德国医院临床运行模式浅析及其启示

德国奥格斯堡中心医院是一所综合性公立性医院,患者就诊能享受几乎全免费医疗服务,其眼科的运行方式,能够代表德国医疗体系的特点。医务人员具有高度的责任感,主动营造良好的医患沟通氛围。临床诊治严格遵循欧洲最新的眼科诊疗指南,询证医学证据。

     

中国手癣和足癣诊疗指南(科普版2022)CSCD

手足癣是皮肤科最常见的疾病之一。为了使国内的皮肤科专业医生及基层医生更好更规范的诊治手足癣,国内医学真菌专家分别于2017年和2020年编写出版了中国手癣和足癣诊疗指南和“指南”的基层医生实践版,这两个指南对广大的皮肤科医生及全科医生均起到了非常好的临床指导作用。     

联邦德国的生物工程

德国是首先对生物工程的重要性给予官方承认的国家之一,在1974年研究与技术部接受了DECHMA报告(德国化学设备制造者协会)的提议,这个协会一直在德国或欧洲促进生物工程的开展,它是欧洲生物工程学联合会(创立于1978年,现在包括来自18个欧洲国家的49个科学协会)的创立协会和秘书处。     

人工定制细胞与精准医疗的最新研究进展

合成生物学研究为生命医学领域中所需求的综合性、多元化基因网络实现时间和空间复杂维度基因调控提供可能,并助力临床医学应用研究实现信息精准化、智能诊疗一体化发展,为未来医疗卫生事业革命性快速发展提供强大的技术支撑。该文以合成生物学技术平台设计开发的人工定制细胞、电子药物、智能诊疗一体化系统等方向为核心内容,对最新的合成生物学生命医学研究案例进行综述分析,讨论当前合成生物学在医学应用研究中存在的问题和未来所面临的挑战,并对其发展前景进行展望。     

女性血脂异常对辅助生殖助孕结局影响的研究进展

诸多研究表明,代谢异常对女性生育结局具有显著影响。对于接受辅助生殖技术(assisted reproductive technology, ART)治疗的代谢异常女性患者,其临床结局应受到高度重视。该文围绕女性血脂代谢异常,综述其在ART治疗中对助孕结局、母婴围产期安全以及后代健康状况的影响,并探讨相关机制和治疗策略的最新研究进展,旨在为妇幼健康领域的诊疗提供更多参考信息和临床策略,以期提升代谢异常女性在接受ART治疗时的助孕效果与安全性,为这一特殊人群的健康生育保驾护航。     

欧盟拔款100万ECU提高生物技术公众意识

欧洲委员会准备在今后三年里提供100万欧洲货币单位(ECU)以促进整个欧洲对生物技术的公众意识和理解。目前,已投资60万ECU给欧洲联合会生物技术公众意识工柞组。随后的40万ECU将用于协调与生物技术工作组有关的国际舆论研究。     

医学真菌分类学最新进展

近年分子生物学、遗传学和生物信息学进步迅速,真菌分子系统学研究日新月异,真菌命名及分类已发生划时代的改变。诸多真菌存在种属拆分与合并,甚至菌名的改变,亟需更新相关信息。该文总结了子囊菌门(Ascomycota)、担子菌门(Basidiomycota)及接合菌门(Zygomycota)等分类学新进展,涵盖了主要医学真菌致病菌,如毛霉菌、皮肤癣菌、念珠菌、隐球菌、马拉色菌及暗色真菌等。     

第20届国际高血压学会年会报道

在ALLHAT(Antihypertensive and Lipidlowering Treatment to Prevent Heart Attack Trial)结果在2002年底发表之后。2003春美国的高血压指南修订完毕,以JNC7的形式发表。欧洲高血压学会(ESH)和欧洲心脏学会的高血压指南不久后发表。此浪潮延续至2004年2月在巴西召开的国际高血压会议的WHO／ISH高血压处理指南修订。     

《酵母遗传学和分子生物学指南》

《酵母遗传学和分子生物学指南》(Guide to yeast genetics and molocular biology)由Christine Guthrie和Gerald R.Fink编著,1991年学术出版社出版,933页。该书是《酶学方法》(Methods in enzymology)多卷书中的第194卷,它汇集了研究酵母基因的各种最新方法和程序。该指南有下列特点:①其程序能使新手建立酵母实验室并掌握     

中国甲真菌病诊疗指南(2021年版)

