中国台湾地区妇产科住院医师培训体系研究与思考

本文介绍中国台湾地区妇产科住院医师培训的历史发展、培训内容、考查机制、管理制度等方面。借鉴中国台湾地区妇产科住院医师规范化培训体系的经验与理念,结合大陆地区妇产科住院医师培训制度的现状与不足,针对大陆妇产科住院医师规范化培训提出建设性建议,以获得更为高效、满意的培训效果,为大陆地区培养优秀的妇产科专科医生提供思路。     

中国台湾地区医学人才培养模式对大陆住院医师规范化培训的启示

通过对大陆和中国台湾地区医学及毕业后医学教育模式进行对比,借鉴中国台湾地区医学教育模式中的成功经验和理念;提出大陆医学院校教育有机衔接住院医师规范化培训,医学生毕业时即考取执业医师资格,以合法执业和以社会化学员身份参加住院医师规范化培训,以及增加住院医师规范化培训初期一般医学能力培训等建议;为大陆进一步完善住院医师规范化培训体系和培训模式提供有益的借鉴。     

中国台湾地区高等医学教育浅析

中国台湾地区高等医学教育的发展和中国大陆一脉相承,并各有千秋。本文通过对中国台湾地区高等医学教育发展历程的简介及当前发展问题的分析,提出针对其发展的合理化建议。并从其整体发展历程的角度,为中国大陆高等医学教育的改革与发展提供借鉴。最终谋求两岸高等医学教育事业的共同腾飞。     

对高等医学院校进行远程网络教学的思考

随着科学技术的发展，计算机在各个领域的应用越来越广泛。为了实现教育信息化，适应教育的发展，国家教育部制定了如下政策以推进教育信息化的发展：第一，以多媒体计算机为核心的教育技术在学校的普及和应用；第二，网络的普及和应用，利用网上资源提高教学质量；第三，开办现代远程教育，建设并提供大量的网络资源，不断满足日益增长     

中国台湾地区急诊住院医师培训体系的介绍与启示

目的 介绍中国台湾地区急诊住院医师的培训体系和内容、考核方法和机制等方面内容,吸取中国台湾地区急诊住院医师规范化培训方面的先进理念和经验。同时结合中国大陆急诊住院医师培训的现状和不足,提出完善中国大陆急诊住院医师规范化培训的建议,以取得更好的培训效果,为培养中国大陆优秀急诊专科医师做准备。     

长三角区域信息化合作背景、思路与对策

区域信息一体化是区域经济一体化的基础。长三角地区应打破行政分割，深化合作，建立健全信息化区域合作机制，从战略和政策层面构筑优势互补、资源共享、技术携手、互惠互利的信息化发展环境。这既是长三角地区经济一体化发展的需要，也是有效参与全球经济竞争，抢占全球信息化制高点的战略选择。     

中国大陆与香港护理教育历史发展的比较及启迪

通过比较中国大陆与香港护理教育历史的发展，认为应借鉴先进地区的经验，积极发展高等护理教育。逐渐过渡到护理教育学位化。     

大陆、台湾两地无偿献血差异与思考

目的实地考察台湾地区无偿献血工作开展情况,学习借鉴其可取之处,推进大陆采供血工作的扎实开展。方法采取针对性项目量化指标比对形式,找出差距与不足,并在实施措施上探求移植或参照的可能。结果 2015年大陆32个血液中心全年采血总人数、采血量仅为台湾地区的2倍多一点,台湾地区总人口与北京、上海市差不多,但采供血量是北京或上海市的5-6倍,通过数据与措施的比对找出两地无偿献血的差异,并力求在政策与措施上推进大陆的采供血能力,满足临床用血需求。结论台湾地区无偿献血在世界各地排名前三,其操作层面的具体做法对大陆各省级血液中心乃至全部采供血机构起到一定的学习示范效应。     

推进全省卫生信息化工作政策解读会在合肥召开

近日，安徽省卫生厅在合肥召开推进全省卫生信息化工作暨完善基层综合医改政策解读会议，贯彻落实全国卫生信息化建设会议精神，进一步部署推进2011年全省卫生信息化试点工作：贯彻落实9月8日至9日省政府召开的全省巩固完善基层医药卫生体制改革工作会议精神，解读全省巩固完善基层综合医改工作有关政策，进一步促进医改政策措施和工作任务落实。     

中华医学会第12次全国病毒性肝炎与肝病学术会议近日在北京召开

中华医学会第12次全国病毒性肝炎与肝病学术会议近日在北京召开。中华医学会肝病学会主任委员庄辉院士表示，近年来乙型肝炎(乙肝)流行病学趁势和特征有所改变。首先，传播途径已有所不同，由于新生儿乙肝疫苗免疫接种的普遍开展，乙肝的母婴传播比例下降，而医源性传播、性行为传播和肠道外传播(如静脉注射毒品等)则明显增多。其次，乙肝e抗原(HBeAg)阴性的患者增多。目前中国大陆地区乙肝e抗原阴性的慢性乙肝患者已上升至21％，中国台湾地区为20％，香港特别行政区为11％。     

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.     

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.     

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…     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.