• 2007年第3期文章目次
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    • >南京医科大学学报(英文版)
    • Recent advancement on autoantigens, autoantibodies and inflammatory cells in subepidermal autoimmune bullous diseases

      2007(3):129-133. DOI: 10.7655

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      摘要:Subepidermal autoimmune bullous diseases (SABD) are some autoimmune skin diseases that can present in a variety of forms and can be a challenging disease to treat. An overview of the different forms of SABD are discussed including bullous pemphigoid (BP), epidermolysis bullosa acquisita (EBA), cicatricial pemphigoid (CP), bullous systemic lupus erythematosus (BSLE), and Anti-p200 pemphigoid. Emphasis on recent advancement is presented. In recent years, improved knowledge of the mechanisms of intercellular and cell-matrix adhesion has led to better understanding of the blistering process in some SABD. Defects of such structures cause the subepidermal bullous diseases and have also led to the discovery of new diseases (e.g. anti-p200-pemphigoid). Recent studies have outlined the important role of autoantibodies, mast cell lymphocytes and their cytokines in pathogenesis of SABD.

    • Construction of Smac gene-containing and human prostate specific antigen promoter-regulated vector and its expression

      2007(3):134-138. DOI: 10.7655

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      摘要:Objective: To construct an eukaryotic expression vector containing Smac gene and study the expression efficiency and specificity of prostate specific antigen(PSA) enhancer/promoter in a possible targeted gene therapy scheme for prostate cancer. Methods: PSA enhancer(PSAE) and promoter(PSAP) sequences were amplified using PCR method. CMV and T7 promoters were deleted from pcDNA3.1-Smac and replaced by the two specific fragments to generate pPSAE-PSAP-Smac. After transfection into different cell lines, the status of cells was observed. And then, we determined the relative concentration of Smac mRNA in RT-PCR. Results: The recombinant plasmid of pPSAE-PSAP-Smac was successfully constructed. And only the prostate cancer cell line PC-3 was suppressed after transfection with pPSAE-PSAP-Smac. However, other nonprostate lines were not. Moreover, the concentration of Smac mRNA regulated by PSA promoter and enhancer was higher in comparison to the CMV promoter-driven control vectors. Conclusion: An expression vector containing the Smac gene (based on elements of the PSA gene regulatory sequences) has been developed and shown to function in prostate cancer cell lines which provides a solid platform for launching clinical studies.

    • Predictors of post coronary artery bypass grafting atrial fibrillation

      2007(3):139-142. DOI: 10.7655

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      摘要:Objective: To investigate the incidence and relative risk factors of post coronary artery bypass grafting(post-CABG) atrial fibrillation(AF). Methods: 312 patients with CABG were reviewed and divided into an AF group and a non-AF group. Statistical analysis was used to compare the data between the two groups and screen for risk factors of post-CABG AF. Results: 103/312 (33.01%) patients developed post-CABG AF. Univariate analysis showed that patients in AF group compared with those in non-AF group were more likely to have advanced age (≥70 years), early postoperative withdrawal of β-blockers, hypertension, left atrial enlargement (≥40 mm), a history of AF, prolonged p-wave duration (≥120 ms) and increased number of grafts (≥3). Multivariate logistic regression analysis showed that advanced age (≥70 years), early postoperative withdrawal of β-blockers, hypertension, left atrial enlargement (≥40 mm) and a history of AF were highly related to post-CABG AF. Conclusion: The incidence of AF in patients following CABG was 33.01% in this study. Advanced age, early postoperative withdrawal of β-blockers, hypertension, left atrial enlargement and a history of AF were independent risk factors of post-CABG AF.

    • Acute and mid-term results of pecutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy

      2007(3):143-146. DOI: 10.7655

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      摘要:Objective: To assess the acute and mid-term results of cardiac function improvements and left ventricular outflow tract gradient (LVOTG)changes in 30 patients displaying hypertrophic obstructive cardiomyopathy (HOCM) treated with percutaneous transluminal septal myocardial ablation(PTSMA). Methods: PTSMA was intended for 32 patients comprising of 13 women and 19 men(average years being 54.1 ± 15.5) to be treated in accordance with the following inclusion criteria: The New York Heart Association(NYHA) definition for cardiac functional class III or IV ,or class II but for whom medical therapies were not tolerated or with syncope; intraventricular septal(IVS) and left ventricular posterior wall(LVPW) hypertrophy asymmetrically associated with ratio of IVS to LVPW≥1.3 and LVOTG≥50 mm Hg at rest or ≥100 mm Hg at provocation(Valsalva maneuver). The target vessels were determined by coronary arteriography that demonstrated more than one septal branch and probatory balloon occlusion produced greater than 50% decrease of LVOTG . Once the target vessel established, the alcohol was administrated into septal ventricular via over-the-wire balloon. LVOTG was assessed by means of echocardiography measurements immediately after procedure and 3 months. Simultaneously, cardiac function class was also evaluated. Results: Two patients were abandoned prior to intervention due to inappropriate septal target vessels and DDD Pacemakers were chosed. Immediately after the procedure, resting LVOTG was reduced from 73.8 ± 35.5 to 16.6 ± 7.8 mmHg, at provocation LVOTG from 149.3 ± 42.5 to 61.9 ± 43.0 mmHg(P < 0.0001 each) by echocardiography measurements. After 3 months, the mean New York Heart Association class was reduced from 2.8 ± 0.6 to 1.1 ± 1.0(P < 0.0001) and the LVOTG also remained decrease(28.5 ± 6.4 mmHg at rest and 75.3 ± 11.6 mmHg at provocation). Conclusion: PTSMA is a promising nonsurgical technique for relief of symptoms and reduction of LVOTG in hypertrophic obstructive cardiomyopathy.

    • Relationship between matrix metalloproteinase-9 polymorphism and acute coronary syndrome

      2007(3):147-150. DOI: 10.7655

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      摘要:Objective: To investigate the relationship of matrix metalloproteinase-9 polymorphism to acute coronary syndrome and its affect on the severity of coronary artery disease. Methods: By means of polymerase chain reaction(PCR) and restriction fragment length polymorphism, genotypes of 245 patients with acute coronary syndrome(ACS) and 205 healthy subjects were tested. Genotypes displaying C-1562T functional promoter polymorphism(of the MMP-9 gene) were determined. The relationship between the polymorphism of the MMP-9 gene and ACS and the severity of coronary vessels diseased was analyzed. Results: The frequency of C/T plus T/T genotypes and T allele in patients with ACS was significantly higher than that in healthy subjects(22.1% vs 12.7% and 11.4% vs 6.6% respectively). But they were not associated with the number of coronary arteries diseased. Conclusion: The MMP-9 polymorphism may be susceptible to ACS. But there was not significant difference between the AMI and UAP subgroups.

    • Application of a new-type sutureless anastomosis stent to the primary reconstruction of the bilioenteric continuity after acute bile duct injury in dogs

      2007(3):151-154. DOI: 10.7655

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      摘要:Objective: To evaluate the effect of a new-type sutureless magnetic bilioenteric anastomosis stent that was used to reconstruct the bilioenteric continuity(primarily under the circumstances of severe inflammation after acute bile duct injury in dogs). Methods: Establishing an animal model of acute bile duct injury with severe inflammation and bile peritonitis in dogs. The new-type sutureless magnetic bilioenteric anastomosis stent was used to reconstruct the bilioenteric continuity primarily. Results: The experiment group anastomosis healed well with a mild local inflammation reaction, and the collagen lined up in order without the occurrence of observable bile leakage and infection. Conclusion: It was safe and feasible to use the new-type anastomosis stent to reconstruct the bilioenteric continuity primarily under the circumstances of severe inflammation after acute bile duct injury in dogs.

