人际交往训练降低医学生心理应激反应的实验研究

目的　探讨人际交往训练降低医学生心理应激反应的有效模式 ,以培养交往手段 ,促进身心健康 ,提高学习效率。方法　从云南中医学院中医专业 2 0 0 0级 8个班 ,41 2名学生中随机抽取 2个班 ,共 1 0 6人为被试对象 ,结合专业学习 ,在生理学课堂教学中贯穿人际交往训练 ,训练前后分别测查 90项症状自评量表 ( SCL-90 )和防御方式问卷 ( DSQ) ,并用 Q分类法检验被试课前和课后自我评价。最后 ,对被试和其余 6个班的学生进行生理测验 ,并对测验成绩进行比较。结果　被试在交友信心、乐观豁达、口头表达、积极接纳、说服技巧方面均比训练前有显著和极显著提高 ;且考前心理应激反应明显降低 ,防御方式趋向成熟 ,测验及格率高于其余 6个班。结论　结合专业进行人际交往训练可在近期内改善医学生的心理健康水平 ,有利于提高学习效率 ,深受大学生欢迎     

Learning,habituation, and training

Summary The apparent efficiency of sub-maximum exercise tends to be lower in subjects with a large aerobic power. This is probably an artefact arising from neglect of the oxygen debt in the calculation of mechanical efficiency. Changes in the extent of oxygen debt can obscure an increased skill of performance with training. Efficiency is improved by repetition of a given mode of exercise, but not by other forms of training. Habituation is greater during work than at rest, but even during work the change in pulse rate of young men does not exceed 2–5 beats/min over 5 experimental days. Habituation is lost if the test procedure is not repeated during training; this can complicate assessments of training from the response to sub-maximum exercise.     

Klinische Charakterisierung der essentiellen Thrombozythämie im Vergleich zu anderen myeloproliferativen Erkrankungen und reaktiven Thrombozytosen

Summary 60 patients with essential thrombocythemia (ET) have been retrospectively and prospectively followed from 1974 through 1987. The presenting signs and symptoms and the course of the disease were analyzed and compared to 10 patients with persisting reactive thrombocytosis selected from 6000 patients with reactive thrombocytosis and to 50 patients with other myeloproliferative diseases. 54 ET-patients presented with complications, 46 with thrombembolic, 3 with hemorrhagic problems and 5 with thrombembolic and hemorrhagic problems. In 6 patients ET was detected accidentally. Disturbances of the microcirculation, mainly of the fingers and the toes, were the most frequent symptom. The average maximal platelet count was 1 207 000/µl. The average platelet count at diagnosis was 880 000/µl. 16 patients had an elevation of the serum creatinin at diagnosis, which deteriorated during the course of the disease. Bone marrow examinations were performed in 56 patients, histology in 48 patients, cytology in 29 patienst. In contrast to the clinical diagnosis the histological diagnosis was in 4 cases each polycythemia vera and myeloproliferative syndrome without further specifiction. 12 patients died thus far. The causes of death were thrombembolic complications in 9, acute leukemia in 2 patients, in 1 patient the cause of death is not known. 10 years after diagnosis 61% of the patients are still alive. It appears that ET is a more important risk factor for the disturbances of the micro- and marcrocirculation than has been recognized until now. ET is, if thrombembolic complications are avoided, a disease with a relatively benign course.

