关于中医药临床研究伦理审查平台建设评估的思考

通过中医药临床研究伦理审查平台建设评估,发现目前医院伦理委员会在建设和发展中存在以下问题:工作缺乏较高的独立性、缺乏针对研究者的系统化伦理培训、多中心审查缺乏统一标准、临床研究后续监管力度不够、缺乏质量管理和利益冲突管理机制等.提出了规范医学伦理学培训、建立联合伦理委员会、制定地方标准、明确质量管理原则和利益冲突防范原则、探索实行伦理委员会认证等对策.     

提高《护理伦理学》教学效果探析

护理伦理学有利于加强护理学生道德修养和沟通协调能力,对建立良好的护患关系有着重要作用。增强该课程的教学效果,可以促进学生的评判性思维能力的形成。采用案例教学、影视教学、角色扮演的教学模式,改变教学办法,能够增强《护理伦理学》的教学效果,可以促进学生的评判性思维能力的形成。笔者就提高护理伦理学教学效果进行了有益的尝试,提高了学生的学习兴趣。     

开展病理学临床教学 激发学习兴趣

在病理学教学中开展临床教学,培养学生的学习兴趣,启发学生的思维能力,提高获取知识的能力,实现了师生之间的互动,真正发挥病理学在医学中的桥梁作用。     

Anticipation and Response Set: Cortical, Cardiac, and Electrodermal Correlates

Three experiments are reported investigating cortical and visceral responding during a twostimulus anticipation paradigm. Male undergraduate volunteers received auditory warning stimuli signalling the presentation of either high or low interest color slides at the end of a 6-sec foreperiod. A between subject factor, reaction time (RT), was included to assess the effects of a motor response on the anticipatory psychophysiology. Subjects performing the reaction time task produced a two component cortical slow potential with both components larger than under no-task conditions. The reaction time procedure also prompted larger visceral responses. The slow cortical response proved most sensitive to the “interest” manipulation when attentional demands were maximized.     

Primary anti-D immunization by weak D type 2 RBCs

BACKGROUND: D is the most immunogenic blood group antigen. In about 0.4 percent of whites, D is expressed on RBCs in a weak form. Recently, it was found that the weak D phenotypes are caused by a large number of distinct RHD alleles generally encoding altered D proteins. No particular molecular weak D type has yet been shown to induce anti-D. The threshold of D antigen density required for anti-D immunization is not known. CASE REPORT: A 72-year-old D- white man received apparently D- RBCs. Nineteen days later, he developed a positive DAT, and anti-D was found in his serum and an eluate from his RBCs. One donor was found to be D+ with a weak D type. The weak D type was determined by RHD exon 9-specific nucleotide sequencing from genomic DNA. The transfusion recipient showed alloanti-D. Ten months later, anti-D but no other antibody was detectable; the DAT was negative and the eluate was nonreactive. The donor of the incriminated unit was D+ (ccDEe) with weak D due to the weak D type 2 allele, expressing about 450 D antigens per RBC. CONCLUSION: This case provides formal proof that RBCs of weak D type 2 phenotype may cause alloanti-D immunization. Among the more prevalent weak D types in whites, weak D type 2 has the lowest D antigen density. Thus, units of blood from donors of the weak D type 2 phenotype should be labeled D+; the weak D type 2 phenotype may be useful for quality assurance.     

Clearance of depot vaccine SPIO-labeled antigen and substrate visualized using MRI

