人体寄生虫学网络课程的应用与评价

目的对郧阳医学院人体寄生虫学网络课程的教学效果进行评价。方法选取2005级临床医学一系和二系分别作为实验组和对照组，对照组的人体寄生虫学采用传统教学方法教学，实验组采用传统教学和本课题组构建的人体寄生虫学网络课程平台进行辅助教学。结果实验组学生的人体寄生虫学理论课程考试成绩和实验课程考试成绩明显优于对照组学生（P〈0．05）。结论人体寄生虫学网络课程能够显著提高教学效果，对突破传统面授教学的局限性和帮助学生网上学习具有重要意义。     

Infective endocarditis at a Hospital of the University of Kiel, 1958–1987

Summary The clinical courses of 214 patients with infective endocarditis treated between 1958 and 1987 at the First Medical Hospital of the University of Kiel (FRG) were analyzed retrospectively. A decrease in the incidence of endocarditis occurred during the 30-year observation period. The mean age of patients was 48 years, and men were more frequently affected than women. In the course of the investigation, a rise in isolated aortic valve disease was noted, whereas the number of patients with isolated involvement of the mitral valve and combined mitral-aortic valvular defects declined. Streptococci (57%) were the most frequent pathogens isolated; as opposed to their increase, the percentages ofStaphylococcus aureus and enterococci decreased. Otolaryngological, dentogenic and urogenital diseases were most frequently held to be responsible for the development of infective endocarditis. Prior cardiosurgical interventions became increasingly significant as a cause of the disease. In this connection, a rising percentage of endocarditis cases was linked with prosthetically replaced heart valves. Complications and concomitant symptoms of endocarditis included the development of heart failure, cerebral embolism and encephalitis, splenomegaly, and renal inflammation. Finally, the marked decrease in mortality contrasted with a simultaneous rise in the number of endocarditis cases achieving full recovery.     

SARS病人外周血T淋巴细胞的动态变化及其在发病进程和发病机理中的意义

目的 :通过研究严重急性呼吸综合征 (SevereAcuteRespiratorySyndrome,SARS)患者外周血免疫细胞的动态变化 ,探讨外周血免疫细胞在SARS发病进程中的意义 ,初步探讨SARS的发病机理 ,并为SARS的诊断和治疗提供有力的实验室依据。方法 :回顾性动态观察我院收治的已治愈SARS病例和SARS死亡病例外周血CD4 + 和CD8+ T淋巴细胞 ,评估外周血免疫细胞在SARS发病进程及预后中的作用。实验方法为流式细胞术检测和分析免疫细胞表面特异性荧光抗体标记 ,T细胞表面标志组合为CD3 CD8 CD4 5 CD4。结果 :所有治愈的SARS病人的CD4 + 和CD8+ T淋巴细胞都有不同程度的可逆性下降 ,而所有的死亡病例有不可逆性显著下降 ,直至死亡。T细胞下降程度和维持的时间与病情密切相关。普通型SARS病例最低CD4 + T淋巴细胞数为 30 5± 15 0cells μl(P <0 .0 0 1)、重型为 139± 6 9cells μl(P <0 .0 0 1) ,普通型SARS病例最低CD8+ T淋巴细胞数为 2 2 3± 89cells μl(P <0 .0 0 1)、重型为 171± 92cells μl(P <0 .0 0 1)。所有普通型病例和大部分重型病例T淋巴细胞恢复正常 ,个别重型病例低于正常或接近正常 ,恢复后普通型平均为 991± 2 86cells μl,重型平均为 5 4 5± 2 2 5cells μl。恢复时间有所不同 ,普通型平均为 17± 5天     

What we know and don't know about the development of independent ingestion in rats

Because suckling behavior differs in many ways from later ingestive behavior, the development of feeding and drinking in rats is best studied apart from the normal suckling situation. Newborn rat pups, separated from their mothers, will actively ingest diet infused into their mouths or spread on the floor beneath them. Such "independent" ingestion resembles the ingestive behavior of adult animals, but it also undergoes developmental changes in organization and control during the pre- and post-weaning periods: When young, deprived pups are fed, they show generalized, non-directed behavioral excitement; but with increasing age, this generalized responding matures into directed and focused ingestive activity. Early independent ingestion depends on a warm test environment; but with development, other familiar environmental and social cues come to influence responding. The internal controls of ingestion also change. Only gastric distension and hydrational status seem to be involved in controlling intake volume during early ingestion, with other ingestive controls emerging later in development. Thus ingestion, independent of suckling from the mother, is a system undergoing revealing developmental changes. These changes offer opportunities for studying ingestion, its controls, and its neural basis at its simplest organizational stage in the newborn, and at higher levels of complexity as maturation adds new components to the feeding system.     