    • The effect of spinal cord injury on the expression of TGF-β and TNF-α in rat articular cartilage

      2007(3):155-158. DOI: 10.7655

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      摘要:Objective: To observe the expression of TGF-β and TNF-α in the spinal cord injured rat model and discuss the significance of the articular cartilage metabolism. Methods: 36 SD female rats were randomly divided into 2 groups: Rats models of spinal cord injury were implemented by Allen method. T10 laminectomy was performed in the control group. Both groups of rats were killed respectively in 1w, 3w and 6w. Hematoxylin-eosin stain was given to each slice in the model group and control group. Immunohistochemical stain was applied by using ABC method in the expression of TGF-β and TNF-α. Those expressed level were performed in image analysis and statistics process. Results: TGF-β and TNF-α were mainly distributed on the surface layer of the articular cartilage, with a weak expression in control group. The expression of TNF-α in the model group was more significant than that in the control group in the 1w, and still remained an evident difference with that in control group until the 6w(P < 0.05). TGF-β expression of the model group had no remarkable difference with the control group in the 1w(P > 0.05) and prominently became stronger at 6w(P < 0.05). Conclusion: The expression of TNF-α occurred early in the development of spinal cord injury, and the expression of TGF-β became stronger with the revival of spinal neural function. Both expressions were strengthened in articular cartilage in the 3rd week.

    • Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

      2007(3):159-164. DOI: 10.7655

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      摘要:Objective: To explore the role of matrix metalloproteinase-1,2(MMP-1, MMP-2) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in endometriosis. Methods: The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular endometria from 40 subjects(excluding endometriosis) were collected and examined by in situ hybridization technology and western blot assay. Results: Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant(P < 0.01). Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion: The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.

    • The investigation for the relationship among serum leptin, erythrocyte membrane Ca2+-ATPase activity and hypertensive disorder complicating pregnancy

      2007(3):165-168. DOI: 10.7655

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      摘要:Objective: To study the significance of Leptin and the activity of erythrocyte membrane Ca2+-ATPase(EMCA) in the development of hypertensive disorder complicating pregnancy. Methods: Radioimmunoassay was used to test the level of serum Leptin,and the activity of EMCA was determined chemically in 38 pregnant women with hypertensive disorder complicating pregnancy and 36 normotensive pregnant women. Results: The level of serum Leptin in hypertensive disorder complicating pregnancy(gestational hypertension: 13.76 ± 3.46 ng/ml; preeclampsia:15.76 ± 5.47 ng/ml; eclampsia: 18.32 ± 6.38 ng/ml)was significantly higher than that in normotensive pregnant women(11.33 ± 2.93 ng/ml),respectively. The average EMCA activity of patients with hypertensive disorder complicating pregnancy(gestational hypertension:1.65 ± 0.24 μmol·pi/mg·h ; preeclampsia:1.37 ± 0.19 μ mol·pi/mg·h; eclampsia:1.12 ± 0.14 μ mol·pi/mg·h) was significantly lower than that of normotensive pregnant women(1.83 ± 0.38 μ mol·pi/mg·h),respectively. There was a negative correlation between the level of serum Leptin and the activity of RMCA in hypertensive disorder complicating pregnancy(r = -0.63). Conclusion: Inhibition of EMCA activity of erythrocyte in hypertensive disorder complicating pregnancy may increase cytoplasmic free calcium, which contributes to the development of hypertensive disorder complicating pregnancy. The negative correlation between the level of serum Leptin and the activity of EMCA, also suggested that serum Leptin and the activity of EMCA may play a role in the development of hypertensive disorder complicating pregnancy.

    • Effects of IL-4 on cyclooxygenase-2 and platelet-derived growth factor in the lungs of COPD rats

      2007(3):169-174. DOI: 10.7655

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      摘要:Objective: To explore the role of interleukin 4(IL-4), expressions of cyclooxygenase-2 (COX-2) and platelet-derived growth factor(PDGF) in the model of chronic obstructive pulmonary disease(COPD), in the lungs of rats. Methods: Male Wistar rats were used to build up the model of COPD. Rats were randomly divided into the control group and model group, the IL-4 group and the dexamethasone group. The expressions of COX-2, PDGF-A and PDGF-B in the lung tissue were detected by western blotting and RT-PCR. Results: The expressions of COX-2, PDGF-A and PDGF-B in the model group were increased significantly. Those expressions in the IL-4 and dexamethasone group were notably decreased. Conclusion: IL-4 and dexamethasone could interfere in the establishment of COPD. The expressions of COX-2 and PDGF in the lung tissue of COPD were increased significantly and IL-4 and dexamethasone could decrease those expressions.

    • Effects of connective tissue growth factor and collagen type Ⅰ scleroderma

      2007(3):175-179. DOI: 10.7655

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      摘要:Objective: To investigate the effects of connective tissue growth factor(CTGF) and collagen type I(COL-I) on the pathogenesis of scleroderma and explore the relationship between the level of COL-I and CTGF. Methods: 12 mice model of scleroderma was established by the injection of Bleomycin. The level of CTGF and COL-I were detected by immunohistochemical method. The relationship was analyzed between CTGF and COL-I level. As control group, 12 healthy mice were selected. Results: The levels of CTGF and COL-I in sclerotic models were higher than in normal controls(P < 0.05). It was found that there was a correlation between the level of CTGF and COL-I. Conclusion: CTGF and COL-I played an important role in the hardening process of the skin lesions of the mice model, which may be involved in the pathogenesis of scleroderma.

    • Detecting drug resistant genetic mutation among pneumoconiosis patients complicated with tuberculosis in Mycobacterium tuberculosis L-forms application of PCR-SSCP technique in Huainan mining district

      2007(3):180-184. DOI: 10.7655

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      摘要:Objective: To study the relationship between drug resistant genetic mutation and drug resistance in Mycobacterium tuberculosis L-form, discuss the internal relationship between drug resistances and drug-resistant related genes and explore the value of PCR-SSCP to clinical application. Methods: A total of 52 clinically isolated strains of tuberculosis L-form were collected among 97 pneumoconiosis patients complicated with tuberculosis. The gene mutations of katG, rpoB and rpsL were detected by PCR-SSCP, and the results were compared with those analyzed by traditional antimicrobial susceptibility test(AST). Results: The gene mutation rates of katG, rpoB and rpsL by PCR-SSCP were respectively 57.70%(30/52), 65.38%(32/52) and 40.38%(21/52). The rate of reversion was 78.85%(41/52) and the result of drug-resistant genes was invariable. The results of AST showed that there were 40(76.92%) multi-drug resistant strains in 52 clinically isolated strains. The number for three-drug resistant strain was 21(40.38%) and that of two-drug resistant was 19(36.54%), but only 12(23.08%) strains were one drug resistant. The rate of total drug-resistance was 100%, but there were 15 strains of allied mutation of three genes, 16 of two mutations and 6 of only one by PCR-SSCP. The coincidences were respectively 71.43%, 84.12% and 50.00%. Then there was no significant difference between the allied mutations of multi-drug resistant gene and the mutations of only one drug resistant gene(P > 0.05). Conclusion: PCR-SSCP technique has a higher sensibility and specificity to detect the genes of katG, rpoB and rpsL in tuberculosis L-form among pneumoconiosis complicated with tuberculosis,and the detecting rate of two drug resistant strains and three drug resistant strains was higher. The combined application of PCR-SSCP and AST has advantages at earlier diagnosis and guidance of clinical medications.

