通过探讨基础仿真模拟技术、高级综合模拟人技术、多媒体教学技术、计算机辅助教学、网络教学等现代教育技术的特点,分析各种现代教育技术手段教学方法的优缺点,提出通过优化组合各技术手段方法,可以实现优势互补,相辅相成,从而建立临床基本技能的立体化教学模式,提高教学效果。

ObjectiveTo investigate the influence of advanced glycation endproducts(AGEs) on CD40 expression in the human umbilical vein endothelial cells and the interference effect of adiponectin(APN) in this process.Methods① HUVEC-12 cells were cultured and incubated with AGEs at different concentrations(0,100,200,400 and 800 mg/L).RT-PCR and Western blotting technology were used to detect mRNA and protein expression of CD40 in different groups.② Pretreated with adiponectin at different concentrations(0,5,10 and 15μg/mL),HUVEC-12 cells were cultured with AGEs(400 mg/L) for 24 h.The mRNA and protein expression of CD40 in different groups were detected by RT-PCR and Western blotting respectively.ResultsThe expression of CD40 was significantly increased in a dose dependent manner by AGEs within 0～800 mg/L for 24 h.Pretreatment with APN at different concentrations attenuated the increased expression of CD40 induced by AGEs in a dose-dependent manner.ConclusionAdiponectin can suppress AGEs induced CD40 high expression in the human umbilical vein endothelial cells.

Objective To investigate the protective effects of polarized solution and astragali solution on myocardium damage caused by acute organic phosphorus poisoning.Methods 81 acute organophosphate poisoning patients including 24 cases of mild-poisoning,26 cases of midrange poisoning and 31 cases of severe poisoning were randomly divided into two groups:group A(conventional therapy group,n=44),group B(conventional therapy + polarized solution and astragali solution therapy group,n=37);plasma levels of creatine kinase(CK),creatine kinase isoenzymeMB(CKMB),lactate dehydrogenase(LDH)were measured by dynamic method. Plasma levels of tumor necrosis factor(TNF),interleukin-1(IL-1) and interleukin-6(IL-6) were measured by euzymelinked immunosorbent assay method(ELISA).Electrocardiograms were monitored at bedside.The dynamic change of indicators were observed and pathogenesis was discussed.Results Plasma levels of biochemical indicators and cytokine were significantly increased in both two groups.There is no significantly difference between group A and B(P0.05).48 hours after treatment,plasma levels of biochemical indicators and cytokine in group A were significantly higher than that in group B(P0.05).Severity abnormal appearance of Electrocardiograms were also significantly higher in group A.Seven days after treatment,plasma levels of such indicators were near to normal.Conclusion Polarized solution and astragali solution have protective effects on the myocardium damage caused by acute organic phosphorus.One of mechanisms might be related to reduce content of inflammatory factor such as TNF and IL.

目的 比较阿奇霉素、红霉素、磺胺嘧啶、大蒜素体外抗弓形虫的效果.方法 用弓形虫RH株速殖子感染培养在盖玻片上的巨噬细胞,每一种药物根据其血药浓度及预实验设立2～3个浓度,分别在速殖子侵入细胞前和侵入细胞后用不同浓度的药物处理,每隔1小时在倒置显微镜下观察细胞及弓形虫的形态及生长情况,9天后取出盖玻片,经吉氏染色、二甲苯透明后,镜下观察.再将培养液及培养细胞注入鼠腹腔,观察小鼠的发病情况.结果 阿奇霉素的浓度在20 μg/mL 时具有抑制虫体生长的作用,＞40 μg/mL 时对巨噬细胞有明显的毒性.红霉素的浓度为100 μg/mL、150 μg/mL时可抑制弓形虫的生长与繁殖,但不能完全杀死虫体,形成假包囊,将假包囊及培养液接种小鼠腹腔,6天后,小鼠发病死亡,解剖小鼠后,可见大量的虫体.没有观察到100 μg/mL 、200 μg/mL的磺胺嘧啶及20 μg/mL、40 μg/mL的大蒜素抑制弓形虫生长的作用.结论 阿奇霉素具有明显的杀灭速殖子的作用,但浓度大于40 μg/mL时对细胞的毒性较大,100 μg/mL的红霉素可抑制弓形虫生长繁殖,形成假包囊(或包囊).当红霉素的浓度达150 μg/mL时,对弓形虫的抑制作用增强,但不能完全杀灭弓形虫.100 μg/mL、200 μg/mL的磺胺嘧啶及20 μg/mL、40 μg/mL的大蒜素对弓形虫的生长无抑制作用.

