参与式教学法在医学留学生骨科临床见习教学中的应用与效果评价

目的：观察参与式教学法对医学留学生骨科临床见习教学效果的影响。方法应用参与式教学法(实验组,50人)和传统教学法(对照组,48人)对医学留学生进行骨科临床见习教学研究,并以成绩考核和问卷调查的形式对教学效果进行评价。结果实验组和对照组的理论笔试成绩分别为(31.25±4.84)分和(30.97±5.65)分,两组成绩比较差异无统计学意义(P>0.05);然而,实验组的临床技能成绩和总成绩分别为(47.62±3.41)分和(78.82±4.37)分,均明显优于对照组的(45.32±4.62)分和(76.29±5.28)分,差异均具有统计学意义(P<0.05);实验组的各项问卷调查结果均好于对照组,差异均具有统计学意义(P<0.05)。结论参与式教学法有利于培养医学留学生在骨科临床见习中的学习能力,并提高教学质量。     

病例教学法在全科医学概论教学中的应用

目的探索病例教学法在全科医学概论中的应用模式和价值,为进一步推广提供依据。方法在2个全科医学教学班的187名学生中采用病例教学方法,分析病例教学法的教学目的、教学对象和教学内容。结果教学评价系统显示,全科医学概论教学评价的平均分数为90.15分。结论与传统教学方法比较,病例教学法的教学效果更好。     

互联网平台在心肺复苏教学中的应用

目的探讨互联网平台应用于心肺复苏(CPR)教学的效果。方法将昆明医学院2007、2008级临床本科学生随机分为两组。对照组98名学生,在CPR教学中采用传统教学法;观察组99名学生,在传统教学法基础上,应用互联网平台进行教学。课程结束后对两组学生进行考核,比较两组学生CPR理论考试和实际操作考核成绩,并调查学生对互联网平台在CPR教学过程中应用的认可程度。结果观察组与对照组平均CPR理论考试成绩分别为(88.2±8.0)分和(78.8±9.1)分,差异有统计学意义(P<0.05);CPR实际操作考核成绩分别为(86.2±5.0)分和(78.3±5.5)分,差异有统计学意义(P<0.05);100%的学生喜欢并接受互联网平台教学。结论互联网教学平台可明显提高CPR理论和实际操作的教学效果,并得到学生的认可,可以明显激发医学生的主动学习兴趣。     

思维导图与传统PPT在骨科实习生中的教学效果比较

目的：比较应用思维导图和传统PPT在骨科实习生中的教学效果。方法：选取2016级在我院实习的临床医学专业3班的学生为受试对象,随机分为试验组(25名)和对照组(26名)。试验组采用思维导图教学法,对照组采用传统PPT课件教学,授课教师、授课内容、授课学时相同。实习结束后对学生进行理论和技能考试,并对每位学生发放临床思维能力评估量表。结果：试验组和对照组学生的理论考试成绩分别为(91.92±5.47)分、(85.69±6.55)分,技能考试成绩分别为(89.56±4.18)分、(84.38±4.47)分,差异有统计学意义(P<0.05)。试验组和对照组学生的临床思维能力评分分别为(91.84±3.69)分、(76.46±3.68)分,差异有统计学意义(P<0.05)。结论：思维导图教学法的效果优于传统PPT教学法,更有助于医学生临床思维能力的提高。     

病例教学法在全科医学概论教学中的应用

目的 探索病例教学法在全科医学概论中的应用模式和价值，为进一步推广提供依据。方法 在2个全科医学教学班的187名学生中采用病例教学方法，分析病例教学法的教学目的、教学对象和教学内容。结果 教学评价系统显示，全科医学概论教学评价的平均分数为90．15分。结论 与传统教学方法比较，病例教学法的教学效果更好。     

PBL教学法在药物化学教学改革磺胺醋酰钠合成中的探索应用

目的 探索基于问题的教学模式(problem-based learning,PBL)对药物化学实验磺胺醋酰钠的合成教学效果的促进作用.方法 2018年9月-2019年1月选取学校高职2017级(二年级)药学专业122人为研究对象,由于药物化学的重要基础是有机化学,故两实验组根据上一学期有机化学期末卷面成绩分为PBL教学组和传统讲授法两个组,以问卷及对问题的理解和解答形式评价教学效果.结果 在各种教学效果比较后,总体课程满意度PBL教学组比传统教学组更好,差异有统计学意义(P＜0.05).实验卷面测试PBL教学组测验平均(90.12±0.53)分高于传统教学组测验平均(81.78±0.68)分,差异有统计学意义(P＜0.05).问卷分析和考卷结果显示,PBL教学方法组在学生课堂气氛优于传统讲授式教学组,可提高学生对磺胺醋酰钠合成的理解和掌握程度,且增加学生的学习自信心及主动学习能力,且对课堂有较好的满意度.结论 相对常规教学法,通过尝试PBL教学法在药物化学课程中的应用,其能够提高教学效果,利于师生共同进步.     