    • >南京医科大学学报(社会科学版)
    • 试论医疗行为的违法阻却事由

      2007(3):181-185. DOI: 10.7655

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      摘要:两害相权取其轻,两利相权取其重。特殊的民事行为有两种:一种是需要从严管束(制约)的民事行为,如环境污染、高危作业、产品缺陷等引起的人身损害行为;另一种特殊的民事行为通常是指国家特别需要的或者能直接为民众带来好处的公益行为,应当从轻或者可以免责的民事行为,如科学试验、见义勇为、救死扶伤、城市公共交通、社会福利等。最高人民法院《关于参照〈医疗事故处理条例〉审理医疗纠纷民事案件的通知》和对医事诉讼适用举证倒置的规则,则是从反面错误理解了“医疗行为的特殊性”的典型例子,从而人为造成了医患关系的紧张,严重阻碍了我国医学事业的发展。故对医疗行为的违法阻却研究便显得十分必要与紧迫。

    • >南京医科大学学报(英文版)
    • Purified protein derivative skin testing on HIV/AIDS patients and logistic regression analysis of its risk factors

      2007(3):185-189. DOI: 10.7655

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      摘要:Objective: To understand the reactivity of purified protein derivative skin test(PPD test) in HIV-infected persons and to determine the influential factors associated with PPD. Methods: 174 HIV/AIDS patients registered in the local center for disease control and prevention(CDC) participated this study from April to June in 2006. Questionnaire,CD4 count and thoracic roentgenogram were performed for all participants. Results: In this study, response rate of questionnaires was 83.65%. The majority of these participants had a different degree of immunodeficiency that accounted for 93.64%. Female patients had a higher CD4 count than that of males. The total positive rate of PPD was 38.15%. Analysis of single factor in our study indicated that CD4 count, previous tuberculosis history, tuberculosis contact history and thoracic roentgenogram manifestation of patients were related to their PPD diameters. Further analysis of multiple factors also supports the previous conclusion that CD4 count and previous tuberculosis history of patients were risk factors in the PPD test. Conclusion: The PPD test of HIV/AIDS patients could be affected by several factors. For persons infected with HIV, the confirmation of latent tuberculosis infection (LTBI) should be considered the combination effect of previous MTB infection and body cellular immune function.

    • >南京医科大学学报(社会科学版)
    • 医疗纠纷案件中行业规范与法律规范之冲突

      2007(3):186-189. DOI: 10.7655

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      摘要:在医疗纠纷案件中,医疗行业规范和法律规范,无论在观念及思维方式上,还是在对医疗责任的认定和理解上,都存在着冲突和差异,增加了案件审理的难度。文章分析了医疗行业规范和法律规范两者间的冲突表现,并究其原因,提出解决这种冲突的方法,最大限度地平衡医患双方的利益。

    • 机会丧失原则探析

      2007(3):190-193. DOI: 10.7655

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      摘要:在患者罹患的是治愈率比较低的疾病的情况下,且医疗过程中又遭遇了医生的疏忽,最终造成患者死亡或者其他后果。根据传统因果关系法则,患者无法证明所遭遇的损害是因为医生的过失所造成的,故难以获赔。鉴于这种案件的不公正性,有学者提出了机会丧失原则。在该框架内,单纯机会丧失学说是在没有改变传统因果关系判断法则和证明中盖然性要求的前提下,转变因果关系之“果”的概念,认为机会的丧失是一种损害,使得事实因果关系易于成立,给予患者合理的救济。美国随后的司法实践中,衍生出不同的解决方法,分别出现了降低盖然性要求的“实质可能性说”和改变传统因果关系法则的“比例因果关系”学说。文章就机会丧失原则进行理论分析,给我国司法界在处理类似医疗纠纷时提供借鉴和参考。

    • >南京医科大学学报(英文版)
    • The diagnostic rules of peripheral lung cancer preliminary study based on data mining technique

      2007(3):190-195. DOI: 10.7655

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      摘要:Objective: To discuss the clinical and imaging diagnostic rules of peripheral lung cancer by data mining technique, and to explore new ideas in the diagnosis of peripheral lung cancer, and to obtain early-stage technology and knowledge support of computer-aided detecting(CAD). Methods: 58 cases of peripheral lung cancer confirmed by clinical pathology were collected. The data were imported into the database after the standardization of the clinical and CT findings attributes were identified. The data was studied comparatively based on Association Rules (AR) of the knowledge discovery process and the Rough Set (RS) reduction algorithm and Genetic Algorithm(GA) of the generic data analysis tool (ROSETTA), respectively. Results: The genetic classification algorithm of ROSETTA generates 5 000 or so diagnosis rules. The RS reduction algorithm of Johnson`s Algorithm generates 51 diagnosis rules and the AR algorithm generates 123 diagnosis rules. Three data mining methods basically consider gender, age, cough, location, lobulation sign, shape, ground-glass density attributes as the main basis for the diagnosis of peripheral lung cancer. Conclusion: These diagnosis rules for peripheral lung cancer with three data mining technology is same as clinical diagnostic rules, and these rules also can be used to build the knowledge base of expert system. This study demonstrated the potential values of data mining technology in clinical imaging diagnosis and differential diagnosis.

    • >南京医科大学学报(社会科学版)
    • 缺陷产品召回制度的民法解析

      2007(3):195-197. DOI: 10.7655

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      摘要:传统产品责任制度只能在产品不符合国家、行业标准或已经造成实际损害的前提下才可以进行退货、修理、赔偿等,已经不足以达到对消费者的保护。缺陷产品召回制度的出现,从某种程度上讲是对产品责任制度的扩张,只要产品存在危及他人人身、财产的不合理危险就可以采取召回措施,更有利于保护消费者的合法权益。文章试图厘清缺陷产品召回制度的基本内涵,以合同法和侵权法为理论基础,从实施主体、归责原则等方面对缺陷产品召回制度做出初步架构。

    • >南京医科大学学报(英文版)
    • Valves replacement operation in treatment of electrical storm induced by rheumatic valves disease

      2007(3):196-199. DOI: 10.7655

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      摘要:Objective: To present a case of electrical storm (ES) in a female patient with rheumatic valve disease. Methods: A female patient with severe rheumatic valve disease suffered an unexpected ES. She received more than 50 electrical shocks for repeated cardiac arrests due to ES over 16 hours. Then she received beta-blocking agent treatment and had an operation of double valves replacement. Results: ES was suppressed by sympathetic blockade with beta-receptor blocker and finally disappeared after the double pathological valves had been replaced. Conclusion: Increased sympathetic activity plays an important role in the genesis of electrical storm and sympathetic blockade may effectively suppress ES. However, the most important thing in the treatment of ES is to identify and eliminate the underlying cause of ES.

    • >南京医科大学学报(社会科学版)
    • 上海市崇明县农民健康认知调查与农村健康促进策略初探

      2007(3):207-210. DOI: 10.7655

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      摘要:目的:了解崇明县当前农民的健康知识知晓率、行为形成率及健康需求,探索适合在农村开展的健康促进策略。方法:采用单纯随机抽样方法,对500名农民进行入户问卷调查。结果:崇明县农民对常见病防治的知晓率较高,对健康生活方式的掌握也较好,但对慢性病和新疾病认识不足。农民认为影响自身健康最大的因素为“收入状况”, 主要倾向于通过书报、杂志、电视、网络等媒体获取相关知识。结论:整合多种宣传渠道和大众媒体,协调各相关部门共同就农民健康促进项目进行有效配合与提供有利支撑和联动机制,共同推进农民健康促进。

