，提出如何建立完善长效的“医信人才”培养机制，并应率先在我国各类医学院校，特别是职业院校的卫生系、中职卫校和医学高等专科学校开展医信课程的观点。     

Effect of triclosan on interferon-gamma production and major histocompatibility complex class II expression in human gingival fibroblasts

BACKGROUND, AIMS: The effect of triclosan (2,4,4'-trichloro-2'-hydroxyl-diphenyl ether) on the production of interferon-gamma (IFN-gamma) and the expression of major histocompatibility complex (MHC) class II antigen was studied in human gingival fibroblasts isolated from 4 individuals. METHODS/RESULTS: All cell lines demonstrated high IFN-gamma production in 24-h cultures of human gingival fibroblasts stimulated by phytohemagglutinin (PHA) (5 microg/ml). Human gingival fibroblasts showed a high expression of MHC class II when stimulated with 500 and 1,000 pg/ml rIFN-gamma in 7-day cultures. Treatment of the cells with triclosan (0.5 microg/ml) reduced both IFN-gamma production and MHC class II expression in human gingival fibroblast cultures. Similar inhibitory effects on IFN-gamma production and MHC class II expression were observed when the anti-inflammatory agent dexamethazone (1 microM) was used. CONCLUSION: The present study further supports the view that the agent has an anti-inflammatory effect in addition to its antibacterial capacity.     

弧型切割缝合器双吻合器技术在低位结直肠吻合术中的应用

目的评价弧型切割缝合器双吻合器技术在结直肠吻合术,尤其是低位结直肠吻合术中的应用价值。方法回顾性分析168例应用弧型切割缝合器双吻合器技术行结直肠吻合术的病历资料,分析其术中情况、术后并发症和随访情况。结果所有患者术中直肠闭合和吻合进程顺利,无手术死亡。术后发生吻合口瘘4例(2.4%),直肠阴道瘘2例(1.2%),吻合口出血3例(1.8%),均经治疗后痊愈;无吻合口狭窄。结论弧型切割缝合器双吻合器技术有助于完成以往手法缝合不易完成的低位结直肠吻合术。