如何上好循证医学绪论课——循证医学绪论课的设计及授后总结

2005年12月3日，哈尔滨医科大学为2001级七年制临床医学专业开设了循证医学（evidence-based medicine．EBM）课程，本人是担任这次循证医学课的主讲老师，这次授课是哈尔滨医科大学有史以来的第一次为七年制学生系统开设循证医学课。万事开头难，绪论课如何讲，本人进行了精心的设计及准备，现总结如下，愿与同道共勉。     

贯通式教学法对药理实验设计及课程认知程度的影响

目的探讨贯通式教学法对医学生药理实验设计及课程认知程度的影响。方法同年级随机分成三组(对照组、实验组A、B),实验组A、B分别进行思想引导和贯通式教学,然后对比分析其药理实验设计情况及课程认知程度。结果贯通式教学法对医学生的药理实验设计和课程认知程度的影响力优于实验组A和对照组(P<0.05或P<0.01),而实验组A又优于对照组(P<0.05或P<0.01)。结论贯通式教学法可提高医学生的科研水平和加强课程认知程度,若结合有效的思想引导,其效果更佳。     

对护理本科解剖学课程设置改革的思考

护理本科教育是培养高级技能型护理人才重要阶段,结合我校护理学专业在解剖学教学过程中存在的问题,提出了对护理本科解剖学课程设置改革的初步设想.     

金属离子对红霉素生物合成的影响

本文采用优化设计方法研究金属离子在红霉素生物合成中的交互作用，应用两水平因子设计和响应面设计，以最终发酵液的生物效价为目标函数建立模型，通过软件分析得出优化结果：钼酸钠0．0461g／100ml；硫酸锌0．004g／100ml；氯化锰0．0133g／100ml；硫酸镁0．0866g／100ml；氯化钙0．0293g／100ml。按优化方案向发酵液中添加所选定的金属盐，可使最终发酵液的生物效价由对照样品的6115u／ml，提高到条件样品的7985u／ml，在一定程度上实现了红霉素生产的优化。     

正交试验法优选甲磺酸帕珠沙星滴丸的制备工艺

目的确立甲磺酸帕珠沙星滴丸的最佳制备工艺。方法以丸重变异系数、溶散时限、滴丸成型率为评价指标,对基质及冷却剂的选择用平行试验法,对药物加入比例、药液温度、冷却液温度及滴速的选择用正交试验法,优选最佳滴制条件。结果以聚乙二醇4000为基质,甲基硅油-液状石蜡(3∶1)为冷却剂,用玻璃注射器做滴管,12号针头,以20~25滴/m in的滴速将(75±2)℃的药液滴入10~12℃的冷却液中(冷却柱高度固定)进行滴制,滴丸成型率最高。结论本实验筛选出的滴丸成型工艺条件制成的滴丸,符合药典规定。     

左旋泮托拉唑钠肠溶片的制备及其稳定性考察

目的：制备左旋泮托拉唑钠肠溶片并考察其稳定性。方法：以3因素3水平（碳酸钠的含量0,5％，10％；黏合剂的种类MC，HPMC和PVP；浓度2％，5％，8％）的正交试验设计进行片芯处方筛选，并参考中国药典2000年版附录考察了制剂的稳定性。结果：确定了以聚乙烯吡咯烷酮（PVP）为黏合剂、10％碳酸钠为稳定剂的处方，恒温加速试验及长期留样试验6个月，含量及有关物质未见明显改变。结论：本法制备肠溶片的处方工艺简便，易于控制和操作。     

正交试验法优选氟尿苷二乙酸酯固体脂质纳米粒制备工艺

目的:优选氟尿苷二乙酸酯固体脂质纳米粒(FUDRA-SLN)的工艺条件。方法:以大豆磷脂为载体,采用薄膜超声分散法制备FUDRA-SLN,以包封率、形态为考察指标,设计正交试验优选工艺条件。结果:按最优工艺条件制得的FUDRA-SLN均匀圆整,粒径为(215±83)nm,包封率为98·27%,载药量为8·20%。结论:选择优化的薄膜超声分散工艺制备FUDRA-SLN,包封率及载药量高,适合于实验室制备。     

Issues in Design and Implementation in an Urban Birth Cohort Study: The Syracuse AUDIT Project

The Syracuse AUDIT (Assessment of Urban Dwellings for Indoor Toxics) project is a birth cohort study of wheezing in the first year of life in a low-income urban setting. Such studies are important because of the documented serious risks to children's health and the lack of attention and published work on asthma development and intervention in communities of this size. We studied 103 infants of mothers with asthma, living predominantly in inner-city households. Our study combines measurements of a large panel of indoor environmental agents, in-home infant assessments, and review of all prenatal and postnatal medical records through the first year of life. We found multiple environmental pollution sources and potential health risks in study homes including high infant exposure to tobacco smoke. The prevalence of maternal smoking during pregnancy was 54%; postnatal environmental tobacco smoke (ETS) exposure was nearly 90%. The majority (73%) of homes showed signs of dampness. Participants' lives were complicated by poverty, unemployment and single-parenthood. Thirty-three percent of fathers were not involved with their children, and 62% of subjects moved at least once during the study period. These socioeconomic issues had an impact on project implementation and led to modification of study eligibility criteria. Extensive outreach, follow up, and relationship-building were required in order to recruit and retain families and resulted in considerable work overload for study staff. Our experiences implementing the project will inform further studies on this and other similar populations. Future reports on this cohort will address the role of multiple environmental variables and their effects on wheezing outcome during the first year of life.Crawford, Hargrave, Liu, Anbar, Hall, Naishadham, Czerwinski, Webster, Lane, and Abraham are with the Department of Pathology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA; Hunt is with the UNYSPEC Ltd., Baldwinsville, NY, USA.     

人工晶状体的材料设计与视觉质量

目前白内障摘出术后的人工晶状体眼视力可以恢复到接近正常。眩光、光晕、暗视力差、客观视力好而主观视物模糊等视觉质量问题与人工晶状体制作材料、构型设计等相关。选用恰当的人工晶状体可以减少术后散光、后发性白内障,并保持一定的调节力。     

超声法制备茵陈、白术挥发油包合物研究

目的 确定超声法制备茵陈、白术挥发油-β-环糊精（β-CD）包合物的最佳工艺。方法 以挥发油的包合率和包合物收率为指标，采用正交设计优化包合工艺的条件。结果 包合工艺的最佳条件为：挥发油与β-CD投料比为1：4（mL：g），β-CD与加水量的比为1：10（g：mL），超声时间为45min。该条件下包合率为78．9％，包合物收得率为87．6％。结论 此制备工艺包合效果较好，具有可行性。