    • >南京医科大学学报(自然科学版)
    • EB病毒潜伏膜蛋白2A胞外区重组基因在大肠杆菌中的表达及其在血清学检测中的应用

      2007(3):209-212. DOI: 10.7655

      摘要 (1979) HTML (62) PDF 0.00 Byte (170) 评论 (0) 收藏

      摘要:目的:构建EB病毒潜伏膜蛋白2A(LMP2A)胞外区重组基因的表达载体在大肠杆菌中表达,并将表达的蛋白用于EB病毒相关鼻咽癌(NPC)患者的血清学检测。方法:用BamHⅠ和EcoRⅠ将含LMP2A胞外区重组基因的质粒pEC2A双酶切后,克隆到pET32a中。重组质粒经PCR、酶切鉴定、核酸序列分析后转化大肠杆菌(E.coli)BL21,以异丙基硫代-β-D-半乳糖苷(IPTG)诱导表达融合蛋白,表达的蛋白经镍柱亲和层析纯化,并用Western blot法检测其抗原活性。用纯化的蛋白进行鼻咽癌患者血清学检测。结果: 重组表达质粒经PCR及酶切鉴定为阳性,核酸序列分析正确。SDS-PAGE和Western blot 结果显示表达的重组蛋白分子质量约为40 ku。以此为抗原能在鼻咽癌患者血清中检测到特异性的抗体。结论:成功获得了LMP2A胞外区重组基因表达的蛋白,纯化的蛋白可用于EBV相关鼻咽癌患者的血清学检测。

    • >南京医科大学学报(社会科学版)
    • 艾滋病防治中的伦理问题刍议

      2007(3):211-214. DOI: 10.7655

      摘要 (1786) HTML (55) PDF 0.00 Byte (126) 评论 (0) 收藏

      摘要:艾滋病(AIDS)不仅仅是一个医学问题,也是一个社会问题。它的流行给医学伦理学带来了前所未有的冲击和挑战。文章对我国AIDS防治工作中遇到的一些伦理问题进行了分析,并提出了自己的观点和建议,同时也呼吁全社会为HIV/AIDS人群创造一个宽容的伦理关爱环境,有效遏止AIDS的流行。

    • >南京医科大学学报(自然科学版)
    • 前列腺素E2对胆管上皮癌细胞增殖的影响

      2007(3):213-215. DOI: 10.7655

      摘要 (2292) HTML (52) PDF 0.00 Byte (135) 评论 (0) 收藏

      摘要:目的:探讨前列腺素E2(prostaglandin E2,PGE2)对胆管上皮癌细胞增殖的影响及其可能机制。方法:体外培养胆管上皮癌细胞株(HuCCT1),给予外源PGE2处理,以WST-1细胞增殖实验检测肿瘤细胞增殖率;Fluo-3/AM荧光负载胆管上皮癌细胞,激光扫描共聚焦显微镜检测细胞内钙离子浓度的变化情况;并用酶联免疫法测定细胞内环磷腺苷(cAMP)的浓度。结果:PGE2可促进胆管上皮癌细胞生长,而且可使细胞内钙离子和cAMP浓度升高。结论:PGE2影响胆管上皮癌细胞内Ca2+和cAMP浓度,可能与PGE2促进肿瘤细胞生长有关。

    • >南京医科大学学报(社会科学版)
    • 新形势下医院防范医疗纠纷的对策

      2007(3):215-217. DOI: 10.7655

      摘要 (1918) HTML (53) PDF 0.00 Byte (131) 评论 (0) 收藏

      摘要:医疗纠纷呈上升趋势,是社会关注的热点和焦点问题,也是困扰医院的难点。医疗纠纷成因是多方面的,文章从院方、患方和社会三方面进行分析,并就如何防范医疗纠纷,构建和谐的医患关系提出看法。

    • >南京医科大学学报(自然科学版)
    • 肝细胞生长因子及受体促进人大肠癌细胞血管内皮生长因子表达

      2007(3):216-219. DOI: 10.7655

      摘要 (1772) HTML (55) PDF 0.00 Byte (108) 评论 (0) 收藏

      摘要:目的:观察不同浓度肝细胞生长因子对体外培养的大肠癌细胞血管内皮生长因子(VEGF)表达的影响。方法:体外培养人大肠癌细胞,分别加入不同浓度的人重组肝细胞生长因子和或其受体抑制剂Herbimycin A(HA), 用Western blot、RT-PCR、ELISA等方法检测肝细胞生长因子对其受体磷酸化表达及大肠癌细胞VEGF表达的影响。结果:肝细胞生长因子在10~100 ng/ml浓度范围内较对照组相比显著促进大肠癌细胞VEGF mRNA(增加了4~5倍)、蛋白质表达(增加了3~10倍);Western blot检测肝细胞生长因子引起其受体磷酸化,并与其诱导的VEGF表达相关。结论:体外培养条件下,肝细胞生长因子呈剂量依赖性促进大肠癌细胞VEGF表达,其表达与其受体磷酸化水平相关;其受体磷酸化抑制剂可以抑制大肠癌细胞VEGF表达。

    • >南京医科大学学报(社会科学版)
    • 加强高校工程建设跟踪审计监督的思考

      2007(3):219-221. DOI: 10.7655

      摘要 (1837) HTML (54) PDF 0.00 Byte (88) 评论 (0) 收藏

      摘要:为适应高等教育快速发展的需要,拓展办学空间,建设重大工程项目,特别是建设新校区已成为众多高校的一种选择。为将工程建设成为优质工程、廉政工程,许多高校引入了跟踪审计,使工程建设效益和效率得到了加强。跟踪审计不仅是一种新的审计模式,也是一种新的监督模式。跟踪审计的实施对工程建设过程中的科学决策、规避风险、提高资金效用,尤其是防治腐败现象的滋生有着极为重要的作用。

    • >南京医科大学学报(自然科学版)
    • 蛋白酶体抑制剂PS-341对U266细胞凋亡和多种细胞因子表达影响的研究

      2007(3):220-223. DOI: 10.7655

      摘要 (2043) HTML (57) PDF 0.00 Byte (178) 评论 (0) 收藏

      摘要:目的:探讨蛋白酶体抑制剂PS-341(bortezomib)诱导多发性骨髓瘤细胞株U266细胞凋亡时对IL-6、IL-1β和SCF细胞因子表达的影响。方法:用含15%FBS的RPMI1640培养液体外培养U266细胞,分别用0、50、100、150、200 nmol/L的PS-341干预U266细胞4 h后收集,荧光显微镜观察细胞凋亡,Annexin V-FITC/PI双染法流式细胞术(FCM)检测细胞凋亡率的变化,反转录聚合酶链反应(RT-PCR)分析U266细胞IL-6、IL-1β和SCF三种细胞因子表达的改变。结果:荧光显微镜和FCM发现PS-341以浓度依赖方式诱导U266细胞凋亡;PS-341明显抑制U266细胞IL-6、IL-1β和SCF的表达(P < 0.05);对IL-6和SCF的抑制与PS-341浓度成正相关,对IL-1β的抑制在PS-341浓度为0~150 nmol/L时成正比关系,当浓度大于150 nmol/L时差异无显著性。结论:蛋白酶体抑制剂PS-341诱导U266 细胞凋亡时明显抑制其IL-6、IL-1β和SCF的表达,是有效治疗MM的机制之一。

    • >南京医科大学学报(社会科学版)
    • 高校人事代理制度的实践与思考

      2007(3):222-224. DOI: 10.7655

      摘要 (2127) HTML (59) PDF 0.00 Byte (217) 评论 (0) 收藏

      摘要:人事代理制度是当前高校人事制度改革的一项重要内容。文章通过分析人事代理制度的基本内涵和实施人事代理制度的现实意义,并结合南京医科大学近四年的实践,对高校人事代理制度在实施过程存在的问题进行探析,以促进人事代理制度的完善。

