基层医院开展细菌学检验的必要性和困难性调查分析

细菌学检验在疾病的诊断和治疗中起着至关重要的作用,然而在我国的基层医院中却未能很好地开展。其困难性是多方面的,主要包括临床医生、患者以及检验人员自身等方面的原因。     

Experimental Autoimmune Encephalomyelitis in the Wistar Rat: Dependence of MBP-specific T Cell Responsiveness on B7 Costimulation

Experimental autoimmune encephalomyelitis (EAE) is an animal model of human multiple sclerosis that requires the activation of autoreactive T cells for the expression of pathology. EAE has been most frequently studied in the Lewis rat model as well as in several murine models of EAE including the PLJ and B10PL strains. In the present study we describe a novel model of EAE induced in the Wistar rat strain by immunization with guinea pig spinal cord antigens and pertussis toxin (PT). T cell responses were induced to myelin basic protein. Autoreactive T cells could be totally blocked by the in vitro treatment with CTLA4Ig, a protein that blocks the costimulation of autoreactive T cells. The addition of IL-2 could reverse the inhibition seen in vitro with CTLA4Ig. The effects of inhibition of B7 costimulation were also examined by an analysis of cytokine responses and IL-2 receptor on T cells. CTLA4Ig treatment in vitro reduced the expression of IL-2 receptor on T cells, enhanced T cell apoptosis and decreased the synthesis of IL-2, IFN- &#110 and TNF- &#102 . CTLA4Ig treatment had no effect on IL-10 synthesis by T cells, a cytokine implicated in the functions of regulatory T cell subsets. Overall, our studies support the rationale of B7 blocking therapies as a potential treatment for models of multiple sclerosis. The induction of EAE in the Wistar rat provides yet another novel model in which to examine the regulation of T cell autoimmunity.     

Evaluation of the optimum time for direct application of fibroblast growth factor to human traumatic tympanic membrane perforations

Abstract

Objective: The aim of this study was to determine the optimum time for direct application of basic fibroblast growth factor (bFGF) on large traumatic tympanic membrane perforations (TMPs). Study design: Prospective clinical study. Setting: Tertiary University Hospital. Methods: Ninety-three patients, with traumatic TMPs greater in extent than 25% of the entire tympanic membrane, were randomized into observation and bFGF-treated groups (～0.2–0.25?mL of bFGF solution was applied directly onto the TM once daily and continued until the perforation closed). Initial visit times were subcategorized into perforation durations of ≤3 and >3 days, thereby rendering two subgroups, as follows: A and B in the observation group; and C and D in the bFGF-treated group. The closure rate and mean closure time were evaluated after 6 months. Results: Eighty-six patients were finally analyzed. After 6 months, the bFGF-treated group exhibited a significantly higher total closure rate (97.8 versus 82.5%, p?<?0.05) and a shorter mean closure time (12.5?±?3.4 versus 34.0?±?5.9 days, p?<?0.05) compared with the spontaneous healing group. In addition, in the observation group, visiting time was not associated with differences in closure rate (p?>?0.05) and mean closure time (p?>?0.05), between the A and B subgroups. Similarly, in the bFGF-treated group, visiting time was not associated with differences in closure rate (p?>?0.05) between the C and D subgroups. However, the D subgroup was characterized by significantly shortened mean closure time compared with the C subgroup (p?<?0.05). Conclusions: This study shows the beneficial effect of bFGF on human traumatic large TMPs when applied after the 3rd day post-injury had passed (i.e. during the proliferative stage of wound healing). The procedure can not only significantly shorten closure time but can also reduce both the clinical administration duration and occurrence of side-effects associated with bFGF.     

Subcellular Distribution and Mitogenic Effect of Basic Fibroblast Growth Factor in Mesenchymal Uncommitted Stem Cells

Uncommitted mesenchymal stem cells (MSC), upon commitment and differentiation give rise to several mature mesenchymal lineages. Although the involvement of specific growth factors, including FGF2, in the development of committed MSC is known, the effect of FGF2 on uncommitted progenitors remains unclear. We have analyzed on a comparative basis, the subcellular distribution and mitogenic effect of FGF2 in committed and uncommitted MSC prepared from human bone marrow. Indirect immunofluorescence studies showed strong nuclear FGF2 staining in both progenitors; however, cytoplasmic staining was only detected in committed cells. Western blot analysis revealed the presence of 22.5 and 21-22 kDa forms of FGF2 in the nucleus of both progenitors; however, their relative content was higher in uncommitted than in committed cells. Exogenous FGF2 stimulated proliferation and sustained quiescence in committed and uncommitted cells, respectively. These results show that both type of progenitors, apart from morphological and proliferative differences, display specific patterns of response to FGF2.     