由中华医学会皮肤性病学分会、中国中西医结合学会皮肤性病专业委员会和中国医师协会皮肤科医师分会共同组织专家组成“甲真菌病指南专家工作组”,对2015年版指南进行了补充和修订,制定了2021年版中国甲真菌病诊疗指南。参加制定本指南的专家为(按姓氏笔划排列)王爱平(北京大学第一医院,国家皮肤与免疫疾病临床医学研究中心)、冉玉平(四川大学华西医院)、占萍(江西省人民医院)、刘维达(中国医学科学院皮肤病医院)、吕雪莲(首都医科大学附属北京安贞医院)、朱红梅(海军军医大学附属长征医院)、朱敏(复旦大学附属华山医院)、李福秋(吉林大学第二医院)、李若瑜(北京大学第一医院,国家皮肤与免疫疾病临床医学研究中心)、余进(北京大学第一医院,国家皮肤与免疫疾病临床医学研究中心)、章强强(复旦大学附属华山医院)、温海(海军军医大学附属长征医院)、潘炜华(海军军医大学附属长征医院)。余进、朱红梅执笔。温海、李若瑜责任作者。     

Anthropology and genetics of the caucasus peoples and the problem of the origin of the caucasoids

The electrophoretical polymorphisms of some blood proteins were studied in the Talysh population of Pirasora situated in South-East Azerbaidjan. We calculated the gene frequencies of these polymorphisms and determined the genetic distances between the Talyshes and some Iranian populations of North, Central and South Iran, Afghans, and three populations of Azerbaijan. The Talyshes are very close to Iranians of Shiraz, whereas they are distant from the Azerbaijanians. Anthropological investigations showed that the Caucasoids and Mongoloids lived in the Aragvi Basin since the Eneolithic period. This was stated by Alexeev (1974), who emphasized the mixture of the Caucasus populations from ancient times on. We calculated the genetic distances between the Caucasus populations and numerous populations of other geographic regions, considering 28 alleles of 12 loci of blood group, serum protein and red cell enzyme polymorphisms and constructed the dendrogram of these populations. The position of the Caucasus populations in the dendrogram corresponds on principle to the earlier anthropological observations. The clustering of the Caucasoid populations corresponds completely with anthropological and historical data, and supports our earlier hypothesis (Nazarova 1999) concerning the differentiation of Caucasoids, Northern Mongoloids and Amerinds from the populations, which inhabitated Asia in palaeolithic times.     

Kinematics and dynamics of the temporomandibular joint and of the movements of the mandible

In order to analyze the complicated movements of the mandible as the open-closing movement and the protrusio are, it is useful to evaluate the basic kinematic principles and reduce them to simple technical constructions. Both the open-closing movement and the protrusio could be reduced to 4-bar links, which were used to simulate the movements with help of a computer. Besides, the polodes and the curves of points in the muscular attachments could be constructed. The 2 entirely different 4-bar links have 3 things in common: The resting system - cranium, the moving system - mandibula, and 1 of the 2 arms connecting these 2 systems - the ligamentum laterale. As this ligament is taut during movements it can be considered a "guiding ligament" representing 1 of the 3 determining components of the mandibular movements. The other of the 2 arms has no anatomical equivalent; this arm, however, is "replaced" by the 2 other determining components of the mandibular movements: the joint and the muscles. The curves, which the Caput mandibulae describes, are practically identical for the open-closing movement and the protrusio despite of the different 4-bar links and these curves exactly correspond to the Discus articularis, taut by the upper part of the M. pterygoideus lateralis. The muscles do not only just move the mandibula, but they are also the component, which can choose between the different mandibular movements. By means of the curves, which points in the muscular attachments describe, the function of the masticatory muscles could be analyzed exactly.     

On the structure and dynamics of the complex of the nucleosome and the linker histone

Several different models of the linker histone (LH)–nucleosome complex have been proposed, but none of them has unambiguously revealed the position and binding sites of the LH on the nucleosome. Using Brownian dynamics-based docking together with normal mode analysis of the nucleosome to account for the flexibility of two flanking 10 bp long linker DNAs (L-DNA), we identified binding modes of the H5-LH globular domain (GH5) to the nucleosome. For a wide range of nucleosomal conformations with the L-DNA ends less than 65 Å apart, one dominant binding mode was identified for GH5 and found to be consistent with fluorescence recovery after photobleaching (FRAP) experiments. GH5 binds asymmetrically with respect to the nucleosomal dyad axis, fitting between the nucleosomal DNA and one of the L-DNAs. For greater distances between L-DNA ends, docking of GH5 to the L-DNA that is more restrained and less open becomes favored. These results suggest a selection mechanism by which GH5 preferentially binds one of the L-DNAs and thereby affects DNA dynamics and accessibility and contributes to formation of a particular chromatin fiber structure. The two binding modes identified would, respectively, favor a tight zigzag chromatin structure or a loose solenoid chromatin fiber.     