    • >南京医科大学学报(自然科学版)
    • 硒对镉诱导肾细胞凋亡及其相关蛋白bcl-2、p53表达的影响

      2007(3):224-227. DOI: 10.7655

      摘要 (2056) HTML (49) PDF 0.00 Byte (142) 评论 (0) 收藏

      摘要:目的:探讨硒对镉诱导肾小管上皮细胞(LLC-PK1)凋亡及其凋亡相关蛋白bcl-2和p53表达的影响。方法:采用四甲基偶氮唑盐(MTT)比色法检测硒对镉抑制LLC-PK1细胞生长的影响,AO/EB荧光双染法观察硒对镉诱导细胞凋亡形态的作用,并通过免疫印迹法检测凋亡相关蛋白bcl-2和p53表达水平的变化。结果:不同浓度硒对镉的细胞毒性具有一定的拮抗作用,并呈剂量效应关系; 40 μmol/L镉可诱导LLC-PK1细胞凋亡,当加入20 μmol/L硒预处理30 min再染镉12 h后,细胞凋亡的程度与单独染镉组相比有所减弱。检测凋亡相关蛋白bcl-2和p53的表达,发现镉可上调p53蛋白表达及下调bcl-2蛋白的表达,当加入硒预处理后可对镉引起的p53蛋白上调具有一定的抑制作用,但硒对镉引起的bcl-2蛋白下调作用不明显。结论:硒可拮抗镉性肾细胞凋亡,其机制可能与抑制镉引起促凋亡蛋白p53的上调有关。

    • >南京医科大学学报(社会科学版)
    • 论医学生就业观的养成

      2007(3):225-227. DOI: 10.7655

      摘要 (2056) HTML (104) PDF 0.00 Byte (112) 评论 (0) 收藏

      摘要:当前医学生就业观中存在的偏差不仅加大了医学生就业的难度,而且造成了医疗卫生人力资源的极大浪费,加剧了医疗卫生事业的区域性和行业性发展的不平衡。研究医学生就业观并加以引导,既有助于解决医学生就业的问题,又有助于我国医疗卫生人力资源的合理配置,推动医疗卫生事业协调可持续发展。

    • 新时期辅导员开展医学生思想政治教育的几点思考

      2007(3):228-230. DOI: 10.7655

      摘要 (1747) HTML (57) PDF 0.00 Byte (90) 评论 (0) 收藏

      摘要:当今发达的信息社会需要“治病”又“治人”的医生,而造就他们的源头主要取决于医学生在校期间的良好教育。辅导员作为医学高等教育队伍中的重要力量,则更应及时、恰当地把握好医学生动态的心理需要和需求开展思想政治教育工作。其中,辅导员献学生爱心,给学生公心,树学生信心,塑学生职业心,让学生伤心是其“攻心”教育工作的重要艺术和必要手段,它们的合理运用将产生深远的教育效果。

    • >南京医科大学学报(自然科学版)
    • 4’-甲醚-黄芩素对绒毛膜癌JAR细胞内Ca2+浓度的影响

      2007(3):228-231. DOI: 10.7655

      摘要 (1958) HTML (53) PDF 0.00 Byte (141) 评论 (0) 收藏

      摘要:目的:探讨4′-甲醚-黄芩素对人绒毛膜癌JAR细胞的增殖抑制作用及细胞内Ca2+浓度的影响。方法:应用MTT法、流式细胞术和激光共聚焦扫描显微镜技术,体外观察该化合物对JAR细胞的影响。结果:4′-甲醚-黄芩素对JAR细胞的生长具有抑制作用。随着药物浓度与作用时间的增加,Annexin Ⅴ-FITC+/PI-细胞、细胞内Ca2+浓度逐渐增加,与对照组相比差异有显著性。结论:4′-甲醚-黄芩素能抑制人绒毛膜癌JAR细胞的增殖,诱导凋亡,其机制与提高细胞内Ca2+浓度有关。

    • >南京医科大学学报(社会科学版)
    • 当代大学生感恩教育刍议

      2007(3):231-233. DOI: 10.7655

      摘要 (1766) HTML (55) PDF 0.00 Byte (108) 评论 (0) 收藏

      摘要:感恩是每个人都应坚守的基本道德准则,是做人的起码修养。加强大学生的感恩教育,有助于培养人格全面,身心健康,有责任感的大学生、有助于和谐社会的构建。针对当前大学生感恩意识缺乏的现状,笔者提出加强大学生的感恩教育应从孝敬父母开始、从教育者自身做起、从营造良好的感恩氛围做起。

    • >南京医科大学学报(自然科学版)
    • 产前给药沐舒坦、地塞米松对大鼠胎肺形态发育的影响

      2007(3):232-234245. DOI: 10.7655

      摘要 (2266) HTML (61) PDF 0.00 Byte (157) 评论 (0) 收藏

      摘要:目的:比较产前给予沐舒坦(盐酸氨溴索注射液)、地塞米松对大鼠胎肺形态发育的影响。方法:9只孕鼠随机分为生理盐水对照组、沐舒坦治疗组及地塞米松治疗组,每组3只。于孕16、17、18天腹腔注射给药,孕19天每只孕鼠取6只胎鼠肺组织作为早产鼠肺模型,通过光镜观察及电镜技术,分析比较两种药物对胎肺形态发育的影响。结果: 光镜下,沐舒坦治疗组、地塞米松治疗组每视野肺泡计数、平均肺泡表面积均高于对照组(P﹤0.01),平均肺泡间隔厚度均低于对照组(P﹤0.01)。地塞米松治疗组每视野肺泡计数、平均肺泡表面积均高于沐舒坦治疗组(P﹤0.01),平均肺泡间隔厚度低于沐舒坦治疗组(P﹤0.01)。透射电镜观察,沐舒坦治疗组、地塞米松治疗组Ⅱ型肺泡上皮内多见板层小体且染色深、致密,胞质内线粒体等细胞器多见,而对照组内难见板层小体、少见细胞器。结论: 产前给药沐舒坦、地塞米松均能显著促进胎肺发育,地塞米松效果优于沐舒坦。但考虑到地塞米松的诸多不良反应,沐舒坦可成为临床上促胎肺成熟的更好选择。

    • 氯胺酮雾化吸入对哮喘大鼠气道高反应性的影响

      2007(3):235-238. DOI: 10.7655

      摘要 (2487) HTML (53) PDF 0.00 Byte (105) 评论 (0) 收藏

      摘要:目的:观察氯胺酮雾化吸入对哮喘模型大鼠气道高反应性的影响。方法:40只Brown Norway 大鼠随机分成对照组(C组)、哮喘模型组(A组)、氯胺酮1组(K1组)、氯胺酮2组(K2组)、氯胺酮3组(K3组),应用动物体描箱法测定大鼠的气道反应性,采用RT-PCR反应测定核因子-кB(NF-кB)的基因表达,采用免疫组化的方法观察NF-кB在支气管上皮的表达。结果:在乙酰胆碱(ACH)浓度为50、100、200 μg/kg时,K1、K2、K3组呼气阻力(Re)的增长率明显小于A组(P < 0.01);在ACH浓度为50、100、200 μg/kg时,K1、K2、K3组肺动态顺应性(Cldyn)的下降率明显小于A组(P < 0.01)。大鼠肺NF-кB p65 mRNA的表达水平和支气管上皮NF-кB阳性细胞率A组显著高于C组(P < 0.05),治疗组K1、K2、K3明显低于A组(P < 0.05)。结论:氯胺酮雾化吸入治疗可明显减轻哮喘模型大鼠气道高反应性。

    • >南京医科大学学报(社会科学版)
    • 从创造性人才培养视角谈我国高等教育改革的方向

      2007(3):235-238. DOI: 10.7655

      摘要 (1697) HTML (61) PDF 0.00 Byte (112) 评论 (0) 收藏

      摘要:面对建设创新性高校和创新型国家的新的历史使命,中国高等教育面临新的严峻挑战。传统的以知识传授为核心的教育理念、教学模式、管理模式;以行政性管理为基础的管理运行模式;以及高度统一和单一性的高等教育招生考试模式,都不能适应创造性人才培养的要求。为此,必须进一步深化改革,实现教育理念和教学模式的转变,培育促进创造性人才成长的校园文化,构建现代大学制度,建立多元化和多样性的高考体制,并扎实推动基础教育改革。

