关键词： 医学工作者   科学杂志   中国科学引文数据库   中文科技期刊全文数据库   国际   中国期刊全文数据库   国家教育部   国外医学  

摘要： 《国际内科学杂志》（原《国外医学内科学分册》）是由国家教育部主管，中山大学主办的一份国家级医学期刊，现已被列为全国内科学类、临床医学类以及中国科学引文数据库医学类的核心期刊，被美国化学文摘、万方数据库、中文科技期刊全文数据库（维普资讯）、中国期刊全文数据库等收录。

关键词： 内科学   冠心痛   内皮舒张功能   肱-踝脉搏波速   动脉弹性  

摘要： 目的探讨冠心病患者肱—踝脉搏波速与内皮依赖性舒张功能的关系。方法选择98例冠心病患者和33例非冠心病对照者,采用高分辨率超声检测肱动脉血流介导的内皮依赖性血管舒张功能;自动脉搏波速度测定仪测定肱—踝脉搏波速。结果冠心病组肱动脉血流介导的内皮依赖性血管舒张功能明显低于对照组(5.4%±2.5%比11.1%±4.4%,P<0.01),冠心病组肱—踝脉搏波速明显高于对照组(1745.3±215.2cm/s比1495.3±202.3cm/s,P<0.01),两组硝酸甘油介导的内皮非依赖性血管舒张功能无明显差异;肱动脉血流介导的内皮依赖性血管舒张功能与肱—踝脉搏波速呈负相关(r=-0.70,P<0.001)。结论冠心病患者血管内皮功能受损和肱—踝脉搏波速增快,提示血管内皮舒张功能的受损伴随冠心病动脉硬化。

关键词： 中华医学会   内科系统   学术会议   浙江省医学会   临床思维方式   临床医师   专题报告   论文交流  

摘要： 为培养临床医师大内科系统、全面的临床思维方式，中华医学会内科学分会于2007年9月在浙江省杭州市召开“中华医学会第11届全国内科学术会议”。此次会议是中华医学会内科学分会年会，由中华医学会内科学分会主办，浙江省医学会承办。会议将邀请国际国内内科各专科的知名专家作专题报告，同时进行论文交流与病例讨论。这对于临床内科及科研人员是一次很好的学习、交流机会。

关键词： 内科学   原发性高血压   左心室肥厚   血管加压素   脑钠尿肽  

摘要： 目的观察原发性高血压左心室肥厚与血浆血管加压素、血浆脑钠尿肽水平的关系。方法原发性高血压患者71例,采用超声心动图测算左心室质量指数后,再按照左心室质量指数分成两组:左心室肥厚组(简称肥厚组)36例,左心室非肥厚组(简称非肥厚组)35例;另设对照组28例。分别用超声心动图测定对照组左心室质量指数,以及三组舒张早期速度峰值与舒张晚期速度峰值,计算两者的比值;放射免疫分析法测定血浆血管加压素和血浆脑钠尿肽水平,并分别与左心室质量指数和舒张早晚期速度峰值的比值作直线相关分析。结果①肥厚组和非肥厚组血浆血管加压素和脑钠尿肽浓度均高于对照组(P<0.01),肥厚组血管加压素和脑钠尿肽浓度均高于非肥厚组(P均<0.01);肥厚组和非肥厚组左心室质量指数均高于对照组(P<0.01和P<0.001),肥厚组左心室质量指数较非肥厚组显著升高(P<0.001);非肥厚组和肥厚组与对照组比较,舒张早晚期速度峰值比值均减小(P均<0.01)。②血浆脑钠尿肽浓度与左心室质量指数呈显著正相关(r=0.552,P<0.01),与舒张早晚期速度峰值比值呈显著负相关(r=-0.803,P<0.01);非肥厚组血浆血管加压素与血浆脑钠尿肽呈正相关(r=0.437P<0.01)与舒张早晚期速度峰值比值呈显著负相关(r=-0.506,P<0.01)。结论①血浆血管加压素水平增加可能参与高血压患者左心室肥厚的形成,导致左心室舒张功能受损;②血浆脑钠尿肽水平可以成为判断原发性高血压患者左心室肥厚和左心舒张功能受损的一项重要指标。

关键词： 费用和收费   家庭   内科学   书面记录   心血管疾病   氧吸入疗法   医师   医院收费   人类  

摘要： 　　心血管病人具有长期住院和经常发病的特点,且心内科病人往往要求发病时吸氧.临床上医生根据病情一般采取间断吸氧和持续吸氧,收费也就分长期和临时收费2种,临床上易造成吸少多收费,多吸少收费的现象,病人及家属对吸氧收费不满,引发经济纠纷.为促进医院收费走向合理化,减少收费纠纷,我们于2006年3月设计了吸氧记录单,解决了这一难题,使用至今效果满意,现介绍如下.……

关键词： Adult   Career Choice   Fellowships and Scholarships   Female   Health Care Surveys   成年人   职业选择   助学金和奖学金   卫生保健调查   内科学   实习医师和住院医师职务   General Practitioners   Hospitalists   Job Application   Occupational Choice   career   Pediatrics   Adults   Health Care Surveys   Fellowships and Scholarships   graduate   Internal Medicine  

