世界高等医学教育研究的现状和趋势及其借鉴

本文作者多年主持多项国际医学教育研究合作项目,多次参加国际性医学教育学术会议,根据文献资料和观察所见,介绍世界高等医学教育研究机构建立的沿革;高等医学教育研究得以发展的动因;高等医学教育研究的功能与任务;对提高医学教育教学质量的最佳途径的研究成果;世界各国开展的“医学教育硕士学位”培养计划,以及借鉴与对策。     

借鉴医学教育国际标准 推动医学教育改革创新

新世纪医学教育已呈全球化发展趋势,中国高等医学教育只有借鉴国际标准,完善小才培养体系,才能实现与国际医学教育的接轨。近年来,随着世界医学教育联合会(WFME)和国际医学教育专门委员会(IIME)研究推荐的《本科医学教育国际标准》和《全球医学教育最基本要求》等医学教育国际标准的出台并在全球范围内的试行,医学教育国际标准本土化的研究已在我国迅速展开。中南大学湘雅医学院同时参与了两个医学教育国际标准的试点研究,力图以医学教育国际化为动力,推动高等医学教育乃至全校本科教育的更为根本性的改革和发展。本文介绍了本校在医学教育国际标准本土化研究、国内外医学教育的比较性研究等方面开展的研究和实践工作,对借鉴医学教育国际标准,深化高等医学教育改革,培养创新型医学人才进行了初步探讨。     

借鉴医学教育国际标准推动医学教育改革创新

新世纪医学教育已呈全球化发展趋势,中国高等医学教育只有借鉴国际标准,完善人才培养体系,才能实现与国际医学教育的接轨.近年来,随着世界医学教育联合会(WFME)和国际医学教育专门委员会(ⅡME)研究推荐的<本科医学教育国际标准>和<全球医学教育最基本要求>等医学教育国际标准的出台并在全球范围内的试行,医学教育国际标准本土化的研究已在我国迅速展开.中南大学湘雅医学院同时参与了两个医学教育国际标准的试点研究,力图以医学教育国际化为动力,推动高等医学教育乃至全校本科教育的更为根本性的改革和发展.本文介绍了本校在医学教育国际标准本土化研究、国内外医学教育的比较性研究等方面开展的研究和实践工作,对借鉴医学教育国际标准,深化高等医学教育改革,培养创新型医学人才进行了初步探讨.     

试论21世纪高等医学教育模式

试论２１世纪高等医学教育模式岳文浩在２１世纪即将来临之时，未来的高等医学教育模式如何建构与发展？对这一问题的思考与研究有着重要意义。ＷＨＯ组织的几次国际高等医学教育会议和有关卫生会议已为２１世纪的高等医学教育模式画出了蓝图：ＷＨＯ（１９４６）在其成立...     

在“医学教育国际标准研讨会”开幕式上的讲话

本次会议对经济全球化时代尤其是加入世界贸易组织之后，全面提升中国医学教育水平和质量，提高中国医学教育国际合作与竞争能力，具有十分重要的意义。要在国际竞争中立于不败之地，中国的高等医学教育必须增强紧迫感和危机感，加强国际交流与合作，加速高等医学教育国际化进程，积极研究并学习和借鉴医学教育国际标准，加快改革与发展，全面提高中国高等医学教育的综合实力。医学教育国际标准的引入，为我们重新审视和制定我国医学教育质量标准提供了十分有价值的参考。     

强化医学伦理学教育与国际医学教育接轨

国际医学教育专门委员会2001年制定了“全球医学教育最低基本要求”，保证各校毕业生具有日后从医的核心能力。这个基本要求包括：职业价值、态度行为和伦理；医学科学的基本知识；沟通能力；临床技能；群体健康和卫生系统信息管理；批判性思维和研究等7项宏观领域。职业价值、态度行为和伦理被列为医学生必备的首要的核心能力。因此，如何加强高等医学院校人文社会医学教学与学科建设，将是医学教育的重要内容。     

论21世纪高等医学教育发展战略

论２１世纪高等医学教育发展战略周申王伟周芳一、基点——回顾与认识自本世纪８０年代，国内外医学教育界就对２１世纪的高等医学教育发展问题予以重视。从医学教育研究的角度看，对此列为重点进行专题探讨是必要的。如一些国际或国内的医学教育学术会议往往将此作为热点...     

展望21世纪探索我国医学教育改革途径

分析医学科学现状，预测21世纪的发展，医学教育正面临严峻挑战。我们应大力发展教育，提高人口素质，把培养跨世纪人才作为一项战略任务。为此，高等医学教育必须改革：修订培养目标，相应调整整个医学教育的课程结构；改革以课堂为中心与以教师为中心的传统教学模式，重视调动学生的积极性，创造条件让学生主动参与，培养其创造与开拓能力；国家教育管理部门应采取相应的改革措施，尽快理顺各类学制，以与国际医学教育同步和接轨。     

对留学生消化系统疾病理论教学的调查与思考

留学生医学教育是高等医学教育的重要组成部分,也体现了当代高等医学教育的水平。在我国高等医学教育与国际医学教育接轨的今天,留学生高等医学教育所带来的挑战和机遇,给我们提出了全新的课题和要求。我校开展留学生高等医学教育,顺应了医学教育国际化发展的潮流。我校于2002年开始招收五年制临床医学专业巴基斯坦留学生,     

借鉴国际经验，促进中医药教育科学发展

本文对照全球医学教育最基本要求，提出了高等中医药教育应该主动与国际医学教育接轨，加强人文素质教育、人际沟通教育和信息技术教育等，努力促进高等中医药教育又好又快地发展。     

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.