miR-216a-5p在HMGB1介导的表皮葡萄球菌感染致腹膜透析相关腹膜炎中的作用

 目的 探讨miR-216a-5p在高迁移率蛋白B1（HMGB1）介导的表皮葡萄球菌感染致小鼠腹膜透析相关腹膜炎（PDAP）中的作用及机制。方法 选取健康雄性C57BL/6J小鼠,随机分为对照组、感染组、感染+HMGB1抑制剂组,收集腹腔积液及腹膜组织分别进行白细胞计数、HE和免疫组织染色;Real-time PCR和Western Blot检测白细胞介素-1α（IL-1α）、白细胞介素-6（IL-6）、肿瘤坏死因素-α（TNF-α）、HMGB1、核转录因子-κB （NF-κB）和核转录因子抑制蛋白（I-κB）的mRNA和蛋白表达水平;生信预测发现,miR-216a-5p可能与HMGB1结合,参与其诱导的PDAP的发生,并构建感染+miR-216a-5p mimics组小鼠,通过双荧光素酶报告基因检测验证miR-216a-5p和HMGB1的关系,采用Real-time PCR、Western Blot、免疫组织染色检测HMGB1的表达变化。结果 与对照组相比,感染组小鼠腹腔积液白细胞计数增多,炎性浸润明显,IL-1α、IL-6、TNF-α,以及HMGB1 mRNA和蛋白表达均升高（均P<0.05）;HMGB1抑制剂（甘草素）干预后,小鼠腹腔积液白细胞计数下降,炎性浸润改善,IL-1α、IL-6、TNF-α,以及HMGB1 mRNA和蛋白表达均下降（均P<0.05）。感染组小鼠NF-κB表达高于对照组,I-κB表达低于对照组;HMGB1抑制剂干预后NF-κB表达降低,I-κB表达升高（均P<0.05）。Real-time PCR结果证实,与对照组相比,miR-216a-5p的含量在感染组中显著减少;双荧光素酶报告基因检测提示,miR-216a-5p可直接作用于HMGB1的3’UTR区;与感染组相比,感染+miR-216a-5p mimics组小鼠中HMGB1 mRNA和蛋白表达均下降（均P<0.05）。结论 HMGB1在表皮葡萄球菌感染致小鼠PDAP中发挥重要作用,抑制HMGB1可改善小鼠炎症反应,miR-216a-5p可通过靶向HMGB1参与表皮葡萄球菌感染致PDAP的发生。     

Determinants and Consequences of Adolescent Fatherhood: A Longitudinal Study in Ethiopia,India, Peru,and Vietnam

PurposeAdolescent parenthood is a major challenge in low- and middle-income countries (LMICs). However, the vast majority of the evidence has focused on adolescent motherhood. Little is known about adolescent fatherhood in LMICs. The aim of this study was to examine the determinants of early fatherhood and its consequences on a range of outcomes among adolescent males.MethodsThis study used three waves of longitudinal data from the multicountry Young Lives cohort study, specifically following a sample of 1,779 adolescent boys at ages 15, 19, and 22 years in Ethiopia, India, Peru, and Vietnam. Individual fixed effects models were conducted to investigate the sociodemographic determinants of adolescent fatherhood and the consequences of adolescent fatherhood on males' education, health, psychosocial well-being, and time use outcomes.ResultsThe results indicated that lower educational attainment, absence of the adolescent's mother and father from the home, larger household size, and poverty increased the likelihood of becoming an adolescent father by age 22 years. The results revealed that becoming an adolescent father was associated with a higher likelihood of school dropout, being overweight, smoking, greater internalizing problems, and less time spent on leisure activities and more time spent on caregiving responsibilities.ConclusionsHighlighting the experiences of young men as adolescent parents in LMICs, findings underscore the importance of prevention strategies to delay early parenthood for adolescent boys and multicomponent interventions to support young fathers and their unique health, socioeconomic, psychosocial, and behavioral needs.     

