学校结核病影响因素及防控策略概述

结核病是一种严重的呼吸系统传染性疾病,在世界范围内广泛传播。某些特殊群体结核病发病风险较高,如学校学生及相关工作人员。学校学生聚集,人口密度大,有利于疾病的传播与扩散,导致聚集性疫情的发生。学校结核病疫情的出现主要与学生免疫力低、就诊延误现象、人口密度大、性别、年龄、知晓率等因素有关。为了尽早发现传染源,减少结核病在校园内的传播,使用合理的方法对密切接触者进行筛查极为重要。应明确各机构在学校结核病防控工作中的职责与重点,共同做好防控工作,减少学校结核病疫情的发生。     

虚拟仿真实验教学项目在临床医学等专业学生培养中的应用

合理设置课程对于人才培养质量起到关键性作用。在临床医学人才培养的课程体系中融入虚拟仿真实验教学项目，是人才培养以及信息化与高等教育实践教学深度融合的内在要求。基于我校虚拟仿真实验教学的开展情况，对虚拟仿真实验教学项目如何在医学生培养中发挥作用进行归纳和总结，包括如何选择虚拟项目，如何融入课程体系等，并以问卷等方式对其教学效果进行调查。结果显示：大部分学生认为虚拟仿真实验教学项目的应用有助于知识的拓展，有助于提升学习效果，有助于培养临床医学人才的临床思维和科研素质，有助于培养自主学习和终身学习能力，有助于掌握信息技术等相关技能。但如何更好地实现虚实融合等问题值得我们进一步的探索和研究。     

Consensus summary report for CEPI/BC March 12–13, 2020 meeting: Assessment of risk of disease enhancement with COVID-19 vaccines

A novel coronavirus (CoV), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in late 2019 in Wuhan, China and has since spread as a global pandemic. Safe and effective vaccines are thus urgently needed to reduce the significant morbidity and mortality of Coronavirus Disease 2019 (COVID-19) disease and ease the major economic impact. There has been an unprecedented rapid response by vaccine developers with now over one hundred vaccine candidates in development and at least six having reached clinical trials. However, a major challenge during rapid development is to avoid safety issues both by thoughtful vaccine design and by thorough evaluation in a timely manner. A syndrome of “disease enhancement” has been reported in the past for a few viral vaccines where those immunized suffered increased severity or death when they later encountered the virus or were found to have an increased frequency of infection. Animal models allowed scientists to determine the underlying mechanism for the former in the case of Respiratory syncytial virus (RSV) vaccine and have been utilized to design and screen new RSV vaccine candidates. Because some Middle East respiratory syndrome (MERS) and SARS-CoV-1 vaccines have shown evidence of disease enhancement in some animal models, this is a particular concern for SARS-CoV-2 vaccines. To address this challenge, the Coalition for Epidemic Preparedness Innovations (CEPI) and the Brighton Collaboration (BC) Safety Platform for Emergency vACcines (SPEAC) convened a scientific working meeting on March 12 and 13, 2020 of experts in the field of vaccine immunology and coronaviruses to consider what vaccine designs could reduce safety concerns and how animal models and immunological assessments in early clinical trials can help to assess the risk. This report summarizes the evidence presented and provides considerations for safety assessment of COVID-19 vaccine candidates in accelerated vaccine development.     

2015—2018年珠海市中小学校教室光环境现状调查

目的 了解珠海市中小学校教室采光照明情况,为改善学校采光照明环境提供参考。方法 依据《学校卫生综合评价》(GB/T 18205-2012),2015—2018年对珠海市217所中小学校的1 302间教室进行现场监测和分析。结果 2015—2018年监测的教室采光系数、窗地面积比、后墙反射比和黑板反射比的合格率分别为50.8%、91.6%、37.9%和30.2%,差异均无统计学意义(P>0.05)。教室朝向、采光方向、课桌面平均照度、课桌面照度均匀度、黑板面平均照度、黑板面照度均匀度、教室灯管(灯桌间距、控照式灯具和灯管垂直黑板)的合格率分别为74.5%、90.5%、24.1%、66.1%、0.5%、31.4%、99.4%、35.6%和86.9%,不同年度间、中小学间的差异均无统计学意义(P>0.05);除黑板面平均照度合格率外,公办学校的教室照明合格率均高于民办学校,差异均有统计学意义(P<0.05)。结论 珠海市中小学教室光环境不尽理想,尤其是民办学校教室照明存在的问题更为突出,应针对性指导学校改善采光照明环境。     

The role of protein intake in the relationship between egg consumption and body composition in young adults. A mediation analysis

