PBL结合模拟病人教学在妇产科临床见习带教中的应用

目的研究PBL结合模拟病人教学在妇产科临床见习带教中的应用。方法将带教班级分为两组。观察组采用PBL结合模拟病人见习教学模式,对照组采用传统见习教学模式结合病例为先导的启发式教学。应用教师自评、问卷调查、成绩分析三种方式评估教学效果。结果问卷调查教学效果满意率,实验组高于对照组,差异有统计学意义（P〈0．05或P〈0．01）。病历成绩及病例分析成绩良好率实验组高于对照组,差异有统计学意义（P〈0．05）,两种方式的及格率与优秀率差异无统计学意义（P〉0．05）;期末考试成绩及格率、良好率与优秀率差异均无统计学意义（P〉0．05）。结论PBL结合模拟病人教学应用于妇产科临床见习带教,有利于培养学生的临床思维和实践能力,提高教学质量。     

PBL结合模拟病人教学在留学生儿科临床见习课的实施体会

目的：研究PBL结合模拟病人教学在留学生儿科临床见习带教中的应用。方法：观察组采用PBL结合模拟病人见习教学模式,对照组采用传统见习教学模式。应用教师自评、问卷调查、成绩分析三种方式评估教学效果。结果：问卷调查教学效果满意率,病历成绩及病例分析成绩良好率两组差异有统计学意义（P〈0．05或P〈0．01）,两种方式的及格率与优秀率,期末考试成绩及格率、良好率与优秀率差异均无统计学意义（P〉0．05）;结论：留学生儿科临床见习中应用PBL结合模拟病人教学,有利于培养学生的临床思维和实践能力,提高教学质量。     

三维动态多媒体课件在产科分娩机制教学中的应用

目的研究三维动态多媒体课件在产科分娩机制课堂教学中的应用。方法依据课程内容与教学要求,设计制作三维动画完成课件制作;将授课班级分为两组,实验组采用三维动态多媒体课件,对照组采用二维演示多媒体课件。应用课堂随机问答、笔试成绩分析、课后问卷调查三种方式评估课堂教学效果。结果课堂随机问答、笔试成绩优秀率,实验组高于对照组,差异有统计学意义(P<0·01),两种方式良好率与及格率差异均无统计学意义(P>0·05或P>0·01);课后问卷调查教学效果满意率,实验组高于对照组,差异有统计学意义(P<0·05)。结论采用三维动态多媒体课件教学的教学效果明显优于二维演示多媒体课件。     

“索引式”教学法在医学影像学见习教学中的应用

目的探讨“索引式”教学法应用于医学影像学见习的教学效果。方法以178名医学本科生为研究对象,其中113名临床医学专业学生为实验组,使用“索引式”教学法;65名麻醉医学专业学生为对照组,使用传统教学法。以见习考核与问卷调查的形式定量及定性评价“索引式”教学法的实施效果。结果实验组见习考核成绩（80．3±16．5）分,显著高于对照组（71．3±25．8）分,差异有统计学意义（P〈0．05）,低分值学生的见习考核成绩显著提高。结论“索引式”教学法在培养学生的影像学诊断思维和解决临床实际问题的能力方面有明显的优势,该教学法的实施效果优于传统教学法。     

护理本科生在消毒供应中心实习方式的探讨

目的：探讨护理本科生在消毒供应中心的实习方式。方法：将在消毒供应中心实习的护理本科生随机分为两组,实验组实施优化实习流程,带教过程中引入“问题”进行临床带教：对照组采用传统教学方法进行临床带教,比较两组护生理论考核和操作考核成绩以及学生对教学效果的评价,调查带教教师对教学效果评价。结果：实验组学生理论考核成绩和操作考核成绩优于对照组（P〈0．05）,实验组学生对教学效果的评价优于对照组（P〈0．05）,实验组带教老师对教学效果评价优于对照组（P〈0．05）。结论：改革后临床教学方法优于传统临床教学法,前者更能激发护生的实习兴趣,提高教学质量,并促进带教老师业务水平和教学能力的提高。     