基于塔巴模式的医院感染预防与控制课程设计研究——来自10所院校师生的数据分析

 目的 调查医院感染预防与控制课程设计中医学生的教育需求及教师的课程设计建议。方法 采用问卷调查全国5个地区10所医学院校师生的医院感染预防与控制教育需求和课程设计意见,参考塔巴目标模式课程设计步骤,论证课程设计方案。结果 584名学生中,仅11.8%(69名)的学生认为当前医院感染预防与控制教育能完全满足其需求,需求得分居前四位的为手卫生、消毒灭菌隔离、医院感染概论和职业防护。352名教师中,72.7%(256名)建议设必修课;86.4%(304名)选择总学时8~24学时,12.5%(44名)选择24学时以上,被调查教师建议10个章节学时平均总和为19.5;需重点掌握13项、熟悉9项知识和技能;86.4%(304名)教师建议理论与见习学时比为1 ∶0.5及以上;53.4%(188名)教师建议采取理论大课+小组见习(含技能操作)+线上学习的形式;63.7%(224名)教师建议师资团队由医院感染管理科+感染病科+护理部教师共同组成。结论 当前医学生的医院感染预防与控制教育远未完全满足需求,单独开课很有必要,建议设置16~24学时必修课,理论联系实践,多学科师资实施多元化教学,按照必修课考核。     

口腔修复科进修医师接诊前培训探析

为了提高进修医师的教学质量和医疗水平,我们在2006届进修医师教学工作中加强和细化了进修医师接诊前的培训,取得了良好的效果.实践证明,实施接诊前培训对于提高进修医师的医疗水平和自信心,实施规范化操作,克服诊疗中的盲目性,减少或避免医疗纠纷,进而提高进修医师的教学质量具有重要意义,值得推广和借签.     

童年期居住环境卫生对农村居民中老年期慢性病患病的影响研究

目的探讨童年期居住环境卫生对农村居民中老年期慢性病患病的影响, 并检验童年期健康状况在其中的中介效应。方法基于中国健康与养老追踪调查2018年最新调查和2014年生命历程调查共同访问的12 506名农村居民数据, 运用χ2检验、秩和检验、logistic回归分析模型、倾向评分加权法、负二项回归模型和KHB分析法进行分析。结果调整其他混杂因素后, 相比童年期居住环境卫生较好的农村居民, 童年居住环境卫生较差的中老年农村居民患哮喘风险提高23.7%(OR=1.237, 95%CI:1.060～1.445), 患肝脏疾病、肾脏疾病和消化系统疾病的风险增加16.4%(OR=1.164, 95%CI:1.006～1.347)、22.4%(OR=1.224, 95%CI:1.083～1.383)和19.6%(OR=1.196, 95%CI:1.103～1.296), 患血脂异常和心脏病的可能性上升了26.6%(OR=1.266, 95%CI:1.153～1.390)和13.6%(OR=1.136, 95%CI:1.031～1.253)。负二项回归模型分析结果显示, 童年居住环境卫生较差的中老年农村...     

微课指导下呼吸训练对肺癌根治术后肺功能的影响

目的 分析微课指导下呼吸训练对肺癌根治术后肺功能的影响。方法 选取本院2016年1月—2018年1月收治的120例肺癌患者,以随机数字表法分为A组60例、B组60例,A组实施常规呼吸训练,B组在A组基础上给予微课指导,对比两组生活质量评分及肺功能指标。结果 B组术后第一秒最大呼出总量(FEV1)、用力深呼吸时肺活量(FVC)及FEV1/FVC分别为(2.08±0.29)L、(3.15±0.41)L、(69.78±12.55),高于A组的(1.74±1.14)L、(2.01±0.56)L、(64.44±12.02),(P<0.05);B组术后生活质量中社会领域、环境领域、生理症状、心理状态评分分别为(16.71±3.71)分、(17.99±3.36)分、(14.97±2.32)分、(16.44±3.85)分,高于A组的(13.58±3.45)分、(15.21±3.45)分、(13.12±2.64)分、(13.45±3.44)分,(P值均<0.05)。结论 微课指导下呼吸训练可有效改善肺癌根治术后肺功能指标及提高生存质量。