严格管理提高医学生临床实习质量

医学是一门实践性很强的科学，医学人才的培养要经过两个阶段，即前期的医学基础理论教学和后期的临床教学。临床教学中包含了专业理论的学习和专业基本技能的学习，而专业基本技能的学习必须在临床实践中通过临床实习去完成。临床实习主要是医学生进行全面系统的临床技能训练的主要阶段，是培养学生理论联系实际的重要教学环节，临床实习完成的好坏，     

完善临床实践教育工作体系的实践和体会

临床实习教育是医学生向医生过渡的关键性实践阶段，我院在长期临床教学中，不断完善临床实践教育工作体系，有效促进了医学实践教育工作，培养出优秀的医学后备人才。     

临床教学医院培养高素质医学生的探讨

医学教育是临床医学院的重要组成部分，其目标是培养高起点、高水平、发展后劲大的高级研究型医学人才和高级临床医学人才。临床教学是医学教育过程中的一个非常重要的组成部分，临床教学质量的好坏与医学人才的培养质量有着直接的关系。临床教学医院怎样才能切实提高教学质量，培养出高素质、合格的、能迎接现代医学挑战的临床医生，笔者看法如下。     

医学生临床实习能力培养的探讨

医学是实践性极强的学科，需要丰富的临床经验积累。临床实习是医学教育工作中的重要环节，是医学生从课堂走向病房、从理论走向实践的过渡阶段，是基础理论与临床实践相结合的桥梁，是将医学生培养成为合格的临床医师的关键时期。临床教学是培养合格医学人才的关键环节，不断提高和保证教学质量是教学工作的永恒主题。临床教学的目的是完成医学生向临床医生的转变，培养学生基本操作技能、基本临床知识及基本临床思维能力。     

骨科临床实习教学体会

医学生的临床实习是使其所学理论知识能应用于实践的必需环节，也是其从学校走向社会，由学生成为医生的过渡阶段，作阐述了其从事临床教学工作的体会，认为临床实习教学中应注重培养医学生的良好医德，医风，充分发挥带教教员为人师表的示范作用。同时注重基本功训练。培养出适应现代社会的合格医学人才。     

提高妇产科临床教学实践与刨新能力的几点思考

妇产科临床实习教学是临床教学的关键，充分认识妇产科临床实习教学的特点和面临的困难，如何提高妇产科学生临床思维和提高临床实习质量，培养妇产科学生临床实践能力与创新能力，这是目前急需解决的问题。因此，充分调动学生主观能动性，提高学生临床实践的积极性，采取启发式教学，倡导以问题为基础的教学法，广泛开展多媒体教学、床边教学，加强基本操作训练，培养学生实践能力、创新能力，这样才能为国家培养出临床创新型、高素质的妇产科医学人才。     

寓过程管理于临床教学培养学生临床思维及技能

在医学高职教育中,将过程管理运用在临床教学中,培养医学生临床思维和实践技能,便于提高学生分析问题和解决问题的能力,是提高临床教学质量,培养应用型人才的有效途径。     

积极开展临床教学基地建设提高临床教学质量

医学是一门极具实践性和应用型的学科,从而决定了对医学人才的培养必然要从培养学生创新精神和实践能力方面入手。而对医学生的临床技能的培养要取决于临床实践教学基地的质量。为此,加强临床教学基地的建设和管理尤为重要。本文介绍了目前临床教学基地的基本情况以及加强临床教学基地建设的措施。     

在诊断学教学中应培养学生循证思维

循证医学教育是培养高素质医学人才的迫切需要,在临床基础课诊断学教学中重视学生循证思维的建立和培养,有利于医学生在接触临床的第一时间掌握医学实践的科学方法,建立正确的临床思维,对后续临床教学的顺利开展和提高医学人才素质具有深远的意义。     

提高临床教学管理质量培养合格医学人才

未来社会的竞争是人才的竞争，尤其是医学人才，而医学又是一门实践性非常强的学科，如何使我们的医学人才适应当前的竞争，是对我们当前医学教育的考验，对医学人才的临床综合能力的培养，是临床教师的艰巨任务。医学生毕业后，面临的是病人，而医学生进入临床后其综合能力的高低，直接反映了医学教育、临床教学管理、临床教学质量等的高低，如何确保医学人才尽快适应当前的竞争关键在于提高临床医学教育质量。     

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…