本科医学院校转化医学教育路径探讨

转化医学作为一门新兴的学科,其研究在国际医学领域里越来越受到重视,其主要目的是消除基础医学与临床医学之间的屏障,把基础研究获得的知识和成果快速转化为临床应用。然而,在我国的医学院校本科教育过程中,基础医学和临床医学教育脱节严重。为更好培养转化医学型人才,加强本科转化医学教育势在必行。     

将转化医学理念引入临床医学系见习教学中的初步探讨

随着生命科学研究的不断深入,基础研究与临床医学之间的鸿沟不断加大,这一差距也体现在临床系本科生的培养过程中。临床本科生培养中引入转化医学理念,不仅是缩短医学本科生培养模式间距离的需要,也是解决疾病谱改变与传统研究模式之间矛盾的需要。文章将结合当代转化医学发展的现状,分析在临床系本科生见习阶段开展转化医学教育的意义、面临的困难以及解决的方法等问题,以期为在医学本科生中开展转化医学教育提供参考。     

转化医学为八年制课程教学带来的思考

转化医学的目的是在基础研究与临床实践之间建立起沟通的桥梁。临床医学八年制代表目前国内医学教育的最高水平。培养八年制学员转化医学能力是实践转化医学的基础,对我国医学事业发展至关重要。     

“以学生为中心”的教学理念在长学制医学生病理生理学教学中的实践与体会

长学制医学教育要达到的目标是培养学生成为"有高尚的思想道德和良好的职业素质,富有人文精神和创新意识,实践能力强,发展潜力大,能参与国际医学科学竞争的高级临床医学专门人才"。病理生理学是一门研究疾病发生、发展、转归的规律和机制的学科,是临床医学与基础医学之间的"桥梁"。     

转化医学在神经病学专业研究培养中的探索

转化医学是近年来出现的新名词,旨在消除基础医学与临床医学之间的屏障,有效快速地将科研成果转化为可为病人所用的药物和医疗器械.分析转化医学在神经病学研究生培养中的意义,并进行初步探索,认为有必要在研究生培养中开展转化医学教育,使之成为真正的高素质医学人才.     

临床医学专业"专升本"人才培养方案的实践研究

临床医学专业"专升本"教育是高等医学教育的重要组成部分.本文在分析临床医学专业专科和本科人才培养方案的基础上,制定了临床医学专业"专升本"人才培养方案,经过两轮次教学实践的证实,该培养方案符合"专升本"人才培养要求;同时,随着医学科学的发展和社会对医学人才需求的变化,该方案仍然需要进一步完善.     

转化医学理念在微生物学教学中的应用

转化医学是基础医学研究与临床医学相互转化的桥梁,医学微生物学是基础医学向临床医学过渡的学科.以转化医学理念指导医学微生物学教学改革,实施病例式教学、开展设计性实验,实验课加入病案讨论,开展文献阅读知识竞赛和大学生科技创新活动,将临床知识及科研意识融入医学微生物学理论与实践教学中,加强了基础与临床的密切联系,提高了学生学习的主动性和学习效率.     

地方院校临床医学本科应用型人才培养特色创建

基于医学教育特点及专业办学标准,探讨地方院校临床医学本科应用型人才培养目标和培养规格定位,阐述"医学人文融通、专业技能卓越"的临床医学本科应用型人才的特色内涵及培养路径。     

转化医学理念在病理学教学中的应用意义

"转化医学"是医疗领域新兴的热门理念,指迅速有效地将基础医学研究的最新成果转向临床应用,再把临床应用的实际情况反馈给实验室,以此完善相关的基础研究并进一步开展新研究的双向过程。在病理教学过程中应用多媒体教学以及科研实践等方式,强化病理学,尤其分子病理学与临床医学的转化研究理念,为研究及人才培养提供交流平台,同时在教学工作中推广应用转化医学理念,培养具有"一专多能"复合型的医学人才。通过分子病理学架起基础医学和临床医学之间的沟通桥梁,让基础研究成果更顺畅地服务于临床,造福于患者。     

以器官系统为中心课程改革的现状

1866年以来我国的医学教育一直沿用的是以学科为中心的课程体系,但该体系基础与临床之间缺乏必要的联系,存在相互脱节等不足。自从1993年爱丁堡“世界医学教育高峰会议”推荐以器官系统为中心的课程体系以来,在国内外许多医学院校进行课程改革实践。90年代初我国在少数几所医学本科院校改革实践,2012年我校在借鉴国内外教育改革经验的同时结合三年制临床医学教育,在专科生中实施了以器官系统的课改。经过人们不断的实践探索。总结出以器官系统课程体系具有很多的优越性,认为它是一种新的适应时代发展需要的课程体系,发展前景远大。     

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.