对106例各种肝脏疾病合并腹泻的住院病人资料进行总结和分析。结果:(1)各种肝脏疾病中,肝源性腹泻发生率由高到低依次为:各型肝硬化(64.15%)、慢性乙型病毒性肝炎(18.87%)、原发性肝癌(11.32%)、脂肪肝(3.77%)和药物性肝病(1.89%),其临床表现无特征性;(2)腹泻发生在肝病早期的较少,大多出现在肝病的中后期;(3)腹泻的严重程度与肝功能密切相关。早期诊断和改善肝功能是治疗肝源性腹泻的关键。

目的:探讨糖尿病新西兰兔心、肾一氧化氮合酶(NOS)活力和抗氧化酶活力变化以及它们在糖尿病发病机制中的作用.方法:采用高脂高糖饲料喂养新西兰兔,建立一种新的糖尿病动物模型.观察糖尿病新西兰兔心、肾一氧化氮水平,一氧化氮合酶(NOS)活力及抗氧化酶活力的变化.结果:糖尿病新西兰兔出现大量蛋白尿(P＜0.05);肌酐清除率(CCr)明显高于对照组(P＜0.01);心脏组织中NO-2水平和NOS活力明显低于对照组(P＜0.05),而肾脏组织中NO-2水平和NOS活力明显高于对照组(P＜0.01);血糖及胰岛素明显高于对照组(P＜0.01);超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(catalase)活性都明显低于对照组(P＜0.01).结论:糖尿病新西兰兔心、肾中的NO-2水平和NOS活力异常,抗氧化酶活力明显降低,糖尿病的心、肾并发症可能与它们的异常变化有关.

目的:探讨糖尿病新西兰兔一氧化氮(NO)水平和抗氧化酶活力变化以及它们在糖尿病发病机制中的作用.方法:采用高脂高糖饲料喂养新西兰兔,建立糖尿病动物模型.观察糖尿病新西兰兔血液中的一氧化氮水平,一氧化氮合酶(NOS)活力及抗氧化酶活力的变化.结果:糖尿病新西兰兔血浆中NO水平和NOS活力明显增高,抗氧化酶活性低于喂正常饲料新西兰兔.结论:糖尿病的起因可能与血浆中NO水平和抗氧化功能的异常变化有关.

Objective: To establish diabetic model in New Zealand rabbits and study the relationship between nitric oxide(NO) pathway and diabetic nephropathy.Methods:Two groups of New Zealand White rabbits received regular rabbit chow (the normal control) or high fat high sucrose diet for 4 months. The levels of plasma insulin and glucose were investigated. The level of renal NO and the activity of renal NO synthase (NOS) were measured besides morphological observation. Results:Glomerular lesions in test group involved mesangial cell proliferation trend of K-W node and fibrin cap and accumulation of mesangial matrix and thickness of glomerular membrane basement.There were still wall thickness and cavity stricture in renal resistant vasculature.Renal NO level and NOS activity were higher in test group than in control group(P0.001). There was an elevation of the kidney/body weight in the early stage of the diabetes(P0.05)as well as a great amount of proteinuria(P0.05).The creatinine clearancerate(CCr) increased apparently(P0.001). Conclusion:New Zealand White rabbits could be used to establish the model of diabetes; Nitric oxide might be the main inductive mediator of the glomerular hyperfiltration in early diabetes.