Immunotherapies, including peptide-based vaccines, are a growing area of cancer research, and understanding their mechanism of action is crucial for their continued development and clinical application. Exploring the biodistribution of vaccine components may be key to understanding this action. This work used magnetic resonance imaging (MRI) to characterize the in vivo biodistribution of the antigen and oil substrate of the vaccine delivery system known as DepoVax^TM. DepoVax uses a novel adjuvanted lipid-in-oil based formulation to solubilise antigens and promote a depot effect. In this study, antigen or oil were tagged with superparamagnetic iron oxide (SPIO), making them visible on MR images. This enables tracking of individual vaccine components to determine changes in biodistribution.Mice were injected with SPIO-labeled antigen or SPIO-labeled oil, and imaged to examine clearance of labeled components from the vaccine site. The SPIO-antigen was steadily cleared, with nearly half cleared within two months post-vaccination. In contrast, the SPIO-oil remained relatively unchanged. The biodistribution of the SPIO-antigen component within the vaccine site was heterogeneous, indicating the presence of active clearance mechanisms, rather than passive diffusion or drainage. Mice injected with SPIO-antigen also showed MRI contrast for several weeks post-vaccination in the draining inguinal lymph node. These results indicate that MRI can visualize the in vivo longitudinal biodistribution of vaccine components. The sustained clearance is consistent with antigen up-take and trafficking by immune cells, leading to accumulation in the draining lymph node, which corresponds to the sustained immune responses and reduced tumor burden observed in vaccinated mice.     

兴趣班参与护理学基础实验室管理的实践与效果分析

目的：研究探讨兴趣班参与护理学基础实验室管理模式的实践与效果。方法选取我校2013级5个班护理学员326人作为研究对象,按照是否参加学校组织的护理实验兴趣班分为研究组和对照组,对照组按照常规方法进行实验室管理,研究组学员参加学校开设的兴趣班,并学习相关缝纫、维修技能。结果研究组学员通过参加兴趣班,护理操作考核成绩、实验器械掌握程度均高于对照组（分别t=4.632、t=4.291,P<0.05）;实验室备品平均更新时间高于对照组（t=4.925,P<0.05）;实验室备品的消耗费用则明显低于对照组（t=5.637,P<0.05）,研究组学员教学满意度为98.41%,显著的高于对照组的75.67%（χ2=26.7076,P<0.05）。结论通过在护理基础教学中开展兴趣班参与实验室管理的实践,能够使学员直接参与到实验室的管理中来,增强节约意识,对于提高学员的护理操作能力,降低实验室运行成本具有重要的意义。     

医学有机化学绪论课的设计

有机化学是医学高等院校开设的一门基础课,学好有机化学是非常重要的。绪论课是教学中第一课,对学生今后的学习起着重要的作用。在绪论课的设计中,通过有机化学＂是什么＂、＂学什么＂、＂为什么学＂和＂怎么学＂这几个问题的讲解使学生明确学习目的,培养他们学习有机化学的兴趣。     

患者隐私权保护中的利益冲突与对策

论述了医疗活动中医务人员需要面对患者隐私权与医务人员的知情权、他人利益与患者隐私权保护、公共利益与患者隐私权保护三方面的冲突;提出保护患者隐私权的对策:提高保护患者的法律意识,自觉养成保护患者隐私的良好习惯,改善硬件条件、创造良好就诊环境。     

Showers, Sweating and Suing: Legionnaires�� Disease and ��New�� Infections in Britain, 1977�C90

Legionnaires’ disease is now routinely discussed as an ‘emerging infectious disease’ (EID) and is said to be one of the earliest such diseases to be recognised. It first appeared in 1976 and its cause was identified in 1977, the same year that Ebola fever, Hantaan virus and Campylobacter jejuni arrived. The designation of Legionnaires’ disease as an EID was retrospective; it was not and could not be otherwise as the category only gained currency in the early 1990s. In this article we reflect on the changing medical understanding and social profile of Legionnaires’ disease in the decade or so from its recognition to the creation of EIDs, especially its ambivalent position between public health and clinical medicine. However, we question any simple opposition, between public health experts who approached Legionnaires’ disease as a new and worrying environmental threat that could be prevented, and clinicians who saw it as another cause of pneumonia that could be managed by improved diagnosis and treatment. We argue that in the British context of public spending cuts and the reform of public health, the category of ‘new’ diseases, in which Legionnaires’ disease was central, was mobilised ahead of the EID lobby of the early 1990s, by interested groups in medicine to defend infectious diseases services.