高等医学院校非直属附属医院建设的实践与思考

充分利用社会资源,建立非直属附属医院,是提高我国高等医学教育质量和办学效益,实现医学教育可持续发展的重要途径.如何建设非直属附属医院,使其形成教育能力和教育规模,是当前高等医学教育研究的重要课题,对解决医学教育资源短缺有着重要的现实意义.本文结合广州中医药大学多年来非直属附属医院的发展历程、建设成效及经验,对高等医学院校非直属附属医院建设进行了思考和总结,为“大众化教育”阶段的高等医学教育提供可资借鉴的经验.     

加强非直属附属医院建设 提高临床教学质量

充分利用社会资源,建立非直属附属医院,是提高我国高等医学教育质量和办学效益的重要途径。如何加强非直属附属医院建设,尽快使其成为有教育能力、教育规模的临床实践教学主干基地,是当前高等医学教育研究的重要课题,同时对解决医学教育资源短缺有着重要的现实意义。     

高等医学院校非直属附属医院的建设与实践

充分利用社会资源,建立非直属附属医院,是提高我国高等医学教育质量和办学效益的重要途径。如何建设非直属附属医学,尽快使其形成教育能力和教育规模,是当前高等医学教育研究的重要课题,对解决医学教育资源短缺有着重要的现实意义。     

非直属附属医院10年建设的实践与思考

高等医学教育大规模扩招带来了临床教学资源不足的问题,而临床教学基地是完成临床教学的主要场所,其数目的 多少和质量的高低直接影响着医学生的培养质量,建立非直属附属医院是保证临床教学质量、实现医学教育可持续发展的重要举措之一.本文对新乡医学院10年非直属附属医院建设过程、建设成效进行了思考和总结,为"大众化教育"阶段的高等医学教育提供了可资借鉴的经验.     

地方高等医学院校非直属附属医院全程教学实践研究

非直属附属医院开展全程教学是近年来在地方高等医学院校解决临床教学资源不足的一种新型临床教学模式,它是医学院校充分利用社会优质资源提高高等医学教育质量和办学效益的重要体现。文章在总结我校非直属附属医院开展全程教学实践经验的同时,客观分析目前非直属附属医院开展全程教学存在的问题,并提出解决问题的对策和建议。     

地方高等医学院校非直属附属医院建设的理论与实践

在我国高等医学教育规模迅速扩大的形势下,建立非直属附属医院是保证高等医学院校临床教学质量、实现可持续发展的重要举措。非直属附属医院建设的关键是通过培养附院意识、规范教学管理、开展师资培训、加强学生教育、改善教学条件等措施,保证并不断提高非直属附属医院的教学质量。     

非直属附属医院持续性发展的探索与实践

在我国高等医学教育规模迅速扩张的形势下,建立非直属附属医院是保证高等医学院校临床教学质量、实现科学发展的重要举措.非直属附属医院承担高等医学教育、科研任务,也是现代社会科学技术综合化、经济发展集约化和高等教育社会化的必然趋势.如何按照"资源共享、优势互补"的原则,不断加强高等医学院校与非直属附属医院的医、教、研合作,推动双方的共同持续性发展,是摆在医学教育管理者面前的重要课题.本文在总结南方医科大学多年校院合作实践经验的基础上,对高等医学院校与非直属附属医院的合作与发展提出了建议.     

我院教学工作的实践与思考

非直属附属医院是现代医院与医学院校建立的新型合作关系,为解决高等医学教育扩大规模后临床教学资源不足的问题发挥了非常重要的作用,但与附属医院相比,在建设过程中也存在一些问题和不足,如何深入推进非直属附属医院与学校之间的密切合作,真正助推非直属附属医院提升科研水平、提高临床教学质量,实现"双赢互惠",需进一步深入探究.文章结合我院作为非直属临床医学院建设的经验,客观地分析了加强临床教学工作的做法、成效及体会,提出非直属临床医学院是高等医学教育发展的必然趋势,院校合作是培养医学人才的必要途径,医院要坚持"科教兴院"的战略,进一步强化医院临床教学职能,完善相关教学管理规章制度,培养出更多高素质医学人才.     

借力非直属附属医院平台 探索校院教学合作新途径

为了解决当前我国高等医学教育规模快速扩大与附属医院临床教学资源不足的突出矛盾,充分发挥社会医院的巨大潜能,非直属附属医院模式应运而生。郑州人民医院医疗集团作为南方医科大学、新乡医学院的非直属附属医院,通过院校合作的探索与实践,医院变被动为主动,充分借力非直属附属医院平台,创新医学教育模式,实现了社会医院医学教育的立体化,促进了医院的快速发展,实现了院校共赢,以及社会大型公立医院从单纯医疗型向医教研复合型的转变。     

医学高等院校非直属附属医院创新医学教育的探索与实践

非直属附属医院承担着高等医学院校临床理论和实践教学的重要任务。如何按照“资源共享、优势互补”的合作原则,不断加强高等医学院校与其非直属附属医院的医、教、研全面合作,推动校院双方的共同持续性发展,是当前摆在医学教育管理者面前的重要课题。作者总结分析了几年来郑州人民医院作为南方医科大学、新乡医学院两所大学共同的非直属附属医院校院合作实践的基础上,三方在创新医学教育发展中以教学为共同点,密切合作,实现多赢,对国内高等医学院校与非直属附属医院的合作与发展提出了可供借鉴的创新经验与做法。     

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.     

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.     

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…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.