咳喘患儿气管支气管异物的检出

气管支气管异物是引起小儿咳喘的重要原因之一。本文就X线诊断中的几点体会作了详细介绍,认为X线检查对气管支气管异物的诊断和治疗有极为重要的价值。     

赖型钩端螺旋体重组DNApCX7的特异性鉴定和限制性内切酶谱分析

本实验将赖型钩端螺旋体（简称钩体）ＤＮＡ基因库的克隆ｐＣＸ７制备成￣（３２）Ｐ－重组ＤＮＡ探针，对８个不同血清群的１７株问号状钩体、双曲钩体ＰａｔｏｃⅠ株以及细螺旋体３０５５株ＤＮＡ进行打点杂交；同时用１５种ＤＮＡ片断进行限制性内切酶谱分析。结果表明，该重组ＤＮＡ具有问号状钩体种（Ｓｐｅｃｉｅｓ）特异性，但与不同问号状钩体之间的同源性程度有差别；限制性内切酶谱分析发现ｐＣＸ７重组ＤＮＡ片段长约１．７ｋｂ，具有１个Ｂｇ１Ⅱ识别位点和３个ＢｓｔＢ１识别位点。     

双相气道内正压呼吸机在老年慢性阻塞性肺疾病康复期和急性肺水肿患者中的临床应用

应用双相气道内正压呼吸机（ＢｉＰＡＰ）对９例慢性阻塞性肺疾病（ＣＯＰＤ）康复期和呼吸衰竭稳定期进行临床观察发现，治疗后动脉血氧分压与治疗前相比显著升高（Ｐ＜０．０１）；肺活量及用力肺活量轻度升高；１例３次发生急性左心衰、急性肺水肿致急性呼衰患者治疗后，病情很快改善；１例阻塞性夜间睡眠呼吸暂停综合征者应用效果满意。该机应用简便、安全，对心率血压无明显影响，为ＣＯＰＤ康复期、急性左心衰兼肺水肿的治疗提供了新途径。     

Neurotrophin-like immunoreactivity in the human pre-term newborn, infant, and adult cerebellum

The immunohistochemical occurrence of the neurotrophin (NT) proteins nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-4 (NT-4), and neurotrophin-3 (NT-3) is shown in the pre-term newborn, infant, and adult human post-mortem cerebellum. The NT-like immunoreactive structures were unevenly distributed and showed regional differences among cerebellar lobules and folia. NGF-, NT-4-, and NT-3-positive neuronal perikarya were observed in all specimens examined. At variance with the other neurotrophins, the BDNF antiserum labelled neuronal cell bodies only in newborn life and infancy, as well as extensive nerve fibre systems, whose density increased with age. The NT-antibodies, tested by Western blot on human cerebellum homogenates, revealed immunoreactive bands corresponding to proteins of heterogenous molecular weight. The results obtained provide a first demonstration of the tissue localization of the NTs in the human cerebellum from perinatal to adult age, thus suggesting their involvement in the development, differentiation and maintenance of the cerebellar connectivity. Codistribution of the four NTs or sets of them was observed in cortical and deep nuclei neurons. Multiple trophic roles for NTs, encompassing the classic target-derived and local mechanisms of support, are envisaged as significant in development, differentiation, and maintenance of the human cerebellar connectivity.     

Foreign body aspiration in children. The diagnostic value of signs,symptoms and pre-operative examination

One hundred and fifteen patients, between 6 months and 12 years of age, had bronchoscopy on suspicion of foreign body aspiration. The histories of these patients were studied to examine the diagnostic value of signs, symptoms and examinations, and to determine the time that passed between aspiration and removal of the foreign body. The sensitivity of the symptoms choking and coughing was fairly high (81 and 78%), but the specificity was poor. The sensitivity of a chest radiograph was 82%, the specificity 44%. The sensitivity of radiographs on inspiration and expiration was 80%, the specificity 55%. The patients had been referred with the initial diagnosis foreign body aspiration (80), pneumonia (34), or subglottic laryngitis (1). In 85 patients a foreign body was identified and extracted. The other 30 patients had respiratory tract infections. The initial diagnosis of foreign body aspiration was correct in 61 out of 85 patients. In these cases, the period between aspiration and extraction of the foreign body was a mean 6 days, compared with 55 days, if the initial diagnosis was pneumonia or sub-glottic laryngitis. We conclude that the diagnosis of foreign body aspiration is too often missed, and that, apart from bronchoscopy, diagnostic tools are of little value.     

Worksite health promotion programs in the United States: progress, lessons and challenges

Worksite health promotion programs have become increasinglyprevalent in the United States, and one or more health promotionprograms are found in two-thirds of all private worksites with50 or more employees. Reasons for recent growth in program frequencyinclude increased concern for worker health, rapidly escalatingemployer payments for health care benefits to workers, and growingevidence of a strong linkage between employee health and productivity.Published results of evaluations to date suggest that worksitehealth promotion programs can have positive impacts on healthbehaviors and health status. In addition, economic analysesare suggesting that some programs can affect the slope of healthcare costs and have the potential of high cost-effectivenesscompared to some clinical interventions. A number of researchchallenges remain, particularly understanding the influencesof the worksite environment and how employee health promotionprograms affect individual and organizational productivity.     

中西医结合治疗肺心病心律失常40例疗效观察

为提高肺心病心律失常的临床疗效,采用中药清肺化痰活血剂配合抗菌素及氧疗法对40例肺心病并发心律失常患者进行了治疗观察,同时与单纯使用抗菌素及氧疗法治疗的40例患者进行对照。临床以心电图改善情况为观察指标,结果两组有效率分别为87.5％和67.5％。Ridit分析结果表明,治疗组疗效明显优于对照组,经显著性检验,两组差异显著(P<0.05)。     

小柴胡汤口服液药效作用的研究

观察了小柴胡汤口服液的主要药理作用。研究表明,小柴胡汤口服液有显著抑制角叉菜胶诱发的大鼠踝关节水肿(p<0.05),保护四氯化碳所致的大鼠急性肝功能损害,有极显著降低血清SGPT及LDH的作用(P<0.01)。对家兔发热反应也有较好的抑制作用。此外,小柴胡汤口服液对小鼠兔疫反应也有一定的增强作用,可促进小鼠碳粒廓清速率,提高血清溶血素水平及增强鸡红细胞所致的迟发性过敏反应。     

Education in family and community health: the challenge faced by a new medical school

This paper describes the efforts of the Department of Family and Community Health at Sultan Qaboos University in providing opportunities for the development of 'hands-on' problem-solving skills appropriate for Oman. The curriculum of the Department is discussed, highlighting the unusual emphasis of this discipline in both the preclinical and clinical curriculum of the College of Medicine. The importance of continuous assessment and supervision of students is discussed. Course-work in the preclinical curriculum of the Department is kept to a minimum. Field-work forms an important part of preclinical training, where application and problem-based learning are emphasized. During the clinical years the students are exposed to an integrated series of lectures and practicals covering core knowledge in clinical medicine. Practical clinical training, over a total period of 15 weeks, takes place at a variety of sites where common problems in primary health care in Oman are handled by students under supervision.