放射医学实习医生实际工作能力的培养

放射诊断实习是使影像学实习生成长为放射诊断专业人才的一个重要阶段,是实现理论与实践结合的重要教学实践模式。提高放射诊断实习质量,增强医学影像专业实习生的有关临床能力是临床教学中值得重视和思考的问题。丰富的学习资源,强调影像表现与临床、病理相结合以及X线、CT、MRI并重,加强阅片和操作技能的培养,强调临床辩证思维等方法有助于改善和提高放射诊断临床教学质量。     

Structural polymorphism of glycophorins demonstrated by immunoblotting techniques

We have explored the polymorphism of the glycophorin system in the human erythrocyte membrane using the immunoblotting techniques and examining 52 individuals selected without prior bias as to their serologic state and ten documented serologic variants of M, N, S, s blood group system. Polyclonal antisera to alpha glycophorin and to alpha glycophorin CNBr carboxyl terminal fragment C (residues 82-131) and M and N specific monoclonal antibodies (MoAbs) were used. The first two reagents detect specific regions of the alpha glycophorin molecule and all electrophoretically resolved species of glycophorins immunologically related to alpha and delta glycophorins (delta glycophorin, [alpha-delta] hybrids and other glycophorins with an alteration in the carboxyl terminal segment); the M and N MoAbs identified the glycophorin species containing or lacking the M or N determinant in the amino terminal octapeptide structures. We find that immunoblotting confirmed in all cases the serologically determined phenotype; we also find that polymorphic forms of the glycophorin system are relatively infrequent; immunoblotting, independent from serologic testing, was capable of detecting five mutants, two most likely S-s-U-phenotypes; a new glycophorin species was detected in normal red cells with both antiglycophorin and antipeptide C sera, which is not evident with MoAbs; immunoblots of known glycophorin variants (En(a-), U-, Mg, Mi I, II, III, V, and Sta) confirmed but also extended our knowledge of the abnormal glycophorins involved; and the He+ and Wrb(-) cells showed normal patterns.     

Orbital cellulitis: a review of 21 cases from Ibadan,Nigeria

This study was set up to review cases of orbital cellulitis admitted to the eye ward of our hospital between 1994 and 1998, and to compare the findings with similar studies. Twenty-one (14 males, 7 females, age range 45 days to 50 years [mean 13 years]) of 35 patients with an initial diagnosis of orbital cellulitis were reviewed (14 patients were excluded from the final analysis). Most of the cases were associated with pansinusitis, the commonest organism isolated being Staphylococcus aureus. All the patients were co-managed with ortorhinolaryngologists, and sometimes also with bacteriologists and paediatricians. Seventy-five per cent of the patients made a full recovery. Complications included orbital abscess (28.6%), optic atrophy (10%), cornea opacities (10%) and seizures (5%). Orbital cellulitis remains a childhood infection with potentially devastating consequences. There appears to have been a reduction not only in the number of cases admitted to the eye ward but also in the number and severity of complications. Prompt treatment and a multidisciplinary approach to management may be partly responsible for the improved outcome. This approach therefore needs to be encouraged.     

An anti-EnaTS detected in the serum of an MiI homozygote

The serum of EH reacted with all red cells (RBCs) except her own, ficin- or trypsin-treated red cells, and En(a-) red cells. This reactivity defined an anti-EnaTS specificity. The red cells of the proposita typed as M-N+S-S+, Vw+Mur-Hil-Hut-Anek-Lane-, Wr(a-b+), EnaKT+. Red cells of five relatives were Vw+ and positive with her serum. Titration studies suggest that EH is genetically an MiI homozygote and that her Vw+ relatives are MiI heterozygotes. There is no history of consanguinity. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting studies have agreed with the serologic observations. A variant sialoglycoprotein of faster mobility than normal glycoprotein A, but no normal glycoprotein A, was detected on her red cells. Treatment with N-glycanase did not alter the mobility, which indicated that there was no N-glycosylation of residue 26. These findings are in agreement with the reported properties of the Mi.I-specific glycoprotein A. The relatives' Vw+ red cells showed the variant sialoglycoprotein and normal glycoprotein A. EH appears to be the first reported MiI homozygote.     

Antibiotic resistance in bacteria - an emerging public health problem

The discovery and eventual introduction of anti-microbial agents to clinical medicine was one of the greatest medical triumphs of the twentieth century that revolutionized the treatment of bacterial diseases. However, the gradual emergence of populations of antibiotic-resistant bacteria resulting from use, misuse and outright abuse of antibiotics has today become a major public health problem of global proportions. This review paper examines the origins and molecular epidemiology of resistance genes, global picture of antibacterial resistance, factors that favour its spread, strategies for its control, problems of control and the consequences of failure to contain antibiotic resistance in bacteria.