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目的 沟通技能是神经科住院医师必须掌握的核心能力之一。本研究旨在了解神经科住院医师医患沟通技能现况，并初步探讨可能的提升方式。 方法 选择北京协和医院神经科25名住院医师为研究对象，在进行年度客观结构化临床考试（objective structured clinical examination，OSCE）考核时，同期采用医患沟通技能评价（set elicit give understand end，SEGUE）量表评估其医患沟通能力，SEGUE量表包括5个维度，分别是“问诊准备”“信息收集”“信息给予”“理解患者”及“结束问诊”，共计25分。分析神经科住院医师医患沟通能力的常见薄弱环节、表现方式，并初步探讨可能的提升措施。 结果 25名住院医师均接受了医患沟通能力评估，平均分为（20.78±3.85）分，不同性别住院医师之间的差异无统计学意义[（20.81±3.68）分 vs.（20.50±4.29）分，P=0.86]。各评估维度平均分由高到低依次为“问诊准备”“理解患者”“信息收集”“信息给予”及“结束问诊”。其中，“进一步说明下一步诊疗方案”单项得分最低，“询问患者是否还有其他问题需要探讨”和“解释诊断性操作的理论依据”两项得分也较低。按照住院医师入职年限进行亚组分析，结果显示住院医师的医患沟通能力虽然随着入职年限增加而升高，但组间差异不具有统计学意义，且各组间不足之处相仿。 结论 神经科住院医师医患沟通能力存在欠缺，且这种不足并未随着临床实践的积累得到显著提高。提高神经科住院医师的医患沟通能力，不仅需要持续提升专业技术能力，还要积极倡导开设系统、专业的医患沟通培训课程，从医疗技术和沟通技术两方面提高医患沟通的效果。 Abstract: Objective Communication skills are one of the core competencies in neurology residency training. This paper aimed to investigate the current status of doctor-patient communication skills among neurological residents, and thus explore possible means to improve them. Methods A total of 25 resident physicians in the neurology department of Peking Union Medical College Hospital were selected as the study subjects, and the doctor-patient communication skills was evaluated by set elicit give understand end (SEGUE) framework during the annual objective structured clinical examination (OSCE). The SEGUE framework consists of 5 dimensions with a full score of 25 points. They are "set the stage" "elicit information" "give information" "understand the patients" and "end the encounter". To analyze the common weaknesses and manifestations of doctor-patient communication skills of neurology residents, and then discussed the possible improvement measures. Results All of the 25 residents received evaluation of doctor-patient communication skills with a mean score of 20.78±3.85, and the difference between different genders was not statistically significant (20.81±3.68 vs. 20.50±4.29, P=0.86). The dimension of "set the stage" reached the highest score, followed by "understand the patients" "elicit information" "give information" and "end the encounter". Among all of the items, the score of item "review next steps with patient" was the lowest, the other two items, "ask if there is anything else patient would like to discuss" and "explain rationale for diagnostic procedures", also had very low scores. Subgroup analysis based on the employment year of resident showed that although the doctor-patient communication skills of residents improved with the increasing of employment year, the difference between the subgroups was not statistically significant. A similar pattern of shortcomings was observed among the different subgroups. Conclusions Doctor-patient communication skills of neurological residents are insufficient, which could not be significantly improved with the accumulation of clinical practice. To improve the doctor-patient communication skills of neurology residents, it is not only necessary to continuously improve the professional technical ability, but also to actively advocate the establishment of systematic and professional doctor-patient communication training courses. Improve the effect of doctor-patient communication from two aspects of medical technology and communication technology.

叉指数优化选择是传统MMSE-Rake（最小均方差Rake接收机）算法的重要组成部分,广泛应用于UWB（超带宽）Rake接收机中。为了提高在低速传输条件下UWB系统对多径信号接收的快速识别能力,提出了一种基于优化抽头系数的MBER（最小误比特率）改进算法,该算法可在不降低多径分辨率的前提下,通过简化Rake叉指数实现快速定位。仿真结果表明,在低速CM3（NLOS信道）和CM4（特殊情况下NLOS信道）多径模拟信道传输条件下,改进后的算法在性能上优于传统MMSERake算法,不仅降低了Rake接收机的复杂度,还提高了信号接收的实时性。

用溶胶-凝胶法合成了发蓝绿光的4SrO·7Al2O3:Eu2+高显色荧光粉.从XRD、DTA以及红外谱图得出当干凝胶经1200℃灼烧可以完全形成4 SrO·7Al2O3晶相,这比用高温固相合成法低了200℃.通过激发光谱和发射光谱分析其发光特性,随着灼烧温度的升高,其发光强度增大.

肿瘤的免疫治疗是治疗肿瘤的新方法,它通过增强肿瘤抗原或肿瘤相关抗原的免疫原性, 诱导机体产生肿瘤特 异性的免疫应答反应而杀伤肿瘤细胞。本系列研究采用同源重组方法构建了表达人癌胚抗原( carcino embryonic antigen, CEA)的重组痘苗病毒, 经动物实验证明了其具有强免疫原性、安全性和防治 CEA 阳性肿瘤的可靠性。

目的: 研究广东汉族人群中人类白细胞抗原(HLA)DQA 1 等位基因频率分布, 为 HLA DQA 1 相关疾病的研究 及人类学的研究提供基础资料。方法: 用序列特异性引物-聚合酶链反应( SSP-PCR)法对广东汉族人群作 HLA DQA 1等位基 因分型,根据出现扩增产物所用的序列特异性引物,直接分析判断受检查者的基因型别。结果: 146例广东汉族健康无血缘关 系个体中共检出 10 个等位基因, 以 DQA 1＊0301 的频率( 0. 291)最高 ,基因型的观察值与期望值相比, 符合 Hardy-Weinberg 平衡,纯合基因型的观察值与期望值相比, P >0. 95, 家系调查及重复性试验显示结果可靠。结论: 广东汉族 HLA DQA 1 基 因与其他 10 组华人群体的资料比较, 总体检验有显著差异,但均以 DQA 1＊0301的频率最高, 显示华人的遗传系统既有共性 亦有各自的特点,南方汉族人群体间或与南方一些少数民族比较均有显著差异,显示南方华人群体遗传背景的复杂性。

摘 要 采用序列特异性引物-聚合酶链反应(PCR-SSP)技术对H LA-DR 亚区进行基因分型。使用鉴定 DR1 ～ DRw18 的序列特异性引物和阳性对照引物, 双盲检测了22 例已知DR 血清型的标本, 二者完全一致。并 对未知血清型的标本作DR 基因分型。本法具有较高分辨度、高特异性和简便快速的特点, 为临床器官组织移 植配型、疾病相关性分析、法医鉴定和人类学研究提供了新的技术方法。

大鼠肝细胞癌变过程中,肝细胞核和细胞质的核糖核酸(RNA)的复杂性有改变,这个变化在诱癌的“早期”(2周之内)已出现,并延续在肝细胞癌变的整个过程中。反映了肝细胞基因表达系统的变化。高等生物具有复杂的基因组织,Britten等人应用DNA复性动力学的方法,按其复性速度的快慢,将真核生物的DNA分为单一顺序、中度重复顺序和高度重复顺序三类不同的基因组织,对基因组织的研究深入了一步。