预防医学实验教学体系改革与实践

目的探索预防医学实验教学的新方法和教学模式,以培养学生的科研思维,加强学生动手操作能力的锻炼。方法针对预防医学实验教学中存在的诸如课程设置因受制于理论课而缺乏系统性和科学性、各学科实验课程设置交叉重复等问题,对预防医学实验教学体系进行了系统改革,通过实践对教学结果进行分析。结果创建了整合式以能力培养为中心的基础性、综合设计性新型实验教学体系,实现了实验课程模块化、实验教学内容系列化、实验项目层次化、实验课程考核方式多样化、教学方法科学化、教学评价制度化等模块化管理。结论新的教学体系通过实践取得的明显效果,对培养具有创新思维和实践动手能力强的复合型高素质预防医学人才具有积极指导作用。     

Cancer incidence due to excess body weight and leisure-time physical inactivity in Canada: Implications for prevention

ObjectiveThis analysis aimed to estimate the number of incident cases of various cancers attributable to excess body weight (overweight, obesity) and leisure-time physical inactivity annually in Canada.MethodsThe number of attributable cancers was estimated using the population attributable fraction (PAF), risk estimates from recent meta-analyses and population exposure prevalence estimates obtained from the Canadian Community Health Survey (2000). Age–sex-site-specific cancer incidence was obtained from Statistics Canada tables for the most up-to-date year with full national data, 2007. Where the evidence for association has been deemed sufficient, we estimated the number of incident cases of the following cancers attributable to obesity: colon, breast, endometrium, esophagus (adenocarcinomas), gallbladder, pancreas and kidney; and to physical inactivity: colon, breast, endometrium, prostate, lung and/or bronchus, and ovarian.ResultsOverall, estimates of all cancer incidence in 2007 suggest that at least 3.5% (n = 5771) and 7.9% (n = 12,885) are attributed to excess body weight and physical inactivity respectively. For both risk factors the burden of disease was greater among women than among men.ConclusionThousands of incident cases of cancer could be prevented annually in Canada as good evidence exists for effective interventions to reduce these risk factors in the population.     

Long-term consequences of exposure to ozone: II. Structural alterations in lung collagen of monkeys

The effects of chronic exposure to ozone on lung collagen crosslinking were investigated in two groups of juvenile cynomolgus monkeys exposed to 0.61 ppm of ozone 8 hrs per day for 1 year. One group was killed immediately after the exposure period; the second exposed group breathed filtered air for 6 months after the ozone exposure before being killed. Previous studies of these monkeys had revealed that lung collagen content was increased in both exposed groups (J. A. Last et al., (1984). Toxicol. Appl. Pharmacol. 72, 111–118). In the present study specific collagen crosslinks were quantified in order to determine whether the excess collagen in the lungs of these animals was structurally normal or abnormal. In the group killed immediately after exposure, the difunctional crosslink dehydrodihydroxylysinonorleucine (DHLNL) was elevated, as was the ratio of DHLNL to dehydrohydroxylysinonorleucine (HLNL). Lung content of the mature nonreducible crosslink hydroxypyridinium was also increased in this group. In the group killed after a 6-month postexposure period, lung content of the difunctional crosslinks DHLNL and HLNL was indistinguishable from control values. However, lung hydroxypyridinium content was significantly increased. The changes in collagen crosslinking observed in the group killed at the termination of exposure are characteristic of those seen in lung tissue in the acute stage of experimental pulmonary fibrosis. The changes seen in the postexposure group suggest that while the lung collagen being synthesized at the time the animals were killed was apparently normal, “abnormal” collagen synthesized during the period of ozone exposure was irreversibly deposited in the lungs. This study suggests that long-term exposure to relatively low levels of ozone may cause irreversible changes in lung collagen structure.     

自动电位滴定法和高效液相色谱法测定深颜色果蔬中维生素C浓度的比较

目的：探讨应用自动电位滴定法和高效液相色谱（HPLC）法定量测定深颜色果蔬中维生素C（Vc）浓度的可行性,为少量或批量果蔬样品Vc浓度的测定提供方法依据。方法：选取市售的15种蔬菜和15种水果的可食部分,加入一定量的草酸做Vc保护剂进行匀浆、过滤、离心处理,取一定量的上清液分别对其中的Vc浓度进行自动电位滴定和HPLC分析,对于同一红柿椒样品,分别用2种分析法对样品的Vc浓度进行准确度和精确度的测定。结果：2种分析法检测30种果蔬中Vc的浓度差异无统计学意义（P>0.05）,电位法对红柿椒中Vc浓度测定的回收率为98.34%～103.98%,HPLC法对Vc浓度测定的回收率为99.66%～101.49%;电位法测定红柿椒中Vc的相对标准偏差（RSD）为1.77%～2.88%,HPLC法测定Vc的RSD为0.15%～0.32%,且HPLC法线性关系良好(R2=0.999　9)。结论：2种分析法对深颜色果蔬样品中Vc浓度测定的准确度和精密度均能满足定量分析的要求,均为较理想的测试方法。     

Multidisciplinary team approach to diabetes. An outlook on providers’ and patients’ perspectives

Objective/BackgroundThis study sought to uncover the perspectives of various stakeholders towards multidisciplinary team (MDT) care, discover new understandings and help inform current practice on MDT care for diabetic patients.Methods5 electronic databases were searched for articles that evaluated patients’ and providers’ perspectives on type 2 Diabetes Mellitus (T2DM) MDT management. Articles retrieved were sieved, coded and findings were analytically themed together in accordance to Thomas and Harden methodology.Results15 articles were identified with three common themes: interactions between healthcare providers, benefits to patients and constraints and facilitators of the healthcare system. Trust and synergistic teamwork are important factors in promoting effective care. Patients commended MDT's improved accessibility and convenience and felt more welcomed. Often plagued by poor support, lack of manpower and resources, MDTs are less efficient and incapable of realizing their full potential.ConclusionThis review illustrates that the MDT model does improve diabetes treatment outcome, help prevent or reduce complications. Nevertheless, the MDT model can be a double-edged sword as poor interactions between HCPs can hamper quality patient care. The current MDT model is also based on available resources of the health system. More effort is needed to modify the MDT model to meet the changing needs of patients.