关键词： 内科学   代谢综合征   动脉硬化   动脉扩张性   动脉紧张度   动脉僵硬度  

摘要： 目的探讨代谢综合征患者颈总动脉扩张性、紧张度和僵硬度的变化。方法采用彩色多功能超声诊断仪对33例正常人、76例非代谢综合征患者和83例代谢综合征患者颈总动脉的收缩和舒张内径进行检测,并计算动脉的扩张性、紧张度和僵硬度。结果与对照组和非代谢综合征组比较,代谢综合征组患者颈总动脉扩张性、紧张度明显下降(P<0.01),僵硬度明显升高(P<0.01);平均内膜中层厚度增厚(P<0.01);等级相关分析发现,左、右颈总动脉的扩张性和紧张度与代谢综合征成分数目呈负相关(P<0.01),左、右颈总动脉的僵硬度与代谢综合征成分数目呈正相关(P<0.01)。结论代谢综合征患者颈动脉的弹性降低,动脉硬化加剧;颈动脉超声可以作为评价代谢综合征患者心血管病危险性的无创性方法。

关键词： 内科学   再狭窄   大鼠   阿托伐他汀   炎症   Toll样受体4   核因子κB  

摘要： 目的观察大鼠颈总动脉球囊损伤术后血管中Toll样受体4及核因子κB的表达情况,并应用阿托伐他汀药物进行干预。探讨Toll样受体4/核因子κB通路在再狭窄过程中的作用。方法雄性SD大鼠56只,随机分为阿托伐他汀治疗7天组、内膜损伤7天组、阿托伐他汀治疗14天组、内膜损伤14天组,以同系动物的右颈总动脉作对照。采用大鼠颈总动脉球囊损伤后再狭窄动物模型,以免疫组织化学染色、逆转录聚合酶链反应、Western blot法检测Toll样受体4及核因子κB在各组大鼠颈总动脉中的表达情况。结果大鼠颈总动脉球囊损伤后7天新生内膜增加,在新生内膜平滑肌中核因子κB(9.8%)及Toll样受体4(15.6%)染色阳性,Toll样受体4 mRNA(0.39)及蛋白水平(26.18)均增高。14天后内膜增生更加明显,管腔显著狭窄,核因子κB(23.2%)及Toll样受体4(37.2%)染色强阳性,Toll样受体4 mRNA(0.49)及蛋白水平(57.12)显著增高。与内膜损伤组相比,阿托伐他汀治疗组内膜增生程度明显减轻,核因子κB及Toll样受体4水平明显下降。结论在大鼠颈总动脉球囊损伤后再狭窄模型中,核因子κB活性增加,Toll样受体4 mRNA及蛋白水平均增高,应用阿托伐他汀后可以抑制Toll样受体4和核因子κB的表达,同时抑制内膜增生,表明Toll样受体4/核因子κB通路有可能参与了再狭窄形成过程。

关键词： 高职临床医学   内科学教学   改革  

摘要： 社会对人才的需求是职业教育发展的动力、源泉。提高教学质量是创办特色卫生职业教育的关键。就目前而言，培养面向农村、社区和基层医院中、初级医疗卫生专业人才是高职临床医学专业的目标。尽管我国高等职业教育已取得初步成效，但对职业教育现代化改革的要求仍非常迫切，教学规律仍是专家、教育工作者需要探讨的核心问题。对此，笔者总结教学心得，对高职临床医学专业内科学教学改革进行探讨。