神经外科围手术期抗菌药物应用临床教学探索

目的：探讨神经外科围手术期抗菌药物应用的临床带教方法。方法：实验组56人，对照组54人，分别采用PBL教学法和传统临床带教方法，比较两组成绩及教学效果。结果：实验组理论知识及病例分析成绩均明显优于对照组（P〈0．01）。实验组带教效果评价明显优于对照组（P〈0．01）。结论：神经外科围手术期抗茵药物应用的教学采用以问题为基础的教学法优于传统临床带教方法，值得推广。     

3D打印技术在脊柱外科临床见习教学中的应用

目的　探索3D打印技术在脊柱外科临床见习教学中的应用。方法　以38名进入脊柱外科见习的临床医学八年制医学生为研究对象，随机分为实验组（19人）与对照组（19人）。以齿状突骨折为例，对照组采用传统方式进行带教，实验组在传统教学基础上结合3D打印技术带教。见习结束后对两组学生进行理论考核和模拟手术操作以评价教学效果，采用SPSS 17.0进行统计学分析，组间计量资料的比较采用t检验。结果　对照组课后即刻考核和课后1个月考核的成绩分别为（82.23±7.52）、（72.36±6.39）分，实验组课后即刻考核和课后1个月考核的成绩分别为（85.58±6.32）、（80.87±6.23）分。实验组两次考核成绩均明显高于对照组，差异有统计学意义（P<0.05）。结论　3D打印技术在脊柱外科临床见习中能明显提高教学效果，具有良好的应用前景。     

双轨教学法在呼吸科护生带教中的应用

目的：探讨PBL联合LBL教学法（双轨教学法）在呼吸内科护生带教中的教学效果.方法：选取2012年8月～2013年8月在呼吸内科实习的96名护生,随机分为实验组50人、对照组46人,实验组采用双轨教学法,对照组采用传统的LBL教学法.实习结束后对两组学生进行统一考试及问卷调查评价教学效果,并对评分进行统计学分析.结果：实验组的理论考试、整体护理考核成绩及课堂效果明显优于对照组,差异有统计学意义（P＜0.05）.结论：双轨教学法使护生更全面掌握呼吸科知识,有利于护生综合能力的培养,值得在呼吸内科护生带教中推广应用.     

四位一体教学法在妇产科临床见习教学中的应用

目的比较四位一体教学法与传统教学法在妇产科临床见习教学中的差异。方法选择第四临床医学院2007、2008级七年制临床见习生各35人为研究对象,2007级见习生为对照组,采用传统教学法;2008级见习生为实验组,采用四位一体教学法。见习结束后,对出科考试成绩、临床技能考核结果采用t检验,P〈0．05为差异有统计学意义;带教满意度采用r检验。结果实验组理论考试成绩为（86．9±7．7）分,对照组为（76．5±8．7）分,差异有统计学意义（P=0．000）。实验组临床技能操作考核成绩为（87．6±6．9）分,对照组为（75．9±7．5）分,差异有统计学意义（P=0．000）。实验组调查问卷的各项指标明显高于对照组,差异有统计学意义（P=-0．000）。结论四位一体教学法有利于妇产科见习生理解和掌握理论知识,熟悉基本临床技能操作,增强他们的学习兴趣和面对病人的自信心,并初步建立临床思维能力和创新能力,为今后的临床实习和科研打下坚实基础。     

问题导向联合任务驱动教学法对神经科见习医生临床思维能力的教学效果

目的：探讨问题导向（PBL）联合任务驱动教学法（DOL）对神经科见习医生临床思维能力的教学效果。方法：将2009年9月至2009年10月在本院见习神经科的广州医学院2006级临床系本科生183人随机分为实验组（93人）和对照组（90人）,分别以PBL＋DOL法及传统教学法（TTM）带教,1月后进行临床思维和理论考核。结果：实验组在见习时答题准确率高于对照组（P=0.026）;见习1月后实验组临床思维考核成绩（P=0.013）、理论考试成绩（P=0.033）及总成绩（P=0.007）均高于对照组。结论：PBL联合DOL对神经科见习医生临床思维能力的教学效果好于TTM,是一种值得推广的教学方法。     

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…     

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     

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.     

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.