人类基因组及后基因组研究进展及其应用与开发研究现状

人类对自身基因组的研究,随着人类基因组工作草图的绘制完成和对基因功能研究的深入已加快进入了实质性、关键性的开发利用阶段。本文概述了人类基因组及后基因组的研究进展及依此开展基因治疗及基因（组）药物研制等应用开发研究的现状。     

Serology and systematics of the Ebenales and the Theales

The systematic position ofthe Ebenaceae, Sapotaceae, Styracaceae, Ochnaceae, Stachyuraceae, Dipterocarpaceae, Clusiaceae and Hypericaceae has been investigated using serological comparisons of sets of antigenic determinants. The results show that the Sytracaceae and Sapotaceae are undoubtedly more closely associated with the Actinidiaeceae and Theaceae, respectively, than with each other. We found no corresponding determinants betnween antigen systems from the Ebenaceae and systems from any other family whose relations to this family have been proposed. As discovered previously, investigations of antigen systems from the Ochnaceae, Dipterocarpaceae, Stachyuraceae, Clusiaceae and Hypericaceae are against the idea of a natural order “Theales” in which these families, or at least some of them, are combined with the Theaceae and Actinidiaceae. This paper completes our previous investigations which largely support a superorder Ericanae sensu Ehrendorfer and Takhtajan. We propose to include the Actinidiaceae and Theaceae in this superorder, assigning them a central position laong with the Sapotaceae and Sytracaeae on one side and the Primulales and Ericales on the other. Another most interesting finding is that there are corresponding determinants between antigen systems from the members of the Ericanae and representatives of the Polemoniaceae and Loasaceae.     

Biophysics and Structure of the Patch and the Gigaseal

Interpreting channel behavior in patches requires an understanding of patch structure and dynamics, especially in studies of mechanosensitive channels. High resolution optical studies show that patch formation occurs via blebbing that disrupts normal membrane structure and redistributes in situ components including ion channels. There is a 1-2 μm region of the seal below the patch where proteins are excluded and this may consist of extracted lipids that form the gigaseal. Patch domes often have complex geometries with inhomogeneous stresses due to the membrane-glass adhesion energy (E_a), cytoskeletal forces, and possible lipid subdomains. The resting tension in the patch dome ranges from 1-4 mN/m, a significant fraction of the lytic tension of a bilayer (∼10 mN/m). Thus, all patch experiments are conducted under substantial, and uneven, resting tension that may alter the kinetics of many channels. E_a seems dominated by van der Waals attraction overlaid with a normally repulsive Coulombic force. High ionic strength pipette saline increased E_a and, surprisingly, increased cytoskeletal rigidity in cell-attached patches. Low pH pipette saline also increased E_a and reduced the seal selectivity for cations, presumably by neutralizing the membrane surface charge. The seal is a negatively charged, cation selective, space with a resistance of ∼7 gigohm/μm in 100 mM KCl, and the high resistivity of the space may result from the presence of high viscosity glycoproteins. Patches creep up the pipette over time with voltage independent and voltage dependent components. Voltage-independent creep is expected from the capillary attraction of E_a and the flow of fresh lipids from the cell. Voltage-dependent creep seems to arise from electroosmosis in the seal. Neutralization of negative charges on the seal membrane with low pH decreased the creep rate and reversed the direction of creep at positive pipette potentials.     

Comparison of the Effects of Flexion and Extension of the Thumb and Fingers on the Position and Cross-Sectional Area of the Median Nerve

Objective

To assess the separate effects of thumb and finger extension/flexion on median nerve position and cross-sectional area.

Methods

Ultrasonography was used to assess median nerve transverse position and cross-sectional area within the carpal tunnel at rest and its movement during volitional flexion of the individual digits of the hand. Both wrists of 165 normal subjects (11 men, 4 women, mean age, 28.6, range, 22 to 38) were studied.

Results

Thumb flexion resulted in transverse movement of the median nerve in radial direction (1.2±0.6 mm), whereas flexion of the fingers produced transverse movement in ulnar direction, which was most pronounced during flexion of the index and middle fingers (3.2±0.9 and 3.1±1.0 mm, respectively). Lesser but still statistically significant movements were noted with flexion of the ring finger (2.0±0.8 mm) and little finger (1.2±0.5 mm). Flexion of the thumb or individual fingers did not change median nerve cross-sectional area (8.5±1.1 mm²).

Conclusions

Volitional flexion of the thumb and individual fingers, particularly the index and middle fingers, produced significant transverse movement of the median nerve within the carpal tunnel but did not alter the cross-sectional area of the nerve. The importance of these findings on the understanding of the pathogenesis of the carpal tunnel syndrome and its treatment remains to be investigated.