    • 对长学制医学生临床和科研能力培养的思考

      2007(3):239-241. DOI: 10.7655

      摘要 (1794) HTML (68) PDF 0.00 Byte (97) 评论 (0) 收藏

      摘要:近年来许多大学在试行七年制或八年制医学教育,对医学教育的发展趋势和规律作实践性探索。其中,对长学制医学教育的目标和培养要求存在着不同认识和探索。正确区分临床医学专业学位和科学学位培养要求的差异,学校内医学教育和毕业后基本职业技能培训的不同,对于进一步明确长学制医学教育的培养目标具有十分重要的意义。

    • >南京医科大学学报(自然科学版)
    • 静脉注射大鼠骨髓MSCs缓解新生大鼠高氧肺损伤

      2007(3):239-241248. DOI: 10.7655

      摘要 (1953) HTML (47) PDF 0.00 Byte (97) 评论 (0) 收藏

      摘要:目的:研究大鼠骨髓间充质干细胞(mesenchymal stem cells, MSCs)对高氧新生大鼠肺组织血管内皮生长因子(Vascular endothelial cell growth factor,VEGF)表达的影响。方法:采用贴壁选择法分离、培养、扩增大鼠骨髓来源MSC,并以5-溴脱氧尿嘧啶核苷(5-bromo-2-deoxyuridine,BrdU)进行标记;3日龄清洁级SD新生大鼠32只,随机分为高氧组(A组)、高氧干预组(B组)、正常干预组(C组)、对照组(D组)4组;A、B二组均置大鼠于95%氧环境下7天后,B组每只动物尾静脉注射5 × 104的MSCs,A组每只注射磷酸盐缓冲液(PBS)50 μl;而C、D二组则置于正常空气环境下,同时分别给予每只大鼠尾静脉注射含5 × 104MSC及PBS 50 μl。注射后72 h(13日龄)处死全部动物,肺组织病理学检测辐射状肺泡计数(radical alveolar counts,RAC),免疫组织化学检测VEGF 吸光度(A)值、BrdU表达情况。结果:仅二个注射MSC组(B、C组)可见BrdU阳性表达,高氧组RAC值及均显著低于对照组,而给予MSC均可使其明显上升,近于对照组。结论:给新生大鼠静脉注射MSC对高氧肺损伤的保护作用可能与增加肺组织VEGF表达有关。

    • 大鼠胰岛分离纯化和功能分析的研究

      2007(3):242-245. DOI: 10.7655

      摘要 (2560) HTML (61) PDF 0.00 Byte (138) 评论 (0) 收藏

      摘要:目的:探讨大鼠胰岛分离纯化的方案。方法:采用胰管内灌注胶原酶Ⅴ消化、Histopaque-1077密度梯度离心分离纯化20只雄性SD大鼠胰岛。椎虫蓝染色判断胰岛存活率,双硫腙染色后计数胰岛,葡萄糖刺激胰岛素释放实验评估胰岛功能,同种异体胰岛门静脉移植治疗5只链脲佐菌素诱导的糖尿病大鼠,监测血糖变化。结果:分离纯化后平均胰岛得率为(646 ± 67)个/大鼠,存活率达到90%以上。新鲜分离的胰岛呈椭圆或圆形,悬浮于培养液面,胞膜光滑完整,直径大于150 μm的细胞团占95%以上。葡萄糖刺激的胰岛素释放试验结果表明:第1、3、5天胰岛的刺激指数分别为2.6倍、1.7倍和1.4倍,两组间低糖和高糖的胰岛分泌量差异均有显著性(P < 0.05)。胰岛门静脉移植术后,第2天大鼠血糖降至11.1 mmol/L,8天内血糖可控制在15 mmol/L以下,随后血糖逐步升高。结论:采用胰管内灌注胶原酶Ⅴ消化联合Histopaque-1077分离纯化是一种较好的大鼠胰岛分离方法,胰岛得率较高且功能良好。

    • >南京医科大学学报(社会科学版)
    • 研究生教育对创新型医学人才的培养

      2007(3):242-243. DOI: 10.7655

      摘要 (1960) HTML (61) PDF 0.00 Byte (139) 评论 (0) 收藏

      摘要:随着社会的发展和学科建设的改革,创新型医学人才已成为社会对医学人才的首要选择。分析当前社会对医学人才的具体要求和高等医学教育中存在的不足,作者提出面对知识经济的挑战,必须加快教育改革的步伐,以培养创新型高素质的医学人才为目标,充分发挥高等院校在培养高素质人才方面的作用,并从教师和学生两个角度探讨怎样培养创新性医学人才。

    • 加强医学研究生人文素质教育的思考

      2007(3):245-248. DOI: 10.7655

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      摘要:在物质生活日益丰富的今天,人文精神普遍缺失已是不争的事实,医学领域同样如此。随着“生物—心理—社会”医学模式的建立, 随着医学的迅速发展,社会对未来医务人员的行为和人文素质的要求愈来愈高, 重视医学人才的人文教育与培养势在必行。

    • >南京医科大学学报(自然科学版)
    • 人胚虹膜色素上皮细胞的初步培养和鉴定

      2007(3):246-248. DOI: 10.7655

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      摘要:目的:建立人胚虹膜色素上皮细胞(IPE)分离、纯化培养体系并进行鉴定,为进一步研究IPE提供实验基础。方法:取胎龄为15周左右新鲜水囊引产的人胚眼球,取下虹膜组织,用胰蛋白酶消化,将虹膜色素上皮细胞置于培养瓶中,2周后传代,倒置相差显微镜观察,并取对数生长期细胞分别用透射电镜和扫描电镜检查,用单克隆鼠抗角蛋白抗体(AE1/AE3)标记培养细胞进行鉴定。结果:用胰酶分离消化法,人胚虹膜色素上皮细胞易分离和贴壁。细胞形态与视网膜色素上皮细胞形态极为相似,表现为多边形和梭形两种形态,胞质内含色素颗粒,传代细胞内的色素颗粒比原代细胞的色素颗粒少。免疫细胞化学染色阳性,胞质内见棕黄色染色。结论:人胚虹膜色素上皮细胞分离、纯化的实现为IPE细胞生理功能和IPE移植的深入研究提供了可能。

    • 曲格列酮抑制甲状腺乳头状癌细胞生长的体外试验

      2007(3):249-252. DOI: 10.7655

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      摘要:目的: 研究曲格列酮对甲状腺癌细胞IHH-4生长的影响及其作用机制。方法:将甲状腺癌细胞IHH-4与不同浓度的曲格列酮共培养,4-甲基偶氮四唑蓝(MTT)法观察其对甲状腺癌细胞增殖的影响,流式细胞仪DNA定量法分析曲格列酮对甲状腺癌细胞细胞周期的影响,半定量RT-PCR法测定曲格列酮对甲状腺癌细胞p27 mRNA 表达的影响。结果: 曲格列酮可以抑制甲状腺乳头状癌细胞的增殖,并具有时间和浓度依赖性(P < 0.05);曲格列酮作用后,甲状腺癌细胞IHH-4的G0/G1细胞的比例增加(P < 0.05);p27 mRNA 的表达显著升高(P < 0.05)。结论: 曲格列酮可以抑制甲状腺癌细胞从G1期向S期的转化,从而抑制其增殖,曲格列酮可能成为治疗难治性甲状腺癌的一种选择。

    • >南京医科大学学报(社会科学版)
    • 人体结构学精品课程特色建设的研究与实践

      2007(3):249-251. DOI: 10.7655

      摘要 (1835) HTML (51) PDF 0.00 Byte (101) 评论 (0) 收藏

      摘要:人体结构学是医学(或健康)相关专业的一门交叉融合的创新课程。针对培养目标,通过形态课程体系的重新构建、学生自主学习平台的完善、学生人文素质的培养、支撑学科的日益强大,逐渐形成了颇具自身特色的课程。

