客观结构化临床考试在五年制医学生毕业考试中的应用

目的探讨客观结构化临床考试在五年制医学生临床操作技能考试中的作用。方法对江汉大学医学院2005届和2006届五年制临床医学专业458名学生进行客观结构化临床考试,考试共设5站,包括标准化病人站和非标准化病人站,考试结束后对部分考生进行了有关客观结构化临床考试的问卷调查。结果客观结构化临床操作技能考试的难度、区分度较好;经过模拟训练的2006届学生总体成绩更好,两届学生得分最低的考站均为辅助检查站;客观结构化临床考试形式已经获得大部分学生的认可。结论客观结构化临床考试对学生的考核较为客观、公正,可以对学生的临床能力进行客观的和多方面的评估。     

客观结构化临床考试在医学生临床技能考试中的实践研究

客观结构化临床考试在临床技能评估中为医学生提供了一种逼真、全面的考试氛围，已经被国内外医学院校广泛应用，具有真实、有效、可靠等特点和广阔的发展前景。为了强化临床医学专业学生的实践技能方法，提高医学生临床应用能力和技能操作水平，提高医院带教教师和病人对医学生的满意度，第三军医大学西南医院选择2003级临床医学专业303名学生为研究对象，对其实施客观结构化临床考试。实践证明，客观结构化临床考试是提高医学生临床应用能力及实践技能水平的有效方法，具有一定的实用价值。     

客观结构化临床考试在实习学生出科考试中的应用

客观结构化临床考试是一种客观、有序的考核模式.辽宁医学院附属第一医院选择2011届五年制临床医学专业实习学生为研究对象,实施客观结构化出科考试.考试结果和学生问卷调查结果显示,在出科考试中应用客观结构化临床考试客观、可行,能够对医学生的临床综合能力进行全面的评估,能够调动医学生在整个实习过程中的积极性.     

临床医学生客观结构化临床考试情况的调查分析

为了进一步提高临床医学生毕业综合考试的质量,探索OSCE考试实践中的问题,不断提高客观结构化临床考试的信度与效度,对参加本次考试的学生进行调查问卷和结果分析,研究临床客观结构化考试中的质量控制和学生的认可情况,为今后考试提供指导和建议。     

眼科学客观结构化临床考试合理性和有效性的初步探究

选择在北京大学第三医院眼科实习的2002级和2003级八年制临床医学专业95名学生进行客观结构化临床考试,并在考试后进行问卷调查,比较客观结构化临床考试和传统笔试对学生学习、生活、心理状态等方面的影响.调查结果表明,客观结构化临床考试可以优化学生的时间安排,且不影响学生对知识的理解;同时,能够提高学生的学习兴趣,降低学习压力和考试焦虑,对学生生活的影响低于传统笔试;客观结构化临床考试较传统笔试难度小、知识覆盖范围广.实践证明,客观结构化临床考试在眼科学教学中的应用具有一定的合理性和有效性.

Abstract：

The aim of this research is to evaluate the strength and weakness of objective structured clinical examination (OSCE) as an assessment method in the course of ophthalmology. 95 Students from the Health Science Center of Peking University took ophthalmology OSCE and were given a questionnaire comparing OSCE and traditional written-test. The results showed that students spent their time quite differently in these two situations with a more rational time allocation in OSCE. No significant knowledge comprehension difference was found between them. Also, students felt more interested in study and less stressed under OSCE. Lastly, students thought OSCE covered more knowledge and felt the test was less difficult than written-test. OSCE is a rational and reliable evaluation tool in medical education.     

医学生对标准化病人多站考试评价的研究

标准化病人的使用为现代临床考试开辟了新的途径,被广泛地应用于教学和客观结构化临床考试。本文着重研究了学生对标准化病人的满意度和客观结构化临床考试的支持程度,旨在为其推广和实施提供理论依据。     

临床专业毕业生客观结构化临床考试的设计与实践

通过临床专业毕业生客观结构化临床考试（OSCE）的设计与实施,不断完善和提高OSCE考试的科学性、客观性、实用性,建立了符合实际情况的客观结构化临床考试体系,并通过考试结果分析和对学生的问卷调查,探究OSCE考试对临床实践教学、临床实习、执业医师考试的指导作用。     

医学生对标准化病人多站考试评价的研究

标准化病人的使用为现代临床考试开辟了新的途径,被广泛地应用于教学和客观结构化临床考试.本文着重研究了学生对标准化病人的满意度和客观结构化临床考试的支持程度,旨在为其推广和实施提供理论依据.     

客观结构化临床考试在精神病学临床技能考核中的应用

尝试在精神病学临床技能考核中采用客观结构化临床考试。结果显示,客观结构化临床考试质量控制良好,考试结果公平,分布合理,客观地反映出学生的临床技能水平,是一种较科学的临床技能考核模式,值得在以后的临床技能教学与考核中推广。     

中医类专业临床技能考核中应用结构化临床考试（OSCE）的探索

客观结构化临床考试（OSCE）,是一种以客观的方式评估医学生临床能力的考核方法,即在模拟临床场景下,使用模型、标准化病人来测试医学生的临床综合能力。同时也是一种知识、技能和态度并重的临床综合能力评估的方法。江西中医学院临床技能中心于2007～2008年对2004、2005级1 239名中医类专业学生实习前进行临床技能统一培训及考试;2008～2009年对2003、2004级598名中医类专业毕业生进行多站式临床技能考核即客观结构化临床考试（OSCE）。通过这种考试的实施,对学生临床综合能力的评价更客观全面,取得了很好的效果。     

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…