模拟诊疗在牙体牙髓病学教学中的应用

我们将模拟病人和多媒体技术引入病例讨论式教学,形成了模拟诊疗的教学方法,其实质是以病例和问题为中心的仿真教学。模拟诊疗可以提高学生以患者为中心、以疾病的正确诊治为目标的分析问题和解决问题的能力,在牙体牙髓病学的理论教学中取得了良好的教学效果。     

模拟诊疗在牙体牙髓病学教学中的应用

我们将模拟病人和多媒体技术引入病例讨论式教学,形成了模拟诊疗的教学方法,其实质是以病例和问题为中心的仿真教学.模拟诊疗可以提高学生以患者为中心、以疾病的正确诊治为目标的分析问题和解决问题的能力,在牙体牙髓病学的理论教学中取得了良好的教学效果.     

重视放射科早交班教学,提升教师的教学意识和教学能力

早交班是放射科医学教育的重要组成部分.在放射科早交班的教学准备、教学点及教学内容的选择等多个方面,通过强化放射科教师主导教学病例准备的意识和责任,以教学大纲为蓝本,进行有针对性的病例筛选,并提前准备教学内容;强调基于临床的多学科相关知识联合的教学方式,多角度、充分发掘早交班的教学点,从临床疾病诊疗的整体流程角度看待影像检查,从更宏观的角度开展早交班教学;根据"同病异征""同征异病"的影像学特点,提升影像学相关知识的系统梳理、总结能力,并结合信息化新手段,可不断提升教师的教学意识和教学能力,实现教学相长,提高放射科从业人员诊疗业务水平.     

七年制临床医学泌尿外科过程参与式教学改革初探

在我校1998及1999级七年制临床医学泌尿外科教学中对过程参与式教学进行了初步探索。其重点是在教学过程中发挥教师在"教"中的主导作用和学生在"学"中的主体作用,在充分利用现代教学手段的基础上,打破既往单一讲授的灌输式教学方式,将原有教学大纲内容按"三三制"划分为大课精讲、现场教学及辅导自学三个部分,采取尽可能丰富的实践形式让学生参与疾病诊疗的全过程,以病例为中心,强调启发式教学,强调独立思考,强调学生综合素质的全面提高,取得了较好的教学效果。     

面向预防医学专业的流行病学教学改革与实践

为培养预防医学专业本科学生的综合能力,在流行病学教学中采用以单元为基础的新教学方式,结合启发式教学和案例教学,重点改革教学及考核体系。结果学生在分析问题能力、口头表达能力上有明显提高,新教学方式有助于培养学生的综合能力。     

病例导入联合循证实践在内科学实习教学中的应用

目前内科学实习教学存在一些弊端,探寻新的教学方式、实施教学改革是提高其教学质量的关键。我院在内科实习带教中尝试应用了病例导入联合循证实践的教学方式,它将病例导入式教学和初步的循证医学方法实践相结合,通过病例提出问题,指导学生分析问题,通过循证的方法查找证据,帮助解决问题。教学中不仅可激发学生学习热情、主动性,培养其正确的临床思维,还可有效提升学生的自主学习能力,促其适应知识更新。这种教学方式值得在内科学实习中进一步推广。     

PDCA循环在住院医师内分泌代谢疾病诊疗能力教学中的应用

为评价PDCA循环在提高住院医师内分泌代谢疾病诊疗能力方面的效果，以内分泌科出科考试试卷结果出现的诊疗能力不足问题为研究切入点，通过问卷调查62名接受规范化培训的住院医师，分析其存在“临床工作忙”“专业临床思维特殊性”和“内分泌科知识难于记忆”等问题的原因。实施了信息化教学、自我教学、遵循记忆规律、加强师资团队建设、改进教学方式等措施，并在教学结束后评价其效果。研究发现，PDCA循环用于教学后，提高了住院医师内分泌代谢疾病的临床诊疗能力。     

全科规培耳鼻咽喉科轮转教学改进研究

目的 探讨全科规培耳鼻咽喉科轮转内容存在问题及改进方法.方法 随机将30名在上海市同仁医院参加规范化培训的全科医学住院医师分成两组,对照组采用传统讲授教学方式,试验组采用新教学方式(包括诊疗思路讲解、重点病种分析、内窥镜结合病例教学),培养规培生的耳鼻咽喉科常见病及急症的临床思维及技能,记录全科住培医师教学终止后的见习成效.结果 新教学模式可以显著提高耳鼻咽喉科规培医师的临床思维及技能.结论 新教学模式在提高全科住院医师耳鼻咽喉科规范化培训的教学质量上具有优势.     

以问题为基础学习结合标准化病人教学方式在妇产科学临床见习中的应用

目的研究以问题为基础学习结合标准化病人教学方式在妇产科学临床见习教学中的应用效果。方法选择中山大学2004级临床医学专业144名本科生为实验组,在临床见习中实施以问题为基础学习教学,讨论病例时由带教教师模拟标准化病人,提出问题并进行分析,考试时采用社会招募的标准化病人,见习后对学生进行问卷调查;同时,随机选取接受传统教学模式的100名同级学生为对照组,比较见习结束时两组学生的考试成绩。结果实验组学生对妇产科常见疾病的临床诊疗技能及考试成绩明显高于对照组学生,其差异具有统计学意义。结论以问题为基础学习结合标准化病人的教学方式能够有效提高妇产科学临床见习的教学质量。     

自主探究式病例教学法在临床外科实验教学中的运用和评价

目的探讨学生自主探究式病例教学法在临床外科实验教学中运用的效果。方法根据教学内容,引入外科病例,以小组为单位,对病例中涉及的问题进行讨论、探究,通过问卷调查对病例教学进行评估。结果绝大部分学生认为自主探究式病例教学法较适合临床医学专业教学,多数学生接受这种教学方式。结论病例教学法有利于激发学生的学习兴趣,提高学生的分析问题、解决问题能力。     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…