    • 南京医科大学实施《学生体质健康标准》现状及对策研究

      2007(3):252-255. DOI: 10.7655

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      摘要:笔者对南京医科大学《学生体质健康标准》的测试数据进行统计分析与评价,指出其存在的主要问题,并提出合理性建议,以期全面落实《学生体质健康标准》,提高学生体质健康水平。

    • >南京医科大学学报(自然科学版)
    • GCS基因的表达与急性白血病耐药的相关性探讨

      2007(3):253-255267. DOI: 10.7655

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      摘要:目的:探讨葡萄糖神经酰胺合成酶(glucosylceramide synthase,GCS)基因的表达与急性白血病患者耐药的相关性。方法:以β-actin基因为内参照物,采用RT-PCR方法分析了36例耐药/非耐药急性白血病患者血标本中GCS基因及经典的多药耐药基因(mdr1)的表达情况;并同时对标本中的BCL-2基因和BAX基因的表达水平亦进行了检测,以初步探讨GCS基因导致肿瘤细胞耐药的机制。结果:急性白血病耐药组标本的GCS基因及mdr1基因的扩增条带吸光度(A)相对比值均明显高于非耐药组(P < 0.001)。耐药组BCL-2基因扩增条带A相对比值同样明显高于非耐药组(P < 0.001),而BAX基因的表达则明显低于非耐药组(P < 0.01),BCL/BAX比值在耐药及非耐药组之间差异有显著性(P < 0.01)。结论: GCS基因在急性白血病细胞耐药的形成过程中可能起重要作用,且GCS促进肿瘤细胞耐药的机制可能与其通过催化神经酰胺糖基化从而影响凋亡相关基因的表达有关。

    • 2型糖尿病患者术后胰岛素治疗方案的比较研究

      2007(3):256-259. DOI: 10.7655

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      摘要:目的:比较2型糖尿病患者术后3种胰岛素治疗方案的有效性、安全性和患者耐受性。方法: 选择接受外科手术且术后禁食或进食不规律的2型糖尿病患者,分设胰岛素泵(CSⅡ)组、长效胰岛素(来得时)组和持续静脉输注胰岛素(CVⅡ)组,观察用药前后空腹血糖(FBG)和餐后血糖(PBG)的变化、血糖控制水平及低血糖发生率。结果: CSⅡ组和来得时组治疗后3、5、7及10天的FBG和PBG水平均较治疗前显著降低(P < 0.01),CVⅡ组治疗后3、5、7及10天的FBG水平较治疗前显著降低(P < 0.01),但仅治疗后第7天的PBG水平较治疗前显著降低(P < 0.05),其他时间点PBG水平均较治疗前无差别;治疗10天时,CSⅡ组FBG控制尚可,PBG控制良好,来得时组FBG和PBG控制均尚可,CVⅡ组均差;患者依从性:CSⅡ组较好,来得时组好,CVⅡ组较差;CSⅡ组无低血糖发生,来得时组和CVⅡ组分别发生1次和4次低血糖事件。结论:2型糖尿病患者术后禁食或进食不规律阶段,采用胰岛素泵和来得时均能有效控制血糖,且不易出现低血糖;使用静脉输注胰岛素治疗,血糖波动较大且患者依从性差;来得时是一种有效、安全且患者易接受的用于2型糖尿病患者术后治疗的药物。

    • >南京医科大学学报(社会科学版)
    • 外科教学中教学差错的避免与预防

      2007(3):256-257. DOI: 10.7655

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      摘要:教学差错是指教学工作中不良的教学行为。外科教学因其自身的临床工作的性质而具有易出教学差错的特点。文章详细分析了外科教学中教学差错的特点,探讨了避免与预防外科教学中教学差错的措施及方法。

    • 循证医学在七年制临床教学中的意义

      2007(3):258-259. DOI: 10.7655

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      摘要:循证医学是临床医学的新趋势,已经渗透到各国医学临床实践中,对临床实践的科学化与规范化起到了重要作用。中国临床医学七年制教育是医学精英教育,不断深入教学改革,提高其教学质量意义深远。在七年制临床教学中运用循证医学的理念和方法,深化其教学改革势在必行。

    • 实践性教学在病历书写临床教学中的应用

      2007(3):260-261. DOI: 10.7655

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      摘要:传统教学中病历书写所占课时少,教师机械性照本宣科一带而过,学生在临床实习中把病历写成流水账,不能反映整个病程的诊治水平,甚至当发生医疗纠纷时,因病历书写不规范而陷入窘境。文章通过分析其成因,提出改革临床教学,严格出科考试制度,充分发挥临床教师的积极性,规范病历书写格式等建议,提高病历书写质量和水平。

    • >南京医科大学学报(自然科学版)
    • 膜固思达治疗慢性糜烂性胃炎的疗效观察

      2007(3):260-263. DOI: 10.7655

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      摘要:目的:观察新型胃黏膜保护剂膜固思达[成分为瑞巴派特(rebamipide),化学名为2-(4-氯苯甲酰胺基)-3-(1,2-二氯-2-氧代-4-喹啉基)-丙酸]治疗慢性糜烂性胃炎(CEG)8周的疗效。方法:本研究共纳入经内镜确诊的慢性糜烂性胃炎60例。分组给药治疗8周后评估症状改善程度,内镜取胃黏膜标本,观察病理、检测PGE2和MDA水平。结果:56例患者完成8周治疗疗程。试验组与对照组症状均较治疗前有显著性改善(P < 0.05),但两组间无明显差异。胃组织病理显示试验组腺体密度和腺体形态恢复明显优于对照组(P < 0.05)。试验组与对照组内镜下糜烂愈合总有效率差异无显著性(P > 0.05)。试验组和对照组中PGE2及MDA的含量较治疗前均有明显改变(P < 0.05),试验组中PGE2的含量较对照组升高明显,MDA的含量较对照组下降明显,试验组与对照组间差异有显著性(P < 0.05)。结论:膜固思达对CEG患者的症状有改善作用,促进胃黏膜糜烂的愈合,减轻炎症反应,提高胃黏膜内PGE2水平及降低MDA水平,膜固思达是一种有效的胃黏膜保护剂。

    • 食管鳞癌和淋巴结组织Paxillin和CD44v6的表达与临床意义

      2007(3):264-267. DOI: 10.7655

      摘要 (1897) HTML (59) PDF 0.00 Byte (126) 评论 (0) 收藏

      摘要:目的:研究桩蛋白(Paxillin)和CD44v6在食管鳞癌组织中的表达及其与食管鳞癌细胞侵袭与转移的关系。方法:应用免疫组化SP法检测24例正常食管黏膜、94例食管鳞癌和83例淋巴结中Paxillin和CD44v6的表达情况。结果:原发癌组织中Paxillin表达率与浸润深度(P < 0.01)、临床分期(P < 0.01)和淋巴结转移(P < 0.05)等因素有关;CD44v6表达率与浸润深度(P < 0.05)、临床分期(P < 0.01) 和淋巴结转移(P < 0.05)等因素有关;原发癌组织和转移淋巴结组织中Paxillin和CD44v6表达率均高于无转移淋巴结组织(P < 0.05); Paxillin和CD44v6在淋巴结组织中表达无相关性(P > 0.05)。结论: Paxillin和CD44v6在食管癌组织和转移淋巴结中高表达,在食管癌的发生、发展过程中具有重要作用,可作为评价食管癌生物学行为的指标。

