白细胞介素-6与2型糖尿病发生的研究进展

白细胞介素 - 6 (IL - 6 )是一种多功能的细胞因子。 IL - 6的升高可通过激活急性相反应影响 2型糖尿病的发病 ,并可通过与胰岛素、瘦素的相互作用与 2型糖尿病的发生相关联     

从国外经验看我国医学生的医患沟通教育

科学技术飞速发展的社会充满了机遇与挑战,也对人才提出了更高的要求。当代医学生不仅要具有专业理论知识和专业技能,还必须具备较高的情商水平才能适应现代医学发展的需要。这就要求医学院校重视和加强医学生的情商教育,只有这样才能培养出真正的合格人才。     

医学生医患沟通教育的目标与模式研究

结合国外医患沟通教育的经验及国内医患沟通教育现状，对医患沟通教育的目标、模式、内容进行探讨，对我国医学院校的教学改革及医学人才的培养提供建议。     

从国外经验看我国医学生的医患沟通教育

本文结合国外医学生医患沟通教育的经验及国内医学生医患沟通教育的现状,对我国医学生医患沟通教育的改革提出了建议,期望能够对医学院校的教学改革及人才培养有所参考.     

An evaluation of leflunomide in the treatment of class Ⅴ lupus nephritis

Objective To investigate the efficacy and safety of leflunomide as induction and mainten-ance therapy for class Ⅴ lupus nephritis. Methods Sixteen patients with lupus nephritis (of which, three proven with Ⅴ +Ⅲ, six with Ⅴ+Ⅳ ), proven by renal biopsies, were included in this study. ALL patients rec-eived LEF plus prednisone treatment. For induction therapy, all patients were given an initial loading dose of LEF 60 mg daily for three days, followed by 20 mg daily for the whole induction treatment period. Prednisone was given starting from 0.8 mg per kilogram daily, then tapered four weeks later. After twenty-four weeks, the dosages of LEF and prednisone were 10 mg/d, 5～10 mg/d respectively during maintenance therapy. We asses-sed total remission rates in the end of twenty-four weeks, as well as the changes of system lupus erythematosus disease activity index (SLEDAI), urinary protein per twenty-four hours (24 h Upr), serum albumin, serum creatinine level, complement C3, complement C4, C reactive protein, serum titer of ANA and anti-dsDNA be-fore treatment, 12 weeks, 24 weeks and 48 weeks after treatment respectively. Meanwhile, seven patients received repeated renal biopsies after completing induction therapy, so we compared pathological activity index (AI) and chroniciry index (CI) between pre-therapy and post-therapy at the same time. T and t' test were selected. Results Sixteen patients were followed-up. After 24 weeks induction therapy, the total remission rate was 75.0%; SLEDAI was significantly lower than pre-therapy [(15.4±3.5) vs (6.9±1.7), P<0.05]; 24 h Upr was also significantly lower than pre-therapy [(5.8±2.2) g vs (l.3±0.5) g, P<0.01 ]. Unfortunately, all seven patients performed repeated renal biopsies with class Ⅴ lupus nephritis again histologically, of which two were transformed other cater-ofies. Comparing with that of pre-therapy, AI was improved after therapy [(2.4±0.9) vs (1.7±0.8), P<0.05]. However, CI indicated no difference. Adverse events including major infection occurred in four patients. The adverse events happened at the 12 th week after treatment. Conclusion The efficacy of LEF plus corticoster-oids as induction and maintenance therapy for class Ⅴ lupus nephritis is remarkable and the tolerance of patients is good.     

头痛宁胶囊治疗丛集性头痛临床观察

丛集性头痛是一种具有反复密集发作的剧烈头痛和神经血管功能障碍在一侧眶周部的严重疾病。常在1d内固定时间发作,持续数周。其发病可能与丘脑下部的功能障碍导致5-羟色胺（5-HT）能介质的异常有关。2006年5月～2008年5月,我们采用头痛宁胶囊治疗丛集性头痛患者36例,效果较好。现报告如下。     

从国外经验看我国医学生的医患沟通教育

本文结合国外医学生医患沟通教育的经验及国内医学生医患沟通教育的现状,对我国医学生医患沟通教育的改革提出了建议,期望能够对医学院校的教学改革及人才培养有所参考.     

An evaluation of leflunomide in the treatment of class Ⅴ lupus nephritis

Objective To investigate the efficacy and safety of leflunomide as induction and mainten-ance therapy for class Ⅴ lupus nephritis. Methods Sixteen patients with lupus nephritis (of which, three proven with Ⅴ +Ⅲ, six with Ⅴ+Ⅳ ), proven by renal biopsies, were included in this study. ALL patients rec-eived LEF plus prednisone treatment. For induction therapy, all patients were given an initial loading dose of LEF 60 mg daily for three days, followed by 20 mg daily for the whole induction treatment period. Prednisone was given starting from 0.8 mg per kilogram daily, then tapered four weeks later. After twenty-four weeks, the dosages of LEF and prednisone were 10 mg/d, 5～10 mg/d respectively during maintenance therapy. We asses-sed total remission rates in the end of twenty-four weeks, as well as the changes of system lupus erythematosus disease activity index (SLEDAI), urinary protein per twenty-four hours (24 h Upr), serum albumin, serum creatinine level, complement C3, complement C4, C reactive protein, serum titer of ANA and anti-dsDNA be-fore treatment, 12 weeks, 24 weeks and 48 weeks after treatment respectively. Meanwhile, seven patients received repeated renal biopsies after completing induction therapy, so we compared pathological activity index (AI) and chroniciry index (CI) between pre-therapy and post-therapy at the same time. T and t' test were selected. Results Sixteen patients were followed-up. After 24 weeks induction therapy, the total remission rate was 75.0%; SLEDAI was significantly lower than pre-therapy [(15.4±3.5) vs (6.9±1.7), P<0.05]; 24 h Upr was also significantly lower than pre-therapy [(5.8±2.2) g vs (l.3±0.5) g, P<0.01 ]. Unfortunately, all seven patients performed repeated renal biopsies with class Ⅴ lupus nephritis again histologically, of which two were transformed other cater-ofies. Comparing with that of pre-therapy, AI was improved after therapy [(2.4±0.9) vs (1.7±0.8), P<0.05]. However, CI indicated no difference. Adverse events including major infection occurred in four patients. The adverse events happened at the 12 th week after treatment. Conclusion The efficacy of LEF plus corticoster-oids as induction and maintenance therapy for class Ⅴ lupus nephritis is remarkable and the tolerance of patients is good.     

初发系统性红斑狼疮患者外周血单核细胞RORγt基因和Foxp3基因的表达

目的通过研究系统性红斑狼疮（systemic lupuseryth ematosus,SLE）患者外周血单核细胞RORγt基因和Foxp3基因的表达,了解两种基因的关系及其对SLE发病的影响,探讨SLE的可能发病机制。方法选取21～40岁初发SLE患者39例为研究对象,同时选取同年龄组33名健康女性作为对照组。荧光实时定量PCR检测外周血单核细胞RORγt基因和Foxp3基因的表达情况。结果（1）SLE组外周血单核细胞RORγt基因和Foxp3基因表达均显著高于正常对照组;（2）SLE患者外周血单核细胞RORγt基因和Foxp3基因表达呈显著正相关。结论SLE的发生与RORγt基因和Foxp3基因表达的升高有关,两种基因的相互作用导致的免疫失衡是引起SLE发生的原因之一。