中医药防治椎动脉型颈椎病研究思路探讨

椎动脉型颈椎病(CSA)是颈椎病中常见的一种类型,为中老年人的常见病、多发病,近年来其发病率呈上升趋势,严重危害人类健康。本文旨在结合国内外研究进展,通过对CSA发病机制、临床研究、实验研究等方面进行回顾、归纳与分析,探讨中医药防治本病研究的物质基础,以期明确研究思路与方法。     

导引术作用机制及临床应用

通过对导引术起源、作用机制及防病治病文献的总结论述,结合中医学理论与现代研究分析,揭示导引术防病治病的应用价值。导引术具有疏通经脉、行气活血、培护元气、扶正祛邪、舒筋通络及调整阴阳的作用,其精髓体现了中医学"天人相应"的整体观。导引术调摄身心,呼吸吐纳,配合运动和意念,动静结合,动中有静,刚柔并济,成为融合中医学与体育学的理念于一体的绿色、健康的特色疗法。导引术在防病治病方面具有一定的优势与特色,尤其在治未病及运动疗法的应用中彰显出现代医学不可替代的优势。在目前临床大量应用现代医学介入治疗的态势下,导引术为非损伤、免介入的绿色疗法,应当引起临床的关注与重视。     

“厚薄”教学理念在病理教学中的应用研究

病理学理论课教学是灌输病理学基础知识的基本手段,是医学教育的关键组成部分,普遍应用LBL教学模式。如何让传统病理学理论教学模式从被动灌输方式转化为主动学习的过程,充分调动教学双方的内在动机,拓展学生的思维能力,这是病理学理论教学研究的重要内容。文章尝试"把书读厚及把书读薄"的教学思想有效应用到病理学教学中,通过引入"思维导图"优化相关教学内容;结合双师型培训机制,灵活做到将病理学"教薄教厚";积极创建网络互动平台,提升学生的动手操作能力,实现把病理学"学薄学厚"。     

情景模拟和PBL教学法在内分泌科临床教学中的应用

目的探讨情景模拟和PBL教学在内分泌科临床教学实践中的应用效果。方法选取内分泌科实习的医学生90例为研究对象,2017年9月—2018年2月的30名学生编入A组,采用传统方法进行带教;2018年3月—2018年8月的30名学生编入B组,在传统教学基础上,联合PBL教学;2018年9月—2019年2月的30名学生编入C组,在传统教学基础上,联合情景模拟教学,观察3组教学效果。结果B组和C组理论成绩均高于A组(P<0.05),B和C组理论成绩差异无统计学意义(P>0.05)。B组和C组技能操作成绩均高于A组(P<0.05),技能操作考试成绩C组高于B组(P<0.05)。B组和C组学生学习兴趣明显高于A组(P<0.05)。结论在传统教学基础上增加情景模拟和PBL教学,能明显增加学生兴趣,提高学习主动性,提高理论成绩和技能操作能力。     

Addressing the Challenges of Collaborative Goal Setting with Children and Their Families

ABSTRACT

Collaborative goal setting between clinicians and clients/families is considered a fundamental component of the pediatric rehabilitation process. However, truly client-centered goal setting is not without its challenges. The purpose of this paper is to highlight theoretical concepts relevant to rehabilitation goal setting, review clinical studies directly evaluating relationships between goal setting and pediatric rehabilitation outcomes, and provide recommendations to facilitate collaborative goal processes. Four theoretical frameworks were identified that may lie behind and help explain the effectiveness of collaborative goal setting. The four relevant outcome studies found in the review revealed that individualized goal setting is an important component of the intervention, engages families more actively in therapy, and is associated to some extent with positive outcomes. The evidence suggests that the impact of fully collaborative goal setting is sufficiently positive to support investment of organizational and individual time, energy, and resources to make it an integral part of the rehabilitation process.     

PBL和PACS在医学影像学教学中的应用

目的浅析影像学教学中开展图像存档和传输系统(PACS)与以问题为导向的教学方法(PBL)相结合的教学方式的作用。方法对本院48名医学影像学医学生开展研究,研究时间开始于2018年1月,结束于2019年1月,依据随机数字法将其分成对照组24例与观察组24例,将传统教学模式应用在对照组教学中,将PBL和PACS相结合的授课形式应用在观察组教学中,比较两组理论成绩以及临床实践能力。结果在理论考核项目和临床实践考核得分方面,观察组均高于对照组(P<0.05)。结论采用PBL和PACS相结合的授课模式,可有效提升医学影像学教学质量,保障学生更加有效地掌握理论知识以及专业技能。     

Theoretical Methods of Domain Structures in Ultrathin Ferroelectric Films: A Review

This review covers methods and recent developments of the theoretical study of domain structures in ultrathin ferroelectric films. The review begins with an introduction to some basic concepts and theories (e.g., polarization and its modern theory, ferroelectric phase transition, domain formation, and finite size effects, etc.) that are relevant to the study of domain structures in ultrathin ferroelectric films. Basic techniques and recent progress of a variety of important approaches for domain structure simulation, including first-principles calculation, molecular dynamics, Monte Carlo simulation, effective Hamiltonian approach and phase field modeling, as well as multiscale simulation are then elaborated. For each approach, its important features and relative merits over other approaches for modeling domain structures in ultrathin ferroelectric films are discussed. Finally, we review recent theoretical studies on some important issues of domain structures in ultrathin ferroelectric films, with an emphasis on the effects of interfacial electrostatics, boundary conditions and external loads.     

A Mixed-Methods Pilot Study of the Acceptability and Effectiveness of a Brief Meditation and Mindfulness Intervention for People with Diabetes and Coronary Heart Disease

Mindfulness-based interventions can successfully target negative perseverative cognitions such as worry and thought suppression, but their acceptability and effectiveness in people with long-term conditions is uncertain. We therefore pilot tested a six-week meditation and mindfulness intervention in people (n = 40) with diabetes mellitus and coronary heart disease. We used a sequential mixed-methods approach that measured change in worry and thought suppression and qualitatively explored acceptability, feasibility, and user experience with a focus group (n = 11) and in-depth interviews (n = 16). The intervention was highly acceptable, with 90% completing ≥5 sessions. Meditation and mindfulness skills led to improved sleep, greater relaxation, and more-accepting approaches to illness and illness experience. At the end of the six-week meditation course, worry, and thought suppression were significantly reduced. Positive impacts of mindfulness-based interventions on psychological health may relate to acquisition and development of meta-cognitive skills but this needs experimental confirmation.     

“肺肠合治法”治疗急性胰腺炎探微

急性胰腺炎属中医脾心痛、胃心痛、结胸等范畴,基本病机为气机郁滞、毒瘀互结,通腑泄下法是中医治疗本病的常用方法之一。本病的发生发展与肺、肠关系密切,故可从肺、肠论治。"肺肠合治法"能加强一身气机调畅,增强各脏腑功能的协同性,与通腑泄下法相契合,以其治疗本病具有一定的理论基础。现代医学对胰腺、肺、肠中炎症因子、P物质、胆囊收缩素的研究则为探讨"肺肠合治法"治疗急性胰腺炎的物质基础提供了思路。