Comparing Humoral and Cellular Immune Response Against HBV Vaccine in Kidney Transplant Patients

Host protection upon vaccination usually results from the complex interplay of humoral and cellular components of the immune system. Exploring hepatitis B surface antigen (HBsAg)‐specific T cell responses and their correlation with humoral responses under immunosuppression, we analyzed 51 renal transplant recipients, differing in HBV vaccine–specific antibody titers (non [NRs]‐, low [LRs]‐, and high responders [HRs]) and in 22 healthy controls (HCs) in a cross‐sectional study. HBsAg‐specific T cells were analyzed by flow cytometry according to expression of activation markers CD40L and/or CD69, and the cytokines IFNγ, IL‐2, TNFα, and IL‐17. No significant differences in responder rate and magnitude of HBsAg‐specific T cell responses were found between HCs and HRs. Interestingly, HBsAg‐specific Th‐cells were also observed in 50% of humoral NRs. Frequencies of HBsAg‐specific CD40L+ Th‐cells were significantly higher in HRs compared to LRs (p = 0.009) and in LRs in comparison to NRs (p = 0.043). All but NRs showed a predominance of multi‐potent HBsAg‐specific TNFα+IL‐2+ Th‐cells. As expected, HBsAg‐specific CD8⁺ T cells were rarely found. In conclusion, mounting of hepatitis B vaccine‐specific T cell responses is possible in kidney transplant recipients despite immunosuppression. Detection of HBV‐specific Th‐cells in a significant proportion of humoral NRs contributes to the current discussion on conferring immune protection by cellular memory in such patients.     

Changing Guidelines of Cardiopulmonary Resuscitation and Basic Life Support for General Dental Practitioners and Oral and Maxillofacial Surgeons

Introduction

Every general dental practitioner and oral and maxillofacial surgeon needs a thorough knowledge of the diagnosis and management of medical emergencies. Cardiopulmonary arrest is the most urgent of emergencies and diagnosis must be done as soon as possible.

Purpose

This paper discusses the importance of the International Liaison Committee on Resuscitation which forms the guidelines for cardiopulmonary resuscitation (CPR), highlighting the important changes in the guidelines of CPR from the year 2000 to 2010, the basic sequence of performing CPR and also the role of defibrillation and the use of automated external defibrillators. Finally the five part chain of survival which is of utmost importance to dental health care professionals and oral and maxillofacial surgeons.

Conclusion

All dental health care personnel and oral & maxillofacial surgeons should recognize the importance of the changes in the guidelines of CPR, be trained and allowed to use a properly maintained defibrillator, to respond to cardiac arrest victims.     

在校护生基本情况对护理软技能水平影响的调查研究

目的:了解在校高职护生基本情况对护理软技能水平的影响,为提高在校护生护理软技能水平提供依据。方法:以护理软技能测评量表为工具,采取调查问卷的方法对在校2 408位高职护生施测,数据录入后用SPSS 17.0对资料进行t检验和方差分析。结果:我院高职护生护理软技能分值为(164.95±0.46)分;是否打工、学历高低、专业选择是否自己意愿等是影响护生护理软技能水平的显著因素(均P<0.05)。结论:在校护生护理软技能水平一般,在校护生的基本情况对护理软技能有明显影响。     

细化评分标准在外科基本技能考评中的应用研究

目的探讨细化评分标准在外科基本技能考评中的应用,旨在提高考核的公平性,进一步提高教学质量。方法将外科基本技能操作无菌术、换药术、手术器械的使用、缝合打结等基本的评分标准进行细化,随机选择10名临床医学专业本科三年级学生进行考核,考核时每名医学生分别由2位教师使用未细化的评分表进行评分,另外2位教师同时使用细化后评分表进行评分,比较使用同一个评分标准2位教师的评分差。对比未细化的评分表和细化后评分表不同教师的评分差。结果应用未细化的评分表进行评分的2位教师所打分值差异具有统计学意义(P=0.015),应用细化的评分表进行评分的2位教师所打分值差异无统计学意义(P=1.452)。结论细化后的评分表不同的教师评分差异性小,评分更精准,能够客观、准确地反映学生对操作的掌握程度。