腰椎横突骨折重要性评价

目的　研究腹部钝性损伤患者腰椎横突骨折的发生与腹部内脏损伤的关系。方法　收集 1997～ 2 0 0 0 -0 7我院收治腹部钝性损伤患者 169例。回顾患者CT片及手术记录 ,总结横突骨折以及内脏损伤的数量及类型。结果　CT显示 81例有横突骨折 ,14 8个横突骨折 ( 43例系单发 ,38例系多发 )。 33例左侧横突骨折 ,2 8例右侧 ,2 0例双侧。L1横突骨折最常见 (n =60 ) ,横突骨折伴发内脏损伤 15例 ,腰椎横突骨折的发生与腹部内脏损伤具有相关性 (Ρ <0 .0 5 )。结论　腰椎横突骨折与腹部内脏损伤具有相关性 ,对临床工作 ,尤其是急救工作具有重要意义     

Stochastic models for geriatric in-patient behaviour

Departments of geriatric medicine engage in two distinct formsof clinical activity: acute/rehabilitative and long-stay care.These are organizationally distinct and have very differentresource needs. Current hospital planning models, however, assumethat patients all move through the system at the same rate,thereby ignoring this effect of inherent heterogeneity in patientbehaviour. The present paper describes the movement of patientsthrough geriatric hospitals by a two-stage continuous-time Markovmodel, where the stages represent acute/rehabilitative and long-staypatients respectively. Patients are initially admitted to thefirst stage, from which they may depart from the system, bydeath or discharge, or move into the second stage, from whichthey eventually depart by death or discharge (unlikely). Admissionsare modelled in two ways: either as replacements for departuresor as a Poisson stream. Expressions for the distribution andmovement of numbers of patients are derived and evaluated fordata from a number of hospitals. Such an approach has the advantage,over previous crude models, of taking into account differenttypes of patients and introducing variability, thus making itpossible to extract variances as well as means of numbers ofgeriatric patients requiring hospital care.     

人胎儿雪旺氏细胞的体外培养及其纯化研究

本实验用酶消化法从孕１４～１９周人胎儿周围神经中分离培养雪旺氏细胞，结合差速贴壁和阿糖胞苷处理进行纯化，根据Ｓ－１００蛋白免疫细胞化学染色和形态学特征，分析不同时期雪旺氏细胞的纯化程度。实验结果显示：培养４ｄ，倒置相差显微镜下观察，雪旺氏细胞呈典型的双极或三极形，端对端或旋涡状排列，Ｓ－１００蛋白免疫细胞化学染色呈阳性反应，其比例约占９８％；在２～３周内，雪旺氏细胞的纯度维持在８５％～９０％；培养３５ｄ，雪旺氏细胞约占８０％；单纯采用阿糖胞苷或差速贴壁处理，培养３５ｄ，雪旺氏细胞约占７０％；原代培养９２ｄ，传代１１代细胞生长良好。实验结果表明，多种方法联合使用较单一方法所得的纯度高。本方法快速、简便，能为雪旺氏细胞作为移植材料提供足够的来源。     

鲁格氏棒横突固定法的实验研究和临床应用

取10具新鲜成年雄性家猪的脊柱标本,分两组观察鲁格氏棒经椎管行椎板固定和鲁格氏棒经横突椎板固定时,受破坏性屈曲力的数据,结果显示鲁格氏棒经椎管固定组在达1048.6（±20）N时,所固定的椎板发生骨折,部分钢丝断裂;鲁格氏棒经横突固定组达2058（±20）N时,仅发生棒弯曲,未发现任何部位骨折或钢丝断裂。临床治疗33例不稳定胸腰椎骨折脱位患者,术后X线片示骨折脱位复位满意,两周后患者可离床活动,随访2～2.5年未发现任何并发症。     