    • 泌尿生殖系统支原体检测及耐药分析

      2007(3):268-271. DOI: 10.7655

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      摘要:目的:了解泌尿生殖系统解脲支原体(UU) 和人型支原体(MH) 的感染及耐药情况,以指导临床合理用药。方法:对682份标本进行支原体培养,并进行9种抗生素药敏试验。结果:682例标本经培养鉴定,共检出359 例支原体阳性,总检出率为52.64%;其中UU 和MH检出率分别为43.7%(298/682)和1.2%(8/682),有7.8%(53/682)为UU/MH混合感染,UU 检出率明显高于MH检出率。支原体感染以21~40 岁者最高,占86.63%(311/359),且女性比男性更易感染支原体(P < 0.05)。药敏试验结果显示,对交沙霉素、原始霉素、强力霉素、四环素较为敏感,对阿奇霉素、红霉素中度敏感,而对环丙沙星、氧氟沙星、克拉霉素等耐药性较高。结论:生殖道支原体感染以UU 为主,并且在青壮年人群中感染率较高;支原体对多种抗生素产生耐药性,特别是在UU/MH混合感染中。在治疗中应首选交沙霉素、原始霉素、强力霉素、四环素。

    • 法洛四联症矫治术前后肺血流量和心功能的变化

      2007(3):272-274. DOI: 10.7655

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      摘要:目的:评估法洛四联症(TOF)患者在矫治术前后肺血流量和心功能的变化。方法: 超声评估17例TOF患者手术前和行矫治术两周后肺血流量和心功能。用二维超声测量RR间期计算出心率(HR)、左房直径(LAD)、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)、左室射血分数(LVEF);用脉冲多普勒技术测量二尖瓣血流的流速积分(VTI)、二尖瓣舒张早期峰流速(E)、心输出量(CO)、每搏量(SV)、和右室等容收缩时间指数(Tei指数);用组织多普勒速度成像技术(TVI)分别测量三尖瓣瓣环的舒张早期运动速度(Ve)和舒张晚期运动速度(Va)。结果:手术前后二尖瓣VTI无明显增加;左心房和左心室较术前明显增大;二尖瓣舒张早期峰流速(E)加快,但EF值无变化;反映右心功能的Ve/Va和Tei指数也无明显变化。结论:TOF患者的肺血流量在手术前后无明显变化,心脏部分腔室增大,左心室舒张功能改善。

    • 小儿过敏性紫癜免疫功能紊乱24例临床分析

      2007(3):275-277. DOI: 10.7655

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      摘要:目的:通过了解过敏性紫癜(henoch-schonlein purpura,HSP)患儿细胞免疫、体液免疫功能的改变,早期了解、干预以减轻肾脏受累。方法:对103例中病史及辅助检查项目较全面的24例患儿作为A组进行T细胞亚群以及血清过敏原特异性IgE检测。B组为28例为随机抽取的健康儿童作为对照。结果:CD3、CD4、CD4/CD8明显低于B组,而血清总IgE水平升高。HSP患儿CD4细胞百分比降低,CD8细胞百分比增高,CD4/CD8比值降低。患者血清过敏原特异性IgE水平升高。结论:HSP 发病与T细胞亚群功能紊乱有关,为其治疗和早期干预肾脏受损提供了依据。

    • 肺炎支原体肺外损伤101例特征分析

      2007(3):278-279286. DOI: 10.7655

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      摘要:目的:探讨小儿支原体肺炎肺外损伤的临床特征。方法:对101例肺炎支原体肺炎的肺外损伤进行回顾分析。结果:有63例发生肺外损伤,最多者同时涉及肺外4个脏器、系统。肺外损伤分别是心脏、消化系统、泌尿系统、皮肤、神经及体液内环境系统的损伤。血CRP增高与肺外损伤有相关性(0.01 < P < 0.05),CRP升高值与肺外损伤脏器个数以及心肌酶、谷丙转氨酶的升高程度无相关性(P > 0.05)。白细胞总数的改变、肺部实变程度与有无肺外损伤亦无相关性;结论:支原体肺炎可并发肺外多脏器损伤,肺外脏器损伤在临床上缺乏特异性,要靠仔细体检和全面实验室检查才能发现,尤其对血 CRP增高者及时监控,对提高预后有帮助。

    • 喜炎平注射液佐治婴幼儿肺炎100例疗效观察

      2007(3):280-281. DOI: 10.7655

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      摘要:目的:研究喜炎平注射液佐治婴幼儿肺炎的临床疗效。方法: 随机选择观察组和对照组肺炎患儿各100例,观察组中加用喜炎平注射液,观察两组临床疗效。结果: 喜炎平注射液具有较好的抗病毒及抗细菌感染作用,治疗婴幼儿肺炎的总有效率达97%;在退热、止咳平喘、肺部■音消失及缩短病程方面均明显优于对照组(P < 0.05),且不良反应轻,用药方便、安全。结论:喜炎平注射液辅助治疗婴幼儿肺炎疗效满意,可予推广应用。

    • 肌电图对肌强直综合征24例诊断分析

      2007(3):282-283294. DOI: 10.7655

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      摘要:目的:探讨肌强直综合征的电生理变化与诊断间关系。方法:24例肌强直组和20例对照组患者的肌电图(EMG)、神经传导速度(NCV)进行检测对比。结果:肌强直组EMG主要特点呈典型肌强直电位发放,肌源性损害,NCV在正常范围。对照组出现肌强直电位较少且声响低平,瞬间即失。两组电静息状态下肌强直电位、插入电位延长、强直后放现象,经统计学处理差异有极显著性(P < 0.01)。结论:EMG肌强直电位发放伴扬声器声响强而持续、插入电位延长、强直后放现象是区别其他神经肌病出现肌强直电位主要依椐。EMG出现肌强直电位的质与量是诊断肌强直综合征的关键。

    • 全自动半自动干式生化分析仪测定尿素与肌酐可比性的研究

      2007(3):284-286. DOI: 10.7655

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      摘要:目的:探讨不同仪器间尿素与肌酐测定结果具有可比性的方法。方法:以校准品和纯标准品及定值混合血清对LISA全自动生化分析仪(仪器2)和MD-100型半自动生化分析仪(仪器3)及用校准品对日立7170全自动生化分析仪(仪器1)定标后,同时分别平行测定6例标本,用均值进行相关分析;仪器1与SP4430全自动干式生化仪(仪器4)同时测定一组24例患者血清,以此测定的相互关系估计两仪器间的校正系数。结果:仪器2尿素相关系数分别为0.98、0.94、1.00,肌酐相关系数分别为0.89、0.76、0.97。仪器3尿素相关系数分别为0.99、0.95、1.00,肌酐相关系数分别为0.92、0.74、0.95。仪器1(X)与仪器4(Y)仪器校正系数分别为尿素Y = 0.80X;肌酐Y = 0.82X。结论:通过校准并且不断以患者标本结果校验,才能使用不同仪器间常规测定项目结果一致。

    • 使用美敦力Cardioblate BP 外科消融系统治疗风湿性心脏瓣膜病伴发的心房颤动

      2007(3):287-287. DOI: 10.7655

      摘要 (1962) HTML (59) PDF 0.00 Byte (109) 评论 (0) 收藏

      摘要:

    • 儿童社区获得性呼吸道感染克雷伯杆菌检测及药敏分析

      2007(3):288-289. DOI: 10.7655

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    • 血管内皮生长因子受体3抗体用于乳腺癌微淋巴管密度检测

      2007(3):290-291. DOI: 10.7655

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      摘要:

    • 星状神经节阻滞治疗干燥综合征1例报告

      2007(3):292-292. DOI: 10.7655

      摘要 (1926) HTML (66) PDF 0.00 Byte (106) 评论 (0) 收藏

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    • 股静脉置管化疗致静脉血栓3例的护理

      2007(3):293-294. DOI: 10.7655

      摘要 (1985) HTML (42) PDF 0.00 Byte (118) 评论 (0) 收藏

      摘要: