医学生胸腔穿刺模拟训练学习曲线的研究

Objectiye The purpose of this study is to document the learning curve of simulation based thoracentesis training and to evaluate its long term outcome. Methods Forty-eight medical students were enrolled in this study. Each participant performed 5 supervised but unmentored thoracentesis on the simulator. Participant's performance was assessed by performance errors (PE), procedure time (PT) and participant's confidence (PC) by the supervisors for every operator on each test trial. Learning curves for each variable were generated. Long term outcomes of the training were measured by the re-test on half year later. Results An obvious improvement was noted in PE, PT and PC when comparing the subjects 1st and4th test trial (P ＜ 0.01 ). A plateau for PE, PT and PC in the learning curve occurred in 4th test trial. The results of re-test on half year later were similar with that in the test trial 5 (P ＞ 0.05). Conclusions This study demonstrated simulation based thoracentesis training can significantly improve the individual's skill.The full effect of learning from the modular can be achieved by four times of practices.     

医学生胸腔穿刺模拟训练学习曲线的研究

Objectiye The purpose of this study is to document the learning curve of simulation based thoracentesis training and to evaluate its long term outcome. Methods Forty-eight medical students were enrolled in this study. Each participant performed 5 supervised but unmentored thoracentesis on the simulator. Participant's performance was assessed by performance errors (PE), procedure time (PT) and participant's confidence (PC) by the supervisors for every operator on each test trial. Learning curves for each variable were generated. Long term outcomes of the training were measured by the re-test on half year later. Results An obvious improvement was noted in PE, PT and PC when comparing the subjects 1st and4th test trial (P ＜ 0.01 ). A plateau for PE, PT and PC in the learning curve occurred in 4th test trial. The results of re-test on half year later were similar with that in the test trial 5 (P ＞ 0.05). Conclusions This study demonstrated simulation based thoracentesis training can significantly improve the individual's skill.The full effect of learning from the modular can be achieved by four times of practices.     

The Undergraduate Medical Students＇ Approach to Learning in University of Latvia

Learning approach of medical students has been pointed out as one of the most important long term success factors for medical career. There are two major differences how students learn. One group of students use deep approach learning that is characterised by understanding of matter of studies. Other part of students using surface approach of learning that is based on memorisation of facts and knowledge. It has been recognised that deep approach learning is more used in modern medical schools but surface learning in traditional medical schools. The purpose of this study was to evaluate, describe and compare the learning approach of students at the University of Latvia in the academic year of 2009/2010. University of Latvia represents traditional medical school, which uses traditional curriculum. The assessment was done using Entwistle＇s Short Inventory of Approaches to Learning consisting of 30 items. The inventory was answered by a total of 345 students. Findings show that learning approach has trend towards surface approach of learning in six groups studied in the University of Latvia in year 2009/2010. It has been recognised that reproduction and learning pathology were found increased in all study years. Results might suggest that modernisation of undergraduate curriculum including assessment with target to improve the way how medical students learn could be topic of discussion in senior management of University of Latvia. Study allows compare findings of this study to similar studies where the same instrument is used for evaluation of learning approaches in longitudinal prospective. It gives opportunity to compare results within findings of medical schools of Europe.     

Effect of behavior training on learning and memory of young rats with fetal growth restriction

Objective： To investigate the effect of behavior training on the learning and memory of young rats with fetal growth restriction （FGR）. Methods： The model of FGR was established by passive smoking method to pregnant rats. The new-born rats were divided into FGR group and normal group, and then randomly subdivided into trained and untrained group respectively. Morris water maze behavior training was performed on postnatal months 2 and 4, then learning and memory abilities of young rats were measured by dark-avoidance testing and step-down testing. Results： In the dark-avoidance and step-down testing, the young rats＇ performance of FGR group was worse than that of control group, and the trained group was better than the untrained group significantly. Conclusion： FGR young rats have descended learning and memory abilities. Behavior training could improve the young rats＇ learning and memory abilities, especially for the FGR young rats.     

Effect of vasoactive intestinal peptide on proliferation of hepatoma cells

It has been found that vasoactive intestinal peptide (VIP) stimulates the growth ofseveral kinds of tumor cells.There is no report so far about the effect of VIP on the growth ofhepatoma cells.Using the tetrazolium colorimetric assay (MTT assay) and cell countingmethod,it was investigated that the effect of VIP on the growth of a cultured rat hepatomaFSK-7902 cells.The results showed that VIP stimulated the proliferation of the rat hepatomacells obviously.The addition of 1μmol/L VIP caused a significant increase in the number of thecultured rat hepatoma cells on 3rd day and maximal increase occured on 4th day and 5th day ( P<0.01).The growth promoting effect was greater as the concentration of VIP increased.Thelowest effective concentration of VIP was 0.5μmol/L.Exposure to VIP for 12 h followed by re-moval of the peptide resulted in sustained growth for several days.     

Effect of behavior training on learning,memory and the expression of NR2B,GluR1 in hippocampus of rats offspring with fetal growth restriction

Objective:To study effects of behavior training on learning,memory and the expression of NR2B,GluR1 in hippocampus of rat's offspring with fetal growth restriction(FGR).Methods:The rat model of FGR was established by passive smoking method.The rats offspring were divided into the FGR group and the control group,then randomly divided into the trained and untrained group,respectively. Morris water maze test was proceeded on postnatal month(PM2/4)as a behavior training method,then the learning-memory of rats was detected through dark-avoidance and step-down tests.The expressions of NR2B and GluR1 subunits in hippocampal CA1 and CA3 areas were detected by immunohistochemical method.Results:In the dark-avoidance and step-down tests,the performance record of rats with FGR was worse than that of control rats,and the behavior-trained rats was better than the untrained rats,when the FGR model and training factors were analyzed singly.The model factor and training factor had significant interaction(P<0.05).The expressions of NR2B and GluR1 subunits in hippocampal CA1 and CA3 areas of rats with FGR reduced.In contrast,the expressions of GluR1 and NR2B subunits in CA1 area of behavior-trained rats increased,when the FGR model and training factors were analyzed singly. Conclusion:These findings suggested that the effect of behavior training on the expressions of NR2B and GluR1 subunits in CA1 area should be the mechanistic basis for the training-induced improvement in learning-memory abilities.     

Effect of behavior training on learning,memory and the expression of NR2B,GluR1 in hippocampus of rats offspring with fetal growth restriction

Objective： To study effects of behavior training on learning, memory and the expression of NR2B, GluR1 in hippocampus of rat＇ s offspring with fetal growth restriction（FGR）. Methods： The rat model of FGR was established by passive smoking method. The rats offspring were divided into the FGR group and the control group, then randomly divided into the trained and untrained group, respectively. Morris water maze test was proceeded on postnatal month（PM2/4） as a behavior training method, then the learning-memory of rats was detected through dark-avoidance and step-down tests. The expressions of NR2B and GluR1 subunits in hippocampal CA1 and CA3 areas were detected by immunohistochemical method. Results： In the dark-avoidance and step-down tests, the performance record of rats with FGR was worse than that of control rats, and the behavior-trained rats was better than the untrained rats, when the FGR model and training factors were analyzed singly. The model factor and training factor had significant interaction（P 〈 0.05）. The expressions of NR2B and GluR1 subunits in hippocampal CA1 and CA3 areas of rats with FGR reduced. In contrast, the expressions of GluR1 and NR2B subunits in CA1 area of behavior-trained rats increased, when the FGR model and training factors were analyzed singly. Conclusion： These findings suggested that the effect of behavior training on the expressions of NR2B and GluR1 subunits in CA1 area should be the mechanistic basis for the training-induced improvement in learning-memory abilities.     

Cancer complementary and alternative medicine research at the US national cancer institute

The United States National Cancer Institute(NCI) supports complementary and alternative medicine(CAM) research which includes different methods and practices (such as nutrition therapies) and other medical systems(such as Chinese medicine). In recent years,NCI has spent around $120 million each year on various CAM-related research projects on cancer prevention,treatment,symptom/side effect management and epidemiology.The categories of CAM research involved include nutritional therapeutics, pharmacological and biological treatments,mind-body interventions,manipulative and body based methods,alternative medical systems,exercise therapies,spiritual therapies and energy therapies on a range of types of cancer.The NCI Office of Cancer Complementary and Alternative Medicine(OCCAM) supports various intramural and extramural cancer CAM research projects.Examples of these cancer CAM projects are presented and discussed.In addition,OCCAM also supports international research projects.     

Bioactivities and Pharmaceutical Effects of 1-Aminocyclopro- panecarboxylic Acid

Objective The 1-aminocyclopropanecarboxylic acid (ACPC) is a natural micromolecule non-protein amino acid that exists only in plants. Despite the determination of its regulating effects on plants, several bioactivities and effects on animals or humans are still unclear. This review focuses the pharmaceutical effects,above all, the neuroprotective effects of ACPC on the cerebro- and cardiovascular system. Methods Two hundred and seventy nine studies were selected and identified from a total of 2457 references in Medline and Chemical Abstracts from 1957 to 2008. Only 38 articles on neuroprotective effects of ACPC from seven different countries qualified to be included in the analysis. Results ACPC has altogether following six general neuroprotective effects on the brain and nervous system: anti-neurotoxicity induced by NMDA, dynorphin-A, glutamate, and morphine; protection from cerebral neurological injury induced by ischemia; antidepressant and anxiolytic effects; anti-convulsion and -seizures and control of epilepsy; facilitation of spatial learning and memory; and the effect of reducing alcohol consumption. Conclusion ACPC has shown a variety of effects on plants and animals. The bioactivities and pharmaceutical effects on animals are of great significance to medical research and public health. Further clinical trials or epidemiological studies are needed to determine its effect in humans. Food intervention with ACPC-rich vegetables and fruits may be a suitable therapy for cerebro- and cardiovascular system diseases. Administration of trace exogenous ACPC could produce vegetables and fruits of rich endogenous ACPC.     

Effects of Cadmium on BMP Induced Bone Formation

Chronic cadmium intoxication can cause sclerotinmalacia and osteopetrosis,but researches about thedirect effect of cadmium on bones remain skimpy.The main reason has been that that the target pointsby which cadmium directly affectsboneshas notbeenidentified[1— 3] .Bone morphogenetic protein (BMP)is an osteognic bone growth factor,which plays avery important role in the growth,development andreconstruction of bones[4 ] .BMP has very strongbone- inducing activity,which is normally used to re-…     

Current Status of Integral Medical Study on Endometriosis

Endometriosis (EM), an estrogen dependent disease that comes from the planting of endometri-al gland and stroma outside the uterine cavity, is characterized by invasiveness, wide planting and liability to relapse. It has been proved by recent studies that the pathogenesis of EM has its genetic background and is closely related with neuro-, en-docrino- and immuno-factors. There has been great progress in the treatment of EM, but the clinical effect is not yet satisfactory. Traditional Chinese medicine (TCM) has definitely played its role in EM treatment. In this article, the current status of integral medical study on EM is reviewed.     

A SURVEY OF RESEARCH ON THE TREATMENT OF ASTHMA BY INVIGORATING BLOOD CIRCULATION TO REMOVE BLOOD STASIS

It has been demonstrated by a lot of clinical practice and experimental research that blood stasis is present in cases of asthma. In regard to the manifestations of asthma with blood stasis, medical doctors in our country carried out many investigations. The symptoms and signs of the disease are recognized consistently. Furthermore, they used blood rheological changes as laboratory indices to reach a more objective diagnosis. In the therapeutic aspect of asthma with blood stasis, either ancient recipes or those formulated by individual doctors have significant therapeutic effects. These are the important progress in the treatment and recognition of the pathogenic mechanisms of asthma.However, in regard to the diagnosis of asthma with blood stasis, at present there are no unified criteria. Therefore, it is necessary to formulate relatively unified diagnostic criteria and the criteria for therapeutic effect evaluation. Doubtlessly, this is of great significance in further research of the disease. In addition, it is also necessary to carry out extensive experimental research concerning the mechanisms of the recipes with the actions of improving blood circulation and removing blood stasis, especially the ancient recipes or those prescribed by individual doctors, which arcscarcely based on systematic animal experimental research. These need to be further studied.     

Short-term Effect of Hydroxyapatite Nanoparticles on Cancer Cells

Hydroxyapatite （HAP） is the main inorganic component of hard tissues and shows excellent biocompatibility and osteoconductivity properties. Nanoparticles of HAP can be synthesised by the precipitation method in distilled water. The needle shaped particles are below 100nm in size with low crystallinity and high surfacial activation. Recent studies have shown an inhibition effect of HAP nanoparticles on the proliferation of cancer cells. However, the effect of the HAP treatment over periods shorter than one day has not been reported. In this paper, the short-term effects of HAP nanoparticle sol on the proliferation of heptocellular carcinoma cells after 12 and 16 hours of treatment were investigated in vitro via MTT assay. The results revealed that the short-term HAP treatment stimulated the growth of cancer cells.     

Structure analysis and performance measurement of Chinese health delivery system

Objective： Although evidence has already demonstrated that the performance of Health Delivery System （HDS） varies widely across nations, relatively little is known about the factors that give rise to these variations and the key point to improve the performance besides adjusting system structure. By setup of HDS performance measurement system on the base of association of financial, social, and environmental characteristics, we construct system dynamic model of HDS to simulate the invention policies. Methods： Performance measures were collected from HDS in 31 regions of China and combined with secondary data sources. Multivariate, linear, nonlinear regression and factor analysis models were used to estimate associ- ations between system characteristics and the performance. Results： Performance varied significantly with the size, financial resources and organizational structure of HDS. Performance measurement system of health delivery system was developed to give the rank of all Chinese regions. Conclusion： Performance measurement system of HDS is the basic of HDS modeling by system dynamic.     