摘要： Objective To compare the job search experience and career plans of medicine-pediatrics (med-peds) and pediatric residents. Study design Annual surveys of graduating med-peds and pediatric residents were compared from 2003 and 2004. Results The survey response rates were 58% for med-peds residents (n = 427) and 61% for pediatric residents (n = 611). Pediatric residents were more likely to be female or an International Medical Graduate. The groups were equally satisfied with their career choice and had equivalent debt. Med-peds residents were more likely to seek and accept generalist and hospitalist positions. Pediatric residents were more likely to seek subspecialty careers and research opportunities. More than 94% of med-peds residents expected to care for pediatric patients. Among residents seeking generalist positions, med-peds residents sent half as many applications to get the same number of interviews and offers as pediatric residents, were more likely to be offered their most desired position, and were more likely to accept a position in a rural area/small town. Med-peds residents had substantially greater starting salaries as hospitalists or generalists compared with pediatric residents. Conclusion Med-peds and pediatric trainees differ in their career plans, although primary care is their most popular choice. Med-peds-trained physicians have an easier job search experience and greater market valuation.

关键词： internal medicine   core competencies   hospital medicine   training  

摘要： Background: The exact medical conditions that every internist needs to know how to diagnose and treat have seldom been explicitly stated. This paper reports an analysis of the conditions, as identified by ICD9 coding, cared for by general internists working in a representative Irish hospital. Methods: In this observational study covering the period from February 17, 2000 to January 29, 2004, the ICD9 codes and mortality of 9214 consecutive patients admitted as acute medical emergencies were examined. Results: The mean number of ICD9 codes per patient was 4.0 +/- 1.8 (median 4.0 codes);935 patients (10.1%) had one ICD9 code and 2972 (32.3%) had six ICD9 codes recorded at the time of discharge. As the number of ICD9 codes recorded increased, so did patient age, 30-day mortality and length of hospital stay. Thirty-four conditions were found to be associated with a statistically significant increased risk of 30-day mortality, and eight with a significantly reduced risk. Of the remaining conditions (i.e. those with neither an increased nor reduced risk of mortality), 32 were observed in 1% or more of all patients. Discussion: Nearly all of the clinical presentations encountered are encompassed within an average of four combinations of 74 conditions, 34 of which are associated with an increased risk of death. (C) 2007 European Federation of Interval Medicine. Published by Elsevier B.V. All rights reserved.

关键词： 内科学   内皮祖细胞   诱导分化   一氧化氮合酶   血管内皮生长因子受体2   假血友病因子   10(r7—3949(20071   15—09—0647—06  

摘要： 目的观察不同年龄段大鼠血清对骨髓内皮祖细胞向成熟内皮细胞诱导分化的影响。方法无菌取1-2月龄、19-26月龄Sprague-Dawley大鼠股骨和胫骨,获取骨髓单个核细胞,用含20%胎牛血清的DMEM/F12培养基培养,经差速贴壁法对二次贴壁细胞在纤维连接蛋白包被的培养板或培养瓶进行体外培养,以DiI-ac-LDL、FITC-UEA-1双荧光染色和FITC-CD31染色进行鉴定;收集制备相应年龄段（1-2月龄、19-26月龄）大鼠血清,将内皮祖细胞分为老年大鼠内皮祖细胞＋老年大鼠血清组、老年大鼠内皮祖细胞＋年轻大鼠血清组、年轻大鼠内皮祖细胞＋老年大鼠血清组、年轻大鼠内皮祖细胞＋年轻大鼠血清组。体外培养的内皮祖细胞经含20%不同年龄段大鼠血清的内皮条件培养基诱导培养后,激光共聚焦显微镜检测DiI-acLDLF、ITC-UEA-1双染色阳性率,免疫组织化学检测假血友病因子表达、逆转录聚合酶链反应分别检测内皮一氧化氮合酶、血管内皮生长因子受体2表达,体外血管生成实验观察内皮祖细胞参与管形生成能力。结果年轻大鼠血清显著提高老年大鼠内皮祖细胞在内皮条件培养基诱导培养后的DiI-acLDLF、ITC-UEA-1双染色阳性率（P〈0.05）,而老年大鼠血清显著降低年轻大鼠内皮祖细胞双染阳性率（P〈0.05）;年轻大鼠血清明显促进老年大鼠内皮祖细胞在内皮条件培养基诱导培养后的血管性血友病因子、内皮型一氧化氮合酶（P〈0.01）及血管内皮生长因子受体2表达（P〈0.05）;年轻大鼠血清显著减少内皮条件培养基诱导培养后未参与血管生成的老年大鼠内皮祖细胞数（P〈0.05）。结论年轻大鼠血清可显著增强老年大鼠内皮祖细胞向内皮细胞诱导分化的能力,而老年大鼠血清可部分抑制年轻大鼠内皮祖细胞向成熟内皮细胞诱导分化;年轻大鼠血清中可能存在激发衰老个体内皮祖细胞活力的系统性血清因子,这些因子可增强衰老个体来源的内皮祖细胞内在分化潜能。