病理生理学课程整合改革设计和实践

南方医科大学病理生理学教研室和第一临床医学院开展了病理生理学与临床相关课程整合教学模式的探讨和实践,从定性和定量两个方面科学地观察基础医学整合课程的教学效果。通过对学生理论课考试成绩、临床病例考试成绩及问卷调查的分析,研究结果显示,改革班成绩高于对照班,学生学习兴趣大大提高。整合课程的教学对于学生在基础医学知识学习、分析问题和解决问题能力等方面均具有积极的意义。     

促红细胞生成素治疗早产儿贫血的疗效评定

为了验证人基因重组促红细胞生成素注射剂(EPO)对早产儿贫血的治疗效果,将53例早产儿贫血患儿随机分为EPO治疗组(31例)和对照组(22例),治疗组予以EPO 200IU/kg皮下注射,每周2次,8周后两组间外周血血红蛋白、红细胞、红细胞压积出现显著性差异(P＜0.001),治疗组上述指标均显著高于对照组,且无明显副作用,说明EPO治疗早产儿贫血安全有效.     

起源于左侧希氏-浦肯野系统的特发性加速性室性自主心律

Objective To clarify the clinical manifestations of patients with idiopathic accelerated ventricular rhythm(AVR)originating from the left His-Purkinje system and to further explore the probable mechanisms of this special entity of cardiac arrhythmias. Methods Eletrogram( ECG)characteristics,clinical manifestations,medications and the prognosis of 4 patients with AVR were retrospectively reviewed. Results Four AVR patients(2 male,mean age 48 years)without structural heart disease were carefully analyzed. ECG indicated that the AVR was in right bundle branch block morphology with QRS width of 0. 11 ～0. 13 s. Right axis deviation during AVR was found in three patients while left axis deviation was found in the remaining one. RR interval of AVR was slightly irregular with the mean rate of 87bpm(55 ～ 110 bpm). AVR was frequently alternating with sinus rhythm. AVR automatically resolved in 2 patients without any medication and in the other 2 patients after a short period of respective medication of propafenone and varapamil. During the 4. 5 years follow-up period(2 ～8 years),no AVR recurred and no other cardiac events occurred in all the patients. Conclusion AVR originating from the left His-Purkinje system in structurally normal hearts is idiopathic with a benign clinical course. AVR in such patients will resolve automatically and not require special treatment.     

射频消融心房颤动患者治疗依从性与社会支持的相关性研究

目的探讨行射频消融术心房颤动患者的治疗依从性状况及其影响因素,以及与社会支持的关系。方法采用自制治疗依从性问卷和社会支持评定量表对120例拟行射频消融治疗的心房颤动患者进行调查。结果心房颤动患者治疗依从性总分为(38.66±5.61)分;年龄、文化程度及医疗费用支付方式是依从性的影响因素;患者的社会支持总分为(36.93±5.76)分;社会支持与依从性呈显著正相关(r=0.384,P0.01)。结论行射频消融治疗的房颤患者治疗依从性不佳,尤其监测行为依从性差,社会支持处于中等水平。医护人员应重视射频消融治疗心房颤动患者的社会支持评估,引导良好依从性氛围的形成,以帮助患者恢复健康及提高临床疗效。