Self-selection of enrollers at the creation of a managed care organization

Factors affecting choice between a managed care organization(MCO) and a fee-for-service insurance plan were examined whenthe University of Geneva health insurance plan was transformedinto an MCO, in October 1992. A case-control study using a mailedquestionnaire (response rate 84%) was conducted to compare formermembers who joined the MCO (joiners, n=421) to former memberswho opted out in order to keep fee-for-service coverage (non-joiners,n=222). Non-joiners were more likely to be women (odds ratio(OR) from multivariate model was 1.15, p=0.50), to be born inSwitzerland (OR=2.04, p<0.01), to have an annual income >75,000Swiss francs (OR=2.00, p<0.01), to have a personal physician(OR=1.96, p<0.01) and to have consulted a specialist (OR=1.69,p=0.02) or used unconventional medicine (OR=4.59, p<0.01)in the past year. During the previous year, non-joiners hadmore health care visits than joiners (14.6 versus 9.1, p=0.01).Non-joiners reported better mental health and fewer complainedof persistent fatigue (OR=2.18, p=0.03). The choice of healthplan was strongly influenced by socio-demographic characteristics,past patterns of health services utilization and health status.The self-selection process was paradoxical: MCO joiners hadused fewer health care visits than non-joiners, but their self-reportedhealth status was worse. The differences we have observed betweenself-selected populations have important implications for thefinancial performance of competing health care delivery systems.     

猪胰细胞膜缩胆囊肽结合蛋白的纯化

从猪胰细胞膜提取、纯化得到一种缩胆囊肽（ＣＣＫ）结合蛋白，达电泳纯。经十二烷基硫酸钠聚丙烯酰胺凝胶电泳（ＳＤＳ－ＰＡＧＥ），其亚基分子量为４３．１×１０－２２ｋｇ。此结合蛋白与不同的ＣＣＫ－Ｓｅｐｈａｒｏｓｅ作用时显示，其与硫酸化ＣＣＫ－８、ＣＣＫ－８、硫酸化亮氨酸脑啡肽（Ｌｅｕ－ｅｎｋ）结合活性较大，而与ＣＣＫ－６、ＣＣＫ－４及Ｌｅｕ－ｅｎｋ结合活性较弱。说明ＣＣＫ羧基末端第七位上酪氨酸的硫酸化对ＣＣＫ结合活性有较大影响。并与ＣＣＫ肽链的长度有关。     

福氏志贺菌毒力蛋白IpaC的表达与纯化

目的表达和纯化福氏志贺菌毒力蛋白IpaC,研究福氏志贺菌的致病机制。方法将含有ipaC基因的pET32a-i-paC表达质粒载体转化大肠杆菌BL21(λDE3),在异丙基硫代-β-D半乳糖苷(IPTG)诱导下表达,对诱导后的表达产物进行SDS-PAGE鉴定,并采用QIA expressionistTM蛋白纯化系统来纯化目的蛋白。结果诱导后的表达产物经SDS-PAGE发现有一相对分子质量约为63 000的条带,其含量约占总蛋白量的11%,以350 mmol/L咪唑洗脱液洗脱,目的蛋白纯度可达90%以上。结论pET32a-ipaC重组表达质粒转入大肠杆菌后,可稳定、高效地表达目的蛋白,QIA-expressionistTM蛋白纯化系统是一种简便、高效的纯化系统,可获得高纯度的目的蛋白。     

The universal algorithm of maturation for secretory and excretory protein precursors.

During maturation, most proteins undergo different posttranslational modifications. In most simple cases, signal peptidases remove the signal or leader peptide from the precursors of the secretory proteins during their translocation across the ER membrane. For biologically active proteins, such as enzymes, regulatory and defense proteins, toxins, etc., additional maturation-regulating mechanisms were shown to proceed with limited proteolysis of inactive precursors by specific enzymes. A number of specific enzymes from different cell types selectively cleave proproteins at specific processing sites. In this work, we analyzed the sequences of protein precursors synthesized in the excretory glands of different animals and identified new, non-traditional processing sites. They differ from the motifs previously identified in secreted proteins' precursors and enabled us to reconstruct the sequence of events leading to the conversion of protein precursors into the final products (mature proteins). We also found that in animals, the maturation mechanism of secretory and excretory proteins and the set of enzymes involved are species specific. The processing sites identified in protein precursors in this study are useful for a more detailed genome analysis and more accurate mature protein sequence prediction.     

乳酸氧化酶分离纯化的研究

粪链球菌发酵液经菌体破壁、丙酮分级沉淀、硫酸铵盐析、DEAE-纤维素柱色谱,Sephadex G-150分子筛和 Sephadex A-50柱色谱等分离步骤,制得较纯的乳酸氧化酶,可用于酶盒测定。     

Expanding Our Strategies to Study the Process of Change

The conceptual and methodological framework proposed by Doss (this issue) makes valuable suggestions for strategic choices in future research. This commentary addresses conceptual and terminological distinctions adopted by Doss, as well as his criticism of add-on/ dismantling studies. We also suggest research topics and methodological developments that could be integrated in Doss's framework to further expand understanding of therapeutic change.