Enlightenment of German social health insurance system reform on China

According to the latest Chinese Healthcare Reform Plan,the medical insurance system is one of the four components of the healthcare sector.The Healthcare financing and payment in China are mainly based on medical insurance.So it is important to learn the experiences of the developed countries.This paper examines the key issues of the German Healthcare system and reforms,with a particular emphasis on basic social medical insurance,which has the broadest coverage in Germany.It reviews the evolution of the background of the German social medical insurance system,describes how the system functions,and analyzes the existing and emerging problems with the system which push the Germany government to adapt a series of reforms.It concludes with a discussion of some enlightenments and suggestions of the German medical insurance system reforms for the development of the Chinese medical insurances system.     

Initiating Hehe (和合) medical system of traditional chinese medicine and biomedicine to realize health cycle of human beings

This paper suggests a novel approach concerning the medical treatment of human beings,which appears to be economically and practically superior to either biomedicine or traditional medicine.A brand new medical system—Hehe(和合) medicine,has been proposed based on a preventive-biomedical-psycho-social treatment model.This is characterized by a dual approach in which life nurturing is consistently practised and medical treatment is applied when necessary in order to maintain a healthy life.Its core value would facilitate the self-restoration to health and self-adaptation to nature through health cultivation and medical means.Medical services would be firstly provided to the prevention of potential disease germinating in the human body,and clinical medical treatment would be the last resort of systematic medical practice.This paper discusses not only this new concept but also the advantages of traditional Chinese medicine and biomedicine,especially how both medical systems compare in cognitive style,on a cultural level,and on a technical level.     

Reform direction of medical education in China: implementing “competency-based” medical education

For over 100 years,medical education has achieved continuous development and progress all over the world.Flexner's report in 1910 brought modern science into the curricula of medical schools.In the 1960s,problem-based learning (PBL) was born in Canada and quickly achieved wide use.From the beginning of the 21st century,with increasing specialization in medicine,the "silo effect" has become more apparent.The inequality in healthcare and low efficiency of the entire health system has become prominent problems.These have brought about new challenges for medical education—how to implement accountable medical education so as to rectify the current situation.Therefore,"competency-based" medical education,as an important feature of the third generation medical education reform,has gradually become the trend.1However,currently in most medical schools in China,PBL is still flourishing,which indicates that we are still at the second generation of medical education reform.     

转化医学及其对中国医学的影响

Translational research has become a globally recognized model of medical research. Chinese government and doctors have begun to discuss the plan for its development. But most articles are focusing on the advantages rather than its pros and cons. In this essay, the authors discuss the disadvantages of translational research, its effects on clinical work and medical education, highlighting some potential problems and risks in theory and practice on case basis. Some important research management requirements are summarized in this essay to help bring the therapy from the research laboratory to the patient’s bedside.

     

Possible effect of fluid shear stress on osteoclastogenesis

Bone remodeling is performed under the joint action of osteoblasts and osteoclasts. Since the effect of osteoclasts has been gradually recognized on bone and joint diseases, targeted researches toward osteoclasts have become a hot research field. This article reviews the relevant medical literature concerning the possible effects of the fluid shear stress （FSS） on the osteoclastogenesis chiefly from the aspects of RANKL-RANK-OPG system, the macrophage colony-stimulating factor （M-CSF）, and calcitonin receptor （CTR）. On the basis of the changes of the expression of osteoclastic activities, it is suggested that FSS is a potent, important regulator of bone metabolism.     

Reverse Gear： Cairo＇s Dependence on a Disappearing Paradigm

In the 1960s and 1970 s, attention was focused on rapid population growth and large scale family planning programs were launched in many developing countries. However, the paradigm for understanding fertility decline assumed that exogenous socioeconomic changes were necessary to reduce family size. By the mid-1990s, the standard model of the demographic transition had been all but discarded, partly there were numerous country experiences inconsistent with the model. The 1994 International Conference on Population and Development （ICPD） emphasized women＇s broader needs, which were important but were promoted by reducing attention to population and the need for family planning. The timing of this shift was peculiar, because the Cairo proponents were depending on an already discredited model of reproductive behavior. The policy shift at Cairo undermined the political coalition that had supported international family planning since the 1960s. As a result of declining financial support, the health of women has deteriorated seriously in the past decade. Meantime, the countries that have been successful in lifting unprecedented numbers of people out of abject poverty were acting independently of the Cairo consensus.