关键词： 内科学   骨髓间充质干细胞   2'脱氧5-氮杂胞苷   细胞移植   心肌梗死   心功能衰竭   慢性实验  

摘要： 目的采用2’脱氧5-氮杂胞苷诱导的骨髓间充质干细胞移植于心肌梗死后心功能衰竭大鼠心肌中,评价其存活、分化及对心功能的保护作用,并研究其慢性演变。方法体外培养的Wistar大鼠骨髓间充质干细胞,用0.3μmol/L的2’脱氧5-氮杂胞苷体外两次诱导第二代骨髓间充质干细胞,并用溴氮胞苷标记后植入心肌梗死10天心功能衰竭大鼠的心肌疤痕中,同时以注射无血清培养基的实验动物为对照。移植前及移植后1、2、3个月通过心脏射血分数等指标评价其对心功能的保护作用,同时通过双重免疫组织化学及电镜观察对移植细胞的存活和分化进行3个月的慢性动态观察。结果移植后1个月,骨髓间充质干细胞移植组大鼠射血分数(83.3%±8.1%,n=13)高于无血清培养基移植组(47.2%±11.8%,n=12)(P<0.01);并且细胞移植组移植后较移植前心功能(64.3%±10.4%)也有改善(P<0.01)。细胞移植组移植后第2个月(射血分数为83.1%±14.4%,n=7)、第3个月(射血分数为86.3%±3.7%,n=6)心功能改善情况继续保持,与无血清培养基移植组第2个月(射血分数为51.6%±11.2%,n=6)、第3个月(射血分数为49.1%±7.7%,n=6)差异均有显著性(P<0.01)。移植的骨髓间充质干细胞在心肌及疤痕中存活,双重免疫组织化学证实其溴氮胞苷及肌钙蛋白T均阳性。电镜观察提示移植后1个月其在疤痕中具心肌样细胞部分特点,但分化细胞核大浆少,未形成明显肌小节及Z带;移植后3个月,可见明显Z带样结构。结论经2’脱氧5-氮杂胞苷诱导的骨髓间充质干细胞可改善心肌梗死后心功能衰竭大鼠的心功能,并能长期保持(观察3个月);其能在心肌梗死后心功能衰竭大鼠心肌及疤痕中存活,并能逐渐向心肌细胞分化。

关键词： 医学生   考试   内科学  

摘要： 内科学是一门重要的临床学科,需要学生多参与实践,不断提高自己的操作技能。积极的对内科学考试进行改革,提高医学生的技能操作水平,是深化高等医学教育改革、强化课程建设的一项重要举措。因此,我们研制应用了内科学考试考核综合测评体系,增强了学生学习的积极性、主动性,也增加了内科学考试的可信度,取得了良好效果。

关键词： 美国疾病预防控制中心   保健体系   糖尿病   研究报告   10年间   内科学  

摘要： 据美国疾病预防控制中心（CDC）的一份最新研究报告显示，美国的糖尿病保健在过去的10年间已得以改善，但还有很长的路要走。该项研究发表在近期的《内科学年鉴》（AIM）上。

ISBN: (纸本)7509102480

关键词： Internship and Residency   Adult   Analysis of Variance   Clinical Competence   Female   HIV Infections   Health Knowledge   Attitudes   Practice   Humans   Internal Medicine   Male   Medical Staff   Hospital   Research Support   Non-U.S. Gov't   Taiwan  

摘要： Having contact and interacting with HIV/AIDS patients has long been recognized as a means for improving AIDS-related knowledge and attitudes among physicians and hence for increasing their intention to provide AIDS care. To investigate the impact of one-month residency training in an AIDS inpatient unit on internal medicine residents, this quasi-experimental, pre-post, two-group study, conducted from April 2000 to April 2001, used questionnaires. At follow-up, residents who received training in the AIDS unit ( experimental group) were significantly more knowledgeable about HIV/AIDS, had more positive attitudes and greater intention to care for HIV-infected patients than residents who did not receive this training (control group). Results suggest that a one-month AIDS residency training intervention can effectively enhance residents' HIV-related knowledge, attitudes and intention to care for patients infected with HIV.

关键词： 内科学   医药卫生人员   技术培训   习题  

ISBN: (纸本)756410483X

摘要： 本书是《医疗机构医务人员三基训练指南——内科》的配套习题集，题型有名词解释、选择题、填充题、问答题。本书可作为医疗机构医务人员业务培训辅导用书。

关键词： Bina   data warehouse   mortality   trend   internal medicine  

摘要： Background: Epidemiological studies are useful both for investigating possible etiologic factors and for determining the extent of health provisions required. In an attempt to improve the quality of care, we have analyzed the trends of admissions to the four internal medicine wards in a community hospital in Israel. Methods: Data was collected on admission to all of the internal medicine wards of Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel, from 1999 to 2004, including discharge diagnosis, duration of stay, and mortality. The data source was the "Bina" data warehouse system of Clalit Health Services. Results: The yearly admission rate was 10,482 +/- 386. Ninety-six percent of the admissions were of Jews and 3% were of Arabs. Most of the patients were older than 75 years (43.1%);23.6% were between 65 and 74 years of age. The readmission rate was 7.4% within 1 week and 16.3% within 1 month. The three most common discharge diagnoses, not including pre-existing illnesses, were: coronary artery disease-related (21.9%), heart failure (5.4%), and pneumonia (5.6%). The average duration of stay was 4.6 +/- 0.1 days. Patients admitted for newly diagnosed malignancy, pneumonia, or CVA had a longer duration of stay (7.1, 6.8, and 6.5 days, respectively). There was a steady decline in mortality from 4.5% in 1999 to 4.2% in 2004. Conclusion: In the 5-year period studied, there was a changing trend in mortality rate, hospital duration rate, and patient age. (C) 2006 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.