以问题为导向的研讨式教学在医学影像学教学中的应用

目的探究以问题为导向的研讨式教学在医学影像学教学实践中的可行性及应用价值。方法将中南大学湘雅医学院2012级临床医学八年制64名学生,在医学影像学见习教学过程中随机分为两组:一组为传统教学组(32人),另一组为以问题为导向的研讨式教学组(32人)。学期结束后由第三方机构对两组学生进行理论测试及阅片能力考核;通过SPSS 20.0进行配对t检验。结果以问题为导向的研讨式教学组在理论测试中问答题及总成绩得分明显优于传统教学组[(13.71±2.16)vs.(11.50±2.59),P=0.002;(79.88±4.70)vs.(74.29±5.16),P=0.0003];以问题为导向的研讨式教学组学生的阅片能力平均成绩优于传统教学组[(87.92±8.46)vs.(80.83±6.86),P=0.003]。结论以问题为导向的研讨式教学较传统教学具有优势,能让学生获得更好的知识应用能力、综合分析能力及阅片思维能力。     

全麻气管插管的教学观察

目的:观察气管插管教学中伴随的问题及术后喉痛及声音嘶哑的发生情况,以期提高气管插管教学的质量。方法:100例全麻手术患者随机分为教学组和医师组,每组50例。记录2组的插管时间、脱氧合发生率和尝试插管次数,并在患者离开麻醉后恢复室时和术后24 h评估患者喉痛和声音嘶哑情况。结果:插管时间、脱氧合发生率和插管次数在教学组均显著高于医师组(P<0.01)。医师组的喉痛视觉模拟评分显著低于教学组(P<0.01),而2组声音嘶哑发生率差异无统计学意义(P>0.05)。结论:气管插管教学会延长插管时间并增加插管次数,同时增加气道损伤的概率。     

PBL教学法在医学生物化学实验中的应用

目的:探讨以问题为基础的学习法(PBL)在生物化学实验教学中的效果.方法:选取200名2年级临床医学专业本科学生为研究对象,其中100名学生为PBL组,另100名学生为传统教学组;对PBL组学生发放问卷调查了解学生对PBL教学的认同度,学期结束时分析比较两组学生的考试成绩.结果:PBL组90％以上的学生能接受PBL教学法,认为PBL教学法能提高学习兴趣及综合分析能力,培养独立思考和解决问题的能力,提高参与意识;PBL教学组期末理论考试成绩优秀的学生(80分以上)多于传统教学组.结论:PBL教学法优于传统讲授法,可在生物化学实验教学中推广.     

以临床胜任力为导向的CBL教学在急危重症护理教学中的实践

目的 探讨基于病例教学（case based learning,CBL）在急危重症护理学本科临床教学中的可行性和有效性。方法 急危重症护理本科生120人随机分为CBL教学组和传统教学组,两组分别采取不同的临床教学方法,并采用理论考试、技能考试以及问卷调查等多种考核方式评价教学效果。结果 与传统教学组相比,CBL教学组在理论考试和技能考试方面均更好,且差异有统计学意义;教学满意度调查方面, CBL教学组也优于传统教学组。结论 以学生临床胜任力为导向的CBL教学应用于急危重症护理本科临床教学是可行的,能有效培养学生的临床思维和提高实际的临床胜任力。     

认知负荷理论在麻醉情境模拟教学中的应用

目的 探讨基于认知负荷理论设计的情境模拟教学联合改良操作技能直接观察评估（direct observation of procedural skil s,DOPS）表在麻醉系本科实习教学中的应用效果。方法选取2021年8月至2022年6月在重庆医科大学附属儿童医院麻醉科实习的麻醉专业学生75名，根据实习时间随机分成传统教学组和情境模拟教学组，情境模拟教学设计以认知负荷理论（cognitive load theory,CLT）为基础，课程完成后比较两组学生出科技能操作成绩、理论考试成绩以及教学满意度，总结情境模拟组学生对教学方式的意见。结果 情境模拟教学组技能操作成绩及理论考试成绩均高于传统教学组，差异有统计学意义（P <0.05）；情境模拟教学组各项学生满意度均高于传统教学组，差异有统计学意义（P <0.05）。结论基于认知负荷理论设计情境模拟教学联合改良DOPS评价表的教学模式在教学效果及学生满意度方面优于传统教学。     