Background & aimsTo date, the literature examining the effects of whole-egg consumption on health outcomes focuses primarily on cardiovascular health markers; however, a significant gap exists in the literature about how egg consumption may influence body composition indicators. The aim of this study was to estimate the association between egg consumption and body composition indicators and to examine whether this relationship is mediated by protein intake in young adults.MethodsA cross-sectional study was conducted involving 355 first-year university students (aged 18–30 years) from a Spanish public university. Body composition was measured using bioimpedance and dual-energy X-ray absorptiometry (DXA) and fitness components were determined using the course-navette test. Egg consumption and protein intake (both in g/day/kg of body weight) were determined using a 137-item Food-Frequency Questionnaire. ANCOVA models were used to test the mean differences in body composition indicators (body mass index [BMI], ratio waist circumference/height [WC/height], body fat mass percentage, and body lean mass percentage) by egg consumption categories (<1 egg/week, 1–4 eggs/week, ≥5 eggs/week). Hayes's PROCESS macro was used for mediation analyses.ResultsParticipants reporting high egg consumption (≥5 eggs/week) showed significantly lower BMI, WC/height and body fat mass percentage values and higher body lean mass percentage values than those reporting low egg consumption (<1 egg/week) (p < 0.05). However, these relationships were not maintained after adjusting for protein intake. Protein intake acted as a full mediator of the relationships of egg consumption with BMI (indirect effect [IE] = ?1.19; 95% CI [?3.33; ?0.36]), WC/height (IE = ?0.01; 95% CI [?0.04; ?0.01]) and body lean mass percentage (IE = 2.99; 95% CI [1.26; 5.73]) as a partial mediator of the relationship be-tween egg consumption and body fat mass percentage (IE = ?2.19; 95% CI [?4.92; ?0.46]).ConclusionsThe association between egg consumption and body composition is mediated by protein intake. This finding is important from a public health perspective, suggesting that higher egg consumption (≥5 eggs/week) may lead to a healthier body composition, especially due to higher protein intake.     

一种氯化铁诱导血栓生成的小鼠大脑中动脉远端缺血模型

目的 建立稳定的小鼠大脑中动脉远端氯化铁血栓模型，评价其造成的脑损伤及神经功能损伤程 度。 方法 C57BL6/J雄性小鼠随机分为脑缺血组和假手术组。脑缺血组用10%氯化铁（ferric chloride， FeCl3）溶液诱导右侧大脑中动脉远端形成血栓。在术前、术后10 mi n、术后1 d和7 d观测术侧脑血流 和手术动脉血流量的变化。术后1 d观察脑组织梗死率。术后1 d、3 d、5 d、7 d用3种神经学评分[改良 加西亚评分（modified Garcia score，mGS）、改良神经损伤严重程度评分（modified neurological severity scores，mNSS）和15分神经学评估表（15-point neurological evaluation scale，NES）]和胶黏纸测试评价小 鼠神经功能。术后7 d免疫荧光染色标记神经细胞核观察脑组织损伤，标记CD16/32、CD206和Iba1观 察胶质细胞表达。 结果 与假手术组相比，脑缺血组术后10 mi n、1 d、7 d脑表面血流和手术动脉血流下降，术后1 d脑 皮层梗死明显，术后7 d仍有明显脑组织损伤；脑缺血组术后1 d、3 d、5 d和7 d时3种神经学评分及胶 黏纸测试均提示小鼠神经功能不同程度损伤。术后7 d脑缺血组梗死周围皮层M1和M2型胶质细胞表 达增加。 结论 FeCl3溶液可诱导形成稳定的小鼠脑缺血模型，该模型可造成手术侧大脑中动脉远端及脑表 面血流量降低，皮层脑梗死，小鼠神经功能受损，梗死周围胶质细胞表达上调。本研究建立了稳定 氯化铁诱导血栓形成的小鼠脑缺血模型，为脑血栓形成和抗栓药物治疗提供了一种可靠的研究工 具。     

伤寒论PBL教学法提高中医八年制学生中医临床思维构建的应用

中医临床思维是中医专业学生临床能力的关键。《伤寒论》是培养中医学生建立中医临床思维的核心课程。中医八年制较传统的中医博士研究生培养模式而言,培养时间大大缩短、教学要求高。为进一步提高中医八年制学员的临床思维能力,我们在《伤寒论》的教学过程中,分别在理论授课、临床实践中采用了PBL教学方法,教学效果良好。现介绍自己教学方法以及教学体会,以供同行参考交流。     

住院医师规范化培训制度对临床医学生就业的影响

目的通过对2019年2月-2019年6月在西安交通大学第二附属医院实习的大学四年级及大学五年级的临床医学专业的医学生就业意向及就业情况的分析,研究住院医师规范化培训制度对医学生就业的影响。方法运用自制的问卷进行匿名填写的方式对大学四年级、大学五年级的临床医学本科生及5+3模式的规范化培训医学生进行调查。结果大部分医学生选择继续升学,选择就业的学生多愿意留在大城市就业,选择住院医师规范化培训的学生只占极少数。结论做好住院医师规范化培训政策的宣传,落实各项优惠政策,鼓励学生进行住院医师规范化培训及到基层工作,引导学生理性考研,是目前社会及医学院校就业指导中的重要内容。