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Abkürzungsverzeichnis ET essentielle Thromobozythämie - PRT persistierende reaktive Thombozytose - PV Polyzythämia vera - CML chronisch myeloische Leukämie - MF Myelofibrose - CMPE chronische myeloproliferative Erkrankung unklarer Zuordnung - MM megakaryozytäre Myelose - ALP alkalische Leukozytenphosphatase - Hb Hämoglobin Herrn Prof. Dr. N. Zöllner zum 65. Geburtstag gewidmet     

Effects of concurrent inspiratory and expiratory muscle training on respiratory and exercise performance in competitive swimmers

The efficiency of the respiratory system presents significant limitations on the bodys ability to perform exercise due to the effects of the increased work of breathing, respiratory muscle fatigue, and dyspnoea. Respiratory muscle training is an intervention that may be able to address these limitations, but the impact of respiratory muscle training on exercise performance remains controversial. Therefore, in this study we evaluated the effects of a 12-week (10 sessions week^–1) concurrent inspiratory and expiratory muscle training (CRMT) program in 34 adolescent competitive swimmers. The CRMT program consisted of 6 weeks during which the experimental group (E, n=17) performed CRMT and the sham group (S, n=17) performed sham CRMT, followed by 6 weeks when the E and S groups performed CRMT of differing intensities. CRMT training resulted in a significant improvement in forced inspiratory volume in 1 s (FIV_1.0) (P=0.050) and forced expiratory volume in 1 s (FEV_1.0) (P=0.045) in the E group, which exceeded the S groups results. Significant improvements in pulmonary function, breathing power, and chemoreflex ventilation threshold were observed in both groups, and there was a trend toward an improvement in swimming critical speed after 12 weeks of training (P=0.08). We concluded that although swim training results in attenuation of the ventilatory response to hypercapnia and in improvements in pulmonary function and sustainable breathing power, supplemental respiratory muscle training has no additional effect except on dynamic pulmonary function variables.     

Primary gastric apoptosis-rich T-cell lymphoma co-expressing CD4, CD8, and cytotoxic molecules

In contrast to primary gastric lymphomas of B-cell type, little is known about primary gastric T-cell lymphomas. We describe three cases with remarkably similar features: diffuse growth, epitheliotropism, medium too large cell size, high apoptotic rates, and a CD3+, CD4+, CD8+, CD45RO+ immunophenotype. Clonal TCRγ gene rearrangement was shown in two cases. Epstein-Barr virus infection was excluded in two cases. Taking advantage of fresh-frozen material, we analyzed two cases further, revealing CD5–, CD16+, CD56–, CD57–, CD25+, CD30+, CD103 (αEβ7)+, bcl-2 protein+, CD95+, CD95 ligand(L)–. CD95L, however, was detected in histiocytic and fibroblastoid by stander cells. The lymphomas expressed granzyme B, perforin, and the TIA-1 antigen in various combinations. All three cases had a very unfavorable clinical course characterized by local recurrence and/or dissemination to other epithelial sites, leading to death within 6–12 months after the initial diagnosis despite surgery and aggressive antineoplastic treatment. These data suggest a novel variant of peripheral T-cell lymphoma operationally characterized as primary gastric, apoptosis-rich, CD103+, EBV-, T-cell lymphoma co-expressing CD4, CD8, CD16 and cytotoxic molecules. Received: 20 August 1999 / Accepted: 2 November 1999     

医药类专业本科物理课程的设置及目标与定位探讨

目的：探讨物理课程在高等医药类专业教育中的作用与地位。方法：对全国部分城市不同类别医院从业医务工作者进行调查，综合国际医学教育标准和我国现实医学教育以及医疗服务行业状况进行分析。结果：探讨了我国高等医药类专业教育中物理课程的设置及目标与定位问题，给出了明确的课程定位与设置标准。结论：现代医学高等教育不应忽视或淡化物理课程在医学人才培养中素质教育和专业水平提高的积极作用与基础地位，在有限的学时空间内合理安排基础性内容和与专业素质培养相关的应用内容。     

Serum hormones in male strength athletes during intensive short term strength training