PBL教学法在神经内科临床护理中的应用

目的:对比PBL教学法与传统教学法在神经内科临床护理运用中的应用效果。方法:选取护理系3年制实习神经内科学生98人,分为10组,1~5组主要采用情景教学结合PBL教学法进行教学,6~10组学生为对照组,采用传统的教学模式教学,期末对以上10组进行考核。结果:采用PBL教学法的1~5组学生考试成绩和教学质量反馈评分均显著高于采用传统教学组的6~10组学生。结论:在护理系学生教学活动中采用以问题为导向的PBL教学法有助于提高教学质量。     

以呼吸内科教学病例库为支撑的PBL在见习教学中的作用

目的探讨以呼吸内科教学病例库为支撑的PBL教学方法与传统教学方法效果差别。方法 60名学生进入见习前,根据前3年考试成绩以分层随机原则分为两组,一组根据传统教学方法组(LBL组),一组以呼吸内科教学病历库为支撑的PBL教学组(PBL组)。在见习结束后,收集学生无记名问卷调查,内容包括:提高学习积极性、提高自学能力、改进学习方法、利于理论联系实际等。病例讨论后老师对学生参与讨论的积极性、回答问题的准确性、逻辑推理的合理性、是否结合理论知识进行临床思维四个方面的表现进行划分等级分别为优良、合格和不合格。结果两组学生对所接受的教学方式评价,PBL组优于LBL组,教师评价认为PBL组学生优良率高于传统教学组。结论在见习带教中以呼吸内科教学病例库为支撑的PBL教学方法优于传统教学方法。     

仿真模型在口腔颌面部阻滞麻醉见习教学中的应用研究

目的：评价仿真模型在口腔颌面部阻滞麻醉见习教学中的应用效果。方法：64名学生随机分为仿真模型组和传统教学组,分别采用仿真模型教学和传统模式教学,课后对学生进行考查和问卷调查。结果：仿真模型组学生的成绩明显优于传统教学组（P〈0.005）。大多数学生认为仿真模型能够增强他们的学习积极性,巩固理论知识,提高操作技能。结论：仿真模型在口腔颌面部阻滞麻醉见习教学中的应用能够提高教学质量,是一种值得推广的教学工具。     

基于网络的PBL嵌合LBL在心血管内科临床教学中的应用

目的:探讨基于网络的以问题为导向(web-based and problem-based learning,WPBL)的教学法嵌合以授课为基础(lecture-based learning,LBL)的教学法在心血管内科临床教学中的应用效果。方法:以2018年1月-2018年5月在某三甲医院心血管内科实习的90名学生作为研究对象,将其随机分为3组,每组30人。教学过程中分别对3组学生采用LBL教学模式、以问题为导向的教学(problem-based learning,PBL)模式和WPBL嵌合LBL模式。结果:实习教学结束后,接受WPBL模式嵌合LBL教学组学生的总成绩及各项考核成绩均比LBL教学组、PBL教学组高,3组间差异具有统计学意义(P<0.05);接受WPBL模式嵌合LBL教学的学生在批判性思维能力总分及开放思想、分析能力、认知成熟度等维度的得分均高于LBL教学模式组和PBL教学模式组,3组间差异有统计学意义(P<0.05);3组实习生对教学形式和教学效果满意度的比较,WPBL模式嵌合LBL教学组最高,且3组间差异具有统计学意义(P<0.05)。结论:WPBL模式嵌合LBL教学模式不仅能提高学生对知识的掌握程度,增强批判性思维能力,还能提高学生对临床教师的教学效果满意度。     

互联网在病理学教学中的应用

目的 将互联网技术应用于病理学教学中,以提高教学质量.方法 将湖南中医药大学2008级中医学专业206名学生作为研究对象,将其分成两组,一组为互联网辅助教学组,一组为传统教学组,分别进行病理学教学.教学结束后进行考试和问卷调查,对比两组学生的考试成绩和调查结果.结果 两组学生的考试成绩相比较,其差异具有统计学意义(P＜0.01);同时,互联网辅助教学组学生对病理学教学的满意度高于传统教学组学生.结论 互联网辅助病理学教学显著提高了学生的考试成绩和学习兴趣,提高了教学效果.     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.