PBL教学法在药物化学教学改革磺胺醋酰钠合成中的探索应用

目的 探索基于问题的教学模式(problem-based learning,PBL)对药物化学实验磺胺醋酰钠的合成教学效果的促进作用.方法 2018年9月-2019年1月选取学校高职2017级(二年级)药学专业122人为研究对象,由于药物化学的重要基础是有机化学,故两实验组根据上一学期有机化学期末卷面成绩分为PBL教学组和传统讲授法两个组,以问卷及对问题的理解和解答形式评价教学效果.结果 在各种教学效果比较后,总体课程满意度PBL教学组比传统教学组更好,差异有统计学意义(P＜0.05).实验卷面测试PBL教学组测验平均(90.12±0.53)分高于传统教学组测验平均(81.78±0.68)分,差异有统计学意义(P＜0.05).问卷分析和考卷结果显示,PBL教学方法组在学生课堂气氛优于传统讲授式教学组,可提高学生对磺胺醋酰钠合成的理解和掌握程度,且增加学生的学习自信心及主动学习能力,且对课堂有较好的满意度.结论 相对常规教学法,通过尝试PBL教学法在药物化学课程中的应用,其能够提高教学效果,利于师生共同进步.     

临床路径与循证医学相结合应用于心内科住院医师规范化培训

目的探讨临床路径与循证医学相结合教学法在心内科住院医师规范化培训中的应用效果。方法选取在我院心内科住院医师规范化培训的60名学生作为研究对象,分为实验组和对照组,每组各30人,对照组采用传统的教学方法,实验组采用临床路径联合循证医学教学法,规范化培训任务结束后进行随堂测试和问卷调查评估教学效果。结果临床路径联合循证医学教学法组的学习成绩显著高于传统教学法组,实验组学生考核成绩为(86.2±3.4)分,对照组学生(79.0±4.6)分,差异有统计学意义(P<0.05);临床路径联合循证医学教学组对培训的满意度优于对照组,差异有显著性(P<0.05)。结论在心血管内科住院医师规范化培训教学中,临床路径联合循证医学教学法优于传统教学法。     

“新医科”背景下WPBL教学法在医学人文英语课程中的效用研究

目的探索新医科背景下在医学人文英语课堂中引入网络环境下以问题为基础的学习(web problem based learning,WPBL)教学法是否有助于课程学习和学生人文素养的提升。方法以西安医学院临床专业2017级602名学生为实验组,2018级610名学生为对照组,围绕八大模块展开持续一学期的研究。对照组采用传统教学法;实验组依托蓝鸽云网络语言学习平台,使用WPBL教学法授课。教学结束后通过期末考试成绩比较、发放自制调查问卷,比较两种教学法对学生自学能力、思维能力、团队合作能力、知识运用能力培养等方面的教学效果。数据采用SPSS 20.0进行统计学处理。结果实验组学生期末平均成绩(62.13±2.11)分高于对照组(60.42±2.03)分,差异有统计学意义(P<0.05)。调查问卷的结果显示,两组学生在评价教学效果的各项目上均存在差异,且实验组的各项比例均在60%以上,显著高于对照组。实验组93.3%的学生满意WPBL教学法,对照组只有43.0%的学生满意传统教学法,两者差异显著。实验组学生在自学能力、查阅资料能力、探索知识能力、语言表达能力和发现问题、解决问题能力方面的评价均高于对照组学生。91.1%的实验组学生认为在课程中引入WPBL教学法有助于提升他们的医学人文素养,高于对照组学生的比例。结论医学人文英语课程引入WPBL教学法既能使学生掌握学习本领,又能强化学生人文素养,有助于推动医学教育发展。     

多媒体教学在微生物学及免疫学中的应用效果

目的探讨多媒体辅助教学在微免学教学中的应用效果。方法在护理大专2005级03、04班微免学教学中,分别应用多媒体辅助教学法和传统教学法,课后调查学生对两种教学法的满意度,用书面测试形式比较两班学生的学习成绩,结果应用多媒体辅助教学在激发学生学习兴趣,增强理解记忆力,培养创造性思维能力,拓宽知识面等显著大于传统教学法(P<0.01)。结论在微免学教学中应用多媒体辅助教学效果好深受学生欢迎。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.