Summary Training-induced adaptations in the endocrine system and strength development were investigated in nine male strength athletes during two separate 3-week intensive strength training periods. The overall amount of training in the periods was maintained at the same level. In both cases the training in the first 2 weeks was very intensive: this was followed by a 3rd week when the overall amount of training was greatly decreased. The two training periods differed only in that training period I included one daily session, while during the first 2 weeks of period II the same amount of training was divided between two daily sessions. In general, only slight and statistically insignificant changes occurred during training period I in mean concentrations of serum hormones examined or sex hormone-binding globulin as well as in maximal isometric leg extensor force. However, during training period II after 2 weeks of intensive strength training a significant decrease (P<0.05) was observed in serum free testosterone concentration [from 98.4 (SD 24.5) to 83.8 (SD 14.7) pmol · l^–1] during the subsequent week of reduced training. No change in the concentration of total testosterone was observed. This training phase was also accompanied by significant increases (P<0.05) in serum luteinizing hormone (LH) and cortisol concentrations. After 2 successive days of rest serum free testosterone and LH returned to (P<0.05) their basal concentrations. Training period II led also to a significant increase (P<0.05) [from 3942 (SD 767) to 4151 (SD 926) N] in maximal force. These findings suggest that in male strength athletes dividing the amount of training into smaller units may create more effective training stimuli leading to further strength development.     

Analysis of fMRI data by blind separation of data in a tiny spatial domain into independent temporal component

Independent Component Analysis (ICA) is a promising tool for the analysis of functional magnetic resonance imaging (fMRI) time series. In these studies, mostly assumed is a spatially independent component map of fMRI data (spatial ICA). In this paper, we assume that the temporal courses of the signal and noises are independent within a Tiny spatial domain (temporal ICA). Then with fast-ICA algorithm, spatially neighboring fMRI data were blindly separated into several temporal courses and were preassumed to be formed by a signal time course and several noise time courses where the signal has the largest correlation coefficient with the reference signal. The final functional imaging was completed for the signals obtained from each voxel. Simulations showed that compared with the spatial ICA method, the new temporal ICA method is more effective than the spatial ICA in detecting weak signal in a fMRI dataset. As background noise, the simulations include simulated Gaussian noise and fMRI data without stimulation. Finally, vivo fMRI tests showed that the excited areas evoked by a visual stimuli are mainly in the region of the primary visual cortex and that evoked by auditory stimuli are mainly in the region of the primary temporal cortex.     

人体寄生虫学网络课程的应用与评价

目的对郧阳医学院人体寄生虫学网络课程的教学效果进行评价。方法选取2005级临床医学一系和二系分别作为实验组和对照组，对照组的人体寄生虫学采用传统教学方法教学，实验组采用传统教学和本课题组构建的人体寄生虫学网络课程平台进行辅助教学。结果实验组学生的人体寄生虫学理论课程考试成绩和实验课程考试成绩明显优于对照组学生（P〈0．05）。结论人体寄生虫学网络课程能够显著提高教学效果，对突破传统面授教学的局限性和帮助学生网上学习具有重要意义。     

Infective endocarditis at a Hospital of the University of Kiel, 1958–1987

Summary The clinical courses of 214 patients with infective endocarditis treated between 1958 and 1987 at the First Medical Hospital of the University of Kiel (FRG) were analyzed retrospectively. A decrease in the incidence of endocarditis occurred during the 30-year observation period. The mean age of patients was 48 years, and men were more frequently affected than women. In the course of the investigation, a rise in isolated aortic valve disease was noted, whereas the number of patients with isolated involvement of the mitral valve and combined mitral-aortic valvular defects declined. Streptococci (57%) were the most frequent pathogens isolated; as opposed to their increase, the percentages ofStaphylococcus aureus and enterococci decreased. Otolaryngological, dentogenic and urogenital diseases were most frequently held to be responsible for the development of infective endocarditis. Prior cardiosurgical interventions became increasingly significant as a cause of the disease. In this connection, a rising percentage of endocarditis cases was linked with prosthetically replaced heart valves. Complications and concomitant symptoms of endocarditis included the development of heart failure, cerebral embolism and encephalitis, splenomegaly, and renal inflammation. Finally, the marked decrease in mortality contrasted with a simultaneous rise in the number of endocarditis cases achieving full recovery.